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.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 07-01-2014 , and ending 06-30-2015
BCheck if applicable:
CName of organization
DIGNITY HEALTH
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
185 Berry Street
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
San Francisco, CA94107
D Employer identification number

94-1196203
E Telephone number

G Gross receipts $ 11,279,915,619
F Name and address of principal officer:
DANIEL MORISSETTE CFO
185 BERRY STREET
SAN FRANCISCO,CA94107
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.dignityhealth.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: 1954
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: Dignity Health is committed to furthering the healing ministry of Jesus through the delivery of affordable health care, advocacy for the poor and community partnerships.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 49,907
6 Total number of volunteers (estimate if necessary) ............. 6 7,792
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 23,764,384
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 98,811,080 105,589,706
9 Program service revenue (Part VIII, line 2g) ......... 8,053,649,140 9,688,887,194
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 443,310,156 242,429,838
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 59,358,653 56,711,926
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 8,655,129,029 10,093,618,664
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 187,309,516 223,463,179
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 4,592,357,636 4,875,399,504
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 3,598,797,109 4,499,905,640
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 8,378,464,261 9,598,768,323
19 Revenue less expenses. Subtract line 18 from line 12....... 276,664,768 494,850,341
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 12,980,966,213 14,252,350,035
21 Total liabilities (Part X, line 26)............. 7,599,300,441 8,783,595,570
22 Net assets or fund balances. Subtract line 21 from line 20..... 5,381,665,772 5,468,754,465
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 (2014)
Form 990 (2014)
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: OUR MISSION: DIGNITY HEALTH IS COMMITTED TO FURTHERING THE HEALING MINISTRY OF JESUS. WE DEDICATE OUR RESOURCES TO DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES; SERVING AND ADVOCATING FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. OUR VISION: A VIBRANT, NATIONAL HEALTH CARE SYSTEM KNOWN FOR SERVICE, CHOSEN FOR CLINICAL EXCELLENCE, STANDING IN PARTNERSHIP WITH PATIENTS, EMPLOYEES AND PHYSICIANS TO IMPROVE THE HEALTH OF ALL COMMUNITIES SERVED. OUR VALUES: DIGNITY HEALTH IS COMMITTED TO PROVIDING HIGH-QUALITY, AFFORDABLE HEALTH CARE TO THE COMMUNITIES WE SERVE. ABOVE ALL ELSE WE VALUE: DIGNITY - RESPECTING THE INHERENT VALUE AND WORTH OF EACH PERSON. COLLABORATION - WORKING TOGETHER WITH PEOPLE WHO SUPPORT COMMON VALUES AND VISION TO ACHIEVE SHARED GOALS. JUSTICE - ADVOCATING FOR SOCIAL CHANGE AND ACTING IN WAYS THAT PROMOTE RESPECT FOR ALL PERSONS AND DEMONSTRATE COMPASSION F
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 $ 8,384,754,012 including grants of $ 223,463,179 ) (Revenue $ 9,677,068,041 )
Dignity Health is a California nonprofit public benefit corporation headquartered in San Francisco, California. Dignity Health, together with its subsidiary corporations, is one of the largest not-for-profit acute health care delivery systems in the United States as measured by annual revenue. Dignity Health operated 39 hospitals throughout major California markets and in the Phoenix, Arizona and Las Vegas, Nevada metropolitan markets during the year ended June 30, 2015. Dignity health and its subordinate corporations' facilities included approximately 8,300 licensed acute care beds and approximately 600 licensed skilled nursing beds as of June 30, 2015. Dignity health maintains a prominent market share in many of its service areas, and many of its hospitals rank among the finest in the nation. With a significant presence in Greater Sacramento, San Francisco Bay Area, Southern California, Central Coast, Central California, and Northern California, Dignity Health's California operations are well dispersed throughout the state. Dignity Health's hospitals operate emergency rooms that are open to all persons regardless of ability to pay; have governing bodies in which primarily independent persons representative of the community comprise a majority; engage in the training and education of healthcare professionals; and participate in Medicaid, Medicare, Tricare and/or other government-sponsored health care programs. This organization is a public benefit corporation exempt from taxation under Section 501(c)(3) of the internal revenue code.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet8,384,754,012
Form 990 (2014)
Form 990 (2014)
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
Yes
 
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
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
Yes
 
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
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
Yes
 
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) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
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 domestic 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 or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 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
Yes
 
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), 501(c)(4), and 501(c)(29) 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 "Yes," complete Schedule L, Part II................ Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..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 (2014)
Form 990 (2014)
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
4,917
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
49,907
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 , BR , DA , GR , HK , ID , IS , KS , PL , TH
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring 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 (2014)
Form 990 (2014)
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
13
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
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
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
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
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
Yes
 
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
AZ , 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, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMARY CONNICK - FINANCE DEPT
185 BERRY STREET
SAN FRANCISCO,CA94107 (415) 438-5500
Form 990 (2014)
Form 990 (2014)
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) Andrew C Agwunobi MD........................................................................
Board Member
 5.0
.......................0.0 		X           48,750 0 0
(2) Jennie Chin Hansen........................................................................
Board Member
 5.0
.......................0.0 		X           0 0 0
(3) Kent Bradley MD........................................................................
Board Member
 5.0
.......................0.0 		X           9,000 0 0
(4) Mark DeMichele........................................................................
Board Member
 5.0
.......................0.0 		X           52,500 0 0
(5) Peter G Hanelt CPA........................................................................
Board Member
 5.0
.......................0.0 		X           52,500 0 0
(6) Julie Hyer OP........................................................................
Board Member
 5.0
.......................0.0 		X           0 0 0
(7) Kavita Patel MD........................................................................
Board Member
 5.0
.......................0.0 		X           9,000 0 0
(8) Todd Pierce........................................................................
Board Member
 5.0
.......................0.0 		X           52,500 0 0
(9) Patrick Steele........................................................................
Board Member
 5.0
.......................0.0 		X           45,000 0 0
(10) Judy Carle RSM........................................................................
Board Vice Chair
 5.0
.......................0.0 		X   X       0 0 0
(11) Caretha Coleman........................................................................
Board Chairperson
 7.0
.......................0.0 		X   X       64,688 0 0
(12) Tessie Guillermo........................................................................
Board Secretary
 5.0
.......................0.0 		X   X       48,750 0 0
(13) Lloyd H Dean........................................................................
PRESIDENT/CEO
 40.0
.......................0.0 		X   X       6,614,389 0 1,082,311
(14) Michael D Blaszyk........................................................................
SEVP/ Chief Financial Officer
 40.0
.......................0.0 		    X       2,372,183 0 288,930
(15) Rick Grossman........................................................................
EVP/ General Counsel
 40.0
.......................0.0 		    X       1,562,814 0 285,774
(16) Diane Lee........................................................................
VP & Associate General Counsel
 40.0
.......................0.0 		    X       520,351 0 74,502
(17) Marvin O'Quinn........................................................................
SEVP/ Chief Operating Officer
 40.0
.......................0.0 		    X       4,643,673 0 739,439
Form 990 (2014)
Form 990 (2014)
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) Elizabeth Shih........................................................................
EVP/ Chief Admin Officer
 40.0
.......................0.0 		    X       1,985,466 0 467,876
(19) Steven Barron........................................................................
SVP/ Operations So Cal East
 40.0
.......................0.0 		      X     1,387,187 0 127,377
(20) Keith Callahan........................................................................
SVP/ Supp & Srvcs Resrcs Mgmt
 40.0
.......................0.0 		      X     882,806 0 94,661
(21) Mary Connick........................................................................
SVP Finance/ Corporate Control
 40.0
.......................0.0 		      X     739,118 0 100,893
(22) Charles P Francis........................................................................
SEVP/ Chief Strategy Officer
 40.0
.......................0.0 		      X     1,784,269 0 314,026
(23) Lisa Gamshad Zuckerman........................................................................
SVP Treasury & Strategic Inves
 40.0
.......................0.0 		      X     662,672 0 112,105
(24) Laurie Harting........................................................................
SVP/ Operations Greater Sacram
 40.0
.......................0.0 		      X     1,329,268 0 105,778
(25) Linda Hunt........................................................................
SVP/ Operations Arizona
 40.0
.......................0.0 		      X     1,331,033 0 131,457
(26) Jeffrey W Land........................................................................
VP/ Corporate Real Estate
 40.0
.......................0.0 		      X     608,491 0 97,743
(27) Bernita McTernan........................................................................
EVP/SPONSORSHIP/MISSION INTEGR
 40.0
.......................0.0 		      X     1,313,002 0 173,063
(28) Timothy Panks........................................................................
SVP/ Finance & Rev Cycle Mgmt
 40.0
.......................0.0 		      X     664,566 0 101,876
(29) Darryl Robinson........................................................................
EVP/ Chief HR Officer
 40.0
.......................0.0 		      X     1,212,191 0 264,767
(30) Karl Silberstein........................................................................
SVP/ Financial Operations
 40.0
.......................0.0 		      X     1,144,180 0 132,764
(31) Jon VanBoening........................................................................
SVP/ Operations- Central Valle
 40.0
.......................0.0 		      X     1,061,546 0 127,479
(32) Robert Wiebe MD........................................................................
EVP/ CHIEF MEDICAL OFFICER
 40.0
.......................0.0 		      X     2,773,945 0 583,723
(33) Tammara Wilcox........................................................................
SVP/ Managed Care
 40.0
.......................0.0 		      X     800,177 0 102,986
(34) Deanna Wise........................................................................
EVP/ Chief Information Officer
 40.0
.......................0.0 		      X     1,252,759 0 270,948
(35) Charles Cova........................................................................
SVP Operations, Central Coast
 40.0
.......................0.0 		        X   822,656 0 96,489
(36) Rodney A Davis........................................................................
SVP Operations, Nevada
 40.0
.......................0.0 		        X   930,964 0 103,737
(37) Joseph Jasser MD........................................................................
President/ CEO DHMF
 40.0
.......................0.0 		        X   972,533 0 97,006
(38) Bruce Swartz........................................................................
SVP Physician Integration
 40.0
.......................0.0 		        X   844,605 0 93,187
(39) Glenna L Vaskelis........................................................................
SVP/ Operations Bay Area
 40.0
.......................0.0 		        X   1,199,997 0 116,578
(40) Karl Ulrich MD........................................................................
Former KE
 40.0
.......................0.0 		          X 124,606 0 12,105
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 41,924,135 0 6,299,580
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet49,907
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
OPTUM360 LLC,
PO BOX 27964
SALT LAKE CITY,UT841270964 		Revenue Cycle Svc 223,939,480
CLARK CONSTRUCTION GROUP,
7500 OLD GEORGETOWN ROAD
BETHESDA,MD208146133 		Contractors 25,749,958
MANATT PHELPS AND PHILLIPS LLP,
11355 W OLYMPIC BOULEVARD
LOS ANGELES,CA900641614 		Consulting Services 12,647,628
COGENT HEALTHCARE INC,
PO BOX 645037
CINCINNATI,OH452645037 		Physican/medical Svc 11,997,096
ALLIEDBARTON SECURITY SERVICES,
161 WASHINGTON STREET SUITE 600
CONSHOHOCKEN,PA19428 		Security services 10,239,019
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet750
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 60,183,070
e Government grants (contributions)1e 25,015,908
f All other contributions, gifts, grants, and
similar amounts not included above1f 		20,390,728
g Noncash contributions included in lines
1a-1f:$ 		11,763,638
h Total. Add lines 1a-1f.......MediumBullet 105,589,706
Program Service RevenueAmt Business Code
2a PATIENT NET OF CHARITY/BAD DEBT 900099 5,483,381,107 5,483,381,107    
b MEDICARE/MEDICAID PAYMENTS 900099 3,958,565,604 3,958,565,604    
c MANAGEMENT SERVICES 541610 142,245,242 142,245,242    
d MEANINGFUL USE INCENTIVES (EHR) 900099 31,306,689 31,306,689    
e MED OFFICE BLDG 621300 10,820,032 10,820,032    
f All other program service revenue . 62,568,520 50,749,367 11,819,153 0
g Total. Add lines 2a–2f........MediumBullet 9,688,887,194
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 109,010,185   11,040,666 97,969,519
4 Income from investment of tax-exempt bond proceeds..MediumBullet 93,467     93,467
5 Royalties...........MediumBullet 4,661     4,661
(i) Real (ii) Personal
6a Gross rents 4,090,210  
b Less: rental expenses 542,251  
c Rental income or (loss) 3,547,959 0
d Net rental income or (loss).......MediumBullet 3,547,959     3,547,959
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 1,315,624,229 3,456,661
b Less: cost or other basis and sales expenses 1,184,713,294 1,041,410
c Gain or (loss) 130,910,935 2,415,251
d Net gain or (loss)..........MediumBullet 133,326,186     133,326,186
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a CAFETERIA 900099 23,314,465 0 0 23,314,465
b GIFT SHOP 453220 4,023,922 0 0 4,023,922
c PARKING LOT 812930 3,646,447 0 181,716 3,464,731
d All other revenue .... 22,174,472 0 722,849 21,451,623
e Total. Add lines 11a–11d ...... MediumBullet 53,159,306
12 Total revenue. See Instructions......MediumBullet 10,093,618,664 9,677,068,041 23,764,384 287,196,533
Form 990 (2014)
Form 990 (2014)
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 domestic organizations and domestic governments. See Part IV, line 21 .... 222,239,845 222,239,845
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 1,187,822 1,187,822
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............ 35,512 35,512
4 Benefits paid to or for members .... 0  
5 Compensation of current officers, directors, trustees, and key employees .... 43,834,397 21,143,503 22,690,894  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 270,257 101,853 168,404  
7 Other salaries and wages .... 3,819,465,157 3,466,090,898 353,374,259  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 211,160,825 186,703,446 24,457,379  
9 Other employee benefits ....... 539,208,205 496,361,214 42,846,991  
10 Payroll taxes ........... 261,460,663 240,455,645 21,005,018  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 26,229,164 96,951 26,132,213  
c Accounting ........... 8,227,616 34,088 8,193,528  
d Lobbying ........... 3,441,671 1,034,871 2,406,800  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 18,431,660   18,431,660  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 1,056,677,023 744,269,930 312,407,093 0
12 Advertising and promotion .... 84,301,680 2,435,500 81,866,180  
13 Office expenses ....... 184,250,301 133,082,159 51,168,142  
14 Information technology ...... 160,530,084 88,928,753 71,601,331  
15 Royalties .. 0      
16 Occupancy ........... 118,241,927 100,830,311 17,411,616  
17 Travel ............ 24,652,474 13,482,898 11,169,576  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 17,045,771 9,591,991 7,453,780  
20 Interest ........... 223,214,557 223,214,557 0  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 448,525,837 373,701,940 74,823,897  
23 Insurance .............. 87,775,599 49,312,907 38,462,692  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 1,189,300,249 1,189,300,249 0 0
b MEDI-CAL PROVIDER FEE 679,816,441 679,816,441 0 0
c MEDICAL PRVDR/OUT-OF NTWRK CST 104,917,649 104,917,649 0 0
d UNRELATED BUSINESS INC TAXES 250,343 0 250,343 0
e All other expenses 64,075,594 36,383,079 27,692,515  
25 Total functional expenses. Add lines 1 through 24e 9,598,768,323 8,384,754,012 1,214,014,311 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
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 ............. 173,627 1 168,840
2 Savings and temporary cash investments ......... 1,376,748,933 2 1,664,032,946
3 Pledges and grants receivable, net ........... 26,966,126 3 24,678,893
4 Accounts receivable, net ............. 1,397,726,348 4 1,412,076,540
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
550,000 5 366,667
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 ............. 59,425,049 7 53,776,426
8 Inventories for sale or use .............. 153,255,364 8 162,977,415
9 Prepaid expenses and deferred charges .......... 381,196,061 9 1,052,071,209
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 9,300,408,740
b Less: accumulated depreciation ..... 10b 5,086,654,981 4,050,118,501 10c 4,213,753,759
11 Investments—publicly traded securities .......... 2,768,684,401 11 2,685,533,631
12 Investments—other securities. See Part IV, line 11 ..... 1,268,139,458 12 1,307,461,616
13 Investments—program-related. See Part IV, line 11 ..... 1,376,607,252 13 1,596,048,620
14 Intangible assets ............... 15,584,695 14 21,372,521
15 Other assets. See Part IV, line 11 ........... 105,790,398 15 58,030,952
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 12,980,966,213 16 14,252,350,035
Liabilities 17 Accounts payable and accrued expenses ......... 1,696,996,132 17 1,989,282,115
18 Grants payable ................. 0 18 447
19 Deferred revenue ................ 29,302,261 19 32,770,122
20 Tax-exempt bond liabilities ............. 3,427,625,299 20 3,242,578,966
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 1,437,005,954 23 2,067,800,453
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 1,008,370,795 25 1,451,163,467
26 Total liabilities. Add lines 17 through 25......... 7,599,300,441 26 8,783,595,570
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 .............. 5,214,735,965 27 5,303,084,584
28 Temporarily restricted net assets ........... 131,586,303 28 130,300,059
29 Permanently restricted net assets ........... 35,343,504 29 35,369,822
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 ........... 5,381,665,772 33 5,468,754,465
34 Total liabilities and net assets/fund balances ........ 12,980,966,213 34 14,252,350,035
Form 990 (2014)
Form 990 (2014)
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
10,093,618,664
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
9,598,768,323
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
494,850,341
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
5,381,665,772
5
Net unrealized gains (losses) on investments ...............
5
-23,091,677
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
-384,669,971
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
5,468,754,465
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 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
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 Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
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
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
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 listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.)..            
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 section 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) 2014
Schedule A (Form 990 or 990-EZ) 2014
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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (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 VI.) ..            
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) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity		  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions		  
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2014 		(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6 		 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)		  
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)		  
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)		  
7 Excess distributions carryover to 2015. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

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
2014
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
DIGNITY HEALTH
  		Employer identification number

94-1196203
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


(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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
DIGNITY HEALTH
  		Employer identification number

94-1196203
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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
DIGNITY HEALTH
  		Employer identification number

94-1196203
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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) (2014)

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 Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$ 510
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
$ 51
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$ 0
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) 2014

Schedule C (Form 990 or 990-EZ) 2014
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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2011 (b) 2012 (c) 2013 (d) 2014 (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) 2014


Schedule C (Form 990 or 990-EZ) 2014
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? .........................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
25,637
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
2,058,285
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
258,433
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
Yes
 
32,113
i
Other activities? ..........................
Yes
 
1,067,203
j
Total. Add lines 1c through 1i ...............................
3,441,671
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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART I-B, LINE 4B During the year, Dignity Health paid membership dues to Valley Industry and Commerce Association ("the Association") and Greater Redding Chamber of Commerce ("the Chamber"). The invoices provided for voluntary contributions to the Chamber's and Association's Political Action Committees (PAC). The check requests for annual dues inadvertently included amounts for voluntary contributions to the PACs. Dignity Health has policies and procedures in place to avoid such transactions, and once the organization became aware of this situation, immediate action was taken to obtain a refund from both the Chamber and the Association for the amounts designated for each PAC. Copies of the refund checks, dated 11/12/2015 and 12/22/2015, evidencing that $500.00 and $10.00 have been recovered, have been attached to Form 4720. These represent the full amount of inadvertent payments made related to voluntary contributions to The Association's and The Chamber's PACs.
PART II-B THE ORGANIZATION PAID FEES TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES, PAID COMPENSATION TO STAFF AND MANAGEMENT IN THE PERFORMANCE OF THEIR DUTIES IN ATTEMPTING TO INFLUENCE LEGISLATION, WHICH INCLUDED RALLIES, MEETING WITH AND CALLING GOVERNMENT OFFICIALS, AND DEVELOPED AND SENT LETTERS. IN ADDITION, THIS ORGANIZATION IS A MEMBER OF HEALTHCARE ASSOCIATIONS WHOSE PURPOSES INCLUDE DIRECTING, DEVELOPING, AND AFFECTING PUBLIC POLICY AND LEGISLATION WITH REGARD TO ISSUES AFFECTING HEALTHCARE. THE ORGANIZATION PAID ANNUAL DUES TO THESE ASSOCIATIONS, WHICH MAY BE USED FOR LOBBYING PURPOSES AS REFLECTED ON PART II-B, LINE 1I, OTHER ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2014

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue 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
Revenue 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) 2014

Schedule D (Form 990) 2014
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, for escrow or custodial account liability?
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 .... 131,179,463 119,411,098 112,677,658 114,824,736 92,617,477
b Contributions ........ 1,807,921 2,115,261 3,857,469 5,904,333 9,388,271
c Net investment earnings, gains, and losses 1,754,826 12,008,691 9,375,208 -1,307,763 14,666,246
d Grants or scholarships ..... 81,194 184,339 211,353 216,638 304,610
e Other expenditures for facilities
and programs ........ 		5,985,052 1,121,080 6,287,884 6,527,010 1,542,648
f Administrative expenses .... 123,683 1,050,168 0 0 0
g End of year balance ...... 128,552,281 131,179,463 119,411,098 112,677,658 114,824,736
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet14.000 %
b
Permanent endowment SchDMd Bullet86.000 %
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
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 .................   207,433,749 207,433,749
b Buildings ................   4,428,468,617 2,142,268,032 2,286,200,585
c Leasehold improvements ............   57,565,716 41,396,546 16,169,170
d Equipment ................   3,933,703,016 2,825,886,662 1,107,816,354
e Other .................   673,237,642 77,103,741 596,133,901
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 4,213,753,759
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
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) POOLED INVESTMENTS 		1,307,461,616 F








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 1,307,461,616
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
(1) INVESTMENT IN UNCONSOLIDATED 162,997,263 F
(2) INVESTMENTS IN HEALTH RELATED 1,394,913,033 F
(3) INVESTMENTS IN HEALTH RELATED 38,138,324 C






Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 1,596,048,620
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
PENSION PAYABLE 1,097,055,182
DUE TO RELATED PARTIES 289,646,276
ASSET RETIREMENT OBLIGATIONS 32,958,489
OTHER NON-CURRENT LIABILITIES 9,979,633
DEFERRED COMPENSATION 21,523,887




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,451,163,467
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) 2014

Schedule D (Form 990) 2014
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 (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCH D, Part V, Line 4 DIGNITY HEALTH HAS VARIOUS SUPPORTING 501(C)(3) FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THEY OPERATE TO RAISE FUNDS FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH'S HOSPITALS. DIGNITY HEALTH'S INTENDED USE FOR THE FUNDS IS TO INVEST IN EXPANDING ACCESS TO CARE, PURCHASE OR CONSTRUCT STATE-OF-THE-ART EQUIPMENT AND BUILDINGS, AND PROVIDE ADVANCED TRAINING AND EDUCATION TO CAREGIVERS AND PATIENTS.
SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2014

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 Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
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
Central America and the Caribbean 0 0 Investments N/A 315,026
Central America and the Caribbean 0 0 Investments N/A 2,113,547,170
Europe (Including Iceland and Greenland) 0 0 Investments N/A 232,870,086
Europe (Including Iceland and Greenland) 0 0 Grantmaking N/A 15,000
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 2,346,747,282
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 2,346,747,282
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
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)		 (a)(c) Region (b)(d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
Europe (Including Iceland and Greenland) GENERAL SUPPORT 15,000 CHECK 0 NONE N/A
Central America and the Caribbean HURRICANE RELIEF 0 N/A 20,000 MED SUPPLIES FMV
             
             
             
             
             
             
             
             
             
             
             
             
             
