Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
A For the 2015 calendar year, or tax year beginning 07-01-2015 , and ending 06-30-2016
BCheck if applicable:
CName of organization
DIGNITY HEALTH
 
% MARY CONNICK - FINANCE DEPT
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
185 Berry Street Suite 300
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
San Francisco, CA94107
D Employer identification number

94-1196203
E Telephone number

G Gross receipts $ 11,495,630,830
F Name and address of principal officer:
DANIEL MORISSETTE CFO
185 BERRY STREET
SAN FRANCISCO,CA94107
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.dignityhealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1954
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Dignity Health is committed to furthering the healing ministry of Jesus through the delivery of affordable health care, advocacy for the poor and community partnerships.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2015 (Part V, line 2a) ...... 5 53,526
6 Total number of volunteers (estimate if necessary) ............. 6 8,015
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 21,113,384
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -1,592,416
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 105,589,706 100,170,520
9 Program service revenue (Part VIII, line 2g) ......... 9,688,887,194 9,791,538,093
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 242,429,838 228,622,421
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 56,711,926 73,047,756
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 10,093,618,664 10,193,378,790
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 223,463,179 248,548,723
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 4,875,399,504 5,233,994,312
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 4,499,905,640 4,679,616,230
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 9,598,768,323 10,162,159,265
19 Revenue less expenses. Subtract line 18 from line 12....... 494,850,341 31,219,525
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 14,252,350,035 13,884,757,255
21 Total liabilities (Part X, line 26)............. 8,783,595,570 9,683,852,610
22 Net assets or fund balances. Subtract line 21 from line 20..... 5,468,754,465 4,200,904,645
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2015)
Form 990 (2015)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: OUR MISSION: DIGNITY HEALTH IS COMMITTED TO FURTHERING THE HEALING MINISTRY OF JESUS. WE DEDICATE OUR RESOURCES TO DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES; SERVING AND ADVOCATING FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. OUR VISION: A VIBRANT, NATIONAL HEALTH CARE SYSTEM KNOWN FOR SERVICE, CHOSEN FOR CLINICAL EXCELLENCE, STANDING IN PARTNERSHIP WITH PATIENTS, EMPLOYEES AND PHYSICIANS TO IMPROVE THE HEALTH OF ALL COMMUNITIES SERVED. OUR VALUES: DIGNITY HEALTH IS COMMITTED TO PROVIDING HIGH-QUALITY, AFFORDABLE HEALTH CARE TO THE COMMUNITIES WE SERVE. ABOVE ALL ELSE WE VALUE: DIGNITY - RESPECTING THE INHERENT VALUE AND WORTH OF EACH PERSON. COLLABORATION - WORKING TOGETHER WITH PEOPLE WHO SUPPORT COMMON VALUES AND VISION TO ACHIEVE SHARED GOALS. JUSTICE - ADVOCATING FOR SOCIAL CHANGE AND ACTING IN WAYS THAT PROMOTE RESPECT FOR ALL PERSONS AND DEMONSTRATE COMPASSION F
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 8,781,024,252 including grants of $ 248,548,723 ) (Revenue $ 9,779,551,388 )
Dignity Health is a California nonprofit public benefit corporation headquartered in San Francisco, California. Dignity Health, together with its subsidiary corporations, is one of the largest not-for-profit acute health care delivery systems in the United States as measured by annual revenue. Dignity Health operated 39 hospitals throughout major California markets and in the Phoenix, Arizona and Las Vegas, Nevada metropolitan markets during the year ended June 30, 2016. Dignity health and its subordinate corporations' facilities included approximately 8,400 licensed acute care beds and approximately 600 licensed skilled nursing beds as of June 30, 2016. Dignity health maintains a prominent market share in many of its service areas, and many of its hospitals rank among the finest in the nation. With a significant presence in Greater Sacramento, San Francisco Bay Area, Southern California, Central Coast, Central California, and Northern California, Dignity Health's California operations are well dispersed throughout the state. Dignity Health's hospitals operate emergency rooms that are open to all persons regardless of ability to pay; have governing bodies in which primarily independent persons representative of the community comprise a majority; engage in the training and education of healthcare professionals; and participate in Medicaid, Medicare, Tricare and/or other government-sponsored health care programs. This organization is a public benefit corporation exempt from taxation under Section 501(c)(3) of the internal revenue code.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet8,781,024,252
Form 990 (2015)
Form 990 (2015)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
Yes
 
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I ...................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II ................Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II ...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I ........Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2015)
Form 990 (2015)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
4,883
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
53,526
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ , BR , DA , ID , IS , KS , MY , TW , TH , TU
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2015)
Form 990 (2015)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
13
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
AZ , CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMARY CONNICK - FINANCE DEPT185 BERRY STREET   SAN FRANCISCO,CA94107 (415) 438-5500
Form 990 (2015)
Form 990 (2015)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Andrew C Agwunobi MD......................................................................
Board Member
5.0
.................
0.0
X           29,250 0 0
(2) Kent Bradley MD......................................................................
Board Member
5.0
.................
0.0
X           27,000 0 0
(3) Jennie Chin Hansen......................................................................
Board Member
5.0
.................
0.0
X           36,000 0 0
(4) Mark DeMichele......................................................................
Board Member
5.0
.................
0.0
X           31,500 0 0
(5) Peter G Hanelt CPA......................................................................
Board Member
5.0
.................
0.0
X           29,250 0 0
(6) Julie Hyer OP......................................................................
Board Member
5.0
.................
0.0
X           0 0 0
(7) Kavita Patel MD......................................................................
Board Member
5.0
.................
0.0
X           27,000 0 0
(8) Todd Pierce......................................................................
Board Member
5.0
.................
0.0
X           29,250 0 0
(9) Patrick Steele......................................................................
Board Member
5.0
.................
0.0
X           27,750 0 0
(10) Judy Carle RSM......................................................................
Board Vice Chair
5.0
.................
0.0
X   X       0 0 0
(11) Caretha Coleman......................................................................
Board Chairperson
7.0
.................
0.0
X   X       34,875 0 0
(12) Tessie Guillermo......................................................................
Board Secretary
5.0
.................
0.0
X   X       32,438 0 0
(13) Lloyd H Dean......................................................................
President /CEO
40.0
.................
0.0
X   X       7,058,864 0 1,214,434
(14) Michael D Blaszyk......................................................................
SEVP, Chief Financial Officer
40.0
.................
0.0
    X       4,159,179 0 273,727
(15) Rick Grossman......................................................................
EVP, General Counsel
40.0
.................
0.0
    X       1,731,628 0 333,799
(16) Diane Lee......................................................................
VP & Associate General Counsel
40.0
.................
0.0
    X       556,026 0 80,308
(17) Daniel J Morissette......................................................................
SEVP, Chief Financial Officer
40.0
.................
0.0
    X       0 0 0
Form 990 (2015)
Form 990 (2015)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Marvin O'Quinn........................................................................
SEVP, Chief Operating Officer
40.0
.......................0.0
    X       3,366,518 0 582,108
(19) Elizabeth Shih........................................................................
EVP, Chief Administrative Offi
40.0
.......................0.0
    X       2,377,553 0 335,299
(20) Steven Barron........................................................................
SVP Operations, So Cal East
40.0
.......................0.0
      X     1,549,921 0 157,734
(21) Brian G Brannman........................................................................
SVP Operations, Nevada
40.0
.......................0.0
      X     875,799 0 111,400
(22) Keith Callahan........................................................................
SVP, Supp & Srvcs Resources Mg
40.0
.......................0.0
      X     924,408 0 102,405
(23) Mary Connick........................................................................
SVP, Finance, Corporate Contro
40.0
.......................0.0
      X     768,835 0 106,863
(24) Charles Cova........................................................................
SVP Operations, Central Coast
40.0
.......................0.0
      X     1,025,173 0 116,293
(25) Charles P Francis........................................................................
SEVP, Chief Strategy Officer
40.0
.......................0.0
      X     1,958,161 0 898,619
(26) Lisa Gamshad Zuckerman........................................................................
SVP Treasury & Strategic Inves
40.0
.......................0.0
      X     732,270 0 120,762
(27) Laurie Harting........................................................................
SVP Operations, Greater Sacram
40.0
.......................0.0
      X     1,258,245 0 127,002
(28) Linda Hunt........................................................................
SVP Operations, Arizona
40.0
.......................0.0
      X     1,351,828 0 140,429
(29) Mark Korth........................................................................
SVP Operations, North State
40.0
.......................0.0
      X     869,701 0 110,473
(30) Jeffrey W Land........................................................................
VP, Corporate Real Estate
40.0
.......................0.0
      X     748,519 0 106,181
(31) Bernita McTernan........................................................................
EVP/Sponsorship/Mission Integr
40.0
.......................0.0
      X     7,115,036 0 194,139
(32) Timothy Panks........................................................................
SVP, Finance & Revenue Cycle M
40.0
.......................0.0
      X     698,748 0 103,082
(33) Darryl Robinson........................................................................
EVP, Chief Human Resource Offi
40.0
.......................0.0
      X     1,512,338 0 330,379
(34) Karl Silberstein........................................................................
SVP, Financial Operations
40.0
.......................0.0
      X     1,206,142 0 139,604
(35) Todd A Strumwasser MD........................................................................
SVP Operations, Bay Area
40.0
.......................0.0
      X     1,881,169 0 158,333
(36) Jon VanBoening........................................................................
SVP Operations, Central Valley
40.0
.......................0.0
      X     1,349,466 0 160,262
(37) Robert Wiebe MD........................................................................
EVP, Chief Medical Officer
40.0
.......................0.0
      X     1,760,969 0 390,058
(38) Tammara Wilcox........................................................................
SVP, Managed Care
40.0
.......................0.0
      X     838,942 0 111,812
(39) Deanna Wise........................................................................
EVP, Chief Information Officer
40.0
.......................0.0
      X     1,361,200 0 304,787
(40) Edmundo Castaneda........................................................................
Hospital President
40.0
.......................0.0
        X   926,462 0 110,770
(41) Mark S Hillard........................................................................
Philanthropy Web consultant
40.0
.......................0.0
        X   994,815 0 78,401
(42) Alan Iftiniuk........................................................................
Hospital President
40.0
.......................0.0
        X   963,913 0 101,105
(43) Darren Lee........................................................................
Hospital President
40.0
.......................0.0
        X   939,860 0 96,321
(44) Scott R Petersen MD........................................................................
Physician
40.0
.......................0.0
        X   910,267 0 77,975
(45) Rodney A Davis........................................................................
Former KE
0.0
.......................0.0
          X 109,132 0 4,230
(46) John M Wray........................................................................
Former KE
0.0
.......................0.0
          X 127,456 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 54,312,856 0 7,279,094
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet13,811
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
OPTUM360 LLC,
11000 OPTUM CIRCLE
EDEN PRAIRIE,MN55344
Revenue Cycle Svc 263,705,031
ARAMARK HEALTHCARE,
27310 NETWORK PL
CHICAGO,IL606731273
Management services 74,355,484
CERNER CORP,
2702 ROCKCREEK PKWY
KANSAS CITY,MO64117
Technology services 72,680,187
THE BARTECH GROUP,
17199 N LAUREL PARK DR SUITE 224
LIVONIA,MI48152
Staffing services 69,861,453
TRIMEDX LLC,
5451 LAKEVIEW PKWY S DR
INDIANAPOLIS,IN46268
Maintenance Services 62,794,593
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet988
Form 990 (2015)
Form 990 (2015)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 64,296,928
e Government grants (contributions)1e 29,661,482
f All other contributions, gifts, grants, and similar amounts not included above1f 6,212,110
g Noncash contributions included in lines 1a-1f:$ 812,942
h Total.Add lines 1a-1f.......MediumBullet 100,170,520
 Program Service RevenueAmt Business Code
2a PATIENT NET OF CHARITY/BAD DEBT 900099 5,700,726,054 5,700,726,054    
b MEDICARE/MEDICAID PAYMENTS 900099 3,819,141,118 3,819,141,118    
c MANAGEMENT SERVICES 541610 167,079,061 167,079,061    
d MEANINGFUL USE INCENTIVES (EHR) 900099 21,821,488 21,821,488    
e MED OFFICE BLDG 621300 13,550,112 13,550,112    
f All other program service revenue. 69,220,260 57,233,555 11,986,705  
g Total.Add lines 2a–2f.....MediumBullet 9,791,538,093
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ..........MediumBullet 122,505,578   10,659,333 111,846,245
4 Income from investment of tax-exempt bond proceedsMediumBullet 102,579     102,579
5 Royalties...........MediumBullet 7,366     7,366
(ii) Personal (i) Real
6a Gross rents   6,897,736
b Less: rental expenses   319,012
c Rental income or (loss) 0 6,578,724
d Net rental income or (loss)......MediumBullet 6,578,724     6,578,724
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 23,662,505 1,384,284,787
b Less: cost or other basis and sales expenses 1,499,146 1,300,433,882
c Gain or (loss) 22,163,359 83,850,905
d Net gain or (loss).....MediumBullet 106,014,264     106,014,264
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CAFETERIA 900099 25,351,070   0 25,351,070
b OPTUM 360 REVENUE 900099 8,006,752   0 8,006,752
c GIFT SHOP 453220 3,440,930   0 3,440,930
d All other revenue .... 29,662,914   -1,532,654 31,195,568
e Total. Add lines 11a–11d ...... MediumBullet 66,461,666
12 Total revenue. See Instructions......MediumBullet 10,193,378,790 9,779,551,388 21,113,384 292,543,498
Form 990 (2015)
Form 990 (2015)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 247,046,262 247,046,262
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 1,502,461 1,502,461
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 55,977,340 28,568,871 27,408,469  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 309,754   309,754  
7 Other salaries and wages 4,013,750,233 3,618,804,309 394,945,924  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 276,656,684 237,498,284 39,158,400  
9 Other employee benefits ....... 614,257,702 535,322,128 78,935,574  
10 Payroll taxes ........... 273,042,599 246,428,632 26,613,967  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 18,281,569 205,358 18,076,211  
c Accounting ........... 8,032,287 103,351 7,928,936  
d Lobbying ........... 3,310,165 2,219,863 1,090,302  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 18,485,366 8,765,840 9,719,526  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,280,324,256 882,124,635 398,199,621 0
12 Advertising and promotion .... 83,144,613 7,118,538 76,026,075  
13 Office expenses ....... 191,427,569 139,190,334 52,237,235  
14 Information technology ...... 168,616,629 95,392,650 73,223,979  
15 Royalties .. 0      
16 Occupancy ........... 125,232,289 100,421,164 24,811,125  
17 Travel ............ 24,431,087 13,972,986 10,458,101  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 12,542,714 6,309,782 6,232,932  
20 Interest ........... 260,792,190 260,792,190    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 478,685,563 406,018,363 72,667,200  
23 Insurance ... 91,356,008 54,190,743 37,165,265  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 1,259,829,773 1,259,829,773 0 0
b MEDI-CAL PROVIDER FEE 460,923,538 460,923,538 0 0
c MEDICAL PRVDR/OUT-OF NTWRK CST 130,234,914 130,234,914 0 0
d UNRELATED BUSINESS INC TAXES 40,585 0 40,585 0
e All other expenses 63,925,115 38,039,283 25,885,832  
25 Total functional expenses. Add lines 1 through 24e 10,162,159,265 8,781,024,252 1,381,135,013 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2015)
Form 990 (2015)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 168,840 1 149,696
2 Savings and temporary cash investments ......... 1,664,032,946 2 1,464,407,617
3 Pledges and grants receivable, net ...... 24,678,893 3 18,811,060
4 Accounts receivable, net ............. 1,412,076,540 4 1,420,398,408
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
366,667 5 183,333
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net .... 53,776,426 7 70,000,662
8 Inventories for sale or use ........ 162,977,415 8 169,480,217
9 Prepaid expenses and deferred charges ...... 1,052,071,209 9 1,215,815,645
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 9,430,775,836
b Less: accumulated depreciation 10b 5,307,174,685 4,213,753,759 10c 4,123,601,151
11 Investments—publicly traded securities . 2,685,533,631 11 1,315,540,516
12 Investments—other securities. See Part IV, line 11 ..... 1,307,461,616 12 2,206,355,087
13 Investments—program-related. See Part IV, line 11 .. 1,596,048,620 13 1,843,393,819
14 Intangible assets ............... 21,372,521 14 20,284,442
15 Other assets. See Part IV, line 11 ........... 58,030,952 15 16,335,602
16 Total assets. Add lines 1 through 15 (must equal line 34)... 14,252,350,035 16 13,884,757,255
Liabilities 17 Accounts payable and accrued expenses ..... 1,989,282,115 17 2,051,312,066
18 Grants payable ... 447 18 67,966
19 Deferred revenue ......... 32,770,122 19 33,124,214
20 Tax-exempt bond liabilities ......... 3,242,578,966 20 3,176,065,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.. 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 2,067,800,453 23 2,196,074,246
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D 1,451,163,467 25 2,227,209,118
26 Total liabilities. Add lines 17 through 25.. 8,783,595,570 26 9,683,852,610
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 5,303,084,584 27 4,031,420,906
28 Temporarily restricted net assets ........... 130,300,059 28 130,953,209
29 Permanently restricted net assets 35,369,822 29 38,530,530
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 5,468,754,465 33 4,200,904,645
34 Total liabilities and net assets/fund balances ........ 14,252,350,035 34 13,884,757,255
Form 990 (2015)
Form 990 (2015)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
10,193,378,790
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
10,162,159,265
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
31,219,525
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
5,468,754,465
5
Net unrealized gains (losses) on investments ...............
5
-239,477,671
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-1,059,591,674
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
4,200,904,645
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2015)
Form 990 (2015)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4


5
6
7
8
9
10
11
a
b
c
d
e
f
Enter the number of supported organizations ..............  

g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total      

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513...            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) 2015 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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
Schedule A (Form 990 or 990-EZ) 2015

Schedule A (Form 990 or 990-EZ) 2015
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)
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 2015 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-2015
(iii)
Distributable
Amount for 2015
1 Distributable amount for 2015 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2015
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......  
e From 2014.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2015 distributable amount  
i Carryover from 2010 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2015 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2015 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2015, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2015. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2016. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a
b
c Excess from 2013.......  
d From 2014.......  
e From 2015.......  
Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015
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) 2015


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2
Name of organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$ RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 3
Name of organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a)
No.from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)
Page 4
Name of organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No.from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data


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

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletInformation about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ......................................................................................................................SchCMd Bullet
$ 16,092
3
Volunteer hours .............................................................................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$ 1,609
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$ 0
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2015

Schedule C (Form 990 or 990-EZ) 2015
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................    
c Total lobbying expenditures (add lines 1a and 1b) .......................................................................    
d Other exempt purpose expenditures .........................................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ..............................................................................................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2012 (b) 2013 (c) 2014 (d) 2015 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2015


Schedule C (Form 990 or 990-EZ) 2015
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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
21,396
e
Publications, or published or broadcast statements? ...........................................................
 
No
0
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
2,219,862
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
271,939
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
796,968
j
Total. Add lines 1c through 1i ....................................................................................................
3,310,165
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART I-B, LINE 4B During the year, Dignity Health paid membership dues to Redding Chamber of Commerce and Los Angeles Area Chamber of Commerce ("the Chambers"). The invoices provided for voluntary contributions to the Chambers Political Action Committees (PAC). The check requests for annual dues inadvertently included amounts for voluntary contributions to the PACs. Dignity Health has policies and procedures in place to avoid such transactions, and once the organization became aware of this situation, immediate action was taken to obtain refunds from the Chambers for the amounts designated for the PACs. The organization issued a credit memo on the Redding Chamber of Commerce invoice in the amount of $10.00 on 12/23/2015, and a refund check from the Los Angeles Area Chamber of Commerce was received in the amount of $50.00 dated 2/4/2016, evidencing both payments have been recovered. Documentation has been attached to Form 4720. These represent the full amount of inadvertent payments made related to voluntary contributions to The Chambers PACs. Additionally, Dignity Health recently learned that RBR Management LLC, a related LLC in which Dignity Health has a 50.1% member interest, made political contributions in 2015 and 2016 in the amounts of $12,525 and $3,507, respectively. Upon discovery, Dignity Health immediately instructed the LLC to cease making political contributions, and will closely monitor this LLC to ensure full compliance going forward. In addition, Dignity Health has instructed RBR Management LLC to take steps to recover the expenditures to the extent possible. Dignity Health is also paying the excise tax on Form 4720.
PART II-B THE ORGANIZATION PAID FEES TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES, PAID COMPENSATION TO STAFF AND MANAGEMENT IN THE PERFORMANCE OF THEIR DUTIES IN ATTEMPTING TO INFLUENCE LEGISLATION, MEETING WITH AND CALLING GOVERNMENT OFFICIALS, AND DEVELOPED AND SENT LETTERS. IN ADDITION, THIS ORGANIZATION IS A MEMBER OF HEALTHCARE ASSOCIATIONS WHOSE PURPOSES INCLUDE DIRECTING, DEVELOPING, AND AFFECTING PUBLIC POLICY AND LEGISLATION WITH REGARD TO ISSUES AFFECTING HEALTHCARE. THE ORGANIZATION PAID ANNUAL DUES TO THESE ASSOCIATIONS, WHICH MAY BE USED FOR LOBBYING PURPOSES AS REFLECTED ON PART II-B, LINE 1I, OTHER ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2015


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on 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
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ....    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................
Part II
Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a)Current year (b)Prior year (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 128,552,281 131,179,463 119,411,098 112,677,658 114,824,736
b Contributions ... 9,081,967 1,807,921 2,115,261 3,857,469 5,904,333
c Net investment earnings, gains, and losses -1,441,121 1,754,826 12,008,691 9,375,208 -1,307,763
d Grants or scholarships ... 75,000 81,194 184,339 211,353 216,638
e Other expenditures for facilities
and programs ...
9,134,573 5,985,052 1,121,080 6,287,884 6,527,010
f Administrative expenses .... 3,616 123,683 1,050,168 0 0
g End of year balance ...... 126,979,938 128,552,281 131,179,463 119,411,098 112,677,658
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet6.000 %
b
Permanent endowment SchDMd Bullet78.000 %
c
Temporarily restricted endowment SchDMd Bullet16.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations .................
3a(i)
Yes
 
(ii) related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on 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 ...   202,323,776 202,323,776
b Buildings   4,407,549,068 2,168,674,668 2,238,874,400
c Leasehold improvements   59,732,128 37,529,432 22,202,696
d Equipment ...   4,151,506,109 3,022,016,603 1,129,489,506
e Other ...   609,664,755 78,953,982 530,710,773
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 4,123,601,151
Schedule D (Form 990) 2015

Schedule D (Form 990) 2015
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c)Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) POOLED INVESTMENTS
2,206,355,087 F
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 2,206,355,087
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)INVESTMENT IN UNCONSOLIDATED 161,863,942 F
(2)INVESTMENTS IN HEALTH RELATED 1,631,317,957 F
(3)INVESTMENTS IN HEALTH RELATED 50,211,920 C
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 1,843,393,819
Part IX
Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
PENSION PAYABLE 1,965,330,594
DUE TO RELATED PARTIES 213,467,430
ASSET RETIREMENT OBLIGATIONS 29,530,002
OTHER NON-CURRENT LIABILITIES 7,323,201
DEFERRED COMPENSATION 11,557,891
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 2,227,209,118
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) 2015

Schedule D (Form 990) 2015
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on 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' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  

Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
SCH D, Part V, Line 4 DIGNITY HEALTH HAS VARIOUS SUPPORTING 501(C)(3) FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THEY OPERATE TO RAISE FUNDS FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH'S HOSPITALS. DIGNITY HEALTH'S INTENDED USE FOR THE FUNDS IS TO INVEST IN EXPANDING ACCESS TO CARE, PURCHASE OR CONSTRUCT STATE-OF-THE-ART EQUIPMENT AND BUILDINGS, AND PROVIDE ADVANCED TRAINING AND EDUCATION TO CAREGIVERS AND PATIENTS.
SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2015


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region
(f) Total expenditures
for and investments
in region
Central America and the Caribbean     Investments N/A 2,784,824
Central America and the Caribbean     Investments N/A 2,094,953,895
Europe (Including Iceland and Greenland)     Investments N/A 381,559,107
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....     2,479,297,826
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)     2,479,297,826
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(a)(c) Region (b)(d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of non-cash
assistance
(h) Description
of non-cash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
non-cash
assistance
(g) Description
of non-cash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2015
Schedule F (Form 990) 2015
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
SCHEDULE F, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL EUROPE (INCLUDING ICELAND AND GREENLAND): ACCRUAL
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2015
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on 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
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: . . . . . . . .
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
  108,493 88,509,672 852,597 87,657,075 0.860 %
b Medicaid (from Worksheet 3, column a) . . . . .   1,216,034 3,002,703,875 2,244,014,393 758,689,482 7.470 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .   274,984 10,395,108 3,758,945 6,635,605 0.070 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .   1,599,511 3,101,608,655 2,248,625,935 852,982,162 8.400 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 562 630,080 72,945,375 8,710,819 64,234,556 0.630 %
f Health professions education (from Worksheet 5) . . . 107 24,140 106,031,990 35,985,598 70,046,392 0.690 %
g Subsidized health services (from Worksheet 6) . . . . 39 325,546 96,008,817 48,075,880 47,932,937 0.470 %
h Research (from Worksheet 7) . 5 518 30,343,720 23,003,736 7,339,984 0.070 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 205 119,169 24,366,493 853,947 23,512,546 0.230 %
j Total. Other Benefits . . 918 1,099,453 329,696,395 116,629,980 213,066,415 2.090 %
k Total. Add lines 7d and 7j . 918 2,698,964 3,431,305,050 2,365,255,915 1,066,048,577 10.490 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 4 53 2,320,519 1,402,502 918,017 0.010 %
2 Economic development 3 1 36,750 0 36,750  
3 Community support 20 555 1,359,195 249,884 1,109,311 0.010 %
4 Environmental improvements 3 0 222,049 3,280 218,769  
5 Leadership development and
training for community members
8 806 439,638 0 439,638  
6 Coalition building 23 11,776 418,495 137,960 280,535  
7 Community health improvement advocacy 22 1,599 363,811 56,374 307,437  
8 Workforce development 9 4,222 841,482 0 841,482 0.010 %
9 Other   0 0 0 0 0 %
10 Total 92 19,012 6,001,939 1,850,000 4,151,939 0.030 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
119,721,480
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
1,941,463,520
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,389,016,752
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-447,553,232
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1ST JOSEPH'S OUTPATIE
 
Surgery 25.65 % 0 % 37.33 %
2DESERT RIDGE OUTPATI
 
Surgery 26.537 % 0 % 23.07 %
3SOUTHWEST ORTHOPEDIC
 
Surgery 5.962 % 0 % 88.1 %
4SURGERY CENTER OF PE
 
Surgery 25 % 0 % 21.3 %
5CHANDLER ENDOSCOPY A
 
Surgery 25.449 % 0 % 49 %
6BNI MANAGEMENT LLC
 
Mgmt services 26.04 % 0 % 73.96 %
7ST JOSEPH'S CARDIOLO
 
Mgmt services 50 % 0 % 50 %
8PARKWAY SURGERY CENT
 
Surgery 27.289 % 0 % 30.201 %
9NORTH STATE SURGERY
 
Surgery 31.88 % 0 % 35.94 %
10SACRAMENTO MIDTOWN E
 
Surgery 25.55 % 0 % 49 %
11FOLSOM SIERRA ENDOSC
 
Surgery 51 % 0 % 37.98 %
12FOLSOM OUTPATIENT SU
 
Surgery 29.98 % 0 % 40.17 %
13ROSEVILLE SURGERY CE
 
Surgery 29.32 % 0 % 17.303 %
14GRASS VALLEY OUTPATI
 
Surgery 45.65 % 0 % 31.598 %
15ST JOSEPH'S SURGERY
 
Surgery 79.96 % 0 % 15.04 %
16STOCKTON OUTPATIENT
 
Surgery 25.55 % 0 % 49 %
17CBCC OUTSMARTING CAN
 
Cancer 51 % 0 % 49 %
18SANTA CRUZ SURGERY C
 
Surgery 50 % 0 % 50 %
19SANTA CRUZ COMPREHEN
 
Imaging 50 % 0 % 50 %
20DOMINICAN BREAST CEN
 
Imaging 50 % 0 % 50 %
21DOMINICAN MAGNETIC R
 
Imaging 80 % 0 % 20 %
22SAN FRANCISCO CYBERK
 
Cancer 26 % 0 % 21 %
23COASTAL SURGICAL SPE
 
Surgery 50.27 % 0 % 49.73 %
24TEMPLETON SURGERY CE
 
Surgery 61.18 % 0 % 32.94 %
25PLAZA SURGERY CENTER
 
Surgery 50.64 % 0 % 49.36 %
26RENAISSANCE IMAGING
 
Imaging 49 % 0 % 51 %
27INLAND ENDOSCOPY CEN
 
Surgery 25 % 0 % 75 %
28MEDICAL PAVILION AT
 
Real Estate (Rent/Lease) 25 % 0 % 45.252 %
29RADIATION ONCOLOGY C
 
Cancer 50 % 0 % 50 %
30NSC CHANNEL ISLANDS
 
Surgery Center 51 % 0 % 44.573 %
31VALLEY PHYSICIANS SU
 
Surgery 49 % 0 % 47.6 %
32PAIN DIAGNOSTIC AND
 
Surgery 25.68 % 0 % 35.04 %
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
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?38
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Joseph's Hospital and Medical Ctr
350 W Thomas Road
Phoenix,AZ85013
www.dignityhealth.org/stjosephs
H-3003
X X   X   X X      
2 Mercy San Juan Medical Center
6501 Coyle Avenue
Carmichael,CA95608
www.dignityhealth.org/mercysanjuan
030000063
X X   X     X      
3 Mercy General Hospital
4001 J Street
Sacramento,CA95819
www.dignityhealth.org/mercygeneral
030000062
X X   X     X      
4 Marian Regional Medical Center Arroy
1400 E Church Street
Santa Maria,CA93454
www.marianmedicalcenter.org/
50000040
X X   X     X      
5 Chandler Regional Hospital
475 South Dobson Road
Chandler,AZ85224
www.dignityhealth.org/chandlerregional
H-3002
X X         X      
6 Mercy Medical Center Redding
2175 Rosaline Avenue
Redding,CA96001
www.dignityhealth.org/mercy-redding
230000024
X X   X     X      
7 California Hospital Medical Center
1401 South Grand Avenue
Los Angeles,CA90015
www.dignityhealth.org/californiahospital
930000024
X X   X     X      
8 St Joseph's Medical Center of Stockto
1800 N California Street
Stockton,CA95204
www.stjosephscares.org/
030000284
X X   X     X      
9 Dominican Hospital
1555 Soquel Drive
Santa Cruz,CA95065
www.dominicanhospital.org
070000030
X X         X      
10 St Rose Dominican Hospital - Siena
3001 St Rose Parkway
Henderson,NV89052
www.dignityhealth.org/las-vegas
2969HOS-21
X X   X     X      
11 Northridge Hospital Medical Center
18330 Roscoe Boulevard
Northridge,CA91325
www.dignityhealth.org/northridgehospital
930000114
X X   X     X      
12 St Bernardine Medical Center
2101 N Waterman Avenue
San Bernardino,CA92404
www.dignityhealth.org/stbernardinemedica
240000206
X X         X      
13 Mercy Medical Center Merced
333 Mercy Avenue
Merced,CA95340
www.mercymercedcares.org/
040000178
X X   X     X      
14 Methodist Hospital of Sacramento
7500 Hospital Drive
Sacramento,CA95823
www.dignityhealth.org/methodistsacrament
030000064
X X   X     X      
15 St Mary Medical Center - Long Beach
1050 Linden Avenue
Long Beach,CA90813
www.dignityhealth.org/stmarymedical
930000012
X X   X     X      
16 Mercy Hospital (Bakersfield)
2215 Truxtun Avenue
Bakersfield,CA93301
www.mercybakersfield.org/
120000184
X X         X      
17 St John's Regional Medical Center
1600 North Rose Avenue
Oxnard,CA93030
www.stjohnshealth.org/
050000064
X X         X      
18 Mercy Gilbert Medical Center
3555 S Val Vista Drive
Gilbert,AZ85297
www.dignityhealth.org/mercygilbert
H-3972
X X         X      
19 Sequoia Hospital
170 Alameda de las Pulgas
Redwood City,CA94062
www.sequoiahospital.org/
220000045
X X   X     X      
20 Mercy Hospital of Folsom
1650 Creekside Drive
Folsom,CA95630
www.dignityhealth.org/mercyfolsom
030000372
X X         X      
21 St Mary's Medical Center
450 Stanyan Street
San Francisco,CA94117
www.stmarysmedicalcenter.org/
220000071
X X   X     X      
22 Glendale Memorial Hospital and Health
1420 South Central Avenue
Glendale,CA91204
www.dignityhealth.org/glendalememorial
930000099
X X         X      
23 St Rose Dominican Hospital - San Mart
8280 West Warm Springs Road
Las Vegas,NV89113
www.dignityhealth.org/las-vegas
4576HOS-6
X X         X      
24 Woodland Memorial Hospital
1325 Cottonwood Street
Woodland,CA95695
www.dignityhealth.org/woodland
030000115
X X         X      
25 French Hospital Medical Center
1911 Johnson Avenue
San Luis Obispo,CA93401
www.frenchmedicalcenter.org
050000031
X X         X      
26 St Rose Dominican Hospital - Rose de
102 E Lake Mead Drive
Henderson,NV89015
www.dignityhealth.org/las-vegas
659HOS-20
X X         X      
27 St John's Pleasant Valley Hospital
2309 Antonio Avenue
Camarillo,CA93010
www.stjohnshealth.org/
050000048
X X         X      
28 St Elizabeth Community Hospital
2550 Sister Mary Columba Drive
Red Bluff,CA96080
www.dignityhealth.org/stelizabethhospita
230000036
X X         X      
29 Mercy Medical Center Mt Shasta
914 Pine Street
Mt Shasta,CA96067
www.mercymtshasta.org/
230000015
X X     X   X      
30 Carondelet St Joseph's Hospital
350 S Wilmot Road
Tucson,AZ85711
www.carondelet.org/our-locations/st-jose
H7308
X X         X      
31 Carondelet St Mary's Hospital
1601 W St Marys Road
Tucson,AZ85745
www.carondelet.org/our-locations/st-mary
H7303
X X         X      
32 Southwest Orthopedic and Spine Hospit
750 North 40th Street
Phoenix,AZ85008
OASISHOSPITAL.COM
SH5128
X               Orthopedic/Spine HOSPITAL  
33 ARIZONA GENERAL HOSPITAL
7171 S 51st Avenue
Laveen,AZ85339
http://www.azgeneraler.com/locations
H6937
X           X X Emergency/Urgent Care Centers  
34 St Joseph's Behavioral Health Center
2510 N California Street
Stockton,CA95204
www.stjosephscanhelp.org/
030000367
X                  
35 Arizona Orthopedic Specialty Hospital
2905 West Warner Road
Chandler,AZ85224
AZOSH.COM
SH3571
X               Orthopedic Hospital  
36 Arizona Spine and Joint Hospital
4620 E Baseline Rd
Mesa,AZ85206
www.azspineandjoint.com
SH3711
X               Orthopedic/Spine HOSPITAL  
37 Carondelet Holy Cross Hospital
1171 W Target Range Road
Nogales,AZ85321
www.carondelet.org/our-locations/holy-cr
H7306
X       X   X      
38 St Joseph's Westgate Medical Center
7300 N 99th Avenue
Glendale,AZ85305
www.dignityhealth.org/westgate
H6522
X X         X      
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Hospital and Medical Ctr
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Hospital and Medical Ctr
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Joseph's Hospital and Medical Ctr
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
4
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
5
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Chandler Regional Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
6
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
8
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Joseph's Medical Center of Stockto
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
9
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
10
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
11
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
12
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
13
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
14
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
15
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
16
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
17
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
18
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
19
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
20
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
21
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
22
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 13
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
23
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
24
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
25
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
26
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
27
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
28
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
29
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 14
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
30
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
31
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
32
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ARIZONA GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
33
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
ARIZONA GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13   No
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15   No
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16   No
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17   No
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

