TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) MOORE JAYNE........................................................................ CHAIR OF THE BOARD	2.00 .......................	X	X	0	0
(2) DRISCOLL JOHN........................................................................ VICE CHAIR	2.00 .......................	X	X	0	0
(3) DICKSON BRUCE........................................................................ SECRETARY/TREASURER	2.00 .......................	X	X	0	0
(4) GOODLIN-JONES BETH........................................................................ DIRECTOR	2.00 .......................	X		0	0
(5) NORRIS HARRY........................................................................ DIRECTOR	2.00 .......................	X		0	0
(6) THOMAS WENDY MATTSON........................................................................ DIRECTOR	2.00 .......................	X		0	0
(7) MASSEY AL........................................................................ DIRECTOR (THROUGH 9/2015)	2.00 .......................	X		0	0
(8) BARNHILL BRAD MD........................................................................ DIRECTOR	2.00 .......................	X		0	0
(9) MARCHINI GABRIELLE........................................................................ DIRECTOR	2.00 .......................	X		0	0
(10) VAN DAM DALE........................................................................ DIRECTOR	2.00 .......................	X		0	0
(11) ABERCROMBIE JIM........................................................................ DIRECTOR	2.00 .......................	X		0	0
(12) HENJUM STANLEY........................................................................ DIRECTOR	2.00 .......................	X		72,000	0
(13) NIELSEN GEORGE........................................................................ DIRECTOR	2.00 .......................	X		0	0
(14) PATHAK RAJIV MD........................................................................ CHIEF OF STAFF	2.00 .......................	X		85,415	0
(15) WHIPPLE JAMES........................................................................ PRESIDENT/CEO	40.00 .......................1.00	X	X	650,625	71,284
(16) TRUESDELL SHANNON........................................................................ CHIEF OPERATING OFFICER	40.00 .......................1.00		X	271,912	137,057
(17) ELDRIDGE LAURIE........................................................................ CHIEF FINANCIAL OFFICER	40.00 .......................1.00		X	274,395	94,230

(A) Name and business address	(B) Description of services	(C) Compensation
MARSHALL PRIMARY CARE MED ASSOCIATES INC 1095 MARSHALL WAY PLACERVILLE,CA95667	PHYSICIAN PRIMARY CARE SERVICES	9,748,599
SIERRA HEART MEDICAL GROUP INC 1004 FOWLER WAY STE 4 PLACERVILLE,CA95667	CARDIOLOGY CARE SERVICES	6,653,796
EL DORADO WOMENS HEALTH GROUP 1095 MARSHALL WAY PLACERVILLE,CA95667	OB/GYN CARE SERVICES	5,384,334
CARTERKELLY INC PO BOX 1477 PLACERVILLE,CA95667	CONSTRUCTION PURCHASED SERVICES	3,881,364
EL DORADO ANESTHESIA MED GROUP PO BOX 34120 RENO,NV89533	ANESTHESIA PROFESSIONAL FEES	3,746,074
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 62

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 ....	244,742	244,742
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	9,200	9,200
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............
4	Benefits paid to or for members ....
5	Compensation of current officers, directors, trustees, and key employees ....	2,669,913		2,669,913
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages ....	74,562,822	61,810,838	12,751,984
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	4,125,249	3,638,007	487,242
9	Other employee benefits .......	24,163,804	19,528,309	4,635,495
10	Payroll taxes ...........	6,503,701	5,275,631	1,228,070
11	Fees for services (non-employees):
a	Management ......	117,034		117,034
b	Legal .........	382,776		382,776
c	Accounting ...........	130,648		130,648
d	Lobbying ...........	129,171		129,171
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	86,250		86,250
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	41,071,725	38,186,464	2,885,261
12	Advertising and promotion ....	41,542	5,567	35,975
13	Office expenses .......	28,726,405	25,713,457	3,012,948
14	Information technology ......	2,298,015		2,298,015
15	Royalties ..
16	Occupancy ...........	4,177,448	1,364,874	2,812,574
17	Travel ............	240,597	133,576	107,021
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....	154,686	48,393	106,293
20	Interest ...........	1,684,428	1,684,428
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	12,119,456	7,205,242	4,914,214
23	Insurance ..............	1,142,090	551,043	591,047
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	BAD DEBT	8,795,127	8,795,127
b	REGISTRY	1,641,983	1,318,158	323,825
c	WORKERS COMP. INSURANCE	1,112,929	898,730	214,199
d	LAUNDRY & LINEN	461,910	461,910
e	All other expenses	820,099	22,019	798,080
25	Total functional expenses. Add lines 1 through 24e	217,613,750	176,895,715	40,718,035	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	11,589,516	1	28,545,431
2	Savings and temporary cash investments .........	4,419,348	2	6,126,566
3	Pledges and grants receivable, net ...........		3
4	Accounts receivable, net .............	28,192,979	4	25,652,932
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
			5
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
			6
7	Notes and loans receivable, net .............	5,830,007	7	3,959,134
8	Inventories for sale or use ..............	2,510,388	8	2,839,766
9	Prepaid expenses and deferred charges ..........	1,952,156	9	2,063,874
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	230,426,792
b	Less: accumulated depreciation .....	10b	117,580,389	115,407,969	10c	112,846,403
11	Investments—publicly traded securities ..........	25,721,186	11	33,162,681
12	Investments—other securities. See Part IV, line 11 .....		12	2,719,665
13	Investments—program-related. See Part IV, line 11 .....	7,598,152	13	7,743,319
14	Intangible assets ...............		14
15	Other assets. See Part IV, line 11 ...........	3,003,744	15	2,980,891
16	Total assets. Add lines 1 through 15 (must equal line 34)......	206,225,445	16	228,640,662
	17	Accounts payable and accrued expenses .........	26,689,780	17	27,411,345
18	Grants payable .................		18
19	Deferred revenue ................		19
20	Tax-exempt bond liabilities .............	66,569,638	20	65,581,172
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
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..........		22
23	Secured mortgages and notes payable to unrelated third parties ..	3,866,244	23	2,550,562
24	Unsecured notes and loans payable to unrelated third parties ....		24
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....................	14,190,872	25	25,783,341
26	Total liabilities. Add lines 17 through 25.........	111,316,534	26	121,326,420
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	94,831,590	27	107,000,617
28	Temporarily restricted net assets ...........	77,321	28	313,625
29	Permanently restricted net assets ...........		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	94,908,911	33	107,314,242
34	Total liabilities and net assets/fund balances ........	206,225,445	34	228,640,662

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

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

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


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

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 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)		(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.

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 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)		(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)		(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.)..

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

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

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.

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....

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

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).

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.

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.

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.

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

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

Has the organization accepted a gift or contribution from any of the following persons?

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

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

11b

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

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

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

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:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2014

Name of the organization

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

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

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization MARSHALL MEDICAL CENTER

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization MARSHALL MEDICAL CENTER

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
MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

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

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

Complete if the organization is described below. SchCMd Bullet

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

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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

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 Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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) .......	129,171
c	Total lobbying expenditures (add lines 1a and 1b) ...................	129,171
d	Other exempt purpose expenditures ........................	217,484,579
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............	217,613,750
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000
	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) .................	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................	0
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................		Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the 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	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	16,103	17,069	269,885	129,171	432,228

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	16,103	17,069			33,172

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)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

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 ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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

			Held at the End of the Year
a	Total number of conservation easements .......................	2a	1
b	Total acreage restricted by conservation easements ..................	2b	0.10
c	Number of conservation easements on a certified historic structure included in (a) .....	2c	0
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	0

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

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

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

Yes No

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

0.00

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

$ 0

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

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No

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


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

Describe in Part 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 .................		4,271,190		4,271,190
b	Buildings ................	25,697,982	126,878,151	67,187,821	85,388,312
c	Leasehold improvements ............
d	Equipment ................		69,422,150	50,392,568	19,029,582
e	Other .................		4,157,319		4,157,319
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......					112,846,403

Schedule D (Form 990) 2014

Page 3

Part VII

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

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








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

Part VIII

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

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









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

Part IX

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

(a) Description				(b) Book value









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

Part X

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

1.(a) Description of liability		(b) Book value
Federal income taxes
PENSION BENEFITS		25,783,341








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		25,783,341
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

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

PART II, LINE 9:

MARSHALL MEDICAL CENTER HAS ONE CONSERVATION EASEMENT FOR THE PROTECTION OF NATURAL HABITAT WHICH WAS OBTAINED ON 04/16/03. THE CONSERVATION EASEMENT IS INCLUDED AS PART OF LAND WHICH IS INCLUDED IN PROPERTY & EQUIPMENT ON THE BALANCE SHEET. NO REVENUE OR MATERIAL EXPENSES ARE ASSOCIATED WITH THE EASEMENT.