             
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
2
3
Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014Page 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) 2014
Schedule F (Form 990) 2014
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; do not file with Form 990)............................
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; do not file with Form 990).....................................
Schedule F (Form 990) 2014
Schedule F (Form 990) 2014
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
SCHEDULE F, PART I, LINE 2 THE GRANTS ARE APPROVED BY THE HOSPITAL'S ADMINISTRATION DEPARTMENT OR A DESIGNATED COMMITTEE REVIEWS AND APPROVES GRANTS TO BE AWARDED. THE INTERNATIONAL ORGANIZATIONS MUST BE ALIGNED WITH DIGNITY HEALTH'S MISSION.
SCHEDULE F, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL EUROPE (INCLUDING ICELAND AND GREENLAND): ACCRUAL GRANTS: ACCRUAL
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2014
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
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 criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		  114,559 130,931,071 1,129,465 129,801,606 1.350 %
b Medicaid (from Worksheet 3,
column a) .... 		  1,171,403 2,966,472,322 2,453,599,176 512,873,146 5.340 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		  268,665 11,190,417 2,907,871 8,282,546 0.090 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		  1,554,627 3,108,593,810 2,457,636,512 650,957,298 6.780 %
Other Benefits
 579 592,713 65,394,952 5,822,742 59,572,210 0.620 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		102 26,818 76,777,567 9,006,727 67,710,840 0.710 %
g Subsidized health services
(from Worksheet 6) .. 		39 98,774 30,676,685 4,783,758 25,892,927 0.270 %
h Research (from Worksheet 7) 17 9,206 31,556,014 20,857,501 10,698,513 0.110 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		205 124,567 38,597,127 697,025 37,900,102 0.390 %
j Total. Other Benefits .. 942 852,078 243,002,345 41,167,753 201,774,592 2.100 %
k Total. Add lines 7d and 7j . 942 2,406,705 3,351,596,155 2,498,804,265 852,731,890 8.880 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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 5 52 2,190,303 761,491 1,428,812 0.020 %
2 Economic development 5 23 230,315 0 230,315  
3 Community support 19 4,563 1,863,117 127,103 1,736,014 0.020 %
4 Environmental improvements 6 2 115,993 0 115,993  
5 Leadership development and training for community members 9 821 291,337 14,530 276,807  
6 Coalition building 25 3,817 70,829 73 70,756  
7 Community health improvement advocacy 25 1,130 495,994 41,100 454,894 0.010 %
8 Workforce development 9 778 1,095,493 0 1,095,493 0.010 %
9 Other   0 0 0 0 0 %
10 Total 103 11,186 6,353,381 944,297 5,409,084 0.060 %
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
123,324,923
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
0
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
1,855,154,950
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,265,019,017
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-409,864,067
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 %
1St Joseph's Outpatie
  		SURGERY 25.080 % 0 % 31.930 %
2Desert Ridge Outpati
  		SURGERY 26.390 % 0 % 11.040 %
3Southwest Orthopedic
  		Surgery 5.960 % 0 % 88.100 %
4Surgery Center of Pe
  		SURGERY 25.360 % 0 % 21.520 %
5Chandler Endoscopy A
  		SURGERY 25.550 % 0 % 49.000 %
6BNI Management LLC
  		Mgmt services 25.000 % 0 % 75.000 %
7St Joseph's Cardiol
  		Mgmt services 50.000 % 0 % 50.000 %
8Parkway Surgery Cent
  		SURGERY 26.130 % 0 % 43.820 %
9North State Surgery
  		SURGERY 31.880 % 0 % 28.330 %
10Sacramento Midtown E
  		SURGERY 25.550 % 0 % 49.000 %
11Folsom Sierra Endosc
  		SURGERY 51.000 % 0 % 37.980 %
12Folsom Outpatient Su
  		SURGERY 30.080 % 0 % 39.970 %
13Roseville Surgery Ce
  		SURGERY 28.820 % 0 % 17.300 %
14Grass Valley Outpati
  		SURGERY 22.850 % 0 % 31.600 %
15St Joseph's Surgery
  		SURGERY 79.960 % 0 % 13.540 %
16Stockton Outpatient
  		SURGERY 25.550 % 0 % 49.000 %
17CBCC Outsmarting Can
  		CANCER 51.000 % 0 % 49.000 %
18Santa Cruz Surgery C
  		SURGERY 50.000 % 0 % 50.000 %
19Santa Cruz Comprehen
  		IMAGING 50.000 % 0 % 50.000 %
20Dominican Breast Cen
  		IMAGING 50.000 % 0 % 50.000 %
21Dominican Magnetic R
  		IMAGING 80.000 % 0 % 20.000 %
22San Francisco Cyberk
  		Cancer 26.000 % 0 % 20.000 %
23Coastal Surgical Spe
  		SURGERY 50.270 % 0 % 49.730 %
24Templeton Surgery Ce
  		SURGERY 70.450 % 0 % 20.450 %
25Plaza Surgery Center
  		SURGERY 50.640 % 0 % 46.020 %
26Renaissance Imaging
  		IMAGING 49.000 % 0 % 32.350 %
27Inland Endoscopy Cen
  		SURGERY 25.000 % 0 % 75.000 %
28Medical Pavilion at
  		Real Estate (Rent/Lease) 25.000 % 0 % 45.250 %
29Radiation Oncology C
  		CANCER 50.000 % 0 % 50.000 %
30NSC Channel Islands
  		SURGERY 51.000 % 0 % 43.570 %
31GEMCare Mercy Memori
  		Mgmt Services 26.010 % 0 % 29.320 %
32Valley Physicians Su
  		SURGERY 49.000 % 0 % 48.500 %
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?34
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 St Joseph's Hospital and Medical CTR
350 W Thomas Road
Phoenix,AZ85013
www.dignityhealth.org/stjosephs
H-3003 		X X   X   X X      
2 Mercy San Juan Medical Center
6501 Coyle Avenue
Carmichael,CA95608
www.dignityhealth.org/mercysanjuan
030000063 		X X   X     X      
3 Mercy General Hospital
4001 J Street
Sacramento,CA95819
www.dignityhealth.org/mercygeneral
030000062 		X X   X     X      
4 St Joseph's Medical Center of Stockto
1800 N California Street
Stockton,CA95204
www.stjosephscares.org/
030000284 		X X   X     X      
5 California Hospital Medical Center
1401 South Grand Avenue
Los Angeles,CA90015
www.dignityhealth.org/californiahospital
930000024 		X X   X     X      
6 Mercy Medical Center Redding
2175 Rosaline Avenue
Redding,CA96001
www.dignityhealth.org/mercy-redding
230000024 		X X   X     X      
7 Chandler Regional Hospital
475 South Dobson Road
Chandler,AZ85224
www.dignityhealth.org/chandlerregional
H-3002 		X X         X      
8 Northridge Hospital Medical Center
18330 Roscoe Boulevard
Northridge,CA91325
www.dignityhealth.org/northridgehospital
930000114 		X X   X     X      
9 Dominican Hospital
1555 Soquel Drive
Santa Cruz,CA95065
www.dominicanhospital.org
70000030 		X X         X      
10 Marian Regional Medical Center
1400 E Church Street
Santa Maria,CA93454
www.marianmedicalcenter.org/
50000040 		X X   X     X      
11 St Bernardine Medical Center
2101 N Waterman Avenue
San Bernardino,CA92404
www.dignityhealth.org/stbernardinemedica
240000206 		X X         X      
12 St Rose Dominican Hospital - Siena
3001 St Rose Parkway
Henderson,NV89052
www.dignityhealth.org/las-vegas.
2969HOS-21 		X X   X     X      
13 Mercy Hospital (Bakersfield)
2215 Truxtun Avenue
Bakersfield,CA93301
www.mercybakersfield.org/
120000184 		X X         X      
14 Mercy Medical Center Merced
333 Mercy Avenue
Merced,CA95340
www.mercymercedcares.org/
40000178 		X X   X     X      
15 Methodist Hospital of Sacramento
7500 Hospital Drive
Sacramento,CA95823
dignityhealth.org/methodistsacramento
30000064 		X X   X     X      
16 St Mary Medical Center - Long Beach
1050 Linden Avenue
Long Beach,CA90813
www.dignityhealth.org/stmarymedical
930000012 		X X   X     X      
17 St John's Regional Medical Center
1600 North Rose Avenue
Oxnard,CA93030
www.stjohnshealth.org/
50000064 		X X         X      
18 Sequoia Hospital
170 Alameda de las Pulgas
Redwood City,CA94062
www.sequoiahospital.org/
220000045 		X X         X      
19 Mercy Gilbert Medical Center
3555 S Val Vista Drive
Gilbert,AZ85297
www.dignityhealth.org/mercygilbert
H-3972 		X X         X      
20 Glendale Memorial Hospital and Health
1420 South Central Avenue
Glendale,CA91204
www.dignityhealth.org/glendalememorial
930000099 		X X         X      
21 St Mary's Medical Center
450 Stanyan Street
San Francisco,CA94117
www.stmarysmedicalcenter.org/
220000071 		X X   X     X      
22 Mercy Hospital of Folsom
1650 Creekside Drive
Folsom,CA95630
www.dignityhealth.org/mercyfolsom
30000372 		X X         X      
23 Woodland Memorial Hospital
1325 Cottonwood Street
Woodland,CA95695
www.dignityhealth.org/woodland
30000115 		X X         X      
24 St Rose Dominican Hospital - San Mart
8280 West Warm Springs Road
Las Vegas,NV89113
www.dignityhealth.org/las-vegas
4576HOS-6 		X X         X      
25 French Hospital Medical Center
1911 Johnson Avenue
San Luis Obispo,CA93401
www.frenchmedicalcenter.org
50000031 		X X         X      
26 St Rose Dominican Hospital - Rose de
102 E Lake Mead Drive
Henderson,NV89015
www.dignityhealth.org/las-vegas
659HOS-20 		X X         X      
27 St John's Pleasant Valley Hospital
2309 Antonio Avenue
Camarillo,CA93010
www.stjohnshealth.org/
50000048 		X X         X      
28 St Elizabeth Community Hospital
2550 Sister Mary Columba Drive
Red Bluff,CA96080
dignityhealth.org/stelizabethhospital
230000036 		X X         X      
29 Southwest Orthopedic and Spine Hospit
750 North 40th Street
Phoenix,AZ85008
OASISHOSPITAL.COM
SH5128 		X               Orthopedic/Spine HOSPITAL  
30 Mercy Medical Center Mt Shasta
914 Pine Street
Mt Shasta,CA96067
www.mercymtshasta.org/
230000015 		X X     X   X      
31 Arizona Orthopedic Specialty Hospital
2905 West Warner Road
Chandler,AZ85224
AZOSH.COM
SH3571 		X               Orthopedic Hospital  
32 St Joseph's Behavioral Health Center
2510 N California Street
Stockton,CA95204
www.stjosephscanhelp.org/
30000367 		X                  
33 Arizona General Hospital
7171 S 51st Avenue
Laveen,AZ85339
http://www.azgeneraler.com/locations
H6937 		X           X X Emergency/Urgent Care Centers  
34 St Joseph's Westgate Medical Center
7300 N 99th Avenue
Glendale,AZ85305
www.dignityhealth.org/westgate
H6522 		X X         X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Hospital and Medical CTR
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Hospital and Medical CTR
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Hospital and Medical CTR
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		4
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		5
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		6
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		8
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		9
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Marian Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		10
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Marian Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Marian Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		11
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		12
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		13
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		14
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		15
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		16
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		17
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		18
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		19
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		20
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		21
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		22
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		23
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		24
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		25
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		26
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		27
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		28
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		29
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		30
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		31
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		32
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Arizona General Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		33
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 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 12.................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Arizona General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13   No
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15   No
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16   No
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17   No
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Arizona General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A): 		34
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2 Yes  
3 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 12.................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ............. 		8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a 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)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, 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) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 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 all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 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
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other 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?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 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
23 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? ................................ 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SECTION B, LINE 2 - ACQUIRED OR PLACED INTO SERVICE IN CURRENT OR PRECEDING TAX YEAR ARIZONA GENERAL HOSPITAL THE HOSPITAL BEGAN OPERATING EFFECTIVE JANUARY 2015. ST. JOSEPH'S WESTGATE MEDICAL CENTER THE HOSPITAL BEGAN OPERATING EFFECTIVE MAY 2014.
SECTION B, LINE 5 - CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY ST JOSEPH'S HOSPITAL AND MEDICAL CENTER IN 2012, THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES COMPLETED A COMPREHENSIVE CHNA FOR MARICOPA COUNTY. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. 429 SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. MERCY SAN JUAN MEDICAL CENTER MERCY SAN JUAN MEDICAL CENTER COMPLETED ITS MOST RECENT CHNA IN 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 31 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). SIX FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY GENERAL HOSPITAL MERCY GENERAL HOSPITAL COMPLETED ITS MOST RECENT CHNA IN 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 37 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). TEN FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS, RETAINED VALLEY VISION, INC., TO CONDUCT THE 2013 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM, HELD IN NOVEMBER 2012. CALIFORNIA HOSPITAL MEDICAL CENTER FOR THE DECEMBER 2013 CHNA, ADOPTED IN OCTOBER 2014, THREE HOSPITALS IN METROPOLITAN LOS ANGELES - CALIFORNIA HOSPITAL MEDICAL CENTER, GOOD SAMARITAN HOSPITAL, AND ST. VINCENT MEDICAL CENTER - COLLABORATED TO WORK WITH THE CENTER FOR NONPROFIT MANAGEMENT CONSULTING TEAM TO CONDUCT THE CHNA. IN THE INITIAL PHASE OF THE CHNA PROCESS, COMMUNITY INPUT WAS COLLECTED THROUGH 10 FOCUS GROUPS AND 29 INTERVIEWS WITH KEY STAKEHOLDERS, INCLUDING HEALTH CARE PROFESSIONALS, GOVERNMENT OFFICIALS, SOCIAL SERVICE PROVIDERS, COMMUNITY RESIDENTS, LEADERS, AND OTHER RELEVANT INDIVIDUALS. THE PURPOSE OF THE PRIMARY DATA COLLECTION COMPONENT WAS TO IDENTIFY BROAD HEALTH NEEDS AND KEY DRIVERS, AS WELL AS ASSETS AND GAPS IN RESOURCES, THROUGH THE PERCEPTIONS AND KNOWLEDGE OF VARIED AND MULTIPLE STAKEHOLDERS. THESE STAKEHOLDERS REPRESENTED A WIDE RANGE OF HEALTH AND SOCIAL SERVICE EXPERTISE, AS WELL AS REPRESENTATIVES FROM DIVERSE ETHNIC BACKGROUNDS INCLUDING AFRICAN-AMERICAN, CHINESE, FILIPINO, KOREAN, AND LATINO. THE INTERVIEW PROTOCOL WAS DESIGNED TO COLLECT RELIABLE AND REPRESENTATIVE INFORMATION ABOUT HEALTH AND OTHER NEEDS AND CHALLENGES FACED BY THE COMMUNITY, ACCESS TO AND UTILIZATION OF HEALTH CARE SERVICES, AND OTHER RELEVANT TOPICS. FOCUS GROUPS TOOK PLACE IN SEVERAL OF LOCATIONS THROUGHOUT THE SERVICE AREA, WITH TRANSLATION AND INTERPRETATION SERVICES PROVIDED WHEN APPROPRIATE. AS WITH THE INTERVIEWS, THE FOCUS GROUP TOPICS WERE DESIGNED TO COLLECT INFORMATION ABOUT HEALTH CARE UTILIZATION, PREVENTIVE AND PRIMARY CARE, HEALTH INSURANCE, ACCESS AND BARRIERS TO CARE, EMERGENCY ROOM USE, CHRONIC DISEASE MANAGEMENT AND OTHER COMMUNITY ISSUES. THE IDENTIFIED HEALTH NEEDS AND DRIVERS OF HEALTH WERE THEN PRESENTED DURING A COMMUNITY FORUM TO ALLOW FOR A RICHER DISCUSSION OF SECONDARY DATA AND ADDITIONAL CONSIDERATIONS. MERCY MEDICAL CENTER REDDING (MMCR) MMCR CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA) RELATING TO A WIDE ARRAY OF COMMUNITY HEALTH INDICATORS. PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MMCR AND THE PUBLIC HEALTH DEPARTMENT AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. THE SURVEYS WERE EMAILED TO APPROXIMATELY 1,000 EMAILS THROUGH A DISTRIBUTION LIST THAT THE HOSPITAL USES TO DISSEMINATE HEALTH EDUCATION MATERIALS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THERE WERE 168 SURVEYS COMPLETED FOR A RETURN RATE OF APPROXIMATELY 16.8%. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MMCR ADVISORY COUNCIL, COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN THE PRIMARY SERVICE AREA, SHASTA COUNTY PUBLIC HEALTH REPRESENTATIVES IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. CHANDLER REGIONAL MEDICAL CENTER (CRMC) THROUGH THE 2012 NEEDS ASSESSMENT, CRMC AND MERCY GILBERT MEDICAL CENTER CONSULTED WITH ARIZONA STATE UNIVERSITY COMMUNITY HEALTH INFORMATION RESEARCH. THE PRIMARY DATA COLLECTION INCLUDED INTERVIEWS WITH STAFF AND LEADERS OF MORE THAN 20 COMMUNITY SERVICES AGENCIES IN FIVE MUNICIPALITIES, AND TWO FOCUS GROUPS IN COMMUNITY AGENCY LOCATIONS. CRMC PARTNERED WITH ARIZONA STATE UNIVERSITY DOCTORAL STUDENTS AND CHANDLER GILBERT COMMUNITY COLLEGE NURSING STUDENTS TO CONDUCT THE AGENCY INTERVIEWS AND FOCUS GROUPS. GOVERNMENT AGENCY RESOURCES INCLUDED ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, ARIZONA DEPARTMENT OF HEALTH SERVICES, PUBLIC DATA SOURCES, ARIZONA CANCER REGISTRY, ARIZONA HEALTH STATUS AND VITAL STATISTICS, ARIZONA HEALTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, AND US CENSUS. NORTHRIDGE HOSPITAL MEDICAL CENTER (NHMC) NHMC, IN COLLABORATION WITH THE VALLEY CARE COMMUNITY CONSORTIUM (VCCC), DEVELOPED NHMC'S 2013 CHNA. VCCC IS THE HEALTH PLANNING COLLABORATIVE FOR THE SAN FERNANDO AND SANTA CLARITA VALLEYS IN LOS ANGELES COUNTY. DATA WAS SUMMARIZED FROM SECONDARY DATA SOURCES TO DESCRIBE 17 HEALTH ISSUES. TABLES OF DISEASES BY ZIP CODE FOCUSING ON THE HOSPITAL'S PRIMARY SERVICE AREA, USING THE 2012 THOMSON REUTERS DATABOOK, WERE COMPARED WITH AVAILABLE COUNTY, STATE AND NATIONAL DATA (CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, LOS ANGELES DEPARTMENT OF PUBLIC HEALTH, THE CENTERS FOR DISEASE CONTROL, AND HEALTHY PEOPLE 2020) A
SECTION B, LINE 5 - CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY ST. JOHN'S REGIONAL MEDICAL CENTER THE PROCESS FOR THE 2013 CHNA FOR THE ST. JOHN'S HOSPITALS SOUGHT THE BROADEST PARTICIPATION POSSIBLE FROM ELECTED OFFICIALS IN VENTURA COUNTY, THE CITY OF OXNARD, CITY OF CAMARILLO, CITY OF PORT HUENEME, AND VENTURA COUNTY HEALTH PROFESSIONALS, LEADERS OF VENTURA COUNTY HUMAN SERVICES ORGANIZATIONS (BOTH PUBLIC AND PRIVATE), HOSPITAL STAFF CURRENTLY INVOLVED WITH COMMUNITY NEEDS, HEALTH CARE CONSUMERS AND COMMUNITY MEMBERS. ELECTED/GOVERNMENT OFFICIALS WERE INTERVIEWED. INVITATIONS WERE SENT TO ORGANIZATIONS THAT SPECIALIZED IN PROVIDING "HUMAN SERVICES" TO THE BROAD POPULATION OF ETHNICALLY DIVERSE POPULATIONS AND POTENTIAL PATIENT/HEALTH CARE CONSUMERS FOR A HEARING HELD ON MAY 1, 2012 AT ST. JOHN'S REGIONAL MEDICAL CENTER. THE HEARING WAS CHAIRED BY THE VICE PRESIDENT OF MISSION INTEGRATION AND FACILITATED/DOCUMENTED BY HOSPITAL COMMUNITY BENEFIT STAFF. HEALTH CARE CONSUMERS WERE INTERVIEWED RANDOMLY DURING THE SESSION ABOUT ACTIVITIES AND OPINIONS RELATED TO MAINTAINING/IMPROVING THEIR HEALTH. SEQUOIA HOSPITAL AS A PART OF THE SEQUOIA HOSPITAL CHNA, IN JANUARY 2013 THE HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY CONVENED A FOCUS GROUP, FACILITATED BY APPLIED SURVEY RESEARCH, CONSISTING OF 20 MEMBERS OF COUNTY COALITIONS, COMMUNITY BASED ORGANIZATIONS AND COMMUNITY LEADERS REPRESENTING THE COMMUNITIES SERVED. THE PURPOSE WAS TO ELICIT FEEDBACK ON AND PRIORITIZATION OF KEY FINDINGS. THE PARTICIPANTS WERE GIVEN A PRESENTATION ON THE MAJOR HEALTH CONDITIONS IDENTIFIED IN THE 2013 SAN MATEO COUNTY CHNA REPORT, WHICH INCLUDED COMMUNITY INPUT IN THE FORM OF MORE THAN 1,700 COMPLETED COMMUNITY SURVEYS. THE FOCUS GROUP PROVIDED REACTIONS TO IT AND RATED 13 TOP HEALTH NEEDS IN THE COUNTY ACROSS FOUR DIMENSIONS. MERCY GILBERT MEDICAL CENTER THROUGH THE 2012 NEEDS ASSESSMENT, MERCY GILBERT MEDICAL CENTER CONSULTED WITH ARIZONA STATE UNIVERSITY COMMUNITY HEALTH INFORMATION RESEARCH. THE PRIMARY DATA COLLECTION INCLUDED DIALOGUE WITH COMMUNITY STAKEHOLDERS INCLUDING INTERVIEWS WITH STAFF AND LEADERS OF MORE THAN 20 COMMUNITY SERVICES AGENCIES IN FIVE MUNICIPALITIES, AND THREE FOCUS GROUPS IN COMMUNITY AGENCY LOCATIONS. MERCY GILBERT MEDICAL CENTER PARTNERED WITH ARIZONA STATE UNIVERSITY DOCTORAL STUDENTS AND CHANDLER GILBERT COMMUNITY COLLEGE NURSING STUDENTS TO CONDUCT THE AGENCY INTERVIEWS AND FOCUS GROUPS. GOVERNMENT AGENCY RESOURCES INCLUDED ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, ARIZONA DEPARTMENT OF HEALTH SERVICES, PUBLIC DATA SOURCES, ARIZONA CANCER REGISTRY, ARIZONA HEALTH STATUS AND VITAL STATISTICS, ARIZONA HEALTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, AND U.S. CENSUS. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER (GMHHC) FOR THE 2013 CHNA, THE THREE GLENDALE HOSPITALS - GMHHC, GLENDALE ADVENTIST MEDICAL CENTER, AND VERDUGO HILLS HOSPITAL - COLLABORATED WITH THE GLENDALE HEALTHIER COMMUNITY COALITION TO WORK WITH THE CENTER FOR NONPROFIT MANAGEMENT CONSULTING TEAM IN CONDUCTING THE CHNA. COMMUNITY INPUT INTO KEY HEALTH FACTORS, NEEDS, BARRIERS, IMPACTED POPULATIONS AND RELATED TOPICS WAS COLLECTED DURING A COMMUNITY FOCUS GROUP ATTENDED BY 37 INDIVIDUALS. ONCE INITIAL ISSUES WERE IDENTIFIED BY COMMUNITY INPUT AND QUANTITATIVE DATA ANALYSIS, THE SAME INDIVIDUALS WERE INVITED TO A COMMUNITY PRIORITIZATION FORUM AND ALSO COMPLETED A PRIORITIZATION SURVEY. PARTICIPANTS INCLUDED REPRESENTATIVES OF HEALTH CARE PROFESSIONALS, MENTAL HEALTH SERVICES, NURSING CARE, PRIMARY AND SECONDARY EDUCATION, COMMUNITY HEALTH CENTERS, HOMELESSNESS, CHILDREN AND YOUTH, OLDER ADULTS, DOMESTIC VIOLENCE VICTIMS, AND OTHER RELEVANT CONSTITUENCIES. ST. MARY'S MEDICAL CENTER ST. MARY'S MEDICAL CENTER COLLABORATED WITH OTHER NON-PROFIT HOSPITALS IN SAN FRANCISCO AND THE DEPARTMENT OF PUBLIC HEALTH AND OTHER COMMUNITY AGENCIES DURING FY2012 TO COMPLETE A CHNA. THIS WAS ACHIEVED THROUGH A COLLABORATIVE PROCESS OF DATA COLLECTION, COLLABORATIVE AND STRATEGIC PARTNERSHIPS, DATA EXCHANGE AND SHARING. AT MONTHLY COMMUNITY STAKEHOLDER MEETINGS HELD IN 2012, MEMBERS OF THE CITY-WIDE COLLABORATION HOSTED PARTICIPANTS REPRESENTING A CROSS-SECTION OF EXPERTISE IN HEALTH AND HUMAN SERVICES. THESE COMMUNITY STAKEHOLDERS CONFIRMED THE RELEVANCE OF THE HEALTH GOALS AND CREATED 24 AFFINITY GROUPS COMPRISED OF SUBJECT MATTER EXPERTS FOR EACH OF THE HEALTH GOALS. THE AFFINITY GROUPS CONSISTENTLY CONTRIBUTED TO THE PROCESS AND CONFIRMED THE ACCURACY OF THE ASSESSMENT. THERE WERE OVER 147 ACTIVE NON-PROFIT PARTNERS, MORE THAN THREE HOSPITAL SYSTEMS, AND ONE PUBLIC HEALTH DEPARTMENT INVOLVED IN THIS SHARED ASSESSMENT PROCESS. INPUT AND DATA WERE ACQUIRED THOUGH QUANTITATIVE SECONDARY DATA AND QUALITATIVE AFFINITY WORKGROUPS. MERCY HOSPITAL OF FOLSOM MERCY HOSPITAL OF FOLSOM COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 18 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). FOUR FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. WOODLAND MEMORIAL HOSPITAL WOODLAND MEMORIAL HOSPITAL COMPLETED ITS MOST RECENT CHNA IN 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WERE OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 13 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). THREE FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. ST. ROSE DOMINICAN HOSPITALS - SAN MARTIN THE HEALTHY COMMUNITIES INSTITUTE (HCI) OF BERKELEY, CALIFORNIA, IN PARTNERSHIP WITH ST. ROSE DOMINICAN HOSPITALS, CONDUCTED A CHNA OF CLARK COUNTY, NEVADA IN 2013. BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODOLOGIES WERE USED TO ENSURE AN ACCURATE PROFILE OF THE ST. ROSE SERVICE AREAS. PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES INCLUDES: PAPER AND ELECTRONIC SURVEYS; DATA FROM EXISTING LITERATURE AND DATABASES; AND INFORMATION FROM COMMUNITY STAKEHOLDERS. SEVERAL TOOLS WERE CREATED FOR PRIMARY DATA COLLECTION, AND MANY METHODOLOGIES WERE UTILIZED, INCLUDING: 1) 221 INDIVIDUALS COMPLETED A SURVEY RANKING THE TOP HEALTH ISSUES FOR THEIR FAMILY AND THE COMMUNITY. THE SURVEY PROVIDED THE LIST OF 15 HEALTH ISSUES THAT WERE SELECTED AFTER AN ANALYSIS OF HCI AND PREVENTION QUALITY INDICATOR DATA. A CONVENIENCE SAMPLE OF THOSE UTILIZING ST. ROSE COMMUNITY OUTREACH PROGRAMS COMPLETED THE SURVEYS; 2) MORE THAN 50 KEY COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES OF THE UNIVERSITY OF NEVADA AT LAS VEGAS DEPARTMENT OF PUBLIC HEALTH, WERE INVITED TO COMPLETE A SURVEY RANKING PRIORITY HEALTH NEEDS IDENTIFYING WAYS ST. ROSE CAN ADDRESS THESE HEALTH ISSUES, AND PROVIDING SUGGESTIONS FOR ENHANCED COLLABORATION WITH PARTNER ORGANIZATIONS. FRENCH HOSPITAL MEDICAL CENTER FRENCH HOSPITAL, AS PART OF THE DIGNITY HEALTH CENTRAL COAST SERVICE AREA, USED PURPOSIVE EXPERT SAMPLING TO IDENTIFY KEY INFORMANTS FOR THE 2012 CHNA, ADOPTED IN JUNE 2013. HOSPITAL STAFF MEMBERS SELECTED KEY INFORMANTS FROM THE LOCAL COMMUNITY ACTION PARTNERSHIP, FIRST FIVE SAN LUIS OBISPO COUNTY, A DAY CARE CENTER, A CHURCH, THE COMMUNITY FOUNDATION, THE PUBLIC HEALTH DEPARTMENT, A FOOD AND SHELTER AGENCY, AND A MENTAL HEALTH ORGANIZATION, AS WELL AS FROM THE HOSPITAL. TEN KEY INFORMANTS WERE INTERVIEWED AND A TOTAL OF 29 PEOPLE PARTICIPATED IN FOCUS GROUPS. TWO FOCUS GROUPS WERE CONDUCTED IN SPANISH WITH A TOTAL OF 17 PARTICIPANTS, AND TWO FOCUS GROUPS WERE CONDUCTED IN ENGLISH WITH A TOTAL OF 12 PARTICIPANTS. QUANTITATIVE SECONDARY DATA ALSO WERE ANALYZED, FROM SOURCES THAT INCLUDED THE: U.S. BUREAU OF THE CENSUS AND AMERICAN COMMUNITY SURVEY, U.S. BUREAU OF LABOR STATISTICS, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA HEALTH INTERVIEW SURVEY, AND HEALTHY PEOPLE 2020 INDICATORS. HELENE FUCHS ASSOCIATES COMPILED, ORGANIZED, AND ANALYZED THE PRIMARY AND SECONDA
SECTION B, LINE 6A- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSESSMENT ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER BANNER HEALTH, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER MERCY GENERAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH CENTER, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER PERMANENTE AND LODI HEALTH CALIFORNIA HOSPITAL MEDICAL CENTER GOOD SAMARITAN HOSPITAL AND ST. VINCENT MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER NORTHRIDGE HOSPITAL MEDICAL CENTER ADVANCE HEALTH MEDICAL CENTER, DEL CARMEN MEDICAL CENTER, GLENDALE ADVENTIST MEDICAL CENTER, HENRY MAYO NEWHALL MEMORIAL HOSPITAL, HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS, KAISER PERMANENTE WOODLAND HILLS, KAISER PERMANENTE PANORAMA CITY, MISSION COMMUNITY HOSPITAL, PROVIDENCE HEALTH CENTER, SHERMAN OAKS HOSPITAL, AND VALLEY PRESBYTERIAN HOSPITAL DOMINICAN HOSPITAL SUTTER MATERNITY AND SURGERY CENTER, WATSONVILLE COMMUNITY HOSPITAL MARIAN REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND FRENCH HOSPITAL MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER COMMUNITY HOSPITAL SAN BERNARDINO ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS ST. ROSE DOMINICAN HOSPITAL SAN MARTIN AND ST. ROSE DOMINICAN HOSPITAL DE LIMA MERCY HOSPITAL BAKERSFIELD DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE AND SAN JOAQUIN COMMUNITY HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. MARY MEDICAL CENTER - LONG BEACH LONG BEACH MEMORIAL, MILLER'S CHILDREN'S HOSPITAL, COMMUNITY HOSPITAL OF LONG BEACH ST. JOHN'S REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL SEQUOIA HOSPITAL STANFORD HOSPITAL AND CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, KAISER PERMANENTE SAN MATEO AREA MERCY GILBERT MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER GLENDALE ADVENTIST MEDICAL CENTER AND USC VERDUGO HILLS HOSPITAL ST. MARY'S MEDICAL CENTER CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE HOSPITAL, SAINT FRANCIS MEMORIAL HOSPITAL, UCSF MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER WOODLAND MEMORIAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL DE LIMA FRENCH HOSPITAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND MARIAN REGIONAL MEDICAL CENTER ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL SAN MARTIN ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. JOHN'S REGIONAL MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER PERMANENTE AND LODI HEALTH
SECTION B, LINE 6b- CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER ARIZONA DEPARTMENT OF HEALTH SERVICES, MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, AND WIDE VARIETY OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, EDUCATION AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, AND OTHER STAKEHOLDERS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON SAN JOAQUIN COUNTY COMMUNITY HEALTH ASSESSMENT COLLABORATIVE, INCLUDING NON-HOSPITAL MEMBERS FIRST 5 SAN JOAQUIN, HEALTH PLAN OF SAN JOAQUIN, SAN JOAQUIN COUNTY PUBLIC HEALTH DEPARTMENT MERCY MEDICAL CENTER REDDING SHASTA COUNTY PUBLIC HEALTH DOMINICAN HOSPITAL ECOLOGY ACTION, BASKIN AND GRANT, UC SANTA CRUZ, SANTA CRUZ COMMUNITY CREDIT UNION, COMMUNITY VENTURES, SANTA CRUZ WOMEN'S HEALTH CENTER, COMMUNITY FOUNDATION OF SANTA CRUZ COUNTY, VOLUNTEER CENTER OF SANTA CRUZ, SECOND HARVEST FOOD BANK, SANTA CRUZ COUNTY HEALTH SERVICES AGENCY, UNITED WAY OF SANTA CRUZ COUNTY, COMMUNITY ACTION BOARD, FIRST 5 SANTA CRUZ COUNTY, HEALTH IMPROVEMENT PARTNERSHIP, COUNTY OF SANTA CRUZ HUMAN SERVICES DEPARTMENT, CABRILLO COLLEGE, PAJARO VALLEY COMMUNITY HEALTH TRUST, IMAGINE SUPPORTED LIVING SERVICES, SANTA CRUZ COUNTY SHERIFF'S OFFICE, CRISIS SUPPORT/DEFENSA DE MUJERES, RUHNKE AND DOST ARCHITECTS, LLP, COMMUNITY BRIDGES, SANTA CRUZ COUNTY OFFICE OF EDUCATION MERCY HOSPITAL BAKERSFIELD KERN COUNTY PUBLIC HEALTH SERVICES, KERN FAMILY HEALTH CARE, ST. FRANCIS PARISH, HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA (LISTED ON WWW.HEALTHYKERN.ORG UNDER "FUNDERS") ST. MARY MEDICAL CENTER - LONG BEACH LONG BEACH HEALTH AND HUMAN SERVICES, LONG BEACH DEVELOPMENT SERVICES PLANNING BUREAU ST. JOHN'S REGIONAL MEDICAL CENTER VENTURA COUNTY GOVERNMENT, CITY OF OXNARD, CITY OF CAMARILLO, AND CITY OF PORT HUENEME SEQUOIA HOSPITAL HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY (SMC), INCLUDING: PENINSULA HEALTH CARE DISTRICT, SMC HUMAN SERVICE AGENCY, SEQUOIA HEALTHCARE DISTRICT, HEALTH PLAN OF SAN MATEO, SMC HEALTH DEPARTMENT, PENINSULA LIBRARY SYSTEM-COMMUNITY INFORMATION PROGRAM, YOUTH AND FAMILY ENRICHMENT SERVICES/STARVISTA. ST. MARY'S MEDICAL CENTER BUILDING A HEALTHY SAN FRANCISCO COALITION, INCLUDING: ANTHEM BLUE CROSS, HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA, MCKESSON FOUNDATION, NICOS CHINESE HEALTH COALITION, SAN FRANCISCO COMMUNITY CLINIC CONSORTIUM, SAN FRANCISCO DEPARTMENT OF HUMAN SERVICES, SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, SAN FRANCISCO FOUNDATION, SAN FRANCISCO MEDICAL SOCIETY, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, UNITED WAY OF THE BAY AREA. ST. JOHN'S PLEASANT VALLEY HOSPITAL VENTURA COUNTY GOVERNMENT, CITY OF OXNARD, CITY OF CAMARILLO, AND CITY OF PORT HUENEME ST. ELIZABETH COMMUNITY HOSPITAL TEHAMA COUNTY PUBLIC HEALTH SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ARIZONA DEPARTMENT OF HEALTH SERVICES, MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, AND WIDE VARIETY OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, EDUCATION AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, AND OTHER STAKEHOLDERS MERCY MEDICAL CENTER MT. SHASTA SISKIYOU COUNTY RURAL HEALTH CLINICS, SISKIYOU COUNTY COMMUNITY RESOURCE CENTERS, SISKIYOU COUNTY PUBLIC HEALTH ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ARIZONA DEPARTMENT OF HEALTH SERVICES, MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, AND WIDE VARIETY OF LOCAL PUBLIC HEALTH SYSTEM PARTNERS, EDUCATION AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, AND OTHER STAKEHOLDERS ST. JOSEPH'S BEHAVIORAL HEALTH CENTER SAN JOAQUIN COUNTY COMMUNITY HEALTH ASSESSMENT COLLABORATIVE, INCLUDING NON-HOSPITAL MEMBERS FIRST 5 SAN JOAQUIN, HEALTH PLAN OF SAN JOAQUIN, SAN JOAQUIN COUNTY PUBLIC HEALTH DEPARTMENT
SECTION B, LINE 7a- CHNA ON HOSPITAL FACILITY'S WEB SITE ALL DIGNITY HEALTH HOSPITAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS CAN BE ACCESSED AT HTTP://WWW.DIGNITYHEALTH.ORG/CM/CONTENT/PAGES/COMMUNITY-BENEFIT.ASP CHNA REPORT WEB SITE LOCATIONS FOR EACH HOSPITAL FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.dignityhealth.org/stjosephs-stockton/about-us/community-program s/community-health-assessment CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/who-we-are/community-benef its MERCY MEDICAL CENTER REDDING http://www.dignityhealth.org/mercy-redding/about-us/community-benefit CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/community-progr ams DOMINICAN HOSPITAL http://www.dignityhealth.org/dominican/about-us/community-benefits MARIAN REGIONAL MEDICAL CENTER http://www.dignityhealth.org/marianregional/about-us/community-benefits ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity/menub78ffb2d-73c8-4769-9b3a-07decf6facb7 ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community MERCY HOSPITAL BAKERSFIELD http://www.dignityhealth.org/mercy-bakersfield/dignity-health-in-kern-coun ty/community-programs/community-benefit-report MERCY MEDICAL CENTER MERCED http://www.dignityhealth.org/mercymedical-merced/dignity-health-in-merced- county/community-benefit-report METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. MARY MEDICAL CENTER - LONG BEACH http://www.dignityhealth.org/stmarymedical/community-benefits ST. JOHN'S REGIONAL MEDICAL CENTER http://www.dignityhealth.org/stjohnsregional/about-us/community-benefit SEQUOIA HOSPITAL http://www.dignityhealth.org/sequoia/about-us/community-benefit MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan ST. MARY'S MEDICAL CENTER http://www.dignityhealth.org/stmarys/about-us/community-benefit MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community FRENCH HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/frenchhospital/about-us/community-benefits ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.dignityhealth.org/pleasantvalley/about-us/community-benefit ST. ELIZABETH COMMUNITY HOSPITAL http://www.dignityhealth.org/stelizabethhospital/about-us/community-benefi t ARROYO GRANDE COMMUNITY HOSPITAL http://www.dignityhealth.org/arroyo-grande/about-us/community-benefits SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ MERCY MEDICAL CENTER MT. SHASTA http://www.dignityhealth.org/mercy-mtshasta/about-us/community-benefit ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL http://azosh.com/community-benefits-reports ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.dignityhealth.org/stjosephsbehavioral/about-us/community-health
SECTION B, LINE 7b - CHNA ON OTHER WEB SITES MERCY HOSPITAL SAN JUAN HTTP://WWW.HEALTHYLIVINGMAP.COM MERCY GENERAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S MEDICAL CENTER OF STOCKTON WWW.HEALTHIERSANJOAQUIN.ORG DOMINICAN HOSPITAL HTTP://WWW.APPLIEDSURVEYRESEARCH.ORG/SCCCAP MERCY HOSPITAL BAKERSFIELD HTTP://WWW.HEALTHYKERN.ORG/ METHODIST HOSPITAL OF SACRAMENTO HTTP://WWW.HEALTHYLIVINGMAP.COM SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG ST. MARY'S MEDICAL CENTER HTTP://WWW.SFHIP.ORG/ MERCY HOSPITAL FOLSOM HTTP://WWW.HEALTHYLIVINGMAP.COM WOODLAND MEMORIAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S BEHAVIORAL HEALTH CENTER WWW.HEALTHIERSANJOAQUIN.ORG
SECTION B, LINE 10a - IMPLEMENTATION STRATEGIES ON WEB SITES ALL DIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED AT http://www.dignityhealth.org/cm/content/pages/community-health-needs.asp IMPLEMENTATION STRATEGY WEB SITE LOCATIONS FOR EACH FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.dignityhealth.org/stjosephs-stockton/about-us/community-program s/community-health-assessment CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/who-we-are/community-benef its MERCY MEDICAL CENTER REDDING http://www.dignityhealth.org/mercy-redding/about-us/community-benefit CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/community-progr ams DOMINICAN HOSPITAL http://www.dignityhealth.org/dominican/about-us/community-benefits MARIAN REGIONAL MEDICAL CENTER http://www.dignityhealth.org/marianregional/about-us/community-benefits ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity/menub78ffb2d-73c8-4769-9b3a-07decf6facb7 ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community MERCY HOSPITAL BAKERSFIELD http://www.dignityhealth.org/mercy-bakersfield/dignity-health-in-kern-coun ty/community-programs/community-benefit-report MERCY MEDICAL CENTER MERCED http://www.dignityhealth.org/mercymedical-merced/dignity-health-in-merced- county/community-benefit-report METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. MARY MEDICAL CENTER - LONG BEACH http://www.dignityhealth.org/stmarymedical/community-benefits ST. JOHN'S REGIONAL MEDICAL CENTER http://www.dignityhealth.org/stjohnsregional/about-us/community-benefit SEQUOIA HOSPITAL http://www.dignityhealth.org/sequoia/about-us/community-benefit MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan ST. MARY'S MEDICAL CENTER http://www.dignityhealth.org/stmarys/about-us/community-benefit MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/menu79e 3b8b8-9537-4b18-9c22-b1e90584f4ab ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community FRENCH HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/frenchhospital/about-us/community-benefits ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/serving-the-community ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.dignityhealth.org/pleasantvalley/about-us/community-benefit ST. ELIZABETH COMMUNITY HOSPITAL http://www.dignityhealth.org/stelizabethhospital/about-us/community-benefi t ARROYO GRANDE COMMUNITY HOSPITAL http://www.dignityhealth.org/arroyo-grande/about-us/community-benefits SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ MERCY MEDICAL CENTER MT. SHASTA http://www.dignityhealth.org/mercy-mtshasta/about-us/community-benefit ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL http://azosh.com/community-benefits-reports ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.dignityhealth.org/stjosephsbehavioral/about-us/community-health