ARIZONA GENERAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
34
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Joseph's Behavioral Health Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
35
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
36
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21   No
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
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)
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
37
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
38
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on 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) 2015
Schedule H (Form 990) 2015
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 6
Part VFacility Information (continued)

St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 7
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SECTION B, LINE 2 - ACQUIRED OR PLACED INTO SERVICE IN CURRENT OR PRECEDING TAX YEAR ARIZONA GENERAL HOSPITAL THE HOSPITAL BEGAN OPERATING EFFECTIVE JANUARY 2015. ARIZONA SPINE AND JOINT HOSPITAL THE HOSPITAL WAS ACQUIRED JULY 2015. CARONDELET ST JOSEPH'S HOSPITAL CARONDELET ST MARY'S HOSPITAL CARONDELET HOLY CROSS HOSPITAL THE HOSPITALS WERE ACQUIRED AUGUST 2015.
SECTION B, LINE 5 - CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER ST. JOSEPHS WESTGATE MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ARIZONA GENERAL HOSPITAL ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL IN THE 2015 CHNA, THE BROAD INTERESTS OF THE COMMUNITY WERE INCORPORATED THROUGH THREE MEANS. FIRST, DATA WERE COLLECTED THROUGH FOCUS GROUPS ENGAGING MEMBERS OF UNDERSERVED POPULATIONS AND COMMUNITIES. SECOND, SURVEYS WERE CONDUCTED WITH KEY INFORMANTS WHO SERVE THE PRIMARY SERVICE AREA. FINALLY, A SERIES OF MEETINGS WERE HELD WITH KEY STAKEHOLDERS IN THE SERVICE AREA, INCLUDING THE LOCAL PUBLIC HEALTH DEPARTMENT. PARTICIPANTS INTENTIONALLY REPRESENTED VULNERABLE AND DISENFRANCHISED POPULATIONS INCLUDING THE HOMELESS, UNINSURED/UNDERINSURED, MEDICAID, MEDICARE, IMMIGRANT, DISABLED, MENTALLY ILL, AND ELDERLY. LISTS OF KEY INFORMANTS AND STAKEHOLDERS CONSULTED, AND THEIR AFFILIATIONS, ARE IN THE CHNA REPORT. A TOTAL OF TWELVE FOCUS GROUPS WERE CONDUCTED WITH 127 COMMUNITY MEMBERS FROM THE FOLLOWING GROUPS: OLDER ADULTS (65-74 YEARS OF AGE); ADULTS WITHOUT CHILDREN; ADULTS WITH CHILDREN; AMERICAN INDIAN ADULTS; LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUESTIONING (LGBTQ) ADULTS; AFRICAN AMERICAN ADULTS; HISPANIC/LATINO ADULTS (ENGLISH); ADULTS WITH CHILDREN (SPANISH); LOW SOCIO-ECONOMIC STATUS ADULTS (SPANISH), AND YOUNG ADULTS (18-30 YEARS OF AGE). THE SURVEY WAS ADMINISTERED TO KEY INFORMANTS WHO PROVIDE SERVICES IN THE COMMUNITY, AND ASKED RESPONDENTS ABOUT FACTORS THAT WOULD IMPROVE "QUALITY OF LIFE," MOST IMPORTANT "HEALTH PROBLEMS," IN THE COMMUNITY, "RISKY BEHAVIORS" OF CONCERN, AND THEIR OVERALL RATING OF THE HEALTH OF THE COMMUNITY. DETAILS ON FOCUS GROUP LOCATIONS AND KEY STAKEHOLDER AGENCIES REPRESENTED ARE IN THE CHNA REPORT. MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY GENERAL HOSPITAL WOODLAND MEMORIAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO COMMUNITY INPUT AND PRIMARY DATA ON HEALTH NEEDS WERE OBTAINED VIA INTERVIEWS WITH SERVICE PROVIDERS AND KEY COMMUNITY INFORMANTS AND THROUGH FOCUS GROUPS IN ENGLISH AND SPANISH WITH MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. TRANSCRIPTS AND NOTES FROM INTERVIEWS AND FOCUS GROUPS WERE ANALYZED TO LOOK FOR THEMES AND TO DETERMINE IF A HEALTH NEED WAS IDENTIFIED AS SIGNIFICANT AND/OR A PRIORITY TO ADDRESS. PARTICIPANTS INCLUDED THE COUNTY PUBLIC HEALTH DEPARTMENT AND PUBLIC AND NON-PROFIT AGENCIES, COMMUNITY MEMBERS AND SERVICE PROVIDERS; A COMPLETE LIST OF KEY INFORMANT INTERVIEW DATA SOURCES, AREAS OF EXPERTISE AND POPULATIONS SERVED, ALONG WITH LISTS OF FOCUS GROUPS WITH PARTICIPANT DEMOGRAPHIC INFORMATION IS IN THE CHNA REPORT APPENDICES. MARIAN REGIONAL MEDICAL CENTER COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED VIA A HEALTH BEHAVIOR SURVEY, FOCUS GROUPS AND INTERVIEWS. THE SURVEY WAS BASED ON QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, PREVIOUS CHNAS PREPARED BY DIGNITY HEALTH, AND INPUT PROVIDED BY PEOPLE REPRESENTING COMMUNITY BENEFIT/OUTREACH ACTIVITIES. THE SURVEY WAS MADE AVAILABLE IN BOTH SPANISH AND ENGLISH. A TOTAL OF 1,067 SURVEYS WERE COLLECTED AT 36 DIFFERENT COMMUNITY LOCATIONS, INCLUDING THE LIBRARY, CHURCHES, SENIOR CENTERS, AND FARMS IN THE SERVICE AREA. THE COMPLETE LIST OF SURVEYED LOCATIONS AND A COPY OF THE QUESTIONNAIRE ARE IN THE CHNA REPORT. TWO FOCUS GROUPS WERE ATTENDED BY KEY INFORMANTS INCLUDING HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS REPRESENTING LOW-INCOME, MINORITY, OR MEDICALLY UNDERSERVED POPULATIONS. THE HOSPITAL INVITED BOTH THE SANTA BARBARA COUNTY PUBLIC HEALTH DEPARTMENT AND THE SAN LUIS OBISPO PUBLIC HEALTH DEPARTMENT TO PARTICIPATE AND CONTRIBUTE INPUT. WHILE THE TIMING OF VARIOUS HOSPITAL AND PUBLIC HEALTH ASSESSMENTS DID NOT ALIGN, DATA AND INFORMATION WAS SHARED AMONG THE ORGANIZATIONS. FIVE COMMUNITY LEADER INTERVIEWS WERE CONDUCTED WITH SANTA BARBARA AND SAN LUIS OBISPO COUNTY SUPERVISORS, THE SANTA BARBARA COUNTY SHERIFF, SANTA MARIA MAYOR, AND SANTA MARIA POLICE DEPARTMENT REPRESENTATIVES. MERCY MEDICAL CENTER REDDING ("MMCR") MMCR CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY and SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA) RELATING TO A WIDE ARRAY OF COMMUNITY HEALTH INDICATORS. PRIMARY SURVEY DATA WAS COLLECTED BY USING PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MMCR AND THE PUBLIC HEALTH DEPARTMENT, AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. THE SURVEYS WERE EMAILED TO APPROXIMATELY 1,000 EMAILS THROUGH A DISTRIBUTION LIST THAT THE HOSPITAL USES TO DISSEMINATE HEALTH EDUCATION MATERIALS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THERE WERE 168 SURVEYS COMPLETED FOR A RETURN RATE OF APPROXIMATELY 16.8%. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MMCR ADVISORY COUNCIL, COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN THE PRIMARY SERVICE AREA, AND SHASTA COUNTY PUBLIC HEALTH REPRESENTATIVES. CALIFORNIA HOSPITAL MEDICAL CENTER FOR THE CHNA ADOPTED IN OCTOBER 2014, THREE HOSPITALS IN METROPOLITAN LOS ANGELES - CALIFORNIA HOSPITAL MEDICAL CENTER, GOOD SAMARITAN HOSPITAL, AND ST. VINCENT MEDICAL CENTER - COLLABORATED TO WORK WITH THE CENTER FOR NONPROFIT MANAGEMENT CONSULTING TEAM TO CONDUCT THE CHNA. IN THE INITIAL PHASE OF THE CHNA PROCESS, COMMUNITY INPUT WAS COLLECTED THROUGH 10 FOCUS GROUPS AND 29 INTERVIEWS WITH KEY STAKEHOLDERS, INCLUDING HEALTH CARE PROFESSIONALS, GOVERNMENT OFFICIALS, SOCIAL SERVICE PROVIDERS, COMMUNITY RESIDENTS, LEADERS, AND OTHER RELEVANT INDIVIDUALS. THE PURPOSE OF THE PRIMARY DATA COLLECTION COMPONENT WAS TO IDENTIFY BROAD HEALTH NEEDS AND KEY DRIVERS, AS WELL AS ASSETS AND GAPS IN RESOURCES, THROUGH THE PERCEPTIONS AND KNOWLEDGE OF VARIED AND MULTIPLE STAKEHOLDERS. THESE STAKEHOLDERS REPRESENTED A WIDE RANGE OF HEALTH AND SOCIAL SERVICE EXPERTISE, AS WELL AS REPRESENTATIVES FROM DIVERSE ETHNIC BACKGROUNDS INCLUDING AFRICAN-AMERICAN, CHINESE, FILIPINO, KOREAN, AND LATINO. THE INTERVIEW PROTOCOL WAS DESIGNED TO COLLECT RELIABLE AND REPRESENTATIVE INFORMATION ABOUT HEALTH AND OTHER NEEDS AND CHALLENGES FACED BY THE COMMUNITY, ACCESS TO AND UTILIZATION OF HEALTH CARE SERVICES, AND OTHER RELEVANT TOPICS. FOCUS GROUPS TOOK PLACE IN SEVERAL LOCATIONS THROUGHOUT THE SERVICE AREA, WITH TRANSLATION AND INTERPRETATION SERVICES PROVIDED WHEN APPROPRIATE. AS WITH THE INTERVIEWS, THE FOCUS GROUP TOPICS WERE DESIGNED TO COLLECT INFORMATION ABOUT HEALTH CARE UTILIZATION, PREVENTIVE AND PRIMARY CARE, HEALTH INSURANCE, ACCESS AND BARRIERS TO CARE, EMERGENCY ROOM USE, CHRONIC DISEASE MANAGEMENT AND OTHER COMMUNITY ISSUES. THE IDENTIFIED HEALTH NEEDS AND DRIVERS OF HEALTH WERE THEN PRESENTED DURING A COMMUNITY FORUM TO ALLOW FOR A RICHER DISCUSSION OF SECONDARY DATA AND ADDITIONAL CONSIDERATIONS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH CENTER THE 2015 CHNA PROCESS INCLUDED SURVEYS OF 2,927 RESIDENTS, 34 INTERVIEWS WITH KEY INFORMANTS INCLUDING THE COUNTY PUBLIC HEALTH DEPARTMENT, AND 29 FOCUS GROUP DISCUSSIONS IN THE COMMUNITY, INCLUDING INPUT FROM PERSONS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. RESIDENTS AND KEY STAKEHOLDERS PROVIDED VALUABLE INPUT ABOUT THE TOP HEALTH NEEDS IN THEIR COMMUNITIES. THE COMMUNITY SURVEY WAS ADMINISTERED TO COLLECT INFORMATION ABOUT A BROAD RANGE OF SOCIAL, ECONOMIC, ENVIRONMENTAL, BEHAVIORAL, AND CLINICAL CARE FACTORS THAT MAY ACT AS CONTRIBUTING DRIVERS OF HEALTH NEED. THE SURVEYS WERE CONDUCTED ON PAPER, ONLINE AND IN PERSON IN MULTIPLE LANGUAGES (ENGLISH, SPANISH, HMONG, CAMBODIAN). THIRTY-FOUR INTERVIEWS WERE CONDUCTED TO OBTAIN INFORMATION FROM KEY STAKEHOLDERS ABOUT A BROAD RANGE OF SOCIAL, ECONOMIC, ENVIRONMENTAL, BEHAVIORAL, AND CLINICAL CARE FACTORS. FOCUS GROUPS WERE CONDUCTED TO ENGAGE RESIDENTS IN CONVERSATION ABOUT STRENGTHS AND NEEDS IN THEIR COMMUNITIES. KEY INFORMANT INTERVIEWS WERE INTENDED TO GIVE A BROAD PERSPECTIVE ON COMMUNITY HEALTH STATUS ACROSS THE COUNTY, WHILE FOCUS GROUPS ADDRESSED NEIGHBORHOOD-SPECIFIC CONCERNS. INTERVIEW PARTICIPANTS AND FOCUS GROUP PARTICIPANT CHARACTERISTICS ARE DETAILED IN THE CHNA REPORT APPENDICES. DOMINICAN HOSPITAL COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED FROM 55 INDIVIDUALS VIA KEY INFORMANT INTERVIEWS WITH LOCAL HEALTH EXPERTS, AND FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES. THESE INCLUDED THE COUNTY PUBLIC HEALTH DEPARTMENT, COUNTY HOSPITAL, NON-PROFIT AGENCIES, COMMUNITY ORGANIZERS, AND THE BUSINESS, EDUCATION AND PHILANTHROP
SECTION B, LINE 5 - CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY MERCY MEDICAL CENTER MERCED THE AUGUST 2015 CHNA OBTAINED COMMUNITY INPUT VIA A REPRESENTATIVE, WEIGHTED RANDOM SAMPLE SURVEY OF 400 COMMUNITY RESIDENTS, AND A SEPARATE KEY INFORMANT SURVEY. THE SURVEY INSTRUMENT USED IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE SURVEY INSTRUMENT IS SIMILAR TO THE PREVIOUS SURVEY USED IN THE REGION, ALLOWING FOR DATA TRENDING. FOR THE COMMUNITY SURVEY, A TELEPHONE INTERVIEW METHODOLOGY INCORPORATING BOTH LANDLINE AND CELL PHONE INTERVIEWS WAS EMPLOYED. SEVENTY-THREE INDIVIDUALS PARTICIPATED IN THE KEY INFORMANT SURVEY, REPRESENTING PUBLIC HEALTH, SOCIAL SERVICES, PHYSICIANS, OTHER HEALTH CARE PROVIDERS, AND COMMUNITY AND BUSINESS LEADERS. A COMPLETE LIST IS IN THE CHNA REPORT. ST. MARY MEDICAL CENTER - LONG BEACH COMMUNITY INPUT INTO THE 2015 CHNA WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS AND LEADERS THROUGH KEY INFORMANT INTERVIEWS AND RESIDENT FOCUS GROUPS. A TOTAL OF 34 KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH PUBLIC HEALTH EXPERTS, REPRESENTATIVES FROM THE LOCAL PUBLIC HEALTH DEPARTMENT, AND LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. OTHER INDIVIDUALS FROM VARIOUS SECTORS WITH EXPERTISE IN LOCAL HEALTH NEEDS WERE ALSO CONSULTED. A COMPLETE LIST OF INTERVIEW PARTICIPANTS, WITH TITLES, ORGANIZATIONS AND AREAS OF COMMUNITY REPRESENTATION, IS IN THE CHNA REPORT. EIGHT FOCUS GROUPS WERE CONDUCTED, USING A NUMBER OF OUTREACH STRATEGIES TO RECRUIT COMMUNITY MEMBERS. FLYERS AND WRITTEN MATERIALS FOR THE FOCUS GROUPS WERE IN THREE LANGUAGES (ENGLISH, SPANISH AND KHMER), AND BILINGUAL-BICULTURAL FACILITATORS WERE RECRUITED SO THAT LANGUAGE WOULD NOT SERVE AS A BARRIER TO PARTICIPATION. FLYERS AND ANNOUNCEMENTS ABOUT THE FOCUS GROUPS WERE DISTRIBUTED ONLINE AND ON PAPER WITH THE HELP OF MANY COMMUNITY AGNECY PARTNERS AND 250 NEIGHBORHOOD ASSOCIATIONS. A TOTAL OF 52 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUPS, INCLUDING LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. MERCY HOSPITAL BAKERSFIELD THE 2015 CHNA PRIMARY DATA COLLECTION PROCESS WAS DESIGNED TO IDENTIFY COMMUNITY ISSUES, SOLICIT INFORMATION ON DISPARITIES AMONG SUBPOPULATIONS, ASCERTAIN COMMUNITY ASSETS TO ADDRESS NEEDS, AND DISCOVER GAPS IN RESOURCES. INFORMATION WAS OBTAINED THROUGH A COMMUNITY SURVEY OF 935 RESIDENTS AND 33 INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS, THE PUBLIC HEALTH DEPARTMENT, SERVICE PROVIDERS, MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, AND INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS. A COMPLETE LIST OF INTERVIEWEES NAMES, TITLES AND ORGANIZATIONS IS IN THE CHNA REPORT. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT AND IN A PAPER VERSION IN ENGLISH AND SPANISH. IT WAS DISTRIBUTED TO HOSPITAL PATIENTS, IN HOSPITAL WAITING ROOMS AND SERVICE SITES, AND THROUGH SOCIAL MEDIA INCLUDING HOSPITAL FACEBOOK PAGES. THE SURVEY WAS ALSO DISTRIBUTED TO COMMUNITY PARTNERS WHO MADE THEM AVAILABLE TO THEIR CLIENTS. THIRTY-FIVE PERCENT OF RESPONDENTS WERE ON MEDICAID OR HAD NO INSURANCE, AND 10 PERCENT HAD MEDICARE COVERAGE. ST. JOHN'S REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL FOR THE 2015 CHNAS, COMMUNITY INPUT WAS OBTAINED THROUGH: A COMMUNITY RESIDENT SURVEY OF 804 RESIDENTS; KEY INFORMANT INTERVIEWS WITH THE VENTURA COUNTY PUBLIC HEALTH DEPARTMENT DIRECTOR, OXNARD POLICE DEPARTMENT CHIEF, A PORT HUENEME CITY COUNCILMAN; AND A STAKEHOLDER FOCUS GROUP WITH REPRESENTATION FROM 19 COMMUNITY SERVICE ORGANIZATIONS. THE SURVEY QUESTIONS WERE BASED ON THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM QUESTIONNAIRE, AND THE QUESTIONNAIRE WAS AVAILABLE IN ENGLISH AND SPANISH IN LOCATIONS SELECTED TO BEST REPRESENT THE COMMUNITY, INCLUDING CHURCHES, SENIOR CENTERS, LOW INCOME HOUSING, AND FARMERS MARKETS. THE FOCUS GROUP INCLUDED LEADERS FROM HEALTH CARE, COMMUNITY ORGANIZATIONS, SOCIAL AND HUMAN SERVICES AGENCIES, AND AN EDUCATIONAL INSTITUTION. COMPLETE LISTS OF BOTH THE SURVEY DISTRIBUTION LOCATIONS AND AGENCIES PARTICIPATING IN THE STAKEHOLDER FOCUS GROUP ARE IN THE CHNA REPORT. SEQUOIA HOSPITAL IN THE 2015 CHNA, PRIMARY DATA WAS OBTAINED THROUGH DIRECT COMMUNITY INPUT: KEY INFORMANT INTERVIEWS WITH LOCAL HEALTH EXPERTS INCLUDING THE LOCAL PUBLIC HEALTH DEPARTMENT, FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES, AND RESIDENT FOCUS GROUPS. FOR THE INTERVIEWS AND COMMUNITY lEADER FOCUS GROUPS, INPUT WAS OBTAINED FROM 38 COMMUNITY REPRESENTATIVES IN THE HEALTH CARE FIELD AND IN COMMUNITY-BASED ORGANIZATIONS THAT FOCUS ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS FOR PEOPLE IN HIGH-NEED POPULATIONS. THESE INCLUDED INDIVIDUALS FROM THE COUNTY HEALTH DEPARTMENT, COUNTY HOSPITAL, COUNTY SUPERVISORS, NON-PROFIT AGENCIES, FAITH-BASED LEADERS, AND THE BUSINESS SECTOR. SPECIFIC INDIVIDUALS AND THEIR TITLES, ORGANIZATIONS AND EXPERTISE ARE IN THE CHNA REPORT APPENDIX. EIGHT RESIDENT FOCUS GROUPS WERE HELD TO REACH MEDICALLY UNDERSERVED YOUTH, MINORITY, LOW-INCOME, SPANISH-SPEAKING, HOMELESS, LGBTQI, TONGAN/SAMOAN, AND GEOGRAPHICALLY ISOLATED POPULATIONS. ST. MARY'S MEDICAL CENTER THE 2015 CHNA TOOK INTO ACCOUNT COMMUNITY INPUT VIA COMMUNITY MEETINGS WITH TARGET RESIDENT POPULATIONS, IN ADDITION TO THE LEADERSHIP AND ACTIVE PARTICIPATION OF THE PUBLIC HEALTH DEPARTMENT AND MANY PUBLIC AND NON-PROFIT AGENCIES. TARGET POPULATIONS FOR THE COMMUNITY MEETINGS WERE SELECTED BASED ON FOUR FACTORS: 1) THE POPULATION HAS KNOWN HEALTH DISPARITIES, 2) LITTLE INFORMATION DESCRIBING THE HEALTH OF THE POPULATION WAS AVAILABLE, 3) THE POPULATION WAS NOT INCLUDED IN A RECENT HEALTH ASSESSMENT, AND 4) THE POPULATION WAS REACHABLE THROUGH AN EXISTING COMMUNITY GROUP. THE MAIN QUESTION ASKED OF MEETING PARTICIPANTS WAS, "WHAT ACTIONS CAN WE TAKE - INCLUDING RESIDENTS, COMMUNITY GROUPS, AND THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP TO IMPROVE HEALTH?" PARTICIPANTS WERE ALSO ASKED ABOUT THE ASSETS AND BARRIERS WHICH EXIST IN THEIR COMMUNITIES REGARDING HEALTH. A TOTAL OF 127 PARTICIPANTS ATTENDED 11 MEETINGS. PARTICIPANTS CAME FROM A VARIETY OF BACKGROUNDS. THE ETHNIC GROUPS WITH THE LARGEST REPRESENTATION IN THE MEETINGS WERE LATINO (23 PERCENT), BLACK/AFRICAN AMERICAN (15 PERCENT), WHITE (17 PERCENT), AND ASIAN (12 PERCENT). OTHER SELF-REPORTED ETHNICITIES INCLUDED ARAB, FILIPINO, JEWISH, MIDDLE EASTERN, AND NATIVE AMERICAN. THE MAJORITY OF PARTICIPANTS WERE FEMALE (59 PERCENT). GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER FOR THE 2013 CHNA, THE THREE GLENDALE HOSPITALS - GMHHC, GLENDALE ADVENTIST MEDICAL CENTER, AND VERDUGO HILLS HOSPITAL - COLLABORATED WITH THE GLENDALE HEALTHIER COMMUNITY COALITION TO WORK WITH THE CENTER FOR NONPROFIT MANAGEMENT CONSULTING TEAM IN CONDUCTING THE CHNA. COMMUNITY INPUT INTO KEY HEALTH FACTORS, NEEDS, BARRIERS, IMPACTED POPULATIONS AND RELATED TOPICS WAS COLLECTED DURING A COMMUNITY FOCUS GROUP ATTENDED BY 37 INDIVIDUALS. ONCE INITIAL ISSUES WERE IDENTIFIED BY COMMUNITY INPUT AND QUANTITATIVE DATA ANALYSIS, THE SAME INDIVIDUALS WERE INVITED TO A COMMUNITY PRIORITIZATION FORUM AND ALSO COMPLETED A PRIORITIZATION SURVEY. PARTICIPANTS INCLUDED REPRESENTATIVES OF HEALTH CARE PROFESSIONALS, MENTAL HEALTH SERVICES, NURSING CARE, PRIMARY AND SECONDARY EDUCATION, COMMUNITY HEALTH CENTERS, HOMELESSNESS, CHILDREN AND YOUTH, OLDER ADULTS, DOMESTIC VIOLENCE VICTIMS, AND OTHER RELEVANT CONSTITUENCIES. FRENCH HOSPITAL MEDICAL CENTER COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED VIA A HEALTH BEHAVIOR SURVEY, FOCUS GROUPS AND INTERVIEWS. THE SURVEY WAS BASED ON QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTIONS BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, PREVIOUS CHNAS PREPARED BY DIGNITY HEALTH, AND INPUT PROVIDED BY PEOPLE REPRESENTING COMMUNITY BENEFIT/OUTREACH ACTIVITIES. THE SURVEY WAS MADE AVAILABLE IN BOTH SPANISH AND ENGLISH. A TOTAL OF 448 SURVEYS WERE COLLECTED AT 20 DIFFERENT COMMUNITY LOCATIONS, INCLUDING CHURCHES, SENIOR HOUSING CENTERS, HOMELESS SHELTERS, SCHOOLS, AND HOUSING AUTHORITY LOCATIONS IN THE SERVICE AREA. THE COMPLETE LIST OF SURVEYED LOCATIONS AND A COPY OF THE QUESTIONNAIRE ARE IN THE CHNA REPORT. FOCUS GROUPS were ATTENDED BY KEY INFORMANTS REPRESENTING LOW-INCOME, MINORITY, OR MEDICALLY UNDERSERVED POPULATIONS, INCLUDING: COMMUNITY HEALTH CENTER OF THE CENTRAL COAST, SAN LUIS OBISPO COUNCIL OF GOVERNMENTS, RIDE-ON-TRANSPORTATION, TRANSITION MENTAL HEALTH ASSOCIATION, SAN LUIS OBISPO OMBUDSMAN, SAN LUIS OBISPO NOOR FOUNDATION, FIRST 5 OF SAN LUIS OBISPO, AND THE HOUSING AUTHORITY OF SAN LUIS OBISPO. THE HOSPITAL CONSULTED THE SAN LUIS OBISP
SECTION B, LINE 6A- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSESSMENT ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, ST. JOSEPHS WESTGATE MEDICAL CENTER, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, ARIZONA ORTHOPEDIC SURGICAL HOSPITAL, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, ARIZONA GENERAL HOSPITAL, BANNER HEALTH, MAYO HOSPITAL, PHOENIX CHILDRENS HOSPITAL MERCY SAN JUAN MEDICAL CENTER, MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, THE GREATER SACRAMENTO HOSPITALS OF UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER HEALTH CALIFORNIA HOSPITAL MEDICAL CENTER, GOOD SAMARITAN HOSPITAL AND ST. VINCENT MEDICAL CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON, ST. JOSEPH'S BEHAVIORAL HEALTH CENTER, DAMERON HOSPITAL ASSOCIATION, KAISER PERMANENTE, SUTTER TRACY COMMUNITY HOSPITAL ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS, ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS, BOULDER CITY HOSPITAL, THE UNIVERSITY MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER, COMMUNITY HOSPITAL SAN BERNARDINO ST. MARY MEDICAL CENTER - LONG BEACH, KAISER PERMANENTE SOUTH BAY, LONG BEACH MEMORIAL HOSPITAL, COMMUNITY HOSPITAL LONG BEACH, MILLER CHILDRENS AND WOMENS HOSPITAL MERCY HOSPITAL BAKERSFIELD, DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE, SAN JOAQUIN COMMUNITY HOSPITAL ST. JOHN'S PLEASANT VALLEY HOSPITAL, ST. JOHN'S REGIONAL MEDICAL CENTER SEQUOIA HOSPITAL, STANFORD HOSPITAL AND CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL, KAISER PERMANENTE SAN MATEO AREA ST. MARY'S MEDICAL CENTER, SAINT FRANCIS MEMORIAL HOSPITAL, SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE SAN FRANCISCO, UCSF MEDICAL CENTER GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER, GLENDALE ADVENTIST MEDICAL CENTER, USC VERDUGO HILLS HOSPITAL
SECTION B, LINE 6b - CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER ST. JOSEPHS WESTGATE MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER ARIZONA ORTHOPEDIC SURGICAL HOSPITAL SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ARIZONA GENERAL HOSPITAL MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, ADELANTE HEALTHCARE, HEALTH CARE FOR THE HOMELESS, MOUNTAIN PARK HEALTH CENTER, AND NATIVE HEALTH MERCY MEDICAL CENTER REDDING SHASTA COUNTY PUBLIC HEALTH ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPHS BEHAVIORAL HEALTH CENTER COMMUNITY MEDICAL CENTERS, COMMUNITY PARTNERSHIP FOR FAMILIES, FIRST 5 SAN JOAQUIN, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, SAN JOAQUIN PUBLIC HEALTH SERVICES, AND 36 PUBLIC AND NON-PROFIT AGENCIES ON THE STEERING COMMITTEE. DOMINICAN HOSPITAL SANTA CRUZ COUNTY COMMUNITY ASSESSMENT PROJECT STEERING COMMITTEE MEMBERS, INCLUDING: UNITED WAY OF SANTA CRUZ COUNTY, SANTA CRUZ COUNTY ALCOHOL & DRUG PROGRAM, UNIVERSITY OF CALIFORNIA-SANTA CRUZ, FIRST 5 SANTA CRUZ COUNTY, SANTA CRUZ COMMUNITY CREDIT UNION - COMMUNITY VENTURES, SOQUEL UNION ELEMENTARY SCHOOL DISTRICT, SANTA CRUZ COMMUNITY HEALTH CENTERS, COMMUNITY FOUNDATION SANTA CRUZ COUNTY, SECOND HARVEST FOOD BANK, COUNTY OF SANTA CRUZ HEALTH SERVICES AGENCY, SANTA CRUZ COUNTY PROBATION DEPARTMENT, COUNTY OF SANTA CRUZ, PAMF/SUTTER HEALTH, ECOLOGY ACTION, DIENTES COMMUNITY DENTAL CARE, SANTA CRUZ COUNTY OFFICE OF EDUCATION, HEALTH IMPROVEMENT PARTNERSHIP SANTA CRUZ COUNTY, COASTAL WATERSHED COUNCIL, CABRILLO COLLEGE, PAJARO VALLEY COMMUNITY HEALTH TRUST, COUNTY OF SANTA CRUZ HUMAN SERVICES DEPARTMENT, CULTURAL COUNCIL OF SANTA CRUZ COUNTY, SANTA CRUZ COUNTY SHERIFFS OFFICE. ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA ST. ROSE DOMINICAN HOSPITAL - SIENA THE CHNA WAS CONDUCTED WITH: SOUTHERN NEVADA HEALTH DISTRICT, AMERICAN HEART ASSOCIATION, CATHOLIC CHARITIES, CENTER FOR PROGRESSIVE POLICY AND PROGRESS, CLARK COUNTY SCHOOL DISTRICT, CLARK COUNTY SOCIAL SERVICES, FEDERAL RESERVE BANK OF SAN FRANCISCO, LAS VEGAS CHAMBER OF COMMERCE, MARCH OF DIMES, NEVADA HAND, UNITED WAY OF SOUTHERN NEVADA, UNIVERSITY OF NEVADA LAS VEGAS, AND THE UNIVERSITY OF NEVADA RENO. ST. MARY MEDICAL CENTER - LONG BEACH CITY OF LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE CHILDRENS CLINIC SEQUOIA HOSPITAL HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY, INCLUDING: PENINSULA HEALTH CARE DISTRICT, SAN MATEO COUNTY HUMAN SERVICE AGENCY, SEQUOIA HEALTHCARE DISTRICT, HEALTH PLAN OF SAN MATEO, SAN MATEO COUNTY HEALTH DEPARTMENT, PENINSULA FAMILY YMCA, PENINSULA LIBRARY SYSTEM-COMMUNITY INFORMATION PROGRAM, SILICON VALLEY COMMUNITY FOUNDATION, YOUTH AND FAMILY ENRICHMENT SERVICES. ST. MARY'S MEDICAL CENTER SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP MEMBERS INCLUDING: SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTES COMMUNITY ENGAGEMENT AND HEALTH POLICY PROGRAM AT UCSF, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, THE OFFICE OF THE MAYOR, THE ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION, HUMAN SERVICE NETWORK, CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION, AFRICAN AMERICAN COMMUNITY HEALTH COUNCIL, COMMUNITY CLINIC CONSORTIUM, 12 OTHER COMMUNITY ENGAGEMENT PARTNERS, AND FAITH BASED AND PHILANTHROPIC PARTNERS. ST. ELIZABETH COMMUNITY HOSPITAL TEHAMA COUNTY PUBLIC HEALTH MERCY MEDICAL CENTER MT. SHASTA SISKIYOU COUNTY RURAL HEALTH CLINICS, SISKIYOU COUNTY COMMUNITY RESOURCE CENTERS, SISKIYOU COUNTY PUBLIC HEALTH
SECTION B, LINE 7a - CHNA ON HOSPITAL FACILITY'S WEB SITE ALL DIGNITY HEALTH HOSPITAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS CAN BE ACCESSED AT HTTP://WWW.DIGNITYHEALTH.ORG/CM/CONTENT/PAGES/COMMUNITY-BENEFIT.ASP CHNA REPORT WEB SITE LOCATIONS FOR EACH HOSPITAL FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY GENERAL HOSPITAL WOODLAND MEMORIAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO https://www.dignityhealth.org/Service%20Areas/sacramento/about-us/communit y-health-and-outreach/health-needs-assessment MARIAN REGIONAL MEDICAL CENTER http://www.dignityhealth.org/marianregional/about-us/community-benefits CHANDLER REGIONAL MEDICAL CENTER http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach MERCY MEDICAL CENTER REDDING http://www.dignityhealth.org/mercy-redding/about-us/community-benefit CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/about-us/community-program s/community-health-needs-assessment-and-plan ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.dignityhealth.org/stjosephs-stockton/about-us/community-program s/community-health-assessment DOMINICAN HOSPITAL http://www.dignityhealth.org/dominican/about-us/community-benefits ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA ST. ROSE DOMINICAN HOSPITALS - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN http://www.dignityhealth.org/las-vegas/about-us/serving-the-community NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/community-benef it-reports ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity/menub78ffb2d-73c8-4769-9b3a-07decf6facb7 MERCY MEDICAL CENTER MERCED http://www.dignityhealth.org/mercymedical-merced/dignity-health-in-merced- county/community-benefit-report ST. MARY MEDICAL CENTER - LONG BEACH http://www.dignityhealth.org/stmarymedical/community-benefits MERCY HOSPITAL BAKERSFIELD http://www.dignityhealth.org/mercy-bakersfield/dignity-health-in-kern-coun ty/community-programs/community-benefit-report ST. JOHN'S REGIONAL MEDICAL CENTER http://www.dignityhealth.org/stjohnsregional/about-us/community-benefit MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach SEQUOIA HOSPITAL http://www.dignityhealth.org/sequoia/about-us/community-benefit ST. MARY'S MEDICAL CENTER http://www.dignityhealth.org/stmarys/about-us/community-benefit GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan FRENCH HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/frenchhospital/about-us/community-benefits ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.dignityhealth.org/pleasantvalley/about-us/community-benefit ST. ELIZABETH COMMUNITY HOSPITAL http://www.dignityhealth.org/stelizabethhospital/about-us/community-benefi t MERCY MEDICAL CENTER MT. SHASTA http://www.dignityhealth.org/mercy-mtshasta/about-us/community-benefit SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ ARIZONA GENERAL HOSPITAL http://www.dignityhealth.org/arizonageneral/about-us/community-benefit ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.dignityhealth.org/stjosephsbehavioral/about-us/community-health ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL http://azosh.com/community-benefits-reports ST. JOSEPHS WESTGATE MEDICAL CENTER http://www.dignityhealth.org/westgate/about-us/community-benefit http://www.dignityhealth.org/westgate/about-us/community-benefit
SECTION B, LINE 7b - CHNA ON OTHER WEB SITES ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH CENTER WWW.HEALTHIERSANJOAQUIN.ORG DOMINICAN HOSPITAL http://www.appliedsurveyresearch.org/scccap MERCY HOSPITAL BAKERSFIELD http://www.healthykern.org/ SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG
SECTION B, LINE 10a - IMPLEMENTATION STRATEGIES ON WEB SITES DIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS. IMPLEMENTATION STRATEGIES ARE ALSO ON EACH HOSPITAL FACILITYS WEB SITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7a ABOVE.
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER ST. JOSEPHS WESTGATE MEDICAL CENTER ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ARIZONA GENERAL HOSPITAL THE HOSPITALS ARE ADDRESSING THE 2015 CHNA SIGNIFICANT HEALTH NEEDS OF: ACCESS TO CARE; MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE; OBESITY AND DIET-RELATED ILLNESSES; CHRONIC CONDITIONS; AND INJURY AND TRAUMA. THE HOSPITALS ARE ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THEIR IMPLEMENTATION STRATEGIES, WHICH ARE WIDELY AVAILABLE TO THE PUBLIC ONLINE. ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL and ARIZONA GENERAL HOSPITAL ARE SMALL, JOINT-VENTURE SPECIALTY HOSPITALS THAT WORK CLOSELY WITH ST. JOSEPHS HOSPITAL AND MEDICAL CENTER. [ACCESS TO HEALTH CARE]: THE HOSPITALS OPERATE 23 ACCESS-RELATED PROGRAMS SERVING NEEDS INCLUDING TRANSITIONAL CARE, CANCER, ALZHEIMIERS, NATIVE AMERICANS, AT-RISK FAMILIES, HOMELESS, AND OTHER TOPICS, AS WELL AS OFFERING PATIENT FINANCIAL ASSISTANCE. [MENTAL AND BEHAVIORAL HEALTH]: HOME-MVP; MATERNAL MOOD DISORDERS/POST-PARTUM DEPRESSION; MENTAL HEALTH FIRST AID; NATIVE COLLABORATION; SOUTHWEST BEHAVIORAL HEALTH SERVICES; TEEN PREGNANCY AND PARENTING. [OBESITY]: FOURTEEN PROGRAMS INCLUDING THOSE FOR CONGESTIVE HEART FAILURE, CHRONIC DISEASE AND DIABETES, AND THE WOMEN, INFANT AND CHILDREN PROGRAM. [CHRONIC HEALTH CONDITIONS]: NINETEEN PROGRAMS INCLUDING THOSE FOR PREVENTING AND ADDRESSING CANCER, CARDIOVASCULAR DISEASE, AND DIABETES. [INJURY AND TRAUMA]: NINETEEN PROGRAMS INCLUDING THOSE FOR PREVENTION OF HEAD INJURIES, WATER SAFETY, FALL PREVENTION, DOMESTIC VIOLENCE, ANTI-HUMAN TRAFFICKING, SENIOR DRIVING, AND PRESCRIPTION DRUG ABUSE. ST. JOSEPHS HOSPITAL AND MEDICAL CENTER AS AN ACUTE CARE HOSPITAL IS NOT LICENSED TO PROVIDE CARE TO CHILDREN LESS THAN FIFTEEN YEARS OF AGE WITHIN THE HOSPITAL SETTING. WITH COLLABORATIVE ENGAGEMENT WITH PHOENIX CHILDRENS HOSPITAL, THE HOSPITALS ARE ABLE TO MEET THE NEEDS LISTED FOR CHILDREN AND ALSO COLLABORATE WITH THE COMMUNITY WHERE AREAS OF NEED ARE UNMET. THE SERVICES THAT ARE NOT MET BY THE HOSPITALS ARE MET BY OTHER HEALTH CARE FACILITIES OR COLLABORATIVE PARTNERSHIPS WITHIN MARICOPA COUNTY. MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO THESE GREATER SACRAMENTO HOSPITALS ARE ADDRESSING OR CURRENTLY DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: 1) ACCESS TO BEHAVIORAL HEALTH SERVICES; 2) ACTIVE LIVING AND HEALTHY EATING; 3) DISEASE PREVENTION, MANAGEMENT, AND TREATMENT; 4) ACCESS TO HIGH QUALITY HEALTH CARE AND SERVICES; 5) SAFE, CRIME AND VIOLENCE FREE COMMUNITIES; AND 6) BASIC NEEDS. INITIATIVES THAT ADDRESS THESE PRIORITIES LARGELY TARGET VULNERABLE AND AT-RISK POPULATIONS, WITH EMPHASIS ON COLLABORATION WITH OTHER DIGNITY HEALTH HOSPITALS AND COMMUNITY PARTNERS. THE HOSPITALS ARE ADDRESSING THESE NEEDS WITH NUMEROUS DIRECT SERVICE PROGRAMS, GRANT FUNDING TO THE COMMUNITY, PATIENT FINANCIAL ASSISTANCE, AND COMMUNITY PARTNERSHIPS DESCRIBED IN DETAIL IN EACH FACILITYS IMPLEMENTATION STRATEGY, WHICH ARE WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS AT THESE HOSPITALS INCLUDE: REFERNET INTENSIVE OUTPATIENT MENTAL HEALTH PARTNERSHIP, TRIAGE NAVIGATOR PROGRAM, MENTAL HEALTH IMPROVEMENT COALITION, MENTAL HEALTH CONSULTATIONS AND CONSERVATORSHIP SERVICES, FOOD LITERACY CENTER, MACK ROAD PARTNERSHIP (METHODIST HOSPITAL ONLY), WAYUP STATION, HEALTHIER LIVING, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, DIABETES EMPOWERMENT EDUCATION PROGRAM, PATIENT NAVIGATOR PROGRAM, CANCER NURSE NAVIGATOR, SACRAMENTO PHYSICIANS INITIATIVE TO REACH OUT, INNOVATE AND TEACH, MERCY FAMILY HEALTH CLINIC (METHODIST HOSPITAL ONLY), PEACH TREE HEALTH CAPACITY BUILDING PROJECT, MERCY CLINIC LOAVES & FISHES, SCHOOL NURSE PROGRAM, MERCY FAITH AND HEALTH PARTNERSHIP, CARE FOR THE UNDOCUMENTED, ANTI-HUMAN TRAFFICKING INITIATIVE, WEAVE WELLNESS CENTER (METHODIST HOSPITAL ONLY), INITIATIVE TO REDUCE AFRICAN AMERICAN CHILD DEATHS, PREVENT ALCOHOL AND RISK-RELATED TRAUMA IN YOUTH, SAFE KIDS PROGRAM, HOMELESS OUTREACH PROJECT, INTERIM CARE PROGRAM, AND HOUSING WITH DIGNITY HOMELESS PROGRAM. THE HOSPITALS DO NOT HAVE THE CAPACITY OR RESOURCES TO ADDRESS ALL PRIORITY HEALTH ISSUES. THE HOSPITALS ARE NOT DIRECTLY ADDRESSING AFFORDABLE AND ACCESSIBLE TRANSPORTATION OR POLLUTION-FREE LIVING AND WORKING ENVIRONMENTS. MANY OF THE CURRENT INITIATIVES INCLUDE A TRANSPORTATION COMPONENT ALTHOUGH SERVICES ARE LIMITED. THE SACRAMENTO AREA COUNCIL OF GOVERNMENTS FOCUSES ON INITIATIVES AROUND TRANSPORTATION PLANNING AND CLEAN AIR INITIATIVES. MARIAN REGIONAL MEDICAL CENTER THE PRIORITIZED SIGNIFICANT HEALTH NEEDS IN THE 2015 CHNA THAT THE HOSPITAL WILL DIRECTLY ADDRESS ARE CARDIOVASCULAR DISEASE AND STROKE AND CANCER SCREENINGS. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: COMMUNITY EDUCATION IN SPANISH AND ENGLISH; ASSESSMENT OF CARDIOVASCULAR RISK STATUS AT TARGETED LOCATIONS IN THE COMMUNITY; HEART AWARE PROGRAM; CARE TRANSITIONS PROGRAM; CHRONIC DISEASE SELF-MANAGEMENT PROGRAM; NUTRITION PROGRAMS; CANCER AWARENESS COMMUNITY EDUCATION AT OUTREACH EVENTS AND LOCAL SCHOOLS; CANCER SCREENINGS; HEREDITARY CANCER RISK ASSESSMENT AND GENETIC COUNSELING; CANCER EXPERIENCE REGISTRY PROGRAM; MISSION HOPE CANCER REHABILITATION PROGRAM; AND CANCER SUPPORT GROUPS. EDUCATION, ACCESS TO MENTAL HEALTH, AND HOMELESSNESS/HOUSING ARE NEEDS THE HOSPITAL HAS CHOSEN NOT TO ADDRESS ALONE, BUT DOES HAVE PROGRAMS OR PLANS IN CONJUNCTION WITH OTHERS. AMONG THE PROGRAM INITIATIVES ARE: REACH OUT AND READ PROGRAM; MATERNAL MOOD DISORDER PILOT PROGRAM; CAREGIVER WORKSHOPS AND SUPPORT GROUPS; FREE ZUMBA AND YOGA CLASSES; RESPITE CARE SERVICES; AND CASE MANAGEMENT OF CHRONICALLY HOMELESS INDIVIDUALS. THE HOSPITAL IS LIMITED IN RESOURCES TO ADDRESS EDUCATION AND HOMELESSNESS/HOUSING INDEPENDENT OF OUR COMMUNITY PARTNERS. CONSIDERABLE INVESTIGATION REVEALED EDUCATION AND HOMELESSNESS/HOUSING ARE BEING ADDRESSED BY OTHERS, BUT THERE IS STILL WORK TO BE DONE. BY INVITATION TO COMMUNITY-BASED ORGANIZATIONS, WE HOPE TO FACILITATE A SEAMLESS CONTINUUM OF CARE AND DEVELOP RELATIONSHIPS THAT CAN BE ADDRESSED THROUGH THE DIGNITY HEALTH COMMUNITY GRANTS PROGRAM. THE HOSPITAL IN PARTNERSHIP WITH THE COUNTY OF SANTA BARBARA PLANS TO OPEN AN INPATIENT BEHAVIORAL HEALTH UNIT IN NORTH SANTA BARBARA COUNTY IN 2019 TO HELP ADDRESS THE CRITICAL MENTAL HEALTH NEEDS OF THE COMMUNITY. CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER THE HOSPITALS ARE ADDRESSING ALL SIGNIFICANT NEEDS IN THE 2015 CHNA IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. [ACCESS TO HEALTH CARE]: NINETEEN PROGRAMS THAT ADDRESS TRANSITIONAL CARE, SCHOOL-BASED HEALTH CARE, FREE AND LOW-COST SERVICES, HOMELESS POPULATION, TRANSPORTATION, ACCESS TO HEALTH INFORMATION, EDUCATION ABOUT INSURANCE, AND ACCESS TO HEALTHY FOOD. [PROBLEMS OF AGING]: SEVENTEEN PROGRAM ACTIVITIES THAT ADDRESS SUPPORT TO CAREGIVERS, ALZHEIMERS, FALL RISKS, CHRONIC DISEASE, TRANSPORTATION, AND CONDITION-SPECIFIC SUPPORT GROUPS. [MENTAL HEALTH/BEHAVIORAL HEALTH]: SEVEN PROGRAMS THAT INCLUDE BEHAVIORAL HEALTH TASK FORCE PARTICIPATION, COMMUNITY EDUCATION, MENTAL HEALTH FIRST AID PROGRAM, MATERNAL POST-PARTUM DEPRESSION, AND PREGNANT AND PARENTING AND TEEN SUPPORT. [DIABETES]: EIGHT PROGRAM ACTIVITIES INCLUDING CENTER FOR DIABETES MANAGEMENT COMMUNITY PROGRAMS, CHRONIC DISEASE AND DIABETES SELF-MANAGEMENT WORKSHOPS, FITNESS EDUCATION AND PARTNERSHIPS, AND AN EVALUATION OF HEALTH FOOD ACCESS. [INJURY PREVENTION]: NINE PROGRAM ACTIVITIES ADDRESSING INJURY PREVENTION FOR BOTH CHILDREN AND ADULTS. CAR SEAT CLINICS AND THE MATTER OF BALANCE FALL PREVENTION PROGRAM ARE EXAMPLES. [CANCER]: PROGRAM STRATEGIES IN IMPROVED EDUCATION ON IMPORTANCE OF EARLY DETECTION AND AVAILABILITY OF RESOURCES, AND IMPROVED AWARENESS OF CANCER SCREENING EVENTS. TO ADDRESS NEEDS NOT SPECIFICALLY MET BY CHANDLER REGIONAL MEDICAL CENTER, STRONG AND EFFECTIVE COMMUNITY PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. THESE SERVICES ARE PROVIDED BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA, INCLUDING MERCY GILBERT MEDICAL CENTER, IRONWOOD CANCER AND RESEARCH CENTER, BANNER HEALTH CARE, PHOENIX CHILDRENS HOSPITAL, VALLEY HOSPITAL, MERCY MARICOPA MENTAL HEALTH SERVICES FOR INPATIENT AND OUTPATIENT SERVICES, AND HONOR HEALTH. MERCY MEDICAL CENTER REDDING THE SIGNIFICANT HEALTH NEEDS IN THE 2014 CHNA ARE: MENTAL HEALTH, OBESITY, CANCERS, DOMESTIC VIOLENCE, CHILD ABUSE/NEGLECT, AGING PROBLE