PART X, LINE 2:

EFFECTIVE JANUARY 1, 2009, THE ORGANIZATION ADOPTED ACCOUNTING STANDARDS CODIFICATION (ASC) 740-10, ISSUED BY THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB), RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS. ASC 740-10 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS AND PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DE-RECOGNITION, INTEREST, PENALTIES, AND DISCLOSURES REQUIRED. THE ORGANIZATION DOES NOT HAVE ANY ENTITY LEVEL UNCERTAIN TAX POSITIONS. THE ORGANIZATION FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND CALIFORNIA STATE JURISDICTION. GENERALLY, THE ORGANIZATION IS SUBJECT TO EXAMINATION BY U.S. FEDERAL TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A TAX RETURN.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other 13800.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

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

Yes

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

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.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

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) ..	6	898	3,748,235		3,748,235	1.790 %
b	Medicaid (from Worksheet 3, column a) ....	1	15,750	45,181,370	28,835,248	16,346,122	7.830 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .	1	226	597,763	74,936	522,827	0.250 %
d	Total Financial Assistance and Means-Tested Government Programs .	8	16,874	49,527,368	28,910,184	20,617,184	9.870 %
Other Benefits		16	2,958	1,556,236	87,861	1,468,375	0.700 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	16	2,958	1,556,236	87,861	1,468,375	0.700 %
f	Health professions education (from Worksheet 5) ..	16	116	32,518		32,518	0.020 %
g	Subsidized health services (from Worksheet 6) ..	0	0
h	Research (from Worksheet 7)	0	0
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	0	0	231,168		231,168	0.110 %
j	Total. Other Benefits ..	32	3,074	1,819,922	87,861	1,732,061	0.830 %
k	Total. Add lines 7d and 7j .	40	19,948	51,347,290	28,998,045	22,349,245	10.700 %

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	1	1	1,923	0	1,923	0 %
2	Economic development	3	4,000	9,305	0	9,305	0 %
3	Community support	5	5,820	25,283	0	25,283	0.010 %
4	Environmental improvements	2	3,100	47,094	0	47,094	0.020 %
5	Leadership development and training for community members	1		5,852	0	5,852	0 %
6	Coalition building	3	3,500	32,816	0	32,816	0.020 %
7	Community health improvement advocacy	21	30,133	102,580	0	102,580	0.050 %
8	Workforce development	3	1,769	16,206	0	16,206	0.010 %
9	Other	3	291	25,932	1,800	24,132	0.010 %
10	Total	42	48,614	266,991	1,800	265,191	0.120 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

8,795,127

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. ......

180,293

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

55,473,959

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

76,507,866

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

-21,033,907

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 EL DORADO SURGERY CENTER LLC	OUTPATIENT SURGERY CENTER	88.000 %	0 %	12.000 %
2
3
4
5
6
7
8
9
10
11
12
13

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?1 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)
1	MARSHALL MEDICAL CENTER 1100 MARSHALL WAY PLACERVILLE,CA95667 HTTPS://WWW.MARSHALLMEDICAL.ORG/ 030000059	X	X	X

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)

	MARSHALL 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):

Yes

Community Health Needs Assessment

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

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..........

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

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

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

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

Yes

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

Hospital facility’s website (list url): HTTPS://WWW.MARSHALLMEDICAL.ORG/

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): HTTP:\WWW.MARSHALLMEDICAL.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

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

Page

Part VFacility Information (continued)

	MARSHALL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 138.000000000000%
and FPG family income limit for eligibility for discounted care of 350.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): HTTPS://WWW.MARSHALLMEDICAL.ORG/

The FAP application form was widely available on a website (list url): HTTPS://WWW.MARSHALLMEDICAL.ORG/

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.MARSHALLMEDICAL.ORG/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

Page

Part VFacility Information (continued)

	MARSHALL MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

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

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

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
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 5: A COMMUNITY-BASED PARTICIPATORY RESEARCH ORIENTATION WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 50 MEMBERS OF THE HOSPITAL SERVICE AREA (HSA), EXPERT INTERVIEWS WITH 15 KEY INFORMANTS INCLUDING REPRESENTATIVES FROM EL DORADO COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT, CAPITOL HEALTH NETWORK, DIVIDE WELLNESS CENTER, EL DORADO COUNTY COMMUNITY HEALTH CENTER, BIPOLAR INSIGHTS, ACCELL COALITION, MARSHALL MEDICAL CENTER COMMUNITY BOARD, AND THE EL DORADO COUNTY MENTAL HEALTH SERVICES, AND FOCUS GROUP INTERVIEWS WITH 43 COMMUNITY MEMBERS. IN ADDITION, THE ASSESSMENT COLLECTED DATA ON MORE THAN 70 HEALTH ASSETS IN THE GREATER EL DORADO COUNTY AREA. SECONDARY DATA USED INCLUDED HEALTH OUTCOME DATA, SOCIO-DEMOGRAPHIC DATA, AND BEHAVIORAL AND ENVIRONMENTAL DATA AT THE ZIP CODE OR CENSUS TRACT LEVEL.
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 7D: CONVENED TWO MEETINGS WITH COMMUNITY BASED NON-PROFIT ORGANIZATIONS TO DISCUSS FINDINGS, PRIORITIZE NEEDS AND EXPLORE COMMUNITY ASSETS AND SOLUTIONS.
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 11: THE TOP 3 PRIORITIZED NEEDS AND THE ACTIONS BEING TAKEN TO ADDRESS THOSE NEEDS FOR THE MARSHALL MEDICAL CENTER SERVICE AREA ARE:1) LIMITED MENTAL HEALTH SERVICES; LACK OF ACCESS TO MENTAL HEALTH SERVICES- MARSHALL PROVIDED FUNDING OF $100,000 FOR EL DORADO HEALTH CONNECTIONS TO CONTINUE CARE MANAGEMENT FOR DISCHARGED PATIENTS WITH SIGNIFICANT SOCIAL ISSUES AND MEDICAL NEEDS.- MARSHALL CONVENED MEETINGS OF KEY COMMUNITY AGENCIES TO IDENTIFY CURRENT MENTAL HEALTH AND SUBSTANCE ABUSE RESOURCES, TO COMPILE INFORMATION ON AVAILABLE SERVICES FOR DISTRIBUTION TO CARE PROVIDERS AND AGENCIES AND TO IDENTIFY FUNDING SOURCES TO IMPROVE ACCESS.- MARSHALL EVALUATED THE ADDITION OF MENTAL HEALTH PROFESSIONALS TO CLINICS AND THE COMMUNITY CARE NETWORK.2) LACK OF ACCESS TO INPATIENT AND OUTPATIENT SUBSTANCE ABUSE TREATMENT- AS STATED ABOVE, MARSHALL PROVIDED $100,000 IN FUNDING TO CONTINUE SERVICE TO SUBSTANCE ABUSE CLIENTS/PATIENTS.- AS STATED ABOVE, MARSHALL MET WITH AND FACILITATED MEETINGS WITH KEY COMMUNITY AGENCIES TO FOCUS ON HEALTH AND SUBSTANCE ABUSE RESOURCES.3) LACK OF COORDINATION OF CARE AMONG PROVIDERS; NO CASE MANAGEMENT SERVICES- MARSHALL ESTABLISHED THE COMMUNITY CARE NETWORK (CCN) TO USE THE EXPERTISE OF MARSHALL PHYSICIANS, SOCIAL SERVICES, PHARMACY, CASE MANAGEMENT, DIABETES & NUTRITIAN, CHATT PROGRAM AND OTHER DEPARTMENTS TO COORDINATE THE CARE OF MARSHALL'S SICKEST PATIENTS. THE SERVICES OF THE CCN (INCLUDING ALL PROFESSIONAL CONSULTATIONS) ARE PROVIDED AT NOT CHARGE TO PATIENTS. ACTUAL EXPENSES ASSOCIATED WITH THIS PROGRAM FOR TAX YEAR 2014 WERE $558,576.- MARSHALL IS ONE OF ONLY 3 HOSPITALS IN CALIFORNIA CHOSEN TO PARTICIPATE IN A PILOT PROGRAM, MEDICARE BUNDLED PAYMENT FOR CARE IMPROVEMENT (BPCI), WHICH HAS A GOAL OF BETTER COORDINATING CARE SO AS TO MAINTAIN OR IMPROVE THE QUALITY OF CARE PATIENTS RECEIVE. READMISSIONS ACROSS ALL BPCI DIAGNOSES HAVE DECREASED FROM 27% TO 21% AND AVERAGE INPATIENT LENGTH OF STAY HAS DECREASED FROM 4.26 DAYS TO 3.86 DAYS.- MARSHALL CREATED A HEALTH COACH PROGRAM TO DEVELOP VOLUNTEER HEALTH COACHES THAT WILL ASSIST CHRONICALLY ILL PATIENTS WITH ADHERENCE TO DIET, EXERCISE AND MEDICATION REGIMENS.
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 13B: - WHEN ANY PATIENT'S SERVICE RESPONSIBILITY EXCEEDS $50,000.00 THE BALANCE ABOVE $50,000.00 WILL BE DISCOUNTED BY 50% AS CATASTROPHIC ADJUSTMENT AUTOMATICALLY UPON FINAL BILLING. PATIENTS ARE NOT REQUIRED TO APPLY FOR THIS PROGRAM TO BE ENTITLED TO THIS 50% OVER $50,000.00 DISCOUNT. IF THE PATIENT APPLIES AND QUALIFIES FOR THE FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL RECEIVE THE APPROPRIATE REDUCTION IN ADDITION TO THE CATASTROPHIC ADJUSTMENT.- A PATIENT WHOSE FAMILY INCOME DOES NOT EXCEED 350 PERCENT OF THE FEDERAL POVERTY LEVEL, AND WHO DOES RECEIVE A DISCOUNTED RATE FROM MARSHALL AS A RESULT OF HIS OR HER THIRD-PARTY COVERAGE MAY QUALIFY FOR CHARITY CARE ON THE BASIS OF HIGH MEDICAL COST. FOR THESE PURPOSES "HIGH MEDICAL COSTS" IS DEFINED TO MEAN ANY OF THE FOLLOWING: * ANNUAL OUT-OF-POCKET COSTS AT THIS FACILITY EXCEED 10% OF SUCH PATIENTS' FAMILY GROSS INCOME AND ESSENTIAL LIVING EXPENSES IN THE PRIOR 12 MONTHS; * ANNUAL OUT-OF-POCKET EXPENSES THAT EXCEED 10% PERCENT OF SUCH PATIENT'S FAMILY GROSS INCOME AND ESSENTIAL LIVING EXPENSES, IF THE PATIENT PROVIDES DOCUMENTATION OF THE PATIENT'S MEDICAL EXPENSES PAID BY THE PATIENT OR THE PATIENT'S FAMILY IN THE PRIOR 12 MONTHS.
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 16I: MMC'S HOSPITAL BILLING DEPARTMENT ALSO ATTEMPTS TO MAKE CONTACT WITH PATIENTS TO INFORM THEM THAT THEY SHOULD APPLY FOR FINANCIAL ASSISTANCE.
MARSHALL MEDICAL CENTER	PART V, SECTION B, LINE 22D: ALL PATIENTS ARE TREATED AS IF THEY HAVE FINANCIAL NEED, ALL ARE GIVEN THE CONSIDERATIONS AND OPPORTUNITIES.
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE:	HTTPS://WWW.MARSHALLMEDICAL.ORG/
MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE:	HTTPS://WWW.MARSHALLMEDICAL.ORG/
MARSHALL MEDICAL CENTER PART V, SECTION B, LINE 16C WEBSITE:	HTTPS://WWW.MARSHALLMEDICAL.ORG/