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT BELOW ARE SUMMARIES OF WAYS THE HOSPITAL FACILITIES ARE ADDRESSING THE SIGNIFICANT HEALTH NEEDS IN THEIR MOST RECENTLY CONDUCTED CHNAS, AS WELL AS NEEDS NOT BEING ADDRESSED AND REASONS WHY. DIGNITY HEALTH HOSPITALS' COMMUNITY BENEFIT PROGRAMS MEET THE GOALS AND OBJECTIVES IDENTIFIED IN THE PRIORITY AREAS. THE PROGRAMS WORK CLOSELY WITH THE COMMUNITY AND OTHER ORGANIZATIONS WITHIN THE COMMUNITY TO MEET THOSE NEEDS THAT CONTINUE TO BE UNMET. ADDITIONAL DETAIL FOR EACH HOSPITAL IS IN ITS COMMUNITY HEALTH IMPLEMENTATION STRATEGY. SEE SCHEDULE H, PART V, SECTION B, LINE 10B FOR URL. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER WORKS CLOSELY WITH ITS HEALTH PARTNERS: OASIS HOSPITAL, UNITED SURGICAL PARTNERS, AND PHOENIX CHILDREN'S HOSPITAL IN PROVIDING SERVICES, PROGRAMS AND PARTNERING WITH COMMUNITY ORGANIZATIONS IN MEETING THE NEEDS OUTLINED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. IN ORDER TO MEET THE GROWING NEEDS OF THE COMMUNITY, ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER CREATED THE ARIZONA COMMUNITIES OF CARE NETWORK WHERE ORGANIZATIONS COME TOGETHER TO DEVELOP A COMMON AGENDA BASED ON A COMMON NEED, GOALS, MUTUALLY REINFORCED ACTIVITIES, STRATEGIES, OBJECTIVES AND OUTCOMES. THIS ENABLES THE HOSPITAL TO FURTHER MAXIMIZE THE OUTCOMES TO IMPROVE THE HEALTH OF THE COMMUNITY WHILE ENGAGING OTHERS IN SUSTAINABLE AND LONG LASTING CHANGE. THE FOCUS IS TO CREATE HEALTHY CONNECTIONS IN ARIZONA BY PROVIDING AND ASSISTING WITH ACCESS TO HEALTH CARE SERVICES, HEALTH INSURANCE COVERAGE, HEALTHY WOMEN AND CHILDREN SERVICES, CHRONIC DISEASE MANAGEMENT PROGRAMS, CANCER PREVENTION AND INJURY PREVENTION PROGRAMS. WITHIN THE SCOPE OF THE HOSPITAL'S SERVICES, THE PRIORITY NEEDS NOT BEING ADDRESSED ARE THOSE OF CHILDREN'S HEALTH FROM 1 TO 15 YEARS OF AGE. THESE HEALTH ISSUES ARE BEING ADDRESSED IN VARIOUS WAYS BY SEVERAL OTHER HEALTH PROVIDERS IN THE COMMUNITY. IN 2012 THE HOSPITAL JOINED PHOENIX CHILDREN'S HOSPITAL IN HELPING TO ADDRESS THESE NEEDS. MERCY SAN JUAN MEDICAL CENTER SEVERAL STRATEGIES HAVE BEEN ESTABLISHED THAT WILL ENHANCE AND BUILD UPON EXISTING EFFORTS, FOCUSING ON THE FOLLOWING PRIORITY HEALTH NEEDS, WITH PARTICULAR EMPHASIS ON THE SIX COMMUNITIES IDENTIFIED: 1. ACCESS TO PRIMARY CARE AND PREVENTATIVE SERVICES; 2. ACCESS TO MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES; 3. ACCESS TO SPECIALTY CARE; 4. IMPROVED TRANSPORTATION SERVICES; 5. EDUCATION ON HEALTH, WELLNESS, AND NUTRITION; AND 6. BASIC NEEDS INCLUDING ADEQUATE SHELTER AND FOOD. THE DIGNITY HEALTH SACRAMENTO SERVICE AREA COMMUNITY HEALTH COMMITTEE PROVIDES REGULAR OVERSIGHT TO ENSURE PRIORITY HEALTH NEEDS CONTINUE TO BE A TOP FOCUS FOR PLANNING AND PROGRAMMING. MONTHLY, THE COMMITTEE ALSO REPORTS TO, AND DISCUSSES ISSUES AND PRIORITIES WITH, THE FULL COMMUNITY BOARD AND HOSPITAL LEADERSHIP. THE PLANNING PROCESS ALSO INCLUDES STAKEHOLDERS IN THE COMMUNITY WHO HAVE EXPERTISE IN THOSE AREAS THAT HAVE BEEN IDENTIFIED AS PRIORITIES IN THE CHNA. SPECIFIC ACTIONS INCLUDE: PARTNERING WITH A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) TO EXPAND PRIMARY CARE CAPACITY; PATIENT NAVIGATOR PROGRAM; COMMUNITY GRANTS PROGRAM; COVERAGE ENROLLMENT ASSISTANCE; REFERNET MENTAL HEALTH CARE ACCESS FOR HOSPITAL ED PATIENTS; INTERIM CARE PROGRAM; PERINATAL RECOVERY NETWORK; SPIRIT PROGRAM TO EXPAND ACCESS TO SPECIALTY CARE; HEALTHIER LIVING AND CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM (CHAMP) CHRONIC DISEASE PREVENTION AND MANAGEMENT. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED BY ANOTHER HOSPITAL IN THE AREA. MERCY GENERAL HOSPITAL SEVERAL STRATEGIES HAVE BEEN ESTABLISHED THAT WILL ENHANCE AND BUILD UPON EXISTING EFFORTS, FOCUSING ON PRIORITY HEALTH NEEDS OF 1) LACK OF ACCESS TO PRIMARY AND PREVENTATIVE SERVICES; 2) LACK OF COORDINATION OF CARE AMONG PROVIDERS AND NO CASE MANAGEMENT SERVICES; 3) LACK OF ACCESS TO LIMITED MENTAL HEALTH SERVICES; 4) LACK OF ACCESS TO SPECIALTY CARE, AND; 5) LACK OF HOUSING AND BASIC SHELTER. THE DIGNITY HEALTH SACRAMENTO SERVICE AREA COMMUNITY HEALTH COMMITTEE PROVIDES REGULAR OVERSIGHT TO ENSURE PRIORITY HEALTH NEEDS CONTINUE TO BE A TOP FOCUS FOR PLANNING AND PROGRAMMING. MONTHLY, THE COMMITTEE ALSO REPORTS TO, AND DISCUSSES ISSUES AND PRIORITIES WITH, THE FULL COMMUNITY BOARD AND HOSPITAL LEADERSHIP. THE PLANNING PROCESS ALSO INCLUDES STAKEHOLDERS IN THE COMMUNITY WHO HAVE EXPERTISE IN THOSE AREAS THAT HAVE BEEN IDENTIFIED AS PRIORITIES IN THE CHNA. SPECIFIC ACTIONS INCLUDE: PATIENT NAVIGATOR PROGRAM; COMMUNITY GRANTS PROGRAM; PROVIDING CORE SERVICES AND ENROLLMENT ASSISTANCE TO COMMUNITY CLINICS AND HOMELESS SERVICES AGENCIES; REFERNET FOR MENTAL HEALTH ACCESS; INTERIM CARE PROGRAM; MENTAL HEALTH CONSULTATIONS; HEALTHIER LIVING AND CHAMP CHRONIC DISEASE PREVENTION AND MANAGEMENT; SPIRIT PROGRAM TO EXPAND ACCESS TO SPECIALTY CARE; COMMUNITY PARTNERSHIPS FOR HOMELESS SERVICES PROVIDING HOUSING, PROMOTING WHOLE HEALTH BY MEETING PHYSICAL NEEDS, PSYCHOLOGICAL NEEDS, AND OTHER SOCIAL NEEDS. THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS; THIS NEED IS ADDRESSED AT ANOTHER HOSPITAL IN THE AREA. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON IDENTIFIED NEEDS INCLUDE: ACCESS TO PRIMARY AND SPECIALTY CARE: MODIFY EXISTING MOBILE CARE VAN (MOBILE CLINIC) TO ADDRESS NEEDS OF THOSE LEFT BEHIND AFTER ACA; WORK WITH FQHC AND COMMUNITY CLINICS TO EXPAND SERVICES BY COLLABORATIVELY DEVELOPING A STRATEGIC PLAN TO EXPAND THEIR CAPACITY TO SERVE MORE PATIENTS; USE RESULTS OF ASSET ANALYSIS TO DEVELOP LINKAGES WITH EXISTING PROGRAMS, AND LEVERAGE THESE TO ACHIEVE GOALS; EXPLORE FUNDING DENTAL CLINIC PROGRAM PROVIDED BY ST. MARY'S INTERFAITH COMMUNITY SERVICES; EXPAND SJMC'S INTERFAITH CAREGIVERS SENIOR PROGRAM. HEALTH EDUCATION: EXPAND EXISTING ENGLISH AND SPANISH DIABETES EDUCATION CLASSES TO INCLUDE HMONG POPULATION IN IDENTIFIED COMMUNITIES OF CONCERN; DEVELOP AND BEGIN DELIVERING A TWO-PART CONGESTIVE HEART FAILURE CLASS IN THE COMMUNITY TARGETING NEWLY DISCHARGED PATIENTS, WHILE BEING OPEN TO THE COMMUNITY; CONTINUE COMMUNITY GRANTS PROGRAM AIMED AT EDUCATION EFFORTS. CULTURALLY COMPETENT CARE: EXPLORE WAYS TO DEVELOP AND IMPLEMENT CULTURALLY COMPETENT CARE MODELS; DEVELOP EDUCATION IN MULTIPLE LANGUAGES THAT WILL EMPOWER CLASS ATTENDEES TO UTILIZE MEDICAL SYSTEM AND BECOME SELF-ADVOCATES; LEVERAGE COMMUNITY PARTNERSHIPS AND DEVELOP EDUCATION FOR MEDICAL CENTER STAFF; DEVELOP COMPETENCES TO BETTER SERVE THE HISPANIC POPULATION; EXPLORE WAYS TO SUPPORT LOCAL SCHOOL ESL PROGRAMS THAT HAVE HEALTH COMPONENTS. IDENTIFIED HEALTH NEEDS NOT BEING ADDRESSED DIRECTLY BY THE HOSPITAL INCLUDE: LACK OF OR LIMITED ACCESS TO DENTAL CARE, LIMITED OR NO NUTRITION LITERACY/ACCESS TO HEALTHY, NUTRITIOUS FOODS, FOOD SECURITY, LIMITED TRANSPORTATION OPTIONS, AND A LACK OF SAFE AND AFFORDABLE PLACES TO BE ACTIVE. ALTHOUGH NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION PLAN, THESE NEEDS WILL RECEIVE SECONDARY SUPPORT BY THE HOSPITAL, AS ABLE. THIS MAY INCLUDE SUPPORTING PARTNERS BETTER SUITED TO ADDRESS THESE NEEDS THROUGH THE COMMUNITY GRANTS PROGRAM. CALIFORNIA HOSPITAL MEDICAL CENTER IDENTIFIED NEEDS INCLUDE: ACCESS TO MENTAL HEALTH, PRIMARY PREVENTION AND TREATMENT TO SUBSTANCE ABUSE AND ALCOHOLISM, TREATMENT OF DIABETES, IMPROVING PHYSICAL ACTIVITY AND DIETARY HABITS AND REDUCING OVERWEIGHT/OBESITY, PREVENTION AND TREATMENT OF CARIOVASCULAR DISEASE, IMPROVING BIRTH OUTCOMES, IMPROVING HEALTH LITERACY, AND INJURY AND VIOLENCE PREVENTION WHICH ARE BEING ADDRESSED THROUGH A VARIETY OF PROGRAMS THROUGH HOPE STREET FAMILY CENTER, THE HEALTH MINISTRY PROGRAM, AND THE COMMUNITY GRANT PROGRAM, AMONG OTHERS. NEEDS IDENTIFIED IN THE CHNA NOT BEING ADDRESSED BY CALIFORNIA HOSPITAL MEDICAL CENTER INCLUDE ALZHEIMER'S DISEASE, ALLERGIES, CANCER, HIV/AIDS, AND SEXUALLY TRANSMITTED DISEASES, AS OTHER ORGANIZATIONS ARE ADDRESSING THEIR ISSUES. MERCY MEDICAL CENTER REDDING THE TOP AREAS OF OPPORTUNITY FOR THE CURRENT ASSESSMENT ARE: MENTAL HEALTH PROBLEMS, OBESITY, CANCERS, DOMESTIC VIOLENCE, CHILD ABUSE/NEGLECT, AGING PROBLEMS, DIABETES, HEART DISEASE AND/OR STROKE. IN ADDITION, THE HEALTH RISK BEHAVIORS OF DRUG ABUSE, BEING OVERWEIGHT, ALCOHOL ABUSE, POOR EATING HABITS, TOBACCO USE, AND LACK OF EXERCISE. 1. HEALTHIER LIVING - CHRONIC DISEASE SELF-MANAGEMENT PROGRAM - THE HOSPITAL WILL CONTINUE TO PROVIDE THE HEALTHIER LIVING WORKSHOP FOR ADULTS WHO HAVE A CHRONIC HEALTH CONDITION OR WHO LIVE WITH SOMEONE WITH A CHRONIC HEALTH CONDITION. HEALTHIER LIVING WORKSHOP PARTICIPANTS LEARN HOW TO MANAGE STRESS, FIGHT FATIGUE AND PAIN, LEARN HOW TO COMMUNICATE WITH THEIR DOCTOR AND FAMILY MEMBERS AND SET GOALS AND LEARN PROBL
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT MARIAN REGIONAL MEDICAL CENTER HEALTH ISSUES IDENTIFIED INCLUDE: ACCESS TO HEALTHCARE; EMERGENCY ROOM UTILIZATION; MENTAL HEALTH; CLINICAL CONDITIONS; ORAL HEALTH; TRANSPORTATION; AND CULTURAL AWARENESS. ACCESS TO HEALTHCARE: MARIAN REGIONAL MEDICAL CENTER PARTNERS WITH COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST (CHCCC), WHICH HAS 15 CLINICS IN SANTA BARBARA COUNTY, AND THE MARIAN COMMUNITY CLINICS TO PROVIDE CHOLESTEROL AND GLUCOSE SCREENINGS, HEIGHT, WEIGHT AND BMI'S. WHILE SOME CLINICS HAVE PROVIDED EXTENDED CLINIC HOURS IN THE COUNTY (EVENINGS AND WEEKENDS); WE WILL INVESTIGATE THE POSSIBILITY OF INCREASED HOURS AT MORE SITES. MRMC WILL WORK INTERNALLY AS WELL AS WITH OUR LOCAL PARTNERS TO FACILITATE A BETTER CONTINUUM OF CARE THROUGH DISCHARGE PLANNING AND CASE MANAGEMENT LINKING PATIENTS NEEDING SERVICES EMPHASIZING THE NEED FOR PRESCRIPTION DRUGS, TRANSPORTATION, FOOD SERVICES AND PROVIDER APPOINTMENTS AFTER DISCHARGE. Key findings such as how to navigate the system, awareness of existing services, affordability of care and inadequate use of preventive care may link to cultural awarenes. SMOOTH WILL BE UTILIZED AS A RESOURCE TO COMMUNICATE ACCESSIBLE TRANSPORTATION FOR DISCHARGED PATIENTS. EMERGENCY ROOM UTILIZATION: MARIAN REGIONAL MEDICAL CENTER WILL COLLABORATE WITH OTHER COMMUNITY PARTNERS TO BETTER FACILITATE HIGH-RISK PATIENTS DISCHARGED FROM THE EMERGENCY ROOM. IT IS PROPOSED TO FACILITATE OPEN COMMUNICATION BETWEEN ER AND PRIMARY CARE PROVIDERS (HEALTH INFORMATION EXCHANGE) MIRRORING THE RELATIONSHIP BETWEEN MRMC'S ER AND CHCCC. MRMC WILL REVIEW PATIENT UTILIZATION OF THE ER TO SEE IF PATIENTS CAN BE REFERRED TO CLINICS OFFERING LATE HOURS FOR FUTURE TREATMENT. KEY FINDINGS IDENTIFIED PATIENTS WHO UTILIZE THE EMERGENCY ROOM AS THEIR PRIMARY CARE PROVIDER MIGHT DO SO BECAUSE CLINIC HOURS ARE NOT CONDUCIVE FOR MIGRANT WORKERS THAT WORK PAST 6 PM AND ON SATURDAYS. THESE SAME MIGRANT WORKERS DELAY HEALTH CARE UNTIL IT IS AN EMERGENT NEED. MENTAL HEALTH WAS IDENTIFIED AS A SUBSTANTIAL NEED FOR SANTA BARBARA COUNTY. WHILE THERE ARE MANY SERVICES BEING OFFERED BY LOCAL PARTNERS IN THE COMMUNITY MORE SERVICES ARE NEEDED. MARIAN REGIONAL MEDICAL CENTER IS COLLABORATING WITH THE COUNTY OF SANTA BARBARA AND A THIRD PARTY TO EVALUATE AND POTENTIALLY DEVELOP A BEHAVIORAL HEALTH INPATIENT FACILITY IN SANTA MARIA. THIS FACILITY WOULD INCLUDE GEROPSYCHIATRIC CARE. CLINICAL CONDITIONS SUCH AS OBESITY, DIABETES, AND NUTRITION AND PHYSICAL EXERCISE. MRMC OFFERS NUTRITION CLASSES IN ENGLISH AND SPANISH. EXERCISE CLASSES ARE PRESENTLY BEING OFFERED FOR ADULTS AND WE WILL OFFER EXERCISE FOR CHILDREN IN THE NEW FISCAL YEAR. THERE IS A DIABETES PROGRAM ACCREDITED BY THE AMERICAN DIABETES ASSOCIATION BASED AT MARIAN REGIONAL MEDICAL CENTER. THIS DIABETES PROGRAM NEEDS TO EXPAND CAPACITY TO THE LATINO SPANISH-SPEAKING COMMUNITY. MANY RESIDENTS IN THE MRMC SERVICE AREA DO NOT KNOW HOW TO NAVIGATE THE SYSTEM FOR NEEDED SERVICE; THEY ARE UNAWARE OF EXISTING SERVICES THAT MIGHT PROVIDE A BETTER USE FOR PREVENTIVE CARE. A MEDIA AND COMMUNICATION CAMPAIGN IS REQUIRED INTERNALLY AND EXTERNALLY TO PROMOTE AVAILABLE SERVICES. THIS COULD ENHANCE THE CONTINUUM OF CARE BETWEEN PROVIDERS IN THE COMMUNITY. BILINGUAL EDUCATION SHOULD BE PROVIDED FOR ALL PROGRAMS SINCE THE LATINO POPULATION IS THE TARGET POPULATION. ORAL HEALTH, CULTURAL AWARENESS AND TRANSPORTATION ARE THREE AREAS IDENTIFIED IN THE NEEDS ASSESSMENT THAT WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL. THE HOSPITAL OFFERS SPACE WITHIN THE FACILITY AND SUPPORT SERVICES FOR SOME ORAL HEALTH NEEDS, BUT THE HEALTH ISSUE IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC FOCUS ON CULTURAL AWARENESS OR TRANSPORTATION, BOTH WILL BE GIVEN CONSIDERATION AS THE OTHER HEALTH PRIORITIES ARE ADDRESSED. ARROYO GRANDE COMMUNITY HOSPITAL CAMPUS THE KEY COMMUNITY HEALTH NEEDS IDENTIFIED BY THE CHNA INCLUDE: ACCESS TO HEALTHCARE; EMERGENCY ROOM UTILIZATION; MENTAL HEALTH; CLINICAL CONDITIONS; ORAL HEALTH; TRANSPORTATION; AND CULTURAL AWARENESS. 1. ACCESS TO HEALTHCARE: THE HOSPITAL PARTNERS WITH COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST (CHCCC) WHICH HAS 14 CLINICS IN SLO COUNTY TO PROVIDE CHOLESTEROL AND GLUCOSE SCREENINGS. WHILE SOME CLINICS HAVE PROVIDED EXTENDED CLINIC HOURS IN THE COUNTY (EVENINGS AND WEEKENDS); WE WILL INVESTIGATE PROBABILITY OF INCREASED SITES. AGCH WILL WORK WITH OUR LOCAL PARTNERS TO FACILITATE A BETTER CONTINUUM OF CARE THROUGH DISCHARGE PLANNING AND CASE MANAGEMENT LINKING PATIENTS WITH SERVICES WITH EMPHASIS ON ACCESS TO PRESCRIPTION DRUGS, TRANSPORTATION, FOOD SERVICES, AND PROVIDER APPOINTMENTS AFTER DISCHARGE. KEY FINDINGS SUCH AS HOW TO NAVIGATE THE SYSTEM, AWARENESS OF EXISTING SERVICES, AFFORDABILITY OF CARE AND INADEQUATE USE OF PREVENTIVE CARE MAY LINK TO CULTURAL AWARENESS. SLO REGIONAL RIDESHARE WILL BE UTILIZED AS A RESOURCE TO COMMUNICATE ACCESSIBLE TRANSPORTATION FOR DISCHARGED PATIENTS. 2. EMERGENCY ROOM UTILIZATION: A COUNTY-WIDE EFFORT WITH ARROYO GRANDE COMMUNITY HOSPITAL WILL COLLABORATE WITH OTHER COMMUNITY PARTNERS TO BETTER FACILITATE HIGH-RISK PATIENTS DISCHARGED FROM THE EMERGENCY ROOM. IT IS PROPOSED TO FACILITATE OPEN COMMUNICATION BETWEEN ER AND PRIMARY CARE PROVIDERS (HEALTH INFORMATION EXCHANGE). AGCH WILL REVIEW PATIENT UTILIZATION OF THE ER TO SEE IF PATIENTS CAN BE REFERRED TO CLINICS OFFERING LATE HOURS FOR FUTURE TREATMENT. SOME COMMUNITY PARTNERS SUCH AS CAPSLO IN SLO COUNTY UTILIZE HEALTH NAVIGATORS TO SUPPORT PATIENTS NEEDING HEALTH RELATED SERVICES. KEY FINDINGS IDENTIFIED PATIENTS WHO UTILIZE THE EMERGENCY ROOM AS THEIR PRIMARY CARE PROVIDER MIGHT DO SO BECAUSE CLINIC HOURS ARE NOT CONDUCIVE FOR MIGRANT WORKERS THAT WORK PAST 6 PM AND ON SATURDAYS. THESE SAME MIGRANT WORKERS DELAY HEALTH CARE UNTIL IT IS AN EMERGENT NEED. 3. MENTAL HEALTH WAS IDENTIFIED AS A SUBSTANTIAL NEED FOR SLO COUNTY. WHILE THERE ARE MANY SERVICES BEING OFFERED BY LOCAL PARTNERS IN THE COMMUNITY MORE SERVICES ARE NEEDED. AGCH WILL PARTNER WITH LOCAL AGENCIES TO PROVIDE A CONTINUUM OF CARE FOR PATIENTS WHOSE MENTAL HEALTH ISSUES ARE IDENTIFIED AT THE TIME OF THEIR ADMISSION TO THE EMERGENCY ROOM. AGCH COULD EXPLORE THE POSSIBILITY OF A COLLABORATIVE WITH THE LOCAL POLICE DEPARTMENT TO PROVIDE AN OFFICER TRAINED IN MENTAL HEALTH ADVOCACY TO BE ON CALL FOR MENTAL HEALTH NEEDS AT THE EMERGENCY ROOM. 4. CLINICAL CONDITIONS SUCH AS: OBESITY, DIABETES, POOR DIETARY HABITS, AND NUTRITION AND PHYSICAL EXERCISE. AGCH OFFERS NUTRITION CLASSES IN BOTH ENGLISH AND SPANISH. EXERCISE CLASSES HAVE RECENTLY BEEN OFFERED AND WILL BE EXPANDED IN THE TWO IDENTIFIED TARGET AREAS. WHILE THERE IS A DIABETES PROGRAM ACCREDITED BY THE ADA ITS HOME BASE IS MARIAN REGIONAL MEDICAL CENTER. THE DIABETES PROGRAM NEEDS TO EXPAND INTO THE AGCH SERVICE AREA TO SERVE THE COMMUNITY IN A MORE LOCAL CAPACITY. MANY RESIDENTS IN THE AGCH SERVICE AREA DO NOT KNOW HOW TO NAVIGATE THE SYSTEM FOR NEEDED SERVICE; THEY ARE UNAWARE OF EXISTING SERVICES THAT MIGHT PROVIDE A BETTER USE FOR PREVENTIVE CARE. A MEDIA AND COMMUNICATION CAMPAIGN IS REQUIRED INTERNALLY AND EXTERNALLY TO PROMOTE AVAILABLE SERVICES. THIS COULD ENHANCE THE CONTINUUM OF CARE BETWEEN PROVIDERS IN THE COMMUNITY. BILINGUAL EDUCATION SHOULD BE PROVIDED FOR ALL PROGRAMS SINCE THE LATINO POPULATION IS THE TARGET POPULATION. ORAL HEALTH, CULTURAL AWARENESS AND TRANSPORTATION ARE THREE AREAS IDENTIFIED IN THE NEEDS ASSESSMENT THAT WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL. THE HOSPITAL OFFERS SPACE WITHIN THE FACILITY AND SUPPORT SERVICES FOR SOME ORAL HEALTH NEEDS, BUT THE HEALTH ISSUE IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC FOCUS ON CULTURAL AWARENESS OR TRANSPORTATION, BOTH WILL BE GIVEN CONSIDERATION AS THE OTHER HEALTH PRIORITIES ARE ADDRESSED. ST. BERNARDINE MEDICAL CENTER THE IDENTIFIED SIGNIFICANT HEALTH NEEDS INCLUDED: CHRONIC DISEASES (ASTHMA, CANCER, HEART DISEASE, DIABETES); ACCESS TO CARE; MENTAL HEALTH; OVERWEIGHT/OBESITY; PREVENTIVE HEALTH CARE; COMMUNITY GROWTH AND ENRICHMENT (SAFETY, HOMELESSNESS, EDUCATION, ECONOMIC DEVELOPMENT); ALCOHOL/DRUGS/TOBACCO; AND DENTAL HEALTH. THESE WERE SUMMARIZED INTO: ACCESS TO CARE; CHRONIC HEALTH CONDITIONS; AND YOUTH DEVELOPMENT. ACCESS TO CARE: EMERGENCY DEPARTMENT NAVIGATOR; FINANCIAL ASSISTANCE; ENROLLMENT ASSISTANCE INTO NO COST OR LOW COST COVERAGE; COMMUNITY EDUCATION, FLU SHOT CLINICS; COMMUNITY GRANTS PROGRAM. CHRONIC HEALTH CONDITIONS: COMMUNITY HEALTH EDUCATION. STANFORD UNIVERSITY CHRONIC DISEASE SELF-MANAGEMENT OFFERED IN ENGLISH AND SPANISH, WITH A FOCUS ON DIABETES AND HEART DISEASE. SWEET SUCCESS PROGRAM IS OFFERED TO EXPECTANT MOTHERS WITH DIABETES. YOUTH DEVELOPMENT: FAMILY FOCUS CENTER: PROVIDES THE OPPORTUNITY TO EDUCATE THE COMMUNITY'S AT-RISK YOUTH IN THE AREAS OF HEALTH, DRUG AND GANG AVOIDANCE, AND EDUCATION PROMOTION TO IMPROVE HIGH SCHOOL GRADUATION RATES. PROGRAMS INCLUD
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT ST. MARY MEDICAL CENTER - LONG BEACH HEALTH PRIORITY NEEDS IDENTIFIED WERE: ASTHMA, OBESITY, MENTAL HEALTH, DIABETES, AND HIGH BLOOD PRESSURE AND ARTHRITIS. ACCESS NEEDS IDENTIFIED WERE: LACK OF INSURANCE, HEALTH EDUCATION AND COMMUNITY OUTREACH ACTIVITIES, AND PROVIDING TRANSPORTATION. SOCIAL NEEDS IDENTIFIED WERE: LACK OF COMMUNITY EXERCISE PROGRAMS; POOR NUTRITION/LACK OF FOOD SUPPORT PROGRAM; LACK OF HEALTH INSURANCE/AFFORDABLE HEALTH CARE; AIR POLLUTION, AND DRUG AND ALCOHOL PROGRAMS. PREVENTION AND TREATMENT OF RESPIRATORY DISORDERS RELATED TO AIR POLLUTION WHICH WOULD INCLUDE BUT NOT LIMITED TO ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISORDER (COPD), AND ADVOCATING ON WAYS TO MAKE THE AIR CLEANER ESPECIALLY FOR VULNERABLE COMMUNITIES: PREVENTION AND TREATMENT OF OBESITY AND RELATED CHRONIC DISORDERS SUCH AS PROMOTION OF NUTRITION, IDENTIFICATION AND TREATMENT OF DIABETES AND HIGH BLOOD PRESSURE; ACCESS TO CARE/DELIVERY SYSTEM WORKING WITH DISPROPORTIONATE UNMET HEALTH NEEDS COMMUNITIES INCLUDING BUT NOT LIMITED TO DENTAL CARE; AND PROMOTION OF MENTAL WELLNESS AND HEALTH INCLUDING IDENTIFYING THOSE WHO NEED CARE AND PREVENTION ACTIVITIES. THE IDEA THAT THE FOCUS NEEDS TO BE DOABLE AND WILL MAKE AN IMPACT. THE ST. MARY MEDICAL CENTER BREATHE MOBILE UNIT FOCUSES ON IDENTIFYING, TREATING AND IMPROVING QUALITY OF LIFE FOR THOSE WITH RESPIRATORY ORDERS. THE OUTPATIENT DIABETES PROGRAM, WHICH WAS THE FIRST OUTPATIENT PROGRAM CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION IN THE GREATER LONG BEACH AREA, FOCUSES ON NUTRITION AND LIFESTYLE EDUCATION FOR THOSE WITH DIABETES. THE ST. MARY FAITH HEALTH AMBASSADOR PROGRAM WORKS WITH THE CHURCHES AND OTHER FAITH CONGREGATIONS TO ENSURE THAT COMMUNITIES IN NEED ARE LINKED TO ACCESS TO CARE AND ARE ASSISTED WITH HEALTH NAVIGATION, EDUCATION, AND INFORMATION. THE C.A.R.E. PROGRAM WORKS WITH MANY COMMUNITIES TO PROMOTE ACCESS TO CARE WITH THE HIV/AIDS AT RISK CLIENTS. ST. MARY TRANSPORTATION ELIMINATES A KEY BARRIER TO ACCESS TO CARE BY PROVIDING TRANSPORTATION FREE TO AND FROM THE CLIENT'S HOME. THE ST. MARY PASSAGES PROGRAM PROVIDES A GERIATRIC PSYCH DAY PROGRAM TO CREATE ACCESS TO MENTAL HEALTH FOR THOSE 55 AND OVER. IN ADDITION, ST. MARY MEDICAL CENTER WILL CONTINUE TO MEET COMMUNITY NEEDS BY PROVIDING CHARITY CARE AND MEDICAID (MEDICAL) SERVICES, CONTINUING THE ST. MARY CLINICS-PEDIATRIC, OB, FAMILY, HIGH RISK ANTENATAL, AND CARE. THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE FOLLOWING PRIORITIES: ARTHRITIS, EXERCISE CLASSES, DRUG AND ALCOHOL PROGRAMS, BEFORE AND AFTER SCHOOL PROGRAMS, COUNSELING AND ASSISTED LIVING. THESE ARE EITHER BEYOND THE EXPERTISE OF THE HOSPITAL OR ARE BEING ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS. ST. JOHN'S REGIONAL MEDICAL CENTER THE PRIORITIZATION PROCESS IDENTIFIED FIVE 'TOP PRIORITY' ISSUES FOR THE COMMUNITY PLUS A SIXTH NEEDING FURTHER STUDY: 1. DIVERSE NEEDS FROM A DIVERSE POPULATION THAT VIEWS, SEEKS HEALTHCARE DIFFERENTLY AND HOLDS DIFFERING EXPECTATIONS REGARDING CARE AND IMPACTING CARE DELIVERY. 2. LACK OF FINANCIAL RESOURCES (ESPECIALLY POVERTY) AS IT AFFECTS ACCESS TO HEALTH CARE, AS MOST SOCIO-ECONOMIC/AGE/ETHNIC STRATA WERE NEGATIVELY IMPACTED BY THE GREAT RECESSION OF 2009, WITH THE MARGINALIZED, UNINSURED AND UNDER-INSURED AND THOSE CONSIDERED AS LIVING IN POVERTY WERE IMPACTED THE WORSE. THE EFFECT WAS THAT FINANCIAL RESOURCES OR FINANCIAL INSECURITY PLAYED A LARGER ROLE THAN EVER BEFORE FOR INDIVIDUALS/FAMILIES IN PRIORITY SETTING FOR THEIR HEALTHCARE NEEDS. 3. CHRONIC DISEASE, INCLUDING: DIABETES, HEART DISEASES, RESPIRATORY DISEASES AND CANCER. 4. OBESITY RATES AMONG ADOLESCENTS IN TERMS OF BOTH CURRENT AND FUTURE IMPACT TO HEALTH OF THE COMMUNITY. 5. MENTAL HEALTH SERVICES IN TERMS OF RESOURCES AND ACCESS. 6. ENVIRONMENTAL ISSUES IMPACTING HEALTH. DIVERSE NEEDS FROM A DIVERSE POPULATION : ST. JOHN'S WILL CONTINUE TRAINING AND EDUCATING STAFF ON CULTURAL DIVERSITY, ESPECIALLY AS IT RELATES TO HEALTHCARE. OF PARTICULAR FOCUS WILL BE HISPANIC CULTURE FOR ST. JOHN'S OXNARD AND CARE OF THE AGED FOR ST. JOHN'S PLEASANT VALLEY HOSPITAL. COMMUNITY BENEFIT PROGRAMS, BOTH CURRENT AND FUTURE, MUST TAKE INTO ACCOUNT THIS ISSUE IN PROGRAM PLANNING AND SPECIFICALLY DELINEATE HOW THE COMMUNITY BENEFIT PROGRAM WILL ADAPT TO DIVERSITY IN DELIVERY OF THE PROGRAM. GIVEN THE LIKELY GROWTH OF HISPANIC POPULATION, CWIL HAS ALSO COMMISSIONED A FOLLOW-ON STUDY TO SURVEY HISPANIC PERCEPTION OF HEALTHCARE AND SPECIFIC NEEDS. THIS STUDY WILL BE COMPLETED IN 2013. LACK OF FINANCIAL RESOURCES AND POVERTY IMPACTING ACCESS TO HEALTH CARE: 1. ST. JOHN'S HOSPITALS' HEALTHY MINISTRY PROGRAMS WILL FOCUS ON THIS NEED BY CONTINUING TO PROVIDE ASSISTANCE FOR BASIC NEEDS SUCH AS RENT, UTILITIES, ETC. AND WILL CONTINUE WEEKLY OPERATION OF ITS FOOD PANTRY IN THE "COLONIA" SECTION OF OXNARD. IN 2013 EXPANSION TO THE CAMARILLO AREA WILL BE CONSIDERED SEEKING THE ASSISTANCE OF A COLLABORATING SITE IN THE CITY OF CAMARILLO AND OUR FOOD SUPPLIER-FOOD SHARE. 2. THE SHOTS FOR KIDS AND ADULTS PROGRAM WILL CONTINUE TO PROVIDE IMMUNIZATIONS AT NO OR LOW COST TO MEMBERS OF THE COMMUNITY. THE NEW MOBILE "WELLNESS VEHICLE" WILL MAKE OUTREACH IN THE COMMUNITY MORE A REALITY. DURING THE NEXT TWO YEARS WE WILL SEARCH FOR A PARTNER TO HELP ST. JOHN'S TAKE THIS PROGRAM TO THE FIELD WORKERS. 3. THE FAITH COMMUNITY NURSE NETWORK AND OTHER NO/LOW COST HEALTH SCREENING PROGRAMS (SUCH AS THE COLLABORATIVE HEALTH FAIR WITH SAI BABA AT OUR LADY OF GUADALUPE CHURCH) WILL EXPAND AS THE FCN NETWORK EXPANDS. 4. THE ST. JOHN'S RMC CAMPUS WILL ALSO LOOK TO EXPAND ITS EMERGENCY DEPARTMENT IN THE NEXT 3 YEARS AT AN ESTIMATED COST OF 5 MILLION DOLLARS. 5. ST. JOHN'S HOSPITALS WILL EXPAND CARE TO THE COMMUNITY BY OPENING ONE URGENT CARE IN CAMARILLO DURING 2013, WITH A SECOND IN THE PORT HUENEME/OXNARD AREA BY 2015 IN COLLABORATION WITH THE DIGNITY HEALTH MEDICAL FOUNDATION PHYSICIANS. 6. ST. JOHN'S THROUGH ITS DIGNITY HEALTH COMMUNITY GRANTS PROGRAM WILL COMMIT A SIGNIFICANT PORTION OF THE TOTAL $150,000 IN GRANTS TO INCREASING ACCESS OPPORTUNITIES TO THOSE WHO LACK FINANCIAL MEANS, ESPECIALLY THE POOR. CHRONIC DISEASES, INCLUDING: DIABETES, HEART DISEASE, RESPIRATORY DISEASES AND CANCER: ST. JOHN'S HOSPITALS WILL EXPAND ITS OFFERINGS OF FREE EDUCATION CLASSES TO THE COMMUNITY ON CHRONIC DISEASE SELF MANAGEMENT, IN ENGLISH AND SPANISH. ADDITIONALLY, DIABETES SELF MANAGEMENT AND SUPPORT GROUPS WILL EXPAND. TRAINING OF MORE EDUCATORS IS AN IDENTIFIED PRIORITY-ESPECIALLY PEER VOLUNTEERS. WE WILL SEEK THOSE VOLUNTEERS FROM AMONG THE FAITH COMMUNITY NURSE NETWORK, THE SENIOR CITIZEN COMMUNITY OF LEISURE VILLAGE LOCATED IN CAMARILLO, AND SPANISH SPEAKING PROMOTORAS FROM THE OXNARD COMMUNITY. WE WILL ALSO SEEK COLLABORATION WITH LOCAL COLLEGE'S AND UNIVERSITY'S NURSING PROGRAMS, BEGINNING WITH CALIFORNIA STATE UNIVERSITY, CHANEL ISLANDS IN CAMARILLO TO SEEK VOLUNTEERS FROM THOSE ENTERING THE PROFESSION TO BECOME TRAINED, FREE OF CHARGE, AS EDUCATORS IN THE STANFORD MODEL OF CHRONIC DISEASE SELF MANAGEMENT. THESE NEW PROFESSIONAL VOLUNTEERS WILL HOPEFULLY OFFER CDSM CLASSES THROUGH THEIR INSTITUTIONS OR ELSEWHERE IN THE COUNTY. THE EXISTING "KNOW YOUR NUMBERS" DIABETES PROGRAM CURRENTLY OFFERED IN OXNARD WILL ALSO BE EXPANDED TO ALSO OFFERING A PROGRAM IN CAMARILLO. OBESITY RATES ESPECIALLY AMONG ADOLESCENTS: ST. JOHN'S HOSPITALS LACK SUFFICIENT RESOURCES TO ADDRESS THIS NEED DIRECTLY IN THE COMMUNITY. HOWEVER, ST, JOHN'S THROUGH ITS DIGNITY HEALTH COMMUNITY GRANTS PROGRAM WILL DEDICATE A SIGNIFICANT AMOUNT OF THE TOTAL $150,000 IN GRANTS TO COLLABORATING ORGANIZATIONS WHO ARE ADDRESSING THIS PROBLEM WITH PROGRAMS THAT DEMONSTRATE MEASURABLE OUTCOMES FOR SUCCESS IN CHANGING LIFE STYLE TO REDUCE OBESITY. ST. JOHN'S WILL ALSO INVOLVE ITS PROFESSIONAL REGISTERED DIETICIAN STAFF IN PLANNING AND SELECTING VIABLE PROGRAMS. FOR EACH OF THE PRIORITY AREAS LISTED ABOVE, ST. JOHN'S HOSPITALS WILL WORK VIA CWIL AND COLLABORATING COMMUNITY PARTNERS WITH THE ASSISTANCE OF DIGNITY HEALTH LEADERSHIP TO: IDENTIFY ANY RELATED ACTIVITIES BEING CONDUCTED BY OTHERS IN THE COMMUNITY THAT COULD BE BUILT UPON OR INCORPORATED TO ADDRESS THE IDENTIFIED HEALTH NEEDS; DEVELOP MEASURABLE GOALS AND OBJECTIVES SO THAT THE EFFECTIVENESS OF PROGRAMS AND OTHER EFFORTS CAN BE MEASURED; BUILD SUPPORT FOR THE INITIATIVES WITHIN THE COMMUNITIES SERVED AND AMONG OTHER HEALTH CARE PROVIDERS TO ADDRESS THESE IDENTIFIED ISSUES; DEVELOP DETAILED ACTION PLANS FOR EACH OF THE IDENTIFIED HEALTH NEEDS; FURTHER STUDY CERTAIN ASPECTS OF THE IDENTIFIED NEEDS AND INCORPORATE THOSE FINDINGS INTO FUTURE PLANS. THE HOSPITAL HAS LIMITED ABILITY TO ADDRESS THE DIFFERENCES IN PROSPERITY/POVERTY AT A PUBLIC POLICY LEVEL, DUE TO A LACK OF A MEANINGFUL AVENUE TO APPROACH THIS ISSUE. NONETHELESS, THE HOSPITAL DOES HAVE REPRESENTATION ON THE GOLD COAST BOARD AND A MONTHLY NETWORKING MEETING IN AN ATTEMPT TO BUILD COHESION AT A HUMAN SERVICES PROVIDER LEVEL. THE CHNA NEED REGARD
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT ST. JOHN'S PLEASANT VALLEY HOSPITAL THE PRIORITIZATION PROCESS IDENTIFIED FIVE 'TOP PRIORITY' ISSUES FOR THE COMMUNITY PLUS A SIXTH NEEDING FURTHER STUDY: 1. DIVERSE NEEDS FROM A DIVERSE POPULATION THAT VIEWS, SEEKS HEALTHCARE DIFFERENTLY AND HOLDS DIFFERING EXPECTATIONS REGARDING CARE AND IMPACTING CARE DELIVERY. 2. LACK OF FINANCIAL RESOURCES (ESPECIALLY POVERTY) AS IT AFFECTS ACCESS TO HEALTH CARE, AS MOST SOCIO-ECONOMIC/AGE/ETHNIC STRATA WERE NEGATIVELY IMPACTED BY THE GREAT RECESSION OF 2009, WITH THE MARGINALIZED, UNINSURED AND UNDER-INSURED AND THOSE CONSIDERED AS LIVING IN POVERTY WERE IMPACTED THE WORSE. THE EFFECT WAS THAT FINANCIAL RESOURCES OR FINANCIAL INSECURITY PLAYED A LARGER ROLE THAN EVER BEFORE FOR INDIVIDUALS/FAMILIES IN PRIORITY SETTING FOR THEIR HEALTHCARE NEEDS. 3. CHRONIC DISEASE, INCLUDING: DIABETES, HEART DISEASES, RESPIRATORY DISEASES AND CANCER. 4. OBESITY RATES AMONG ADOLESCENTS IN TERMS OF BOTH CURRENT AND FUTURE IMPACT TO HEALTH OF THE COMMUNITY. 5. MENTAL HEALTH SERVICES IN TERMS OF RESOURCES AND ACCESS. 6. ENVIRONMENTAL ISSUES IMPACTING HEALTH. DIVERSE NEEDS FROM A DIVERSE POPULATION. ST. JOHN'S WILL CONTINUE TRAINING AND EDUCATING STAFF ON CULTURAL DIVERSITY, ESPECIALLY AS IT RELATES TO HEALTHCARE. OF PARTICULAR FOCUS WILL BE HISPANIC CULTURE FOR ST. JOHN'S OXNARD AND CARE OF THE AGED FOR ST. JOHN'S PLEASANT VALLEY HOSPITAL. COMMUNITY BENEFIT PROGRAMS, BOTH CURRENT AND FUTURE, MUST TAKE INTO ACCOUNT THIS ISSUE IN PROGRAM PLANNING AND SPECIFICALLY DELINEATE HOW THE COMMUNITY BENEFIT PROGRAM WILL ADAPT TO DIVERSITY IN DELIVERY OF THE PROGRAM. GIVEN THE LIKELY GROWTH OF HISPANIC POPULATION, CWIL HAS ALSO COMMISSIONED A FOLLOW-ON STUDY TO SURVEY HISPANIC PERCEPTION OF HEALTHCARE AND SPECIFIC NEEDS. THIS STUDY WILL BE COMPLETED IN 2013. LACK OF FINANCIAL RESOURCES AND POVERTY IMPACTING ACCESS TO HEALTH CARE 1. ST. JOHN'S HOSPITALS' HEALTHY MINISTRY PROGRAMS WILL FOCUS ON THIS NEED BY CONTINUING TO PROVIDE ASSISTANCE FOR BASIC NEEDS SUCH AS RENT, UTILITIES, ETC. AND WILL CONTINUE WEEKLY OPERATION OF ITS FOOD PANTRY IN THE "COLONIA" SECTION OF OXNARD. IN 2013 EXPANSION TO THE CAMARILLO AREA WILL BE CONSIDERED SEEKING THE ASSISTANCE OF A COLLABORATING SITE IN THE CITY OF CAMARILLO AND OUR FOOD SUPPLIER-FOOD SHARE. 2. THE SHOTS FOR KIDS AND ADULTS PROGRAM WILL CONTINUE TO PROVIDE IMMUNIZATIONS AT NO OR LOW COST TO MEMBERS OF THE COMMUNITY. THE NEW MOBILE "WELLNESS VEHICLE" WILL MAKE OUTREACH IN THE COMMUNITY MORE A REALITY. DURING THE NEXT TWO YEARS WE WILL SEARCH FOR A PARTNER TO HELP ST. JOHN'S TAKE THIS PROGRAM TO THE FIELD WORKERS. 3. THE FAITH COMMUNITY NURSE NETWORK AND OTHER NO/LOW COST HEALTH SCREENING PROGRAMS (SUCH AS THE COLLABORATIVE HEALTH FAIR WITH SAI BABA AT OUR LADY OF GUADALUPE CHURCH) WILL EXPAND AS THE FCN NETWORK EXPANDS. 4. THE ST. JOHN'S RMC CAMPUS WILL ALSO LOOK TO EXPAND ITS EMERGENCY DEPARTMENT IN THE NEXT 3 YEARS AT AN ESTIMATED COST OF 5 MILLION DOLLARS. 5. ST. JOHN'S HOSPITALS WILL EXPAND CARE TO THE COMMUNITY BY OPENING ONE URGENT CARE IN CAMARILLO DURING 2013, WITH A SECOND IN THE PORT HUENEME/OXNARD AREA BY 2015 IN COLLABORATION WITH THE DIGNITY HEALTH MEDICAL FOUNDATION PHYSICIANS. 6. ST. JOHN'S THROUGH ITS DIGNITY HEALTH COMMUNITY GRANTS PROGRAM WILL COMMIT A SIGNIFICANT PORTION OF THE TOTAL $150,000 IN GRANTS TO INCREASING ACCESS OPPORTUNITIES TO THOSE WHO LACK FINANCIAL MEANS, ESPECIALLY THE POOR. CHRONIC DISEASES, INCLUDING: DIABETES, HEART DISEASE, RESPIRATORY DISEASES AND CANCER. ST. JOHN'S HOSPITALS WILL EXPAND ITS OFFERINGS OF FREE EDUCATION CLASSES TO THE COMMUNITY ON CHRONIC DISEASE SELF MANAGEMENT, IN ENGLISH AND SPANISH. ADDITIONALLY, DIABETES SELF MANAGEMENT AND SUPPORT GROUPS WILL EXPAND. TRAINING OF MORE EDUCATORS IS AN IDENTIFIED PRIORITY-ESPECIALLY PEER VOLUNTEERS. WE WILL SEEK THOSE VOLUNTEERS FROM AMONG THE FAITH COMMUNITY NURSE NETWORK, THE SENIOR CITIZEN COMMUNITY OF LEISURE VILLAGE LOCATED IN CAMARILLO, AND SPANISH SPEAKING PROMOTORAS FROM THE OXNARD COMMUNITY. WE WILL ALSO SEEK COLLABORATION WITH LOCAL COLLEGE'S AND UNIVERSITY'S NURSING PROGRAMS, BEGINNING WITH CALIFORNIA STATE UNIVERSITY, CHANEL ISLANDS IN CAMARILLO TO SEEK VOLUNTEERS FROM THOSE ENTERING THE PROFESSION TO BECOME TRAINED, FREE OF CHARGE, AS EDUCATORS IN THE STANFORD MODEL OF CHRONIC DISEASE SELF MANAGEMENT. THESE NEW PROFESSIONAL VOLUNTEERS WILL HOPEFULLY OFFER CDSM CLASSES THROUGH THEIR INSTITUTIONS OR ELSEWHERE IN THE COUNTY. THE EXISTING "KNOW YOUR NUMBERS" DIABETES PROGRAM CURRENTLY OFFERED IN OXNARD WILL ALSO BE EXPANDED TO ALSO OFFERING A PROGRAM IN CAMARILLO. OBESITY RATES ESPECIALLY AMONG ADOLESCENTS ST. JOHN'S HOSPITALS LACK SUFFICIENT RESOURCES TO ADDRESS THIS NEED DIRECTLY IN THE COMMUNITY. HOWEVER, ST, JOHN'S THROUGH ITS DIGNITY HEALTH COMMUNITY GRANTS PROGRAM WILL DEDICATE A SIGNIFICANT AMOUNT OF THE TOTAL $150,000 IN GRANTS TO COLLABORATING ORGANIZATIONS WHO ARE ADDRESSING THIS PROBLEM WITH PROGRAMS THAT DEMONSTRATE MEASURABLE OUTCOMES FOR SUCCESS IN CHANGING LIFE STYLE TO REDUCE OBESITY. ST. JOHN'S WILL ALSO INVOLVE ITS PROFESSIONAL REGISTERED DIETICIAN STAFF IN PLANNING AND SELECTING VIABLE PROGRAMS. FOR EACH OF THE PRIORITY AREAS LISTED ABOVE, ST. JOHN'S HOSPITALS WILL WORK VIA CWIL AND COLLABORATING COMMUNITY PARTNERS WITH THE ASSISTANCE OF DIGNITY HEALTH LEADERSHIP TO: IDENTIFY ANY RELATED ACTIVITIES BEING CONDUCTED BY OTHERS IN THE COMMUNITY THAT COULD BE BUILT UPON OR INCORPORATED TO ADDRESS THE IDENTIFIED HEALTH NEEDS; DEVELOP MEASURABLE GOALS AND OBJECTIVES SO THAT THE EFFECTIVENESS OF PROGRAMS AND OTHER EFFORTS CAN BE MEASURED; BUILD SUPPORT FOR THE INITIATIVES WITHIN THE COMMUNITIES SERVED AND AMONG OTHER HEALTH CARE PROVIDERS TO ADDRESS THESE IDENTIFIED ISSUES; DEVELOP DETAILED ACTION PLANS FOR EACH OF THE IDENTIFIED HEALTH NEEDS; FURTHER STUDY CERTAIN ASPECTS OF THE IDENTIFIED NEEDS AND INCORPORATE THOSE FINDINGS INTO FUTURE PLANS. THE HOSPITAL HAS LIMITED ABILITY TO ADDRESS THE DIFFERENCES IN PROSPERITY/POVERTY AT A PUBLIC POLICY LEVEL, DUE TO A LACK OF A MEANINGFUL AVENUE TO APPROACH THIS ISSUE. NONETHELESS, THE HOSPITAL DOES HAVE REPRESENTATION ON THE GOLD COAST BOARD AND A MONTHLY NETWORKING MEETING IN AN ATTEMPT TO BUILD COHESION AT A HUMAN SERVICES PROVIDER LEVEL. THE CHNA NEED REGARDING "CONTINUING ENVIRONMENTAL DEGRADATION" IS NOT ADDRESSED DUE TO A LACK OF STAFF AND FUNDING; HOWEVER ST. JOHN'S HOSPITAL HAS AN EFFECTIVE IN-HOUSE ECOLOGY PROGRAM WHICH IS INTENDED TO REDUCE THE FACILITY'S OWN ECOLOGICAL FOOTPRINT. ST. ELIZABETH COMMUNITY HOSPITAL IDENTIFIED HEALTH RISK BEHAVIORS: POOR EATING HABITS, BEING OVERWEIGHT, ALCOHOL ABUSE, LACK OF EXERCISE, TOBACCO USE, NOT USING BIRTH CONTROL. IDENTIFIED HEALTH CONCERNS: OBESITY, MENTAL HEALTH PROBLEMS, DIABETES, AGING PROBLEMS (ARTHRITIS, HEARING/VISION LOSS, ETC.), CHILD ABUSE/NEGLECT, DENTAL PROBLEMS, CANCERS, DOMESTIC VIOLENCE, HEART DISEASE AND/OR STROKE. THE HOSPITAL REMAINS COMMITTED TO DEVELOPING PROGRAMS AND SERVICES NOT ONLY BASED ON THE OUTCOMES FROM THE COMMUNITY HEALTH ASSESSMENT BUT ALSO FOCUSED ON THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN ADDITION TO SPECIFIC COMMUNITY BENEFIT PROGRAMS, THE HOSPITAL IS COMMITTED TO PROVIDING PAYMENT ASSISTANCE TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED OR UNDER-INSURED. CONGESTIVE HEART FAILURE (CHF) - THE CHF PROGRAM CONSISTS OF FOLLOW-UP PHONE CALLS AND DISCHARGE INTERVENTION TO PROMOTE WELLNESS AND IS CONDUCTED BY AN RN. PATIENTS AND PUBLIC HAVE ACCESS TO CARDIAC SUPPORT EDUCATION CLASSES. UPON DISCHARGE, THE CHF PATIENTS RECEIVE A SELF-CARE HANDBOOK: LEARNING TO LIVE WITH HEART FAILURE. ALSO AVAILABLE FOR CHARITY CARE PATIENTS, SCALES TO WEIGH THEMSELVES FOR UNEXPECTED RAPID WEIGHT GAIN WHICH INDICATES BUILD-UP OF FLUIDS. HEALTHIER LIVING - CHRONIC DISEASE SELF-MANAGEMENT PROGRAM -THE HOSPITAL WILL CONTINUE TO PROVIDE THE HEALTHIER LIVING WORKSHOP FOR ADULTS WHO HAVE A CHRONIC HEALTH CONDITION OR WHO LIVE WITH SOMEONE WITH A CHRONIC HEALTH CONDITION. HEALTHIER LIVING WORKSHOP PARTICIPANTS LEARN HOW TO MANAGE STRESS, FIGHT FATIGUE AND PAIN, LEARN HOW TO COMMUNICATE WITH THEIR DOCTOR AND FAMILY MEMBERS AND SET GOALS AND LEARN PROBLEM SOLVING TECHNIQUES. WHILE THE HEALTH NEEDS AND RISKS OF MENTAL HEALTH, CHILD ABUSE/NEGLECT, DOMESTIC VIOLENCE, AND DENTAL PROBLEMS WERE IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT, THE HOSPITAL HAS LIMITED RESOURCES AND ABILITY TO EFFECT SUSTAINABLE CHANGE FOR THESE NEEDS. THE HOSPITAL WILL CONTINUE TO PROVIDE RESOURCES TO COMMUNITY ORGANIZATIONS THAT ARE PROVIDING SERVICES IN THESE AREAS THOUGH THE COMMUNITY GRANTS PROGRAM OR THROUGH APPROPRIATE DONATIONS AND SPONSORSHIPS OF THEIR ACTIVITIES. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL THE CHNA IDENTIFIED FIVE ISSUES AS HEALTH PRIORITIES: OBESITY, DIABETES, LUNG CANCER, CARDIOVASCULAR DISEASE, AND ACCESS TO HEALTH CARE. CONTRIBUTING RISK FACTORS AND SOCIAL DETERMINANTS OF HEALTH RELATED TO THESE HEALTH PRIORITIES INCLUDE THE ABILITY TO ACCESS CARE AND ALS
SECTION B, LINE 13H - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA DIGNITY HEALTH OPERATES THREE FOR-PROFIT HOSPITALS THROUGH JOINT VENTURE ARRANGEMENTS. THESE HOSPITALS ARE SPECIALTY HOSPITALS THAT PRIMARILY PROVIDE ELECTIVE SURGERY TO PATIENTS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY PATIENTS. ARIZONA GENERAL HOSPITAL IS CURRENTLY DEVELOPING A FINANCIAL ASSISTANCE PROGRAM. THE OPERATING AGREEMENT WITH THIS JOINT VENTURE REQUIRES COMPLIANCE WITH SECTION 501(R), INCLUDING THE ADOPTION OF A FINANCIAL ASSISTANCE AND EMERGENCY MEDICAL CARE POLICY. CURRENTLY, INDIVIDUALS WHO PRESENT THEMSELVES AT THIS LOCATION WHO NEED FINANCIAL ASSISTANCE ARE STABILIZED AND TRANSFERRED TO ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER.
SECTION B, LINE 16b - FAP APPLICATION FORM WEBSITE ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/patients-and-visitors/for-patients/ billing-and-payment-information/payment-assistance MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/patients-visitors/for-patients/bil ling-information/payment-assistance MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/patients-visitors/for-patients/bil ling-information/payment-assistance ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.dignityhealth.org/stjosephs-stockton/patients-and-visitors/pati ents/billing-information/payment-assistance CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/patients-and-visitors/pati ents/billing-and-payment/payment-assistance MERCY MEDICAL CENTER REDDING http://www.dignityhealth.org/mercy-redding/patients-and-visitors/patients/ billing-information/payment-assistance-programs CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/patients-and-visitors/for-pa tients/billing-and-payment-services/payment-assistance-programs NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/patients-and-visitors/for- patients/payment-assistance DOMINICAN HOSPITAL http://www.dignityhealth.org/dominican/patients-and-visitors/patients/bill ing/payment-assistance MARIAN REGIONAL MEDICAL CENTER http://www.dignityhealth.org/marianregional/patients-and-visitors/patients /billing-information/payment-assistance ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/patients-and-visitors/pat ients/billing-and-payments/payment-assistance ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/patients-and-visitors/for-patients/ billing-information/payment-assistance MERCY HOSPITAL BAKERSFIELD http://www.dignityhealth.org/mercy-bakersfield/patients-and-visitors/patie nts/billing-information/payment-assistance MERCY MEDICAL CENTER MERCED http://www.dignityhealth.org/mercymedical-merced/patients-and-visitors/pat ients/billing-information/payment-assistance-programs METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/patients-visitors/for-patients/bil ling-information/payment-assistance ST. MARY MEDICAL CENTER - LONG BEACH http://www.dignityhealth.org/stmarymedical/patients-and-visitors/patients/ billing-payment-and-financial-services/payment-assistance-programs ST. JOHN'S REGIONAL MEDICAL CENTER http://www.dignityhealth.org/stjohnsregional/patients-and-visitors/patient s/billing-and-payment-information/payment-assistance SEQUOIA HOSPITAL http://www.dignityhealth.org/sequoia/patients-and-visitors/patients/billin g/payment-assistance MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/patients-visitors/for-patients/b illing-payment-services/payment-assistance-programs GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/patients-and-visitors/for-pa tients/billing-payment-and-financial-services/payment-assistance-programs ST. MARY'S MEDICAL CENTER http://www.dignityhealth.org/stmarys/patients-and-visitors/patients/billin g/payment-assistance MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/patients-visitors/for-patients/bil ling-information/payment-assistance WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/sacramento/patients-visitors/for-patients/bil ling-information/payment-assistance ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/patients-and-visitors/for-patients/ billing-information/payment-assistance FRENCH HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/frenchhospital/patients-and-visitors/patients /billing-information/payment-assistance ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/patients-and-visitors/for-patients/ billing-information/payment-assistance ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.dignityhealth.org/pleasantvalley/patients-and-visitors/patients /billing-and-payment-information/payment-assistance ST. ELIZABETH COMMUNITY HOSPITAL http://www.dignityhealth.org/stelizabethhospital/patients-and-visitors/pat ients/billing-information/payment-assistance-programs ARROYO GRANDE COMMUNITY HOSPITAL http://www.dignityhealth.org/arroyo-grande/patients-and-visitors/patients/ billing-information/payment-assistance MERCY MEDICAL CENTER MT. SHASTA http://www.dignityhealth.org/mercy-mtshasta/patients-and-visitors/patients /billing-information/payment-assistance-programs ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.dignityhealth.org/stjosephsbehavioral/patients-and-visitors/pat ients/billing-information/payment-assistance ST. JOSEPH'S WESTGATE MEDICAL CENTER http://www.dignityhealth.org/westgate/patients-and-visitors/for-patients/b illing-and-payments/payment-assistance