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA ST. ROSE DOMINICAN HOSPITALS - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN THE HOSPITALS WILL ADDRESS THE 2015 CHNA SIGNIFICANT HEALTH NEEDS OF: ACCESS TO HEALTHCARE; POLICY AND FUNDING FOR PUBLIC HEALTH; AND CHRONIC DISEASE. THE HOSPITALS ARE ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THEIR IMPLEMENTATION STRATEGIES, WHICH ARE WIDELY AVAILABLE TO THE PUBLIC ONLINE. [ACCESS TO HEALTHCARE]: HEALTHLINK NAVIGATORS FOR COVERAGE ENROLLMENT ASSISTANCE, PARTNER WITH VOLUNTEERS IN MEDICINE AND THE NEVADA HEALTH CENTERS, BUILD FOUR NEIGHBORHOOD HOSPITALS WITH COMMUNITY HEALTH PROGRAMS IN KEY AREAS OF NEED, OFFER HELPING HANDS MEDICAL APPOINTMENT TRANSPORTATION, INCREASE ACCESS TO PRIMARY CARE PROVIDERS. [POLICY AND FUNDING]: COORDINATE THE MATERNAL CHILD HEALTH COALITION, PARTICIPATE ON THE NEVADA TOBACCO PREVENTION COALITION AND THE NEVADA CANCER COALITION, AND 20 OTHER COMMITTEES AND GROUPS TO ADVOCATE FOR HEALTH ISSUES. [CHRONIC DISEASE]: DELIVER OR PARTICIPATE IN 40 DIFFERENT PROGRAM ACTIVITIES ADDRESSING OBESITY, NUTRITION, PHYSICAL ACTIVITY, AND TOBACCO USE. THE HOSPITALS USED THE CRITERIA OF IMPACT, MAGNITUDE, SERIOUSNESS, FEASIBILITY, AND CONSEQUENCES OF INACTION IN DECIDING WHICH NEEDS TO ADDRESS. THE HOSPITALS ARE NOT DIRECTLY OR PRIMARILY ADDRESSING: MATERNAL AND CHILD HEALTH (PREMATURITY, LOW BIRTHWEIGHT, TEEN BIRTH); INJURY INCLUDING SUICIDE AND DRUG POISONING; PNEUMONIA AND INFLUENZA, AND QUALITY AND CONTINUITY OF CARE. HOWEVER, ST. ROSE DOMINICAN MANAGES THE STATEWIDE MATERNAL CHILD HEALTH COALITION AND ONE FOCUS AREA IS LOW BIRTH WEIGHT BABIES. OTHER ORGANIZATIONS ADDRESS THESE HEALTH NEEDS, INCLUDING WIC LINKAGE PROGRAM, PRENATAL EDUCATION PROGRAMS, MARCH OF DIMES, SOUTHERN NEVADA INJURY PREVENTION PARTNERSHIP, IMMUNIZE NEVADA, AND HEALTH INSIGHT. NORTHRIDGE HOSPITAL MEDICAL CENTER THE HOSPITAL WILL TAKE STEPS TO HELP ADDRESS EACH OF THE 10 SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: DIABETES SELF-MANAGEMENT PROGRAM AND DIABETES EMPOWERMENT EDUCATION PROGRAM; MEET EACH NEED WITH DIGNITY; CHOOSE HEALTH LA KIDS; SCHOOL WELLNESS INITIATIVE; SOS MENTOR HEALTHY KIDS KINDNESS; EMERGENCY DEPARTMENT INITIATIVE; ACTIVATE YOUR HEART; COMMUNITY CHOLESTEROL SCREENINGS; FINANCIAL ASSISTANCE FOR THE UNINSURED; LOAN TO THE LA FAMILY HOUSING CORPORATION; PATIENT NAVIGATOR PROGRAM; FAMILY MEDICINE CENTER & RESIDENCY PROGRAM; SHAPE UP YOUR HEART; CENTER FOR ASSAULT TREATMENT SERVICES; COALITION TO ABOLISH SLAVERY AND TRAFFICKING; AND ESTABLISHMENT OF A FREE CLINIC CREATING CAPACITY FOR AN ADDITIONAL 36 FREE ADULT DENTAL APPOINTMENTS PER MONTH. ST. BERNARDINE MEDICAL CENTER THE IDENTIFIED SIGNIFICANT HEALTH NEEDS INCLUDED: CHRONIC DISEASES (ASTHMA, CANCER, HEART DISEASE, DIABETES); ACCESS TO CARE; MENTAL HEALTH; OVERWEIGHT/OBESITY; PREVENTIVE HEALTH CARE; COMMUNITY GROWTH AND ENRICHMENT (SAFETY, HOMELESSNESS, EDUCATION, ECONOMIC DEVELOPMENT); ALCOHOL/DRUGS/TOBACCO; AND DENTAL HEALTH. THESE WERE SUMMARIZED INTO: ACCESS TO CARE; CHRONIC HEALTH CONDITIONS; AND YOUTH DEVELOPMENT. ACCESS TO CARE: EMERGENCY DEPARTMENT NAVIGATOR; FINANCIAL ASSISTANCE; ENROLLMENT ASSISTANCE INTO NO COST OR LOW COST COVERAGE; COMMUNITY EDUCATION, FLU SHOT CLINICS; COMMUNITY GRANTS PROGRAM. CHRONIC HEALTH CONDITIONS: COMMUNITY HEALTH EDUCATION. STANFORD UNIVERSITY CHRONIC DISEASE SELF-MANAGEMENT OFFERED IN ENGLISH AND SPANISH, WITH A FOCUS ON DIABETES AND HEART DISEASE. SWEET SUCCESS PROGRAM IS OFFERED TO EXPECTANT MOTHERS WITH DIABETES. YOUTH DEVELOPMENT: FAMILY FOCUS CENTER: PROVIDES THE OPPORTUNITY TO EDUCATE THE COMMUNITY'S AT-RISK YOUTH IN THE AREAS OF HEALTH, DRUG AND GANG AVOIDANCE, AND EDUCATION PROMOTION TO IMPROVE HIGH SCHOOL GRADUATION RATES. PROGRAMS INCLUDE AFTER SCHOOL ACTIVITIES, A SUMMER CAMP AND COLLABORATION WITH VARIOUS LOCAL AGENCIES. TEEN CHOICES, A PROGRAM AIMED TO PROVIDE EXPERT INFORMATION AND ADVICE FOR PREGNANT AND PARENTING TEENS WHO WANT TO MAKE THE BEST DECISIONS FOR THEIR BABIES AND THEMSELVES. STEPPING STONES PROVIDES COMMUNITY YOUTH WITH HOSPITAL-BASED INTERNSHIP, MENTORING AND CAREER DEVELOPMENT OPPORTUNITIES TO INCREASE EXPOSURE TO AND EMPLOYMENT IN THE HEALTH CARE FIELD. SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA THAT ARE NOT ADDRESSED IN THE IMPLEMENTATION STRATEGY ARE COMMUNITY GROWTH AND ENRICHMENT (SAFETY, HOMELESSNESS, EDUCATION, ECONOMIC DEVELOPMENT) SPECIFIC TO ADULT POPULATIONS. WE ARE STRONGLY COMMITTED TO BREAKING THE CYCLE OF PHENOMENA (I.E. EDUCATION, POVERTY, AND EMPLOYMENT) THAT IMPACT THE SOCIAL DETERMINANTS OF HEALTH. THEREFORE OUR EFFORTS AT COMMUNITY GROWTH AND ENRICHMENT ARE TARGETED TO YOUTH. WHILE RECOGNIZING THAT THERE ARE OTHER VALID CONCERNS THAT IMPACT THE HEALTH OF THE COMMUNITY, THE COMMITTEE IDENTIFIED THE HOSPITAL HAS LIMITED RESOURCES. THEREFORE, THE COMMITTEE ELECTED TO FOCUS ON THIS ISSUE SPECIFIC TO AT-RISK YOUTH POPULATIONS. THERE ARE EXISTING PROGRAMS IN PLACE THAT HAVE THE COMPETENCIES AND CAPACITY TO ADDRESS THE OTHER ISSUES. MERCY MEDICAL CENTER MERCED MERCY MEDICAL CENTER MERCED IS ADDRESSING THE FOLLOWING IDENTIFIED SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTH SERVICES; CANCER; DIABETES; HEART DISEASE & STROKE; IMMUNIZATION & INFECTIOUS DISEASES; INFANT HEALTH; MENTAL HEALTH; RESPIRATORY DISEASES; AND NUTRITION, PHYSICAL ACTIVITY AND WEIGHT. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS DELIVERED OR SUPPORTED INCLUDE: FINANCIAL ASSISTANCE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS; FAMILY PRACTICE CENTER, KIDS CARE AND GENERAL MEDICINE; CLINIC RURAL HEALTH CARE OUTPATIENT CLINICS; EMERGENCY DEPARTMENT PHYSICIAN SERVICES FOR INDIGENT PATIENTS; COMMUNITY GRANTS PROGRAM FUNDING OF HOPE RESPITE CARE, ALPHA CRISIS PREGNANCY PROGRAM, MERCED COUNTY WHOLE HEALTH PARTNERSHIP, AND OTHERS; CHRONIC DISEASE SELF-MANAGEMENT PROGRAM; DIABETES SELF-MANAGEMENT PROGRAM; LIVING WELL WITH DIABETES; LABOR OF LOVE CHILDBIRTH PREPARATION; MERCY YOGA AND ZUMBA CLASSES; STROKE SUPPORT GROUP AND EDUCATION; BI-NATIONAL WEEK HEALTH ACTIVITIES; AND CANCER CENTER COMMUNITY PROGRAMS. SIGNIFICANT NEEDS IDENTIFIED BUT NOT BEING ADDRESSED BY THE HOSPITAL ARE: FAMILY PLANNING; DEMENTIA INCLUDING ALZHEIMERS DISEASE; INJURY AND VIOLENCE; POTENTIALLY DISABLING CONDITIONS; AND SUBSTANCE ABUSE. SERVICES FOR THESE HEALTH PRIORITIES ARE BEING PROVIDED IN THE COMMUNITY BY OTHER ENTITIES, AND THE HOSPITAL DOES NOT HAVE EXPERTISE IN THESE AREAS. ST. MARY MEDICAL CENTER - LONG BEACH AMONG THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA, THE HOSPITAL WILL ADDRESS: ACCESS TO CARE; CHRONIC DISEASES; OVERWEIGHT AND DIABETES; PREGNANCY AND BIRTH OUTCOMES; AND PREVENTIVE CARE. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: PATIENT FINANCIAL ASSISTANCE; C.A.R.E. PROGRAM, AN HIV MEDICAL AND PSYCHOSOCIAL SERVICE PROGRAM; FAMILY CLINIC OF LONG BEACH; FAMILIES IN GOOD HEALTH; MEDICAL TRANSPORTATION PROGRAM; BAZZENI WELLNESS CENTER; CHRONIC DISEASE SELF-MANAGEMENT PROGRAM IN ENGLISH AND SPANISH; FAMILY CLINIC OF LONG BEACH; ST. MARY OUTPATIENT DIABETES PROGRAM; EVERY WOMAN COUNTS; MOBILE CARE UNIT; WELCOME BABY; AND MARY HILTON FAMILY HEALTH CENTER. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, ST. MARY MEDICAL CENTER WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: MENTAL HEALTH, ENVIRONMENTAL HEALTH, ECONOMIC SECURITY, ACCESS TO HOUSING, EDUCATION, CRIME AND VIOLENCE, ORAL HEALTH AND SUBSTANCE ABUSE. THE HOSPITAL CANNOT ADDRESS ALL THE SOCIAL DETERMINANTS OF HEALTH OR THE HEALTH NEEDS PRESENT IN THE COMMUNITY; THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATIONS AREAS OF FOCUS AND EXPERTISE. MERCY HOSPITAL BAKERSFIELD AMONG THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA, THE HOSPITAL WILL ADDRESS: OVERWEIGHT AND OBESITY; ACCESS TO HEALTH CARE; CHRONIC DISEASES (ASTHMA/LUNG DISEASE, CANCER, CARDIOVASCULAR DISEASE, DIABETES); AND BASIC NEEDS SERVICES. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: PATIENT FINANCIAL ASSISTANCE; BREAST HEALTH PROGRAM; COMMUNITY HEALTH INITIATIVE; HOMEMAKER CARE PROGRAM; PRESCRIPTION PURCHASES FOR INDIGENTS; COMMUNITY WELLNESS PROGRAM; CHRONIC DISEASE SELF-MANAGEMENT PROGRAM/DIABETES SELF-MANAGEMENT PROGRAM; ASTHMA MANAGEMENT PROJECT; SMOKING CESSATION PROGRAM; IN-HOME HEALTH EDUCATION; HEALTH EDUCATION AND SCREENINGS; HEALTHY KIDS IN HEALTHY HOMES; LEARNI
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN NEEDS ASSESSMENT GLENDALE MEMORIAL HOSPITAL and HEALTH CENTER THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT INDICATES NINE PRIORITIZED HEALTH CONCERNS. The PLAN TO ADDRESS SIX OF THESE NEEDS INCLUDES THE FOLLOWING: (1) OBESITY/OVERWEIGHT: WITH THE GLENDALE HEALTHIER COMMUNITY COALITION, DEVELOP STRATEGIES TO ADDRESS OBESITY IN THE COMMUNITY. The HOSPITAL HAS PROVIDED GRANT MONEY TO THE FOLLOWING ORGANIZATIONS ADDRESSING OBESITY: CITY OF GLENDALE COMMISSION ON THE STATUS OF WOMEN-CAMP ROSIE; GLENDALE HEALTHY KIDS IN COLLABORATION WITH GLENDALE UNIFIED SCHOOL DISTRICT. (2) MENTAL HEALTH: THE HOSPITAL OPENED A BEHAVIORAL HEALTH UNIT IN THE FALL OF 2013 AND CONTINUES TO MAINTAIN THIS SERVICE. ThE HOSPITAL IS ALSO PARTNERING WITH CORPORATION FOR SUPPORTIVE HOUSING TO IDENTIFY HOMELESS INDIVIDUALS TO ENGAGE AND PLACE HOMELESS HIGH UTILIZERS IN HOUSING CONNECTED TO INTEGRATED PRIMARY AND BEHAVIORAL HEALTH SERVICES. PROVIDE GRANT MONEY TO THE FOLLOWING ORGANIZATIONS ADDRESSING MENTAL HEALTH: CITY OF GLENDALE COMMISSION ON THE STATUS OF WOMEN-CAMP ROSIE; GLENDALE ASSOCIATION FOR THE RETARDED; ASCENCIA; CORPORATION FOR SUPPORTIVE HOUSING; YWCA. (3) DIABETES: OFFER AN OUTPATIENT DIABETES PROGRAM AND A PROGRAM CALLED SWEET SUCCESS FOR PREGNANT WOMEN WITH GESTATIONAL DIABETES. SERVE ON THE GLENDALE HEALTHIER COMMUNITY COALITION THAT IS WORKING TO DEVELOP STRATEGIES TO ADDRESS DIABETES IN THE COMMUNITY. PROVIDE GRANT MONEY TO THE FOLLOWING ORGANIZATIONS ADDRESSING DIABETES: GLENDALE ASSOCIATION FOR THE RETARDED; GLENDALE HEALTHY KIDS. (4) CARDIOVASCULAR DISEASE: PROVIDE CHRONIC DISEASE MANAGEMENT TO PATIENTS WITH CONGESTIVE HEART FAILURE. (5) HYPERTENSION: PROVIDE GRANT MONEY TO GLENDALE ASSOCIATION FOR THE RETARDED WHICH IS ADDRESSING HYPERTENSION IN THE PROGRAMS/ACTIVITIES WE ARE FUNDING. (6) DISABILITY: PROVIDE GRANT MONEY TO THE FOLLOWING ORGANIZATIONS ADDRESSING DISABILITY IN THE PROGRAMS/ACTIVITIES WE ARE FUNDING: ASCENCIA; GLENDALE ASSOCIATION FOR THE RETARDED. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER WILL NOT BE ADDRESSING ALCOHOL AND SUBSTANCE ABUSE, CHOLESTEROL, AND ORAL HEALTH DUE TO LIMITED RESOURCES. FURTHERMORE, GLENDALE HEALTHY KIDS WORKS WITH CHILDREN IN THE COMMUNITY TO PROVIDE ORAL HEALTH EDUCATION AND SERVICES FOR CHILDREN. WOODLAND MEMORIAL HOSPITAL WOODLAND MEMORIAL IS ADDRESSING OR DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: ACTIVE LIVING AND HEALTHY EATING; ACCESS TO BEHAVIORAL HEALTH SERVICES; DISEASE PREVENTION, MANAGEMENT, AND TREATMENT; SAFE, CRIME AND VIOLENCE FREE COMMUNITIES; AND ACCESS TO HIGH QUALITY HEALTH CARE AND SERVICES. INITIATIVES THAT ADDRESS THESE PRIORITIES LARGELY TARGET VULNERABLE AND AT-RISK POPULATIONS, WITH EMPHASIS ON COLLABORATION WITH OTHER DIGNITY HEALTH HOSPITALS AND COMMUNITY PARTNERS. THE HOSPITAL IS ADDRESSING THESE NEEDS WITH NUMEROUS DIRECT SERVICE PROGRAMS, GRANT FUNDING TO THE COMMUNITY, PATIENT FINANCIAL ASSISTANCE, AND COMMUNITY PARTNERSHIPS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS AT THE HOSPITAL INCLUDE: FARMERS MARKET, NUTRITION EDUCATION AND COUNSELING, COMMIT2FIT, INPATIENT MENTAL HEALTH SERVICES, MENTAL HEALTH CONTINUUM OF CARE PARTNERSHIP, HEALTHY LIVES (VIDA SANA), DIABETES CARE MANAGEMENT PROGRAM, YOUR LIFE/TAKE CARE, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, MULTIPLE SCLEROSIS SUPPORT GROUP, ANTI-HUMAN TRAFFICKING INITIATIVE, YOLO CRISIS NURSERY, EMPOWER YOLO, YOLO ADULT DAY HEALTH CENTER, YOLO HEALTHY AGING ALLIANCE, COMMUNICARE CAPACITY BUILDING, BABY AND ME SUPPORT GROUP, RESOURCE CONNECTION, RISE INC., MIGRANT CENTER VISITS, HEALTHY LIVING OUTREACH AND SCREENINGS, CANCER NURSE NAVIGATOR, SCHOOL NURSE PROGRAM, MERCY FAITH AND HEALTH PARTNERSHIP, FINANCIAL ASSISTANCE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS, AND DIGNITY HEALTH COMMUNITY GRANTS PROGRAM. WOODLAND MEMORIAL DOES NOT HAVE THE CAPACITY OR RESOURCES TO DIRECTLY ADDRESS BASIC NEEDS, ALTHOUGH THE HOSPITAL IS AN ACTIVE PARTNER IN COLLABORATIVE PROGRAMS IN PLACE TO ASSIST COMMUNITY RESIDENTS. THE HOSPITAL IS NOT ADDRESSING AFFORDABLE AND ACCESSIBLE TRANSPORTATION AND POLLUTION-FREE LIVING AND WORKING ENVIRONMENTS, AS THESE PRIORITIES ARE BEYOND THE CAPACITY AND EXPERTISE OF WOODLAND MEMORIAL. FRENCH HOSPITAL MEDICAL CENTER THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED BY THE 2015 CHNA THAT THE HOSPITAL WILL PRIMARILY ADDRESS ARE: ACCESS TO HEALTH CARE, INCLUDING BEHAVIORAL HEALTH; HOUSING; CANCER SCREENINGS; AND CARDIOVASCULAR DISEASE AND STROKE. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: SUPPORT GROUPS FOR CANCER, DIABETES, STROKE AND GRIEF; PATIENT FINANCIAL ASSISTANCE; ALLIANCE FOR PHARMACEUTICAL ACCESS; TRANSPORTATION VOUCHERS FOR DISCHARGED PATIENTS; CANCER AWARENESS COMMUNITY EDUCATION; CANCER SCREENINGS (COLONOSCOPIES, MAMMOGRAM, AND CERVICAL); HEREDITARY CANCER RISK ASSESSMENT AND GENETIC COUNSELING; CANCER EXPERIENCE REGISTRY PROGRAM; CANCER SUPPORT GROUPS; COMMUNITY EDUCATION IN SPANISH AND ENGLISH ON FACTORS FOR HEART ATTACK AND STROKE; ASSESSMENT OF CARDIOVASCULAR RISK STATUS; HEART AWARE PROGRAM; CARE TRANSITIONS PROGRAM; CHRONIC DISEASE SELF-MANAGEMENT PROGRAM; NUTRITION PROGRAMS; HEART HEALTHY DIET EDUCATION; CASE MANAGEMENT OF CHRONICALLY HOMELESS INDIVIDUALS; FRENCH HOSPITAL ANDERSON HOTEL HOMELESS RESPITE CARE PROGRAM; DONATIONS OF AMENITY BAGS CONTAINING PERSONAL HYGIENE PRODUCTS TO PRADO DAY HOMELESS SHELTER AND EL CAMINO HOMELESS ORGANIZATION SHELTER. THE HOSPITAL WILL NOT DIRECTLY ADDRESS BEHAVIORAL HEALTH OR HOMELESSNESS, APART FROM THE ABOVE PROGRAMS IN COLLABORATION WITH PARTNERS. THE HOSPITAL IS LIMITED IN RESOURCES TO ADDRESS THESE ISSUES, AND THEY ARE BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THE HOSPITAL WILL REMAIN ENGAGED ON THESE ISSUES TO HELP FACILITATE A SEAMLESS CONTINUUM OF CARE IN THE COMMUNITY. ST. JOHN'S PLEASANT VALLEY HOSPITAL SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA INCLUDE: OBESITY AND OVERWEIGHT; LACK OF MENTAL HEALTH RESOURCES; FAMILY CAREGIVER SUPPORT AND RESPITE; DIABETES AND PREDIABETES; CARDIOVASCULAR HEALTH; CANCERS; AND ARTHRITIS. THE HOSPITAL DOES NOT PLAN TO ADDRESS LACK OF MENTAL HEALTH RESOURCES OR FAMILY CAREGIVER SUPPORT AND RESPITE, DUE TO A LACK OF RESOURCES, BUT WILL EXPLORE FUTURE COLLABORATIVE AND GRANT OPPORTUNITIES TO HELP ADDRESS THESE. THE HOSPITAL PLANS TO ADDRESS ALL OTHER SIGNIFICANT NEEDS IN NUMEROUS WAYS, BOTH DIRECTLY AND THROUGH GREATER COLLABORATION BETWEEN THE HOSPITALS IN VENTURA COUNTY AND VENTURA COUNTY PUBLIC HEALTH. THE PROGRAMS BELOW ARE DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS WIDELY AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: INCREASED HEALTH EDUCATION, ESPECIALLY OF YOUTH, TO CHANGE LIFESTYLE BEHAVIOR PATTERNS; HEALTH FAIRS WHEN BMI SCREENINGS INDICATE EDUCATION IS APPROPRIATE; SENIOR WELLNESS & WALKING PROGRAM; DIABETES EMPOWERMENT EDUCATION PROGRAM; CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM; KNOW YOUR NUMBERS; ONE-ON-ONE HEALTH EDUCATION; SENIOR WELLNESS PROGRAM; AND "MOVE FREE" ARTHRITIS CLASSES IN COLLABORATION WITH THE ARTHRITIS FOUNDATION OF VENTURA COUNTY. ST. ELIZABETH COMMUNITY HOSPITAL IDENTIFIED HEALTH RISK BEHAVIORS INCLUDE: POOR EATING HABITS, BEING OVERWEIGHT, ALCOHOL ABUSE, LACK OF EXERCISE, TOBACCO USE, NOT USING BIRTH CONTROL. IDENTIFIED HEALTH CONCERNS INCLUDE: OBESITY, MENTAL HEALTH PROBLEMS, DIABETES, AGING PROBLEMS (ARTHRITIS, HEARING/VISION LOSS, ETC.), CHILD ABUSE/NEGLECT, DENTAL PROBLEMS, CANCERS, DOMESTIC VIOLENCE, HEART DISEASE AND/OR STROKE. THE HOSPITAL REMAINS COMMITTED TO DEVELOPING PROGRAMS AND SERVICES NOT ONLY BASED ON THE OUTCOMES FROM THE COMMUNITY HEALTH ASSESSMENT BUT ALSO FOCUSED ON THE MOST VULNERABLE POPULATIONS IN THE COMMUNITY. IN ADDITION TO SPECIFIC COMMUNITY BENEFIT PROGRAMS, THE HOSPITAL IS COMMITTED TO PROVIDING PAYMENT ASSISTANCE TO PERSONS WHO HAVE HEALTH CARE NEEDS AND ARE UNINSURED OR UNDER-INSURED. CONGESTIVE HEART FAILURE (CHF) - THE CHF PROGRAM CONSISTS OF FOLLOW-UP PHONE CALLS AND DISCHARGE INTERVENTION TO PROMOTE WELLNESS AND IS CONDUCTED BY A REGISTERED NURSE. PATIENTS AND THE PUBLIC HAVE ACCESS TO CARDIAC SUPPORT EDUCATION CLASSES. UPON DISCHARGE, THE CHF PATIENTS RECEIVE A SELF-CARE HANDBOOK: LEARNING TO LIVE WITH HEART FAILURE. ALSO AVAILABLE FOR CHARITY CARE PATIENTS, SCALES TO WEIGH THEMSELVES FOR UNEXPECTED RAPID WEIGHT GAIN WHICH INDICATES BUILD-UP OF FLUIDS. HEALTHIER LIVING - CHRONIC DISEASE SELF-MANAGEMENT PROGRAM - THE HOSPITAL WILL CONTINUE TO PROVIDE THE HEALTHIER LIVING WORKSHOP FOR ADULTS WHO HAVE A CHRONIC HEALTH CONDITION OR WHO LIVE WITH SOMEONE WITH A CHRONIC HEALTH CONDITION. HEALTHIER LIVING WORKSHOP PARTICIPANTS LEARN HOW TO MANAGE STRESS, FIGHT FATIGUE AND PAIN, LEARN HOW TO COMMUNICATE WITH THEIR DOCTOR AND FAMILY MEMBERS
SECTION B, LINE 13H - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA CARONDELET ST. JOSEPH'S HOSPITAL CARONDELET ST. MARY'S HOSPITAL CARONDELET HOLY CROSS HOSPITAL QUALIFIED FOR DISCOUNTED CARE IF GROSS FAMILY INCOME IS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LEVEL AT THE TIME OF THE APPLICATION, AND HOSPITAL CHARGES IN THE PAST SIX MONTHS EXCEED TWICE THE PATIENTS GROSS ANNUAL FAMILY INCOME. DIGNITY HEALTH OPERATES OTHER FOR-PROFIT HOSPITALS THROUGH JOINT VENTURE ARRANGEMENTS. THESE HOSPITALS ARE SPECIALTY HOSPITALS THAT PRIMARILY PROVIDE ELECTIVE SURGERY TO PATIENTS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY PATIENTS. ARIZONA GENERAL HOSPITAL IS CURRENTLY DEVELOPING A FINANCIAL ASSISTANCE PROGRAM. THE OPERATING AGREEMENT WITH THIS JOINT VENTURE REQUIRES COMPLIANCE WITH SECTION 501(R), INCLUDING THE ADOPTION OF A FINANCIAL ASSISTANCE AND EMERGENCY MEDICAL CARE POLICY. CURRENTLY, INDIVIDUALS WHO PRESENT THEMSELVES AT THIS LOCATION WHO NEED FINANCIAL ASSISTANCE ARE STABILIZED AND TRANSFERRED TO ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER. ARIZONA SPINE AND JOINT HOSPITAL UPON REQUEST, PATIENTS WITH PATIENT FAMILY INCOME ABOVE 200% BUT AT OR BELOW 500% OF FPL WHO RECEIVE A DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY WILL ALSO BE PROVIDED AN EXTENDED PAYMENT PLAN.
SECTION B, LINE 16A, 16B AND 16C - FAP APPLICATION FORM WEBSITE ST JOSEPHS HOSPITAL AND MEDICAL CENTER www.dignityhealth.org/stjosephs/patients-and-visitors/for-patients/billing -and-payment-information/payment-assistance MERCY SAN JUAN MEDICAL CENTER MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM WOODLAND MEMORIAL HOSPITAL www.dignityhealth.org/sacramento/patients-visitors/for-patients/billing-in formation/payment-assistance MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE www.dignityhealth.org/marianregional/patients-and-visitors/patients/billin g-information/payment-assistance CHANDLER REGIONAL HOSPITAL www.dignityhealth.org/chandlerregional/patients-and-visitors/for-patients/ billing-and-payment-services/payment-assistance-programs MERCY MEDICAL CENTER REDDING www.dignityhealth.org/mercy-redding/patients-and-visitors/patients/billing -information/payment-assistance-programs CALIFORNIA HOSPITAL MEDICAL CENTER www.dignityhealth.org/californiahospital/patients-and-visitors/patients/bi lling-and-payment/payment-assistance ST JOSEPHS MEDICAL CENTER OF STOCKTON www.dignityhealth.org/stjosephs-stockton/patients-and-visitors/patients/bi lling-information/payment-assistance DOMINICAN HOSPITAL www.dignityhealth.org/dominican/patients-and-visitors/patients/billing/pay ment-assistance ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA ST. ROSE DOMINICAN HOSPITALS - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN www.dignityhealth.org/las-vegas/patients-and-visitors/for-patients/billing -information/payment-assistance NORTHRIDGE HOSPITAL MEDICAL CENTER www.dignityhealth.org/northridgehospital/paymenthelp ST BERNARDINE MEDICAL CENTER www.dignityhealth.org/stbernardinemedical/patients-and-visitors/patients/b illing-and-payments/payment-assistance MERCY MEDICAL CENTER MERCED www.dignityhealth.org/mercymedical-merced/patients-and-visitors/patients/b illing-information/payment-assistance-programs ST MARY MEDICAL CENTER - LONG BEACH www.dignityhealth.org/stmarymedical/patients-and-visitors/patients/billing -payment-and-financial-services/payment-assistance-programs MERCY HOSPITAL (BAKERSFIELD) www.dignityhealth.org/mercy-bakersfield/patients-and-visitors/patients/bil ling-information/payment-assistance ST JOHNS REGIONAL MEDICAL CENTER www.dignityhealth.org/stjohnsregional/patients-and-visitors/patients/billi ng-and-payment-information/payment-assistance MERCY GILBERT MEDICAL CENTER www.dignityhealth.org/mercygilbert/patients-visitors/for-patients/billing- payment-services/payment-assistance-programs SEQUOIA HOSPITAL www.dignityhealth.org/sequoia/patients-and-visitors/patients/billing/payme nt-assistance ST MARYS MEDICAL CENTER www.dignityhealth.org/stmarys/patients-and-visitors/patients/billing/payme nt-assistance GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER www.dignityhealth.org/glendalememorial/patients-and-visitors/for-patients/ billing-payment-and-financial-services/payment-assistance-programs WOODLAND MEMORIAL HOSPITAL www.dignityhealth.org/woodland/patients-and-visitors/billing-information/p ayment-assistance FRENCH HOSPITAL MEDICAL CENTER www.dignityhealth.org/frenchhospital/patients-and-visitors/patients/billin g-information/payment-assistance ST JOHNS PLEASANT VALLEY HOSPITAL www.dignityhealth.org/pleasantvalley/patients-and-visitors/patients/billin g-and-payment-information/payment-assistance ST ELIZABETH COMMUNITY HOSPITAL www.dignityhealth.org/stelizabethhospital/patients-and-visitors/patients/b illing-information/payment-assistance-programs MERCY MEDICAL CENTER MT SHASTA www.dignityhealth.org/mercy-mtshasta/patients-and-visitors/patients/billin g-information/payment-assistance-programs CARONDELET ST JOSEPH'S HOSPITAL CARONDELET ST MARY'S HOSPITAL CARONDELET HOLY CROSS HOSPITAL https://www.carondelet.org/for-patients/insurance-financial-support/billin g-insurance-questions ST JOSEPHS BEHAVIORAL HEALTH CENTER www.dignityhealth.org/stjosephsbehavioral/patients-and-visitors/patients/b illing-information/payment-assistance ST JOSEPH'S WESTGATE MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/westgate/patients-and-visi tors/for-patients/billing-and-payment/financial-assistance
SECTION B, LINE 16i - OTHER MEASURES TO PUBLICIZE THE POLICY FOR ALL HOSPITALS THAT MARKED BOX 16I ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, A COPY OF THE FINANCIAL ASSISTANCE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION. THE FACILITY'S WEB SITE ALSO CONTAINS THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY OF THE POLICY, APPLICATION, BILLING AND COLLECTION POLICY, A DESCRIPTION OF THE AMOUNT GENERALLY BILLED AND A LISTING OF PROVIDERS AT EACH FACILITY THAT ARE COVERED AND NOT COVERED BY THE FINANICAL ASSISTANCE POLICY. CONTACT INFORMATION CAN ALSO BE FOUND ON EACH FACILITYS WEB PAGE. THE AVAILABILITY OF PATIENT FINANCIAL ASSISTANCE AND THE PLAIN LANGUAGE SUMMARY OF THE POLICY ARE ALSO INCLUDED IN EACH FACILITYS ANNUAL COMMUNITY BENEFIT REPORT, WHICH IS ON EACH FACILITYS WEB PAGE.
SECTION B, LINE 22D FOR ALL HOSPITALS THAT MARKED BOX 22D WITH THE EXCEPTION OF CARONDELET HOSPITALS UNINSURED PATIENTS WHO ARE APPLYING FOR FINANCIAL ASSISTANCE WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES IN CALIFORNIA, AND IN ARIZONA AND NEVADA THE AMOUNT GENERALLY BILLED. THE MAXIMUM CHARGE THAT MAY BE BILLED TO A PATIENT WHO IS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS FINANCIAL ASSISTANCE POLICY IS KNOWN AS THE AMOUNT GENERALLY BILLED (AGB). NO PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED MORE THAN THE AGB FOR THE ELIGIBLE SERVICE(S) PROVIDED TO THE PATIENT. DIGNITY HEALTH CALCULATES THE AGB ON A FACILITY-BY-FACILITY BASIS USING THE "LOOKBACK" METHOD BY MULTIPLYING THE "GROSS CHARGES" FOR ANY ELIGIBLE SERVICES THAT IT PROVIDES BY AGB PERCENTAGES WHICH ARE BASED UPON PAST CLAIMS ALLOWED UNDER MEDICARE AND PRIVATE INSURANCE AS SET FORTH IN FEDERAL LAW.
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 8
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?120
Name and address Type of Facility (describe)
1 NICU Operating CO of Santa Cruz LLC
1555 Soquel Drive
Santa Cruz,CA95065
Neonatal Healthcare
2 St Joseph's Outpatient Surgery Center
240 West thomas Road
Phoenix,AZ85013
Surgery Center
3 St Joseph's Surgery Center LP (USPI)
1800 N California Street Ste 1
Stockton,CA95204
Surgery Center
4 Folsom Sierra Endoscopy Center
1600 Creekside Drive
Folsom,CA95630
Endoscopy Center
5 Carondelet Medical Group Inc
PO Box 204539
Dallas,TX753204539
Medical Group
6 Simon Med - Greenfield (same as Guadalup
1425 S Greenfield Suite 114
Mesa,AZ85206
Imaging Center
7 USP Surgery Center - Parkway
100 N Green Valley Pkwy 125
Henderson,NV89074
Surgery Center
8 Simon Med - Dobson III
235 S Dobson Stes 1 1870 W Frye R
Chandler,AZ85224
Imaging Center
9 DH Nevada Imaging Center Siena
861 Coronada Center Drive 101
Henderson,NV89052
Imaging Center
10 Surgery Center of Scottsdale (Main)
8962 East Desert Cove Drive
Scottsdale,AZ85260
Surgery Center
11 Coastal Surgical Specialist Inc
921 Oak Park Boulevard 100B
Pismo Beach,CA93449
Surgery Center
12 Simon Med - Thunderbird III & III
5410 W Thunderbird Road 100/105/210
Glendale,AZ85306
Imaging Center Cyberknife
13 CBCC Outsmarting Cancer LLC
6501 Truxtun Avenue
Bakersfield,CA93309
Radiation / Oncology incl Cyberknife
14 Metro Surgery Center LP
3131 W Peoria Avenue
Phoenix,AZ95381
Surgery Center
15 Surgery Center of Peoria
13260 North 94th Drive Suite 200
Peoria,AZ85381
Surgery Center
16 Surgery Center of ScottsdaleGilbert
2450 E Guadalupe Rd Suite 101
Gilbert,AZ85234
Surgery Center
17 Folsom Outpatient Surgery Center (USPI)
1651 Creekside Drive
Folsom,CA95630
Surgery Center
18 USP Surgery Center - Durango
8530 W Sunset Road
Las Vegas,NV89113
Surgery Center
19 Pleasanton Surgery Center (USPI)
4626 Willow Road Ste 100
Pleasanton,CA94588
Surgery Center
20 Desert Ridge Outpatient Surgery Center
20940 North Tatum Boulevard Suite 1
Phoenix,AZ85050
Surgery Center
21 Simon Med - Central Phoenix
2620 N 3rd St 102
Phoenix,AZ85004
Imaging Center
22 Crockett School Family Practice Clinic
4825 E Roosevelt Street
Phoenix,AZ85008
Surgery Center
23 Simon Med - Spectrum
2680 S Val Vista Drive Bldg 7 Suite
Gilbert,AZ85295
Imaging Center
24 Surgery Center of ScottsdaleGlendale
18555 N 79th Avenue Suite C104
Glendale,AZ853088370
Surgery Center
25 Simon Med - Mountain View
9201 E Mountain View Road Suite 150
Scottsdale,AZ85258
Imaging Center
26 Simon Med - Avondale
10815 W McDowell Rd Suite 102
Avondale,AZ85323
Imaging Center
27 Renaissance Imaging Center at Northridge
18436 Roscoe Boulevard
Northridge,CA91328
Imaging Center
28 21st Century Oncology (Redding)
963 Butte Street
Redding,CA96001
Radiation Oncology Center
29 Mercy Surgery Center
2175 Rosaline Avenue Suite A
Redding,CA96001
Surgery Center
30 Plaza Surgery Center
525 E Plaza 100
Santa Maria,CA93454
Surgery Center
31 St John's Regional Imaging Center LLC
1700 N Rose Avenue 110
Oxnard,CA93030
Imaging center
32 Santa Cruz Surgery Center
3003 Paul Sweet Road
Santa Cruz,CA95065
Surgery Center
33 NSC Channel Islands LLC
2030 Wankel Way
Oxnard,CA93030
Surgery Center
34 Huger Mercy Living Center
2345 W Orangewood
Phoenix,AZ85021
Assisted Living Facility
35 Simon Med - Fashion Square
6740 E Camelback Road Suites 100
Scottsdale,AZ85251
Imaging Center
36 Radiation Oncology Center of Ventura Cou
5301 Mission Oaks Boulevard Suite A
Camarillo,CA93012
Radiation Oncology Center
37 Court Street Surgery Center
2184 Court Street
Redding,CA96001
Surgery Center
38 Simon Med - Sun City - Peoria
9403 W Thunderbird Road
Peoria,AZ95381
Imaging Center
39 Chandler Endoscopy Center
2095 W Pecos Road Suite 1
Chandler,AZ85224
Surgery Center
40 Warner Park Ambulatory Surgical
604 West Warner Road Bldg A
Chandler,AZ85225
Surgery Center
41 Simon Med - San Francisco
325 Sacramento Street
San Francisco,CA94104
Imaging Center
42 Dignity Health Medical Group Nevada LLC
8205 W Warm Springs Rd Suite 210
Las Vegas,NV89113
Multi-specialty clinics
43 Simon Med - Desert Ridge
20830 N Tatum Blvd Suite 190
Phoenix,AZ85050
Imaging Center
44 Simon Med - Baywood
130 S 63rd Street Bldg 4
Mesa,AZ85206
Imaging Center
45 NICU Sequoia Lucile Packard Children Hos
170 Alameda de las Pulgas
Redwood City,CA94062
Neonatal Healthcare
46 Simon Med - Daly City
455 Hickey Blvd Suite 200
Daly City,CA94015
Imaging Center
47 Simon Med - Queen Creek
36297 N Gantzel Road Suite 101
Queen Creek,AZ85140
Imaging Center
48 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 101
Henderson,NV89052
Multi-specialty clinics
49 Roseville USP Surgery Center
1420 E Roseville Parkway No 100
Roseville,CA95661
Surgery Center
50 Stockton Outpatient Surgery Center LLC
2388 N California Street
Stockton,CA95204
Surgery Center
51 Simon Med - Ahwatukee
15810 S 45th Street Suite 110
Phoenix,AZ85048
Imaging Center
52 Dominican Magnetic Resonance Imaging Cen
1545 Soquel Drive
Santa Cruz,CA95065
Imaging Center
53 Simon Med - Surprise Stadium Village
14823 W Bell Road Suite 110
Surprise,AZ85374
Imaging Center
54 Templeton Surgery Center
1310 Las Tables Road Suite 104
Templeton,CA93465
Surgery Center
55 Simon Med - Palm Valley III (aka Goodye
13657 W McDowell Rd Suites 207 21
Goodyear,AZ85338
Imaging Center
56 St Joseph's Medical Group Maternal Fetal
1727 W Frye Suite 210
Chandler,AZ85224
Multi-specialty clinics
57 Simon Med - Deer Valley
20414 N 27th Avenue
Phoenix,AZ85027
Imaging Center
58 Woodland Adult Day Health
20 N Cottonwood Street
Woodland,CA95695
Health Center
59 Simon Med- Arrowhead
6320 W Union Hills 120
Glendale,AZ85308
Imaging Center
60 Simon Med - Sun City West
13624 W Camino Del Sol Suite 300
Sun City West,AZ85375
Imaging Center
61 Sacramento Midtown Endoscopy
3941 J Street
Sacramento,CA95819
Endoscopy Center
62 DH Nevada Imaging Center Spring Valley
5495 S Rainbow Blvd 101 103 203
Las Vegas,NV89118
Imaging Center
63 St Joseph's Medical Group Adult Cardiova
1727 W Frye Suite 210
Chandler,AZ85224
Multi-specialty clinics
64 Dominican Breast Center
1661 Soquel Drive Bldg G
Santa Cruz,CA95065
Oncology
65 Simon Med - Prescott Valley
3033 N Windsong Drive Suite 102
Prescott Valley,AZ86314
Imaging Center
66 Simon Med - Monterey
665 Munras Avenue 109
Monterey,CA93940
Imaging Center
67 Dignity Health Medical Group Nevada LLC
8689 W Charleston Blvd Suite 105
Las Vegas,NV89117
Multi-specialty clinics
68 Simon Med - Los Gatos
14651 S Bascom
Los Gatos,CA95032
Imaging Center
69 Simon Med - 19th Avenue
6707 N 19th Avenue Suite 108
Phoenix,AZ85015
Imaging Center
70 Simon Med - San Francisco - MRI
50 Francisco Street Suite 105
San Francisco,CA94133
Imaging Center
71 St Joseph's Medical Group Peoria North C
7727 W Deer Valley Road
Peoria,AZ85382
Multi-specialty clinics
72 Simon Med - Chandler Imaging (PDI)
725 S Dobson Road Suite 105
Chandler,AZ85224
Imaging Center
73 Simon Med - Superstition Imaging (PDI)
875 N Greenfield Road Suite 107
Gilbert,AZ85234
Imaging Center
74 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 209
Henderson,NV89052
Multi-specialty clinics
75 Simon Med - Redwood City
345 Convention Way Suite D1
Redwood City,CA94063
Imaging Center
76 Simon Med - OPEN MRI & Imaging Phoenix
1331 N 7th Street Suite 150
Phoenix,AZ85006
Imaging Center
77 USP Surgery Center - Parkway-Horizon
10561 Jeffreys Street Suite 130
Henderson,NV89052
Surgery Center
78 Valley Physicians Surgery Center
18330 Roscoe Boulevard
Northridge,CA91325
Imaging Center
79 Trinity Care Infusion Services
18440 Roscoe Boulevard
Northridge,CA91325
Infusion Center
80 OMG Arizona LLC
2201 E Camelback Road Suite 101A
Phoenix,AZ85016
Multi-specialty clinics
81 The Barbara Greenspun Women's Care Cente
100 N Green Valley Pkwy Suite 330
Henderson,NV89074
Health Center
82 Santa Cruz Comprehensive Imaging LLC
1685 Commercial Way
Santa Cruz,CA95065
Imaging Center
83 Simon Med - Stand Up MRI of Beverly Hill
8370 Wilshire Blvd Suite 110
Beverly Hills,CA90211
Imaging Center
84 Simon Med - Burlingame
1860 El Camino Real Suite 101
Burlingame,CA94010
Imaging Center
85 Surgery Center of ScottsdalePHX Metro
3131 West Peoria Avenue