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

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, LINE 7:	BEGINNING WITH TAX YEAR 2014, MARSHALL IMPLEMENTED A COST ACCOUNTING SYSTEM TO ESTIMATE DIRECT AND INDIRECT COSTS OF PROVIDING PATIENT CARE. THE RESULTING COST-TO-CHARGE RATIO WAS APPLIED TO GROSS REVENUES ASSOCIATED WITH FINANCIAL ASSISTANCE AND MEANS-TESTED PROGRAMS IN ORDER TO CALCULATE FINANCIAL ASSISTANCE AT COST.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $8,795,127.
PART II, COMMUNITY BUILDING ACTIVITIES:	PHYSICAL IMPROVEMENTS AND HOUSING:- LOS PROGRAM - PROVIDED HOUSING FOR VULNERABLE PATIENTS AFTER DISCHARGE FROM OUR FACILITY IF THEY HAVE NO AVAILABLE CARE RESOURCES.ECONOMIC DEVELOPMENT:- EL DORADO COUNTY ECONOMIC DEVELOPMENT CORP - SUPPORTED THIS CONSORTIUM OF PRIVATE AND PUBLIC ENTITIES THAT ARE INTERESTED IN BRINGING AND RETAINING JOBS IN THE COUNTY.- EL DORADO COUNTY ECONOMIC ADVISORY COMMITTEE - FOSTERED A HEALTHIER ECONOMIC ENVIRONMENT IN EL DORADO COUNTY WHICH WILL AID IN PROMOTING THE HEALTH OF THE COMMUNITY BY REDUCING VULNERABLE POPULATIONS.- CHAMBERS OF COMMERCE - PARTICIPATED IN FOSTERING A HEALTHIER ECONOMIC DEVELOPMENT AND ENVIRONMENT IN EL DORADO COUNTY.COMMUNITY SUPPORT:- EVERY 15 MINUTES - TO EDUCATE STUDENTS ABOUT THE RISKS OF DRINKING AND DRIVING AND THE CONSEQUENCES OF SUCH.- EL DORADO HIGH SCHOOL HEALTH CAREER FAIR - TO EDUCATE STUDENTS ABOUT CAREER OPTIONS IN HEALTHCARE.- DISASTER/PUBLIC HEALTH EMERGENCY - A PROGRAM WE PARTICIPATE IN, ABOVE AND BEYOND OUR REQUIRED PARTICIPATION, THAT CONDUCTS DRILLS AND EXERCISES TO BE PREPARED FOR EMERGENCIES.- SUPPORT GROUP - HOSTED AND MODERATED LOCAL STROKE SUPPORT GROUP.- PUBLIC USE OF CONFERENCE ROOMS - SUPPORTED SEVERAL LOCAL HEALTH RELATED GROUPS BY ALLOWING USE OF OUR LEASED OR OWNED SPACE FOR VARIOUS SUPPORT AND EDUCATIONAL PROGRAMS AND SERVICES.ENVIRONMENTAL IMPROVEMENTS:- GREEN TEAM - FACILITATED RECYCLING AT ALL MARSHALL MEDICAL CENTER LOCATIONS.- EWASTE COLLECTION - FACILITATED EWASTE REMOVAL FROM LANDFILLS.LEADERSHIP DEVELOPMENT & TRAINING COMMUNITY MEMBERS:- LEADERSHIP EL DORADO - SUPPORTED THIS PROGRAM THAT FOSTERED RELATIONSHIPS WITH LOCAL REGULATORY AGENCIES (EL DORADO COUNTY, EID, COUNTY JAIL, ETC.).COALITION BUILDING:- ACCEL CARE PATHWAYS PROJECT - PARTICIPATED IN THIS COUNTYWIDE HEALTH COLLABORATIVE DEDICATED TO IMPROVING EL DORADO COUNTY RESIDENTS ACCESS TO AND QUALITY OF HEALTHCARE BY DEVELOPING AND IMPLEMENTING A PATIENT CASE MANAGEMENT SERVICES PROGRAM.- TRIBAL HEALTH PROJECTS - PARTICIPATED IN ACTIVITIES TO BUILD A RELATIONSHIP WITH THE LOCAL TRIBE TO COORDINATE AND PROVIDE SERVICES TO A VULNERABLE POPULATION.- ACA IMPACT COMMITTEE - PARTICIPATED IN LOCAL COALITION TO EDUCATE COUNTY GOVERNING BOARD ABOUT EXPECTED IMPACT OF THE AFFORDABLE CARE ACT. COMMUNITY HEALTH IMPROVEMENT ADVOCACY:- TAXI CABS AND OTHER MEDICAL NEEDS - ASSISTED DISCHARGED PATIENTS WITH TRANSPORTATION NEEDS, PRESCRIPTIONS, CAREGIVERS AND DURABLE MEDICAL EQUIPMENT.- INFECTION CONTROL - EDUCATED LOCAL ORGANIZATIONS ABOUT INFECTION CONTROL, MULTI DRUG RESISTANT ORGANISMS AND ISOLATION TECHNIQUES TO REDUCE THE OCCURENCE OF DISEASE IN THE COUNTY.- SPORTS NIGHT - HOSTED A ONCE A YEAR FREE SPORTS PHYSICAL CLINIC TO FOSTER COMRADERIE BETWEEN LOCAL HIGH SCHOOLS AS WELL AS GOOD HEALTH THROUGH PHYSICAL ACTIVITY.- RELAY FOR LIFE (CANCER SERVICES) - PARTICIPATED IN FUND RAISING ACTIVITY TO EDUCATE COMMUNITY ABOUT CANCER RESOURCES AVAILABLE.- SUSAN G. KOMEN - TO PARTICIPATE IN FUND RAISING ACTIVITY TO EDUCATE COMMUNITY ABOUT BREAST CANCER RESOURCES AVAILABLE.- RELAY FOR LIFE (LAB) - TO PARTICIPATE IN FUND RAISING ACTIVITY TO EDUCATE THE COMMUNITY ABOUT CANCER RESOURCES AVAILABLE.- PARAMEDIC EDUCATION - PROVIDED SKILLS REVIEW CLASSES FOR LOCAL MEDICS.- PARTNERS IN CARE - SUPPORTED THE ORGANIZATION WITH THEIR MISSION OF "TO SUPPORT THE DIGNITY AND CHOICE OF PEOPLE IN OUR COMMUNITY AS THEY WALK THE PATH OF SERIOUS ILLNESS".- EL DORADO COMMUNITY HEALTH CLINIC BOARD PARTICIPATION - SUPPORTED THIS LOCAL ORGANIZATION'S COMMUNITY HEALTH RELATED EFFORTS.- AMERICAN HEART ASSOCIATION RED DRESS DAY EVENT - TO SUPPORT HEART HEALTH THROUGH RAISING FUNDS WITH A "JEAN DAY" EVENT.- WOMEN'S HEALTH EXPO (EDH) - TO SUPPORT WOMEN'S HEALTH THROUGH PARTICIPATION. NUMEROUS HEALTH SCREENINGS ARE DONE BY MEDICAL PERSONNEL.- AFFAIR OF THE HEART - ANNUAL EVENT TO EDUCATE AND PROVIDE FREE HEALTH SCREENING.- VARIOUS FUNDRAISING EVENTS FOR NONPROFIT ORGANIZATIONS - PARTICIPATED IN VARIOUS PERIODIC EVENTS TO HELP RAISE FUNDS FOR LOCAL NON-PROFITS.- SPEAKERS BUREAU - ASSORTMENT OF COMMUNITY EVENTS TO EDUCATE THE PUBLIC ABOUT STROKE AWARENESS, PLASTIC SURGERY OPTIONS, OB/GYN ISSUES AND OTHER HEALTH ISSUES.- SPEAKERS BUREAU - PERIODIC EVENTS TO EDUCATE THE PUBLIC ABOUT STROKE AWARENESS, PLASTIC SURGERY OPTIONS, OB/GYN ISSUES AND OTHER HEALTH ISSUES.- CARDIAC SERVICES EMPLOYEES COMMUNITY OUTREACH - SPEAKING TO LOCAL ORGANIZATIONS ABOUT HEALTHY LIFESTYLE CHOICES.- VARIOUS HEALTH ORGANIZATION BOARDS PARTICIPATION - SUPPORTED STATE AND NATIONAL HEALTH ORGANIZATION'S EFFORTS FOR BETTER HEALTHCARE.- ADVERSE CHILDHOOD EXPERIENCE TASKFORCE - PARTICIPATED IN A COLLABORATIVE EFFORT OF NUMEROUS EL DORADO COUNTY ORGANIZATIONS TO BRING ABOUT A HEALTHY ENVIRONMENT FOR THE COUNTIES CHILDREN.- EL DORADO COUNTY HEALTH ADVISORY - PARTICIPATED IN A GROUP OF ORGANIZATIONS THAT BRAINSTORM SOLUTIONS TO IMPROVE HEALTH IN OUR COMMUNITY.- MINI CONFERENCE (BREASTFEEDING COALITION) - SUPPORTED THE EFFORTS OF OUR LOCAL BREASTFEEDING COALITION.- WESTERN SLOPE COMMUNITY STRENGTHENING GROUP - SUPPORTED EFFORTS OF VARIOUS LOCAL HEALTH ORGANIZATIONS.- KID'S EXPO - PARTICIPATED IN ANNUAL EVENT TO EDUCATE AND PROMOTE HEALTHY LIFESTYLE.WORKFORCE DEVELOPMENT:- EL DORADO UNION HS DISTRICT CAREER TECHNICAL EDUCATION ADVISORY COMMITTEE - PARTICIPATED IN A PROGRAM OF PRIVATE ENTITIES THAT HELP THE HIGH SCHOOL DISTRICT PLAN AND PREPARE FOR TECHNICAL CAREERS AND EDUCATION OFFERINGS.- MATTHEW BONSER SCHOLARSHIP - SUPPORTED A LOCAL SCHOLARSHIP FUND THAT ENCOURAGES AND SUPPORTS THE NURSING PROFESSION.- HEALTH CAREER EXPLORATION - PARTICIPATED IN AN ALL DAY EVENT THAT ALLOWED PARTICIPANTS TO SHADOW PROFESSIONALS AT MARSHALL MEDICAL CENTER.OTHER:- COMMUNITY EDUCATION FOR LEVEL 3 TRAUMA DESIGNATION - EDUCATED THE ELDERLY TO PREVENT FALLS. PARTICIPATED BY HAVING TRAUMA MEDICAL DIRECTOR SPEAK TO THE MEDICAL STAFF, DISTRIBUTE POSTERS TO VARIOUS LOCATIONS (ER, MD OFFICES, AND OTHER COMMUNITY CENTERS) AND HAND OUT PAMPHLETS IN ER TO GERIATRIC PATIENTS.- AUXILIARY - ENABLED AND SUPPORTED VOLUNTEERISM.- PATERNITY OPPORTUNITY PROGRAM - HELPED UNMARRIED FATHERS GAIN LEGAL RIGHTS AS THE CHILD'S FATHER.