SECTION B, LINE 16i - OTHER MEASURES TO PUBLICIZE THE POLICY FOR ALL HOSPITALS THAT MARKED BOX 16I ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS, A COPY OF THE CHARITY CARE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION, AND THE FACILITY'S WEBPAGE ADDRESS WHERE ADDITIONAL INFORMATION AND APPLICATIONS CAN BE ACCESSED.
SECTION B, LINE 22D FOR ALL HOSPITALS THAT MARKED BOX 22D PATIENTS WHO ARE APPLYING FOR DISCOUNTS UNDER THE DISCOUNT PROVISION POLICY WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES. PATIENTS WHOSE INCOME IS ABOVE 350% BUT NOT MORE THAN 500% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT 135% OF THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES TO PATIENTS COVERED BY MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT-SPONSORED HEALTH ROGRAM OF HEALTH BENEFITS IN WHICH THE HOSPITAL PARTICIPATES.
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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?99
Name and address Type of Facility (describe)
1 St Joseph's Outpatient Surgery Center
240 West thomas Road
Phoenix,AZ85013 		Surgery Center
2 NICU Operating CO of Santa Cruz LLC
1555 Soquel Drive
Santa Cruz,CA95065 		Neonatal Healthcare
3 Simon Med - Greenfield (same as Guadalup
1425 S Greenfield Suite 114
Mesa,AZ85206 		Imaging Center
4 USP Surgery Center - Parkway
100 N Green Valley Pkwy 125
Henderson,NV89074 		Surgery Center
5 St Joseph's Surgery Center LP (USPI)
1800 N California Street Ste 1
Stockton,CA95204 		Surgery Center
6 Simon Med - Thunderbird III & III
5410 W Thunderbird Road Suites 100/
Glendale,AZ85306 		Imaging Center
7 Metro Surgery Center LP
3131 W Peoria Avenue
Phoenix,AZ95381 		Surgery Center
8 NSC Channel Islands LLC
2030 Wankel Way
Oxnard,CA93030 		Surgery Center
9 Folsom Sierra Endoscopy Center
1600 Creekside Drive
Folsom,CA95630 		Endoscopy Center
10 Desert Ridge Outpatient Surgery Center
20940 North Tatum Boulevard Suite 1
Phoenix,AZ85050 		Surgery Center
11 Folsom Outpatient Surgery Center (USPI)
1651 Creekside Drive
Folsom,CA95630 		Surgery Center Cyberknife
12 Simon Med - Dobson III
235 S Dobson Stes 1 1870 W Frye R
Chandler,AZ85224 		Imaging Center
13 Simon Med - Central Phoenix
2620 N 3rd St 102
Phoenix,AZ85004 		Imaging Center
14 Surgery Center of Peoria
13260 North 94th Drive Suite 200
Peoria,AZ85381 		Surgery Center
15 Simon Med - Mountain View
9201 E Mountain View Road Suite 150
Scottsdale,AZ85258 		Imaging Center
16 Surgery Center of Scottsdale (Main)
8962 East Desert Cove Drive
Scottsdale,AZ85260 		Surgery Center
17 Simon Med - Spectrum
2680 S Val Vista Drive Bldg 7 Suite
Gilbert,AZ85295 		Imaging Center
18 USP Surgery Center - Durango
8530 W Sunset Road
Las Vegas,NV89113 		Surgery Center
19 Simon Med - Avondale
10815 W McDowell Rd Suite 102
Avondale,AZ85323 		Imaging Center
20 Warner Park Ambulatory Surgical
604 West Warner Road Bldg A
Chandler,AZ85225 		Surgery Center
21 DH Nevada Imaging Center Siena
861 Coronada Center Drive 101
Henderson,NV89052 		Imaging Center
22 Court Street Surgery Center
2184 Court Street
Redding,CA96001 		Surgery Center
23 Renaissance Imaging Center at Northridge
18436 Roscoe Boulevard
Northridge,CA91328 		Imaging Center
24 Pleasanton Surgery Center (USPI)
4626 Willow Road Ste 100
Pleasanton,CA94588 		Surgery Center
25 Mercy Surgery Center
2175 Rosaline Avenue Suite A
Redding,CA96001 		Surgery Center
26 Coastal Surgical Specialist Inc
921 Oak Park Boulevard 100B
Pismo Beach,CA93449 		Surgery Center
27 CBCC Outsmarting Cancer LLC
6501 Truxtun Avenue
Bakersfield,CA93309 		Radiation / Oncology incl cyberknife
28 Radiation Oncology Center of Ventura Cou
1700 N Rose Avenue 120
Oxnard,CA93030 		Imaging Center
29 Simon Med - Sun City - Peoria
9403 W Thunderbird Road
Peoria,AZ95381 		Imaging Center
30 Simon Med - Fashion Square
6740 E Camelback Road Suites 100
Scottsdale,AZ85251 		Imaging Center
31 Chandler Endoscopy Center
2095 W Pecos Road Suite 1
Chandler,AZ85224 		Surgery Center
32 Simon Med - Desert Ridge
20830 N Tatum Blvd Suite 190
Phoenix,AZ85050 		Imaging Center
33 Simon Med - Dobson Imaging (PDI)
1111 S Dobson Road
Mesa,AZ85202 		Imaging Center
34 Crockett School Family Practice Clinic
4825 E Roosevelt Street
Phoenix,AZ85008 		Surgery Center
35 Simon Med - Baywood
130 S 63rd Street Bldg 4
Mesa,AZ85206 		Imaging Center
36 St John's Regional Imaging Center LLC
1700 N Rose Avenue 110
Oxnard,CA93030 		Imaging center
37 Simon Med - Queen Creek
36297 N Gantzel Road Suite 101
Queen Creek,AZ85140 		Imaging Center
38 Simon Med - Deer Valley
20414 N 27th Avenue
Phoenix,AZ85027 		Imaging Center
39 Roseville USP Surgery Center
1420 E Roseville Parkway No 100
Roseville,CA95661 		Surgery Center
40 Simon Med - Surprise Stadium Village
14823 W Bell Road Suite 110
Surprise,AZ85374 		Imaging Center
41 Stockton Outpatient Surgery Center LLC
2388 N California Street
Stockton,CA95204 		Surgery Center
42 Simon Med - Palm Valley III (aka Goodye
13657 W McDowell Rd Suites 207 21
Goodyear,AZ85338 		Imaging Center
43 Simon Med - Ahwatukee
15810 S 45th Street Suite 110
Phoenix,AZ85048 		Imaging Center
44 Simon Med - Sun City West
13624 W Camino Del Sol Suite 300
Sun City West,AZ85375 		Imaging Center
45 Santa Cruz Surgery Center
3003 Paul Sweet Road
Santa Cruz,CA95065 		Surgery Center
46 Huger Mercy Living Center
2345 W Orangewood
Phoenix,AZ85021 		Assisted Living Facility
47 Plaza Surgery Center
525 E Plaza 100
Santa Maria,CA93454 		Surgery Center
48 Surgery Center of ScottsdaleGilbert
2450 E Guadalupe Rd Suite 101
Gilbert,AZ85234 		Surgery Center
49 Simon Med - Prescott Valley
3033 N Windsong Drive Suite 102
Prescott Valley,AZ86314 		Imaging Center
50 St Joseph's Medical Group Maternal Fetal
1727 W Frye Suite 210
Chandler,AZ85224 		Multi-specialty clinics
51 Simon Med - San Francisco
325 Sacramento Street
San Francisco,CA94104 		Imaging Center
52 Simon Med - Daly City
455 Hickey Blvd Suite 200
Daly City,CA94015 		Imaging Center
53 Simon Med - 19th Avenue
6707 N 19th Avenue Suite 108
Phoenix,AZ85015 		Imaging Center
54 Templeton Surgery Center
1310 Las Tables Road Suite 104
Templeton,CA93465 		Surgery Center
55 21st Century Oncology (Redding)
963 Butte Street
Redding,CA96001 		Oncology
56 Simon Med - Chandler Imaging (PDI)
725 S Dobson Road Suite 105
Chandler,AZ85224 		Imaging Center
57 Surgery Center of ScottsdaleGlendale
18555 N 79th Avenue Suite C104
Glendale,AZ853088370 		Surgery Center
58 Simon Med - OPEN MRI & Imaging Phoenix
1331 N 7th Street Suite 150
Phoenix,AZ85006 		Imaging Center
59 Simon Med - Superstition Imaging (PDI)
875 N Greenfield Road Suite 107
Gilbert,AZ85234 		Imaging Center
60 Woodland Adult Day Health
20 N Cottonwood Street
Woodland,CA95695 		Health Center
61 Dominican Magnetic Resonance Imaging Cen
1545 Soquel Drive
Santa Cruz,CA95065 		Imaging Center
62 Sacramento Midtown Endoscopy
3941 J Street
Sacramento,CA95819 		Endoscopy Center
63 Dominican Breast Center
1661 Soquel Drive Bldg G
Santa Cruz,CA95065 		Oncology
64 St Joseph's Medical Group Adult Cardiova
1727 W Frye Suite 210
Chandler,AZ85224 		Multi-specialty clinics
65 Simon Med - Monterey
665 Munras Avenue 109
Monterey,CA93940 		Imaging Center
66 St Joseph's Medical Group Peoria North C
7727 W Deer Valley Road
Peoria,AZ85382 		Multi-specialty clinics
67 Simon Med - Redwood City
345 Convention Way Suite D1
Redwood City,CA94063 		Imaging Center
68 Simon Med - Mesa Drive
456 N Mesa Drive
Mesa,AZ85201 		Imaging Center
69 Simon Med - Orange Grove LLC
1845 W Orange Grove Rd Bldg 5 Suite
Tucson,AZ85704 		Imaging Center
70 Trinity Care Infusion Services
18440 Roscoe Boulevard
Northridge,CA91325 		Infusion Center
71 Dignity Health Medical Group Nevada LLC
8205 W Warm Springs Rd Suite 210
Las Vegas,NV89113 		Multi-specialty clinics
72 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 101
Henderson,NV89052 		Multi-specialty clinics
73 DH Nevada Imaging Center Spring Valley
5495 S Rainbow Blvd 101 103 203
Las Vegas,NV89118 		Imaging Center
74 Simon Med - Los Gatos
14651 S Bascom
Los Gatos,CA95032 		Imaging Center
75 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 209
Henderson,NV89052 		Multi-specialty clinics
76 Simon Med - Academy (LLC)
310 N Wilmot Rd - 302 303 304
Tucson,AZ85711 		Imaging Center
77 Southwest Lithotripsy
100 W Third Ave Suite 350
Columbus,OH43201 		Lithotripsy
78 Simon Med - Stand Up MRI of Beverly Hill
8370 Wilshire Blvd Suite 110
Beverly Hills,CA90211 		Imaging Center
79 Dignity Health Medical Group Nevada LLC
8689 W Charleston Blvd Suite 105
Las Vegas,NV89117 		Multi-specialty clinics
80 Santa Cruz Comprehensive Imaging LLC
1685 Commercial Way
Santa Cruz,CA95065 		Imaging Center
81 Simon Med - Burlingame
1860 El Camino Real Suite 101
Burlingame,CA94010 		Imaging Center
82 Valley Physicians Surgery Center
18330 Roscoe Boulevard
Northridge,CA91325 		Imaging Center
83 Simon Med - San Francisco - MRI
50 Francisco Street Suite 105
San Francisco,CA94133 		Imaging Center
84 Simon Med - San Rafael
4144 Redwood Highway Suite B
San Rafael,CA94903 		Imaging Center
85 NICU Sequoia Lucile Packard Children Hos
170 Alameda de las Pulgas
Redwood City,CA94062 		Neonatal Healthcare
86 Dignity Health Medical Group Nevada LLC
102 E Lake Mead Pkwy Suite 104
Henderson,NV89015 		Multi-specialty clinics
87 Simon Med - Mountain View
105 South Drive St100/110
Mountain View,CA94040 		Imaging Center
88 The Barbara Greenspun Women's Care Cente
100 N Green Valley Pkwy Suite 330
Henderson,NV89074 		Health Center
89 Surgery Center of ScottsdalePHX Metro
3131 West Peoria Avenue
Phoenix,AZ85029 		Surgery Center
90 Mercy Davis Cancer Center LLC
333 Mercy Avenue
Merced,CA95340 		Cancer Center
91 OMG Arizona LLC
2201 E Camelback Road Suite 101A
Phoenix,AZ85016 		Multi-specialty clinics
92 Simon Med - Thompson Peak
7304 E Deer Valley Road Bldg E
Scottsdale,AZ85255 		Imaging Center
93 Simon Med - McCormick Ranch
8630 E Via De Ventura St 208
Scottsdale,AZ85258 		Imaging Center
94 Simon Med - Fiesta
1457 W Southern Ave Suite 26
Mesa,AZ85202 		Imaging Center
95 21st Century Oncology (Mt Shasta)
902 Pine Street
Mt Shasta,CA96067 		Oncology
96 Northern Arizona Congenital Heart Center
1330 Rim Drive Suite A
Flagstaff,AZ86001 		Congenital Heart Center
97 Redding Surgery Center
2439 Sonoma
Redding,CA96001 		Surgery Center
98 CHWUSP Oxnard Surgery Centers LLC
1700 N Rose Avenue Ste 100
Oxnard,CA93030 		Surgery Center
99 Radiation Oncology Center of Ventura Cou
5301 Mission Oaks Boulevard Suite A
Camarillo,CA93012 		Surgery Center
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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
PART I, LINES 6A & 6B - COMMUNITY BENEFIT EACH TAX-EXEMPT HOSPITAL FACILITY LISTED IN SCHEDULE H, PART V, PREPARED A SEPARATE COMMUNITY BENEFIT REPORT. CALIFORNIA HOSPITALS SUBMIT THEIR REPORTS TO THE OFFICE OF STATEWIDE HEALTH PLANNING DEPARTMENT AND NEVADA HOSPITALS SUBMIT THEIR REPORTS TO THE NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIGNITY HEALTH INCLUDES A CONSOLIDATED COMMUNITY BENEFIT REPORT IN ITS ANNUAL AUDITED FINANCIAL STATEMENTS FOR ITS HOSPITALS AND THE HOSPITALS OF RELATED ORGANIZATIONS THAT ARE CONSOLIDATED FOR FINANCIAL REPORTING PURPOSES (SEE PART VI, LINE 6). DIGNITY HEALTH'S FINANCIAL STATEMENTS ARE POSTED ON DIGNITY HEALTH'S EXTERNAL WEB SITE. THE INDIVIDUAL HOSPITALS' COMMUNITY BENEFIT REPORTS ARE MADE AVALABLE TO THE PUBLIC ON BOTH DIGNITY HEALTH'S AND EACH HOSPITAL'S WEB SITES, AND ARE AVAILABLE BY REQUEST.
Part I, Line 7 - FINANCIAL ASSISTANCE & CERTAIN OTHER COMMUNITY BENEFITS A COSTING METHODOLOGY IS USED TO CALCULATE FINANCIAL ASSISTANCE FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE. DIGNITY HEALTH USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO PATIENTS. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL HOSPITAL WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE CALCULATION ON WORKSHEET 2 OF THE INSTRUCTIONS FOR FORM 990, SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN AGGREGATED FOR EACH PATIENT BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH SERVICES PROVIDED TO EACH PATIENT. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF PAYMENT ASSISTANCE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR PAYMENT ASSISTANCE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH AND CASH AND IN-KIND DONATIONS. PART I, LINE 7B - MEDICAID INCLUDED IN COMMUNITY BENEFIT EXPENSE FOR MEDICAID, COLUMN (C) IS $680.0 MILLION OF QUALITY ASSURANCE FEES ASSESSED TO DIGNITY HEALTH IN ACCORDANCE WITH THE CALIFORNIA PROVIDER FEE PROGRAMS. INCLUDED IN DIRECT OFFSETTING REVENUE FOR MEDICAID, COLUMN (D), IS $1.17 BILLION IN SUPPLEMENTAL PAYMENTS RECEIVED UNDER THESE PROGRAMS. PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), WHICH IS NON-PATIENT RELATED BAD DEBT EXPENSE, IS $744,563 AND HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN COLUMN (F). PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES INCLUDED IN SUBSIDIZED HELATH SERVICES IS $5.5 MILLION OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION. PART I, LINE 7I INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $19.50 MILLION IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT"). CHFT WAS ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA.
Part II - COMMUNITY BUILDING ACTIVITIES DIGNITY HEALTH'S EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED GO BEYOND PROVIDING HEALTH SERVICES. DIGNITY HEALTH SUPPORTS COMMUNITIES BY OFFERING THE EXPERTISE AND SERVICES OF THE ORGANIZATION IN MULTIPLE WAYS. DIGNITY HEALTH TAKES A PROACTIVE APPROACH TO ADDRESSING THE SOCIAL AND ECONOMIC BARRIERS TO GOOD HEALTH, AND SUPPORTS THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH AS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. THROUGH THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM, LOW INTEREST LOANS AND LINES OF CREDIT ARE PROVIDED TO NON-PROFITS THAT ARE ADDRESSING SOCIAL DETERMINANTS OF HEALTH, INCLUDING AFFORDABLE HOUSING AND SOCIAL SERVICES VITAL TO A COMMUNITY'S HEALTH. THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM HAS PROVIDED LOANS TOTALING $179 MILLION SINCE ITS INCEPTION IN 1990. SIXTY-FOUR MILLION DOLLARS IN LOANS AND GUARANTEES ARE CURRENTLY APPROVED. THE INVESTMENT IMPACTS HAVE INCLUDED: HOUSING - FORTY-SIX PERCENT OF DIGNITY HEALTH'S LOAN DOLLARS HAVE BEEN TO SUPPORT AFFORDABLE HOUSING IN VULNERABLE COMMUNITIES. NEARLY 500 RENTALS AND HOMES HAVE BEEN CONSTRUCTED OR IMPROVED IN CALIFORNIA, AND 180 UNITS OF AFFORDABLE SENIOR RENTAL AND ASSISTED LIVING UNITS HAVE BEEN DEVELOPED IN NEVADA; COMMUNITY DEVELOPMENT - ACCESS TO SHELTERS SERVING HOMELESS INDIVIDUALS DISCHARGED FROM HOSPITAL EMERGENCY ROOMS HAVE BEEN PROVIDED IN CENTRAL LOS ANGELES AND PHOENIX; COMMUNITY CLINICS - EXPANSION OF TWO HEALTH CENTERS IN SANTA CRUZ HAS BEEN PROVIDED AS WELL AS FINANCING ASSISTANCE OF AN INNOVATIVE TRANSIT ORIENTED DEVELOPMENT PROJECT IN THE WATTS DISTRICT OF SOUTH LOS ANGELES, REFURBISHING A 140-UNIT RENTAL COMPLEX THAT WILL HAVE A NEW FEDERALLY QUALIFIED HEALTH CLINIC ON THE PREMISES; FRESH FOODS - THE FRESHWORKS FUND INVESTED OVER $31 MILLION IN 11 HEALTHY FOOD PROJECTS AND CREATED NEARLY 400 NEW JOBS; MICROLENDING - FINANCED 55 SMALL BUSINESSES IN ARIZONA, NEVADA AND CALIFORNIA; AND INTERMEDIARIES - LOANS WILL LEVERAGE $25 MILLION FOR THE CONSTRUCTION OF AFFORDABLE HOUSING AND COMMUNITY FACILITIES (PRIMARY HEALTH CLINICS) FOR THE ELDERLY AND DISABLED. GRANTS ARE OFFERED TO COMMUNITY ORGANIZATIONS FOR THE PURPOSE OF HELPING ENSURE A CONTINUUM OF CARE AND SOCIAL SUPPORT FOR THE COMMUNITY. YOUTH PROGRAMS FOCUS ON ACTIVITIES TO DETER DELINQUENCY, DEVELOP LEADERSHIP SKILLS, ENHANCE LITERACY AND ACADEMIC SUCCESS, IMPROVE HEALTH, CULTIVATE COMMUNITY RESPONSIBILITY, PROVIDE EDUCATION WITH CULTURAL ENRICHMENT, AND OFFER CAREER EXPLORATION OPPORTUNITIES. DIGNITY HEALTH HOSPITALS OPEN THEIR DOORS TO COMMUNITY GROUPS AND ALSO SERVE AS MEMBERS OF COMMUNITY COALITIONS THAT FOCUS ON THE WELL-BEING OF THEIR RESPECTIVE COMMUNITIES. DIGNITY HEALTH ADVOCACY REPRESENTATIVES WORK TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE THE HEALTH OF THE PUBLIC, AND ADVOCATE FOR SOCIAL JUSTICE AND HUMAN RIGHTS AS PART OF A MISSION-DRIVEN "FOUNDATIONAL" ADVOCACY. IN MEDICALLY UNDERSERVED AREAS, EFFORTS TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS ARE ONGOING, AS ARE PARTNERSHIPS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORK-FORCE SHORTAGES. MANY DIGNITY HEALTH HOSPITALS OFFER HEALTH CAREER MENTORING PROJECTS AND PROVIDE SCHOOL-BASED AND COMMUNITY PROGRAMS THAT DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE. COMMUNITY BUILDING - PHYSICAL IMPROVEMENTS AND HOUSING EXAMPLES OF PHYSICAL IMPROVEMENTS AND HOUSING INCLUDE LOW-INTEREST LOANS THROUGH THE COMMUNITY INVESTMENT PROGRAM, SUBSIDIZING LOW INCOME HOUSING UNITS IN SANTA CRUZ AND PARTNERING WITH "REBUILDING TOGETHER" TO RESTORE HOMES OF LOW INCOME INDIVIDUALS IN THE LAS VEGAS VALLEY. COMMUNITY BUILDING - ECONOMIC DEVELOPMENT ACTIVITIES INCLUDE THE PARTICIPATION OF LEADERSHIP STAFF OF SEVERAL DIGNITY HEALTH FACILITIES IN CHAMBERS OF COMMERCE AND VARIOUS CIVIC ORGANIZATIONS, AS WELL AS THROUGH CHARITABLE CONTRIBUTIONS AIMED AT ENSURING THE ECONOMIC DEVELOPMENT, VITALITY AND STABILITY OF THE LOCAL COMMUNITIES. COMMUNITY BUILDING - COMMUNITY SUPPORT DIGNITY HEALTH FACILITIES LEAD AND/OR COLLABORATE WITH OTHER COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF THE SUCCESS OF CHILDREN, YOUTH AND FAMILIES, WHICH ENGAGE AND STRENGTHEN THE COMMUNITIES SERVED. COMMUNITY BUILDING - ENVIRONMENTAL IMPROVEMENTS DIGNITY HEATH IS ENGAGED IN ONGOING EFFORTS TO REDUCE COMMUNITY ENVIRONMENTAL HAZARDS IN THE AIR, WATER AND GROUND, AS WELL AS THE SAFE REMOVAL OF OTHER TOXIC WASTE PRODUCTS, IN PART THROUGH ADVOCACY. THE COMMITMENT OF DIGNITY HEALTH TO IMPROVE AND SUSTAIN THE ENVIRONMENT IS CODIFIED BY POLICIES, INCLUDING A PURCHASING POLICY WHICH PURSUES MULTIPLE ENVIRONMENTAL GOALS TO REDUCE WASTE AT ITS SOURCE AND TO REDUCE THE AMOUNT OF VIRGIN MATERIALS PURCHASED. DIGNITY HEALTH ATTEMPTS TO PURCHASE GOODS WITH RECYCLED CONTENT AND ONCE PURCHASES REACH THE END OF THEIR INITIAL USE, DIGNITY HEALTH FOCUSES ON REUSE WITHIN THE HOSPITAL, TRANSFER TO OTHER USERS (SUCH AS COMMUNITY ORGANIZATIONS), RECYCLING, AND FINALLY, PROPER WASTE DISPOSAL. DIGNITY HEALTH HAS TRANSITIONED TO PRODUCTS THAT ARE FREE OF POLYVINYL CHLORIDE (PVC) AND DI (2-ETHYLHEXYL) PHTHALATE (DEHP) AND HAS ELIMINATED THE USE OF MERCURY. COMMUNITY BUILDING - LEADERSHIP DEVELOPMENT/TRAINING FOR COMMUNITY MEMBERS DIGNITY HEALTH HOSPITALS ARE COMMITTED TO BUILDING HEALTHIER COMMUNITIES THROUGH LEADERSHIP DEVELOPMENT, PARTICULARLY OF ADOLESCENT, TEEN AND YOUNG ADULT LEADERSHIP, AND CAREER DEVELOPMENT. COMMUNITY BUILDING - COALITION BUILDING THE DIGNITY HEALTH MISSION STATEMENT SPECIFICALLY CALLS UPON US "TO PARTNER WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE." IN THIS REGARD, DIGNITY HEALTH FACILITIES PROVIDE REPRESENTATION ON COMMUNITY COALITIONS AND COLLABORATIVE PARTNERSHIPS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY, AND HOST AND/OR PARTICIPATE IN COMMUNITY COALITION MEETINGS AND SPECIFIC PROJECTS AND INITIATIVES. COMMUNITY BUILDING - ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT STAFF AT DIGNITY HEALTH HOSPITALS ADVOCATE ON BEHALF OF THE POOR AND DISENFRANCHISED, PARTICULARLY FOR IMPROVED ACCESS TO HEALTH CARE SERVICES AS WELL AS FOR ENVIRONMENTAL IMPROVEMENTS. DIGNITY HEALTH ALSO ADVOCATES FOR SOCIAL JUSTICE AND HUMAN RIGHTS THROUGH DUES AND GIFTS TO ORGANIZATIONS THAT SUPPORT SOCIAL JUSTICE, AND BY ADVOCATING FOR SOCIAL JUSTICE, ENVIRONMENTAL RESPONSIBILITY AND HUMAN RIGHTS THROUGH INVESTMENTS AS A SHAREHOLDER. COMMUNITY BUILDING - WORKFORCE DEVELOPMENT DIGNITY HEALTH IS COMMITTED TO THE DEVELOPMENT OF THE HEALTH CARE WORKFORCE, AND ACTIVELY ENGAGES IN THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN MEDICALLY UNDERSERVED AREAS. DIGNITY HEALTH SUPPORTS THE TRAINING AND RECRUITMENT OF UNDERREPRESENTED MINORITIES AND PARTICIPATES IN COMMUNITY WORKFORCE BOARDS AND PARTNERSHIPS. SEVERAL DIGNITY HEALTH FACILITIES, AS WELL AS THE ORGANIZATION ITSELF, HAVE PARTNERED WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORKFORCE SHORTAGE AND ACTIVELY ENGAGE IN HEALTH CAREER MENTORING PROGRAMS.
Part III - BAD DEBT, MEDICARE, & COLLECTION PRACTICES SECTION A, LINE 2 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED. DIGNITY HEALTH PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 200%, 201%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 25% FOR PATIENTS SEEN AT CALIFORNIA AND ARIZONA FACILITIES, AND 30% FOR PATIENTS SEEN AT NEVADA FACILITIES. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. SECTION A, LINE 3 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT AS COMMUNITY BENEFIT DIGNITY HEALTH MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. SECTION A, LINE 4 - BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE FOLLOWING ARE EXCERPTS FROM DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2015, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. DIGNITY HEALTH REGULARLY REVIEWS ACCOUNTS AND CONTRACTS AND PROVIDES APPROPRIATE CONTRACTUAL ALLOWANCES AND RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS, A SIGNIFICANT PORTION OF DIGNITY HEALTH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, DIGNITY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBT RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. SECTION B, LINE 8 - COMMUNITY BENEFIT AND METHODOLOGY FOR DETERMINING MEDICARE COSTS DIGNITY HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. IN HOSPITALS, ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL OF $756.1 MILLION, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY DIGNITY HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $409.9 MILLION REPORTED ON PART III, SECTION B, LINE 7, FOR FEE FOR SERVICE MEDICARE PATIENTS, THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS. SECTION C, LINE 9B - COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE DIGNITY HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. DIGNITY HEALTH'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE DIGNITY HEALTH FACILITY, OR BILLING COMPANY RETAINED BY DIGNITY HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, DIGNITY HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF EACH HOSPITAL PATIENT PAYMENT ASSISTANCE DEPARTMENT. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, DIGNITY HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
PART VI, LINE 2 - NEEDS ASSESSMENT IN ADDITION TO CHNAS REPORTED IN PART V, SECTION B IN ADDITION TO EACH LICENSED HOSPITAL CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS, DIGNITY HEALTH CONTINUOUSLY ASSESSES THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES BY WORKING COLLABORATIVELY WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, OTHER NON-PROFIT CLINICS, PUBLIC HEALTH DEPARTMENTS, AND OTHER HEALTH, SOCIAL SERVICE AND COMMUNITY DEVELOPMENT ORGANIZATIONS. DIGNITY HEALTH GAINS AND MAINTAINS KNOWLEDGE OF HEALTH NEEDS IN PART THROUGH REFERRAL RELATIONSHIPS, SERVICE PLANNING ACTIVITIES, AND LOCAL ADVOCACY CONDUCTED IN CONJUNCTION WITH THESE COMMUNITY PARTNERS. DIGNITY HEALTH HOSPITALS CREATE AND MAKE WIDELY AVAILABLE TO THE PUBLIC ANNUAL COMMUNITY BENEFIT REPORTS THAT SUMMARIZE IDENTIFIED HEALTH NEEDS, UPDATE COMMUNITY DEMOGRAPHIC INFORMATION, AND REPORT ON RECENT AND PLANNED COMMUNITY HEALTH PROGRAMS, INCLUDING GOALS, OBJECTIVES AND MEASURABLE RESULTS. DIGNITY HEALTH ALSO USES HEALTH CARE UTILIZATION DATA TO ASSESS THE DEMAND FOR CARE FOR PERSONS PRESENTING WITH AMBULATORY CARE SENSITIVE CONDITIONS THAT EVIDENCE SUGGESTS COULD HAVE BEEN AVOIDED, AT LEAST IN PART, THROUGH MORE ROBUST COMMUNITY ACCESS TO OR USE OF PRIMARY AND PREVENTIVE OUTPATIENT CARE RESOURCES. HOSPITALS, COMMUNITY LEADERS, AND POLICY MAKERS USE SUCH DATA TO IDENTIFY COMMUNITY NEED LEVELS, TARGET RESOURCES, AND TRACK THE IMPACT OF PROGRAMMATIC AND POLICY INTERVENTIONS. DIGNITY HEALTH, IN PARTNERSHIP WITH TRUVEN HEALTH ANALYTICS, DEVELOPED A COMMUNITY NEED INDEX (CNI) WHICH PROVIDES AN AGGREGATE SCORE OF THE SOCIOECONOMIC BARRIERS THAT PUT RESIDENTS AT GREATER RISK OF NEEDING HEALTH SERVICES. THE CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS KNOWN TO CONTRIBUTE TO HEALTH DISPARITY. THESE INCLUDE INCOME, CULTURE/LANGUAGE, EDUCATION, HOUSING STATUS, AND INSURANCE COVERAGE. THE INDEX BASED ON THIS DATA IS CALCULATED ANNUALLY FOR EVERY ZIP CODE IN THE UNITED STATES. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATION FOR MANAGABLE CONDITIONS AS COMMUNITIES WITH THE LOWEST CNI SCORES. THE CNI PROVIDES COMPELLING EVIDENCE FOR ADDRESSING SOCIOECONOMIC BARRIERS WHEN CONSIDERING HEALTH POLICY AND LOCAL HEALTH PLANNING. THE TOOL HIGHLIGHTS HEALTH CARE DISPARITIES AND ENABLES HEALTH CARE PROVIDERS, POLICYMAKERS, AND OTHERS TO TARGET RESOURCES WHERE THEY ARE MOST NEEDED. ADDITIONAL INFORMATION ABOUT THE CNI IS ACCESSIBLE ON DIGNITY HEALTH'S WEBSITE: http://www.dignityhealth.org/cm/content/pages/community-investments.asp
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC FOR DIGNITY HEALTH'S WHOLLY OWNED HOSPITALS: INFORMATION ABOUT DIGNITY HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE DIGNITY HEALTH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES DIGNITY HEALTH'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS WITH ANNUAL INCOMES LESS THAN $250,000 RECEIVE AN UNINSURED DISCOUNT OF 25% FOR SERVICES PROVIDED IN A CALIFORNIA OR ARIZONA FACILITY, AND 30% FOR SERVICES PROVIDED IN A NEVADA FACILITY, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON DIGNITY HEALTH'S WEBSITE AT WWW.DIGNITYHEALTH.ORG. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. UNINSURED PATIENTS RECEIVE COPIES OF THE FINANCIAL ASSISTANCE AND MEDICAID APPLICATIONS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THAT THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF DIGNITY HEALTH REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE DIGNITY HEALTH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4 - COMMUNITY INFORMATION DIGNITY HEALTH HOSPITALS DELIVER CARE TO DIVERSE COMMUNITIES ACROSS ARIZONA, CALIFORNIA AND NEVADA. FOLLOWING ARE BRIEF DESCRIPTIONS AND DEMOGRAPHIC SUMMARIES OF THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS. DIGNITY HEALTH HOSPITALS DEFINE THE COMMUNITY AS THE PRIMARY GEOGRAPHIC AREA SERVED BY THE HOSPITAL. THIS IS BASED ON A MAJORITY PERCENTAGE OF HOSPITAL DISCHARGES. SECONDARY SERVICE AREAS INCLUDE NEIGHBORING AREAS AND POPULATIONS BEYOND THE PRIMARY SERVICE AREAS THAT HAVE UNMET HEALTH NEEDS. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, LOCATED IN PHOENIX, ARIZONA, IDENTIFIES ITS PRIMARY SERVICE AREA AS MARICOPA COUNTY. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 4,013,164 DIVERSITY: CAUCASIAN 56.7%, LATINO/HISPANIC 29.1%, ASIAN/PI 4.3%, BLACK OR AFRICAN AMERICAN 4.6%, AMERICAN INDIAN/ALASKA NATIVE 2.7%, TWO OR MORE RACES 2.6%, OTHER 0.0% MEDIAN HOUSEHOLD INCOME: $53,596 UNINSURED: 19.0% UNEMPLOYMENT: 6.0% NO HS DIPLOMA: 13.6% CNI SCORE: 3.9 MEDICAID POPULATION: 35,773 OTHER AREA HOSPITALS: 48 MERCY SAN JUAN MEDICAL CENTER'S PRIMARY SERVICE AREA ENCOMPASSES A BROAD SUBURBAN AREA IN THE NORTHERN PORTION OF SACRAMENTO COUNTY AND EXTENDS INTO SOUTH PLACER COUNTY. WITHIN ITS PRIMARY SERVICE AREA, THE HOSPITAL SERVES CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, NORTH HIGHLANDS, ANTELOPE, AND OTHER SURROUNDING NEIGHBORHOODS. POPULATION: 905,627 DIVERSITY: CAUCASIAN 61.1%, HISPANIC 19.3%, AFRICAN AMERICAN 6.1%, ASIAN/PI 8.5%, AMERICAN INDIAN/ALASKA NATIVE 0.6%, TWO OR MORE RACES 4.2%, OTHER 0.2% MEDIAN HOUSEHOLD INCOME: $56,028 UNINSURED: 9.2% UNEMPLOYMENT: 8.7% NO HS DIPLOMA: 10.7% CNI MEDIAN SCORE: 3.6 MEDICAID POPULATION: 23.6% OTHER AREA HOSPITALS: 6 MERCY GENERAL HOSPITAL, A TERTIARY CARE FACILITY, SERVES RESIDENTS FROM A BROAD GEOGRAPHIC AREA. THE HOSPITAL'S PRIMARY SERVICE AREA LIES IN THE CENTRAL DOWNTOWN AREA OF SACRAMENTO, AND INCLUDES 40 ZIP CODES. POPULATION: 1,390,613 DIVERSITY: CAUCASIAN 47%, HISPANIC 22.8%, AFRICAN AMERICAN 15.1%, ASIAN/PI 15.2%, AMERICAN INDIAN/ALASKA NATIVE 0.5%, TWO OR MORE RACES 4.8%, OTHER 0.3% MEDIAN HOUSEHOLD INCOME: $55,407 UNINSURED: 10.7% UNEMPLOYMENT: 9.2% NO HIGH SCHOOL DIPLOMA: 14% CNI SCORE: 4.2 MEDICAID POPULATION: 28% OTHER AREA HOSPITALS: 7 ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE PRIMARY SERVICE AREA OF ST. JOSEPH'S MEDICAL CENTER IS THE CITY OF STOCKTON, WITH A SECONDARY SERVICE AREA OF SAN JOAQUIN COUNTY. MANY OF THE COMMUNITIES SERVED BY THE HOSPITAL ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND THE MIGRANT FARM WORKERS SERVED BY THE HOSPITAL ARE DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION. POPULATION: 367,082 DIVERSITY: CAUCASIAN 23.7%, HISPANIC/LATINO 44.8%, AFRICAN AMERICAN 9.5%, ASIAN/PI 17.8%, AMERICAN INDIAN/ALASKA NATIVE 0.5%, TWO OR MORE RACES 3.5%, OTHER 0.2% MEDIAN HOUSEHOLD INCOME: $44,735 UNINSURED: 12.5% UNEMPLOYMENT: 11.2% NO HS DIPLOMA: 26.4% CNI SCORE: 4.8 MEDICAID POPULATION: 40.4% OTHER AREA HOSPITALS: 7 CALIFORNIA HOSPITAL MEDICAL CENTER WHILE THE HOSPITAL IS LOCATED IN SERVICE PLANNING AREA (SPA) 4 OF METRO LOS ANGELES, ITS SERVICE AREA ALSO INCLUDES PARTS OF SPA 6 (SOUTH) AND SPA 8 (SOUTH BAY). CALIFORNIA HOSPITAL MEDICAL CENTER IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. POPULATION: 690,780 DIVERSITY: CAUCASIAN 4.8%, HISPANIC 68.3%, ASIAN/PI 6.4%, AFRICAN AMERICAN 18.7%, AMERICAN INDIAN/ALASKA NATIVE 0.2%, TWO OR MORE RACES, 1.2%, OTHER 0.4% MEDIAN HOUSEHOLD INCOME: $30,808 UNINSURED: 17.9% UNEMPLOYMENT: 8.7% NO HS DIPLOMA: 44.1% CNI SCORE: 5 MEDICAID POPULATION: 57.7% OTHER AREA HOSPITALS: 6 MERCY MEDICAL CENTER REDDING SERVES AN AREA COMPRISED OF ZIP CODES IN REDDING AND SURROUNDING COMMUNITIES IN SHASTA, TEHAMA AND TRINITY COUNTY. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 205,186 DIVERSITY: CAUCASIAN 79.9% , HISPANIC 10.7% , ASIAN/PI 2.6%, AFRICAN AMERICAN 0.9%, AMERICAN INDIAN/ALASKA NATIVE 2.2%, TWO OR MORE RACES 3.6%, OTHER 0.1% MEDIAN HOUSEHOLD INCOME: $46,270 UNINSURED: 9.8% UNEMPLOYMENT: 7.4% NO HS DIPLOMA: 12.1% CNI MEDIAN SCORE: 3.6 MEDICAID POPULATION: 27.2% OTHER AREA HOSPITALS: 1 CHANDLER REGIONAL MEDICAL CENTER THE HOSPITAL'S COMMUNITY INCLUDES CITIES IN MARICOPA AND PINAL COUNTIES, ARIZONA. THE CITIES ARE: CHANDLER, GILBERT, MESA, TEMPE, AWHATUKEE, SACATON, APACHE JUNCTION, CASA GRANDE, GILA RIVER INDIAN RESERVATION, AND GUADALUUPE. . THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION IN SEVERAL ZIP CODES OF THE SERVICE AREA. POPULATION: 790,009 DIVERSITY: CAUCASIAN 58.4%, HISPANIC 25%, ASIAN/PI 6.0%, AFRICAN AMERICAN 4.9%, TWO OR MORE RACES 2.5%, AMERICAN INDIAN/ALASKA NATIVE 3.0%, OTHER .14% MEDIAN HOUSEHOLD INCOME: $81,496 UNINSURED: 7.09% UNEMPLOYMENT: 4.9% NO HS DIPLOMA: 9.5% CNI SCORE: 2.8 MEDICAID POPULATION: 13.1% OTHER AREA HOSPITALS: 2 IN THE PRIMARY SERVICE AREA, 12 IN THE SECONDARY SERVICE AREA NORTHRIDGE HOSPITAL MEDICAL CENTER'S SERVICE AREA INCLUDES PARTS OF THE SAN FERNANDO AND SANTA CLARITA VALLEYS OF LOS ANGELES COUNTY AND A PORTION OF THE CITY OF SIMI VALLEY IN VENTURA COUNTY. THE HOSPITAL IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. POPULATION: 1,325,928 DIVERSITY: CAUCASIAN 33.9%, LATINO 48.6%, ASIAN/PI 10.7%, AFRICAN AMERICAN 4.0%, AMERICAN INDIAN/ALASKAN NATIVE 0.2%, TWO OR MORE RACES 2.2%, OTHER 0.4% MEDIAN HOUSEHOLD INCOME: $58,666 NO H.S. DIPLOMA: 21.5% UNINSURED: 8.9% UNEMPLOYED: 7.9% MEDICAID POPULATION: 30.1% CNI SCORE: 4.0 OTHER AREA HOSPITALS: 7 DOMINICAN HOSPITAL. THE PRIMARY SERVICE AREA IS SANTA CRUZ COUNTY WHICH COVERS 441 SQUARE MILES, AND IS A RELATIVELY ISOLATED COMMUNITY. THE TWO MAJOR CITIES ARE SANTA CRUZ, LOCATED ON THE NORTHERN SIDE OF THE MONTEREY BAY, AND WATSONVILLE, SITUATED IN THE SOUTHERN PART OF THE COUNTY. OTHER INCORPORATED AREAS IN THE COUNTY INCLUDE THE CITIES OF SCOTTS VALLEY AND CAPITOLA. APPROXIMATELY 51% OF THE POPULATION LIVES IN THE UNINCORPORATED PARTS OF THE COUNTY, INCLUDING THE TOWNS OF APTOS, DAVENPORT, FREEDOM, SOQUEL, FELTON, BEN LOMOND AND BOULDER CREEK, AND DISTRICTS SUCH AS THE SAN LORENZO VALLEY, LIVE OAK AND PAJARO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 271,804 DIVERSITY: CAUCASIAN 56.1%, HISPANIC 35.1%, ASIAN/PI 4.3%, AFRICAN AMERICAN 1.0%, AMERICAN INDIAN/ALASKA NATIVE 0.4%, TWO OR MORE RACES 2.9%, OTHER 0.2% MEDIAN HOUSEHOLD INCOME: $82,904 UNINSURED: OVERALL 16.2% UNEMPLOYMENT: 9.5% NO HS DIPLOMA: 13% CNI SCORE: 3.2 MEDICAID POPULATION: 14.7% OTHER AREA HOSPITALS: 2 MARIAN REGIONAL MEDICAL CENTER IS LOCATED IN NORTHERN SANTA BARBARA COUNTY WITH THE SANTA MARIA VALLEY AS THE LARGEST REGION IN ITS SERVICE AREA. THE LARGEST COMMUNITIES IN MARIAN'S PRIMARY SERVICE AREA INCLUDE THE CITY OF SANTA MARIA AND GUADALUPE WITH THE SECONDARY SERVICE AREA BEING NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 170,218 DIVERSITY: CAUCASIAN 31.2%, HISPANIC 60.8%, ASIAN/PI 4.5%, AFRICAN AMERICAN 1.2%, TWO OR MORE RACES 1.7%, OTHER 0.2% MEDIAN HOUSEHOLD INCOME: $58,952 UNINSURED: 6.9% UNEMPLOYMENT: 7.0% NO HS DIPLOMA: 28.9% CNI SCORE: 4.4 MEDICAID POPULATION: 20.6% OTHER AREA HOSPITALS: 0 THE ARROYO GRANDE COMMUNITY HOSPITAL CAMPUS SERVES THE SOUTHERN PART OF SAN LUIS OBISPO COUNTY INCLUDING THE CITIES OF ARROYO GRANDE, GROVER BEACH, OCEANO, PISMO BEACH AND SHELL BEACH AND THE NORTHERN PART OF THE CITY OF NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 77,873 DIVERSITY: CAUCASIAN 65.4%, HISPANIC 27.1%, ASIAN OR PACIFIC ISLANDER (ASIAN/PI) 35%, AFRICAN AMERICAN 0.5%, AMERICAN INDIAN/ALASKA NATIVE 0.5%, TWO OR MORE RACES 2.6%, OTHER 0.2% MEDIAN HOUSEHOLD INCOME: $63,546 UNINSURED: 5.9% UNEMPLOYMENT: 5.0% NO HS DIPLOMA: 9.8% CNI SCORE: 3.0 MEDICAID POPULATION: 13.5% OTHER AREA HOSPITALS: 1 ST. BERNARDINE MEDICAL CENTER SERVES A BROAD AND DIVERSE POPULATION. WHILE A FEW OF THE COMMUNITIES ENJOY A HIGHER STANDARD OF LIVING, THE MAJORITY OF THE COMMUNITIES ARE HIGH NEED. EIGHTY PERCENT (80%) OF DISCHARGES COME FROM THE FOLLOWING CITIES: BANNING, BEAUMONT, BLOOMINGTON, COLTON, CRESTLINE, FONTANA, HEMET, HESPERIA, HIGHLAND, RANCHO CUCAMONGA, REDLANDS, RIALTO, SAN BERNARDINO, VICTORVILLE AND YUCAIPA. MANY OF THE NEIGHBORHOODS SERVED HAVE BEEN FEDERALLY-DESIGNATED AS MEDICALLY UNDERSERVED AREAS. POPULATION: 1,279,196 DIVERSITY: CAUCASIAN 27.2%, HISPANIC 56.3%, AFRICAN AMERICAN 8.7%, ASIAN/PI 5.0%, AMERICAN INDIAN/ALASKA NATIVE 0.4%, TWO OR MORE RACES 2.1%, ALL OTHERS 0.3% MEDIAN HOUSEHOLD INCOME: $48,575 UNINSURED: 11.3% UNEMPLOYMENT: 9.2% NO HIGH SCHOOL DIPLOMA: 25.0% CNI SCORE: 4.2 MEDICAID POPULATION: 35.9% OTHER AREA HOSPITALS: 5 ST. ROSE DOMINICAN HOSPITALS - DE LIMA CAMPUS,
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, DIGNITY HEALTH REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR DIGNITY HEALTH TO DELIVER ON ITS MISSION, INCLUDING ENSURING THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTHCARE. OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS GATHERS AND VERIFIES CREDENTIALS, ALLOWS THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND TO ULTIMATELY MAKE A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES. CREDENTIALS VERIFICATION IS THE DETERMINATION OF WHETHER A PRACTITIONER'S CREDENTIALS ARE AUTHENTIC AND VALID. THE ROLE OF THE BOARD: THE DIGNITY HEALTH BOARD OF DIRECTORS ESTABLISHES KEY MEASURES OF SYSTEM-WIDE COMMUNITY BENEFIT PERFORMANCE AND RECEIVES REGULAR REPORTS ON PROGRESS TOWARD ESTABLISHED GOALS. DIGNITY HEALTH HOSPITAL COMMUNITY BOARDS, WHICH ARE RATIFIED BY THE DIGNITY HEALTH BOARD, ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS DEVELOP PROGRAMS TO ADDRESS THE DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS OF THE COMMUNITIES THE HOSPITALS SERVE, AND FOR ADOPTING COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS AND IMPLEMENTATION STRATEGIES. COMMUNITY BOARDS ENSURE THE DEVELOPMENT OF COMMUNITY BENEFIT INITIATIVES TO PROMOTE THE BROADER HEALTH OF THE COMMUNITY. IN FULFILLING THESE RESPONSIBILITIES, THE COMMUNITY BOARDS MAY DESIGNATE A COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEE OF THE BOARD TO INCLUDE AT LEAST TWO BOARD MEMBERS, WITH A MAJORITY REPRESENTATION FROM A RANGE OF COMMUNITY STAKEHOLDERS WHO HAVE KNOWLEDGE OF THE COMMUNITY. THE COMMUNITY BOARD, OR BOARD COMMITTEE, PARTICIPATES IN THE PROCESS OF ESTABLISHING PROGRAM PRIORITIES BASED ON COMMUNITY NEEDS ASSESSMENTS, DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY, AND MONITORING PROGRESS TOWARD IDENTIFIED GOALS. IF APPLICABLE, MEMBERS OF THE COMMITTEE ENSURE THAT THE COMMUNITY BOARD IS REGULARLY BRIEFED ON ACTIVITIES AND DEVELOPMENTS AND THAT THE COMMITTEE HAS INFORMATION FROM THE COMMUNITY BOARD AND MANAGEMENT NEEDED TO MAKE INFORMED DECISIONS. THE COMMUNITY BOARDS ARE ALSO RESPONSIBLE FOR REVIEW AND APPROVAL OF THE ANNUAL HOSPITAL COMMUNITY BENEFIT PLAN AND REPORT. DIGNITY HEALTH PROVIDES HOSPITAL SERVICES AND CARRIES OUT ITS MISSION AT THE HOSPITAL FACILITIES LISTED IN PART V, SECTION A. FOR DETAILED INFORMATION ON THE SERVICES AND COMMUNITY BENEFITS PROVIDED AT THESE FACILITIES, AS WELL AS COPIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS, IMPLEMENTATION STRATEGIES AND COMMUNITY BENEFIT REPORTS FOR EACH FACILITY, PLEASE VISIT THE DIGNITY HEALTH WEBSITE AT HTTP://WWW.DIGNITYHEALTH.ORG/COMMUNITYBENEFIT.
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM AFFILIATES OF DIGNITY HEALTH ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, AND GRASS VALLEY/NEVADA CITY, CALIFORNIA. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE FOR DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS FOR THE YEAR ENDED JUNE 30, 2015, IS AS FOLLOWS. Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 155,869 144,043,000 1.2% Unpaid Costs of Medicaid/Medi-Cal 1,529,842 582,988,000 4.9% Other Means-tested Programs 269,823 9,201,000 0.1% Community Services: Community Health Services 376,686 41,756,000 0.3% Health Professions Education 79 3,000 0.0% Subsidized Health Services 96,294 24,872,000 0.2% Donations 123,504 36,533,000 0.3% Community Building Activities 7,795 1,818,000 0.0% Community Benefit Operations 143 7,124,000 0.1% Total Community Services for the poor 604,501 112,106,000 0.9% Total Benefits for the Poor 2,560,035 848,338,000 7.1% Benefits for the Broader Community: Community Services: Community Health Services 278,419 12,046,000 0.1% Health Professions Education 27,306 67,915,000 0.6% Subsidized Health Services 3,641 1,441,000 0.0% Research 14,806 10,910,000 0.1% Donations 31,341 8,662,000 0.1% Community Building Activities 7,583 3,822,000 0.0% Community Benefit Operations 31 1,333,000 0.0% Total Benefits for the Broader Community 363,127 106,129,000 0.9% Total Community Benefits 2,923,162 954,467,000 8.0% Unpaid Costs of Medicare 1,042,065 756,109,000 6.3% Total Community Benefits including Cost of Medicare 3,965,227 1,710,576,000 14.3%
Schedule H (Form 990) 2014
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
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
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 Domestic Organizations and Domestic Governments. 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 section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) 5 CITIES HOMELESS COALITION
Po Box 558
GROVER BEACH,CA93483 		27-0413593 501(c)(3) 25,350 0 N/A N/A Community Health
(2) Ability360 Inc
15218 S 45Th Place
PHOENIX,AZ85044 		86-0486447 501(c)(3) 82,000 0 N/A N/A Community Health
(3) Adelante Healthcare Inc
9520 W Palm Lane Suite 200
Phoenix,AZ85037 		86-0377821 501(c)(3) 1,776,017 0 N/A N/A Community Health Friends Fore Golf
(4) ADRIAN DOMINICAN SISTERS
1257 E Siena Heights Drive
ADRIAN,MI49221 		38-1879966 501(c)(3) 64,500 0 N/A N/A Community Health
(5) ADVANCED CENTER FOR EYE CARE
1721 Westwind Drive Suite B
BAKERSFIELD,CA93301 		27-3257780 501(c)(3) 75,000 0 N/A N/A Community Health