Phoenix,AZ85029
Surgery Center
86 Dignity Health Medical Group Nevada LLC
102 E Lake Mead Pkwy Suite 104
Henderson,NV89015
Multi-specialty clinics
87 Simon Med - Orange Grove LLC
1845 W Orange Grove Rd Bldg 5 Suite
Tucson,AZ85704
Imaging Center
88 Simon Med - Mesa Drive
456 N Mesa Drive
Mesa,AZ85201
Imaging Center
89 Carondelet Imaging Center
6567 E Carondelet Dr Suite 105
Tucson,AZ85710
Imaging Center
90 Simon Med - Academy (LLC)
310 N Wilmot Rd 302 303 304
Tucson,AZ85711
Imaging Center
91 Sac Pain Diagnostic and Treatment Center
2805 J Street Suite 200
Sacramento,CA95816
Surgery Center
92 Simon Med - San Rafael
4144 Redwood Highway Suite B
San Rafael,CA94903
Imaging Center
93 Carondelet Medical Mall at Green Valley
400 W Camino Casa Verde Suite 200
Green Valley,AZ85614
Imaging Center
94 Mercy Davis Cancer Center LLC
333 Mercy Avenue
Merced,CA95340
Cancer Center
95 Simon Med - Mountain View
105 South Drive St 100/110
Mountain View,CA94040
Imaging Center
96 Cyberknife (Redwood City)
170 Alameda de las Pulgas
Redwood City,CA94062
Radiation Oncology Center
97 Cyberknife (San Francisco)
450 Stanyan Street
San Francisco,CA94117
Radiation Oncology Center
98 Simon Med- Maryvale
4616 N 51st Ave 104
Phoenix,AZ85031
Imaging Center
99 Simon Med - Thompson Peak
7304 E Deer Valley Road Bldg E
Scottsdale,AZ85255
Imaging Center
100 Simon Med- Metro
3201 W Peoria Ave 102
Phoenix,AZ85029
Imaging Center
101 Dignity Health Medical Group Nevada LLC
400 S Rampart Blvd 240
Las Vegas,NV89145
Multi-specialty clinics
102 Carondelet River Stone Imaging Center
4892 N Stone Ave Suite 180
Tucson,AZ85704
Imaging Center
103 Glendale Advanced Imaging Center LLC
1510 Cotner Ave
Los Angeles,CA90025
Imaging Center
104 21st Century Oncology (Mt Shasta)
902 Pine Street
Mt Shasta,CA96067
Radiation Oncology Center
105 Dignity Health Medical Group Nevada LLC
1701 Green Valley Pkwy 10A
Henderson,NV89074
Multi-specialty clinics
106 Simon Med- Tucson St Mary's
1313 W St Marys Rd
Tucson,AZ85745
Imaging Center
107 Simon Med - McCormick Ranch
8630 E Via De Ventura St 208
Scottsdale,AZ85258
Imaging Center
108 Simon Med- Paradise Valley
4219 E Bell Rd
Phoenix,AZ85032
Imaging Center
109 Simon Med- Apache Junction
2080 W Southern Ave Bldg C
Apache Junction,AZ85120
Imaging Center
110 Carondelet Medical Mall at Rita Ranch Im
8290 S Houghton Rd Suite 100
Tucson,AZ85747
Imaging Center
111 Simon Med- Biltmore
2502 E Camelback Rd 160
Phoenix,AZ85016
Imaging Center
112 Southwest Lithotripsy
100 W Third Ave Suite 350
Columbus,OH43201
Lithotripsy
113 USP Surgery Center - Parkway Recovery Ce
100 N Green Valley Pkwy Ste 330
Henderson,NV89074
Surgery Center
114 Simon Med- Sun Lakes
10440 East Riggs Road 110
Chandler,AZ85248
Imaging Center
115 Simon Med - Fiesta
1457 W Southern Ave Suite 26
Mesa,AZ85202
Imaging Center
116 Redding Surgery Center
2439 Sonoma
Redding,CA96001
Surgery Center
117 CHWUSP Oxnard Surgery Centers LLC
1700 N Rose Avenue Ste 100
Oxnard,CA93030
Surgery Center
118 Northern Arizona Congenital Heart Center
1330 Rim Drive Suite A
Flagstaff,AZ86001
Congenital Heart Center
119 Radiation Oncology Center of Ventura Cou
1700 N Rose Avenue 120
Oxnard,CA93030
Radiation Oncology Center
120 Simon Med - Dobson Imaging (PDI)
1111 S Dobson Road
Mesa,AZ85202
Imaging Center
Schedule H (Form 990) 2015
Schedule H (Form 990) 2015
Page 9
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINES 6A & 6B - COMMUNITY BENEFIT EACH TAX-EXEMPT HOSPITAL FACILITY LISTED IN SCHEDULE H, PART V, PREPARED A SEPARATE COMMUNITY BENEFIT REPORT. CALIFORNIA HOSPITALS SUBMIT THEIR REPORTS TO THE OFFICE OF STATEWIDE HEALTH PLANNING DEPARTMENT AND NEVADA HOSPITALS SUBMIT THEIR REPORTS TO THE NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIGNITY HEALTH INCLUDES A CONSOLIDATED COMMUNITY BENEFIT REPORT IN ITS ANNUAL AUDITED FINANCIAL STATEMENTS FOR ITS HOSPITALS AND THE HOSPITALS OF RELATED ORGANIZATIONS THAT ARE CONSOLIDATED FOR FINANCIAL REPORTING PURPOSES (SEE PART VI, LINE 6). DIGNITY HEALTH'S FINANCIAL STATEMENTS ARE POSTED ON DIGNITY HEALTH'S EXTERNAL WEB SITE. THE INDIVIDUAL HOSPITALS' COMMUNITY BENEFIT REPORTS ARE MADE AVALABLE TO THE PUBLIC ON BOTH DIGNITY HEALTH'S AND EACH HOSPITAL'S WEB SITES, AND ARE AVAILABLE BY REQUEST.
Part I, Line 7 - FINANCIAL ASSISTANCE & CERTAIN OTHER COMMUNITY BENEFITS A COSTING METHODOLOGY IS USED TO CALCULATE FINANCIAL ASSISTANCE FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE. DIGNITY HEALTH USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO PATIENTS. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL HOSPITAL WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE CALCULATION ON WORKSHEET 2 OF THE INSTRUCTIONS FOR FORM 990, SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN AGGREGATED FOR EACH PATIENT BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH SERVICES PROVIDED TO EACH PATIENT. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF PAYMENT ASSISTANCE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR PAYMENT ASSISTANCE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH AND CASH AND IN-KIND DONATIONS. PART I, LINE 7B - MEDICAID INCLUDED IN COMMUNITY BENEFIT EXPENSE FOR MEDICAID, COLUMN (C) IS $435.2 MILLION OF QUALITY ASSURANCE FEES ASSESSED TO DIGNITY HEALTH IN ACCORDANCE WITH THE CALIFORNIA PROVIDER FEE PROGRAMS. INCLUDED IN DIRECT OFFSETTING REVENUE FOR MEDICAID, COLUMN (D), IS $815.7 MILLION IN SUPPLEMENTAL PAYMENTS RECEIVED UNDER THESE PROGRAMS. PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES IS $2.7 MILLION OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION. PART I, LINE 7I INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $8.1 MILLION IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT"). CHFT WAS ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA.
Part II - COMMUNITY BUILDING ACTIVITIES DIGNITY HEALTH'S EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED EXTEND BEYOND PROVIDING HEALTH CARE SERVICES. DIGNITY HEALTH TAKES A PROACTIVE APPROACH TO ADDRESSING THE SOCIAL, ECONOMIC AND ENVIRONMENTAL BARRIERS TO GOOD HEALTH, AND SUPPORTS THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH AS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM HAS PROVIDED, SINCE 1990, LOW INTEREST LOANS AND LINES OF CREDIT TO NON-PROFIT ORGANIZATIONS THAT ARE ADDRESSING SOCIAL DETERMINANTS OF HEALTH, INCLUDING AFFORDABLE HOUSING AND SOCIAL SERVICES VITAL TO A COMMUNITY'S HEALTH. IN FISCAL YEAR 2016, 19 LOANS TOTALING $30.6 MILLION WERE APPROVED, AND THE TOTAL PORTFOLIO CONSISTED OF 68 LOANS TOTALLING $76.8 MILLION. FORTY-SIX PERCENT OF DIGNITY HEALTH'S LOAN DOLLARS SUPPORT AFFORDABLE HOUSING IN VULNERABLE COMMUNITIES, AND 25% ARE HEALTH-RELATED. NEARLY 500 RENTALS AND HOMES HAVE BEEN CONSTRUCTED OR IMPROVED IN CALIFORNIA, AND 180 UNITS OF AFFORDABLE SENIOR RENTAL AND ASSISTED LIVING UNITS HAVE BEEN DEVELOPED IN NEVADA; COMMUNITY DEVELOPMENT - ACCESS TO SHELTERS SERVING HOMELESS INDIVIDUALS DISCHARGED FROM HOSPITAL EMERGENCY ROOMS HAVE BEEN PROVIDED IN CENTRAL LOS ANGELES AND PHOENIX; COMMUNITY CLINICS - EXPANSION OF TWO HEALTH CENTERS IN SANTA CRUZ HAS BEEN PROVIDED AS WELL AS FINANCING ASSISTANCE OF AN INNOVATIVE TRANSIT ORIENTED DEVELOPMENT PROJECT IN THE WATTS DISTRICT OF SOUTH LOS ANGELES, REFURBISHING A 140-UNIT RENTAL COMPLEX THAT WILL HAVE A NEW FEDERALLY QUALIFIED HEALTH CLINIC ON THE PREMISES; FRESH FOODS - THE FRESHWORKS FUND INVESTED OVER $31 MILLION IN 11 HEALTHY FOOD PROJECTS AND CREATED NEARLY 400 NEW JOBS; MICROLENDING - FINANCED 55 SMALL BUSINESSES IN ARIZONA, NEVADA AND CALIFORNIA; AND INTERMEDIARIES - LOANS WILL LEVERAGE $25 MILLION FOR THE CONSTRUCTION OF AFFORDABLE HOUSING AND COMMUNITY FACILITIES (PRIMARY HEALTH CLINICS) FOR THE ELDERLY AND DISABLED. DIGNITY HEALTH PROVIDES MORE THAN $4 MILLION IN COMMUNITY GRANTS TO COMMUNITY ORGANIZATIONS FOR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) NEEDS THAT ARE EITHER COMMUNITY BENEFIT OR COMMUNITY BUILDING. THE GRANTS HELP ENSURE A CONTINUUM OF CARE AND ADDRESS HEALTH-RELATED SOCIAL NEEDS FOR THE COMMUNITY. DIGNITY HEALTH HOSPITALS OPEN THEIR DOORS TO COMMUNITY GROUPS AND ALSO SERVE AS MEMBERS OF COMMUNITY COALITIONS THAT FOCUS ON THE WELL-BEING OF THEIR RESPECTIVE COMMUNITIES. DIGNITY HEALTH ADVOCACY REPRESENTATIVES WORK TO IMPROVE ACCESS TO HEALTH CARE, PROMOTE THE HEALTH OF THE PUBLIC, AND ADVOCATE FOR SOCIAL JUSTICE AND HUMAN RIGHTS AS PART OF A MISSION-DRIVEN "FOUNDATIONAL" ADVOCACY. IN MEDICALLY UNDERSERVED AREAS, EFFORTS TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS ARE ONGOING, AS ARE PARTNERSHIPS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORK-FORCE SHORTAGES. A NUMBER OF DIGNITY HEALTH HOSPITALS OFFER HEALTH CAREER MENTORING PROJECTS AND PROVIDE SCHOOL-BASED AND COMMUNITY PROGRAMS THAT DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE. COMMUNITY BUILDING - PHYSICAL IMPROVEMENTS AND HOUSING EXAMPLES OF PHYSICAL IMPROVEMENTS AND HOUSING INCLUDE LOW-INTEREST LOANS THROUGH THE COMMUNITY INVESTMENT PROGRAM, SUBSIDIZING LOW INCOME HOUSING UNITS IN SANTA CRUZ AND PARTNERING WITH "REBUILDING TOGETHER" TO RESTORE HOMES OF LOW INCOME INDIVIDUALS IN THE LAS VEGAS VALLEY. COMMUNITY BUILDING - ECONOMIC DEVELOPMENT ACTIVITIES INCLUDE THE PARTICIPATION OF LEADERSHIP STAFF OF SEVERAL DIGNITY HEALTH FACILITIES IN CHAMBERS OF COMMERCE AND VARIOUS CIVIC ORGANIZATIONS, AS WELL AS THROUGH CHARITABLE CONTRIBUTIONS AIMED AT ENSURING THE ECONOMIC DEVELOPMENT, VITALITY AND STABILITY OF THE LOCAL COMMUNITIES. COMMUNITY BUILDING - COMMUNITY SUPPORT DIGNITY HEALTH FACILITIES LEAD AND/OR COLLABORATE WITH OTHER COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF THE SUCCESS OF CHILDREN, YOUTH AND FAMILIES, WHICH ENGAGE AND STRENGTHEN THE COMMUNITIES SERVED. COMMUNITY BUILDING - ENVIRONMENTAL IMPROVEMENTS DIGNITY HEATH IS ENGAGED IN ONGOING EFFORTS TO REDUCE COMMUNITY ENVIRONMENTAL HAZARDS IN THE AIR, WATER AND GROUND, AS WELL AS THE SAFE REMOVAL OF OTHER TOXIC WASTE PRODUCTS, IN PART THROUGH ADVOCACY. THE COMMITMENT OF DIGNITY HEALTH TO IMPROVE AND SUSTAIN THE ENVIRONMENT IS CODIFIED BY POLICIES, INCLUDING A PURCHASING POLICY WHICH PURSUES MULTIPLE ENVIRONMENTAL GOALS TO REDUCE WASTE AT ITS SOURCE AND TO REDUCE THE AMOUNT OF VIRGIN MATERIALS PURCHASED. DIGNITY HEALTHS INVESTMENT POLICY SCREENS TO EXCLUDE FROM OUR PORTFOLIO COMPANIES THAT EXTRACT AND/OR BURN THERMAL COAL, A PRODUCT WHOSE IMPACT ON THE HEALTH OF PERSONS, COMMUNITIES AND THE EARTH MAKES IT CONTRARY TO OUR HEALING MISSION. DIGNITY HEALTH ATTEMPTS TO PURCHASE GOODS WITH RECYCLED CONTENT AND ONCE PURCHASES REACH THE END OF THEIR INITIAL USE, DIGNITY HEALTH FOCUSES ON REUSE WITHIN THE HOSPITAL, TRANSFER TO OTHER USERS (SUCH AS COMMUNITY ORGANIZATIONS), RECYCLING, AND FINALLY, PROPER WASTE DISPOSAL. DIGNITY HEALTH HAS TRANSITIONED TO PRODUCTS THAT ARE FREE OF POLYVINYL CHLORIDE (PVC) AND DI (2-ETHYLHEXYL) PHTHALATE (DEHP) AND HAS ELIMINATED THE USE OF MERCURY. COMMUNITY BUILDING - LEADERSHIP DEVELOPMENT/TRAINING FOR COMMUNITY MEMBERS DIGNITY HEALTH HOSPITALS ARE COMMITTED TO BUILDING HEALTHIER COMMUNITIES THROUGH LEADERSHIP DEVELOPMENT, PARTICULARLY OF ADOLESCENT, TEEN AND YOUNG ADULT LEADERSHIP, AND CAREER DEVELOPMENT. COMMUNITY BUILDING - COALITION BUILDING THE DIGNITY HEALTH MISSION STATEMENT SPECIFICALLY CALLS UPON US "TO PARTNER WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE." IN THIS REGARD, DIGNITY HEALTH FACILITIES PROVIDE REPRESENTATION ON COMMUNITY COALITIONS AND COLLABORATIVE PARTNERSHIPS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY, AND HOST AND/OR PARTICIPATE IN COMMUNITY COALITION MEETINGS AND SPECIFIC PROJECTS AND INITIATIVES. COMMUNITY BUILDING - ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT STAFF AT DIGNITY HEALTH HOSPITALS ADVOCATE ON BEHALF OF THE POOR AND DISENFRANCHISED, PARTICULARLY FOR IMPROVED ACCESS TO HEALTH CARE SERVICES AS WELL AS FOR ENVIRONMENTAL IMPROVEMENTS. DIGNITY HEALTH ALSO ADVOCATES FOR SOCIAL JUSTICE AND HUMAN RIGHTS THROUGH DUES AND GIFTS TO ORGANIZATIONS THAT SUPPORT SOCIAL JUSTICE, AND BY ADVOCATING FOR SOCIAL JUSTICE, ENVIRONMENTAL RESPONSIBILITY AND HUMAN RIGHTS THROUGH INVESTMENTS AS A SHAREHOLDER. COMMUNITY BUILDING - WORKFORCE DEVELOPMENT DIGNITY HEALTH IS COMMITTED TO THE DEVELOPMENT OF THE HEALTH CARE WORKFORCE, AND ACTIVELY ENGAGES IN THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN MEDICALLY UNDERSERVED AREAS. DIGNITY HEALTH SUPPORTS THE TRAINING AND RECRUITMENT OF UNDERREPRESENTED MINORITIES AND PARTICIPATES IN COMMUNITY WORKFORCE BOARDS AND PARTNERSHIPS. SEVERAL DIGNITY HEALTH FACILITIES, AS WELL AS THE ORGANIZATION ITSELF, HAVE PARTNERED WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORKFORCE SHORTAGE AND ACTIVELY ENGAGE IN HEALTH CAREER MENTORING PROGRAMS.
Part III - BAD DEBT, MEDICARE, & COLLECTION PRACTICES SECTION A, LINE 2 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED. DIGNITY HEALTH PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 200%, 201%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL DIGNITY HEALTH FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 30%. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. SECTION A, LINE 3 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT AS COMMUNITY BENEFIT DIGNITY HEALTH MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. SECTION A, LINE 4 - BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE FOLLOWING ARE EXCERPTS FROM DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2016, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. DIGNITY HEALTH REGULARLY REVIEWS ACCOUNTS AND CONTRACTS AND PROVIDES APPROPRIATE CONTRACTUAL ALLOWANCES AND RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS, A SIGNIFICANT PORTION OF DIGNITY HEALTH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, DIGNITY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBT RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. SECTION B, LINE 8 - COMMUNITY BENEFIT AND METHODOLOGY FOR DETERMINING MEDICARE COSTS DIGNITY HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. IN HOSPITALS, ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL OF $895.5 MILLION FOR THE CONSOLIDATED ENTITIES, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY DIGNITY HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $447.6 MILLION REPORTED ON PART III, SECTION B, LINE 7, FOR FEE FOR SERVICE MEDICARE PATIENTS, THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS. SECTION C, LINE 9B - COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE DIGNITY HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. DIGNITY HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE DIGNITY HEALTH FACILITY, OR BILLING COMPANY RETAINED BY DIGNITY HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, DIGNITY HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY DIGNITY HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, DIGNITY HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
PART VI, LINE 2 - NEEDS ASSESSMENT IN ADDITION TO CHNAS REPORTED IN PART V, SECTION B IN ADDITION TO EACH LICENSED HOSPITAL CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS, DIGNITY HEALTH CONTINUOUSLY ASSESSES THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES BY WORKING COLLABORATIVELY WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, OTHER NON-PROFIT CLINICS, PUBLIC HEALTH DEPARTMENTS, AND OTHER HEALTH, SOCIAL SERVICE AND COMMUNITY DEVELOPMENT ORGANIZATIONS. DIGNITY HEALTH GAINS AND MAINTAINS KNOWLEDGE OF HEALTH NEEDS IN PART THROUGH REFERRAL RELATIONSHIPS, SERVICE PLANNING ACTIVITIES, COMMUNITY HEALTH PARTNERSHIPS, AND LOCAL ADVOCACY CONDUCTED IN CONJUNCTION WITH COMMUNITY PARTNERS. DIGNITY HEALTH HOSPITALS CREATE AND MAKE WIDELY AVAILABLE TO THE PUBLIC ANNUAL COMMUNITY BENEFIT REPORTS THAT SUMMARIZE IDENTIFIED HEALTH NEEDS, UPDATE COMMUNITY DEMOGRAPHIC INFORMATION, AND REPORT ON RECENT AND PLANNED COMMUNITY HEALTH PROGRAMS, INCLUDING GOALS, OBJECTIVES AND MEASURABLE RESULTS. DIGNITY HEALTH ALSO USES DATA ON ADMISSIONS FOR AMBULATORY CARE SENSITIVE CONDITIONS THAT EVIDENCE SUGGESTS COULD HAVE BEEN AVOIDED, AT LEAST IN PART, THROUGH MORE ROBUST COMMUNITY ACCESS TO OR USE OF PRIMARY AND PREVENTIVE CARE RESOURCES. HOSPITALS, COMMUNITY LEADERS, AND POLICY MAKERS USE SUCH DATA TO IDENTIFY COMMUNITY NEED LEVELS, TARGET RESOURCES, AND TRACK THE IMPACT OF PROGRAM AND POLICY INTERVENTIONS. DIGNITY HEALTH, IN PARTNERSHIP WITH TRUVEN HEALTH ANALYTICS, DEVELOPED A COMMUNITY NEED INDEX (CNI) WHICH PROVIDES AN AGGREGATE SCORE OF THE SOCIOECONOMIC BARRIERS THAT PUT RESIDENTS AT GREATER RISK OF NEEDING HEALTH SERVICES. THE CNI AGGREGATES NINE INDICATORS INTO FIVE SOCIOECONOMIC FACTORS KNOWN TO CONTRIBUTE TO HEALTH DISPARITY. THE FIVE INCLUDE INCOME, CULTURE/LANGUAGE, EDUCATION, HOUSING STATUS, AND INSURANCE COVERAGE. THE INDEX IS CALCULATED ANNUALLY FOR EVERY ZIP CODE IN THE UNITED STATES. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATION FOR MANAGABLE CONDITIONS AS COMMUNITIES WITH THE LOWEST CNI SCORES. THE CNI PROVIDES COMPELLING EVIDENCE FOR ADDRESSING SOCIOECONOMIC BARRIERS WHEN CONSIDERING HEALTH POLICY AND LOCAL HEALTH PLANNING. THE TOOL HIGHLIGHTS HEALTH CARE DISPARITIES AND ENABLES HEALTH CARE PROVIDERS, POLICYMAKERS, AND OTHERS TO TARGET RESOURCES WHERE THEY ARE MOST NEEDED. ADDITIONAL INFORMATION ABOUT THE CNI IS ACCESSIBLE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS.
PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC FOR DIGNITY HEALTH'S WHOLLY OWNED HOSPITALS INFORMATION ABOUT DIGNITY HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE DIGNITY HEALTH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES DIGNITY HEALTH'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS RECEIVE AN UNINSURED DISCOUNT OF 30%, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION OR WITH PROMPT PAYMENT. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON DIGNITY HEALTH'S WEBSITE AT WWW.DIGNITYHEALTH.ORG. AT THE POINT OF REGISTRATION, BROCHURES ARE MADE AVAILABLE TO ALL PATIENTS EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. COPIES OF THE FINANCIAL ASSISTANCE APPLICATION ARE MADE AVAILABLE TO ALL UNINSURED PATIENTS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THAT THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF DIGNITY HEALTH REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE DIGNITY HEALTH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4 - COMMUNITY INFORMATION DIGNITY HEALTH HOSPITALS DELIVER CARE TO DIVERSE COMMUNITIES ACROSS ARIZONA, CALIFORNIA AND NEVADA. FOLLOWING ARE BRIEF DESCRIPTIONS AND DEMOGRAPHIC SUMMARIES OF THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS. DIGNITY HEALTH HOSPITALS DEFINE THE COMMUNITY AS THE PRIMARY GEOGRAPHIC AREA SERVED BY THE HOSPITAL, BASED ON THE ORIGINS OF THE TOP 75-80 PERCENT OF HOSPITAL DISCHARGES. FOR CHNA PURPOSES, SOME HOSPITALS USE THEIR COUNTY AS THE COMMUNITY DEFINITION. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER IS LOCATED IN PHOENIX, ARIZONA WITHIN THE COUNTY OF MARICOPA. IT SERVES ALL OF MARICOPA COUNTY AND AREAS BEYOND, BUT ITS PRIMARY SERVICE AREA IS BASED ON 68 ZIP CODES REPRESENTING THE TOP 75% OF PATIENTS BY VOLUME. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. Total Population: 2,845,558 Race/Ethnicity: White - Non-Hispanic 47.5%; Black/African American - Non-Hispanic 5.9%; Hispanic or Latino 38.8%; Asian/Pacific Islander 3.6%; All Others 4.2% Median Income: $51,090 Unemployment: 5.8% No High School Diploma: 17.3% Medicaid: 24.0% Uninsured: 8.4% OTHER AREA HOSPITALS: 48 MERCY SAN JUAN MEDICAL CENTER'S PRIMARY SERVICE AREA ENCOMPASSES A BROAD SUBURBAN AREA IN THE NORTHERN PORTION OF SACRAMENTO COUNTY AND EXTENDS INTO SOUTH PLACER COUNTY. WITHIN ITS PRIMARY SERVICE AREA, THE HOSPITAL SERVES CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, NORTH HIGHLANDS, ANTELOPE, AND OTHER SURROUNDING NEIGHBORHOODS. Total Population: 1,056,782 Race/Ethnicity: White - Non-Hispanic 56.0%; Black/African American - Non-Hispanic 7.2%; Hispanic or Latino 20.1%; Asian/Pacific Islander 11.5%; All Others 5.2% Median Income: $61,395 Unemployment: 7.8% No High School Diploma: 11.0% Medicaid: 29.7% Uninsured: 6.4% OTHER AREA HOSPITALS: 6 MERCY GENERAL HOSPITAL, A TERTIARY CARE FACILITY, SERVES RESIDENTS FROM A BROAD GEOGRAPHIC AREA. THE HOSPITAL'S PRIMARY SERVICE AREA LIES IN THE CENTRAL DOWNTOWN AREA OF SACRAMENTO, AND INCLUDES 40 ZIP CODES. Total Population: 1,523,151 Race/Ethnicity: White - Non-Hispanic 46.2%; Black/African American - Non-Hispanic 9.5%; Hispanic or Latino 22.6%; Asian/Pacific Islander 16.0%; All Others 5.7% Median Income: $58,960 Unemployment: 8.1% No High School Diploma: 13.3% Medicaid: 32.9% Uninsured: 7.2% OTHER AREA HOSPITALS: 7 MARIAN REGIONAL MEDICAL CENTER IS LOCATED IN NORTHERN SANTA BARBARA COUNTY WITH THE SANTA MARIA VALLEY AS THE LARGEST REGION IN ITS SERVICE AREA. THE LARGEST COMMUNITIES IN MARIAN'S PRIMARY SERVICE AREA INCLUDE THE CITY OF SANTA MARIA AND GUADALUPE, WITH THE SECONDARY SERVICE AREA BEING NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. Total Population in Primary Service Area: 152,552 Race/Ethnicity: White - Non-Hispanic 27.7%; Black/African American - Non-Hispanic 1.3%; Hispanic or Latino 64.0%; Asian/Pacific Islander 4.7%; All Others 2.3% Median Income: $58,879 Unemployment: 6.4% No High School Diploma: 32.6% Medicaid: 28.0% Uninsured: 5.4% OTHER AREA HOSPITALS: 0 THE ARROYO GRANDE COMMUNITY HOSPITAL CAMPUS OF THE LICENSED MARIAN REGIONAL MEDICAL CENTER SERVES THE SOUTHERN PART OF SAN LUIS OBISPO COUNTY INCLUDING THE CITIES OF ARROYO GRANDE, GROVER BEACH, OCEANO, PISMO BEACH AND SHELL BEACH AND THE NORTHERN PART OF THE CITY OF NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. Total Population: 78,953 Race/Ethnicity: White - Non-Hispanic 65.3%; Black/African American - Non-Hispanic 0.7%; Hispanic or Latino 27.2%; Asian/Pacific Islander 3.5%; All Others 3.3% Median Income: $64,253 Unemployment: 3.9% No High School Diploma: 11.3% Medicaid: 19.3% Uninsured: 5.2% OTHER AREA HOSPITALS: 1 CHANDLER REGIONAL MEDICAL CENTER THE HOSPITAL'S COMMUNITY INCLUDES CITIES IN MARICOPA AND PINAL COUNTIES, ARIZONA. THE CITIES ARE: CHANDLER, GILBERT, MESA, TEMPE, AWHATUKEE, SACATON, APACHE JUNCTION, CASA GRANDE, GILA RIVER INDIAN RESERVATION, AND GUADALUUPE. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION IN SEVERAL ZIP CODES OF THE SERVICE AREA. Total Population: 638,265 Race/Ethnicity: White - Non-Hispanic 59.0%; Black/African American - Non-Hispanic 5.3%; Hispanic or Latino 23.4%; Asian/Pacific Islander 5.9%; All Others 6.4% Median Income: $65,049 Unemployment: 5.1% No High School Diploma: 9.2% Medicaid: 14.8% Uninsured: 5.5% OTHER AREA HOSPITALS: 2 IN THE PRIMARY SERVICE AREA, 12 IN THE SECONDARY SERVICE AREA MERCY MEDICAL CENTER REDDING SERVES AN AREA COMPRISED OF ZIP CODES IN REDDING AND SURROUNDING COMMUNITIES IN SHASTA, TEHAMA AND TRINITY COUNTY. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. Population: 210,648 Hispanic or Latino: 11.1% Race: 79.4% White; 0.9% Black/African American; 2.8% Asian/Pacific Islander; All Others 5.8% Median Income: $44,050 Uninsured: 8.0% Unemployment: 6.4% No High School Diploma: 12.2% Medicaid: 33.6% Other Area Hospitals: 1 CALIFORNIA HOSPITAL MEDICAL CENTER WHILE THE HOSPITAL IS LOCATED IN SERVICE PLANNING AREA (SPA) 4 OF METRO LOS ANGELES, ITS SERVICE AREA ALSO INCLUDES PARTS OF SPA 6 (SOUTH) AND SPA 8 (SOUTH BAY). CALIFORNIA HOSPITAL MEDICAL CENTER IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. Total Population: 697,267 Race/Ethnicity: White - Non-Hispanic 4.9%; Black/African American - Non-Hispanic 18.4%; Hispanic or Latino 68.4%; Asian/Pacific Islander 6.5%; All Others 1.8% Median Income:$32,125 Unemployment: 7.9% No High School Diploma: 44.1% Medicaid: 56.7% Uninsured: 12.9% OTHER AREA HOSPITALS: 6 ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE PRIMARY SERVICE AREA OF ST. JOSEPH'S MEDICAL CENTER IS THE CITY OF STOCKTON, WITH A SECONDARY SERVICE AREA OF SAN JOAQUIN COUNTY. MANY OF THE COMMUNITIES SERVED BY THE HOSPITAL ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND THE MIGRANT FARM WORKERS SERVED BY THE HOSPITAL ARE DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION. Total Population: 373,238 Race/Ethnicity: White - Non-Hispanic 23.6%; Black/African American - Non-Hispanic 9.2%; Hispanic or Latino 45.3%; Asian/Pacific Islander 17.8%; All Others 4.1% Median Income: $46,770 Unemployment: 9.8% No High School Diploma: 26.2% Medicaid: 37.4% Uninsured: 9.4% OTHER AREA HOSPITALS: 7 DOMINICAN HOSPITAL THE PRIMARY SERVICE AREA IS SANTA CRUZ COUNTY WHICH COVERS 441 SQUARE MILES, AND IS A RELATIVELY ISOLATED COMMUNITY. THE TWO MAJOR CITIES ARE SANTA CRUZ, LOCATED ON THE NORTHERN SIDE OF THE MONTEREY BAY, AND WATSONVILLE, SITUATED IN THE SOUTHERN PART OF THE COUNTY. OTHER INCORPORATED AREAS IN THE COUNTY INCLUDE THE CITIES OF SCOTTS VALLEY AND CAPITOLA. APPROXIMATELY 51% OF THE POPULATION LIVES IN THE UNINCORPORATED PARTS OF THE COUNTY, INCLUDING THE TOWNS OF APTOS, DAVENPORT, FREEDOM, SOQUEL, FELTON, BEN LOMOND AND BOULDER CREEK, AND DISTRICTS SUCH AS THE SAN LORENZO VALLEY, LIVE OAK AND PAJARO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. Total Population: 294,081 Race/Ethnicity: White - Non-Hispanic 56.0%; Black/African American - Non-Hispanic 1.0%; Hispanic or Latino 35.2%; Asian/Pacific Islander 4.2%; All Others 3.6% Median Income: $72,667 Unemployment: 5.6% No High School Diploma: 14.7% Medicaid: 26.3% Uninsured: 5.5% OTHER AREA HOSPITALS: 2 ST. ROSE DOMINICAN HOSPITALS - DE LIMA, SAN MARTIN, AND SIENA SERVE THE AREAS SURROUNDING THE THREE ACUTE CARE FACILITIES IN THE SOUTHERN PORTION OF THE LAS VEGAS VALLEY, AS WELL AS CLARK COUNTY AS A WHOLE. THIS AREA ENCOMPASSES URBAN AND SUBURBAN AREAS WITH DIVERSE SOCIOECONOMIC CONDITIONS. THE HOSPITALS SERVE A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED POPULATION. Total Population: 2,119,853 Race/Ethnicity: White Non-Hispanic 44.3%; Black/African American - Non-Hispanic 10.6%; Hispanic or Latino 30.7%; Asian/Pacific Islander 10.2%; All Others 4.2% Median Income: $52,583 Uninsured: 9.5% Unemployment: 7.6% No HS Diploma: 15.6% Medicaid: 19.0% OTHER AREA HOSPITALS: 13 acute care; 11 long term acute, rehabilitation, and behavioral health NORTHRIDGE HOSPITAL MEDICAL CENTER'S SERVICE AREA INCLUDES PARTS OF THE SAN FERNANDO AND SANTA CLARITA VALLEYS OF LOS ANGELES COUNTY AND A PORTION OF THE CITY OF SIMI VALLEY IN VENTURA COUNTY. THE HOSPITAL IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. Total Population: 1,341,223 Race/Ethnicity: White - Non-Hispanic 33.7%; Black/African American - Non-Hispanic 4.1%; Hispanic or Latino 48.6%; Asian/Pacific Islander 10.8%; All Others 2.8% Median Income: $62,668 Unemployment: 7.2% No High School Diploma: 21.7% Medicaid: 30.4% Uninsured: 6.0% OTHER AREA HOSPITALS: 7 ST. BERNARDINE MEDICAL CENTER SERVES A BROAD AND DIVERSE POPULATION. WHILE A FEW OF THE COMMUNITIES ENJOY A HIGHER STANDARD OF LIVING, THE MAJORITY OF THE COMMUNITIES ARE HIGH NEED. EIGHTY PERCENT (80%) OF DISCHARGES COME FROM THE FOLLOWING CITIES:
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, DIGNITY HEALTH REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR DIGNITY HEALTH TO DELIVER ON ITS MISSION, INCLUDING ENSURING THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE. OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS GATHERS AND VERIFIES CREDENTIALS, ALLOWS THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND TO ULTIMATELY MAKE A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS. THE ROLE OF THE BOARD: THE DIGNITY HEALTH BOARD OF DIRECTORS AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL POLICY-BASED ROLES TO SET PRIORITIES AND TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. DIGNITY HEALTH HOSPITAL COMMUNITY BOARDS, WHICH ARE RATIFIED BY THE DIGNITY HEALTH BOARD, ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS DEVELOP PROGRAMS TO ADDRESS THE DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS OF THE COMMUNITIES THE HOSPITALS SERVE, AND FOR CONDUCTING AND ADOPTING COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS AND IMPLEMENTATION STRATEGIES. COMMUNITY BOARDS ENSURE THE DEVELOPMENT OF COMMUNITY HEALTH INITIATIVES TO PROMOTE THE BROADER HEALTH OF THE COMMUNITY. IN FULFILLING THESE RESPONSIBILITIES, THE COMMUNITY BOARDS MAY DESIGNATE A COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEE TO INCLUDE AT LEAST TWO BOARD MEMBERS, WITH A MAJORITY REPRESENTATION FROM A RANGE OF COMMUNITY STAKEHOLDERS WHO HAVE KNOWLEDGE OF THE COMMUNITY. THE COMMUNITY BOARD, OR BOARD COMMITTEE, PARTICIPATES IN THE PROCESS OF ESTABLISHING PROGRAM PRIORITIES BASED ON COMMUNITY HEALTH NEEDS ASSESSMENTS, DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY, AND MONITORING PROGRESS TOWARD IDENTIFIED GOALS. IF APPLICABLE, MEMBERS OF THE COMMITTEE ENSURE THAT THE COMMUNITY BOARD IS REGULARLY BRIEFED ON ACTIVITIES AND DEVELOPMENTS, AND THAT THE COMMITTEE HAS INFORMATION FROM THE COMMUNITY BOARD AND MANAGEMENT NEEDED TO MAKE INFORMED DECISIONS. THE COMMUNITY BOARDS ARE ALSO RESPONSIBLE FOR REVIEW AND APPROVAL OF THE ANNUAL HOSPITAL COMMUNITY BENEFIT PLAN AND REPORT. COMMUNITY GRANTS, SOCIAL INNOVATION PARTNERSHIP GRANTS, AND COMMUNITY INVESTMENT: DIGNITY HEALTH HOSPITALS PROVIDE MORE THAN $4 MILLION IN FINANCIAL GRANTS ANNUALLY TO COMMUNITY ORGANIZATIONS THAT ARE ADDRESSING SIGNIFICANT HEALTH NEEDS FROM LOCAL CHNAS. DIGNITY HEALTH OPERATES A SOCIAL INNOVATION PARTNERSHIP GRANT PROGRAM TO SPUR NEW APPROACHES AND SOLUTIONS TO ENHANCING HEALTH AND HEALTH CARE NEEDS IN THE COMMUNITIES SERVED BY OUR HOSPITALS. DIGNITY HEALTH OPERATES A $100 MILLION COMMUNITY INVESTMENT PROGRAM THAT HELPS BUILD CAPACITY OF NON-PROFIT ORGANIZATIONS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, INCLUDING HOUSING FOR VULNERABLE POPULATIONS, SUPPORT FOR PRIMARY CARE, AND MORE. MORE INFORMATION ABOUT EACH OF THESE INITIATIVES IS ONLINE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH. DIGNITY HEALTH PROVIDES HOSPITAL SERVICES AND CARRIES OUT ITS MISSION AT THE HOSPITAL FACILITIES LISTED IN PART V, SECTION A. FOR DETAILED INFORMATION ON THE SERVICES AND COMMUNITY BENEFITS PROVIDED AT THESE FACILITIES, AS WELL AS COPIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS, IMPLEMENTATION STRATEGIES AND COMMUNITY BENEFIT REPORTS FOR EACH FACILITY, VISIT THE DIGNITY HEALTH WEBSITE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS.
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM AFFILIATES OF DIGNITY HEALTH ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, AND GRASS VALLEY/NEVADA CITY, CALIFORNIA. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE FOR DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS FOR THE YEAR ENDED JUNE 30, 2016, IS AS FOLLOWS. Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 140,490 96,453,000 0.8% Unpaid Costs of Medicaid/Medi-Cal 1,623,229 927,750,000 7.3% Other Means-tested Programs 275,647 7,027,000 0.1% Community Services: Community Health Services 371,669 44,816,000 0.4% Health Professions Education 84 48,000 0.0% Subsidized Health Services 321,882 47,172,000 0.4% Donations 108,977 22,245,000 0.2% Community Building Activities 6,090 1,679,000 0.0% Community Benefit Operations 65 8,030,000 0.1% Total Community Services for the poor 808,767 123,990,000 1.1% Total Benefits for the Poor 2,848,133 1,155,220,000 9.3% Benefits for the Broader Community: Community Services: Community Health Services 307,874 13,768,000 0.1% Health Professions Education 24,127 70,327,000 0.6% Subsidized Health Services 5,215 1,147,000 0.0% Research 565 7,370,000 0.1% Donations 36,410 6,544,000 0.1% Community Building Activities 16,623 2,724,000 0.0% Community Benefit Operations 28 1,318,000 0.0% Total Benefits for the Broader Community 390,842 103,198,000 0.8% Total Community Benefits 3,238,975 1,258,418,000 10.1% Unpaid Costs of Medicare 1,098,561 895,491,000 7.1% Total Community Benefits including Unpaid Cost of Medicare 4,337,536 2,153,909,000 17.2%
Schedule H (Form 990) 2015
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on 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
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) 5 CITIES HOMELESS COALTION
Po Box 558
GROVER BEACH,CA93483
27-0413593 501(c)(3) 50,400 0 N/A N/A Community Health
(2) Ability360 Inc
15218 S 45Th Place
PHOENIX,AZ85044
86-0486447 501(c)(3) 75,000 0 N/A N/A Community Health
(3) Adelante Healthcare Inc
9520 W Palm Lane Ste 200
Phoenix,AZ850374403
86-0377821 501(c)(3) 176,000 0 N/A N/A Community Health
(4) ADVANCED CENTER FOR EYE CARE
1721 Westwind Dr Suite B
BAKERSFIELD,CA93301
27-3257780 501(c)(3) 72,000 0 N/A N/A Community Health
(5) Aids Legal Referral Panel of the San Francisco Bay
1663 Mission St Suite 500
SAN FRANCISCO,CA94103
94-3111738 501(c)(3) 9,400 0 N/A N/A Community Health
(6) Allan Hancock College Foundation
800 S COLLEGE Drive
SANTA MARIA,CA934546399
95-3143396 501(c)(3) 215,000 0 N/A N/A Education Support
(7) Alliance for Pharmaceutical Access Incorporated
221 TOWN CENTER WEST 122
SANTA MARIA,CA93458
20-3117940 501(c)(3) 115,000 0 N/A N/A Community health
(8) ALTERNATIVES TO VIOLENCE
1805 Walnut Street
RED BLUFF,CA96080
68-0330191 501(c)(3) 13,500 0 N/A N/A Community Health
(9) ALZHEIMER'S ASSOCIATION
1777-A Capitola Road
SANTA CRUZ,CA95062
94-2897949 501(c)(3) 52,000 0 N/A N/A Community Health
(10) ALZHEIMER'S DISEASE ASSOC OF KERN COUNTY
5500 Olive Dr Building 1
BAKERSFIELD,CA93308
77-0017561 501(c)(3) 77,500 0 N/A N/A Community Health
(11) AMERICAN CANCER SOCIETY
1165 EAST AVE STE 100
CHICO,CA95926
13-1788491 501(c)(3) 48,250 0 N/A N/A Community Health
(12) AMERICAN HEART ASSOCIATION INC
7272 Greenville Avenue
Dallas,TX752315129
13-5613797 501(c)(3) 233,590 0 N/A N/A Community Health
(13) AMERICAN LIVER FOUNDATION
39 Broadway Suite 2700
New York,NY10006
36-2883000 501(c)(3) 6,600 0 N/A N/A Community Health
(14) AMERICAN LUNG ASSOCIATION OF THE SOUTHWEST INC
102 WMcDowell
Phoenix,AZ850031297
86-0111676 501(c)(3) 9,750 0 N/A N/A Community Health
(15) ARIZONA STATE UNIVERSITY FOUNDATION
PO Box 2260
Tempe,AZ852802260
86-6021042 501(c)(3) 50,205 0 N/A N/A Education Support
(16) ARMAN (ASYLEE REFUGEE MIGRANT ASSISTANCE NETWORK)
1000 Garces Avenue
LAS VEGAS,NV89101
46-2139994 501(C)(3) 44,537 0 N/A N/A Community Health
(17) Armenian American Medical Society of California In
PO Box 32
Glendale,CA91209