PART III, LINE 4:	SEE FINANCIAL STATEMENT NOTE 1 - "PATIENT ACCOUNT RECEIVABLE AND "ALLOWANCE FOR DOUBTFUL ACCOUNTS" SECTIONS ON FINANCIAL STATEMENT PAGE 11. MARSHALL MEDICAL CENTER (MMC) MAKES A BEST EFFORT TO APPLY ALL KNOWN DISCOUNTS AND PAYMENTS POSTED TO THE PATIENT ACCOUNT PRIOR TO DETERMINATION OF BAD DEBT WRITE-OFF. NON-COMPLIANT PATIENTS MAY RESULT IN THE DELAY OF PROPERLY APPLIED DISCOUNTS.DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE ABOVE - IN ACCORDANCE WITH CALIFORNIA HEALTH AND SAFETY CODE SECTIONS 127400 ET SEQ., MMC DISCOUNTS PAYMENT AND PROVIDES CHARITY CARE TO FINANCIALLY QUALIFIED PATIENTS. PATIENTS WHO QUALIFY FOR THESE DISCOUNTS OR CHARITY CARE UNDER OUR POLICIES INCLUDE PATIENTS WHO MEET BOTH OF THE FOLLOWING QUALIFICATIONS: 1. THE PATIENT EITHER IS SELF-PAY PATIENT OR HAS HIGH MEDICAL COSTS, AS DEFINED IN OUR DISCOUNT PAYMENT AND CHARITY CARE POLICIES; AND 2. THE PATIENT HAS A FAMILY INCOME (AS DEFINED IN THE POLICIES) THAT DOES NOT EXCEED 350% OF THE FEDERAL POVERTY LEVEL.METHOD TO DETERMINE LINE 3 - MMC ESTIMATES THAT APPROXIMATELY 2.05% OF ALL PATIENTS ACCOUNTS ASSIGNED TO BAD DEBT MIGHT BE ATTRIBUTABLE TO PATIENTS WHO MIGHT HAVE QUALIFIED FOR FINANCIAL ASSISTANCE HAD THOSE PATIENTS PROVIDED SUFFICIENT INFORMATION TO BECOME QUALIFIED.RATIONALE FOR INCLUDING BAD DEBT AS COMMUNITY BENEFIT - N/A - NOT INCLUDED.
PART III, LINE 8:	THE SHORTFALL INCURRED ON MEDICARE PATIENTS CAN BE CONSIDERED A COMMUNITY BENEFIT BECAUSE MARSHALL MEDICAL CENTER IS THE ONLY HOSPITAL FACILITY WITHIN APPROX 25 MILES. THEREFORE, PATIENTS WOULD HAVE TO TRAVEL OUTSIDE OF THE COMMUNITY TO OBTAIN HEALTHCARE SERVICES. THE ONLY OTHER HOSPITAL FACILITY IN EL DORADO COUNTY IS APPROXIMATELY 50 MILES FROM PLACERVILLE AND PATIENTS WOULD HAVE TO TRAVERSE A 7000+ FOOT ELEVATION MOUNTAIN PASS TO OBTAIN HEALTHCARE SERVICES FROM THAT FACILITY. OUR PATIENT POPULATION IS HEAVILY MEDICARE WEIGHTED AND MARSHALL PROVIDES A VAST AMOUNT OF CARE TO THIS MEDICARE POPULATION WHICH TEND TOWARDS MORE ACUTE ILLNESSES WHICH DOES NOT LEND ITSELF TO TRAVEL. BECAUSE WE ARE A COMMUNITY BASED HOSPITAL, WE HAVE TO PROVIDE A BROAD RANGE OF SERVICES TO MEET THE NEEDS OF THE COMMUNITY, THERE IS NO OTHER LOCAL FACILITY. THIS IMPACTS THE ABILITY TO SPECIALIZE IN MORE FOCUSED SERVICES.COSTING METHODOLOGY - REPORTED MEDICARE ALLOWABLE COSTS ARE SPECIFIC COSTS REPORTED ON THE MEDICARE COST REPORT, BASED ON ALLOWABLE PER DIEM RATES DERIVED FROM STEP-DOWN COST ALLOCATION.
PART III, LINE 9B:	PATIENTS ARE PRESENTED AT THE TIME OF REGISTRATION AND FIRST BILLING STATEMENT OF ALL DISCOUNT AND PROGRAM OPTIONS AVAILABLE. BILLING STATEMENTS 2 THROUGH 5 REMIND THE PATIENT OF DISCOUNTS AVAILABLE. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED COVERAGE OR FOR MARSHALL MEDICAL CENTER'S OWN FINANCIAL ASSISTANCE PROGRAM, MARSHALL MEDICAL CENTER SHALL NOT KNOWINGLY SEND OR ASSIGN SUCH PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY PRIOR TO 180 DAYS FROM THE DATE OF MARSHALL MEDICAL CENTER'S INITIAL BILLING OF THAT ACCOUNT. PRIOR TO FILING ANY LEGAL ACTION AGAINST A PATIENT, THE DEBT COLLECTION AGENCY WILL (I) PERFORM AN ANALYSIS OF THE PATIENT'S ASSETS AND INCOME TO DETERMINE WHETHER THE PATIENT HAS ASSETS AND INCOME SUFFICIENT TO JUSTIFY FILING THE LEGAL ACTION (II) PRESENT THE ANALYSIS TO MARSHALL MEDICAL CENTER DIRECTOR OF HOSPITAL PATIENT BILLING, IN SUCH FORMAT AS MARSHALL MEDICAL CENTER MAY REQUEST, AND (III) OBTAIN THE DIRECTOR'S APPROVAL FOR FILING THE LEGAL ACTION AGAINST THE PATIENT.
PART VI, LINE 2:	COMMUNITY'S HEALTHCARE NEEDS ARE DETERMINED BASED ON MANY FACTORS WHICH INCLUDES BUT ARE NOT LIMITED TO: MARKET STUDIES, PHYSICIAN FEEDBACK BASED ON THE NEEDS OF THEIR PATIENTS, HEALTH MANPOWER STUDIES, SURVEYS, AND A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS.
PART VI, LINE 3:	AT THE TIME OF REGISTRATION, EVERY UNINSURED PATIENT IS PRESENTED WITH A DOCUMENT THAT OUTLINES ALL THE FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS, AS WELL AS THE ORGANIZATIONAL CHARITY CARE POLICY THAT THEY MAY BE ABLE TO QUALIFY FOR. MARSHALL MEDICAL CENTER PROVIDES, AT ITS EXPENSE, PRIVATE CONSULTANTS AND COUNTY MEDI-CAL EMPLOYEES WHO WORK WITH PATIENTS DURING AND AFTER HOSPITALIZATION TO ENSURE THAT THEY UNDERSTAND ELIGIBILITY REQUIREMENTS, TO HELP THEM COMPLETE THE NECESSARY FORMS, TO FILE ALL THE NECESSARY DOCUMENTS AND TO ATTEND ANY REQUISITE APPOINTMENTS WITH PROVIDING AGENCIES.
PART VI, LINE 4:	MARSHALL MEDICAL CENTER SERVES APPROXIMATELY 190,000 RESIDENTS ON THE WESTERN SLOPE OF THE SIERRAS IN EL DORADO COUNTY. OTHER PERTINENT DEMOGRAPHICS ABOUT OUR HOSPITAL SERVICE AREA INCLUDE:* MEDIAN AGE OF POPULATION IS 50-59 YEARS OLD* AVERAGE HOUSEHOLD INCOME IS $67,019* PERCENTAGE LIVING IN POVERTY IS 7.8%* PERCENTAGE UNEMPLOYED IS 11.3%* PERCENTAGE UNINSURED IS 11.4%* ETHNIC PERCENTAGES ARE: WHITE 84%, LATINO 11%, AFRICAN AMERICAN .004%, ASIAN/PACIFIC ISLANDER 2%, NATIVE AMERICAN .007%, OTHER 2%
PART VI, LINE 5:	- MARSHALL MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY THROUGH A LARGE AND VARIED ARRAY OF HEALTHCARE SERVICES INCLUDING BUT NOT LIMITED TO INPATIENT SERVICES (OBSETRICS, SURGERIES, RADIOLOGY, DIAGNOSTIC CARDIAC CATHETERIZATIONS), OUTPATIENT SERVICES(EMERGENCY ROOM, OUTPATIENT SURGERIES, RADIOLOGY, LABORATORY, DIAGNOSTIC CARDIAC CATHETERIZATIONS, NUMEROUS FAMILY AND SPECIALTY CLINICS, RURAL HEALTH CLINIC, CANCER PROGRAMS, AND HOME HEALTH VISITS). WE RECOGNIZE THAT WE HAVE AN OBLIGATION TO PROVIDE SERVICES ABOVE AND BEYOND OUR ROLE AS A HEALING FACILITY.- OPEN MEDICAL STAFF: WE OFFER AN "OPEN MEDICAL STAFF" MODEL EXCEPT FOR A FEW SELECT SPECIALTIES WHICH ARE "EXCLUSIVE CONTRACTS".- COMMUNITY BOARD: OUR BOARD OF DIRECTORS IS COMPRISED OF 13 (ONE SEAT WAS VACANT AT OCTOBER 31) VOLUNTEER COMMUNITY MEMBERS. THEY DEDICATE NUMEROUS HOURS OF THEIR OWN TIME TO CONTRIBUTE TO A POSITIVE HEALTH ENVIRONMENT THROUGH MARSHALL MEDICAL CENTER.- USE OF SURPLUS FUNDS: EXCESS REVENUE (SURPLUS FUNDS) ARE RETAINED FOR FUTURE COMMUNITY NEEDS INCLUDING BUT NOT LIMITED TO CAPITAL IMPROVEMENTS, EXPANSION OF NEW SERVICES AND TECHNOLOGICAL IMPROVEMENTS. THE COMMUNITY BASED BOARD OF DIRECTORS CONTROLS THE DIRECTION OF THE USE OF SURPLUS FUNDS.
PART VI, LINE 6:	N/A
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
MARSHALL MEDICAL CENTER