(6) Aids Legal Referral Panel Of The San Francisco Bay
1663 Mission Street Suite 500
SAN FRANCISCO,CA94103 		94-3111738 501(c)(3) 10,000 0 N/A N/A Community Health
(7) AIM HIGH FOR HIGH SCHOOL
2030 Harrison Street 3rd Floor
SAN FRANCISCO,CA94110 		94-3296338 501(c)(3) 19,740 0 N/A N/A Education Support
(8) ALLAN HANCOCK COLLEGE
800 S COLLEGE Drive
SANTA MARIA,CA934546399 		52-1692042 Govt 200,000 0 N/A N/A EDUCATION Support
(9) ALLIANCE FOR PHARMACEUTICAL Access Incorporated
237 Town Center West 122
SANTA MARIA,CA93458 		20-3117940 501(c)(3) 90,000 0 N/A N/A Community Health
(10) ALPHA CRISIS PREGNANCY CENTER
700 Loughborough Drive Suite A
MERCED,CA95348 		77-0079754 501(c)(3) 15,000 0 N/A N/A Community Health
(11) ALPHA HOUSE-A PLACE FOR NEW BEGINNINGS
Po Box 712
TAFT,CA93268 		77-0366593 501(c)(3) 50,000 0 N/A N/A Community Health
(12) Alzheimers Disease And Related Disorders Associati
1777-A Capitola Road
SANTA CRUZ,CA95062 		94-2897949 501(c)(3) 50,000 0 N/A N/A Community Health
(13) AMERICAN CANCER SOCIETY
4550 East Bell Road Suite 126
Phoenix,AZ85032 		13-1788491 501(c)(3) 56,000 0 N/A N/A Community Health
(14) AMERICAN HEART ASSOCIATION Inc
100 Montgomery Sreet Suite 1650
SAN FRANCISCO,CA94104 		13-5613797 501(c)(3) 466,447 0 N/A N/A Community Health
(15) AMERICAN LIVER FOUNDATION
4545 E Shea Boulevard Suite 246
Phoenix,AZ85028 		36-2883000 501(c)(3) 6,600 0 N/A N/A Community Health
(16) AMERICAN LUNG ASSOCiation in California
575 Market Street 2125
SAN FRANCISCO,CA941052870 		94-0362650 501(c)(3) 37,571 0 N/A N/A Community Health
(17) American Lung Association Of The Southwest Inc
3552 W Cheyenne Avenue Suite 130
North Las Vegas,NV89032 		86-0111676 501(c)(3) 12,000 0 N/A N/A Community Health
(18) AMERICAN NATIONAL RED CROSS
85 2Nd Street 8Th Floor
SAN FRANCISCO,CA94105 		53-0196605 501(c)(3) 152,142 0 N/A N/A Community Health
(19) ANTI-DEFAMATION LEAGUE
One E Camelback Road Suite 670
Phoenix,AZ85012 		13-1818723 501(c)(3) 9,000 0 N/A N/A Community Health
(20) Arizona YWCA METROPOLITAN
755 E Willetta Street
Phoenix,AZ85006 		86-0098936 501(c)(3) 8,720 0 N/A N/A Community Health
(21) Armenian Relief Society of Western USA Inc
221 W Chestnut Street 201
Glendale,CA91204 		95-3928295 501(c)(3) 21,750 0 N/A N/A Community Health
(22) Arroyo Grande Community Hospital Foundation
345 S Halcyon Road
Arroyo Grande,CA93406 		20-3256066 501(c)(3) 774,001 0 N/A N/A Foundation Support
(23) ASCENCIA
437 Fernando Court
GLENDALE,CA91104 		20-4233822 501(c)(3) 45,000 0 N/A N/A Community Health
(24) ASIAN PACIFIC SELF DEVELOPMENT AND RESIDENCIAL ASS
3830 N ALVARADO STreet STE C
STOCKTON,CA95204 		68-0224100 501(c)(3) 5,400 0 N/A N/A Community Health
(25) ASSOCIATION OF CALIFORNIA NURSE LEADERS
2520 Venture Oaks Way Suite 210
SACRAMENTO,CA95833 		94-2910850 501(c)(3) 7,500 0 N/A N/A Community Health
(26) ASTHMA & ALLERGY Foundation OF AMERica National
8201 Corporate Dr Suite 100
LANDOVER,MD20785 		13-1691693 501(c)(3) 10,000 0 N/A N/A Community Health Training Kits
(27) AZ DIAMONDBACKS Foundation Inc
Po Box 52847
Phoenix,AZ850722847 		86-0901615 501(c)(3) 35,381 0 N/A N/A Community Health
(28) Bakersfield Crisis Pregnancy Center Inc
1801 21st Street 1
Bakersfield,CA93301 		77-0024688 501(c)(3) 10,000 0 N/A N/A Community Health
(29) Barrow Foundation UK
350 W Thomas Road
Phoenix,AZ85013 		31-1724184 501(c)(3) 293,949 0 N/A N/A Foundation Support
(30) BARROW NEUROLOGICAL FOUNDATION
350 W Thomas Road
Phoenix,AZ85013 		86-0174371 501(c)(3) 3,785,221 0 N/A N/A Foundation Support
(31) BAY AREA COUNCIL
201 California Street 1450
SAN FRANCISCO,CA94111 		23-7325853 501(c)(4) 19,525 0 N/A N/A Community Health
(32) BAY AREA COUNCIL FOUNDATION
201 California Street Suite 1450
SAN FRANCISCO,CA94111 		20-1826827 501(c)(3) 10,000 0 N/A N/A Community Health
(33) Board Of Trustee Of The Glide Foundation
330 Ellis Street
SAN FRANCISCO,CA94102 		94-1156481 501(c)(3) 24,310 0 N/A N/A Community Health
(34) BOYS & GIRLS CLUB OF OXNARD & PORT HUENEME
1900 W 5Th Street
OXNARD,CA93030 		95-1785162 501(c)(3) 10,450 0 N/A N/A Community Health
(35) BOYS & GIRLS CLUBS OF MERCED
615 W 15Th Street
MERCED,CA95340 		77-0357487 501(c)(3) 20,888 0 N/A N/A Community Health
(36) CABRILLO COLLEGE FOUNDATION
6500 SOQUEL Drive
APTOS,CA95003 		94-6121953 501(c)(3) 22,300 0 N/A N/A Education Support
(37) California Health Foundation Trust
1215 K Street Suite 800
Sacramento,CA95814 		94-1498697 501(c)(3) 19,489,010 0 N/A N/A Community Health
(38) California Hospital Medical Center Foundation
1401 South Grand Avenue
Los Angeles,CA90015 		95-4000909 501(c)(3) 2,534,901 0 N/A N/A Foundation Support
(39) California State University Bakersfield
9001 Stockdale Highway
Bakersfield,CA933111099 		77-0314545 Govt 9,000 0 N/A N/A Education Support
(40) CAlifornia STATE UNIVERSITY NORTHRIDGE Foundation
18111 Nordhoff Street
NORTHRIDGE,CA91330 		95-6196006 501(c)(3) 43,460 0 N/A N/A Education Support
(41) California State University Stanislaus
One University Circle
Turlock,CA95382 		77-0207337 Govt 6,500 0 N/A N/A Education Support
(42) CAMBODIAN ASSOCiation OF AMERICA
2390 Pacific Avenue
LONG BEACH,CA90806 		95-3528706 501(c)(3) 37,571 0 N/A N/A Community Health
(43) CAPACITAR INTERNATIONAL
23 E Beach Street Suite 206
Watsonville,CA950764638 		77-0387846 501(c)(3) 20,000 0 N/A N/A Community Health
(44) CATHOLIC CHARITIES
1450 N D Street
SAN BERNARDINO,CA92405 		95-3516461 501(c)(3) 40,000 0 N/A N/A Community Health
(45) CATHOLIC CHARITIES DIOCESE OF MONTEREY
922 HILBY AVEnue SuiTE C
SEASIDE,CA93955 		77-0042961 501(c)(3) 30,700 0 N/A N/A Community Health
(46) CATHOLIC CHARITIES DIOCESE OF STOCKTON
1106 N El Dorado Street
STOCKTON,CA95202 		94-1629114 501(c)(3) 145,875 0 N/A N/A Community Health
(47) CATHOLIC CHARITIES OF Los Angeles
607 West Main Street
SANTA MARIA,CA93458 		95-1690973 501(c)(3) 8,300 0 N/A N/A Community Health
(48) Catholic Charities Of Southern Nevada
1501 Las Vegas Boulevard North
Las Vegas,NV89101 		88-0059425 501(c)(3) 75,000 0 N/A N/A Community Health
(49) CATHOLIC CHARITIES OF THE DIOCESE OF FRESNO
149 N FULTON Street
FRESNO,CA937011607 		94-1678938 501(c)(3) 10,100 0 N/A N/A Community Health
(50) CELEBRITY FIGHT NIGHT FOUNDATIon Inc
2425 E Camelback Road Suite 150
PHOENIX,AZ85016 		86-0903119 501(c)(3) 99,000 0 N/A N/A Community Health
(51) Center for Community Health and Well-being Inc
1900 T Street
Sacramento,CA95811 		68-0248303 501(c)(3) 25,000 0 N/A N/A Community Health
(52) CENTER FOR ENVIRONMENTAL HeaLTH
2201 Broadway Suite 302
OAKLAND,CA94612 		94-3251981 501(c)(3) 14,500 0 N/A N/A Community Health
(53) Center for Healthcare Decisions Inc
3400 Data Drive
Rancho Cordova,CA95670 		68-0441958 501(c)(3) 25,000 0 N/A N/A Community Health
(54) Central City Association of Los Angeles
626 Wilshire Boulevard Ste 200
Los Angeles,CA90017 		95-0691090 501(c)(6) 9,600 0 N/A N/A Community Health
(55) Get Off The Couch Potato Sports Productions LLC
205 SUBURBAN RoaD 6
SAN LUIS OBISPO,CA93401 		27-2625758 N/A 6,000 0 N/A N/A community health
(56) CHANDLER-GILBERT YMCA
1655 W Frye Road
Chandler,AZ85244 		86-0096799 501(c)(3) 6,720 0 N/A N/A Community Health
(57) CHARLES R DREW UNIVERSITY of MEDICINE & SCIENCE
1731 W 120Th Street
LOS ANGELES,CA90059 		95-6151774 501(c)(3) 750,000 0 N/A N/A Education Support
(58) CHILD ABUSE PREVENTION COUNCIL OF SAN JOAQUIN COUN
PO Box 1257
STockton,CA95201 		94-2497046 501(c)(3) 6,000 0 N/A N/A Community Health
(59) CHILDRENS MUSEUM OF Phoenix
215 N 7th Street
Phoenix,AZ85034 		86-0934323 501(c)(3) 7,735 0 N/A N/A Community Support
(60) CIRCLE THE CITY
333 W Indian School Road
PHOENIX,AZ85203 		26-2420730 501(c)(3) 51,750 0 N/A N/A Community Health
(61) CITY & COUNTY OF SAN FRANCISCO
1001 Potrero Street
SAN FRANCISCO,CA84110 		94-6000417 Govt 5,706 0 N/A N/A Community Health
(62) CITY OF FOLSOM
50 NATOMA Street
FOLSOM,CA95630 		94-6000334 Govt 10,000 0 N/A N/A Community Health
(63) Clark County Public Education Foundation Inc
4350 South Maryland Parkway
Las Vegas,NV89119 		88-0275767 501(c)(3) 6,250 0 N/A N/A Education Support
(64) CLEAN PRODUCTION ACTION
1310 Broadway Suite 101
SOMERVILLE,MA02144 		45-3560728 501(c)(3) 7,500 0 N/A N/A Community Health
(65) COLLECTIVE IMPACT
Po Box 156853
SAN FRANCISCO,CA94115 		20-8964069 501(c)(3) 15,000 0 N/A N/A Community Health
(66) COLON CANCER ALLIANCE
1025 Vermont Ave NW Street 1066
Washington,DC20005 		86-0947831 501(c)(3) 9,050 0 N/A N/A Community Health
(67) Communicare Health Centers
PO BOX 1260
DAVIS,CA95617 		94-2188574 501(c)(3) 20,000 0 N/A N/A Community Health
(68) COMMUNITY ACTION COMMISSION OF SANTA BARBARA COUNT
5638 Hollister Avenue Suite 230
GOLETA,CA93117 		95-2491790 501(c)(3) 24,977 0 N/A N/A Community Health
(69) COMMUNITY BRIDGES
236 Santa Cruz Avenue
APTOS,CA95003 		94-2460211 501(c)(3) 48,571 0 N/A N/A Community Health
(70) Community Initiatives
Po Box 15693
SAN FRANCISCO,CA94115 		94-3255070 501(c)(3) 20,000 0 N/A N/A Community Health
(71) CORPORATION FOR SUPPORTIVE HOUSING
800 S Figueroa Suite 810
LOS ANGELES,CA90017 		13-3600232 501(c)(3) 47,021 0 N/A N/A Community Health
(72) COUNTY OF KERN
1800 MT VERNON AVE 3RD FLOOR
BAKERSFIELD,CA93306 		95-6000925 Govt 7,890 0 N/A N/A Community Health
(73) COUNTY OF SANTA CRUZ
701 OCEAN STreet RM 312
SANTA CRUZ,CA95060 		94-6000534 Govt 145,200 0 N/A N/A Community Health
(74) Creighton University
Po Box 30282
Omaha,NE68103 		47-0376583 501(c)(3) 212,000 0 N/A N/A Education Support
(75) CUESTA COLLEGE FOUNDATION
PO BOX 8016
SAN LUIS OBISPO,CA93403 		23-7225601 501(c)(3) 60,000 0 N/A N/A Education Support
(76) DIENTES COMMUNITY DENTAL CARE
1830 Commercial Way
SANTA CRUZ,CA95065 		77-0311752 501(c)(3) 10,000 0 N/A N/A Community Health
(77) Dignity Health Foundation
185 Berry Street
San Francisco,CA94107 		46-2037641 501(c)(3) 781,826 0 N/A N/A Foundation Support
(78) Dignity Health Foundation East Valley
1727 West Frye Road Suite 230
Chandler,AZ85224 		74-2418514 501(c)(3) 2,057,085 0 N/A N/A Foundation Support
(79) Dignity Health Medical Foundation
3400 Data Drive
Rancho Cordova,CA85670 		68-0220314 501(c)(3) 135,610,942 0 N/A N/A Medical Fnd Support
(80) Diocese of San Bernardino
1201 East Highland Avenue
San Bernadino,CA92404 		95-3293901 501(c)(3) 7,660 0 N/A N/A Community Health
(81) Dolores Street Community Services
938 Valencia Street
SAN FRANCISCO,CA94110 		94-2919302 501(c)(3) 9,430 0 n/a n/a Community Health
(82) Dominican Hospital Foundation
1555 Soquel Drive
Santa Cruz,CA95065 		94-2450442 501(c)(3) 1,059,962 0 N/A N/A Foundation Support
(83) DR EARL R CRANE CHILDRENS DENTaL HEALTH CENTER
580 W 6Th Street
SAN BERNARDINO,CA92410 		95-1627155 501(c)(3) 50,864 0 N/A N/A Community Health
(84) Economic Development Corporation of Shasta County
410 Hemsted Drive Ste 100
Redding,CA96002 		94-1417261 501(c)(3) 12,500 0 N/A N/A Community Health
(85) El Centrito Family Learning Centers
Po Box 1613
OXNARD,CA930321613 		31-1652255 501(c)(3) 70,000 0 N/A N/A Community Health
(86) EL DORADO HILLS COMMUNITY VISION INC
PO BOX 1342
FOLSOM,CA95763 		91-1764812 501(c)(3) 10,000 0 N/A N/A Community Health
(87) EMPIRE HOTEL EHARC Inc
1237 California Street
REDDING,CA960010618 		94-2326975 501(c)(3) 25,000 0 N/A N/A Community Health
(88) Encompass Community Services
195 Harvey West Boulevard
SANTA CRUZ,CA95060 		23-7275290 501(c)(3) 15,000 0 N/A N/A Community Health
(89) ENTERPRISE COMMUNITY PARTNERS
101 Montgomery Street Suite 1350
SAN FRANCISCO,CA94104 		52-1231931 501(c)(3) 13,500 0 N/A N/A Community Health
(90) ESKATON FOUNDATION
5105 MANZANITA AVEnue
CARMICHAEL,CA95608 		68-0227233 501(c)(3) 25,000 0 N/A N/A Community Health
(91) EXECUTIVE LEADERSHIP COUNCIL Inc
1001 N Fairfax Street Suite 300
ALEXANDRIA,VA22314 		52-1583401 501(c)(6) 25,000 0 N/A N/A Community Health
(92) FACING HISTORY & OURSELVES Inc
24301 Southland Dr Suite 207
HAYWARD,CA94545 		04-2761636 501(c)(3) 10,000 0 N/A N/A Community Health
(93) FELLOWSHIP OF CHRISTIAN ATHLETES
9530 HAGEMAN RoaD SUITE B163
BAKERSFIELD,CA93312 		44-0610626 501(c)(3) 13,770 0 N/A N/A Community Health
(94) FIELD OF HONOR VETERANS MEMorial
Po Box 4008 MS 500
Chandler,AZ85244 		86-6004791 Govt 15,000 0 N/A N/A Community Health
(95) FIRST GRADUATE
3130 20Th Street Suite 275
SAN FRANCISCO,CA94110 		94-3381171 501(c)(3) 10,000 0 N/A N/A Education Support
(96) FLOOD BAKERSFIELD MINISTRIES CORP
3509 UNION AVEnue
BAKERSFIELD,CA93305 		26-2780103 501(c)(3) 10,000 0 N/A N/A Community Health
(97) Flying Doctors of America
212 W Ironwood Drive Suite D
Coeur dAlene,ID83814 		58-1900004 501(c)(3) 0 12,453 Book Medical supplies/equ Community Health
(98) FREED CENTER FOR INDEPENDENT LIVING
117 New Mohawk Road Suite A
NEVADA CITY,CA95959 		68-0085639 501(c)(3) 63,000 0 N/A N/A Community Health
(99) French Hospital Medical Center Foundation
1911 Johnson Avenue
San Luis Obispo,CA93401 		20-3256125 501(c)(3) 947,963 0 N/A N/A Foundation Support
(100) FRESH START FOR WOMENS FOUNDATION
1130 E McDowell Road
Phoenix,AZ85006 		86-0762610 501(c)(3) 8,402 0 N/A N/A Community Health
(101) FRIENDS OF FAITH
418 30Th Street Suite B
OAKLAND,CA94609 		94-3307705 501(c)(3) 5,300 0 N/A N/A Community Health
(102) FROM THE GARDEN TO THE TABLE
1442A Walnut Street Suite 134
BERKELEY,CA94709 		30-0221004 501(c)(3) 75,000 0 N/A N/A Community Health
(103) FSL Programs
1201 E Thomas Road
PHOENIX,AZ85014 		86-0411904 501(c)(3) 75,000 0 N/A N/A Community Health
(104) GARDEN PATHWAYS Inc
1616 29Th Street
BAKERSFIELD,CA93301 		77-0442212 501(c)(3) 95,885 0 N/A N/A Community Health related
(105) GLENDALE HEALTHY KIDS
223 N Jackson Street B-17
GLENDALE,CA91206 		95-4487466 501(c)(3) 15,644 0 N/A N/A Community Health
(106) Glendale Kiwanis Foundation
PO Box 10545
Glendale,CA91209 		95-6225168 501(c)(3) 10,000 0 N/A N/A Community Health
(107) Glendale Memorial Health Foundation
1420 S Central Avenue
Glendale,CA91204 		95-3625651 501(c)(3) 1,035,316 0 N/A N/A Foundation Support
(108) GLENDALE PARKS & OPEN SPACE Foundation
613 E Broadway Rm 120
GLENDALE,CA91204 		27-0676361 501(c)(3) 24,400 0 N/A N/A Community Health
(109) Global Family Care Network Inc
PO Box 13160
Bakersfield,CA93389 		20-8346599 501(c)(3) 6,000 0 N/A N/A Community Health
(110) Golden Umbrella
200 Mercy Oaks Drive
Redding,CA96003 		23-7115371 501(c)(3) 147,743 0 N/A N/A Community Support
(111) Good News Rescue Mission
3100 S Market Street
Redding,CA96001 		94-1652602 501(c)(3) 9,000 0 N/A N/A Community Health
(112) GOOD SAMARITAN SHELTER INC
731 S Lincoln Street
SANTA MARIA,CA93454 		77-0133375 501(c)(3) 52,500 0 N/A N/A Community Health
(113) GOSPEL CENTER RESCUE MISSION
445 S SAN JOAQUIN Street
STOCKTON,CA95203 		94-1375835 501(c)(3) 63,139 8,000 book beds Community Health
(114) GREAT NORTHERN SERVICES
Po Box 20
WEED,CA96064 		94-2562423 501(c)(3) 10,000 0 N/A N/A Community Health
(115) H STREET CLINIC INC
1329 NORTH H Street
SAN BERNARDINO,CA92405 		20-8191393 501(c)(3) 450,000 0 N/A N/A Community Health
(116) HAVE A BALL FOUNDATION Inc
662 ROCK ISLAND CIRcle
DANVILLE,CA94526 		20-2420378 501(c)(3) 10,000 0 N/A N/A Community Health
(117) Health Alliance of Northern California
2280 Benton Drive BLD C Ste C
Redding,CA96003 		31-1580642 501(c)(3) 18,072 0 N/A N/A Community Health
(118) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ CNTY
PO BOX 962
SANTA CRUZ,CA95062 		01-0826156 501(c)(3) 20,000 0 N/A N/A Community Health
(119) Healthy Community Forum For The Greater Sacramento
8928 Volunteer Lane Suite 220
Sacramento,CA958263238 		68-0377256 501(c)(3) 40,000 0 N/A N/A Community Health Barrow Neurological Institute
(120) Henderson Chamber Of Commerce Foundation Inc
590 South Boulder Highway
Henderson,NV89015 		88-0358312 501(c)(3) 13,000 0 N/A N/A Community Health
(121) HOFFMANN HOSPICE OF THE VALLEY INC
8501 BRIMHALL RD STE 100
BAKERSFIELD,CA93312 		77-0386207 501(c)(3) 7,200 0 N/A N/A Community Health
(122) HOMELESS PRENATAL PROGRAM INC
2500 18Th Street
SAN FRANCISCO,CA94110 		94-3146280 501(c)(3) 25,000 0 N/A N/A Community Health
(123) HOMELESS SERVICES CENTER
115-B Coral Street
SANTA CRUZ,CA95060 		77-0126783 501(c)(3) 93,510 0 N/A N/A Community Health
(124) HOSPICE OF SANTA CRUZ COUNTY
940 Disc Drive
SCOTTS VALLEY,CA95066 		94-2497618 501(c)(3) 10,000 0 N/A N/A Community Health
(125) Hospital Consortium of San Mateo County
222 W 39th Avenue 3rd Fl
San Mateo,CA94403 		94-2637032 501(c)(3) 61,000 0 N/A N/A Community Health
(126) HUMAN SERVICES CAMPUS LLC
204 S 12Th Avenue
PHOENIX,AZ85007 		86-1050572 501(c)(3) 35,000 0 N/A N/A Community Health communities.
(127) ICAN
650 E Morelos Street
CHANDLER,AZ85225 		86-0761030 501(c)(3) 62,882 0 N/A N/A Community Health
(128) IMMANUEL PRESBYTERIAN CHURCH
3300 Wilshire Boulevard
LOS ANGELES,CA90010 		95-1643330 501(c)(3) 55,000 0 N/A N/A Community Health
(129) INCARNATE WORD ACADEMY
609 Crawford Street
HOUSTON,TX77002 		74-1280554 501(c)(3) 10,000 0 N/A N/A Education Support
(130) InnVision Shelter Network
1580A Maple Street
REDWOOD CITY,CA94063 		77-0160469 501(c)(3) 0 26,502 Cost Food Community Health
(131) International Society For Cardiovascular Translati
5580 LA Jolla Boulevard 605
LA Jolla,CA92037 		77-0682420 501(c)(3) 48,799 0 N/A N/A Community Health
(132) INTERSECTION FOR THE ARTS
925 Mission Street Suite 109
SAN FRANCISCO,CA94103 		94-1593216 501(c)(3) 10,000 0 N/A N/A Community Health
(133) Jdrf International
811 Wilshire Boulevard 1600
Los Angeles,CA90017 		23-1907729 501(c)(3) 5,500 0 N/A N/A Community Health
(134) Lao Family Community Empowerment Inc
8338 W Lane
Stockton,CA95210 		68-0142838 501(c)(3) 8,200 0 N/A N/A Community Health
(135) LATINA BREAST CANCER AGENCY
4271 Mission Street 2Nd Floor
SAN FRANCISCO,CA94131 		01-0628124 501(c)(3) 40,000 0 N/A N/A Community Health
(136) LEGAL AID SOCIETY OF San Bernardino
588 W Sixth Street
SAN BERNARDINO,CA92410 		95-1997024 501(c)(3) 67,500 0 N/A N/A Community Health
(137) LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION
1996 Eastman Avenue 101
VENTURA,CA93003 		95-1693538 501(c)(3) 13,000 0 N/A N/A Community Health
(138) LODESTAR DAY RESOURCE CENTER
1125 W Jackson Street
PHOENIX,AZ85007 		26-0235106 501(c)(3) 55,000 0 N/A N/A Community Health
(139) LOS ANGELES POLICE FOUNDATION
515 S Flower Street 1680
LOS ANGELES,CA90071 		95-4700442 501(c)(3) 21,000 0 N/A N/A Community Health
(140) LUTHERAN SOCial SerViCeS OF NEVADA
Po Box 2079
LAS VEGAS,NV89101 		86-0845241 501(c)(3) 75,000 0 N/A N/A Community Health
(141) MAGGIE'S PLACE
Po Box 1102
Phoenix,AZ85001 		27-2545687 501(c)(3) 5,500 0 N/A N/A Community Health
(142) MARCH OF DIMES FOUNDATION
5564 S Fort Apache Suite 100
Las Vegas,NV89148 		13-1846366 501(c)(3) 57,245 0 N/A N/A Community Health
(143) Marian Regional Medical Center Foundation
1400 E Church Street
Santa Maria,CA93454 		95-3818027 501(c)(3) 940,680 0 N/A N/A Foundation Support
(144) MARY'S MERCY CENTER
Po Box 7563
SAN BERNARDINO,CA92411 		33-0632426 501(c)(3) 25,000 0 N/A N/A Community Health
(145) MCCLOUD HEALTHCARE CLINIC INC
116 W Minnesota Avenue
MCCLOUD,CA96057 		68-0427383 501(c)(3) 10,000 0 N/A N/A Community Health grant)
(146) MEDSHARE INTERNATIONAL
3240 Clifton Springs Road
DECATUR,GA30034 		58-2433968 501(c)(3) 305,400 0 N/A N/A Community Health
(147) MERCED COMMUNITY COLLEGE DISTRICT
3600 M Street
MERCED,CA95348 		77-0362218 Govt 115,763 0 N/A N/A Education Support
(148) MERCED COUNTY RESUCE MISSION
Po Box 3319
MERCED,CA95344 		77-0284849 501(c)(3) 75,500 0 N/A N/A Community Health
(149) MERCED UNION HIGH SCHOOL DISTRICT
3430 A STREET
ATWATER,CA95301 		77-0572114 Govt 8,000 0 N/A N/A Education Support
(150) MERCY BEYOND BORDERS
1885 De La Cruz Boulevard Suite 101
SANTA CLARA,CA950503000 		26-0323282 501(c)(3) 20,000 0 N/A N/A Community Health
(151) Mercy Foundation
3400 Data Drive
Rancho Cordova,CA95670 		23-7072762 501(c)(3) 2,558,597 0 N/A N/A Foundation Support
(152) Mercy Foundation Bakersfield
PO Box 119
Bakersfield,CA93302 		77-0201321 501(c)(3) 815,415 0 N/A N/A Foundation Support
(153) MERCY FOUNDATION NORTH
2625 Edith Avenue Suite E
REDDING,CA960013040 		94-3136799 501(c)(3) 1,010,844 0 N/A N/A Foundation Support
(154) MERCY HAVEN INC
859 Connetquot Ave Suite 10
ISLIP TERRACE,NY11752 		11-2783877 501(c)(3) 10,000 0 N/A N/A Community Health
(155) Mercy Housing Inc
1350 Mission Street
SAN FRANCISCO,CA94103 		84-1559406 501(c)(3) 200,000 0 N/A N/A Community Health
(156) Mercy Medical Center Merced Foundation
301 East 13th Street
Merced,CA95340 		77-0035928 501(c)(3) 501,219 0 N/A N/A Foundation Support
(157) MIND MATTERS CLINIC INC
150 Big Trees Road Suite D
MURPHYS,CA95247 		26-1442370 501(c)(3) 25,307 0 N/A N/A Community Health support
(158) MISSION DOLORES ACADEMY
3371 16Th Street
SAN FRANCISCO,CA84114 		20-2849575 501(c)(3) 50,000 0 N/A N/A Education Support
(159) MISSION OF MERCY INC
360 E Coronado Road Suite 160
Phoenix,AZ85004 		86-0704883 501(c)(3) 154,747 0 N/A N/A Community Health support
(160) MOUNTAIN VALLEYS HEALTH Centers
554-850 Medical Center Drive
BIEBER,CA96009 		94-2533006 501(c)(3) 65,817 0 N/A N/A Community Health
(161) MT SHASTA NORDIC SKI ORGANIZATION
Po Box 765
MT SHASTA,CA96067 		20-4805805 501(c)(3) 5,300 0 N/A N/A Community Health
(162) NATIONAL COALITION OF 100 BLACK WOMEN INC
Po Box 24231
OAKLAND,CA946231231 		94-3298877 501(c)(3) 6,840 0 N/A N/A Community Health
(163) National Health Foundation
515 S Figuerora Street Ste 1300
Los Angeles,CA90017 		23-7314808 501(c)(3) 13,144 0 N/A N/A Community Health
(164) NATIONAL MINORITY AIDS COUNCIL
1931 13Th Street NW
WASHINGTON,DC20009 		52-1578289 501(c)(3) 10,000 0 N/A N/A Community Health
(165) National Multiple Sclerosis Society
1700 Owens Street Suite 190
San Francisco,CA94158 		94-1294935 501(c)(3) 16,455 0 N/A N/A Community Health
(166) NATIVE AMERICAN CONNECTIONS Inc
4520 N Central Avenue Suite 600
PHOENIX,AZ85012 		86-0293585 501(c)(3) 75,000 0 N/A N/A Community Health
(167) NATL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PE
1215 K Street
SACRAMENTO,CA95814 		95-4617376 501(c)(4) 19,550 0 N/A N/A Community Health
(168) Needs Center Committee
Po Box 933
TAFT,CA93268 		77-0006310 501(c)(3) 30,500 0 N/A N/A Community Health
(169) NEHEMIAH COMMUNITY REINVESTMENT FUND INC
640 Bercut Drive Suite A
SACRAMENTO,CA95811 		68-0365842 501(c)(3) 150,000 0 N/A N/A Community Health
(170) NEIGHBORS WHO CARE INC
10450 E Riggs Road Suite 113
SUN LAKES,AZ85248 		86-0966061 501(c)(3) 87,200 0 N/A N/A Community Health
(171) NETWORK EDUCATION PROGRAM
25 E Street NW Suite 200
WASHINGTON,DC200011630 		52-1307764 501(c)(3) 30,000 0 N/A N/A Community Health
(172) NEVADA CLINICAL SERVICES Inc
3186 S Maryland Parkway
Las Vegas,NV89119 		45-2211040 N/A 692,000 0 N/A N/A Community Health
(173) NEVADA DIABETES ASSOCIATION FOR CHILDERN AND ADULT
1005 Terminal Way 104
RENO,NV88502 		88-0386000 501(c)(3) 6,944 0 N/A N/A Community Health
(174) NEW GENESIS INC
2575 Lynnwood Street
LAS VEGAS,NV89102 		84-1291505 501(c)(3) 70,000 0 N/A N/A Community Health
(175) NORTHERN CALIFornia Center FOR FAMILY AWARENESS
Po Box 991473
REDDING,CA96003 		68-0363217 501(c)(3) 30,000 0 N/A N/A Community Health
(176) NORTHERN CALIFORNIA CHILD DEVelopment Inc
220 Sycamore Street Suite 200
RED BLUFF,CA96080 		94-1642028 501(c)(3) 19,899 0 N/A N/A Community Health
(177) NOrthern CAlifornia PRESBYTERIAN HOMES & Services
1525 Post Street
SAN FRANCISCO,CA94109 		94-1437728 501(c)(3) 27,000 0 N/A N/A Community Health
(178) Northern Valley Catholic Social Service Inc
2400 Washington Avenue
Redding,CA96001 		20-0984601 501(c)(3) 10,200 368 Cost gifts/toys Community Health
(179) Northridge Hospital Foundation
18300 Roscoe Boulevard
Northridge,CA91328 		23-7444901 501(c)(3) 1,519,267 0 N/A N/A Foundation Support
(180) NOT FOR SALE FUND
2225 3Rd Street
SAN FRANCISCO,CA94107 		20-5659783 501(c)(3) 65,000 0 N/A N/A Community Health
(181) Opportunity Village Foundation
6300 W Oakway Boulevard
Las Vegas,NV89146 		88-0272831 501(c)(3) 5,500 0 N/A N/A Community Health
(182) PANETTA INSTITUTE FOR PUBLIC
100 Campus Center Building 86E
SEASIDE,CA93955 		77-0495799 501(c)(3) 20,150 0 N/A N/A Community Health
(183) Partners Healthcare System Inc
55 Fruit Street
BOSTON,MA02114 		04-1564655 501(c)(3) 9,550 0 N/A N/A Community Health
(184) PATHWAYS HOME HEALTH AND HOSPICE
585 N MARY AVEnue
SUNNYVALE,CA94085 		94-2823240 501(c)(3) 24,600 0 N/A N/A Community Health
(185) PATHWAYS VOLUNTEER HOSPICE
3701 Michelson Street
LAKEWOOD,CA90712 		33-0241726 501(c)(3) 37,571 0 N/A N/A Community Health
(186) PEACH TREE HEALTHCARE
1114 YUBA STreet SuiTE 144
MARYSVILLE,CA95901 		68-0371679 501(c)(3) 1,100,000 0 N/A N/A Community Health assistant
(187) PENINSULA FAMILY SERVICE
24 Second Avenue
SAN MATEO,CA94401 		94-1186169 501(c)(3) 75,680 0 N/A N/A Community Health
(188) PENINSULA VOLUNTEERS INC
800 Middle Avenue
MENLO PARK,CA94025 		94-1294939 501(c)(3) 36,075 0 N/A N/A Community Health
(189) PHOENIX CHILDRENS HOSPITAL FOUNDATION
2929 E Camelback Roadd Suite 122
Phoenix,AZ85016 		74-2421549 501(c)(3) 5,850 0 N/A N/A Community Health
(190) PIAZZA SAINT FRANCIS A POETS PLAZA INC
700 Montgomery Street
SAN FRANCISCO,CA94111 		45-5060006 501(c)(3) 50,000 0 N/A N/A Community Health
(191) POSITIVE PATHS
1525 S Greenfield Road
Mesa,AZ85206 		46-4943070 501(c)(3) 9,400 0 N/A N/A Community Health
(192) PROJECT CURE
10377 E Geddes Avenue Suite 200
CENTENNIAL,CO801123740 		84-1568566 501(c)(3) 55,000 0 N/A N/A Community Health
(193) REDWOOD CITY SAN MATEO COUNTY CHAMBER OF COMMERCE
1450 VETERANS Boulevard SuiTE 125
REDWOOD CITY,CA94063 		94-0377914 501(c)(6) 13,200 0 N/A N/A Community Health
(194) Regents Of The University Of California
4625 Second Avenue Rm 1101
SACRAMENTO,CA95817 		94-6036494 501(c)(3) 15,564 0 N/A N/A Education Support
(195) Regents of the University of California at Irvine
Bldg 22A RT 82 101 City Dr So
Orange,CA92688 		95-2226406 501(c)(3) 15,000 0 N/A N/A Education Support
(196) Retreat & Refresh Stroke Camp
425 W Giles Lane
Peoria,IL61614 		64-0954851 501(c)(3) 14,000 0 N/A N/A Community Health
(197) Roman Archbishop Of Los Angeles
3424 Wilshire Boulevard
LOS ANGELES,CA900102241 		95-1642382 501(c)(3) 23,200 0 N/A N/A Community Health
(198) Roman Catholic Archbishop Of San Francisco
1 Peter Yorke Way
SAN FRANCISCO,CA94109 		94-1156707 501(c)(3) 25,000 0 N/A N/A Community Health
(199) ROMAN CATHOLIC BISHOP OF SACRAMENTO
2110 BROADWAY
SACRAMENTO,CA95818 		94-1270353 501(c)(3) 267,500 0 N/A N/A Community Health
(200) ROTACARE BAY AREA INC
Po Box 18430
SAN JOSE,CA951588430 		77-0328723 501(c)(3) 15,000 0 N/A N/A Community Health
(201) Sacramento Regional Family Justice Center Foundati
1477 Drew Avenue Ste 103
Davis,CA95618 		46-4522608 501(c)(3) 24,600 0 N/A N/A Community Health
(202) SACRAMENTO STEPS FORWARD
1331 Garden Highway Suite 100
SACRAMENTO,CA95833 		27-4907397 501(c)(3) 203,204 0 N/A N/A Community Health
(203) Saint Francis Memorial Hospital
900 Hyde Street
San Francisco,CA94109 		94-1156295 501(c)(3) 216,855 0 N/A N/A Hospital Support
(204) SAN FRANCISCO JAZZ ORGANIZATION
201 Franklin Street
SAN FRANCISCO,CA94102 		94-2990335 501(c)(3) 60,000 0 N/A N/A Community Support
(205) SAN FRANCISCO MEDICAL SOCIETY
1003A OReilly Avenue
SAN FRANCISCO,CA94129 		94-0835165 501(c)(6) 6,000 0 N/A N/A Community Health
(206) SAN FRANCISCO PARKS ALLIANCE
501 Stanyan Street
SAN FRANCISCO,CA94117 		23-7131784 501(c)(3) 11,534 0 N/A N/A Community Health Children
(207) SAN FRANCISCO SYMPHONY
201 Van Ness
SAN FRANCISCO,CA94102 		94-1156284 501(c)(3) 50,000 0 N/A N/A Community Support
(208) San Francisco Travel Foundation
465 California Street Suite 425
SAN FRANCISCO,CA94104 		81-0618666 501(c)(3) 250,000 0 N/A N/A Education Support
(209) San Joaquin Delta Community College District
5151 Pacific Avenue
Stockton,CA95207 		94-1044400 Govt 6,500 0 N/A N/A Education Support
(210) San Luis Obispo County Aids Support Network
Po Box 12158
SAN LUIS OBISPO,CA93401 		77-0205717 501(c)(3) 17,757 0 N/A N/A Community Health
(211) SANTA BARBARA COUNTY Education Office
402 FARNEL RoaD SUITE M
SANTA MARIA,CA93458 		95-6000940 Govt 5,800 0 N/A N/A Education Support
(212) SECOND HARVEST FOOD BANK SANTA CRUZ COUNTY
800 Ohlone Parkway
WATSONVILLE,CA95076 		77-0326685 501(c)(3) 10,000 0 N/A N/A Community Health
(213) SELF HELP FOR THE ELDERLY
407 Sansome Street
SAN FRANCISCO,CA941113123 		94-1750717 501(c)(3) 40,225 0 N/A N/A Community Health
(214) Sequoia Hospital Foundation
170 Alameda de Las Pulgas
Redwood City,CA94062 		94-2909990 501(c)(3) 1,340,283 0 N/A N/A Foundation Support
(215) Serotonin Surge Charities
1955 Cowell Boulevard
Davis,CA95616 		68-0411254 501(c)(3) 35,000 0 N/A N/A Community Health
(216) SF AFRICAN AMER HISTORICAL & CULTURAL SOCIETY
680 Mcallister Street
SAN FRANCISCO,CA94102 		94-1721596 501(c)(3) 10,000 0 N/A N/A Community Health
(217) SF FORTY NINERS FOUNDATION
4949 Marie P Debartolo Way
SANTA CLARA,CA95054 		77-0287514 501(c)(3) 16,667 0 N/A N/A Community Health
(218) SF SB COMMITTEE INC
555 Mission Street Suite 3000
SAN FRANCISCO,CA94105 		46-1177365 501(c)(6) 62,500 0 N/A N/A Community Support
(219) SHASTA COUNTY CHEMICAL PEOPLE Incorporated
Po Box 493777
REDDING,CA96049 		68-0027888 501(c)(3) 30,000 0 N/A N/A Community Health
(220) Shasta County Public Health Dept
1855 PLACER STreet STE 201
REDDING,CA96001 		94-6000535 Govt 20,000 0 N/A N/A Community Health
(221) Shasta Senior Nutrition Program
100 Mercy Oaks Drive
Redding,CA96003 		94-2650429 501(c)(3) 162,017 0 N/A N/A Community Support
(222) SHINGLETOWN MEDICAL CENTER
31292 Alpine Meadows Road
SHINGLETOWN,CA96088 		68-0063054 501(c)(3) 10,000 0 N/A N/A Community Health
(223) SIMPSON COLLEGE FOUNDATION
2211 COLLEGE VIEW Drive
REDDING,CA96003 		68-0274677 501(c)(3) 50,000 0 N/A N/A Education Support
(224) Sisters Of Presentation Of BVM San Francisco
2014 8808 Cameron Way
SILVER SPRINGS,MD20910 		94-2209052 501(c)(3) 10,000 0 N/A N/A Community Health
(225) SISTERS OF ST DOMINIC CONGREGATION OF THE MOST HOL
1520 Grand Avenue
SAN RAFAEL,CA949012236 		94-6080138 501(c)(3) 30,000 0 N/A N/A Community Health
(226) SISTERS OF ST FRANCIS - Mt Alverno
1330 Brewster Avenue
REDWOOD CITY,CA94062 		23-7290790 501(c)(3) 20,000 0 N/A N/A Community Health
(227) SLO NOOR FOUNDATION
1428 Phillips Lane Suite B4
SAN LUIS OBISPO,CA93401 		27-1412176 501(c)(3) 36,000 0 N/A N/A Community Health
(228) Society Of St Vincent De Paul Particular Council O
50 N B Street
SAN MATEO,CA94401 		94-1375833 501(c)(3) 25,718 0 N/A N/A Community Health
(229) SOUTHERN NEVADA HEALTH DISTRICT
330 S Valley View Boulevard
Las Vegas,NV89127 		88-0151573 Govt 9,000 0 N/A N/A Community Health
(230) SOUTHWEST HUMAN DEVELOPMENT
2850 N 24Th Street
PHOENIX,AZ85008 		86-0407179 501(c)(3) 60,000 0 N/A N/A Community Health
(231) St Bernardine Medical Center Foundation
2101 N WATERMAN AVEnue
SAN BERNARDINO,CA92404 		23-7440086 501(c)(3) 737,196 0 N/A N/A Foundation Support
(232) St John's Healthcare Foundation
1600 North Rose Avenue
Oxnard,CA93030 		20-2865781 501(c)(3) 1,123,734 0 N/A N/A Foundation Support
(233) St Joseph's Foundation
350 W Thomas Road
Phoenix,AZ85013 		94-2941245 501(c)(3) 1,594,878 0 N/A N/A Foundation Support
(234) St Joseph's Foundation of San Joaquin
1800 N California Street
Stockton,CA95204 		51-0432777 501(c)(3) 759,376 0 N/A N/A Foundation Support
(235) St Mary Medical Center Foundation
1045 Atlantic Avenue 610
Long Beach,CA90813 		23-7153876 501(c)(3) 2,139,174 0 N/A N/A Foundation Support
(236) St Mary's Dining Room
545 W Sonora Street
Stockton,CA95203 		94-2687280 501(c)(3) 88,017 5,842 Cost FOOD Community Health
(237) St Mary's Medical Center Foundation
450 Stanyan Street
San Francisco,CA94117 		94-3336143 501(c)(3) 1,137,985 0 N/A N/A Foundation Support
(238) St Rose Dominican Health Foundation
3001 St Rose Parkway
Henderson,NV89052 		88-0349432 501(c)(3) 2,529,728 0 N/A N/A Foundation Support
(239) St Vincent De Paul Store Inc
300 Baker Street
Bakersfield,CA93305 		95-1853364 501(c)(3) 7,638 0 N/A N/A Community Health
(240) STOCKTON SYMPHONY ASSOCIATION INC
4629 QUAIL LAKE Drive
STOCKTON,CA95207 		94-1462758 501(c)(3) 10,000 0 N/A N/A Community Support
(241) SUICIDE PREVENTION OF YOLO COUNTY INC
Po Box 622
DAVIS,CA95617 		94-2619492 501(c)(3) 50,000 0 N/A N/A Community Health
(242) TARZANA TREATMENT CENTERS Inc
18646 Oxnard Street
TARZANA,CA91356 		94-2219349 501(c)(3) 40,000 0 N/A N/A Community Health
(243) TEMPE COMMUNITY ACTION AGENCY Inc
2150 E Orange Street
TEMPE,AZ85281 		86-0254820 501(c)(3) 100,000 0 N/A N/A Community Health
(244) The Community Service Education and Research Fund
5380 Elvas Avenue
Sacramento,CA95819 		23-7003581 501(c)(3) 15,000 0 N/A N/A Community Health
(245) The Congenital Heart Foundation
350 W Thomas Road
Phoenix,AZ85013 		26-3342554 501(c)(3) 5,732 0 N/A N/A Foundation Support
(246) The MUSEUM OF the AFRICAN DIASPORA
685 Mission Street 3Rd Fl
SAN FRANCISCO,CA94105 		94-3338239 501(c)(3) 125,000 0 N/A N/A Community Support
(247) The PACIFIC PRIDE FOUNDATION Inc
126 E Haley St Suite A-11
SANTA BARBARA,CA93101 		95-3133613 501(c)(3) 27,950 0 N/A N/A Community Health
(248) THE PHOENIX SYMPHONY
One North First Street Ste 200
Phoenix,AZ85004 		86-6000134 501(c)(3) 26,410 0 N/A N/A Community Support
(249) THE SALVATION ARMY
900 W James M Wood Boulevard
LOS ANGELES,CA90015 		94-1156347 501(c)(3) 57,350 0 N/A N/A Community Health
(250) THEATRE RESIDENCIES INC
171 Maynard Street
SAN FRANCISCO,CA94112 		94-3289489 501(c)(3) 27,255 0 N/A N/A Community Support
(251) TRIUMPH FOUNDATION
17186 Hickory Ridge Court
CANYON COUNTRY,CA91387 		26-3295161 501(c)(3) 18,240 0 N/A N/A Community Health
(252) TURNING POINT COMMUNITY PROGrams
3440 Viking Drive Suite 114
SACRAMENTO,CA95827 		94-2609766 501(c)(3) 300,000 0 N/A N/A Community Health
(253) TURNING POINT FOUNDATION
505 Poli Street Suite 401
VENTURA,CA93001 		77-0213467 501(c)(3) 70,000 0 N/A N/A Community Health
(254) University of Arizona
Po Box 3520
Tucson,AZ857223520 		74-2652689 Govt 18,000,000 0 N/A N/A Education Support related
(255) UNITED NEGRO COLLEGE FUND Inc
220 Montgomery Street Suite1120
SAN FRANCISCO,CA94104 		13-1624241 501(c)(3) 20,000 0 N/A N/A Education Support
(256) UNITED STATES CONFERENCE OF CATHOLIC BISHOP
3211 4Th Street Ne
WASHINGTON,DC200171194 		53-0196617 501(c)(3) 10,000 0 N/A N/A Community Health
(257) UNITED WAY OF NORTHERN CALIFornia
2280 Benton Drive Bldg B
REDDING,CA96003 		94-1251675 501(c)(3) 45,000 0 N/A N/A Community Health
(258) UNITED WAY OF SANTA CRUZ COUNTY
4450 Capitola Road Suite 106
CAPITOLA,CA95010 		94-1422471 501(c)(3) 56,500 0 N/A N/A Community Health
(259) University Of California San Francisco
521 Parnassus Avenue
SAN FRANCISCO,CA941430622 		94-6036493 501(c)(3) 23,500 0 N/A N/A Community Health
(260) University Of Nevada Las Vegas Foundation
Box 451006/4505 S Maryland Parkway
Las Vegas,NV89154 		94-2790134 501(c)(3) 49,680 0 N/A N/A Education Support
(261) URQUHART MEMORIAL FOUNDATION
12734 E Appaloosa Place
SCOTTSDALE,AZ85259 		81-0556451 501(c)(3) 15,000 0 N/A N/A Community Support
(262) VOLUNTEERS IN MEDICINE Of Southern Nevada
4770 Harrison Drive Suite 200
LAS VEGAS,NV89121 		39-2072453 501(c)(3) 93,300 0 N/A N/A Community Health
(263) Weave Inc
1900 K Street
Sacramento,CA95814 		94-2493158 501(c)(3) 55,033 0 N/A N/A Community Health
(264) WELL OF HEALING MOBILE MEDical Clinic
7625 East Avenue
FONTANA,CA92336 		33-0831503 501(c)(3) 75,000 0 N/A N/A Community Health
(265) WELLNESS WORKS Community Health Center
540 W Broadway Avenue
GLENDALE,CA91204 		95-4554824 501(c)(3) 30,000 0 N/A N/A Community Health
(266) Wellspace Health Family Service Agency
8912 Volunteer Lane 100
Sacramento,CA95826 		94-1713704 501(c)(3) 565,000 0 N/A N/A Community Health
(267) WESTCARE NEVADA INC
Po Box 94738
LAS VEGAS,NV891934738 		94-2778981 501(c)(3) 121,292 0 N/A N/A Community Health
(268) Willie L Brown Jr Center On Politics And Public Se
100 Embarcadero Penthouse
SAN FRANCISCO,CA94105 		42-1572763 501(c)(3) 9,000 0 N/A N/A Community Health
(269) Womens Center Youth & Family Services
620 N San Joaquin Street
STOCKTON,CA95202 		94-2341360 501(c)(3) 63,688 0 N/A N/A Community Health
(270) Woodland Memorial Hospital Foundation
1321 Cottonwood Street
Woodland,CA95695 		94-6167964 501(c)(3) 470,498 0 N/A N/A Foundation Support
(271) YMCA OF SAN JOAQUIN COUNTY
6135 Tam OShanter Drive
STOCKTON,CA95210 		94-1156319 501(c)(3) 70,860 0 N/A N/A Community Health
(272) Yolo County Childrens Alliance
600 A Street Suite Y
Davis,CA95616 		68-0526185 501(c)(3) 36,000 0 N/A N/A Community Health
(273) YOLO HEALTHY AGING ALLIANCE
600 A Street Suite B
DAVIS,CA95616 		46-1075195 501(c)(3) 30,000 0 N/A N/A Community Health
(274) YOUTH VIOLENCE PREVENTion COUNCIL of Shasta County
1700 Pine Street
REDDING,CA96001 		68-0381728 501(c)(3) 25,000 0 N/A N/A Community Health
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
265
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
9
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) DIRECT CASH ASSISTANCE 2 800 0 none n/a
(2) FINANCIAL ASSISTANCE FOR COMMUNITY PROGRAMS 1251 19,700 0 n/a n/a
(3) FINANCIAL ASSISTANCE TO PATIENTS/NEEDY 4555 358,791 0 n/a n/a
(4) SCHOLARSHIP 128 67,300 0 n/a n/a
(5) SPONSORSHIP OF MEDICAL CONFERENCE 1 10,000 0 n/a n/a
(6) DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY 9380 0 99,420 cost clothing, car seats
(7) MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS 73 0 34,451 book medical supplies
(8) PHARMACY CHARITY PRESCRIPTION 206 0 23,171 cost Pharmaceuticals
(9) PROVISION OF FOOD/MEALS 93618 0 516,335 cost Food/meals
(10) PROVISION OF SUPPLIES FOR COMMUNITY PROGRAMS 350 0 57,833 cost posters, handouts
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, line 1 INCLUDED IN PART II ABOVE IS $4,467,264 RELATED TO The Dignity Health Community Grants program. THIS PROGRAM IS one way in which Dignity Health supports and enhances the advocacy, social justice and healthier communities efforts of its hospitals and the religious sponsors of our Catholic hospitals. Begun in 1990, the program's initial objectives were: (1) to strengthen the bonds among our member hospitals; and (2) to partner with other nonprofit organizations that share our values and also work to improve the health status and quality of life of the communities we serve. Each of the grant recipients are required to submit an annual accountability report to Dignity Health. The reports reflect activities performed, objectives, and outcomes reached by the grant recipientS. All organizations that apply for these grants are required to be a 501(c)(3) organization. OTHER GRANTS ARE PROVIDED BY Dignity Health (AND ITS MEMBER HOSPITALS) TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER Dignity Health'S EXEMPT PURPOSE. GRANTS ARE ALSO PROVIDED TO THE FUNDRAISING FOUNDATIONS THAT SUPPORT Dignity Health AND ITS MEMBER HOSPITALS TO FUND THE OPERATIONS OF THOSE FOUNDATIONS. Several grants are provided to other organizations in which Dignity Health supports community efforts. In addition, grants are provided to individuals, primarily patients, due to financial need or urgent, unforeseen occurrences requiring immediate action. Examples of assistance include transportation costs to a hospital for treatment, pharmacy costs for indigent patients, and sheltered meals. The grants are approved by the hospital's Administration department or a designated committee reviews and approves grants to be awarded.
Part II $19,489,010 IN GRANT PAYMENTS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST, A 501(C)(3) PUBLIC BENEFIT CHARITY ESTABLISHED TO SPONSOR AND SUPPORT HEALTH CARE, WERE RECOGNIZED IN CONNECTION WITH THE CALIFORNIA PROVIDER FEE PROGRAMS IN FISCAL YEAR 2015. $18,000,000 IN GRANT PAYMENTS WERE PROVIDED TO UNIVERSITY OF ARIZONA, A GOVERNMENT INSTITUTION, TO SUPPORT THE DEVELOPMENT OF EDUCATION, TRAINING AND CLINICAL RESEARCH PROGRAMS. IN ADDITION, $692,000 IN GRANT PAYMENTS WERE ALSO PROVIDED TO A NON-PROFIT CORPORATION, NEVADA CLINICAL SERVICES, INC, TO ENSURE THE AVAILABILITY OF, AND TO PROVIDE FOR MORE COST EFFECTIVE, QUALITY HEALTH CARE SERVICES TO THE LOW INCOME AND NEEDY RESIDENTS IN THE NEVADA COMMUNITY.
Schedule I (Form 990) 2014