95-4108352 501(c)(3) 9,400 0 N/A N/A Community Health
(18) Arroyo Grande Community Hospital Foundation
345 S Halcyon Road
Arroyo Grande,CA93420
20-3256066 501(c)(3) 662,942 225 FMV SF Giants Tickets Foundation Support
(19) ASCENCIA
437 Fernando Court
GLENDALE,CA91104
20-4233822 501(c)(3) 40,000 0 N/A N/A Community Health
(20) ASIAN PACIFIC SELF DEVELOPMENT AND RESIDENCIAL ASS
3830 N ALVARADO ST STE C
STOCKTON,CA95204
68-0224100 501(c)(3) 11,200 0 N/A N/A Community Health
(21) AZ DIAMONDBACKS FOUNDATION INC
401 E Jefferson Street
Phoenix,AZ850042438
86-0901615 501(c)(3) 9,000 0 N/A N/A Community Health
(22) BAKERSFIELD SYMPHONY ORCHESTRA
1328 34TH ST STE A
BAKERSFIELD,CA93301
95-6001765 501(c)(3) 10,350 0 N/A N/A Community Support
(23) Barrow Foundation UK
350 W Thomas Road
Phoenix,AZ85013
31-1724184 501(C)(3) 273,592 0 N/A N/A Foundation Support
(24) BARROW NEUROLOGICAL FOUNDATION
350 W Thomas Road
Phoenix,AZ850134409
86-0174371 501(c)(3) 3,891,972 0 N/A N/A Foundation support
(25) BAY AREA COUNCIL
201 California St Suite 1450
SAN FRANCISCO,CA94111
23-7325853 501(c)(4) 38,100 0 N/A N/A Community Health
(26) BAY AREA COUNCIL FOUNDATION
201 California St Suite 1450
SAN FRANCISCO,CA94111
20-1826827 501(c)(3) 122,175 0 N/A N/A Community Health
(27) BETHANY SERVICES
5401 BUSINESS PARK SOUTH STE 122
BAKERSFIELD,CA93309
95-2858936 501(c)(3) 7,950 0 N/A N/A Community Health
(28) Board of Regents Nevada System of Higher Education
2601 Enterprise Road
Las Vegas,NV89512
88-6000024 Govt 75,250 0 N/A N/A Education Support
(29) Board Of Trustee Of The Glide Foundation
330 Ellis Street
SAN FRANCISCO,CA94102
94-1156481 501(c)(3) 29,160 170 COST food Community Health
(30) BOY SCOUTS OF AMERICA-LAS VEGAS AREA COUNCIL
7220 S Paradise Road
LAS VEGAS,NV89119
22-1576300 501(c)(3) 10,000 0 N/A N/A Community Health
(31) BOYS & GIRLS CLUB OF METROPOLITAN PHOENIX INC
4309 E Belleview Street BLDG14
Phoenix,AZ85008
86-0107639 501(c)(3) 7,624 0 N/A N/A Community Health
(32) BOYS & GIRLS CLUB OF THE EAST VALLEY
2602 W Baseline Rd Ste 25
Mesa,AZ85202
86-0550646 501(c)(3) 5,400 0 N/A N/A Community Health
(33) BOYS & GIRLS CLUBS OF MERCED
615 W 15Th Street
MERCED,CA95340
77-0357487 501(c)(3) 17,674 0 N/A N/A Community Health
(34) CABRILLO COLLEGE FOUNDATION
6500 SOQUEL Drive
APTOS,CA95003
94-6121953 501(c)(3) 10,000 0 N/A N/A Education Support
(35) California Health Foundation and Trust
1215 K Street Suite 800
Sacramento,CA95814
94-1498697 501(c)(3) 8,058,557 0 N/A N/A Community Health
(36) California Hospital Medical Center Foundation
1401 South Grand Avenue
Los Angeles,CA90015
95-4000909 501(C)(3) 2,658,979 0 N/A N/A Foundation Support
(37) CALIFORNIA STATE UNIVERSITY LONG BEACH RESEARCH FO
11344 Coloma Rd Ste 560
GOLD RIVER,CA95670
95-6106694 501(c)(3) 60,000 0 N/A N/A education support
(38) CAPACITAR INTERNATIONAL
2901 Park Avenue
SOQUEL,CA95073
77-0387846 501(c)(3) 25,000 0 N/A N/A Community Health
(39) CATHOLIC CHARITIES COMMUNITY SERVICES INC
4747 N 7Th Avenue
PHOENIX,AZ85013
86-0223999 501(c)(3) 65,000 0 N/A N/A Community Health
(40) CATHOLIC CHARITIES CYO of the Archdiocese of San F
2255 Hayes Street
SAN FRANSISCO,CA94117
94-1498472 501(c)(3) 6,450 0 N/A N/A Community Health
(41) CATHOLIC CHARITIES DIOCESE OF STOCKTON
1106 N El Dorado Street
STOCKTON,CA95202
94-1629114 501(c)(3) 167,255 0 N/A N/A Community Health
(42) CATHOLIC CHARITIES OF S Nevada
1501 N Las Vegas Blvd
LAS VEGAS,NV89101
88-0059425 501(c)(3) 46,400 0 N/A N/A Community Health
(43) CATHOLIC CHARITIES OF SANTA CLARA COUNTY
2625 Zanker Avenue
SAN JOSE,CA95134
94-2762269 501(c)(3) 10,000 0 N/A N/A Community Health
(44) CATHOLIC CHARITIES OF THE DIOCESE OF FRESNO
149 N FULTON Street
FRESNO,CA937011607
94-1678938 501(c)(3) 16,700 0 N/A N/A Community Health
(45) CATHOLIC OUTREACH CENTER FOUNDATION FOR SENIOR LIV
1201 E Thomas Road
PHOENIX,AZ85014
86-0411904 501(c)(3) 75,000 0 N/A N/A Community Health
(46) CELEBRITY FIGHT NIGHT FOUNDATI
2425 E Camelback Rd Ste 150
PHOENIX,AZ85016
86-0903119 501(c)(3) 84,000 0 N/A N/A Community Health
(47) CENTER FOR HEALTHCARE DECISIONS INC
3400 DATA DRive
RANCHO CORDOVA,CA95670
68-0441958 501(c)(3) 25,000 0 N/A N/A Community Health
(48) Central City Association of Los Angeles
626 Wilshire Blvd Ste 200
Los Angeles,CA90017
95-0691090 501(c)(6) 7,036 0 N/A N/A Community Health
(49) CENTRAL CITY LUTHERAN MISSION
1354 N G Street
SAN BERNARDINO,CA92405
33-0634580 501(c)(3) 27,700 0 N/A N/A Community Health
(50) CHANDLER CHRISTIAN COMMUNITY CENTER INC
345 S California Street
CHANDLER,AZ85225
86-0428780 501(c)(3) 70,000 0 N/A N/A Community Health
(51) CHANDLER EDUCATION FOUNDATION
1525 West Frye Road
Chandler,AZ85224
86-0589677 501(c)(3) 16,000 0 N/A N/A Education Support
(52) CHILDRENS BURN FOUNDATION
5000 Van Nuys Blvd Ste 210
SHERMAN OAKS,CA91403
95-3954352 501(c)(3) 10,000 0 N/A N/A Community Health
(53) CHILDRENS MUSEUM OF PHOENIX
215 N 7th Street
Phoenix,AZ85034
86-0934323 501(c)(3) 7,500 0 N/A N/A Community Health
(54) CIRCLE THE CITY
333 W Indian School Rd
PHOENIX,AZ85203
26-2420730 501(c)(3) 75,000 0 N/A N/A Community Health
(55) CITY OF CHANDLER
Po Box 4008- Mail Stop 501
Chandler,AZ852444008
86-6000238 Govt 18,000 0 N/A N/A Community Health
(56) CITY OF FOLSOM
50 NATOMA Street
FOLSOM,CA95630
94-6000334 Govt 9,000 0 N/A N/A Community Health
(57) Clark County Public Education Foundation Inc
4350 South Maryland Parkway
Las Vegas,NV89119
88-0275767 501(c)(3) 5,200 0 N/A N/A Education Support
(58) CLEAN PRODUCTION ACTION INC
1310 Broadway Suite 101
SOMERVILLE,MA02144
45-3560728 501(c)(3) 9,000 0 N/A N/A Community Health
(59) Climate Resolve
525 S Hewitt Street
Los Angeles,CA90013
46-4736278 501(c)(3) 12,250 0 N/A N/A Community Health
(60) CLINIC BY THE BAY
4877 Mission Street
SAN FRANCISCO,CA94112
26-2593712 501(c)(3) 5,900 0 N/A N/A Community Health
(61) COALITION TO ABOLISH SLAVERY & TRAFFICKING
5042 Wilshire Blvd 568
LOS ANGELES,CA90036
10-0008533 501(c)(3) 40,392 0 N/A N/A Community Health
(62) COLLECTIVE IMPACT
1050 Mcallister Street
SAN FRANCISCO,CA94115
20-8964069 501(c)(3) 7,500 0 N/A N/A Community Health
(63) COLON CANCER ALLIANCE
1025 Vermont Ave NW
Washington,DC02005
86-0947831 501(c)(3) 10,000 0 N/A N/A Community Health
(64) COMMUNICARE HEALTH CENTERS
PO BOX 1260
DAVIS,CA95617
94-2188574 501(c)(3) 20,000 0 N/A N/A Community Health
(65) COMMUNITY COUNSELING CENTER OF SAN LUIS OBISPO CNT
129 Marsh Street
SAN LUIS OBISPO,CA93401
95-2906369 501(c)(3) 50,000 0 N/A N/A Community Health
(66) COMMUNITY MEDICAL CENTERS INC
7210 MURRAY DRIVE
STOCKTON,CA952103339
94-2437106 501(c)(3) 203,079 0 N/A N/A Community Health
(67) CORPORATION FOR SUPPORTIVE HOUSING
800 S Figueroa Suite 810
LOS ANGELES,CA90017
13-3600232 501(c)(3) 202,000 0 N/A N/A Community Health
(68) COUNTY OF SANTA CRUZ
701 OCEAN ST RM 312
SANTA CRUZ,CA95060
94-6000534 Govt 20,000 0 N/A N/A Community Health
(69) CREIGHTON UNIVERSITY
2500 California Plaza
Omaha,NE68178
47-0376583 501(c)(3) 200,621 0 N/A N/A Education Support
(70) CSULB 49er Foundation
6300 E State University Drive
Long Beach,CA90815
45-2163910 501(C)(3) 71,005 0 N/A N/A Community Health
(71) Cuesta College Foundation
PO BOX 8106
SAN LUIS OBISPO,CA93403
23-7225601 501(c)(3) 31,200 0 N/A N/A Education Support
(72) Dignity Health East Valley Foundation
1727 West Frye Road Suite 230
Chandler,AZ85224
74-2418514 501(C)(3) 2,125,147 0 N/A N/A Foundation Support
(73) Dignity Health Foundation
185 Berry Street
San Francisco,CA94107
46-2037641 501(c)(3) 1,504,975 0 N/A N/A Foundation Support
(74) Dignity Health Medical Foundation
3400 Data Drive
Rancho Cordova,CA95670
68-0220314 501(C)(3) 175,386,321 0 N/A N/A MEDICAL Foundation Support
(75) Dominican Hospital Foundation
1555 Soquel Drive
Santa Cruz,CA95065
94-2450442 501(c)(3) 1,130,831 127 COST jewelery/clothing fo Foundation Support
(76) EAST VALLEY ADULT RESOURCES
45 W University Drive Ste A
MESA,AZ852015831
94-2596075 501(c)(3) 62,373 0 N/A N/A Community Health
(77) EAST VALLEY HISPANIC CHAMBER OF COMMERCE
215 N Robson Street
Mesa,AZ85201
27-5501336 501(c)(6) 7,254 0 N/A N/A Community Health
(78) EL CENTRITO DE LA COLONIA
450 South K Street
OXNARD,CA93030
31-1652255 501(c)(3) 75,000 0 N/A N/A Community Health
(79) EMPIRE HOTEL ALCOHOLIC REHABILITATION CENTER
1237 California Street
REDDING,CA960010618
94-2326975 501(c)(3) 75,000 0 N/A N/A community health
(80) ESKATON FOUNDATION
5105 MANZANITA AVE
CARMICHAEL,CA95608
68-0227233 501(c)(3) 12,500 0 N/A N/A Community Health
(81) ETHIOPIA HEALTH AID INC
3690 Karen Sue Lane Ste 400
LA CANADA,CA91011
27-3488964 501(c)(3) 15,000 0 N/A N/A Community Health
(82) FACING HISTORY & OURSELVES
24301 Southland Drive Suite 316
HAYWARD,CA94545
04-2761636 501(c)(3) 28,000 0 N/A N/A Community Health
(83) FATHERS & FAMILIES OF SAN JOAQUIN
PO BOX 30674
STOCKTON,CA95213
32-0171398 501(c)(3) 18,000 0 N/A N/A Community Health
(84) First Friday Foundation Las Vegas
1301 S 6th Street
Las Vegas,NV89104
46-1097401 501(c)(3) 22,500 0 N/A N/A Community Health
(85) FIRST GRADUATE
3130 20Th Street Suite 275
SAN FRANCISCO,CA94110
94-3381171 501(c)(3) 10,000 0 N/A N/A Community Health
(86) FOLSOM CHAMBER OF COMMERCE
200 WOOL Street
FOLSOM,CA95630
94-1573092 501(c)(6) 10,000 0 N/A N/A Community Health
(87) FOOD BANK OF SANTA BARBARA
490 W Foster Road
SANTA MARIA,CA93455
77-0169214 501(c)(3) 30,855 0 N/A N/A Community Health
(88) FREED CENTER FOR INDEPENDENT LIVING
117 New Mohawk Rd Suite A
NEVADA CITY,CA95959
68-0085639 501(c)(3) 62,508 0 N/A N/A Community Health
(89) French Hospital Medical Center Foundation
1911 Johnson Avenue
San Luis Obispo,CA93401
20-3256125 501(C)(3) 904,692 0 N/A N/A Foundation Support
(90) FRESH START WOMEN'S FOUNDATION
1130 E McDowell Road
Phoenix,AZ85006
86-0762610 501(c)(3) 8,339 0 N/A N/A Community Health
(91) FRIENDS OF WHISKEYTOWN
1978 Eddy Way
WHISKEYTOWN,CA96002
46-0511279 501(c)(3) 20,100 0 N/A N/A Community Health
(92) FRIENDSHIP BRIDGE
405 Urban Street 140
LAKEWOOD,CO80228
84-1141078 501(c)(3) 10,000 0 N/A N/A Community Health
(93) FROM THE GARDEN TO THE TABLE
1442A Walnut St Suite 134
BERKELEY,CA94709
30-0221004 501(c)(3) 75,000 0 N/A N/A Community Health
(94) FUSE CORPS
925 Mission St 109
SAN FRANCISCO,CA94103
27-5469219 501(c)(3) 30,000 0 N/A N/A Community Health
(95) GIANTS COMMUNITY FUND
24 Willie Mays Plaza
SAN FRANCISCO,CA94107
94-3200061 501(c)(3) 7,315 0 N/A N/A Community Health
(96) GILBERT EDUCATION FOUNDATION INC
Po Box 2461
Gilbert,AZ852992461
86-1023126 501(c)(3) 17,185 0 N/A N/A Education Support
(97) GIRL SCOUTS OF TIERRA DEL ORO
3621 Forest Glenn Drive
MODESTO,CA95355
94-1582429 501(c)(3) 10,000 0 N/A N/A Community Health
(98) GLENDALE COMMUNITY FREE HEALTH CLINIC
134 N Kenwood St Rm 330
GLENDALE,CA91206
87-0732681 501(c)(3) 25,000 0 N/A N/A Community Health
(99) Glendale Memorial Health Foundation
1420 S Central Avenue
Glendale,CA91204
95-3625651 501(C)(3) 1,261,141 0 N/A N/A Foundation Support
(100) Glendale Parks & Open Space Foundation
613 E Broadway Rm 120
Glendale,CA91206
27-0676361 501(c)(3) 5,750 0 N/A N/A Community Health
(101) GLOBAL FAMILY CARE NETWORK INC
PO BOX 13160
BAKERSFIELD,CA93389
20-8346599 501(c)(3) 25,000 0 N/A N/A Community Health
(102) Golden Umbrella
200 Mercy Oaks Drive
Redding,CA96003
23-7115371 501(c)(3) 571,346 0 N/A N/A Community Health
(103) GOSPEL CENTER RESCUE MISSION
445 S San Joaquin St Attn Bill Bro
STOCKTON,CA95203
94-1375835 501(c)(3) 65,760 0 N/A N/A Community Health
(104) GRAND CANYON UNIVERSITY
3300 W CAMELBACK RD
PHOENIX,AZ850173030
20-3356009 Govt 9,000 0 N/A N/A Education Support
(105) GREAT NORTHERN CORP
310 Boles Street
WEED,CA96064
94-2562423 501(c)(3) 25,500 0 N/A N/A Community Health
(106) GREATER SACRAMENTO URBAN LEAGUE
3725 Marysville Blvd
SACRAMENTO,CA95838
94-1686314 501(c)(3) 19,450 0 N/A N/A Community Health
(107) H Street Clinic Inc
1329 NORTH H ST
SAN BERNARDINO,CA92405
20-8191393 501(c)(3) 75,000 0 N/A N/A Community Health
(108) HABITAT FOR HUMANITY SAN FRAN
645 Harrison Street Ste 201
SAN FRANCISCO,CA94107
94-3088881 501(c)(3) 9,648 0 N/A N/A Community Health
(109) Harold Pump Foundation
13636 Ventura Blvd Suite 416
Sherman Oaks,CA91423
95-4807001 501(c)(3) 29,050 0 N/A N/A Community Health
(110) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNT
PO BOX 962
SANTA CRUZ,CA95062
01-0826156 501(c)(3) 20,000 0 N/A N/A Community Health
(111) HEALTHCARE WITHOUT HARM
12355 Sunrise Valley Drive Ste 680
RESTON,VA20191
52-2358837 501(c)(3) 15,000 0 N/A N/A Community Health
(112) Healthy Community Forum For The Greater Sacramento
8928 VOLUNTEER LaNe STE 220
SACRAMENTO,CA958263238
68-0377256 501(c)(3) 45,000 0 N/A N/A Community Health
(113) Henderson Chamber of Commerce Foundation Inc
590 South Boulder Hwy
Henderson,NV89015
88-0358312 501(c)(3) 18,133 0 N/A N/A Community health
(114) HOFFMANN HOSPICE OF THE VALLEY
8501 BRIMHALL RD STE 100
BAKERSFIELD,CA93312
77-0386207 501(c)(3) 9,300 0 N/A N/A Community Health
(115) Homeless Foundation for San Luis Obispo County
PO BOX 1444
SAN LUIS OBISPO,CA93406
30-0811413 501(c)(3) 10,000 0 N/A N/A Community health
(116) HOMELESS SERVICES CENTER
115-B Coral Street
SANTA CRUZ,CA95060
77-0126783 501(c)(3) 91,247 0 N/A N/A Community Health
(117) HOSPICE OF SAN JOAQUIN
3888 PACIFIC AVEnue
STOCKTON,CA952041953
94-2777980 501(c)(3) 8,750 0 N/A N/A Community Health
(118) HOSPITAL CONSORTIUM OF SAN MATEO COUNTY
222 W 39TH AVE 3RD Floor
SAN MATEO,CA94403
94-2637032 501(c)(3) 11,000 0 N/A N/A Community Health
(119) HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA
1215 K STreet 800
SACRAMENTO,CA95814
94-1533644 501(c)(6) 16,650 0 N/A N/A Community Health
(120) ICAN
650 E Morelos Street
CHANDLER,AZ85225
86-0761030 501(c)(3) 70,000 0 N/A N/A Community Health
(121) IMMANUEL PRESBYTERIAN CHURCH
3300 Wilshire Boulevard
LOS ANGELES,CA90010
95-1643330 501(c)(3) 52,000 0 N/A N/A Community Health
(122) INLAND CAREGIVER RESOURCE CTN
1430 E Cooley Drive Suite 124
COLTON,CA92324
33-0460833 501(c)(3) 24,750 0 N/A N/A Community Health
(123) INNVISION SHELTER NETWORK
181 Constitution Drive
MENLO PARK,CA94025
77-0160469 501(c)(3) 15,200 0 N/A N/A Community Health
(124) JDRF INTERNATIONAL
26 Broadway 14th Floor
New York,NY10004
23-1907729 501(c)(3) 12,250 0 N/A N/A Community Health
(125) JEFFERSON AWARDS FOR PUBLIC SERVICE
100 W 10Th St Suite 215
WILMINGTON,DE19801
52-0959336 501(c)(3) 13,000 0 N/A N/A Community Health
(126) JEWISH FAMILY & CHILDRENS SERVICE
4747 N 7th Street Ste 100
Phoenix,AZ85014
86-0096781 501(c)(3) 27,500 0 N/A N/A Community Health
(127) JJ S LEGACY
PO BOX 12793
BAKERSFIELD,CA93389
27-3546375 501(c)(3) 8,500 0 N/A N/A Community Health
(128) JMJ MATERNITY HOMES MARYS MANTLE
435 W 21St Street
MERCED,CA95340
20-5611546 501(c)(3) 15,000 0 N/A N/A Community Health
(129) Keep Memory Alive
888 W Bonneville Avenue
Las Vegas,NV89106
88-0515534 501(c)(3) 21,000 0 N/A N/A Community Health
(130) KERN CITIZENS FOR SUSTAINABLE GOVERNMENT CORP
PO BOX 81075
BAKERSFIELD,CA93380
27-3702300 501(c)(3) 7,100 0 N/A N/A Community Health
(131) KERN CNTY HISP CHAMBER OF COM
231 H Street
BAKERSFIELD,CA93304
68-0182048 501(c)(6) 17,000 0 N/A N/A community health
(132) KIDS FOR PEACE INC
3303 James Drive
CARLSBAD,CA92008
26-1564351 501(c)(3) 100,000 0 N/A N/A community health
(133) LEGAL AID SOCIETY OF SB
588 W Sixth Street
SAN BERNARDINO,CA92410
95-1997024 501(c)(3) 32,519 0 N/A N/A Community Health
(134) LESTONNAC FREE CLINIC
1215 E Chapman Avenue
ORANGE,CA92866
95-3499011 501(c)(3) 75,000 0 N/A N/A Community Health
(135) LINKS FOR LIFE
1706 Chester Avenue 200
BAKERSFIELD,CA93301
93-1088003 501(c)(3) 50,000 0 N/A N/A Community Health
(136) Living Grace Homes Inc
1806 Somersby Way
Henderson,NV89014
26-3911446 501(c)(3) 8,100 0 N/A N/A Community Health
(137) LOS ANGELES TRUST FOR CHILDRENS HEALTH
333 S Beaudry Ave 29Th Floor
LOS ANGELES,CA90017
95-4262448 501(c)(3) 52,000 0 N/A N/A Community Health
(138) LOS RIOS FOUNDATION
1919 SPANOS Court
SACRAMENTO,CA95825
94-2506591 501(c)(3) 15,000 0 N/A N/A Education Support
(139) MARCH OF DIMES FOUNDATION
1275 Mamaroneck Avenue
White Plains,NY10605
13-1846366 501(c)(3) 101,020 0 N/A N/A Community Health
(140) Marian Regional Medical Center Foundation
1400 E CHURCH Street
SANTA MARIA,CA93454
95-3818027 501(c)(3) 971,519 0 N/A N/A Foundation Support
(141) MARK TWAIN MED CENTER FOUNDATION
768 Mountain Ranch Road
SAN ANDREAS,CA95249
68-0023507 501(c)(3) 300,000 0 N/A N/A Foundation Support
(142) MARY'S MERCY CENTER
Po Box 7563
SAN BERNARDINO,CA92411
33-0632426 501(c)(3) 25,000 0 N/A N/A Community Health
(143) MEDICARE RIGHTS CENTER
266 W 37Th St 3Rd Floor
NEW YORK,NY10018
13-3505372 501(c)(3) 10,000 0 N/A N/A Community Health
(144) MEDSHARE INTERNATIONAL
3240 Clifton Springs Road
DECATUR,GA30034
58-2433968 501(c)(3) 100,000 217,372 BOOK Medical supplies/equ Community Health
(145) MEND - MEET EACH NEED WITH DIGNITY
10641 N San Fernando Road
PACOIMA,CA91331
23-7306337 501(c)(3) 10,000 0 N/A N/A Community Health
(146) MENTAL HEALTH AMERICA OF LA
100 W Broadway Ste 5010
LONG BEACH,CA90802
95-1881491 501(c)(3) 50,761 0 N/A N/A Community Health
(147) MERCED COMMUNITY COLLEGE DISTRICT
3600 M Street
MERCED,CA95348
77-0362218 Govt 122,251 0 N/A N/A Education Support
(148) MERCED COUNTY RESCUE MISSION
Po Box 3319
MERCED,CA95344
77-0284849 501(c)(3) 70,000 0 N/A N/A Community Health
(149) Merced Union High School District
3430 A STREET
ATWATER,CA95301
77-0572114 Govt 18,000 0 N/A N/A Education Support
(150) MERCY BEYOND BORDERS
1885 De La Cruz Blvd Suite 101
SANTA CLARA,CA950503000
26-0323282 501(c)(3) 10,000 0 N/A N/A Community Health
(151) MERCY FOUNDATION
3400 Data Drive
RANCHO CORDOVA,CA95670
23-7072762 501(c)(3) 2,264,119 0 N/A N/A Foundation Support
(152) Mercy Foundation Bakersfield
PO Box 119
Bakersfield,CA93302
77-0201321 501(c)(3) 778,047 0 N/A N/A Foundation Support
(153) Mercy Foundation North
2400 Washington Street Suite 410
Redding,CA96001
94-3136799 501(c)(3) 942,199 0 N/A N/A Foundation Support
(154) MERCY HIGH SCHOOL SAN FRANCISCO
3250 Nineteenth Avenue
SAN FRANCISCO,CA94132
94-1231000 501(c)(3) 10,000 0 N/A N/A education support
(155) MERCY HOUSING CALIFORNIA
1350 Mission Street
SAN FRANCISCO,CA94103
84-1559406 501(c)(3) 200,000 0 N/A N/A Community Health
(156) Mercy Medical Center Merced Foundation
301 East 13th Street
Merced,CA95340
77-0035928 501(c)(3) 462,356 0 N/A N/A Foundation Support
(157) MISSION DOLORES ACADEMY
3371 16Th Street
SAN FRANCISCO,CA84114
20-2849575 501(c)(3) 24,400 0 N/A N/A Community Health
(158) MT SHASTA RECREATION & PARKS DISTRICT
PO BOX 314
MT SHASTA,CA96067
94-6003419 Govt 8,250 0 N/A N/A Community Health
(159) MUSEUM OF AFRICAN DIASPORA
685 Mission St 3Rd Floor
SAN FRANCISCO,CA94105
94-3338239 501(c)(3) 259,000 0 N/A N/A Community Health
(160) NAHSE SOCAL CHAPTER
14937 Sherman Way Unit 6
VAN NUYS,CA91405
47-3255329 N/A 10,000 0 N/A N/A Community Health
(161) NATIONAL ASSOC OF HEALTH SERVICES EXECUTIVES
8630 Fenton Street Ste 126
SILVER SPRING,MD20910
62-1312239 501(c)(3) 37,600 0 N/A N/A Community Health
(162) NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLOR
1215 K Street STE 1609
SACRAMENTO,CA95814
95-4617376 501(c)(3) 9,900 0 N/A N/A Community Health
(163) National Health Foundation
515 S Figueroa Street Ste 1300
Los Angeles,CA90071
23-7314808 501(c)(3) 5,420 0 N/A N/A Community Health
(164) NATIONAL MULTIPLE SCLEROSIS SOCIETY
1700 OWENS STreet STE 190
SAN FRANCISCO,CA94158
94-1294935 501(c)(3) 7,147 0 N/A N/A Community Health
(165) NATIVE AMERICAN CONNECTIONS
4520 N Central Avenue Ste 600
PHOENIX,AZ85012
86-0293585 501(c)(3) 57,500 0 N/A N/A Community Health
(166) NEEDS CENTER
518 Main Street
TAFT,CA93268
65-1305502 501(c)(3) 30,000 0 N/A N/A Community Health
(167) NEHEMIAH COMMUNITY REINVESTMENT FUND INC
640 BERCUT DRive STE A
SACRAMENTO,CA95811
68-0365842 501(c)(3) 151,250 0 N/A N/A Community Health
(168) NEIGHBORS WHO CARE INC
10450 E Riggs Rd Suite 113
SUN LAKES,AZ85248
86-0966061 501(c)(3) 70,000 0 N/A N/A Community Health
(169) NETWORK EDUCATION PROGRAM
25 E Street NW Suite 200
WASHINGTON,DC200011630
52-1307764 501(c)(3) 25,000 0 N/A N/A education support
(170) Nevada Clinical Services Inc
3186 S Maryland Pkwy
Las Vegas,NV89119
45-2211040 N/A 927,000 0 N/A N/A Community Health
(171) NICHI BEI FOUNDATION
Po Box 15693
SAN FRANCISCO,CA94115
27-0700443 501(c)(3) 20,000 0 N/A N/A Community Health
(172) NORTH VALLEY FAMILY YMCA
11336 Corbin Avenue
NORTHRIDGE,CA91326
95-1644052 501(c)(3) 25,000 0 N/A N/A Community Health
(173) NORTHERN ARIZONA UNIVERSITY FOUNDATION INC
PO Box 4094
Flagstaff,AZ860115676
86-0193726 501(c)(3) 6,000 0 N/A N/A Education Support
(174) NORTHERN CALIF CENTER FOR FAMILY AWARENESS
Po Box 991473
REDDING,CA96003
68-0363217 501(c)(3) 20,000 0 N/A N/A Community Health
(175) NORTHERN CALIFORNIA CHILD DEVELOPMENT INC
220 Sycamore Street Suite 200
RED BLUFF,CA96080
94-1642028 501(c)(3) 24,603 0 N/A N/A Community Health
(176) Northern Santa Barbara County United Way Inc
PO BOX 947
SANTA MARIA,CA93456
95-6006513 501(c)(3) 25,800 0 N/A N/A community Health
(177) Northridge Hospital Foundation
18300 Roscoe Boulevard
Northridge,CA91328
23-7444901 501(c)(3) 1,598,708 0 N/A N/A Foundation Support
(178) NOT FOR SALE
2225 3Rd Street
SAN FRANCISCO,CA94107
20-5659783 501(c)(3) 23,000 0 N/A N/A Community Health
(179) OPENHOUSE
1800 Market Street PMB 93
SAN FRANCISCO,CA94102
94-3337955 501(c)(3) 15,000 0 N/A N/A Community Health
(180) OPERA NOIR INC
Po Box 1933
ORINDA,CA94563
77-0503778 501(c)(3) 25,000 0 N/A N/A Community Support
(181) Opportunity Village Association for Retarded Citiz
6300 W Oakey Boulevard
Las Vegas,NV89146
88-6003567 501(c)(3) 6,500 0 N/A N/A Community Health
(182) PANETTA INSTITUTE FOR PUBLIC
100 Campus Center Bldg 86E
SEASIDE,CA93955
77-0495799 501(c)(3) 10,150 0 N/A N/A Community Health
(183) PARTNERS IN CARE FOUNDATION
15030 Ventura Blvd 19-812
SHERMAN OAKS,CA91403
95-3954057 501(c)(3) 18,500 0 N/A N/A Community Health
(184) PATHWAYS HOME HEALTH AND HOSPICE
585 N MARY AVEnue
SUNNYVALE,CA94085
94-2823240 501(c)(3) 24,500 0 N/A N/A Community Health
(185) PEACH TREE HEALTHCARE
1114 YUBA STreet STE 144
MARYSVILLE,CA95901
68-0371679 501(c)(3) 1,400,000 0 N/A N/A Community Health
(186) PENINSULA FAMILY SERVICE
24 Second Avenue
SAN MATEO,CA94401
94-1186169 501(c)(3) 45,000 0 N/A N/A Community Health
(187) PENINSULA VOLUNTEERS INC
800 Middle Avenue
MENLO PARK,CA94025
94-1294939 501(c)(3) 24,750 0 N/A N/A Community Health
(188) PEPPERDINE UNIVERSITY
24255 Pacific Coast Highway
Malibu,CA90263
95-1644037 501(c)(3) 9,125 0 N/A N/A education support
(189) PHOENIX CHILDRENS HOSPITAL FOUNDATION
2929 Camelback Rd 122
Phoenix,AZ85015
74-2421549 501(c)(3) 8,750 0 N/A N/A Community Health
(190) PHOENIX SYMPHONY ASSOCIATION
One North First St Ste 200
Phoenix,AZ85004
86-6000134 501(c)(3) 20,385 0 N/A N/A Community Support
(191) POOR AND THE HOMELESS TEHAMA COUNTY COALITION
PO BOX 315
RED BLUFF,CA96080
68-0465095 501(c)(3) 5,500 0 N/A N/A Community Health
(192) POSITIVE PATHS
1525 SGreenfield Road
Mesa,AZ85206
46-4943070 501(c)(3) 9,250 0 N/A N/A Community Health
(193) PROJECT SUNSHINE INC
211 E 43Rd St Ste 401
NEW YORK,NY10017
22-3607512 501(c)(3) 10,000 0 N/A N/A Community Health
(194) REGENTS OF THE UNIVERSITY OF CALIFORNIA AT BERKELE
50 Universisty Hall - MC 7360
BERKELEY,CA321420162
94-6002123 501(c)(3) 10,000 0 N/A N/A education support
(195) ROMAN CATHOLIC ARCHBISHOP OF SAN FRANCISCO A CORP
1 Peter Yorke Way
SAN FRANCISCO,CA94109
94-1156707 501(c)(3) 25,000 0 N/A N/A Community Health
(196) ROMAN CATHOLIC BISHOP DIOCESE OF FRESNO
1550 N FRESNO Street
FRESNO,CA93703
94-1294942 501(c)(3) 13,925 0 N/A N/A Community Health
(197) ROTACARE BAY AREA INC
514 Valley Way
Milpitas,CA95035
77-0328723 501(c)(3) 15,306 0 N/A N/A Community Health
(198) RURAL COMMUNITY ASSIST CORP
3120 Freeboard Dr Suite 201
W SACRAMENTO,CA95691
94-2512284 501(c)(3) 50,000 0 N/A N/A Community Health
(199) SACRAMENTO SELF HELP HOUSING INC
PO BOX 188445
SACRAMENTO,CA95818
68-0217383 501(c)(3) 33,300 0 N/A N/A Community Health
(200) SACRAMENTO STEPS FORWARD
1331 Garden Hwy Suite 100
SACRAMENTO,CA95833
27-4907397 501(c)(3) 200,000 0 N/A N/A Community Health
(201) SAINT VINCENT DE PAUL CENTER
300 Baker Street
BAKERSFIELD,CA93305
95-1853364 501(c)(3) 56,828 0 N/A N/A Community Health
(202) SALVATION ARMY THE
900 W James M Wood Blvd
LOS ANGELES,CA90015
94-1156347 501(c)(3) 33,780 0 N/A N/A Community Health
(203) SAN BERNARDINO SEXUAL ASSAULT
444 N Arrowhead Ave 101
SAN BERNARDINO,CA92401
95-3543081 501(c)(3) 33,750 0 N/A N/A Community Health
(204) SAN FRANCISCO PARKS ALLIANCE
501 Stanyan Street
SAN FRANCISCO,CA94117
23-7131784 501(c)(3) 8,476 0 N/A N/A Community Health
(205) SAN FRANCISCO STATE UNIVERSITY
1600 Holloway Avenue ADM 471
SAN FRANCISCO,CA94132
93-1137247 govt 6,000 0 N/A N/A EDUCATION SUPPORT
(206) San Luis Obispo Visitors & Conference Bureau Incor
1334 Marsh Street
SAN LUIS OBISPO,CA93401
77-0221126 501(c)(6) 10,000 0 N/A N/A Community health
(207) SANTA CRUZ COMMUNITY COUNSELING CENTER
195 Harvey West Boulevard
SANTA CRUZ,CA95060
23-7275290 501(c)(3) 30,152 0 N/A N/A Community Health
(208) Santa Maria Philharmonic Society
120 EAST JONES ST SUITE 120
SANTA MARIA,CA93454
77-0288378 501(c)(3) 14,400 0 N/A N/A Community Support
(209) SELF HELP FOR THE ELDERLY
407 Sansome Street
SAN FRANCISCO,CA941113123
94-1750717 501(c)(3) 40,000 0 N/A N/A Community Health
(210) Senoras of Excellence Senores of Distinction
1709 Shadow Mountain Place
Las Vegas,NV89108
26-4252853 501(c)(3) 6,860 0 N/A N/A Education Support
(211) SEQUOIA HOSPITAL FOUNDATION
170 Alameda De Las Pulgas
REDWOOD CITY,CA940622799
94-2909990 501(c)(3) 1,480,877 0 N/A N/A Foundation Support
(212) SEQUOIA VILLAGE
711 Nevada Street
Redwood City,CA94061
47-3571718 501(c)(3) 20,000 0 N/A N/A Community Health
(213) SEROTONIN SURGE CHARITIES
824 FALCON AVEnue
DAVIS,CA95616
68-0411254 501(c)(3) 35,000 0 N/A N/A Community Health
(214) SF FORTY NINERS FOUNDATION
4949 Marie P Debartolo Way
SANTA CLARA,CA95054
77-0287514 501(c)(3) 6,000 0 N/A N/A Community Health
(215) SF SB COMMITTEE INC
555 Mission St Suite 3000
SAN FRANCISCO,CA94105
46-1177365 501(c)(6) 75,000 0 N/A N/A Community support
(216) SF SPECIAL EVENTS COMMITTEE
City Hall 1 Dr Carlton B Goodlet Pl
SAN FRANCISCO,CA94102
94-3001337 501(c)(3) 10,000 0 N/A N/A Community support
(217) SHANTI PROJECT
730 Polk Street
SAN FRANCISCO,CA941097813
94-2297147 501(c)(3) 66,948 0 N/A N/A Community Health
(218) SHASTA COUNTY CHILD ABUSE PREVENTION COORDINATING
2280 Benton Drive Bldg C B
REDDING,CA96003
68-0151867 501(c)(3) 30,000 0 N/A N/A Community Health
(219) Shasta County Health & Human Services
1810 Market Street
Redding,CA96001
94-6001568 Govt 20,000 0 N/A N/A Community Health
(220) Shasta Senior Nutrition Program
100 Mercy Oaks Drive
Redding,CA96003
94-2650429 501(c)(3) 553,344 0 N/A N/A Community Health
(221) Simpson College Foundation
2211 COLLEGE VIEW Drive
REDDING,CA96003
68-0274677 501(c)(3) 50,000 0 N/A N/A Education Support
(222) SISTERS OF MERCY BURLINGAME
2300 Adeline Drive
BURLINGAME,CA94010
26-2400800 501(c)(3) 52,500 0 N/A N/A Community Health
(223) SISTERS OF MERCY OF THE AMERICAS CCASA COMMUNITY I
8380 Colesville Road Ste 300
SILVER SPRING,MD209106264
26-2486726 501(c)(3) 15,000 0 N/A N/A Community Health
(224) SISTERS OF ST FRANCIS
1330 Brewster Avenue
REDWOOD CITY,CA94064
20-4019358 501(c)(3) 25,000 0 N/A N/A Community Health
(225) SLO NOOR FOUNDATION
1428 Phillips Lane Suite B4
SAN LUIS OBISPO,CA93401
27-1412176 501(c)(3) 54,235 0 N/A N/A Community Health
(226) SMITHSONIAN INSTITUTE OFFICE OF THE COMPTROLLER
1000 Jefferson Drive Sw
WASHINGTON,DC20560
53-0206027 501(c)(3) 1,000,000 0 N/A N/A Community Support
(227) SOSMENTOR
23622 Calabasas Rd 146
CALABASAS,CA91302
95-4722980 501(c)(3) 25,000 0 N/A N/A Community Health
(228) Southern Highlands Golf Club Charitable Foundation
11411 Southern Highlands Parkway Su
Las Vegas,NV89141
88-0509995 501(c)(3) 16,904 0 N/A N/A Community Health
(229) Southern Nevada Health District
280 S Decatur Blvd
Las Vegas,NV89127
88-0151573 Govt 19,000 0 N/A N/A Community Health
(230) SOUTHWEST HUMAN DEVELOPMENT
2850 N 24Th Street
PHOENIX,AZ85008
86-0407179 501(c)(3) 74,253 0 N/A N/A Community Health
(231) ST ANTHONY FOUNDATION
150 Gold Gate Avenue
SAN FRANCISCO,CA94102
94-1513140 501(c)(3) 201,000 0 N/A N/A Community Health
(232) St Bernardine Medical Center Foundation
2101 N Waterman Avenue
San Bernardino,CA92404
23-7440086 501(C)(3) 724,068 0 N/A N/A Foundation Support
(233) ST HOPE ACADEMY
Po Box 5447
SACRAMENTO,CA95817
68-0193050 501(c)(3) 23,000 0 N/A N/A Community Health
(234) ST JOHN'S HEALTHCARE FOUNDATION
1600 North Rose Avenue
OXNARD,CA93030
20-2865781 501(c)(3) 947,785 0 N/A N/A Foundation Support
(235) ST JOHNS SEMINARY
5012 Seminary Road
CAMARILLO,CA93012
95-1642384 501(c)(3) 22,900 0 N/A N/A Community Health
(236) ST JOSEPH'S FOUNDATION
350 W Thomas Road
Phoenix,AZ85013
94-2941245 501(c)(3) 1,328,206 0 N/A N/A Foundation Support
(237) ST JOSEPH'S Foundation OF SAN JOAQUIN
1800 N California Street
STOCKTON,CA95204
51-0432777 501(c)(3) 600,212 0 N/A N/A Foundation Support
(238) St Mary Medical Center Foundation
1045 Atlantic Avenue
Long Beach,CA90813
23-7153876 501(C)(3) 2,524,280 0 N/A N/A Foundation Support
(239) St Marys Dining Room
545 W Sonora Street
STOCKTON,CA95203
94-2687280 501(c)(3) 154,812 2,533 COST food Community Health
(240) St Mary's Medical Center Foundation
450 Stanyan Street
San Francisco,CA94117
94-3336143 501(c)(3) 1,031,085 0 N/A N/A Foundation Support
(241) St Rose Dominican Heallth Foundation
3001 St Rose Parkway
Henderson,NV89052
88-0349432 501(C)(3) 2,663,150 0 N/A N/A Foundation Support
(242) Society Of St Vincent De Paul Particular Council O
50 N B Street
SAN MATEO,CA94401
94-1375833 501(c)(3) 9,760 0 N/A N/A Community Health
(243) STUDENTS SUPPORTING BRAIN TUMOR RESEARCH
8390 E Via De Ventura Ste F-110
Scottsdale,AZ85258
20-0345903 501(c)(3) 5,750 0 N/A N/A Community Health
(244) SUICIDE PREVENTION OF YOLO COUNTY INC
Po Box 622
DAVIS,CA95617
94-2619492 501(c)(3) 67,851 0 N/A N/A Community Health
(245) Surfing for Hope Foundation
1304 WOODSIDE Drive
SAN LUIS OBISPO,CA93401
36-4762809 501(c)(3) 5,600 0 N/A N/A Community Support
(246) TARZANA TREATMENT CENTERS
18646 Oxnard Street
TARZANA,CA91356
94-2219349 501(c)(3) 40,000 0 N/A N/A Community Health
(247) Tehama County Solid Waste Management Agency
PO BOX 689
RED BLUFF,CA96080
94-6000543 Govt 5,600 0 N/A N/A Community support
(248) THE ARC OF AMADOR & CALAVERAS
75 Academy Drive
SUTTER CREEK,CA95685
23-7312930 501(c)(3) 28,573 0 N/A N/A Community Health
(249) THE COMMUNITY SERVICE EDUCATION AND RESEARCH FUND
5380 ELVAS AVEnue
SACRAMENTO,CA95819
23-7003581 501(c)(3) 35,000 0 N/A N/A Community Health
(250) The Crohn's & Colitis Foundation fo America Inc
733 Third Ave Suite 510
New York,NY10017
13-6193105 501(c)(3) 6,000 0 N/A N/A Community Health
(251) THE HISTORYMAKERS
1900 S Michigan Avenue
CHICAGO,IL60616
36-4328170 501(c)(3) 10,000 0 N/A N/A Community Health
(252) THE LEVERAGE NETWORK INC
200 S Wacker Drive Ste 3100
CHICAGO,IL60606
47-3517179 501(c)(3) 13,300 0 N/A N/A Community Health
(253) THE REGENTS OF THE UCSF
1600 Holloway Avenue 425
SAN FRANCISCO,CA94104
94-6036493 501(c)(3) 10,100 0 N/A N/A Education support
(254) THE UNIVERSITY CORPORATION SAN FRANCISCO STATE
205 13Th Street 3280
SAN FRANCISCO,CA94103
94-1384645 501(c)(3) 100,000 0 N/A N/A Education support
(255) THEATRE RESIDENCIES INC
171 Maynard Street
SAN FRANCISCO,CA94112
94-3289489 501(c)(3) 28,322 0 N/A N/A Community Health
(256) TRIUMPH FOUNDATION
17186 Hickory Ridge Court
CANYON COUNTRY,CA91387
26-3295161 501(c)(3) 15,000 0 N/A N/A Community Health
(257) TRUE NORTH INC
Po Box 242
SHINGLETOWN,CA96088
68-0480331 501(c)(3) 8,460 0 N/A N/A Community Health
(258) TURNING POINT COMMUNITY PROG
3440 Viking Drive Suite 114
SACRAMENTO,CA95827
94-2609766 501(c)(3) 320,000 0 N/A N/A Community Health
(259) Tyler Robinson Foundation Inc
222 S Main 5th Floor
Salt Lake City,UT84101
46-2570835 501(c)(3) 8,500 0 N/A N/A Community Health
(260) UNITED NEGRO COLLEGE FUND
220 Montgomery Street Ste 1120
SAN FRANCISCO,CA94104
13-1624241 501(c)(3) 19,800 0 N/A N/A Education support
(261) UNITED WAY OF NORTHERN CALIFORNIA
2280 Benton Drive Box 14
REDDING,CA96003
94-1251675 501(c)(3) 38,000 0 N/A N/A Community Health
(262) UNITED WAY OF SANTA CRUZ COUNTY
4450 Capitola Road Ste 106
CAPITOLA,CA95010
94-1422471 501(c)(3) 304,350 0 N/A N/A Community Health
(263) University of Arizona
Po Box 3520
Tucson,AZ857223520
74-2652689 Govt 14,400,000 0 N/A N/A Education Support
(264) UNIVERSITY OF ARIZONA FOUNDATION
1111 N Cherry Avenue
Tucson,AZ857210109
86-6050388 501(c)(3) 11,300 0 N/A N/A Education support
(265) University Of California San Francisco Foundation
Campus Box 0248
SAN FRANCISCO,CA941430248
94-2829914 501(c)(3) 50,000 0 N/A N/A Education support
(266) University of Nevada Las Vegas Foundation
4505 S Maryland Parkway Box 451006
Las Vegas,NV89154
94-2790134 501(c)(3) 75,000 0 N/A N/A Education Support
(267) VMSN INC
4770 Harrison Drive Suite 105
Las Vegas,NV89121
39-2072453 501(c)(3) 84,100 0 N/A N/A Community Health
(268) WEAVE INCORPORATED
1900 K Street
SACRAMENTO,CA95814
94-2493158 501(c)(3) 55,000 0 N/A N/A Community health
(269) WELLNESS WORKS COMMUNITY HEALTH CENTER
540 W Broadway Avenue
GLENDALE,CA91204
95-4554824 501(c)(3) 31,000 0 N/A N/A Community health
(270) Wellspace Health Family Service Agency
8912 VOLUNTEER LN STE 100
SACRAMENTO,CA95826
94-1713704 501(c)(3) 40,000 0 N/A N/A Community Health
(271) WESTCARE NEVADA INC
1711 Whitney Mesa Drive
LAS VEGAS,NV891934738
94-2778981 501(c)(3) 150,334 0 N/A N/A Community Health
(272) Win-Win Entertainment Inc
3565 Las Vegas Blvd South 174
Las Vegas,NV89109
27-5179304 501(c)(3) 7,920 0 N/A N/A Community Support
(273) Woodland Memorial Hospital Foundation
1321 Cottonwood Street
Woodland,CA95695
94-6167964 501(c)(3) 546,516 0 N/A N/A Foundation Support
(274) YOLO CRISIS NURSERY INC
1477 DREW AVENUE STE 103
DAVIS,CA95618
47-1006055 501(c)(3) 10,000 0 N/A N/A Community Health
(275) Yolo Food Bank
1244 Fortna Avenue
Woodland,CA95776
23-7111782 501(c)(3) 15,000 0 N/A N/A Community Health
(276) YOLO HEALTHY AGING ALLIANCE
600 A STreet STE B
DAVIS,CA95616
46-1075195 501(c)(3) 5,900 0 N/A N/A Community Health
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
267
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
10
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2015

Schedule I (Form 990) 2015
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients
(c) Amount of
cash grant
(d) Amount of
non-cash assistance
(e) Method of valuation (book,
FMV, appraisal, other)
(f) Description of non-cash assistance
(1) DIRECT CASH ASSISTANCE 495 20,680 0 N/A n/a
(2) FINANCIAL ASSISTANCE FOR COMMUNITY PROGRAMS 1550 33,481 0 n/a n/a
(3) FINANCIAL ASSISTANCE TO PATIENTS/NEEDY 6478 517,831 0 n/a n/a
(4) SCHOLARSHIP 62 119,750 0 n/a n/a
(5) DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY 11307 0 98,127 cost clothing, car seats
(6) MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS 58 0 136,444 book medical supplies
(7) PHARMACY CHARITY PRESCRIPTION 1782   61,224 cost Pharmaceuticals
(8) PROVISION OF FOOD/MEALS 80962 0 514,924 cost Food/meals
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Part I, line 1 INCLUDED IN PART II ABOVE IS $4,472,063 RELATED TO The Dignity Health CommunIty Grants program. THIS PROGRAM IS one way in which Dignity Health supports and enhances the advocacy, social justice and healthier communities efforts of its hospitals and the religious sponsors of our Catholic hospitals. Begun in 1990, the program's initial objectives were: (1) to strengthen the bonds among our member hospitals; and (2) to partner with other nonprofit organizations that share our values and also work to improve the health status and quality of life of the communities we serve. Each of the grant recipients is required to submit an annual accountability report to Dignity Health. The reports reflect activities performed, objectives, and outcomes reached by the grant recipientS. All organizations that apply for these grants are required to be 501(c)(3) organizations. OTHER GRANTS ARE PROVIDED BY Dignity Health (AND ITS MEMBER HOSPITALS) TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER Dignity Health'S EXEMPT PURPOSE. GRANTS ARE ALSO PROVIDED TO THE FUNDRAISING FOUNDATIONS THAT SUPPORT Dignity Health AND ITS MEMBER HOSPITALS TO FUND THE OPERATIONS OF THOSE FOUNDATIONS. Several grants are provided to other organizations in which Dignity Health supports community efforts. In addition, grants are provided to individuals, primarily patients, due to financial need or urgent, unforeseen occurrences requiring immediate action. Examples of assistance include transportation costs to a hospital for treatment, pharmacy costs for indigent patients, and sheltered meals. The grants are approved by the hospital's Administration department or a designated committee reviews and approves grants to be awarded.
Part II $8,058,557 IN GRANT PAYMENTS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST, A 501(C)(3) PUBLIC BENEFIT CHARITY ESTABLISHED TO SPONSOR AND SUPPORT HEALTH CARE, WERE RECOGNIZED IN CONNECTION WITH THE CALIFORNIA PROVIDER FEE PROGRAMS IN FISCAL YEAR 2016. $14,400,000 IN GRANT PAYMENTS WERE PROVIDED TO THE UNIVERSITY OF ARIZONA, A GOVERNMENT INSTITUTION, TO SUPPORT THE DEVELOPMENT OF EDUCATION, TRAINING AND CLINICAL RESEARCH PROGRAMS. $1,400,000 IN GRANT PAYMENTS WERE PROVIDED TO PEACH TREE HEALTHCARE, A 501C(3) ORGANIZATION, TO SUPPORT THE EXPANSION EFFORTS BY PROVIDING PRIMARY HEALTH CARE SERVICES AS PART OF THE "SAFETY NET" HEALTH SERVICES TO UNINSURED, UNDERINSURED AND MEDI-CAL PATIENTS. IN ADDITION, $927,000 IN GRANT PAYMENTS WERE PROVIDED TO A NON-PROFIT CORPORATION, NEVADA CLINICAL SERVICES, INC, TO ENSURE THE AVAILABILITY OF, AND TO PROVIDE FOR MORE COST EFFECTIVE, QUALITY HEALTH CARE SERVICES TO THE LOW INCOME AND NEEDY RESIDENTS IN THE NEVADA COMMUNITY.
Schedule I (Form 990) 2015



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on 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
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization?
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization?
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
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 on 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 on prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1Lloyd H DeanPresident /CEO (i)

(ii)
1,661,119
-------------
0
4,779,900
-------------
0
617,845
-------------
0
1,118,725
-------------
0
95,709
-------------
0
8,273,298
-------------
0
572,831
-------------
0
2Michael D BlaszykSEVP, Chief Financial Officer (i)

(ii)
868,941
-------------
0
1,735,503
-------------
0
1,554,735
-------------
0
199,324
-------------
0
74,403
-------------
0
4,432,906
-------------
0
1,351,443
-------------
0
3Rick GrossmanEVP, General Counsel (i)

(ii)
601,987
-------------
0
750,724
-------------
0
378,917
-------------
0
263,814
-------------
0
69,985
-------------
0
2,065,427
-------------
0
0
-------------
0
4Diane LeeVP & Associate General Counsel (i)

(ii)
289,888
-------------
0
254,823
-------------
0
11,315
-------------
0
47,760
-------------
0
32,548
-------------
0
636,334
-------------
0
0
-------------
0
5Marvin O'QuinnSEVP, Chief Operating Officer (i)

(ii)
1,108,841
-------------
0
1,903,624
-------------
0
354,053
-------------
0
519,262
-------------
0
62,846
-------------
0
3,948,626
-------------
0
265,387
-------------
0
6Elizabeth ShihEVP, Chief Administrative Offi (i)

(ii)
798,897
-------------
0
1,131,973
-------------
0
446,683
-------------
0
252,280
-------------
0
83,019
-------------
0
2,712,852
-------------
0
348,471
-------------
0
7Steven BarronSVP Operations, So Cal East (i)

(ii)
546,419
-------------
0
629,167
-------------
0
374,335
-------------
0
95,231
-------------
0
62,503
-------------
0
1,707,655
-------------
0
327,210
-------------
0
8Brian G BrannmanSVP Operations, Nevada (i)

(ii)
440,454
-------------
0
417,994
-------------
0
17,351
-------------
0
63,787
-------------
0
47,613
-------------
0
987,199
-------------
0
0
-------------
0
9Keith CallahanSVP, Supp & Srvcs Resources Mg (i)

(ii)
385,012
-------------
0
366,347
-------------
0
173,049
-------------
0
63,592
-------------
0
38,813
-------------
0
1,026,813
-------------
0
150,674
-------------
0
10Mary ConnickSVP, Finance, Corporate Contro (i)

(ii)
387,400
-------------
0
366,347
-------------
0
15,088
-------------
0
63,592
-------------
0
43,271
-------------
0
875,698
-------------
0
0
-------------
0
11Charles CovaSVP Operations, Central Coast (i)

(ii)
483,194
-------------
0
505,117
-------------
0
36,862
-------------
0
80,536
-------------
0
35,757
-------------
0
1,141,466
-------------
0
0
-------------
0
12Charles P FrancisSEVP, Chief Strategy Officer (i)

(ii)
729,862
-------------
0
1,030,200
-------------
0
198,099
-------------
0
838,446
-------------
0
60,173
-------------
0
2,856,780
-------------
0
175,682
-------------
0
13Lisa Gamshad ZuckermanSVP Treasury & Strategic Inves (i)

(ii)
375,288
-------------
0
351,797
-------------
0
5,185
-------------
0
62,517
-------------
0
58,245
-------------
0
853,032
-------------
0
0
-------------
0
14Laurie HartingSVP Operations, Greater Sacram (i)

(ii)
614,820
-------------
0
614,030
-------------
0
29,395
-------------
0
97,669
-------------
0
29,333
-------------
0
1,385,247
-------------
0
0
-------------
0
15Linda HuntSVP Operations, Arizona (i)

(ii)
591,562
-------------
0
603,926
-------------
0
156,340
-------------
0
95,694
-------------
0
44,735
-------------
0
1,492,257
-------------
0
129,468
-------------
0
16Mark KorthSVP Operations, North State (i)

(ii)
421,167
-------------
0
437,530
-------------
0
11,004
-------------
0
70,195
-------------
0
40,278
-------------
0
980,174
-------------
0
0
-------------
0
17Jeffrey W LandVP, Corporate Real Estate (i)

(ii)
334,817
-------------
0
293,914
-------------
0
119,788
-------------
0
54,066
-------------
0
52,115
-------------
0
854,700
-------------
0
114,536
-------------
0
18Bernita McTernanEVP/Sponsorship/Mission Integr (i)

(ii)
462,339
-------------
0
1,088,080
-------------
0
5,564,617
-------------
0
122,434
-------------
0
71,705
-------------
0
7,309,175
-------------
0
5,431,331
-------------
0
19Timothy PanksSVP, Finance & Revenue Cycle M (i)

(ii)
360,475
-------------
0
333,585
-------------
0
4,688
-------------
0
58,616
-------------
0
44,466
-------------
0
801,830
-------------
0
0
-------------
0
20Darryl RobinsonEVP, Chief Human Resource Offi (i)

(ii)
680,589
-------------
0
824,354
-------------
0
7,395
-------------
0
281,611
-------------
0
48,768
-------------
0
1,842,717
-------------
0
0
-------------
0
21Karl SilbersteinSVP, Financial Operations (i)

(ii)
578,216
-------------
0
537,311
-------------
0
90,615
-------------
0
89,559
-------------
0
50,045
-------------
0
1,345,746
-------------
0
67,914
-------------
0
22Todd A Strumwasser MDSVP Operations, Bay Area (i)

(ii)
500,001
-------------
0
1,036,990
-------------
0
344,178
-------------
0
113,034
-------------
0
45,299
-------------
0
2,039,502
-------------
0
0
-------------
0
23Jon VanBoeningSVP Operations, Central Valley (i)

(ii)
565,596
-------------
0
584,164
-------------
0
199,706
-------------
0
91,946
-------------
0
68,316
-------------
0
1,509,728
-------------
0
158,356
-------------
0
24Robert Wiebe MDEVP, Chief Medical Officer (i)

(ii)
777,642
-------------
0
971,244
-------------
0
12,083
-------------
0
358,895
-------------
0
31,163
-------------
0
2,151,027
-------------
0
0
-------------
0
25Tammara WilcoxSVP, Managed Care (i)

(ii)
428,773
-------------
0
400,541
-------------
0
9,628
-------------
0
68,786
-------------
0
43,026
-------------
0
950,754
-------------
0
0
-------------
0
26Deanna WiseEVP, Chief Information Officer (i)

(ii)
610,359
-------------
0
746,077
-------------
0
4,764
-------------
0
271,254
-------------
0
33,533
-------------
0
1,665,987
-------------
0
0
-------------
0
27Edmundo CastanedaHospital President (i)

(ii)
481,400
-------------
0
435,851
-------------
0
9,211
-------------
0
74,909
-------------
0
35,861
-------------
0
1,037,232
-------------
0
0
-------------
0
28Mark S HillardPhilanthropy Web consultant (i)

(ii)
298,558
-------------
0
292,412
-------------
0
403,845
-------------
0
51,091
-------------
0
27,310
-------------
0
1,073,216
-------------
0
0
-------------
0
29Alan IftiniukHospital President (i)

(ii)
383,094
-------------
0
355,231
-------------
0
225,588
-------------
0
62,408
-------------
0
38,697
-------------
0
1,065,018
-------------
0
200,782
-------------
0
30Darren LeeHospital President (i)

(ii)
386,099
-------------
0
327,199
-------------
0
226,562
-------------
0
59,080
-------------
0
37,241
-------------
0
1,036,181
-------------
0
0
-------------
0
31Scott R Petersen MDPhysician (i)

(ii)
604,542
-------------
0
148,312
-------------
0
157,413
-------------
0
63,048
-------------
0
14,927
-------------
0
988,242
-------------
0
147,364
-------------
0
32Rodney A DavisFormer KE (i)

(ii)
15,291
-------------
0
0
-------------
0
93,841
-------------
0
4,230
-------------
0
0
-------------
0
113,362
-------------
0
5,334
-------------
0
33John M WrayFormer KE (i)

(ii)
0
-------------
0
0
-------------
0
127,456
-------------
0
0
-------------
0
0
-------------
0
127,456
-------------
0
127,456
-------------
0
Schedule J (Form 990) 2015

Schedule J (Form 990) 2015
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
Sch J, PART I, LINES 1A, 4A, & 4B PART I, 1A First class travel and upgrades to such are treated on an exception basis according to Dignity Health policy. Such travel totaling $12,521 was provided to four officers, directors and highest compensated employees. No amounts have been included as reportable compensation as these travel expenses were incurred for business purposes. There was no charter travel in 2015. Tax gross-up payments were provided to one officer, four key employees and one highest compensated employee. These gross up payments were included as taxable compensation to the listed persons. Club dues have been paid by Dignity Health for business use by four key employees and one highest compensated employee. No amount has been paid for club dues for officers. Dignity Health does not pay or reimburse for any health club memberships. No amounts have been reported as income. Security services, including a vehicle and a driver, are provided to an officer pursuant to a qualified security assessment. No amounts have been reported as income. PART I, 4A Dignity Health's key employees and officers and certain highly compensated employees participate in a severance plan that provides market-standard compensation, ranging from payments of 6 months to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Payments pursuant to the plan arrangement for one highest compensated employee occurred during 2015: M. Hillard $364,967. PART I, 4B Certain officers and key employees participate in the Dignity Health Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the Dignity Health Retirement Plan whose benefits are affected by the limitations imposed by sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. Payments pursuant to the plan for one officer and one key employee occurred during 2015 include M. Blaszyk, $1,324,942; and B. McTernan, $5,431,331. Dignity Health's key employees and certain officers and highly compensated employees are eligible to participate in non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. Benefits vest under this 457(f) plan at the later of the date the participant attains age 62 or is credited with 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service; the plan also allows for special awards. Payments pursuant to the plan arrangements for two officers, four key employees, one highest compensated employee and one former key employee occurred during 2015 include L. Dean, $572,831; M. OQuinn, $265,387, S. Barron, $327,210; K. Callahan, $150,674; L. Hunt, $129,468; J. VanBoening, $158,356; A. Iftiniuk, $200,782; and R. Davis, $5,334. One highest compensated employee participates in the Arizona 457(f) Plan. The Arizona 457(f) Plan is a non-qualified retirement plan for the physicians in Arizona. It is a notional defined contribution plan, providing a 2% contribution on eligible pay to eligible physicians. The contributions are invested in a balanced investment fund. Upon vesting, as defined by Arizona 457(f) Plan, the balance in the plan is distributed to the physician. In subsequent years, vested physicians receive the 2% contribution as a distribution from the plan. Distributions are taxable in the year they become vested in the contributions and earnings. Distributions are not eligible for rollover. A payment of $147,364 was made pursuant to this plan for S. Petersen during 2015. Certain listed persons participate in the Dignity Health Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. Payments pursuant to the plan for two key employees and one former key employee occurred during 2015 include J. Land, $114,536; K. Silberstein, $67,914; and J Wray, $127,456. Certain officers and key employees participate in the Dignity Health Supplemental Executive Retention/Retirement Plan, a nonqualified supplemental benefit plan which in 2002 was offered to members of the executive management team by the Dignity Health Board of Directors and would be paid only if the executives stayed with the organization for a specified number of years as the primary purpose of this plan is to provide for the retention and retirement of the participants. The executive management team is recruited from stable careers in organizations from across the country and from various industries. Duties are both extensive and complex and require substantial and diverse experience and skill sets to execute successfully. The calculation for the payments to each executive is based on the value of a final average pay annuity benefit based on retirement age and service years to the organization. Distribution occurs each July 1 if the plan formula warrants a payment. Payments made during 2015 pursuant to this plan include M. Blaszyk, $26,501; E. Shih; $348,471; and C. Francis, $175,682. Compensation amounts for the supplemental nonqualified retirement plans discussed above are reported as deferred compensation in the year accrued (Schedule J, Part II, column C) and are reflected again as reportable compensation in the year paid (Schedule J, Part II, column B(iii)).
Sch J - PART II Dignity Health's executive compensation philosophy is designed to assist Dignity Health in attracting and retaining the caliber of executives required to enable Dignity Health to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities Dignity Health serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and Dignity Health's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size, revenues and complexity.
Schedule J (Form 990) 2015
Additional Data


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

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
 
88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
 
88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.200 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.900 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085,000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2009.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
Schedule K (Form 990) 2015

Additional Data


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

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
 
88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
 
88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.200 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.900 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085,000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2009.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
Schedule K (Form 990) 2015

Additional Data


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

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
 
88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
 
88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.200 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.900 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085,000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2009.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
Schedule K (Form 990) 2015

Additional Data


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

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
 
88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
 
88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.200 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.900 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085,000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2009.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
Schedule K (Form 990) 2015

Additional Data


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

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DR5 04-26-2007 276,250,000 BOND F: CUSIP 130795DR5-SEE PRT VI   X   X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816HP2 04-26-2007 178,702,052 BOND G: CUSIP 566816HP2-SEE PRT VI X     X   X
CITY OF RENO NEVADA
 
88-6000201 759835AA9 04-26-2007 98,635,589 BOND H: CUSIP 759835AA9-SEE PRT VI X     X   X
CITY OF HENDERSON NEVADA
 
88-6000720 425203CF1 04-26-2007 200,626,751 BOND I: CUSIP 425203CF1-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LAZ0 05-14-2009 457,778,078 BOND J: CUSIP 13033LAZ0-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? .... X     X   X   X
15 Were the bonds issued as part of an advance refunding issue? ..... X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.200 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.900 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2015

Schedule K (Form 990) 2015
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009 THE AHFA 2008 SERIES ABC BONDS AND NOVEMBER 2009. THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41, THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/28/2015. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND F: CUSIP 130795DR5 PART I, COLUMN (C) CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY (CSCDA) 2007 SERIES G-L, OF WHICH CSCDA 2007 SERIES G-J WERE EXCHANGED FOR CSCDA 2008 SERIES ABDE. THE CUSIP NUMBER NOTED ON SCHEDULE K '130795DR5' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2007 SERIES G-L BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR CSCDA 2008 SERIES ABDE, AND THERE WAS AN INTEREST RATE CONVERSION ON THE CSCDA 2007 SERIES KL BONDS. THE LATEST MATURITIES ON THE CURRENTLY OUTSTANDING EXCHANGED BONDS ARE THE CSCDA 2007 SERIES KL BONDS, BOTH OF WHICH HAVE A FINAL MATURITY DATE OF JULY 1, 2041. THE CUSIPS ARE '130795TV9' FOR THE CSCDA 2007 SERIES K BONDS AND '130795TW7' FOR THE CSCDA SERIES 2007 L BONDS. THE CSCDA 2007 SERIES GHIJ BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES ABDE BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2013.
BOND G: CUSIP 566816HP2 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - AZ 1999 A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND H: CUSIP 759835AA9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION AND RENOVATION OF HOSPITAL FACILITY (INCLUDING EMERGENCY ROOM) AND ACQUISITION OF MEDICAL EQUIPMENT. PART III, LINE 3A REMEDIAL ACTION (DEFEASANCE OF NONQUALIFED BONDS) WAS TAKEN WITH RESPECT TO 2007A BONDS IN CONNECTION WITH THE SALE OF ALL PROPERTY FINANCED BY SUCH BONDS. PART III, LINE 8A ALTHOUGH THE CITY OF RENO, NEVADA, HEALTH FACILITY REVENUE BONDS, 2007 SERIES A (THE "2007 RENO BONDS"), ARE SHOWN ON LINE 1 OF PART I OF THIS SCHEDULE K, DIGNITY HEALTH AND THE CITY OF RENO, NEVADA (THE "CITY"), TOOK APPROPRIATE REMEDIAL ACTION WITH RESPECT TO ALL OF THE 2007 RENO BONDS, UNDER SECTION 1.141-12(D) OF THE TREASURY REGULATIONS, ON SEPTEMBER 24, 2012, BY DEFEASING A PRO RATA PORTION OF THE 2007 RENO BONDS, IN THE PRINCIPAL AMOUNT OF $42,085,000, WITHIN 90 DAYS OF THE SALE BY DIGNITY HEALTH OF SAINT MARY'S REGIONAL MEDICAL CENTER ("SMRMC"), IN RENO, NEVADA. SUCH DEFEASANCE WILL CAUSE SUCH PORTION OF THE 2007 RENO BONDS TO BE REDEEMED ON THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. BECAUSE THE CONSIDERATION FOR THE SALE OF SMRMC WAS EXCLUSIVELY CASH, PURSUANT TO SECTION 1.141-12(D)(2) OF THE TREASURY REGULATIONS, DIGNITY HEALTH AND THE CITY WERE PERMITTED TO MEET, AND MET, THE REQUIREMENTS OF SECTION 1.141-12(D) OF THE TREASURY REGULATIONS WITH RESPECT TO ALL OF THE 2007 RENO BONDS BY APPLYING THE "DISPOSITION PROCEEDS" RECEIVED FROM THE SALE OF SMRMC TO THE DEFEASANCE OF A PRO RATA PORTION OF THE 2007 RENO BONDS THROUGH THEIR FIRST OPTIONAL REDEMPTION DATE OF JULY 1, 2017. SUCH PRO RATA PORTION OF THE 2007 RENO BONDS WAS DETERMINED TO HAVE A PRINCIPAL AMOUNT OF $42,085,000. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND I: CUSIP 425203CF1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - NV 1998 A (ISSUED DECEMBER 3, 1998); NV 1999 SERIES A (ISSUED DECEMBER 9, 1999); NV 2004 SERIES B (ISSUED APRIL 28, 2004); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND J: CUSIP 13033LAZ0 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES CDE (ISSUED MAY 16, 2008); AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES G (ISSUED MAY 16, 2008); AND TO FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2014.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2011.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2009.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2015.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 6/30/2016.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
Schedule K (Form 990) 2015

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) Rick Grossman OF relocation   X 550,000 183,333   No   No Yes  
Total ...............Small Bullet $ 183,333
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2015
Schedule L (Form 990 or 990-EZ) 2015
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Wade Dean Family member of L Dean 58,009 Employment   No
(2) Allison Cova Family member of C Cova 175,561 Employment   No
(3) Angela DeMichele Family membr, M DeMichele 76,184 Employement   No
(4) E-lead Resources Inc Family member of L Dean 2,618,197 Marketing products & services   No
(5) Melissa Panks Consulting Family member of T Panks 198,368 Consulting Services   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990
OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 5 111,350 appraisal
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 5,261 RESALE VALUE
5 Clothing and household
goods .......
X 299,318 RESALE VALUE
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ... X 2 1,300 COMPARABLE SALE
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens .. X 1 46,450 COMPARABLE SALE
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( SERVICES/ENTERTAINMENT NON-OWNER DONATIONS ) X 20 185,087 COST
26 Other Right pointing arrow large image ( MEDICAL EQUIPMENT ) X 9 58,148 COMPARABLE SALE
27 Other Right pointing arrow large image ( OFFICE EQUIPMENT ) X 5 38,018 COMPARABLE SALE
28 Other Right pointing arrow large image ( TICKETS/GIFT CERTIFICATES ) X 82 27,191 COMPARABLE SALE
Other Right pointing arrow large image ( TOYS ) X 14 18,300 COMPARABLE SALE
Other Right pointing arrow large image ( GLASS DONOR WALL ) X 1 10,125 COMPARABLE SALE
Other Right pointing arrow large image ( FOOD & WINE/ GIFT BASKETS ) X 17 7,138 COMPARABLE SALE
Other Right pointing arrow large image ( PHOTOS & FRAMING ) X 1 2,429 COMPARABLE SALE
Other Right pointing arrow large image ( ELECTRONICS ) X 4 1,832 COMPARABLE SALE
Other Right pointing arrow large image ( SPORTING GOODS ) X 1 750 COMPARABLE SALE
Other Right pointing arrow large image ( FLORAL ARRANGEMENTS ) X 2 235 COMPARABLE SALE
Other Right pointing arrow large image ( DIGITAL PDF ) X 1 10 COMPARABLE SALE
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
1
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2015)
Schedule M (Form 990) (2015)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
SCH M, PART I-EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS ART - WORKS OF ART: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. FOOD INVENTORY: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. SCIENTIFIC SPECIMENS: THE ORGANIZATION IS REPORTING THE NUMBER OF ITEMS RECEIVED. SERVICES/ENTERTAINMENT NON-OWNER DONATIONS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. MEDICAL EQUIPMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OFFICE EQUIPMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. TICKETS/GIFT CERTIFICATES: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. GLASS DONOR WALL: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FOOD & WINE/ GIFT BASKETS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. PHOTOS & FRAMING: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. ELECTRONICS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. SPORTING GOODS: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FLORAL ARRANGEMENTS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. DIGITAL PDF: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED.
Sch M, Part 1, Line 32b DIGNITY HEALTH IS SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS SOLICIT AND PROCESS NON-CASH CONTRIBUTIONS ON BEHALF OF DIGNITY HEALTH'S HOSPITALS.
Schedule M (Form 990) (2015)

Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2015
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Return Reference Explanation
FORM 990, PART VI, GOVERNANCE AND MANAGEMENT DISCLOSURES FORM 990, PART VI, SECTION A, LINE 2 Business relationships as members of the Boards of Directors of Dignity Health subsidiaries and joint ventures: M. Blaszyk, P. Hanelt D. Morissette, P. Hanelt R. Grossman, D. Morissette, M. OQuinn, C. Cova, R. Wiebe, MD M. Blaszyk, R. Grossman, M. OQuinn, E. Shih, C. Francis K. Silberstein, D. Wise K. Bradley, MD, E. Shih, C. Francis M. OQuinn, L. Hunt J. Van Boening, T. Wilcox S. Barron, T. Wilcox FORM 990, PART VI, SECTION A, LINE 7B The corporation has committed in its bylaws to continue a healing ministry based on the life and works of Jesus in the provision of healthcare services in the communities it serves ("the healing ministry"). To further the healing ministry, rights have been reserved to the religious founding co-sponsors of Dignity Health as follows, pursuant to the bylaws: A Sponsorship Council, composed of members of the co-sponsoring organizations, is responsible for overseeing and acting upon issues of Catholic identity for Catholic-sponsored facilities, and informing the healing ministry of the corporation, including both Catholic-sponsored and non-Catholic sponsored facilities, through the right to appoint three of seven members of the Mission Integrity Committee of the Board of Directors and to approve any changes in the Statement of Common Values. The Mission Integrity Committee is responsible for evaluation and resolution of management, operational, and patient care issues that impact conformance with the mission and values of the healing ministry in the operations of the corporation; approving policies and procedures with respect to implementation and conformance to the mission and values of the healing ministry; establishing and maintaining systems for monitoring compliance with the mission and values of the healing ministry, the operational integrity of the Statement of Common Values and the Ethical and Religious Directives; the operational integrity of mission integration standards; pastoral care and education programs; and ministry leadership formation programs. In addition, the Mission Integrity Committee has the power and responsibility to review and monitor the system's labor practices and pension administration. The Mission Integrity Committee may propose changes to the Statement of Common Values, provided the proposal is first reviewed with the Sponsorship Council, which has the sole power to veto any such changes before they are presented to the corporation's Board of Directors for final approval. In addition to working through the Sponsorship Council, at least two members of the Dignity Health Board of Directors continue to be women religious, serving as individuals, not as representatives of their congregations. Also, each individual sponsoring congregation continues to have the right to approve the sale or closure of its sponsored Catholic hospitals or disposition of its other stable patrimony, or the change of name of such Catholic hospital. FORM 990, PART VI, SECTION B, LINE 11B The Board of Directors delegated the review of the Form 990 to the Audit and Compliance Committee. The organization's VP/Financial Services and Reporting, and the outside accounting firm it engaged to review the return, presented each section of the final draft of this Form 990 to the Audit and Compliance Committee. Compensation schedules and disclosures were presented to the Human Resources and Compensation Committee of the Dignity Health Board of Directors by executive management. The Audit and Compliance Committee also met with various personnel involved in the preparation of the return, including, but not limited to, THE EVP/General Counsel, SVP/Finance and Corporate Controller, VP/Corporate Compliance Officer, and the Tax Manager. The review included an explanation of each schedule of the Form 990 and the pertinent information contained on each schedule. Subsequent to its review, the Audit and Compliance Committee reported back to the Board of Directors regarding its oversight of the Form 990 and the complete copy of the Form 990 was provided to the entire Board of Directors before the return was filed. FORM 990, PART VI, SECTION B, LINE 12C The Board of Directors has promulgated policies for the disclosure and management of conflicts of interest. Under such policies, the EVP/General Counsel is responsible for collecting, reviewing and validating annual disclosures of all covered persons (i.e., Board and Board Committee members, officers and executive leadership, key employees, management personnel at the vice president level and above, and any other personnel at his or her discretion). All covered persons are required to disclose real or potential conflicts arising from the business, financial and personal interests held by such covered persons or their family members. Covered persons are required to disclose to their superiors and to relevant decision makers any interest that may present a conflict, or the appearance of a conflict of interest. Such disclosure is required on a transactional basis at the time such conflicts arise, when an individual becomes a covered person, and annually thereafter. Each covered person is required to certify at least annually that he/she: (1) has received a copy of the policy applicable to his/her position; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement as required by the policy. The President/CEO and EVP/General Counsel prepare annual reports of reported conflicts of interest, which are provided to the Board of Directors, Committee Chairs, and key leaders of the organization to enable responsible individuals to monitor and manage disclosed conflicts of interest and assure decisions are made in the organization's best interests. The procedures for addressing a conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board of Directors, members of Board Committees with subject matter jurisdiction and any other relevant decision-makers; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the interested person is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) the transaction or action is approved by a majority of disinterested persons, consistent with any requirements of bylaws or policies; and (6) any conflicting issues arising during the course of a board meeting which cannot be resolved may be referred to an independent committee of the Board of Directors. There are similar conflicts of interest provisions under the Standards of Conduct, which are applicable to all employees and which are administered by the VP/Corporate Compliance Officer who has reporting responsibility to the President/CEO as well as to the Audit and Compliance Committee of the Board of Directors. FORM 990, PART VI, SECTION B, LINE 15A & 15B The Board of Directors appoints a Human Resources and Compensation Committee, comprised of independent directors, who are accountable for setting reasonable compensation packages for each officer and certain key employees (including the President/CEO). The Human Resources and Compensation Committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for officers and key executives. The Human Resources and Compensation Committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the Committee are documented in meeting minutes which are approved at the next Committee meeting and provided to the Board of Directors. The documentation of the deliberations includes (a) the terms of the transaction approved and the date approved; (b) the members of the Committee who were present during discussion of the approved transaction and those who voted on it; and (c) the comparability data obtained and relied upon by the Committee and how the data was obtained.
FORM 990, PART XI, Line 9 - Reconciliation of Net Assets CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY; (886,749,000) REVENUE FROM HEALTH-RELATED ACTIVITIES ORGANIZED AS CORPORATIONS/EXEMPT ORGANIZATIONS; 36,346,453 MARK-TO-MARKET ON INTEREST RATE SWAPS; 2,682,936 INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATION/RELATED ENTITES; (1,133,321) Contribution of certain net assets to a related joint venture, Port City Operating Company LLC; (249,573,552) OTHER FUND BALANCE TRANSFERS; 38,834,810
FORM 990, PART XII, Line 3a - Financial Statements AND Reporting The organization's federal awards were included in dignity health and subordinate corporations' consolidated OMB Circular A-133 audited schedule of federal expenditures.
SAFE HARBOR ELECTION DISCLOSURE TANGIBLE PROPERTY REGULATION STATEMENT SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION TAXPAYER IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER TREASURY REGULATION 1.263(A)-1(F) FOR ALL ELIGIBLE AMOUNTS PAID OR INCURRED DURING THE TAXABLE YEAR.
FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL FEES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REVENUE CYCLE SERVICES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REPAIRS/MAINTENANCE/DEMOLITION TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL/CONSULTING FEES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY/LINEN SERVICES TOTAL FEES:10648824
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:XXX-XX-XXXX
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2015


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2015
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) CHMC Hope Street Family Center Property
1401 South Grand Avenue
Los Angeles,CA90015
27-0967098
Real Property CA 49,292 10,323,091 DIGNITY HLTH
 
(2) Dignity Health Medical Group Nevada LLC
3001 St Rose Parkway
Henderson,NV89052
46-2574491
CLINICS NV 6,220,974 3,726,417 DIGNITY HLTH
 
(3) Dignity Health Nevada Imaging Company LL
5495 South Rainbow Blvd Suite 203
Las Vegas,NV89118
26-3322792
Imaging SVC NV 1,429,926 79,315 DIGNITY HLTH
 
(4) Dignity Health Provider Resources LLC
4550 California Avenue Suite 100
Bakersfield,CA93309
47-3373662
Holding Compa CA 4 1,671,316 DIGNITY HLTH
 
(5) Dignity Health Purchasing Network LLC
3033 North Third Avenue
Phoenix,AZ85013
45-5555133
Group Purchas AZ 4,459,284 3,919,012 DIGNITY HLTH
 
(6) Dignity Health USP Oxnard Surgery Center
1700 N ROSE AVENUE STE 100
OXNARD,CA93030
20-0707388
OP Surgery CA 0 0 DIGNITY HLTH
 
(7) Sequoia Quality Care Network LLC
170 Alameda de las Pulgas
Redwood City,CA94062
47-2083870
Care Network CA 7,815 124,723 DIGNITY HLTH
 
(8) Southern California Integrated Care Netw
2101 NORTH WATERMAN AVENUE
San Bernardino,CA92404
45-5566171
Care Network CA 235,245 290,889 DIGNITY HLTH
 
(9) St Francis Foundation LLC
112 E Victoria Street
Santa Barbara,CA93101
42-1691710
Leasing CA 0 1,472,894 DIGNITY HLTH
 
(10) St John's Regional Imaging Center LLC
1700 N ROSE AVENUE STE 110
Oxnard,CA93030
77-0483564
OP Radiology CA 2,478,419 2,187,723 DIGNITY HLTH
 
(11) St Rose Quality Care Network LLC
102 E Lake Mead Drive
Henderson,NV89015
46-2147857
Care Network NV 7,895 147,711 DIGNITY HLTH
 
(12) Trinity Care LLC
901 Corporate Center Drive Suite 40
Monterey Park,CA91754
33-0805338
Health care CA 12,885,141 48,019 DIGNITY HLTH
 
(13) Valley Integrated Provider Network LLC
420 34th Street
Bakersfield,CA93301
47-2094529
Care Network CA 3,302 44,160 DIGNITY HLTH
 
(14) North State Quality Care Network LLC
2175 Rosaline Avenue
Redding,CA96001
81-0973771
Care Network CA 0 0 DIGNITY HLTH
 
(15) Dignity Health Management Services Organ
251 S Lake Avenue
Pasadena,CA91101
81-3117046
Mgmt Svcs Org CA 0 0 DIGNITY HLTH
 
Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

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

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

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

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

Rancho Cordova,CA95670
68-0220314
Multi-sp clin CA 501(c)(3) 11A-I DIGNITY HLTH
 
Yes
 
(5)Dignity Health Workers' Comp Self-Insura
185 Berry Street

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Phoenix,AZ85040
86-0527381
Health Plan AZ 501(c)(3) 11A-I NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) AGH Phoenix LLC

7171 51st Avenue
Laveen Village,AZ85339
47-1584330
Hospital AZ Dignity Health
 
Related -1,645,535 9,138,465   No 0   No 50.100 %
(2) Arizona Care Network LLC

350 W Thomas Rd
Phoenix,AZ85013
45-4494682
Care Network AZ Dignity Health
 
RELATED -647,826 870,299   No 0 Yes   50.000 %
(3) CBCC Outsmarting Cancer LLC

6501 Truxtun Avenue
Bakersfield,CA93309
46-1602286
Radiation/Onc CA Dignity Health
 
RELATED 96,960 16,803,658   No 0 Yes   51.000 %
(4) DHRT Holdings LLC

185 Berry Street Suite 300
San Francisco,CA94107
35-2484591
Holding Compa DE Dignity Health
 
RELATED 2,139,715 91,033,364   No 0 Yes   33.867 %
(5) DignityAbrazo Health Network LLC dba AC

3030 N Central Avenue Suite 1402
Phoenix,AZ85012
46-5477985
Management Sv AZ Dignity Health
 
RELATED -208,694 3,537,415   No 0   No 50.000 %
(6) DIGNITYUSP LAS VEGAS SURGERY CENTERS LL

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-2999237
Surgery TX Dignity Health
 
RELATED -261,689 7,241,425   No 0   No 50.100 %
(7) DIGNITYUSP NORCAL SURGERY CENTERS LLC

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-2468509
Surgery TX Dignity Health
 
RELATED 5,274,021 33,123,699   No 0   No 50.100 %
(8) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
13-4248908
Surgery TX Dignity Health
 
RELATED 6,989,536 37,964,017   No 0   No 50.100 %
(9) Dominican Breast Center LLC

1661 SOQUEL DRIVE SUITE G
SANTA CRUZ,CA95065
77-0419106
IMAGING CA Dignity Health
 
RELATED 39,792 407,446   No 0 Yes   69.662 %
(10) Dominican Magnetic Resonance Imaging Cen

1545 Soquel Drive
Santa Cruz,CA94065
77-0095477
Imaging Cente CA Dignity Health
 
RELATED -60,926 605,990   No 0 Yes   80.000 %
(11) Folsom Sierra Endoscopy Center LP

1650 Creekside Drive 1600
Folsom,CA95630
68-0482416
Endoscopy CA Dignity Health
 
RELATED 1,552,007 1,258,358   No 0 Yes   51.000 %
(12) Mercy Davis Cancer Center Management Co

2740 M Street
Merced,CA95340
94-3358445
Mgmt of Cance CA Dignity Health
 
RELATED -261,281 4,360,445   No 0 Yes   50.000 %
(13) NICU Operating CO of Santa Cruz LLC

1555 Soquel Drive
Santa Cruz,CA95065
46-0502935
Neonatal Heal CA Dignity Health
 
RELATED 8,285,851 9,996,585   No 0   No 51.000 %
(14) NSC Channel Islands LLC

3000 Riverchase Galleria Suite 500
Birmingham,AL35244
77-0418197
Ambulatory su CA Dignity Health
 
RELATED 390,026 2,627,514   No 0 Yes   51.000 %
(15) Plaza Surgery Center LP

525 E Plaza Drive Suite 100
Santa Maria,CA93454
77-0573567
Surgery CA HSPCC Inc
 
RELATED 0 0   No 0 Yes   50.637 %
(16) Radiation Oncology Centers of Ventura Co

1700 N ROSE AVENUE SUITE 120
OXNARD,CA93030
77-0191706
IMAGING CA Dignity Health
 
RELATED 311,348 535,103   No 0 Yes   50.000 %
(17) RBR Management LLC

91 Corporate Park Drive Suite 120
Henderson,NV89074
27-1466450
Ambulance NV Dignity Health
 
RELATED 618,764 819,829   No 0   No 50.100 %
(18) Santa Cruz Land & Building LP

1555 Soquel Drive
Santa Cruz,CA95065
77-0285236
Real Estate CA Dominican Healt
 
RELATED 0 0   No 0 Yes   86.206 %
(19) SMI Imaging LLC

6740 E Camelback Road Suite 101
Scottsdale,AZ85251
26-4000683
Imaging Cente CA Dignity Health
 
RELATED 861,955 33,099,048   No 0   No 59.650 %
(20) St Joseph's Surgery Center LP

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-1019390
Surgery TX Dignity Health
 
RELATED 1,685,752 3,199,156   No 0 Yes   79.962 %
(21) Templeton Surgery Center LLC

1310 Las Tablas Road Suite 104
Templeton,CA94365
20-2246616
Surgery CA Dignity Health
 
RELATED -96,174 1,567,642   No 0 Yes   70.454 %
(22) The Medical Pavilion at St John's

1700 Rose Avenue
Oxnard,CA93030
77-0332349
Real Estate CA Dignity Health
 
RELATED 97,457 1,737,345   No 0 Yes   25.000 %
(23) OMG Arizona LLC

130 Sutter Street 2nd Flr
San Francisco,CA94104
47-1708588
Medical Offic AZ Dignity Health
 
RELATED -1,635,514 8,832,288   No 0 Yes   56.900 %
(24) Valley Physicians Surgery Center At Nort

18330 Roscoe Blvd
Northridge,CA91328
80-0864336
Surgery CA Dignity Health
 
RELATED -513,389 743,575   No 0 Yes   49.000 %
(25) Gemcare Mercy Memorial Health System

4550 California Avenue Suite 500
Bakersfield,CA93309
47-0484764
Admin Svcs CA Dignity Health
 
RELATED -408,881 2,051,222   No 0   No 67.678 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Coastal Surgical Specialists Inc

921 Oak Park Blvd Suite 101
Pismo Beach,CA93449
74-3000596
Ambulatory Surger CA DIGNITY HEALTH
 
S Corp 1,661,260 1,320,387 50.270 % Yes  
(2) Dignity Health Insurance Ltd

PO Box 1051
  Grand Cayman IslaKY1-1102
CJ
98-1065338
Self Ins Fund CJ DIGNITY HEALTH
 
C Corp 10,390,355 45,096,257 100.000 % Yes  
(3) Dignity Health Provider Resources Inc

185 Berry Street Suite 300
San Francisco,CA94107
47-3366764
Health Plan CA DIGNITY HEALTH
 
C Corp 0 1,607,431 100.000 % Yes  
(4) Inland Health Organization of Southern C

1980 Orange Tree Lane Ste 200
Redlands,CA92374
33-0578944
Hlth Care Mgmt CA DIGNITY HEALTH
 
C Corp 11,960,852 3,326,023 100.000 % Yes  
(5) Management Services Organization of Sant

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

1400 E Church Street
Santa Maria,CA93454
77-0074057
Health Services CA DIGNITY HEALTH
 
C Corp 409,786 1,240,699 100.000 % Yes  
(7) Millenium Surgery Center Inc

9300 Stockdale Hwy 200
Bakersfield,CA93311
77-0513445
OP Surgery Svcs CA Bakersfield Mem
 
S Corp 1,472,213 2,997,086 57.980 % Yes  
(8) St Mary Health Ventures Inc

1050 Linden Avenue
Long Beach,CA90813
95-1912528
Retail Pharmacy CA DIGNITY HEALTH
 
C Corp 1,602,840 3,056,715 100.000 % Yes  
(9) Trinity Care Infusion Services

18440 Roscoe Boulevard
Northridge,CA91325
33-0828794
Home Care Med Svc CA DIGNITY HEALTH
 
C Corp 748,355 354,597 100.000 % Yes  
(10) Dignity Health Holding Corporation

185 Berry Street Suite 300
San Francisco,CA94107
46-0675371
HOLDING COMPANY NV DIGNITY HEALTH
 
C Corp 10,789,240 740,158,236 100.000 % Yes  
(11) USHW Holding Corporation

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

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

25124 Springfield Court Suite 200
Valencia,CA91355
04-3289947
Occupatnl Med SVC CA US Healthworks
 
C Corp 1,772,629 538,717,070 100.000 % Yes  
(14) US HealthWorks Medical Group of Alaska L

25124 Springfield Court Suite 200
Valencia,CA91355
63-1219117
Occupatnl Med SVC AK US Healthworks
 
C Corp 19,632,844 3,151,221 100.000 % Yes  
(15) USHW of California Inc

25124 Springfield Court Suite 200
Valencia,CA91355
95-4585828
Occupatnl Med SVC CA US Healthworks
 
C Corp 262,259,558 64,176,026 100.000 % Yes  
(16) US HealthWorks Medical Group of Florida

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654983
Occupatnl Med SVC FL US Healthworks
 
C Corp 21,584,092 6,533,119 100.000 % Yes  
(17) US HealthWorks of Indiana Inc

25124 Springfield Court Suite 200
Valencia,CA91355
35-1991196
Occupatnl Med SVC IN US Healthworks
 
C Corp 20,890,152 17,739,035 100.000 % Yes  
(18) US HealthWorks Medical Group of Maine In

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654976
Occupatnl Med SVC ME US Healthworks
 
C Corp 2,330,816 976,979 100.000 % Yes  
(19) US HealthWorks of New Jersey Inc

25124 Springfield Court Suite 200
Valencia,CA91355
04-3323869
Occupatnl Med SVC NJ US Healthworks
 
C Corp 11,708,447 3,594,593 100.000 % Yes  
(20) US HealthWorks of North Carolina Inc

25124 Springfield Court Suite 200
Valencia,CA91355
56-2029468
Occupatnl Med SVC NC US Healthworks
 
C Corp 4,856,694 2,021,519 100.000 % Yes  
(21) US HealthWorks of Pennsylvania Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2660955
Occupatnl Med SVC PA US Healthworks
 
C Corp 4,528,349 2,700,729 100.000 % Yes  
(22) USHW of Texas Inc

25124 Springfield Court Suite 200
Valencia,CA91355
74-2785392
Occupatnl Med SVC TX US Healthworks
 
C Corp 24,429,614 12,766,457 100.000 % Yes  
(23) US HealthWorks of Washington Inc

25124 Springfield Court Suite 200
Valencia,CA91355
91-1173613
Occupatnl Med SVC WA US Healthworks
 
C Corp 47,628,877 10,080,355 100.000 % Yes  
(24) RUSHWINC Properties Inc

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

25124 Springfield Court Suite 200
Valencia,CA91355
45-2494357
Occupatnl Med SVC MN US Healthworks
 
C Corp 5,195,713 1,196,074 100.000 % Yes  
(26) US HealthWorks of Tennessee Inc

25124 Springfield Court Suite 200
Valencia,CA91355
45-2697510
Occupatnl Med SVC TN US Healthworks
 
C Corp 4,882,358 1,230,691 100.000 % Yes  
(27) US HealthWorks of Illinois Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384805
Occupatnl Med SVC IL US Healthworks
 
C Corp 7,448,455 8,235,963 100.000 % Yes  
(28) US HealthWorks of Wisconsin Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384564
Occupatnl Med SVC WI US Healthworks
 
C Corp 7,730,096 9,114,234 100.000 % Yes  
(29) US HealthWorks of Kansas City Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-2754415
Occupatnl Med SVC KS US Healthworks
 
C Corp 13,619,059 16,481,799 100.000 % Yes  
(30) US HealthWorks Medical Group of Arizona

25124 Springfield Court Suite 200
Valencia,CA91355
58-2625710
Occupatnl Med SVC AZ US Healthworks
 
C Corp 6,790,515 1,784,510 100.000 % Yes  
(31) US HealthWorks Medical Group of Georgia

25124 Springfield Court Suite 200
Valencia,CA91355
58-2625714
Occupatnl Med SVC GA US Healthworks
 
C Corp 11,611,172 23,635,304 100.000 % Yes  
(32) US HealthWorks Medical Group of Ohio Inc

25124 Springfield Court Suite 200
Valencia,CA91355
31-1540841
Occupatnl Med SVC OH US Healthworks
 
C Corp 12,329,343 4,615,738 100.000 % Yes  
(33) US HealthWorks Medical Group of Kentucky

25124 Springfield Court Suite 200
Valencia,CA91355
47-3277440
Occupatnl Med SVC KY US Healthworks
 
C Corp 3,787,361 4,644,263 100.000 % Yes  
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Community Hospital San Bernardino

a 9,021,592 SEE PART VII
(2) Dignity Health Holding Corporation

a 10,534,333 SEE PART VII
(3) Dignity Health Medical Foundation

a 4,756,240 SEE PART VII
(4) DignityUSP NorCal Surgery Centers LLC

a 458,460 SEE PART VII
(5) Dominican Magnetic Resonance Imaging Center

a 110,370 SEE PART VII
(6) Golden Umbrella

a 143,058 SEE PART VII
(7) Pacific Central Coast Health Centers

a 110,147 SEE PART VII
(8) Shasta Senior Nutrition Program

a 267,438 SEE PART VII
(9) SMI Imaging LLC

a 244,346 SEE PART VII
(10) St Joseph's Surgery Center LP

a 435,516 SEE PART VII
(11) St Mary Health Ventures

a 35,109 SEE PART VII
(12) Arroyo Grande Community Hospital Foundation

b 663,167 SEE PART VII
(13) California Hospital Medical Center Foundation

b 2,658,979 SEE PART VII
(14) Dignity Health Foundation

b 1,504,975 SEE PART VII
(15) Dignity Health Foundation East Valley

b 2,125,146 SEE PART VII
(16) Dignity Health Medical Foundation

b 175,386,321 SEE PART VII
(17) DignityUSP NorCal Surgery Centers LLC

b 4,159,860 SEE PART VII
(18) Dominican Hospital Foundation

b 1,130,958 SEE PART VII
(19) French Hospital Medical Center Foundation

b 904,692 SEE PART VII
(20) Glendale Memorial Health Foundation

b 1,261,141 SEE PART VII
(21) Golden Umbrella

b 571,346 SEE PART VII
(22) Marian Regional Medical Center Foundation

b 971,519 SEE PART VII
(23) Mercy Foundation Bakersfield

b 778,047 SEE PART VII
(24) Mercy Medical Center Merced Foundation

b 462,356 SEE PART VII
(25) NICU Operating CO of Santa Cruz LLC

b 249,654 SEE PART VII
(26) Northridge Hospital Foundation

b 1,598,708 SEE PART VII
(27) Shasta Senior Nutrition Program

b 553,344 SEE PART VII
(28) St Bernardine Medical Center Foundation

b 724,068 SEE PART VII
(29) St John's Healthcare Foundation

b 947,785 SEE PART VII
(30) St Joseph's Foundation

b 1,328,206 SEE PART VII
(31) St Joseph's Foundation of San Joaquin

b 600,212 SEE PART VII
(32) St Mary Medical Center Foundation

b 2,524,280 SEE PART VII
(33) St Mary's Medical Center Foundation

b 1,031,085 SEE PART VII
(34) St Rose Dominican Health Foundation

b 2,658,150 SEE PART VII
(35) Bakersfield Memorial Hospital

c 300,000 SEE PART VII
(36) California Hospital Medical Center Foundation

c 3,499,212 SEE PART VII
(37) Community Hospital San Bernardino

c 445,363 SEE PART VII
(38) Dignity Health Foundation

c 259,014 SEE PART VII
(39) Dignity Health Foundation East Valley

c 2,404,561 SEE PART VII
(40) Dominican Health Services

c 113,582 SEE PART VII
(41) Dominican Hospital Foundation

c 2,841,495 SEE PART VII
(42) French Hospital Medical Center Foundation

c 3,022,627 SEE PART VII
(43) Glendale Memorial Health Foundation

c 3,440,843 SEE PART VII
(44) Marian Regional Medical Center Foundation

c 3,619,709 SEE PART VII
(45) Mercy Foundation Bakersfield

c 1,991,961 SEE PART VII
(46) Mercy Medical Center Merced Foundation

c 953,889 SEE PART VII
(47) Northridge Hospital Foundation

c 4,145,635 SEE PART VII
(48) St Bernardine Medical Center Foundation

c 1,108,837 SEE PART VII
(49) St John's Healthcare Foundation

c 3,332,732 SEE PART VII
(50) St Joseph's Foundation

c 4,470,579 SEE PART VII
(51) St Joseph's Foundation of San Joaquin

c 1,724,268 SEE PART VII
(52) St Mary Medical Center Foundation

c 5,194,632 SEE PART VII
(53) St Mary's Medical Center Foundation

c 1,534,779 SEE PART VII
(54) St Rose Dominican Health Foundation

c 3,537,716 SEE PART VII
(55) Dignity Health Holding Corporation

d 125,000 SEE PART VII
(56) Templeton Surgery Center LLC

d 250,457 SEE PART VII
(57) Coastal Surgical Specialists Inc

k 103,660 SEE PART VII
(58) Arroyo Grande Community Hospital Foundation

l 85,940 SEE PART VII
(59) Bakersfield Memorial Hospital

l 34,144,795 SEE PART VII
(60) California Hospital Medical Center Foundation

l 1,659,530 SEE PART VII
(61) Community Hospital San Bernardino

l 23,030,639 SEE PART VII
(62) Community Hospital San Bernardino Foundation

l 69,919 SEE PART VII
(63) Dignity Health Foundation

l 1,305,856 SEE PART VII
(64) Dignity Health Foundation East Valley

l 858,613 SEE PART VII
(65) Dignity Health Hospital Prof Liab Self-Insura

l 17,277,882 SEE PART VII
(66) Dignity Health Medical Foundation

l 37,427,076 SEE PART VII
(67) Dignity Health Workers' Comp Self-Insurance T

l 897,534 SEE PART VII
(68) DignityUSP NorCal Surgery Centers LLC

l 5,257,118 SEE PART VII
(69) Dominican Hospital Foundation

l 625,745 SEE PART VII
(70) Dominican Oaks Corporation

l 1,980,993 SEE PART VII
(71) Folsom Sierra Endoscopy Center

l 2,854,982 SEE PART VII
(72) French Hospital Medical Center Foundation

l 461,022 SEE PART VII
(73) Glendale Memorial Health Foundation

l 110,865 SEE PART VII
(74) Golden Umbrella

l 73,844 SEE PART VII
(75) Health Services of the Pacific Central Coast

l 89,314 SEE PART VII
(76) Inland Health Organization of Southern Califo

l 1,115,782 SEE PART VII
(77) Marian Regional Medical Center Foundation

l 471,686 SEE PART VII
(78) Mercy Davis Cancer Center Management Co LLC

l 2,453,498 SEE PART VII
(79) Mercy Foundation Bakersfield

l 340,796 SEE PART VII
(80) Mercy McMahon Terrace

l 81,643 SEE PART VII
(81) Mercy Medical Center Merced Foundation

l 211,888 SEE PART VII
(82) NICU Operating CO of Santa Cruz LLC

l 6,677,336 SEE PART VII
(83) Northridge Hospital Foundation

l 756,160 SEE PART VII
(84) Pacific Central Coast Health Centers

l 7,072,982 SEE PART VII
(85) Plaza Surgery Center LP

l 1,121,879 SEE PART VII
(86) Port City Operating Company LLC

l 3,329,828 SEE PART VII
(87) Saint Francis Memorial Hospital

l 22,513,110 SEE PART VII
(88) Sierra Nevada Memorial Miners Hospital

l 15,384,356 SEE PART VII
(89) St Bernardine Medical Center Foundation

l 466,797 SEE PART VII
(90) St John's Healthcare Foundation

l 710,064 SEE PART VII
(91) St Joseph's Foundation

l 145,880 SEE PART VII
(92) St Joseph's Foundation of San Joaquin

l 348,320 SEE PART VII
(93) St Joseph's Surgery Center LP

l 4,764,012 SEE PART VII
(94) St Mary Health Ventures

l 3,599,797 SEE PART VII
(95) St Mary Medical Center Foundation

l 991,939 SEE PART VII
(96) St Mary's Medical Center Foundation

l 554,042 SEE PART VII
(97) St Rose Dominican Health Foundation

l 929,032 SEE PART VII
(98) Trinity Care Infusion Services

l 113,377 SEE PART VII
(99) Bakersfield Memorial Hospital

m 3,334,416 SEE PART VII
(100) Dignity Health Hospital Prof Liab Self-Insura

m 90,666,744 SEE PART VII
(101) Dignity Health Medical Foundation

m 36,235,248 SEE PART VII
(102) Dignity Health Workers' Comp Self-Insurance T

m 61,708,027 SEE PART VII
(103) Folsom Sierra Endoscopy Center

m 7,257,902 SEE PART VII
(104) Inland Health Organization of Southern Califo

m 1,556,158 SEE PART VII
(105) Port City Operating Company LLC

m 284,679 SEE PART VII
(106) Saint Francis Memorial Hospital

m 309,416 SEE PART VII
(107) Port City Operating Company LLC

r 249,573,552 SEE PART VII
(108) DignityUSP NorCal Surgery Centers LLC

s 2,279,527 SEE PART VII
(109) Dominican Health Services

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

s 1,492,770 SEE PART VII
(111) NICU Operating CO of Santa Cruz LLC

s 7,013,458 SEE PART VII
(112) NSC Channel Islands LLC

s 159,464 SEE PART VII
(113) RBR Management LLC

s 421,682 SEE PART VII
(114) Santa Cruz Land & Building LP

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

s 1,461,983 SEE PART VII
(116) St Mary Professional Building

s 227,355 SEE PART VII
(117) Gemcare Mercy Memorial Health System

s 1,302,550 SEE PART VII
Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2015
Schedule R (Form 990) 2015
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R, Part V, Line 2 column (c) PART V, LINE 1A - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT TO CERTAIN RELATED ORGANIZATIONS (WHOLLY-OWNED ORGANIZATIONS, MEDICAL FOUNDATIONS AND JOINT VENTURES). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE AMOUNTS CHARGED FOR SUCH AGREEMENTS. SUCH CHARGES REPRESENT FAIR MARKET VALUE OF THE AMOUNTS CHARGED UNDER THESE AGREEMENTS. DIGNITY HEALTH PROVIDES LOANS TO RELATED ORGANIZATIONS (HOSPITALS, JOINT VENTURES AND WHOLLY-OWNED ORGANIZATIONS). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE INTEREST PAYMENTS CHARGED FOR THESE LOANS. PART V, LINE 1B, AND 1C - DIGNITY HEALTH AND ITS HOSPITAL FACILITIES ARE SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS OPERATE FOR THE BENEFIT OF, TO RAISE FUNDS FOR, OR TO CARRY OUT THE PURPOSES OF DIGNITY HEALTH AND ITS HOSPITALS. AS A RESULT, PAYMENTS ARE MADE DIRECTLY TO DIGNITY HEALTH FROM THE FOUNDATIONS OR DIRECTLY TO THE FOUNDATIONS FROM DIGNITY HEALTH. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" INCLUDE FUNDS EXPENDED BY DIGNITY HEALTH ON BEHALF OF THE FOUNDATIONS FOR OPERATIONAL EXPENSES. AMOUNTS REPORTED AS TRANSACTION TYPE "C" REPRESENT FUNDS RECEIVED AS GRANTS BY DIGNITY HEALTH HOSPITALS FROM THE FOUNDATIONS. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" ALSO INCLUDE FUNDING SUPPORT TO DIGNITY HEALTH MEDICAL FOUNDATION (DHMF), WHICH OPERATES CLINICS IN THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS THROUGHOUT CALIFORNIA. DIGNITY HEALTH ALSO PROVIDES FUNDING SUPPORT TO OTHER EXEMPT ORGANIZATIONS THAT PROVIDE SERVICES TO COMMUNITIES SERVED BY DIGNITY HEALTH FACILITIES WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". DIGNITY HEALTH ALSO PROVIDES CAPITAL FUNDING TO CERTAIN RELATED ORGANIZATIONS, WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". PART V, LINE 1D - DIGNITY HEALTH made LOANS TO AND LOAN GUARANTEES ON BEHALF OF VARIOUS RELATED ORGANIZATIONS. AMOUNTS REPORTED AS TRANSACTION TYPE "D" REPRESENT THE FAIR MARKET VALUE OF THE LOANS ISSUED DURING THE YEAR AND GUARANTEE FEES RECORDED DURING THE YEAR. PART V, LINE 1K - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT FROM CERTAIN RELATED ORGANIZATIONS (JOINT VENTURES). AMOUNTS REPORTED AS TRANSACTION TYPE "K" REPRESENT THE AMOUNTS PAID FOR SUCH AGREEMENTS. PART V, LINE 1L - DIGNITY HEALTH FACILITIES PERFORM VARIOUS SERVICES FOR OTHER RELATED ORGANIZATIONS. BELOW IS A SUMMARY OF THE TRANSACTIONS AMONG RELATED ORGANIZATIONS FOR SUCH ACTIVITIES. DIGNITY HEALTH'S CONTROLLED ENTITIES ARE ASSESSED AN AMOUNT TO COVER THE SYSTEM OFFICE OPERATIONS. IN ADDITION, AN EXPENSE IS ALSO ASSESSED TO COVER CENTRALIZED INFORMATION TECHNOLOGY COSTS OF THE ORGANIZATION, CENTRALIZED ACCOUNTS PAYABLE, PAYROLL, ACCOUNTING, DECISION SUPPORT, AND CERTAIN OTHER MANAGEMENT SERVICES. IN FY16, DIGNITY HEALTH HOSPITALS ALSO PERFORMED SERVICES FOR OTHER RELATED ORGANIZATIONS. SERVICES INCLUDED PLANT MAINTENANCE, LAUNDRY SERVICES, CENTRAL STERILIZATION SERVICES, CATERING SERVICES FOR PATIENT NOURISHMENT, AND OTHER SERVICES AS DEEMED NECESSARY. THE SERVICES PERFORMED ARE REIMBURSED AT COST. PART V, LINE 1M - PHYSICIAN CLINIC SUPPORT SERVICES ARE PROVIDED TO DIGNITY HEALTH HOSPITALS BY DHMF. DHMF OPERATES CLINICS WITH LOCATIONS THROUGHOUT CALIFORNIA. AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE PAYMENTS MADE TO DHMF FOR THE HOSPITALISTS AND RISK POOL PROGRAMS. DIGNITY HEALTH IS SELF-INSURED FOR WORKERS' COMPENSATION BENEFITS AND FOR HOSPITAL PROFESSIONAL AND GENERAL LIABILITY RISKS. DIGNITY HEALTH MAINTAINS SEPARATE TRUSTS FOR THESE PROGRAMS FROM WHICH CLAIMS AND RELATED EXPENSES AND COSTS OF ADMINISTERING THE PLANS ARE PAID. DIGNITY HEALTH HOSPITALS FUND THE TRUSTS, SUCH THAT OVER TIME, ASSETS HELD EQUAL LIABILITIES FOR CLAIMS INCURRED. THE AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE CASH TRANSFERRED FROM DIGNITY HEALTH TO THE TRUSTS FOR THE FY16 FUNDING OF THE SELF-INSURANCE PROGRAMS. PART V, LINE 1R - AMOUNT REPORTED UNDER TRANSACTION TYPE "R" REPRESENTS INITITAL CAPITAL FUNDING FOR A TAX-EXEMPT JOINT VENTURE. PART V, LINE 1S - AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS.
Schedule R (Form 990) 2015

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