Employer identification number
94-1450151

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to 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	(h) Purpose of grant or assistance
(1) MARSHALL FOUNDATION FOR COMMUNITY HEALTH PO BOX 1996 PLACERVILLE,CA95667	23-7419011	501(C)(3)	188,033	PROGRAM SUPPORT
(2) PARTNERS IN CARE PO BOX 845 PLACERVILLE,CA95667	20-5016935	501(C)(3)	25,000	PROGRAM SUPPORT

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

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

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

Cat. No. 50055P

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
(1) MARKETING SCHOLARSHIPS	9	9,000
(2) EDUCATION SCHOLARSHIPS	1	200

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 2:

MARSHALL MEDICAL CENTER'S ASSISTANCE TO EITHER AN ORGANIZATION OR AN INDIVIDUAL IS LIMITED. THE PROCEDURES FOR MONITORING THE GRANTS ARE DIFFERENT FOR EACH TYPE OF ASSISTANCE. * MARKETING SPONSORSHIP ASSISTANCE - THE AMOUNTS TO EACH ORGANIZATION ARE NOMINAL AND USUALLY GIVEN TO NON-PROFIT ORGANIZATIONS. NO MONITORING IS NEEDED ON THESE DONATED MONIES BASED ON MATERIALITY AND CRITERIA FOR SELECTION. * PROGRAM SUPPORT RELATED TO PAYROLL FUNDING - MONITORING IS CONDUCTED AS THE FUNDS ARE ISSUED TO COVER THE PAYROLL AND BENEFIT EXPENSES OF A RELATED NON-PROFIT ORGANIZATION. ADDITIONALLY, THE GRANT RECIPIENT SHARES A BOARD MEMBER WITH MARSHALL AND RECIPIENT MANAGEMENT REPORTS TO MARSHALL'S BOARD OF DIRECTORS ON AN ANNUAL BASIS. * PROGRAM SUPPORT RELATED TO COMMUNITY HEALTH ISSUES - THIS FINANCIAL ASSISTANCE IS GIVEN TO A HEALTHCARE NON-PROFIT FOR COMMUNITY HEALTH NEEDS. THE CARE MANAGER FOR THE RECEIVING ORGANIZATION ATTENDS CASE MANAGEMENT MEETINGS HERE AT MARSHALL AND GIVES PERIODICAL VERBAL REPORTS ON PROGRESS MADE WITH THE GRANT ASSISTANCE MONIES. THE ORGANIZATION ALSO PROVIDES COMPREHENSIVE WRITTEN REPORTS REGARDING PROGRESS ON AN ANNUAL BASIS TO MANAGEMENT. * ASSISTANCE TO INDIVIDUALS IN THE FORM OF EDUCATIONAL SCHOLARSHIPS - THESE ASSISTANCE AWARDS ARE NOMINAL AND ARE GIVEN TO RECIPIENTS FOR EDUCATION NEEDS WITHOUT FOLLOWUP MONITORING. RECIPIENTS MUST MEET SELECTION CRITERIA BEFORE SUPPORT IS PROVIDED.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

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

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

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

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

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

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

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

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

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

Cat. No. 50053T

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1WHIPPLE JAMESPRESIDENT/CEO	(i) (ii)	378,238 ............................... 0	271,199 ............................... 0	1,188 ............................... 0	40,667 ............................... 0	30,617 ............................... 0	721,909 ............................... 0	0 ............................... 0
2TRUESDELL SHANNONCHIEF OPERATING OFFICER	(i) (ii)	256,080 ............................... 0	14,644 ............................... 0	1,188 ............................... 0	114,358 ............................... 0	22,699 ............................... 0	408,969 ............................... 0	0 ............................... 0
3ELDRIDGE LAURIECHIEF FINANCIAL OFFICER	(i) (ii)	259,881 ............................... 0	14,244 ............................... 0	270 ............................... 0	65,116 ............................... 0	29,114 ............................... 0	368,625 ............................... 0	0 ............................... 0
4KREJCI KATHYCHIEF NURSING OFFICER	(i) (ii)	209,090 ............................... 0	15,757 ............................... 0	414 ............................... 0	84,436 ............................... 0	17,984 ............................... 0	327,681 ............................... 0	0 ............................... 0
5SAHARA VERNVP-PRIMARY CARE & CLINICAL	(i) (ii)	179,819 ............................... 0	2,150 ............................... 0	1,188 ............................... 0	36,309 ............................... 0	17,984 ............................... 0	237,450 ............................... 0	0 ............................... 0
6DIPONTI ROBERTDIRECTOR OF PHARMACY	(i) (ii)	181,231 ............................... 0	1,465 ............................... 0	774 ............................... 0	23,454 ............................... 0	10,691 ............................... 0	217,615 ............................... 0	0 ............................... 0
7RICE CYNTHIAVP OF CLINICAL NURSING SERVICES	(i) (ii)	155,698 ............................... 0	1,753 ............................... 0	414 ............................... 0	15,446 ............................... 0	16,582 ............................... 0	189,893 ............................... 0	0 ............................... 0
8RICE REGINALD D SRVP OF MEDICAL STAFF	(i) (ii)	225,249 ............................... 0	0 ............................... 0	0 ............................... 0	18,725 ............................... 0	20,200 ............................... 0	264,174 ............................... 0	0 ............................... 0
9HUGHES SAMSTAFF RN	(i) (ii)	172,372 ............................... 0	0 ............................... 0	287 ............................... 0	22,282 ............................... 0	27,659 ............................... 0	222,600 ............................... 0	0 ............................... 0
10COMER SCOTTVP OF EMPLOYEE SERVICES	(i) (ii)	166,836 ............................... 0	10,746 ............................... 0	414 ............................... 0	17,863 ............................... 0	19,082 ............................... 0	214,941 ............................... 0	0 ............................... 0
11BRONNY CORINNASTAFF RN	(i) (ii)	181,010 ............................... 0	0 ............................... 0	96 ............................... 0	19,455 ............................... 0	16,582 ............................... 0	217,143 ............................... 0	0 ............................... 0
12SEIVERT KERSTINCASE MANAGEMENT NURSING DIRECTOR	(i) (ii)	169,259 ............................... 0	2,185 ............................... 0	1,188 ............................... 0	83,671 ............................... 0	22,699 ............................... 0	279,002 ............................... 0	0 ............................... 0

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
PART I, LINE 1A	THE CEO RECEIVES A STIPEND WHICH HE MAY USE AT HIS DISCRETION; MMC DOES NOT REQUIRE SUBSTANTIATION. UNSUBSTANTIATED STIPEND USED IS TREATED AS TAXABLE COMPENSATION TO THE CEO.
PART I, LINE 7	BONUS IS CALCULATED USING A PRE-DETERMINED FORMULA BUT THE BOARD HAS THE ABILITY TO TAKE INTO ACCOUNT OTHER FACTORS AND ADJUST IT AT THEIR DISCRETION.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Information 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
MARSHALL MEDICAL CENTER

Employer identification number
94-1450151

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033FRK8	03-25-2004	49,592,200	SEE PART VI		X		X		X
B	CA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033LD79	09-26-2012	19,682,430	CURRENT REFUND PRIOR BONDS, PAY COSTS OF ISSUANCE, AND FUND A RESERVE		X		X		X
C	CA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13033L6R3	04-09-2015	30,423,048	CURRENT REFINANCING OF PRIOR BONDS AND TO PAY RELATED COSTS OF ISSUANCE		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	30,000,000		4,065,000
2 Amount of bonds legally defeased . . . . . . . . . . .
3 Total proceeds of issue . . . . . . . . . . . . . .	21,059,218		19,682,432		30,423,053
4 Gross proceeds in reserve funds . . . . . . . . . . . .	649,044		2,480,944		1,351,513
5 Capitalized interest from proceeds . . . . . . . . . . .	1,460,000
6 Proceeds in refunding escrows . . . . . . . . . . . .
7 Issuance costs from proceeds . . . . . . . . . . . .	378,778		391,443		511,836
8 Credit enhancement from proceeds . . . . . . . . . . .	2,171,170		414,659		791,050
9 Working capital expenditures from proceeds . . . . . . . . .
10 Capital expenditures from proceeds . . . . . . . . . . .	16,399,270
11 Other spent proceeds . . . . . . . . . . . . . .	1,866		16,377,424		29,110,678
12 Other unspent proceeds . . . . . . . . . . . . . .	9,488				9,488
13 Year of substantial completion . . . . . . . . . . . .	2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .		X	X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X		X		X
16 Has the final allocation of proceeds been made? . . . . . . . .	X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .	X		X

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

Cat. No. 50193E

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
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
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		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?
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 . .	1.000 %		1.000 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .	0 %		0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . .	1.000 %		1.000 %
7 Does the bond issue meet the private security or payment test? . . . . .		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .
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

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
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .		X	X		X
b Exception to rebate? . . . . . . . .		X	X		X
c No rebate due? . . . . . . . .	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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . . .
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

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
b Name of provider . . . . . . . . .
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .	X			X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	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

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
BOND A:	DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNED ON BOND PROCEEDS. PART I(F): BOND PROCEEDS WERE USED FOR THE FINANCING AND RENOVATIONS TO CERTAIN HEALTH FACILITIES, FOR FUNDING A DEBT SERVICE RESERVE, TO PAY RELATED CAPITALIZED INTEREST AND TO PAY COSTS OF ISSUANCE ON THE BONDS. PART II, LINE 1: 2004 SERIES A BONDS WERE REFUNDED BY THE 2015 BONDS ON MAY 11, 2015. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE ORBUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(C): THE REBATE COMPUTATION WAS PERFORMED AS OF MARCH 25, 2014.
BOND B:	DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNED ON BOND PROCEEDS. PART I(F): THE BONDS CURRENTLY REFUNDED SERIES 1993A BONDS AND SERIES 1998A BONDS WHICH WERE ISSUED ON OCTOBER 6, 1993 AND MAY 13, 1998, RESPECTIVELY. PART II, LINE 13: SINCE THE PROCEEDS OF THE BONDS WERE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III: BECAUSE PROCEEDS OF THE BONDS WERE USED TO REFUND BONDS ISSUED BEFORE JANUARY 1, 2003, THE ISSUER HAS NOT COMPLETED PART III WITH RESPECT TO THE BONDS. PART IV, LINE 2(B): THE PORTION OF THE PROCEEDS OF THE BONDS USED FOR CURRENT REFUNDING MET THE 6-MONTH EXPENDITURE EXCEPTION.
BOND C:	DIFFERENCE BETWEEN PART I(E) AND PART II, LINE 3 IS DUE TO INTEREST EARNED ON BOND PROCEEDS. PART I(F): THE BONDS CURRENTLY REFUNDED THE BORROWER'S SERIES 2004A BONDS (ORIGINALLY ISSUED ON MARCH 25, 2004). PART II, LINE 4: THE SERIES 2015 BOND RESERVE ACCOUNT WAS FUNDED BY BOND PROCEEDS OF THE SERIES 2004A AND SERIES 2012A BONDS. PART II, LINE 13: PROCEEDS OF THE BONDS WERE ISSUED FOR THE PURPOSE OF CURRENT REFUNDING; THEREFORE, THE PROJECT PERIOD IS NOT ALLOCABLE FOR THIS BOND ISSUE. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE.ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6.THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINES 2(B) & 2(C): BOND PROCEEDS WERE EXPENDED FOR THE CURRENT REFUNDING OF SERIES 2004A AND HAS MET THE 6-MONTH SPENDING EXCEPTION TO REBATE. NO COMPUTATION HAS BEEN MADE THAT WOULD INDICATE WHETHER ANY REBATE WOULD BE DUE ON THE PROCEEDS TRANSFERRED FROM THE PRIOR BONDS.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	JAMES WHIPPLE, SHANNON TRUESDELL AND LAURIE ELDRIDGE ARE BOARD MEMBERS OF EL DORADO SURGERY CENTER, LLC.
FORM 990, PART VI, SECTION A, LINE 4	THE BOARD OF DIRECTORS COMPOSITION WAS CHANGED AND APPROVED ON DECEMBER 4, 2014. THE NUMBER OF MEMBERS CHANGED TO NOT LESS THAN 15 OR MORE THAN 17". ALSO IT WAS ADDED THAT THE "PRESIDENT" (FORMERLY CALLED CEO) BE ADDED AS A VOTING MEMBER.
FORM 990, PART VI, SECTION B, LINE 11	PRIOR TO FILING THE FORM 990, MANAGEMENT (CFO AND DIRECTOR OF FINANCE) REVIEWS THE FORM 990 IN DETAIL. ANY APPROPRIATE CHANGES ARE MADE AND THEN THE FORM 990 IS SUBMITTED TO THE GOVERNING BOARD OF DIRECTORS (BOD) AUDIT COMMITTEE, A SUBCOMMITTEE OF THE FULL GOVERNING BOD. THE FULL GOVERNING BOD HAS DELEGATED THE RESPONSIBILIY OF REVIEWING THE FORM 990 PRIOR TO FILING WITH THE IRS TO THE BOD AUDIT COMMITTEE. THE BOD AUDIT COMMITTEE PERFORMS A HIGH-LEVEL REVIEW OF THE FORM 990 AND REQUESTS MANAGEMENT TO MAKE ANY CHANGES THE COMMITTEE DEEMS NECESSARY. PRIOR TO FILING THE FORM 990 WITH THE IRS, THE BOD AUDIT COMMITTEE PROVIDES A SUMMARY TO THE FULL GOVERNING BOARD OF THE BOD AUDIT COMMITTEE'S REVIEW OF THE FORM 990. AT ANY TIME, BOTH BEFORE OR AFTER FILING, THE COMPLETE FORM 990 IS AVAILABLE UPON REQUEST TO ANY MEMBER OF THE GOVERNING BOARD.
FORM 990, PART VI, SECTION B, LINE 12C	OUR POLICY IS TO OBTAIN ON AN ANNUAL BASIS FROM CHIEF ADMINISTRATIVE OFFICERS, VICE PRESIDENTS, DIRECTORS, ASSISTANT DIRECTORS, PURCHASING STAFF, LEGAL STAFF, AND COMPLIANCE STAFF A DISCLOSURE STATEMENT NAMING ANY ORGANIZATIONS, INCLUDING THOSE AFFILIATED WITH MARSHALL MEDICAL CENTER, IN WHICH THE EMPLOYEE AND OR A MEMBER OF HIS/HER IMMEDIATE FAMILY MAY HAVE AN INTEREST EITHER THROUGH EMPLOYMENT, STOCK OR SHARES OWNERSHIP OF FIVE PERCENT OR MORE, CONTRACTUAL AGREEMENT, BOARD MEMBERSHIP, OR DIRECT COMPENSATION OF $1,000 OR MORE. IMMEDIATE FAMILY INCLUDES ANY SPOUSE, PARENT, CHILD, AND/OR SIBLING THAT LIVE IN THE SAME HOUSEHOLD AS THE EMPLOYEE. DISCLOSURE STATEMENTS ARE REVIEWED BY THE CHIEF EXECUTIVE OFFICER FOR ANY ACTUAL OR POTENTIAL CONFLICTS. THE CEO'S DISCLOSURE STATEMENT IS REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEES OF THE BOARD OF DIRECTORS. ADDITIONALLY, UPON CONSIDERATION OF ANY NEW CONTRACT AGREEMENT, POTENTIAL PARTIES MUST IDENTIFY ANY POTENTIAL INTERESTED PARTIES IN COMMON. SHOULD ANY TRANSACTION INVOLVING POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARISE, THE CEO APPOINTS A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE ARRANGEMENT IN QUESTION. DUE DILIGENCE IS EXERCISED TO DETERMINE WHETHER MARSHALL MEDICAL CENTER CAN, WITH REASONABLE EFFORTS, OBTAIN A MORE ADVANTAGEOUS TRANSACTION FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE CEO MAKES THE DETERMINATION WHETHER THE TRANSACTION IS IN MARSHALL MEDICAL CENTER'S BEST INTEREST, BENEFIT, AND IS FAIR AND REASONABLE. IN THE EVENT THAT ANY OF THE AFOREMENTIONED EMPLOYEES OR IMMEDIATE FAMILY MEMBERS HAS AN OUTSIDE INTEREST THAT CONFLICTS OR SUGGESTS A POSSIBLE CONFLICT WITH MARSHALL MEDICAL CENTER'S BUSINESS INTERESTS, SAID EMPLOYEES ARE RECUSED FROM PARTICIPATING IN DELIBERATIONS AND/OR DECISIONS ABOUT A BUSINESS TRANSACTION. OUR POLICY IS TO OBTAIN ON AN ANNUAL BASIS FROM MEMBERS OF THE GOVERNING BOARD A DISCLOSURE STATEMENT NAMING ANY ORGANIZATIONS, INCLUDING THOSE AFFILIATED WITH MARSHALL MEDICAL CENTER, IN WHICH THE GOVERNING BOARD MEMBER OR AN IMMEDIATE FAMILY MEMBER OF THE BOARD MEMBER MAY HAVE AN INTEREST EITHER THROUGH EMPLOYMENT, OWNERSHIP, CONTRACTUAL AGREEMENT, BOARD MEMBERSHIP, OR COMPENSATION OF $1,000 OR MORE. DISCLOSURE STATEMENTS ARE REVIEWED BY ADMINISTRATVIE OFFICE PERSONNEL FOR ANY ACTUAL OR POTENTIAL CONFLICTS AND ARE AVAILABLE TO ALL BOARD MEMBERS FOR REVIEW. ANY MATERIAL FINDINGS ARE FORWARDED TO ADMINISTRATION FOR RESOLUTION. ADDITIONALLY, UPON CONSIDERATION OF ANY NEW CONTRACT AGREEMENT, VENDORS ARE REVIEWED FOR POTENTIAL CONFLICT OF INTEREST TO IDENTIFY ANY POTENTIAL INTERESTED PARTIES IN COMMON. SHOULD ANY TRANSACTION INVOLVING POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARISE, THE TRANSACTION MAY BE ENTERED INTO ONLY AFTER THE FOLLOWING STEPS ARE TAKEN BY THE BOARD: A. CONCLUDED THAT THE TRANSACTION WILL BENEFIT THE HOSPITAL AND THAT THE HOSPITAL IS ENTERING INTO THE TRANSACTION FOR ITS OWN BENEFIT (THE MINUTES SHOULD DELINEATE THE BENEFIT); B. CONCLUDED THAT THE TRANSACTION IS FAIR AND REASONABLE TO THE HOSPITAL AT THE TIME IT IS ENTERED; C. AUTHORIZED OR APPROVED IT IN GOOD FAITH BY A VOTE OF THE DIRECTORS WITHOUT COUNTING THE VOTE OF THE INTERESTED PERSON(S), AND WITH KNOWLEDGE OF THE MATERIAL FACTS CONCERNING THE TRANSACTION AND THE DIRECTOR(S)' INTEREST IN THE TRANSACTION, AND D. PRIOR TO AUTHORIZING OR APPROVING THE TRANSACTION THE BOARD HAS DETERMINED AFTER REASONABLE INVESTIGATION AND IN GOOD FAITH THAT THE HOSPITAL COULD NOT HAVE OBTAINED THROUGH REASONABLE EFFORT A MORE ADVANTAGEOUS ARRANGEMENT UNDER THE CIRCUMSTANCES.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS DECIDES THE CEO'S COMPENSATION WITH INPUT FROM THE AUDIT AND COMPLIANCE COMMITTEES USING DATA COMPILED FROM THE CALIFORNIA HEALTHCARE ASSOCIATION'S ALLIED FOR HEALTH EXECUTIVE COMPENSATION SURVEY AND OTHER SOURCES SUCH AS AN INDEPENDENT COMPENSATION CONSULTANT, AND FOLLOWING THE EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT. THE DATA INCLUDES HOSPITALS FROM NORTHERN AND SOUTHERN CALIFORNIA, AS WELL AS RURAL AND URBAN HOSPITALS. THE DATA DIFFERENTIATES BY BED SIZE, OPERATING EXPENSES, AND FULL-TIME EQUIVILENTS (FTES). ALL INFORMATION UTILIZES AGGREGATE, HISTORICAL INFORMATION. THE AUDIT AND COMPLIANCE COMMITTEES MEET QUARTERLY BUT INCORPORATES COMPENSATION REVIEW ANNUALLY WHEN A REVIEW OF THE CEO'S COMPENSATION IS IN ORDER. THE CEO (ADMINISTRATOR) DECIDES THE COMPENSATION FOR THE COO (ASSISTANT ADMINISTRATOR), CNO (CHIEF NURSING OFFICER) AND CFO (CHIEF FINANCIAL OFFICER), REVIEWING THEM ANNUALLY. THE CHIEF EXECUTIVE TEAM DECIDES COMPENSATION FOR ALL DIVISION/INTERNAL LEADERSHIP VICE PRESIDENTS. THE ABOVE COMPENSATION WAS DETERMINED USING A STATEMENT OF EXECUTIVE COMPENSATION PHILOSOPHY CREATED WITH INPUT FROM AN INDEPENDENT COMPENSATION CONSULTANT WHICH USED DATA COMPILED FROM THE CALIFORNIA HEALTHCARE ASSOCIATION'S ALLIED FOR HEALTH EXECUTIVE COMPENSATION SURVEY AS WELL AS OTHER SURVEYS. THE DATA INCLUDES HOSPITALS FROM NORTHERN AND SOUTHERN CALIFORNIA, AS WELL AS RURAL AND URBAN HOSPITALS. THE DATA DIFFERENTIATES BY BED SIZE, OPERATING EXPENSES, AND FULL-TIME EQUIVALENTS (FTES). ALL INFORMATION UTILIZES AGGREGATE, HISTORICAL INFORMATION.
FORM 990, PART VI, SECTION C, LINE 19	- MARSHALL MEDICAL CENTER'S GOVERNING DOCUMENTS ARE MADE AVAILABLE ACCORDING TO THE CALIFORNIA CORPORATIONS CODE REQUIREMENTS. - OUR CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. - SELECTED FINANCIAL INFORMATION IS PUBLISHED ANNUALLY IN OUR PERIODIC PUBLICATION, "FOR YOUR HEALTH." THIS PUBLICATION IS INCLUDED IN TWO LOCAL NEWSPAPERS WITH A CIRCULATION OF APPROXIMATELY 35,000 HOMES. THE PUBLICATION IS ALSO PLACED IN VARIOUS PUBLIC AREAS INCLUDING DOCTOR'S OFFICES, LIBRARIES, THE CHAMBER OF COMMERCE, REAL ESTATE OFFICES, AND ALL OF OUR LOCATION WAITING ROOMS.
FORM 990, PART IX, LINE 11G	PHYSICIAN PROF FEES: PROGRAM SERVICE EXPENSES 30,057,170. MANAGEMENT AND GENERAL EXPENSES 430,925. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 30,488,095. PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 3,586,401. MANAGEMENT AND GENERAL EXPENSES 2,165,074. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,751,475. RECRUITING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 105,145. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,145. OTHER PROF FEES: PROGRAM SERVICE EXPENSES 4,542,893. MANAGEMENT AND GENERAL EXPENSES 184,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,727,010.
FORM 990, PART XI, LINE 9:	PENSION RELATED CHANGES -11,592,469.

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

MARSHALL MEDICAL CENTER

Employer identification number

94-1450151

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

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No

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

Cat. No. 50135Y

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) EL DORADO SURGERY CENTER LLC 4300 GOLDEN CENTER DRIVE SUITE E PLACERVILLE,CA95667 45-0586784	SURGICAL SERVICES	CA	N/A	RELATED	959,637	7,887,782		No		Yes		88.000 %

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	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

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

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

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

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

Yes

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

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

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

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

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

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

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

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

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

Yes

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

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

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) EL DORADO SURGERY CENTER	S	1,321,742	FMV

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

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: OUR MISSION IS TO PROVIDE HEALTHCARE & RELATED SERVICES TO THE LOCAL COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	15
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	12
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	1,558
6	Total number of volunteers (estimate if necessary) .............	6	245
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	107,255
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	52,923

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	405,917	1,205,722
9	Program service revenue (Part VIII, line 2g) .........	214,350,824	240,149,037
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	675,163	726,341
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,182,386	553,271
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	217,614,290	242,634,371
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	324,103	253,942
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)	109,761,481	112,025,489
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	106,239,619	105,334,319
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	216,325,203	217,613,750
19	Revenue less expenses. Subtract line 18 from line 12.......	1,289,087	25,020,621
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	206,225,445	228,640,662
21	Total liabilities (Part X, line 26).............	111,316,534	121,326,420
22	Net assets or fund balances. Subtract line 21 from line 20.....	94,908,911	107,314,242

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 176,895,715 including grants of $ 253,942 ) (Revenue $ 240,149,037 )
	IN KEEPING WITH THE COMMITMENT TO PROMOTE HEALTH IMPROVEMENT AND PROVIDE HEALTH SERVICES OF EXTRAORDINARY VALUE AND QUALITY TO OUR COMMUNITY, THE FOLLOWING WILL BE CONSIDERED WHEN INDIVIDUALS WHO NEED HEALTH CARE CANNOT PAY: - PROVIDING FREE CARE AND/OR SUBSIDIZED CARE- PROVIDING CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST- PROVIDING HEALTH/WELLNESS ACTIVITIES AND COMMUNITY EDUCATION PROGRAMS NOT ONLY DOES MARSHALL MEDICAL CENTER PROVIDE LOW-COST CARE TO INDIVIDUALS COVERED BY GOVERNMENT PROGRAMS AND THOSE UNABLE TO AFFORD HEALTH CARE, BUT IT ALSO HELPS PATIENTS FIND AND ACCESS PRIVATE AND GOVERNMENTAL RESOURCES FOR HEALTH CARE BENEFITS. MARSHALL MEDICAL CENTER RECOGNIZES BELOW COST REIMBURSEMENTS AS CHARITY AND UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY.INPATIENT SERVICES IN TAX YEAR 2014 WERE PROVIDED TO 5,460 PATIENTS. SOME EXAMPLES FOR SERVICES INCLUDED:- BABIES DELIVERED - 534- SURGERIES PERFORMED - 965- RADIOLOGY PROCEDURES PERFORMED - 5,243- CARDIAC CATHETERIZATIONS - 140- LABORATORY TESTS PERFORMED - 117,634- CT SCANS - 1,171OUTPATIENT SERVICES IN TAX YEAR 2014 WERE PROVIDED TO 505,502 PATIENTS.SOME EXAMPLES FOR SERVICES INCLUDED:- EMERGENCY ROOM VISITS - 28,945- OUTPATIENT SURGERIES PERFORMED - 2,391- RADIOLOGY PROCEDURES PERFORMED - 50,418- CARDIAC CATHETERIZATIONS - 376- LABORATORY TESTS PERFORMED - 447,008- CT SCANS - 10,988- RURAL HEALTH CLINIC - 3,118- CARDIOLOGY CLINIC - 20,790 VISITS- ONCOLOGY CLINIC - 5,518 VISITS- OP INFUSION CLINIC - 4,162 VISITS- RHEUMATOLOGY CLINIC - 2,633 VISITS- PEDIATRIC CLINIC - 13,446 VISITS- OB CLINICS - 16,144 VISITS- CANCER PROGRAM - 5,732 CASES- HOME HEALTH VISITS - 11,238 VISITS- FAMILY PRACTICE CLINICS - 50,858 VISITS- GASTROENTEROLOGY CLINIC - 1,605 VISITS- ENT CLINIC - 2,772 VISITS- HEARING CLINIC - 4,045 VISITS- ORTHOPEDIC CLINIC - 13,032 VISITS- SURGERY CLINIC - 8,393 VISITS- UROLOGY CLINIC - 5,689- HOSPITALISTS - 19,849 VISITSMARSHALL MEDICAL CENTER RECOGNIZES IT HAS AN OBLIGATION TO PROVIDE SERVICES ABOVE AND BEYOND ITS ROLE AS A HEALING FACILITY. THE FOLLOWING COMMUNITY BENEFITS DEMONSTRATE THE TANGIBLE WAYS IN WHICH THE ORGANIZATION IS FULFULLING ITS MISSION:- HEALTH FAIRS (LOCAL COMPANIES AND OTHER HEALTH SERVICE AGENCIES)- BLOOD PRESSURE CLINICS THROUGH AUXILIARY VOLUNTEERS- FLU CLINICS- VOLUNTEER PROGRAM- CHRISTMAS ANGEL TREE PROGRAM- AMERICAN CANCER SOCIETY (BREAST CANCER AWARENESS MONTH, RELAY FOR LIFE, DAFFODIL DAYS, WOMENS HEART HEALTH AWARENESS)- AMERICAN HEART ASSOCIATION (WOMEN'S HEART HEALTH AND RED DRESS EVENTS)- FOR YOUR HEALTH (A COMMUNITY MAGAZINE)- DIABETES PROGRAM- CANCER RESOURCE CENTER- PALLIATIVE CARE PROGRAM- HOLIDAY FOOD DRIVE FOR VARIOUS FOOD BANKS- SEXUAL ASSAULT RESPONSE TEAM PROGRAM- COMMUNITY HEALTH LIBRARY- CHILDBIRTH CLASSES- CONGESTIVE HEART ACTIVE TELEPHONE TREATMENT PROGRAM- SCHOLARSHIPS- PHARMACEUTICAL TRIALS- USE OF HOSPITAL CONFERENCE ROOMS FOR COMMUNITY BASED ORGANIZATIONS- SEMINARS AND SUPPORT GROUPS- FREE TRAINING FOR PHARMACY STUDENTS, NURSING STUDENTS, LVN STUDENTS, AND OTHER HEALTHCARE PROFESSIONALS- SMOKING CESSATION PROGRAM- CONTRIBUTED TO THE COMMUNITY THROUGH VOLUNTEER SERVICE TO ORGANIZATIONS INCLUDING ROTARY, CHAMBERS OF COMMERCE AND MORE YOUTH SPORTS PHYSICALS- LOW-COST MAMMOGRAPHY PROGRAM- DONATION OF HEALTHCARE SUPPLIES TO 3RD WORLD COUNTRIES- HELD NUMEROUS COMMUNITY HEALTH EDUCATION CLASSES- MARSHALL MEDICAL CENTER'S CHAPLAIN PROVIDED 2,569 PATIENT VISITS, 28 EMERGENCY VISITS, 136 PATIENT COUNSELING VISITS, CONDUCTED 21 MEMORIAL SERVICES AND OFFICIATED 23 WEDDINGS- ACCEL PROGRAM (LOCAL PROJECT TO COORDINATE THE SAFETY NETWORK FOR EL DORADO COUNTY)- ELECTRONIC HEALTH INFORMATION EXCHANGE- PROVIDED FREE TRANSPORTATION TO PATIENTS UNABLE TO AFFORD TRANSPORTATION- PROVIDED MEETING LOCATION FOR NUMEROUS SUPPORT GROUPS (BI-POLAR INSIGHTS, BREAST CANCER SUPPORT, NAMI, STROKE SUPPORT AND MORE) AT NO CHARGE- CLOTHES DRIVE TO ASSIST ER PATIENTS- COMMUNITY SPONSORSHIPS INCLUDING BUT NOT LIMITED TO: AMERICAN CANCER SOCIETY RELAY FOR LIFE, CENTER FOR VIOLENCE FREE RELATIONSHIPS ANNUAL GALA, SATURDAY IN THE PARK, EL DORADO HILLS COMMUNITY SERVICES DISTRICT SUMMER AT THE POOL AND SUMMER SPECTACULAR, BOYS & GIRLS CLUB TRIPLE PLAY PROGRAM, EL DORADO HILLS COMMUNITY VISION MARDI GRAS, HANDS4HOPE PREMIER DINNER, PINK RIBBON CLASSIC TOURNAMENT, ROTARY CLUB OF EL DORADO HILLS CRAB FEED, ROTARY CLUB OF EL DORADO HILLS WINE AT TOWN CENTER EVENT, UNION MINE HIGH SCHOOL CHILD SAFETY DAY.- ENCOURAGED EMPLOYEES TO PARTICIPATE IN VARIOUS COMMUNITY BUILDING ORGANIZATIONS INCLUDING BUT NOT LIMITED TO: TRIBAL HEALTH PROJECTS, PARTNERS IN CARE, SNOWLINE HOSPICE BOARD, EL DORADO COMMUNITY HEALTH CLINIC BOARD, EL DORADO COUNTY ECONOMIC DEVELOPMENT CORP, EL DORADO ECONOMIC ADVISORY COMMITTEE, LEADERSHIP EL DORADO, EVERY 15 MINUTES, CAREER TECHNICAL PARTNERSHIP STEERING COMMITTEE, EL DORADO UNION HIGH SCHOOL DISTRICT CAREER TECHNICAL EDUCATION ADVISORY COMMITTEE, AND VARIOUS HEALTH ORGANIZATION BOARDS.

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 expenses176,895,715

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) KREJCI KATHY........................................................................ CHIEF NURSING OFFICER	40.00 .......................	X			225,261	0	102,420
(19) SAHARA VERN........................................................................ VP-PRIMARY CARE & CLINICAL	40.00 .......................		X		183,157	0	54,293
(20) DIPONTI ROBERT........................................................................ DIRECTOR OF PHARMACY	40.00 .......................		X		183,470	0	34,145
(21) RICE CYNTHIA........................................................................ VP OF CLINICAL NURSING SERVICES	40.00 .......................		X		157,865	0	32,028
(22) RICE REGINALD D SR........................................................................ VP OF MEDICAL STAFF	32.00 .......................			X	225,249	0	38,925
(23) HUGHES SAM........................................................................ STAFF RN	40.00 .......................			X	172,659	0	49,941
(24) COMER SCOTT........................................................................ VP OF EMPLOYEE SERVICES	40.00 .......................			X	177,996	0	36,945
(25) BRONNY CORINNA........................................................................ STAFF RN	40.00 .......................			X	181,106	0	36,037
(26) SEIVERT KERSTIN........................................................................ CASE MANAGEMENT NURSING DIRECTOR	40.00 .......................			X	172,632	0	106,370

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	3,033,742	0	793,675

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		76,179

f	All other contributions, gifts, grants, and similar amounts not included above1f		1,129,543

g	Noncash contributions included in lines 1a-1f:$		20,993
h	Total. Add lines 1a-1f.......			1,205,722
			Business Code
2a	PATIENT REVENUE, NET		900099	238,110,602	238,021,312	89,290
b	EL DORADO SURGERY CTR		621400	1,466,909	1,466,909
c	CAFETERIA		722210	528,175	528,175
d	EDUCATIONAL CLASSES		900099	43,351	43,351
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			240,149,037
3	Investment income (including dividends, interest, and other similar amounts).......			1,029,450			1,029,450
4	Income from investment of tax-exempt bond proceeds..
5	Royalties...........
		(i) Real	(ii) Personal
6a	Gross rents	223,927
b	Less: rental expenses	222,828
c	Rental income or (loss)	1,099
d	Net rental income or (loss).......			1,099			1,099
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory		46,050
b	Less: cost or other basis and sales expenses		349,159
c	Gain or (loss)		-303,109
d	Net gain or (loss)..........			-303,109			-303,109
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..
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...
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..
Miscellaneous Revenue			Business Code
11a	REBATES		900099	313,609			313,609
b	EHR INCENTIVE		900099	156,021			156,021
c	MISC REVENUE		900099	82,542		17,965	64,577
d	All other revenue ....
e	Total. Add lines 11a–11d ......			552,172
12	Total revenue. See Instructions......			242,634,371	240,059,747	107,255	1,261,647


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			11,589,516	1	28,545,431
2	Savings and temporary cash investments .........			4,419,348	2	6,126,566
3	Pledges and grants receivable, net ...........				3
4	Accounts receivable, net .............			28,192,979	4	25,652,932
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
					5
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
					6
7	Notes and loans receivable, net .............			5,830,007	7	3,959,134
8	Inventories for sale or use ..............			2,510,388	8	2,839,766
9	Prepaid expenses and deferred charges ..........			1,952,156	9	2,063,874
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	230,426,792
b	Less: accumulated depreciation .....	10b	117,580,389	115,407,969	10c	112,846,403
11	Investments—publicly traded securities ..........			25,721,186	11	33,162,681
12	Investments—other securities. See Part IV, line 11 .....				12	2,719,665
13	Investments—program-related. See Part IV, line 11 .....			7,598,152	13	7,743,319
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			3,003,744	15	2,980,891
16	Total assets. Add lines 1 through 15 (must equal line 34)......			206,225,445	16	228,640,662
17	Accounts payable and accrued expenses .........			26,689,780	17	27,411,345
18	Grants payable .................				18
19	Deferred revenue ................				19
20	Tax-exempt bond liabilities .............			66,569,638	20	65,581,172
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
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..........				22
23	Secured mortgages and notes payable to unrelated third parties ..			3,866,244	23	2,550,562
24	Unsecured notes and loans payable to unrelated third parties ....				24
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....................			14,190,872	25	25,783,341
26	Total liabilities. Add lines 17 through 25.........			111,316,534	26	121,326,420
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			94,831,590	27	107,000,617
28	Temporarily restricted net assets ...........			77,321	28	313,625
29	Permanently restricted net assets ...........				29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			94,908,911	33	107,314,242
34	Total liabilities and net assets/fund balances ........			206,225,445	34	228,640,662