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 Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
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
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations 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) 2014

Schedule J (Form 990) 2014
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 in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Lloyd H DeanPRESIDENT/CEO (i)
(ii)		 1,630,336
...............................
0 		4,228,309
...............................
0 		755,744
...............................
0 		990,359
...............................
0 		91,952
...............................
0 		7,696,700
...............................
0 		647,634
...............................
0
2Michael D BlaszykSEVP/ Chief Financial Officer (i)
(ii)		 903,619
...............................
0 		1,155,540
...............................
0 		313,024
...............................
0 		214,344
...............................
0 		74,586
...............................
0 		2,661,113
...............................
0 		287,228
...............................
0
3Rick GrossmanEVP/ General Counsel (i)
(ii)		 545,201
...............................
0 		645,364
...............................
0 		372,249
...............................
0 		221,515
...............................
0 		64,259
...............................
0 		1,848,588
...............................
0 		0
...............................
0
4Diane LeeVP & Associate General Counsel (i)
(ii)		 277,062
...............................
0 		233,693
...............................
0 		9,596
...............................
0 		43,375
...............................
0 		31,127
...............................
0 		594,853
...............................
0 		0
...............................
0
5Marvin O'QuinnSEVP/ Chief Operating Officer (i)
(ii)		 1,005,277
...............................
0 		1,553,872
...............................
0 		2,084,524
...............................
0 		680,945
...............................
0 		58,494
...............................
0 		5,383,112
...............................
0 		2,003,606
...............................
0
6Elizabeth ShihEVP/ Chief Admin Officer (i)
(ii)		 800,349
...............................
0 		1,109,001
...............................
0 		76,116
...............................
0 		386,301
...............................
0 		81,575
...............................
0 		2,453,342
...............................
0 		0
...............................
0
7Steven BarronSVP/ Operations So Cal East (i)
(ii)		 459,721
...............................
0 		482,876
...............................
0 		444,590
...............................
0 		68,448
...............................
0 		58,929
...............................
0 		1,514,564
...............................
0 		401,861
...............................
0
8Keith CallahanSVP/ Supp & Srvcs Resrcs Mgmt (i)
(ii)		 376,711
...............................
0 		346,721
...............................
0 		159,374
...............................
0 		58,399
...............................
0 		36,262
...............................
0 		977,467
...............................
0 		127,031
...............................
0
9Mary ConnickSVP Finance/ Corporate Control (i)
(ii)		 377,114
...............................
0 		346,721
...............................
0 		15,283
...............................
0 		58,399
...............................
0 		42,494
...............................
0 		840,011
...............................
0 		0
...............................
0
10Charles P FrancisSEVP/ Chief Strategy Officer (i)
(ii)		 708,402
...............................
0 		928,902
...............................
0 		146,965
...............................
0 		256,683
...............................
0 		57,343
...............................
0 		2,098,295
...............................
0 		99,764
...............................
0
11Lisa Gamshad ZuckermanSVP Treasury & Strategic Inves (i)
(ii)		 342,298
...............................
0 		316,458
...............................
0 		3,916
...............................
0 		54,272
...............................
0 		57,833
...............................
0 		774,777
...............................
0 		0
...............................
0
12Laurie HartingSVP/ Operations Greater Sacram (i)
(ii)		 498,349
...............................
0 		562,352
...............................
0 		268,567
...............................
0 		81,149
...............................
0 		24,629
...............................
0 		1,435,046
...............................
0 		0
...............................
0
13Linda HuntSVP/ Operations Arizona (i)
(ii)		 577,815
...............................
0 		579,157
...............................
0 		174,061
...............................
0 		88,059
...............................
0 		43,398
...............................
0 		1,462,490
...............................
0 		149,465
...............................
0
14Jeffrey W LandVP/ Corporate Real Estate (i)
(ii)		 326,893
...............................
0 		276,969
...............................
0 		4,629
...............................
0 		49,673
...............................
0 		48,070
...............................
0 		706,234
...............................
0 		0
...............................
0
15Bernita McTernanEVP/SPONSORSHIP/MISSION INTEGR (i)
(ii)		 532,484
...............................
0 		738,891
...............................
0 		41,627
...............................
0 		96,733
...............................
0 		76,330
...............................
0 		1,486,065
...............................
0 		0
...............................
0
16Timothy PanksSVP/ Finance & Rev Cycle Mgmt (i)
(ii)		 352,019
...............................
0 		308,637
...............................
0 		3,910
...............................
0 		53,385
...............................
0 		48,491
...............................
0 		766,442
...............................
0 		0
...............................
0
17Darryl RobinsonEVP/ Chief HR Officer (i)
(ii)		 597,897
...............................
0 		607,469
...............................
0 		6,825
...............................
0 		218,860
...............................
0 		45,907
...............................
0 		1,476,958
...............................
0 		0
...............................
0
18Karl SilbersteinSVP/ Financial Operations (i)
(ii)		 564,597
...............................
0 		558,524
...............................
0 		21,059
...............................
0 		85,461
...............................
0 		47,303
...............................
0 		1,276,944
...............................
0 		0
...............................
0
19Jon VanBoeningSVP/ Operations- Central Valle (i)
(ii)		 492,498
...............................
0 		434,496
...............................
0 		134,552
...............................
0 		71,821
...............................
0 		55,658
...............................
0 		1,189,025
...............................
0 		104,170
...............................
0
20Robert Wiebe MDEVP/ CHIEF MEDICAL OFFICER (i)
(ii)		 732,361
...............................
0 		906,977
...............................
0 		1,134,607
...............................
0 		553,652
...............................
0 		30,071
...............................
0 		3,357,668
...............................
0 		1,123,600
...............................
0
21Tammara WilcoxSVP/ Managed Care (i)
(ii)		 415,941
...............................
0 		379,082
...............................
0 		5,154
...............................
0 		63,121
...............................
0 		39,865
...............................
0 		903,163
...............................
0 		0
...............................
0
22Deanna WiseEVP/ Chief Information Officer (i)
(ii)		 560,358
...............................
0 		690,100
...............................
0 		2,301
...............................
0 		239,069
...............................
0 		31,879
...............................
0 		1,523,707
...............................
0 		0
...............................
0
23Charles CovaSVP Operations, Central Coast (i)
(ii)		 434,701
...............................
0 		368,567
...............................
0 		19,388
...............................
0 		63,543
...............................
0 		32,946
...............................
0 		919,145
...............................
0 		0
...............................
0
24Rodney A DavisSVP Operations, Nevada (i)
(ii)		 477,175
...............................
0 		372,123
...............................
0 		81,666
...............................
0 		67,122
...............................
0 		36,615
...............................
0 		1,034,701
...............................
0 		45,535
...............................
0
25Joseph Jasser MDPresident/ CEO DHMF (i)
(ii)		 444,614
...............................
0 		427,201
...............................
0 		100,718
...............................
0 		60,226
...............................
0 		36,780
...............................
0 		1,069,539
...............................
0 		0
...............................
0
26Bruce SwartzSVP Physician Integration (i)
(ii)		 434,587
...............................
0 		389,540
...............................
0 		20,478
...............................
0 		64,918
...............................
0 		28,269
...............................
0 		937,792
...............................
0 		0
...............................
0
27Glenna L VaskelisSVP/ Operations Bay Area (i)
(ii)		 433,436
...............................
0 		326,305
...............................
0 		440,256
...............................
0 		60,547
...............................
0 		56,031
...............................
0 		1,316,575
...............................
0 		413,469
...............................
0
28Karl Ulrich MDFormer KE (i)
(ii)		 72,178
...............................
0 		6,667
...............................
0 		45,761
...............................
0 		5,456
...............................
0 		6,649
...............................
0 		136,711
...............................
0 		0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
Sch J, PART I, LINES 1A, 4A, & 4B PART I, 1A First class travel and upgrades to such are treated on an exception basis according to Dignity Health policy. Such travel totaling $28,177 was provided to seven officers, directors and key employees. No amounts have been included as reportable compensation as these travel expenses were incurred for business purposes. There was no charter travel in 2014. Tax gross-up payments were provided to one officer, three key employees and two highest compensated employees. These gross up payments were included as taxable compensation to the listed persons. Club dues have been paid by Dignity Health for business use by two key employees and two highest compensated employees. Expenses totaling $3,511 have been included as reportable income to one highest compensated employee for amounts related to personal usage. No amount has been paid for club dues for officers. Dignity Health does not pay or reimburse for any health club memberships. Security services, including a vehicle and a driver, are provided to an officer pursuant to a qualified security assessment. No amounts have been reported as income. PART I, 4A Dignity Health's key employees and officers and certain highly compensated employees participate in a severance plan that provides market-standard compensation, ranging from payments of 6 months to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. There were no payments related to this plan in 2014. PART I, 4B Certain officers and key employees participate in the Dignity Health Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the Dignity Health Retirement Plan whose benefits are affected by the limitations imposed by sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. There were no payments related to this plan in 2014. Dignity Health's key employees and certain officers and highly compensated employees are eligible to participate in one of two non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. Benefits vest under this 457(f) plan at the later of the date the participant attains age 62 or is credited with 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service; the plan also allows for special awards. Payments pursuant to the plan arrangements for two officers, five key employees and two highest compensated employees occurred during 2014 include L. Dean, $647,634; M. O'Quinn, $2,003,606; R. Wiebe, $1,123,600,S. Barron, $401,861; K. Callahan, $127,031; L. Hunt, $149,465; J. VanBoening, $104,170; R. Davis, $45,535; and G. Vaskelis, $413,469. Certain listed persons participate in the Dignity Health Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. There were no payments related to this plan in 2014. Certain officers and key employees participate in the Dignity Health Supplemental Executive Retention/Retirement Plan, a nonqualified supplemental benefit plan which in 2002 was offered to members of the executive management team by the Dignity Health Board of Directors and would be paid only if the executives stayed with the organization for a specified number of years as the primary purpose of this plan is to provide for the retention and retirement of the participants. The executive management team is recruited from stable careers in organizations from across the country and from various industries. Duties are both extensive and complex and require substantial and diverse experience and skill sets to execute successfully. The calculation for the payments to each executive is based on the value of a final average pay annuity benefit based on retirement age and service years to the organization. Distribution occurs each July 1 if the plan formula warrants a payment. Payments made during 2014 pursuant to this plan include $287,228 to M. Blaszyk and $99,764 to C. Francis. Compensation amounts for the supplemental nonqualified retirement plans discussed above are reported as deferred compensation in the year accrued (Schedule J, Part II, column C) and are reflected again as reportable compensation in the year paid (Schedule J, Part II, column B(iii)).
Sch J - PART II Dignity Health's executive compensation philosophy is designed to assist Dignity Health in attracting and retaining the caliber of executives required to enable Dignity Health to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities Dignity Health serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and Dignity Health's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size, revenues and complexity.
Schedule J (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
  		88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
  		88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 395,000 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 441,080,000 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 473,074,676 143,117,037 162,665,635 224,006,108
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 6,640,000 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 4,074,727 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 25,069,705 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 7,774,340 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 134,070,621 162,665,635 224,006,108
11 Other spent proceeds . . . . . . . . . . . . . . 429,515,904 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 9,046,416 0 0
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0.900 % 1.200 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 1.600 % 2.500 % 0.800 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   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 "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . CITIGROUP & JPMORGAN
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . . 21.2      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . LEHMAN BROTHERS
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . . 22.2      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' AND AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085.000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS.
Schedule K (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
  		88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
  		88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 395,000 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 441,080,000 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 473,074,676 143,117,037 162,665,635 224,006,108
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 6,640,000 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 4,074,727 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 25,069,705 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 7,774,340 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 134,070,621 162,665,635 224,006,108
11 Other spent proceeds . . . . . . . . . . . . . . 429,515,904 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 9,046,416 0 0
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0.900 % 1.200 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 1.600 % 2.500 % 0.800 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   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 "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . CITIGROUP & JPMORGAN
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . . 21.2      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . LEHMAN BROTHERS
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . . 22.2      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' AND AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085.000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS.
Schedule K (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
  		88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
  		88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 395,000 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 441,080,000 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 473,074,676 143,117,037 162,665,635 224,006,108
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 6,640,000 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 4,074,727 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 25,069,705 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 7,774,340 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 134,070,621 162,665,635 224,006,108
11 Other spent proceeds . . . . . . . . . . . . . . 429,515,904 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 9,046,416 0 0
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0.900 % 1.200 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 1.600 % 2.500 % 0.800 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   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 "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . CITIGROUP & JPMORGAN
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . . 21.2      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . LEHMAN BROTHERS
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . . 22.2      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' AND AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085.000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS.
Schedule K (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
  		88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
  		88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 395,000 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 441,080,000 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 473,074,676 143,117,037 162,665,635 224,006,108
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 6,640,000 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 4,074,727 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 25,069,705 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 7,774,340 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 134,070,621 162,665,635 224,006,108
11 Other spent proceeds . . . . . . . . . . . . . . 429,515,904 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 9,046,416 0 0
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0.900 % 1.200 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 1.600 % 2.500 % 0.800 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   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 "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . CITIGROUP & JPMORGAN
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . . 21.2      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . LEHMAN BROTHERS
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . . 22.2      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' AND AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085.000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS.
Schedule K (Form 990) 2014

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
  		68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
  		88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
  		88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
  		86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
  		86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
  		52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 395,000 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 441,080,000 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 473,074,676 143,117,037 162,665,635 224,006,108
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 6,640,000 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 4,074,727 0 0 0
8 Credit enhancement from proceeds . . . . . . . . . . . 25,069,705 0 0 0
9 Working capital expenditures from proceeds . . . . . . . . . 7,774,340 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 0 134,070,621 162,665,635 224,006,108
11 Other spent proceeds . . . . . . . . . . . . . . 429,515,904 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 9,046,416 0 0
13 Year of substantial completion . . . . . . . . . . . . 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . . X     X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0.900 % 1.200 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 1.600 % 2.500 % 0.800 %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   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 "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . . X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider . . . . . . . . . CITIGROUP & JPMORGAN
  		0
  		0
  		 
 
c Term of hedge . . . . . . . . . . 21.2      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X     X   X   X
b Name of provider . . . . . . . . . LEHMAN BROTHERS
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . . 22.2      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X              
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0' AND AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAP" AND COLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085.000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITALS.
Schedule K (Form 990) 2014

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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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) Rick Grossman OFFICER relocation   X 550,000 366,667   No   No Yes  
Total ......Small Bullet $ 366,667
Part III
Grants or Assistance Benefiting 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) 2014
Schedule L (Form 990 or 990-EZ) 2014
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) Wade Dean Family member of L Dean 58,677 Employment   No
(2) Paige Gemuenden Famly membr of K Callahan 43,176 Employment   No
(3) Allison Cova Family member of C Cova 168,404 Employment   No
(4) E-lead Resources Inc Family member of L Dean 2,496,376 Marketing products & services   No
(5) Melissa Panks Consulting Family member of T Panks 86,221 Consulting Services   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

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
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 255 220,786 resale value
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 3,370 RESALE VALUE
5 Clothing and household
goods ....... 		X 235,921 RESALE VALUE
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ... X 1 10,370,000 APPRAISAL
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 ( MEDICAL EQUIPMENT ) X 9 762,185 COMPARABLE SALE
26 Other Right pointing arrow large image ( TICKETS/GIFT CERTIFICATES ) X 668 153,412 COMPARABLE SALE
27 Other Right pointing arrow large image ( ELECTRONICS ) X 6 7,254 COMPARABLE SALE
28 Other Right pointing arrow large image ( ADVERTISING ) X 1 3,000 COST
Other Right pointing arrow large image ( TOYS ) X 7 2,511 COMPARABLE SALE
Other Right pointing arrow large image ( FLAGPOLE ) X 1 2,261 COMPARABLE SALE
Other Right pointing arrow large image ( FOOD & WINE/ GIFT BASKETS ) X 23 1,537 COMPARABLE SALE
Other Right pointing arrow large image ( HEALTH & HYGIENE ITEMS ) X 1 1,400 COMPARABLE SALE
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
14
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) (2014)
Schedule M (Form 990) (2014)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
SCH M, PART I-EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS ART - WORKS OF ART: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. REAL ESTATE-OTHER: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. MEDICAL EQUIPMENT: THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. TICKETS/GIFT CERTIFICATES: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. ELECTRONICS: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. ADVERTISING: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. FLAGPOLE: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FOOD & WINE/ GIFT BASKETS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. HEALTH & HYGIENE: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED.
Sch M, Part 1, Line 32b DIGNITY HEALTH IS SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS SOLICIT AND PROCESS NON-CASH CONTRIBUTIONS ON BEHALF OF DIGNITY HEALTH'S HOSPITALS.
Schedule M (Form 990) (2014)
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 990-EZ 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
2014
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Return Reference Explanation
FORM 990, PART V, LINE 4B - NAME OF FOREIGN COUNTRY (CONT'D) TURKEY and TAIWAN
FORM 990, PART VI, GOVERNANCE AND MANAGEMENT DISCLOSURES FORM 990, PART VI, SECTION A, LINE 2 Business relationships as members of the Boards of Directors of Dignity Health subsidiaries and joint ventures: M. Blaszyk, P. Hanelt M. Blaszyk, M. O'Quinn, C. Francis M. O'Quinn, K. Silberstein M. Blaszyk, R. Grossman, M. O'Quinn, R. Wiebe, MD FORM 990, PART VI, SECTION A, LINE 7B The corporation has committed in its bylaws to continue a healing ministry based on the life and works of Jesus in the provision of healthcare services in the communities it serves ("the healing ministry"). To further the healing ministry, rights have been reserved to the religious founding co-sponsors of Dignity Health as follows, pursuant to the bylaws: A Sponsorship Council, composed of members of the co-sponsoring organizations, is responsible for overseeing and acting upon issues of Catholic identity for Catholic-sponsored facilities, and informing the healing ministry of the corporation, including both Catholic-sponsored and non-Catholic sponsored facilities, through the right to appoint three of seven members of the Mission Integrity Committee of the Board of Directors and to approve any changes in the Statement of Common Values. The Mission Integrity Committee is responsible for evaluation and resolution of management, operational, and patient care issues that impact conformance with the mission and values of the healing ministry in the operations of the corporation; approving policies and procedures with respect to implementation and conformance to the mission and values of the healing ministry; establishing and maintaining systems for monitoring compliance with the mission and values of the healing ministry, the operational integrity of the Statement of Common Values and the Ethical and Religious Directives; the operational integrity of mission integration standards; pastoral care and education programs; and ministry leadership formation programs. In addition, the Mission Integrity Committee has the power and responsibility to review and monitor the system's labor practices and pension administration. The Mission Integrity Committee may propose changes to the Statement of Common Values, provided the proposal is first reviewed with the Sponsorship Council, which has the sole power to veto any such changes before they are presented to the corporation's Board of Directors for final approval. In addition to working through the Sponsorship Council, at least two members of the Dignity Health Board of Directors continue to be women religious, serving as individuals, not as representatives of their congregations. Also, each individual sponsoring congregation continues to have the right to approve the sale or closure of its sponsored Catholic hospitals or disposition of its other stable patrimony, or the change of name of such Catholic hospital. FORM 990, PART VI, SECTION B, LINE 11B The Board of Directors delegated the review of the Form 990 to the Audit and Compliance Committee. The organization's VP/Financial Services and Reporting, and the outside accounting firm it engaged to review the return, presented each section of the final draft of this Form 990 to the Audit and Compliance Committee. Compensation schedules and disclosures were presented to the Human Resources and Compensation Committee of the Dignity Health Board of Directors by executive management. The Audit and Compliance Committee also met with various personnel involved in the preparation of the return, including, but not limited to, the SEVP/Chief Financial Officer, EVP/General Counsel, SVP/Finance and Corporate Controller, VP/Corporate Compliance Officer, and the Tax Manager. The review included an explanation of each schedule of the Form 990 and the pertinent information contained on each schedule. Subsequent to its review, the Audit and Compliance Committee reported back to the Board of Directors regarding its oversight of the Form 990 and the complete copy of the Form 990 was provided to the entire Board of Directors before the return was filed. FORM 990, PART VI, SECTION B, LINE 12C The Board of Directors has promulgated policies for the disclosure and management of conflicts of interest. Under such policies, the EVP/General Counsel is responsible for collecting, reviewing and validating annual disclosures of all covered persons (i.e., Board and Board Committee members, officers and executive leadership, key employees, management personnel at the vice president level and above, and any other personnel at his or her discretion). All covered persons are required to disclose real or potential conflicts arising from the business, financial and personal interests held by such covered persons or their family members. Covered persons are required to disclose to their superiors and to relevant decision makers any interest that may present a conflict, or the appearance of a conflict, of interest. Such disclosure is required on a transactional basis at the time such conflicts arise, when an individual becomes a covered person, and annually thereafter. Each covered person is required to certify at least annually that he/she: (1) has received a copy of the policy applicable to his/her position; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement as required by the policy. The President/CEO and EVP/General Counsel prepare annual reports of reported conflicts of interest, which are provided to the Board of Directors, Committee Chairs, and key leaders of the organization to enable responsible individuals to monitor and manage disclosed conflicts of interest and assure decisions are made in the organization's best interests. The procedures for addressing a conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board of Directors; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the interested person is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) the transaction or action is approved by a majority of disinterested persons, consistent with any requirements of bylaws or policies; and (6) any conflicting issues arising during the course of a board meeting which cannot be resolved may be referred to an independent committee of the Board of Directors. There are similar conflicts of interest provisions under the Standards of Conduct, which are applicable to all employees and which are administered by the VP/Corporate Compliance Officer who has reporting responsibility to the President/CEO as well as to the Audit and Compliance Committee of the Board of Directors. FORM 990, PART VI, SECTION B, LINE 15A & 15B The Board of Directors appoints a Human Resources and Compensation Committee, comprised of independent directors, who are accountable for setting reasonable compensation packages for each officer and certain key employees (including the President/CEO). The Human Resources and Compensation Committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for officers and key employees. The Human Resources and Compensation Committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the Committee are documented in meeting minutes which are approved at the next Committee meeting and provided to the Board of Directors. The documentation of the deliberations includes (a) the terms of the transaction approved and the date approved, (b) the members of the Committee who were present during discussion of the approved transaction and those who voted on it, and (c) the comparability data obtained and relied upon by the Committee and how the data was obtained. FORM 990, PART VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT REQUIRE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES RELATED TO CONFLICTS OF INTEREST BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE AND UPON REQUEST. THE FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990.
FORM 990, PART XI, Line 9 - Reconciliation of Net Assets CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY; (461,581,000) REVENUE FROM HEALTH-RELATED ACTIVITIES ORGANIZED AS CORPORATIONS/EXEMPT ORGANIZATIONS; 71,108,371 MARK-TO-MARKET ON INTEREST RATE SWAPS; 2,682,936 INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATION/RELATED ENTITES; 4,916,996 OTHER FUND BALANCE TRANSFERS; (1,797,274)
FORM 990, PART XII, Line 3a - Financial Statements AND Reporting The organization's federal awards were included in dignity health and subordinate corporations' consolidated OMB Circular A-133 audited schedule of federal expenditures.
SAFE HARBOR ELECTION DISCLOSURE TANGIBLE PROPERTY REGULATION STATEMENT SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION TAXPAYER IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER TREASURY REGULATION 1.263(A)-1(F) FOR ALL ELIGIBLE AMOUNTS PAID OR INCURRED DURING THE TAXABLE YEAR.
FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL FEES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REPAIRS/MAINT/DEMOLITION TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES/CONSULTING TOTAL FEES:72595253
FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY/LINEN SERVICES TOTAL FEES:28381027
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:XXX-XX-XXXX
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

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

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) CHMC Hope Street Family Center Property
1401 South Grand Avenue
Los Angeles,CA90015
27-0967098 		Real Property CA 100,793 10,812,965 DIGNITY HLTH
 
(2) Dignity Health Medical Group Nevada LLC
3001 St Rose Parkway
Henderson,NV89052
46-2574491 		CLINICS NV 3,428,737 3,667,820 DIGNITY HLTH
 
(3) Dignity Health Nevada Imaging Company LL
5495 South Rainbow Blvd Suite 203
Las Vegas,NV89118
26-3322792 		Imaging SVC NV 3,133,744 1,769,940 DIGNITY HLTH
 
(4) Dignity Health Provider Resources LLC
4550 California Avenue Suite 100
Bakersfield,CA93309
47-3373662 		Holding Compa CA 146 1,900,146 DIGNITY HLTH
 
(5) Dignity Health Purchasing Network LLC
3033 North Third Avenue
Phoenix,AZ85013
45-5555133 		Group Purchas AZ 2,914,703 2,860,298 DIGNITY HLTH
 
(6) Dignity Health USP Oxnard Surgery Center
1700 N ROSE AVENUE STE 100
OXNARD,CA93030
20-0707388 		OP Surgery CA 0 0 DIGNITY HLTH
 
(7) Sequoia Quality Care Network LLC
170 Alameda de las Pulgas
Redwood City,CA94062
47-2083870 		Care Network CA 1,952 561,368 DIGNITY HLTH
 
(8) Southern California Integrated Care Netw
2101 NORTH WATERMAN AVENUE
San Bernardino,CA92404
45-5566171 		Care Network CA 194,458 920,105 DIGNITY HLTH
 
(9) St Francis Foundation LLC
112 E Victoria Street
Santa Barbara,CA93101
42-1691710 		Leasing CA 0 1,496,694 DIGNITY HLTH
 
(10) St John's Regional Imaging Center LLC
1700 N ROSE AVENUE STE 110
Oxnard,CA93030
77-0483564 		OP Radiology CA 3,199,269 1,564,457 DIGNITY HLTH
 
(11) St Rose Quality Care Network LLC
102 E Lake Mead Drive
Henderson,NV89015
46-2147857 		Care Network NV 86,091 622,156 DIGNITY HLTH
 
(12) Trinity Care LLC
901 Corporate Center Drive Suite 40
Monterey Park,CA91754
33-0805338 		Health care CA 13,796,170 943,836 DIGNITY HLTH
 
(13) Valley Integrated Provider Network LLC
420 34th Street
Bakersfield,CA93301
47-2094529 		Care Network CA 28 123,764 DIGNITY HLTH
 
Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) Bakersfield Memorial Hospital
420 34TH Street

Bakersfield,CA93301
95-1802779 		Hospital CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(2) Community Hospital of San Bernardino
1805 Medical Center Drive

San Bernardino,CA92411
95-1643373 		Hospital CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(3) Dignity Health HPL Self-Insurance Trust
185 Berry Street

San Francisco,CA94107
94-3006034 		Administratio CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(4) Dignity Health Medical Foundation
3400 Data Drive

Rancho Cordova,CA95670
68-0220314 		Multi-sp clin CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(5) Dignity Health Provider Resources Inc
185 Berry Street Suite 300

San Francisco,CA94107
47-3366764 		Health plan CA 501(c)(4) n/a DHPR LLC
 
Yes
 
(6) Dignity Health Workers' Comp Self-Insura
185 Berry Street

San Francisco,CA94107
94-6612446 		Administratio CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(7) Dominican Health Services
1555 Soquel Drive

Santa Cruz,CA95065
77-0056778 		Community Hea CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(8) Dominican Oaks Corporation
1555 Soquel Drive

Santa Cruz,CA95065
77-0127719 		Sr Housing CA 501(c)(3) 9 DHS
 
Yes
 
(9) Golden Umbrella
200 Mercy Oaks Drive

Redding,CA96003
23-7115371 		Senior ctr CA 501(c)(3) 7 DIGNITY HLTH
 
Yes
 
(10) Mark Twain Medical Center
768 Mountain Ranch Road

San Andreas,CA95249
68-0127677 		Hospital CA 501(c)(3) 3 NA
 
 
No
(11) Mercy Senior Housing Inc
3865 J Street

Sacramento,CA95816
68-0117340 		SR HOUSING CA 501(c)(3) 9 DIGNITY HLTH
 
Yes
 
(12) Pacific Central Coast Health Centers
1400 E Church Street

Santa Maria,CA93454
77-0447575 		Clinic CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(13) Port City Operating Company LLC
3400 Data Drive

Rancho Cordova,CA95670
46-5322209 		INACTIVE CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(14) Saint Francis Memorial Hospital
900 Hyde Street

San Francisco,CA94109
94-1156295 		Hospital CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(15) Shasta Senior Nutrition Program
100 Mercy Oaks Drive

Redding,CA96003
94-2650429 		Sr Meal CA 501(c)(3) 7 DIGNITY HLTH
 
Yes
 
(16) Sierra Nevada Memorial-Miners Hospital
155 Glasson Way

Grass Valley,CA95945
94-1439787 		Hospital CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(17) St Francis Hospital Support Corporation
601 E Micheltorena Street

Santa Barbara,CA93103
77-0022302 		INACTIVE CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(18) St Mary Catholic Housing Corporation
1050 Linden Avenue

Long Beach,CA90813
33-0007728 		Sr HOusing CA 501(c)(3) 1 DIGNITY HLTH
 
Yes
 
(19) St Mary Professional Building Inc
1050 Linden Avenue

Long Beach,CA90813
23-7373088 		office space CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(20) Arroyo Grande Community Hospital Foundat
345 S Halcyon Rd

Arroyo Grande,CA93420
20-3256066 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(21) Barrow Foundation UK
16 Old Bailey
London   EC4M 7EG
UK
31-1724184 		FNDRSING FND UK 501(c)(3) NFI NA
 
 
No
(22) Barrow Neurological Foundation
350 West Thomas Road

Phoenix,AZ85013
86-0174371 		FNDRSING FND AZ 501(c)(3) 7 DIGNITY HLTH
 
 
No
(23) California Hospital Medical Center Found
1401 South Grand Avenue

Los Angeles,CA90015
95-4000909 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(24) Community Hospital Foundation of San Ber
1805 Medical Center Drive

San Bernardino,CA92411
95-3051931 		FNDRSING FND CA 501(c)(3) 11A-I CHSB
 
Yes
 
(25) Dignity Health Foundation
185 Berry Street Suite 300

San Francisco,CA94107
46-2037641 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(26) Dignity Health Foundation East Valley
475 South Dobson Road

Chandler,AZ85224
74-2418514 		FNDRSING FND AZ 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(27) Dominican Hospital Foundation
1555 Soquel Drive

Santa Cruz,CA95065
94-2450442 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(28) French Hospital Medical Center Foundatio
1911 Johnson Avenue

San Luis Obispo,CA93401
20-3256125 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(29) Glendale Memorial Health Foundation
1420 South Central Avenue

Glendale,CA91204
95-3625651 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(30) Marian Regional Medical Center Foundatio
1400 E Church Street

Santa Maria,CA93454
95-3818027 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(31) Mercy Foundation Bakersfield
PO Box 119

Bakersfield,CA93302
77-0201321 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(32) Mercy Foundation Sacramento
3400 Data Drive 3rd Flr

Rancho Cordova,CA95670
23-7072762 		FNDRSING FND CA 501(c)(3) 11A-I NA
 
 
No
(33) Mercy Medical Center Merced Foundation
301 E 13th Street

Merced,CA95340
77-0035928 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(34) Northridge Hospital Foundation
18300 Roscoe Blvd

Northridge,CA91328
23-7444901 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(35) San Gabriel Valley Medical Center Founda
438 West Las Tunas Drive

San Gabriel,CA91776
95-3430341 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(36) Sequoia Hospital Foundation
170 Alameda de las Pulgas

Redwood City,CA94062
94-2909990 		FNDRSING FND CA 501(c)(3) 11C-III-FI NA
 
 
No
(37) St Bernardine Medical Center Foundation
2101 N Waterman Avenue

San Bernardino,CA92404
23-7440086 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(38) St Francis Foundation of Santa Barbara
2323 De La Vina St Suite 104

Santa Barbara,CA93105
23-7137119 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(39) St John's Healthcare Foundation
1600 North Rose Avenue

Oxnard,CA93030
20-2865781 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(40) St Joseph's Foundation
350 West Thomas Road

Phoenix,AZ85013
94-2941245 		FNDRSING FND AZ 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(41) St Joseph's Foundation of San Joaquin
1800 N California Street

Stockton,CA95204
51-0432777 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(42) St Mary Medical Center Foundation
1050 Linden Avenue

Long Beach,CA90813
23-7153876 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(43) St Mary's Medical Center Foundation
450 Stanyan Street

San Francisco,CA94117
94-3336143 		FNDRSING FND CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(44) St Rose Dominican Health Foundation
3001 St Rose Parkway

Henderson,NV89052
88-0349432 		FNDRSING FND NV 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(45) The Congenital Heart Foundation
350 W Thomas Road

Phoenix,AZ85013
26-3342554 		FNDRSING FND AZ 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(46) Woodland Memorial Hospital Foundation
1321 Cottonwood Street 305

Woodland,CA95695
94-6167964 		FNDRSING FND CA 501(c)(3) 7 NA
 
 
No
(47) Southwest Catholic Health Network Corpor
4350 E Cotton Center Blvd Bldg D

Phoenix,AZ85040
86-0527381 		Health Plan AZ 501(c)(3) 11A-I NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) AGH Phoenix LLC

7171 51st Avenue
Laveen Village,AZ85339
47-1584330 		Hospital AZ Dignity Health
  		Related -826,606 2,108,915   No 0   No 50.100 %
(2) Arizona Care Network LLC

350 W Thomas Rd
Phoenix,AZ85013
45-4494682 		Care Network AZ Dignity Health
  		Related -18,884 1,791,232   No 0 Yes   50.000 %
(3) CBCC Outsmarting Cancer LLC

6501 Truxtun Avenue
Bakersfield,CA93309
46-1602286 		Radiation/Oncolog CA Dignity Health
  		Related -112,116 20,579,177   No 0 Yes   51.000 %
(4) DHRT Holdings LLC

185 Berry Street Suite 300
San Francisco,CA94107
35-2484591 		Holding Company DE Dignity Health
  		Related 1,571,566 79,862,275   No 0 Yes   33.870 %
(5) DignityAbrazo Health Network LLC dba AC

3030 N Central Avenue Suite 1402
Phoenix,AZ85012
46-5477985 		Management Svcs AZ Dignity Health
  		Related -301,041 3,744,684   No 0   No 50.000 %
(6) DIGNITYUSP LAS VEGAS SURGERY CENTERS LL

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-2999237 		Surgery TX Dignity Health
  		Related -10,383 7,167,877   No 0   No 50.100 %
(7) DIGNITYUSP NORCAL SURGERY CENTERS LLC

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-2468509 		Surgery TX Dignity Health
  		Related 3,755,459 27,427,913   No 0   No 50.100 %
(8) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
13-4248908 		Surgery TX Dignity Health
  		Related 3,553,765 33,118,323   No 0   No 50.100 %
(9) Dominican Breast Center LLC

1661 SOQUEL DRIVE SUITE G
SANTA CRUZ,CA95065
77-0419106 		IMAGING CA Dignity Health
  		Related -82,025 377,364   No 0 Yes   50.000 %
(10) Dominican Magnetic Resonance Imaging Cen

1545 Soquel Drive
Santa Cruz,CA94065
77-0095477 		Imaging Center CA Dignity Health
  		Related -239,730 477,849   No 0 Yes   80.000 %
(11) Folsom Sierra Endoscopy Center LP

1650 Creekside Drive 1600
Folsom,CA95630
68-0482416 		Endoscopy CA Dignity Health
  		Related 1,200,033 1,190,283   No 0 Yes   51.000 %
(12) Mercy Davis Cancer Center Management Co

2740 M Street
Merced,CA95340
94-3358445 		Mgmt of Cancer Ct CA Dignity Health
  		Related 240,684 4,681,695   No 0 Yes   50.000 %
(13) NICU Operating CO of Santa Cruz LLC

1555 Soquel Drive
Santa Cruz,CA95065
46-0502935 		Neonatal Healthca CA Dignity Health
  		Related 4,395,504 8,950,043   No 0   No 51.000 %
(14) NSC Channel Islands LLC

3000 Riverchase Galleria Suite 500
Birmingham,AL35244
77-0418197 		Ambulatory surgic CA Dignity Health
  		Related 157,863 2,686,878   No 0 Yes   51.000 %
(15) Plaza Surgery Center LP

525 E Plaza Drive Suite 100
Santa Maria,CA93454
77-0573567 		Surgery CA HSPCC Inc
  		Related 0 0   No 0 Yes   50.800 %
(16) Radiation Oncology Centers of Ventura Co

1700 N ROSE AVENUE SUITE 120
OXNARD,CA93030
77-0191706 		IMAGING CA Dignity Health
  		Related 282,622 528,062   No 0 Yes   50.000 %
(17) RBR Management LLC

91 Corporate Park Drive Suite 120
Henderson,NV89074
27-1466450 		Ambulance NV Dignity Health
  		Related 554,363 831,772   No 0   No 50.100 %
(18) Santa Cruz Land & Building LP

1555 Soquel Drive
Santa Cruz,CA95065
77-0285236 		Real Estate CA Dominican Healt
  		Related 0 0   No 0 Yes   86.210 %
(19) SMI Imaging LLC

6740 E Camelback Road Suite 101
Scottsdale,AZ85251
26-4000683 		Imaging Center CA Dignity Health
  		Related 1,606,707 40,207,880   No 0   No 59.710 %
(20) St Joseph's Surgery Center LP

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-1019390 		Surgery TX Dignity Health
  		Related 1,452,018 3,162,454   No 0 Yes   79.760 %
(21) Templeton Surgery Center LLC

1310 Las Tablas Road Suite 104
Templeton,CA94365
20-2246616 		Surgery CA Dignity Health
  		Related -10,481 1,797,373   No 0 Yes   70.450 %
(22) The Medical Pavilion at St John's

1700 Rose Avenue
Oxnard,CA93030
77-0332349 		Real Estate CA Dignity Health
  		Related -413,868 2,012,089   No 0 Yes   25.000 %
(23) OMG Arizona LLC

130 Sutter Street 2nd Flr
San Francisco,CA94104
47-1708588 		Medical Office AZ Dignity Health
  		Related -7,804 9,992,196   No 0 Yes   56.900 %
(24) Valley Physicians Surgery Center At Nort

18330 Roscoe Blvd
Northridge,CA91328
80-0864336 		Surgery CA Dignity Health
  		Related -355,928 858,569   No 0 Yes   49.000 %
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) Coastal Surgical Specialists Inc

921 Oak Park Blvd Suite 101
Pismo Beach,CA93449
74-3000596 		Ambulatory Surger CA DIGNITY HEALTH
  		S Corp 1,504,902 1,608,101 50.270 % Yes  
(2) Dignity Health Insurance Ltd

PO Box 1051
  Grand Cayman IslaKY1-1102
CJ
98-1065338 		Self Ins Fund CJ DIGNITY HEALTH
  		C Corp 169,041 38,336,857 100.000 % Yes  
(3) Glendale Memorial Services Corporation

1420 South Central Avenue
Glendale,CA91204
95-4051021 		INACTIVE CA DIGNITY HEALTH
  		C Corp 0 0 100.000 % Yes  
(4) Inland Health Organization of Southern C

1980 Orange Tree Lane Ste 200
Redlands,CA92374
33-0578944 		Hlth Care Mgmt CA DIGNITY HEALTH
  		C Corp 9,584,847 2,441,019 100.000 % Yes  
(5) Management Services Organization of Sant

1400 E Church Street
Santa Maria,CA93454
77-0318135 		INACTIVE CA DIGNITY HEALTH
  		C Corp 0 0 100.000 % Yes  
(6) Health Services of the Pacific Central C

1400 E Church Street
Santa Maria,CA93454
77-0074057 		Health Services CA DIGNITY HEALTH
  		C Corp 343,962 1,404,386 100.000 % Yes  
(7) Millenium Surgery Center Inc

9300 Stockdale Hwy 200
Bakersfield,CA93311
77-0513445 		OP Surgery Svc CA Bakersfield Mem
  		S Corp 1,043,879 7,626,307 57.980 % Yes  
(8) St Mary Health Ventures Inc

1050 Linden Avenue
Long Beach,CA90813
95-1912528 		Retail Pharmacy CA DIGNITY HEALTH
  		C Corp 1,516,540 3,071,607 100.000 % Yes  
(9) Trinity Care Infusion Services

18440 Roscoe Boulevard
Northridge,CA91325
33-0828794 		Home Care Med Svc CA DIGNITY HEALTH
  		C Corp 895,082 303,708 100.000 % Yes  
(10) Dignity Health Holding Corporation

185 Berry Street Suite 300
San Francisco,CA94107
46-0675371 		HOLDING COMPANY NV DIGNITY HEALTH
  		C Corp 8,626,179 738,673,443 100.000 % Yes  
(11) USHW Holding Corporation

25124 Springfield Court Suite 200
Valencia,CA91355
20-8050895 		Occupatnl Med Svc DE Dignity Health
  		C Corp 0 0 100.000 % Yes  
(12) US HealthWorks Holding Company Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2420844 		Occupatnl Med Svc CA US Healthworks
  		C Corp 0 0 100.000 % Yes  
(13) US HealthWorks Inc

25124 Springfield Court Suite 200
Valencia,CA91355
04-3289947 		Occupatnl Med Svc CA US Healthworks
  		C Corp 1,636,198 527,144,507 100.000 % Yes  
(14) US HealthWorks Medical Group of Alaska L

25124 Springfield Court Suite 200
Valencia,CA91355
63-1219117 		Occupatnl Med Svc AK US Healthworks
  		C Corp 18,305,605 3,576,590 100.000 % Yes  
(15) US HealthWorks of Arizona Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2660957 		Occupatnl Med Svc AZ US Healthworks
  		C Corp 7,303,959 2,094,874 100.000 % Yes  
(16) USHW of California Inc

25124 Springfield Court Suite 200
Valencia,CA91355
95-4585828 		Occupatnl Med Svc CA US Healthworks
  		C Corp 235,787,011 65,893,481 100.000 % Yes  
(17) US HealthWorks Medical Group of Florida

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654983 		Occupatnl Med Svc FL US Healthworks
  		C Corp 21,721,697 6,199,032 100.000 % Yes  
(18) US HealthWorks of Georgia Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2660956 		Occupatnl Med Svc GA US Healthworks
  		C Corp 5,940,520 24,035,079 100.000 % Yes  
(19) US HealthWorks of Indiana Inc

25124 Springfield Court Suite 200
Valencia,CA91355
35-1991196 		Occupatnl Med Svc IN US Healthworks
  		C Corp 19,725,112 17,919,217 100.000 % Yes  
(20) US HealthWorks Medical Group of Maine In

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654976 		Occupatnl Med Svc ME US Healthworks
  		C Corp 2,179,572 352,680 100.000 % Yes  
(21) US HealthWorks of New Jersey Inc

25124 Springfield Court Suite 200
Valencia,CA91355
04-3323869 		Occupatnl Med Svc NJ US Healthworks
  		C Corp 11,494,710 4,072,648 100.000 % Yes  
(22) US HealthWorks of North Carolina Inc

25124 Springfield Court Suite 200
Valencia,CA91355
56-2029468 		Occupatnl Med Svc NC US Healthworks
  		C Corp 3,866,742 1,835,588 100.000 % Yes  
(23) US HealthWorks of Ohio Inc

25124 Springfield Court Suite 200
Valencia,CA91355
31-1249564 		Occupatnl Med Svc OH US Healthworks
  		C Corp 12,109,672 4,981,174 100.000 % Yes  
(24) US HealthWorks of Pennsylvania Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2660955 		Occupatnl Med Svc PA US Healthworks
  		C Corp 5,022,830 2,779,080 100.000 % Yes  
(25) USHW of Texas Inc

25124 Springfield Court Suite 200
Valencia,CA91355
74-2785392 		Occupatnl Med Svc TX US Healthworks
  		C Corp 24,456,377 5,114,111 100.000 % Yes  
(26) US HealthWorks of Washington Inc

25124 Springfield Court Suite 200
Valencia,CA91355
91-1173613 		Occupatnl Med Svc WA US Healthworks
  		C Corp 46,962,243 9,359,398 100.000 % Yes  
(27) RUSHWINC Properties Inc

25124 Springfield Court Suite 200
Valencia,CA91355
75-3160650 		Lease negotiation GA US Healthworks
  		C Corp 0 0 100.000 % Yes  
(28) US HealthWorks of Minnesota Inc

25124 Springfield Court Suite 200
Valencia,CA91355
45-2494357 		Occupatnl Med Svc MN US Healthworks
  		C Corp 4,689,755 1,318,546 100.000 % Yes  
(29) US HealthWorks of Tennessee Inc

25124 Springfield Court Suite 200
Valencia,CA91355
45-2697510 		Occupatnl Med Svc TN US Healthworks
  		C Corp 4,879,972 1,336,379 100.000 % Yes  
(30) US HealthWorks of Illinois Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384805 		Occupatnl Med Svc IL US Healthworks
  		C Corp 9,905,766 9,191,251 100.000 % Yes  
(31) US HealthWorks of Wisconsin Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384564 		Occupatnl Med Svc WI US Healthworks
  		C Corp 7,907,227 9,601,843 100.000 % Yes  
(32) US HealthWorks of Kansas City Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-2754415 		Occupatnl Med Svc KS US Healthworks
  		C Corp 12,837,224 17,105,288 100.000 % Yes  
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
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
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
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) Community Hospital San Bernardino

 a 7,083,606 SEE PART VII
(2) Dignity Health Holding Corporation

 a 10,915,667 SEE PART VII
(3) Dignity Health Medical Foundation

 a 3,909,195 SEE PART VII
(4) DignityUSP NorCal Surgery Centers LLC

 a 424,176 SEE PART VII
(5) Dominican Magnetic Resonance Imaging Center

 a 109,909 SEE PART VII
(6) Golden Umbrella

 a 145,757 SEE PART VII
(7) Pacific Central Coast Health Centers

 a 103,246 SEE PART VII
(8) Shasta Senior Nutrition Program

 a 272,484 SEE PART VII
(9) SMI Imaging LLC

 a 65,870 SEE PART VII
(10) St Joseph's Surgery Center LP

 a 472,806 SEE PART VII
(11) St Mary Health Venture

 a 35,109 SEE PART VII
(12) St Mary Professional Building

 a 229,342 SEE PART VII
(13) Arroyo Grande Community Hospital Foundation

 b 773,961 SEE PART VII
(14) California Hospital Medical Center Foundation

 b 2,527,081 SEE PART VII
(15) DignityAbrazo Health Network LLC

 b 1,425,000 SEE PART VII
(16) Dignity Health Foundation

 b 781,826 SEE PART VII
(17) Dignity Health Foundation East Valley

 b 2,049,345 SEE PART VII
(18) Dignity Health Holding Corporation

 b 55,000,000 SEE PART VII
(19) Dignity Health Medical Foundation

 b 135,610,942 SEE PART VII
(20) DignityUSP NorCal Surgery Centers LLC

 b 11,291,915 SEE PART VII
(21) Dominican Hospital Foundation

 b 1,052,962 SEE PART VII
(22) Dominican Magnetic Resonance Imaging Center

 b 510,000 SEE PART VII
(23) French Hospital Medical Center Foundation

 b 906,128 SEE PART VII
(24) Glendale Memorial Health Foundation

 b 1,035,316 SEE PART VII
(25) Golden Umbrella

 b 147,743 SEE PART VII
(26) Inland Health Organization of Southern Califo

 b 2,216,209 SEE PART VII
(27) Marian Regional Medical Center Foundation

 b 940,680 SEE PART VII
(28) Mercy Foundation Bakersfield

 b 815,415 SEE PART VII
(29) Mercy Medical Center Merced Foundation

 b 501,219 SEE PART VII
(30) NICU Operating CO of Santa Cruz LLC

 b 80,715 SEE PART VII
(31) Northridge Hospital Foundation

 b 1,447,276 SEE PART VII
(32) One Medical Group LLC

 b 10,000,000 SEE PART VII
(33) Saint Francis Memorial Hospital

 b 216,855 SEE PART VII
(34) Shasta Senior Nutrition Program

 b 159,517 SEE PART VII
(35) SMI Imaging LLC

 b 1,595,691 SEE PART VII
(36) St Bernardine Medical Center Foundation

 b 737,196 SEE PART VII
(37) St John's Healthcare Foundation

 b 1,122,384 SEE PART VII
(38) St Joseph's Foundation

 b 1,592,611 SEE PART VII
(39) St Joseph's Foundation of San Joaquin

 b 759,376 SEE PART VII
(40) St Mary Medical Center Foundation

 b 2,137,924 SEE PART VII
(41) St Mary's Medical Center Foundation

 b 1,137,985 SEE PART VII
(42) St Rose Dominican Health Foundation

 b 2,529,728 SEE PART VII
(43) Arroyo Grande Community Hospital Foundation

 c 173,433 SEE PART VII
(44) California Hospital Medical Center Foundation

 c 2,363,123 SEE PART VII
(45) Dignity Health Foundation

 c 175,969 SEE PART VII
(46) Dignity Health Foundation East Valley

 c 3,392,697 SEE PART VII
(47) Dominican Hospital Foundation

 c 2,281,887 SEE PART VII
(48) French Hospital Medical Center Foundation

 c 503,242 SEE PART VII
(49) Glendale Memorial Health Foundation

 c 1,774,946 SEE PART VII
(50) Marian Regional Medical Center Foundation

 c 2,869,643 SEE PART VII
(51) Mercy Foundation Bakersfield

 c 2,094,660 SEE PART VII
(52) Mercy Medical Center Merced Foundation

 c 602,867 SEE PART VII
(53) Northridge Hospital Foundation

 c 3,805,037 SEE PART VII
(54) St Bernardine Medical Center Foundation

 c 653,036 SEE PART VII
(55) St John's Healthcare Foundation

 c 838,500 SEE PART VII
(56) St Joseph's Foundation

 c 4,042,210 SEE PART VII
(57) St Joseph's Foundation of San Joaquin

 c 1,022,799 SEE PART VII
(58) St Mary Medical Center Foundation

 c 4,238,826 SEE PART VII
(59) St Mary's Medical Center Foundation

 c 3,511,834 SEE PART VII
(60) St Rose Dominican Health Foundation

 c 5,084,166 SEE PART VII
(61) Dignity Health Holding Corporation

 d 125,000 SEE PART VII
(62) SMI Imaging LLC

 d 1,015,973 SEE PART VII
(63) Templeton Surgery Center LLC

 d 116,986 SEE PART VII
(64) Coastal Surgical Specialists Inc

 k 101,380 SEE PART VII
(65) Arroyo Grande Community Hospital Foundation

 l 54,448 SEE PART VII
(66) Bakersfield Memorial Hospital

 l 31,081,690 SEE PART VII
(67) California Hospital Medical Center Foundation

 l 210,408 SEE PART VII
(68) Community Hospital San Bernardino

 l 18,765,344 SEE PART VII
(69) Community Hospital San Bernardino Foundation

 l 72,987 SEE PART VII
(70) DignityAbrazo Health Network LLC

 l 165,933 SEE PART VII
(71) Dignity Health Foundation

 l 150,279 SEE PART VII
(72) Dignity Health Foundation East Valley

 l 201,591 SEE PART VII
(73) Dignity Health Hospital Prof Liab Self-Insura

 l 8,651,644 SEE PART VII
(74) Dignity Health Medical Foundation

 l 28,692,702 SEE PART VII
(75) Dignity Health Workers' Comp Self-Insurance T

 l 951,041 SEE PART VII
(76) DignityUSP NorCal Surgery Centers LLC

 l 3,892,129 SEE PART VII
(77) Dominican Hospital Foundation

 l 98,435 SEE PART VII
(78) Dominican Oaks Corporation

 l 1,032,926 SEE PART VII
(79) Folsom Sierra Endoscopy Center

 l 2,463,414 SEE PART VII
(80) French Hospital Medical Center Foundation

 l 86,856 SEE PART VII
(81) Glendale Memorial Health Foundation

 l 95,148 SEE PART VII
(82) Health Services of the Pacific Central Coast

 l 51,087 SEE PART VII
(83) Inland Health Organization of Southern Califo

 l 865,164 SEE PART VII
(84) Marian Regional Medical Center Foundation

 l 86,269 SEE PART VII
(85) Mercy Davis Cancer Center Management Co LLC

 l 2,818,948 SEE PART VII
(86) Mercy Foundation Bakersfield

 l 77,190 SEE PART VII
(87) Mercy McMahon Terrace

 l 57,519 SEE PART VII
(88) NICU Operating CO of Santa Cruz LLC

 l 5,771,432 SEE PART VII
(89) Northridge Hospital Foundation

 l 134,076 SEE PART VII
(90) Pacific Central Coast Health Centers

 l 1,056,498 SEE PART VII
(91) Plaza Surgery Center LP

 l 1,162,973 SEE PART VII
(92) Saint Francis Memorial Hospital

 l 19,957,158 SEE PART VII
(93) Sierra Nevada Memorial Miners Hospital

 l 13,577,250 SEE PART VII
(94) St Bernardine Medical Center Foundation

 l 80,618 SEE PART VII
(95) St John's Healthcare Foundation

 l 104,450 SEE PART VII
(96) St Joseph's Foundation of San Joaquin

 l 90,832 SEE PART VII
(97) St Joseph's Foundation

 l 185,197 SEE PART VII
(98) St Joseph's Surgery Center LP

 l 4,869,166 SEE PART VII
(99) St Mary Health Venture

 l 2,971,568 SEE PART VII
(100) St Mary Medical Center Foundation

 l 382,636 SEE PART VII
(101) St Mary Professional Building

 l 195,517 SEE PART VII
(102) St Mary's Foundation

 l 115,372 SEE PART VII
(103) St Rose Dominican Health Foundation

 l 209,410 SEE PART VII
(104) Trinity Care Infusion Services

 l 110,836 SEE PART VII
(105) Bakersfield Memorial Hospital

 m 2,632,207 SEE PART VII
(106) Dignity Health Hospital Prof Liab Self-Insura

 m 86,839,884 SEE PART VII
(107) Dignity Health Medical Foundation

 m 36,326,809 SEE PART VII
(108) Dignity Health Workers' Comp Self-Insurance T

 m 29,770,440 SEE PART VII
(109) Folsom Sierra Endoscopy Center

 m 5,928,329 SEE PART VII
(110) Saint Francis Memorial Hospital

 m 710,468 SEE PART VII
(111) DignityUSP NorCal Surgery Centers LLC

 s 9,343,119 SEE PART VII
(112) Dominican Health Services

 s 75,000 SEE PART VII
(113) Folsom Sierra Endoscopy Center

 s 1,534,080 SEE PART VII
(114) Mercy Davis Cancer Center Management Co LLC

 s 1,400,000 SEE PART VII
(115) NICU Operating CO of Santa Cruz LLC

 s 7,976,972 SEE PART VII
(116) NSC Channel Islands LLC

 s 125,392 SEE PART VII
(117) RBR Management LLC

 s 627,505 SEE PART VII
(118) Santa Cruz Land & Building LP

 s 75,000 SEE PART VII
(119) St Joseph's Surgery Center LP

 s 1,205,202 SEE PART VII
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
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) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R, Part V, Line 2 column (c) PART V, LINE 1A - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT TO CERTAIN RELATED ORGANIZATIONS (WHOLLY-OWNED ORGANIZATIONS, JOINT VENTURES AND MEDICAL FOUNDATION). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE AMOUNTS CHARGED FOR SUCH AGREEMENTS. SUCH CHARGES REPRESENT FAIR MARKET VALUE OF THE AMOUNTS CHARGED UNDER THESE AGREEMENTS. DIGNITY HEALTH PROVIDES LOANS TO RELATED ORGANIZATIONS (HOSPITALS, JOINT VENTURES AND WHOLLY-OWNED ORGANIZATIONS). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE INTEREST PAYMENTS CHARGED FOR THESE LOANS. PART V, LINE 1B, AND 1C - DIGNITY HEALTH AND ITS HOSPITAL FACILITIES ARE SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS OPERATE FOR THE BENEFIT OF, TO RAISE FUNDS FOR, OR TO CARRY OUT THE PURPOSES OF DIGNITY HEALTH AND ITS HOSPITALS. AS A RESULT, PAYMENTS ARE MADE DIRECTLY TO DIGNITY HEALTH FROM THE FOUNDATIONS OR DIRECTLY TO THE FOUNDATIONS FROM DIGNITY HEALTH. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" INCLUDE FUNDS EXPENDED BY DIGNITY HEALTH ON BEHALF OF THE FOUNDATIONS FOR OPERATIONAL EXPENSES. AMOUNTS REPORTED AS TRANSACTION TYPE "C" REPRESENT FUNDS RECEIVED AS GRANTS BY DIGNITY HEALTH HOSPITALS FROM THE FOUNDATIONS. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" ALSO INCLUDE FUNDING SUPPORT OF DIGNITY HEALTH MEDICAL FOUNDATION (DHMF), WHICH OPERATES CLINICS IN THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS THROUGHOUT CALIFORNIA. DIGNITY HEALTH ALSO PROVIDES FUNDING SUPPORT OF OTHER EXEMPT ORGANIZATIONS THAT PROVIDE SERVICES TO COMMUNITIES SERVED BY DIGNITY HEALTH FACILITIES WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". DIGNITY HEALTH ALSO PROVIDES CAPITAL FUNDING TO CERTAIN RELATED ORGANIZATIONS, WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". PART V, LINE 1D - DIGNITY HEALTH made LOANS TO AND LOAN GUARANTEES ON BEHALF OF VARIOUS RELATED ORGANIZATIONS. AMOUNTS REPORTED AS TRANSACTION TYPE "D" REPRESENT THE FAIR MARKET VALUE OF THE LOANS ISSUED DURING THE YEAR AND GUARANTEE FEES RECORDED DURING THE YEAR. PART V, LINE 1K - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT FROM CERTAIN RELATED ORGANIZATIONS (JOINT VENTURES). AMOUNTS REPORTED AS TRANSACTION TYPE "K" REPRESENT THE AMOUNTS CHARGED FOR SUCH AGREEMENTS. PART V, LINE 1L - DIGNITY HEALTH FACILITIES PERFORM VARIOUS SERVICES FOR OTHER RELATED ORGANIZATIONS. BELOW IS A SUMMARY OF THE TRANSACTIONS AMONG RELATED ORGANIZATIONS FOR SUCH ACTIVITIES. DIGNITY HEALTH'S CONTROLLED ENTITIES ARE ASSESSED AN AMOUNT TO COVER THE SYSTEM OFFICE OPERATIONS. IN ADDITION, AN EXPENSE IS ALSO ASSESSED TO COVER CENTRALIZED INFORMATION TECHNOLOGY COSTS OF THE ORGANIZATION, CENTRALIZED ACCOUNTS PAYABLE, PAYROLL, ACCOUNTING, DECISION SUPPORT, AND CERTAIN OTHER MANAGEMENT SERVICES. IN FY15, DIGNITY HEALTH HOSPITALS ALSO PERFORMED SERVICES FOR OTHER RELATED ORGANIZATIONS. SERVICES INCLUDED PLANT MAINTENANCE, LAUNDRY SERVICES, CENTRAL STERILIZATION SERVICES, CATERING SERVICES FOR PATIENT NOURISHMENT, AND OTHER SERVICES AS DEEMED NECESSARY. THE SERVICES PERFORMED ARE REIMBURSED AT COST. PART V, LINE 1M - PHYSICIAN CLINIC SUPPORT SERVICES ARE PROVIDED TO DIGNITY HEALTH HOSPITALS BY DHMF. DHMF OPERATES CLINICS WITH LOCATIONS THROUGHOUT NORTHERN CALIFORNIA. AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE PAYMENTS MADE TO DHMF FOR THE HOSPITALISTS AND RISK POOL PROGRAMS. DIGNITY HEALTH IS SELF-INSURED FOR WORKERS' COMPENSATION BENEFITS AND FOR HOSPITAL PROFESSIONAL AND GENERAL LIABILITY RISKS. DIGNITY HEALTH MAINTAINS SEPARATE TRUSTS FOR THESE PROGRAMS FROM WHICH CLAIMS AND RELATED EXPENSES AND COSTS OF ADMINISTERING THE PLANS ARE PAID. DIGNITY HEALTH HOSPITALS FUND THE TRUSTS, SUCH THAT OVER TIME, ASSETS HELD EQUAL LIABILITIES FOR CLAIMS INCURRED. THE AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE CASH TRANSFERRED FROM DIGNITY HEALTH TO THE TRUSTS FOR THE FY15 FUNDING OF THE SELF-INSURANCE PROGRAMS. PART V, LINE 1S - AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS.
Schedule R (Form 990) 2014
Additional Data


Software ID:  
Software Version: