TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) PAUL KIRINCIC...................................................................... CHAIR	2.00 ................. 1.00	X	X		0	0
(2) DAVID HILL...................................................................... VICE CHAIR	2.00 ................. 0.00	X	X		0	0
(3) ANDREA SCHULTZ...................................................................... SECRETARY	2.00 ................. 2.00	X	X		0	0
(4) ROBERT PEIRCE...................................................................... TREASURER	2.00 ................. 0.00	X	X		0	0
(5) JOSHUA ADLER MD...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(6) JOSEPH C EUPHRAT...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(7) ANN KAO MD...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(8) MARK R LARET...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(9) DENISE LUCY EDD...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(10) GENE MARIE O'CONNELL RN MS...................................................................... BOARD MEMBER	2.00 ................. 2.00	X			0	0
(11) MARA PEREZ PHD...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(12) WALTER B ROSE...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0
(13) STEVEN A SCHROEDER MD...................................................................... BOARD MEMBER THROUGH 5/2018	2.00 ................. 0.00	X			0	0
(14) TIM SOWERBY MD...................................................................... BOARD MEMBER THROUGH 1/2018	2.00 ................. 2.00	X			0	0
(15) LEE DOMANICO...................................................................... CEO/EX-OFFICIO VOTING BOARD MEMBER	46.00 ................. 4.00	X	X		1,441,325	22,630
(16) JAMES P MCMANUS...................................................................... CHIEF FINANCIAL OFFICER	46.00 ................. 4.00		X		676,816	43,519
(17) JON D FRIEDENBERG...................................................................... CHIEF OPERATING OFFICER	46.00 ................. 4.00			X	708,242	48,336

(A) Name and business address	(B) Description of services	(C) Compensation
PRIMA MEDICAL FOUNDATION 9 COMMERCIAL BOULEVARD SUITE 200 NOVATO,CA94949	PHYSICIAN SERVICES	5,966,616
MARIN HOSPITALIST MEDICAL GROUP PO BOX 708 NOVATO,CA94948	PHYSICIAN SERVICES	3,816,714
MARIN CANCER CARE INC 1350 SOUTH ELISEO SUITE 200 GREENBRAE,CA94904	PHYSICIAN SERVICES	2,250,225
TECH KNOWLEDGE ASSOCIATES LLC 1 CENTERPOINTE DRIVE SUITE 200 LA PALMA,CA90623	BIOMED MANAGEMENT SERVICES	1,951,682
ANESTHESIOLOGY CONSULTANTS OF MARIN PO BOX 527 LARKSPUR,CA94977	ANESTHESIA SERVICES	1,913,810
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 60

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

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 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

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

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

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

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

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (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.

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) .

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).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 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.

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

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) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

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

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (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?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

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

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

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

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization MARIN GENERAL HOSPITAL

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization MARIN GENERAL HOSPITAL		Employer identification number 94-2823538

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization MARIN GENERAL HOSPITAL			Employer identification number 94-2823538
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

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

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Part I-A

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

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
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) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

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

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

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(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) 2018

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)

Yes

(b)

Amount

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

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

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

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

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

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

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

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

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

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

Yes

23,747

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

23,747

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1:	THE ORGANIZATION PAYS MEMBERSHIP DUES TO (I) THE CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS, AND (II) THE DISTRICT HOSPITAL LEADERSHIP FORUM. A PORTION OF THESE DUES PAID WERE USED FOR LOBBYING PURPOSES.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

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 ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

Endowment Funds. Complete if the organization answered "Yes" 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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" 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 .....
b	Buildings ....	27,495,380	26,521,955	973,425
c	Leasehold improvements	83,806,322	58,246,841	25,559,481
d	Equipment ....	161,087,982	121,081,465	40,006,517
e	Other .....	31,035,154	940,227	30,094,927
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				96,634,350

Schedule D (Form 990) 2018

Page 3

Part VII

InvestmentsOther 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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram 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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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.)...........

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
WORKERS COMPENSATION LIABILITY	7,147,515
POST-RETIREMENT HEALTH OBLIGATION	9,235,647
DUE TO RELATED ORGANIZATIONS	895,280
PENSION BENEFIT OBLIGATION	24,560,673
PROFESSIONAL LIABILITY OBLIGATION	1,883,000
MASTER ALLIANCE AGREEMENT CONTRACT LIABILITY	20,000,000
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	63,722,115
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) 2018

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

PART X, LINE 2:

MGH IS ORGANIZED AS A NOT-FOR-PROFIT ENTITY UNDER THE GENERAL NONPROFIT CORPORATION LAWS OF THE STATE OF CALIFORNIA. EXEMPTIONS FROM FEDERAL INCOME TAXATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA FRANCHISE TAXATION HAVE BEEN OBTAINED. CERTAIN ACTIVITIES AND SUBSIDIARIES MAY BE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other 40000.0000000000 %

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

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

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	1,483,852		1,483,852	0.350 %
b	Medicaid (from Worksheet 3, column a) . . . . .	51,899,120	33,585,161	18,313,959	4.360 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	14,674		14,674	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	53,397,646	33,585,161	19,812,485	4.710 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	579,145	6,220	572,925	0.140 %
f	Health professions education (from Worksheet 5) . . .	1,753,467		1,753,467	0.420 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	27,120,472		27,120,472	6.460 %
j	Total. Other Benefits . .	29,453,084	6,220	29,446,864	7.020 %
k	Total. Add lines 7d and 7j .	82,850,730	33,591,381	49,259,349	11.730 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	16,000	16,000	0 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	16,000	16,000	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

4,844,641

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

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

Section B. Medicare

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

97,465,754

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

160,829,764

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

-63,364,010

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2018

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?1Name, 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)					Other (describe)
1	MARIN GENERAL HOSPITAL DBA MARINHEALTH MEDICAL CENTER 250 BON AIR ROAD GREENBRAE,CA94904 WWW.MYMARINHEALTH.ORG 110000361	X	X	X	ACUTE PSYCHIATRIC HOSPITAL

Schedule H (Form 990) 2018

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)

	MARIN GENERAL HOSPITAL DBA MARINHEALTH
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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

Yes

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): HTTPS://WWW.MYMARINHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/

Other website (list url):

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

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

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

Yes

If "Yes" (list url): HTTPS://WWW.MYMARINHEALTH.ORG/ABOUT-US/COMMUNITY-BENEFIT/

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

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

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

12b

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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MARIN GENERAL HOSPITAL DBA MARINHEALTH
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

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

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

The FAP was widely available on a website (list url):

WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS

The FAP application form was widely available on a website (list url):

WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS

A plain language summary of the FAP was widely available on a website (list url):
WWW.MYMARINHEALTH.ORG/PATIENTS-VISITORS/MEDICAL-CENTER-PATIENTS-VISITORS

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	MARIN GENERAL HOSPITAL DBA MARINHEALTH
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	MARIN GENERAL HOSPITAL DBA MARINHEALTH
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

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, 16j, 18e, 19e, 20e, 21c, 21d, 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
MARIN GENERAL HOSPITAL DBA MARINHEALTH	PART V, SECTION B, LINE 5: COMMUNITY INPUT WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS AND LEADERS THROUGH KEY INFORMANT INTERVIEWS AND FOCUS GROUPS.INDIVIDUALS IDENTIFIED BY THE MARIN COUNTY CHNA COLLABORATIVE AS HAVING VALUABLE KNOWLEDGE, INFORMATION, AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE INTERVIEWED. INTERVIEWEES INCLUDED REPRESENTATIVES FROM THE LOCAL PUBLIC HEALTH DEPARTMENT AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. OTHER INDIVIDUALS FROM VARIOUS SECTORS WITH EXPERTISE OF LOCAL HEALTH NEEDS WERE ALSO CONSULTED. A TOTAL OF 20 KEY INFORMANT INTERVIEWS WERE CONDUCTED DURING THE NEEDS ASSESSMENT PROCESS IN SEPTEMBER/OCTOBER 2015 WITH LEADERS/REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS: APPLE FAMILY WORKS, CANAL ALLIANCE, COASTAL ALLIANCE, EXTRAFOOD.ORG, HOMEWARD BOUND, HUCKLEBERRY YOUTH PROGRAM, KAISER PERMANENTE MEDICAL CENTER, MARIN CENTER FOR INDEPENDENT LIVING, MARIN COMMUNITY CLINICS, MARIN COUNTY BOARD OF SUPERVISORS, MARIN COUNTY HEALTH & HUMAN SERVICES, MARIN COUNTY OFFICE OF EDUCATION, MARIN GENERAL HOSPITAL, NOVATO COMMUNITY HOSPITAL, ROTACARE CLINIC OF SAN RAFAEL, WHISTLESTOP, MARIN YMCA, MARIN CITY COMMUNITY SERVICES DISTRICT, THE SAN RAFAEL POLICE DEPARTMENT, AND THE NOVATO UNIFIED SCHOOL DISTRICT.ADDITIONALLY, EIGHT FOCUS GROUPS WERE CONDUCTED THROUGHOUT MARIN COUNTY DURING OCTOBER 2015. THESE GROUPS WERE INTENTIONALLY SAMPLED TO REACH SPECIFIC SUBPOPULATIONS OF THE COUNTY THAT WERE IDENTIFIED AS HIGH-RISK POPULATIONS BY THE MARIN COUNTY CHNA COLLABORATIVE. THESE SUBPOPULATIONS INCLUDED YOUTH, ADULTS IN RECOVERY FROM SUBSTANCE ABUSE, INDIVIDUALS EXPERIENCING HOMELESSNESS, AND RESIDENTS IN MARIN CITY, NOVATO, SAN GERONIMO, THE CANAL DISTRICT, AND WEST MARIN. FOCUS GROUPS WERE MONOLINGUAL, CONDUCTED IN EITHER ENGLISH OR SPANISH.
MARIN GENERAL HOSPITAL DBA MARINHEALTH	PART V, SECTION B, LINE 6A: MHMC CONDUCTED ITS 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN CONJUNCTION WITH HEALTHY MARIN PARTNERSHIP, WHICH INCLUDES ALL ACUTE-CARE HOSPITALS IN MARIN COUNTY: MARINHEALTH MEDICAL CENTER, KAISER PERMANENTE-SAN RAFAEL, AND NOVATO COMMUNITY HOSPITAL.
MARIN GENERAL HOSPITAL DBA MARINHEALTH	PART V, SECTION B, LINE 6B: THE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES WHO ARE MEMBERS OF HEALTHY MARIN PARTNERSHIP WITH WHICH MARINHEALTH MEDICAL CENTER CONDUCTED ITS 2016 CHNA INCLUDE: MARIN COUNTY HEALTH & HUMAN SERVICES, MARIN COMMUNITY FOUNDATION, MARIN COUNTY OFFICE OF EDUCATION, AND REPRESENTATIVES OF THE BUSINESS COMMUNITY.
MARIN GENERAL HOSPITAL DBA MARINHEALTH	PART V, SECTION B, LINE 11: THE HOSPITAL'S COMMUNITY BENEFIT ADVISORY COMMITTEE, WHICH INCLUDES COMMUNITY REPRESENTATIVES, APPLIED A CRITERIA-BASED DECISION MAKING PROCESS TO EXAMINE THE HEALTH NEEDS IDENTIFIED THROUGH THE CHNA PROCESS, TO SELECT THE COMMUNITY HEALTH NEEDS IT WILL ADDRESS, AND TO DEVELOP AN IMPLEMENTATION STRATEGY PLAN TO ADDRESS THE SELECTED HEALTH NEEDS. THESE STRATEGIES BUILD ON THE HOSPITAL'S ASSETS AND RESOURCES.IN ORDER TO SELECT THE HOSPITAL PRIORITIES, THE COMMUNITY BENEFIT ADVISORY COMMITTEE REVIEWED THE CHNA DATA AND COMMUNITY-IDENTIFIED PRIORITIES, UPDATED ITS PRIORITIZATION CRITERIA FROM PREVIOUS CHNA PERIODS, AND REVIEWED THE AVAILABLE COMMUNITY RESOURCES FOR THE COMMUNITY-IDENTIFIED PRIORITIES. THE COMMUNITY BENEFIT ADVISORY COMMITTEE USED A NUMERICAL RANKING PROCESS TO IDENTIFY THE COMMUNITY NEEDS WHERE THE HOSPITAL COULD BUILD ON ITS PAST COMMUNITY BENEFIT WORK AND OTHER COMMUNITY RESOURCES TO ADDRESS THE COMMUNITY PRIORITIES. THE CRITERIA USED TO RANK THE COMMUNITY PRIORITIES INCLUDE: SEVERITY; DISPARITIES; PREVENTION; LEVERAGE; AND HOSPITAL ASSETS. SPECIFIC STRATEGIES TO ADDRESS THE PRIORITIZED COMMUNITY HEALTH NEEDS WERE IDENTIFIED BY REVIEWING THE IMPACT OF PAST GRANTS OR PROGRAMS IN THE PRIORITY AREAS, EVIDENCE-BASED STRATEGIES, AND AVAILABLE HOSPITAL AND COMMUNITY RESOURCES.THE HOSPITAL SELECTED ACCESS TO HEALTH CARE AS ITS SELECTED HEALTH PRIORITY. ACCESS TO HEALTH CARE IS A HEALTH NEED BECAUSE THE ABILITY TO UTILIZE AND PAY FOR COMPREHENSIVE, AFFORDABLE, QUALITY PHYSICAL, MENTAL AND ORAL HEALTH CARE IS ESSENTIAL TO MAXIMIZE THE PREVENTION, EARLY INTERVENTION, AND TREATMENT OF HEALTH CONDITIONS SUCH AS OBESITY, CANCER, HEART DISEASE, ASTHMA, ORAL HEALTH, MENTAL HEALTH, SUBSTANCE ABUSE, AND DIABETES. IN ORDER TO INCREASE THE NUMBER OF INDIVIDUALS WHO HAVE ACCESS TO AND RECEIVE APPROPRIATE HEALTH CARE SERVICES IN MARIN COUNTY, THE HOSPITAL HAS OUTLINED THE FOLLOWING STRATEGIES: (I) PARTICIPATE IN GOVERNMENT-SPONSORED PROGRAMS FOR LOW-INCOME INDIVIDUALS, I.E., MEDI-CAL MANAGED CARE AND MEDI-CAL FEE-FOR-SERVICE; (II) PROVIDE CHARITY CARE FOR QUALIFYING INDIVIDUALS; (III) GRANT MAKING TO SUPPORT FEDERALLY QUALIFIED HEALTH CENTERS OR FREE CLINICS (E.G. MARIN COMMUNITY CLINIC AND ROTACARE FREE CLINIC) TO STRENGTHEN COORDINATED CARE FOR VULNERABLE, AT-RISK, LOW-INCOME, OR UNINSURED INDIVIDUALS; AND (IV) GRANT MAKING OR LEVERAGING INTERNAL RESOURCES TO SUPPORT COMMUNITY-BASED SERVICES THAT INCREASE ACCESS TO CULTURALLY COMPETENT HEALTH CARE, CASE MANAGEMENT, ADVOCACY, EDUCATION AND/OR SCREENING AND EARLY INTERVENTION FOR VULNERABLE, AT-RISK, LOW-INCOME, OR UNINSURED INDIVIDUALS. PLANS TO MONITOR THE HOSPITAL'S STRATEGIES WILL INCLUDE THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES, SUCH AS THE NUMBER OF DOLLARS SPENT, NUMBER OF PEOPLE REACHED/SERVED, AND NUMBER OF GRANTS MADE.THE HOSPITAL DOES NOT INTEND TO SPECIFICALLY ADDRESS THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE CHNA, FOR THE FOLLOWING REASONS:OBESITY AND DIABETES WILL NOT BE ADDRESSED DUE TO RESOURCE CONSTRAINTS. THE HOSPITAL DOES ADDRESS THIS NEED INDIRECTLY THROUGH PARTICIPATION IN THE HEALTHY MARIN PARTNERSHIP COLLABORATIVE, HOWEVER. ALSO, OTHER HOSPITAL SYSTEMS WITH CONSIDERABLE EXPERTISE ARE FOCUSING ON OBESITY PREVENTION.ECONOMIC AND HOUSING INSECURITY AND EDUCATION WILL NOT BE ADDRESSED DUE TO RESOURCE CONSTRAINTS AND ITS LIMITED ABILITY TO HAVE A MEANINGFUL IMPACT ON EMPLOYMENT, INCOME, OR EDUCATION ACHIEVEMENT. ADDITIONALLY, THE HOSPITAL ALREADY ACKNOWLEDGES THE IMPACT OF SOCIOECONOMIC STATUS ON AN INDIVIDUAL'S HEALTH STATUS BY FOCUSING ITS COMMUNITY BENEFIT CONTRIBUTIONS ON ACCESS TO CARE FOR VULNERABLE, AT-RISK, OR LOW-INCOME INDIVIDUALS.MENTAL HEALTH WILL NOT BE DIRECTLY ADDRESSED DUE TO RESOURCE CONSTRAINTS. HOWEVER, THE HEALTH NEED IS BEING PARTLY ADDRESSED VIA ITS CONTRIBUTION TO THE ACCESS TO CARE HEALTH NEED AND ITS PRIORITY TO INCREASE CARE TO THOSE IN NEED OF MENTAL HEALTH SERVICES.SUBSTANCE ABUSE WILL NOT BE ADDRESSED DUE TO RESOURCE CONSTRAINTS AND THE HOSPITAL'S LIMITED ABILITY TO MAKE A MEANINGFUL IMPACT.ORAL HEALTH WILL NOT BE ADDRESSED DUE TO RESOURCE CONSTRAINTS; HOWEVER, THROUGH ITS GRANTS PROGRAM, THE HOSPITAL SUPPORTS ACCESS TO FEDERALLY QUALIFIED HEALTH CENTERS, WHICH PROVIDES DENTAL SERVICES.VIOLENCE AND UNINTENTIONAL INJURY WILL NOT BE ADDRESSED DUE TO RESOURCE CONSTRAINTS AND THE HOSPITAL'S LIMITED ABILITY TO MAKE A MEANINGFUL IMPACT.

Schedule H (Form 990) 2018

Page 9

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?55
Name and address		Type of Facility (describe)
1	1 - MARINHEALTH ADULT AFTER-HOURS CARE 75 ROWLAND WAY SUITE 101 NOVATO,CA94945	ADULT AFTER-HOURS CLINIC
2	2 - MARINHEALTH BONE DENSITY TESTING 100A DRAKES LANDING ROAD SUITE 140 GREENBRAE,CA94904	BONE DENSITY TESTING CENTER
3	3 - MARINHEALTH BRADEN DIABETES CENTER 1100 SOUTH ELISEO DRIVE SUITE 2 GREENBRAE,CA94904	DIABETES HEALTH CLINIC
4	4 - MARINHEALTH BREAST HEALTH CENTER 100A DRAKES LANDING ROAD SUITE 140 GREENBRAE,CA94904	BREAST HEALTH CLINIC
5	5 - MARINHEALTH CANCER CARE 1350 S ELISEO DRIVE GREENBRAE,CA94904	CANCER HEALTH CLINIC
6	6 - MARINHEALTH CARDIOVASCULAR MEDICINE 75 ROWLAND WAY SUITE 250 NOVATO,CA94945	CARDIOVASCULAR CLINIC
7	7 - MARINHEALTH CARDIOVASCULAR MEDICINE 651 FIRST STREET WEST SUITE L SONOMA,CA95476	CARDIOVASCULAR CLINIC
8	8 - MARINHEALTH CARDIOVASCULAR PERF CTR 75 ROWLAND WAY SUITE 250 NOVATO,CA94945	CARDIOVASCULAR PERFORMANCE CENTER
9	9 - MARINHEALTH CRIT CARE & PULMONOLOGY 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR,CA94939	CRITICAL CARE & PULMONOLOGY CLINIC
10	10 - MARINHEALTH ENDOCRINE & DIABETES CARE 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	ENDOCRINE & DIABETES CLINIC
11	11 - MARINHEALTH ENDOCRINE & DIABETES CARE 900 SOUTH ELISEO DRIVE SUITE 201 GREENBRAE,CA94904	ENDOCRINE & DIABETES CLINIC
12	12 - MARINHEALTH FAMILY MEDICINE 75 ROWLAND WAY SUITE 230 NOVATO,CA94945	FAMILY MEDICINE CLINIC
13	13 - MARINHEALTH BREAST SURGICAL ONCOLOGY 1350 S ELISEO DRIVE SUITE 300 GREENBRAE,CA94904	BREAST/GYNECOLOGIC SURGERY CENTER
14	14 - MARINHEALTH FAMILY MEDICINE 706 D STREET SAN RAFAEL,CA94901	FAMILY MEDICINE CLINIC
15	15 - MARINHEALTH GENERAL & COLORECTAL SURGERY 5 BON AIR ROAD SUITE 101 LARKSPUR,CA94939	SURGERY CENTER
16	16 - MARINHEALTH GENERAL SURGERY 75 ROWLAND WAY SUITE 100 NOVATO,CA94945	SURGERY CENTER
17	17 - MARINHEALTH HEARING & SPEECH 1350 S ELISEO DRIVE SUITE 130 LARKSPUR,CA94939	HEARING & SPEECH THERAPY FACILITY
18	18 - MARINHEALTH INFECTIOUS DISEASE 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR,CA94939	INFECTIOUS DISEASE CLINIC
19	19 - MARINHEALTH INTEGRATIVE WELLNESS CENTER 1350 S ELISEO DRIVE SUITE 140 GREENBRAE,CA94904	INTEGRATIVE WELLNESS CENTER
20	20 - MARINHEALTH INTERNAL MEDICINE 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	INTERNAL MEDICINE CLINIC
21	21 - MARINHEALTH INTERNAL MEDICINE 23 REED BOULEVARD SUITE 120 MILL VALLEY,CA94941	INTERNAL MEDICINE CLINIC
22	22 - MARINHEALTH INTERNAL MEDICINE 1341 S ELISEO DRIVE SUITE 200 GREENBRAE,CA94904	INTERNAL MEDICINE CLINIC
23	23 - MARINHEALTH MEN'S CARE CENTER 1240 S ELISEO DRIVE SUITE 101 GREENBRAE,CA94904	MEN'S CARE CENTER
24	24 - MARINHEALTH OBGYN 100A DRAKES LANDING ROAD SUITE 225 GREENBRAE,CA94904	OB/GYN CLINIC
25	25 - MARINHEALTH OBGYN 75 ROWLAND WAY SUITE 275 NOVATO,CA94945	OB/GYN CLINIC
26	26 - MARINHEALTH ORTHOPEDIC SURGERY 347 ANDRIEUX STREET SONOMA,CA95476	ORTHOPEDIC SURGERY CENTER
27	27 - MARINHEALTH OUTPATIENT IMAGING CENTER 1240 S ELISEO DRIVE SUITE 103 GREENBRAE,CA94904	OUTPATIENT IMAGING CENTER
28	28 - MARINHEALTH OUTPATIENT MRI 1260 S ELISEO DRIVE SUITE 100 GREENBRAE,CA94904	OUTPATIENT MRI CENTER
29	29 - MARINHEALTH OUTPATIENT PHYS THERAPY 1350 S ELISEO DRIVE SUITE 250 GREENBRAE,CA94904	OUTPATIENT PHYSICAL THERAPY
30	30 - MARINHEALTH PED AFTER-HOURS CARE 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR,CA94939	AFTER-HOURS PEDIATRIC CARE CLINIC
31	31 - MARINHEALTH PEDIATRIC CARE 651 FIRST STREET WEST SUITE H SONOMA,CA95476	PEDIATRIC CARE CLINIC
32	32 - MARINHEALTH PEDIATRIC CARE 4000 CIVIC CENTER DRIVE SUITE 205 SAN RAFAEL,CA94903	PEDIATRIC CARE CLINIC
33	33 - MARINHEALTH PRE-ADMISSION CENTER 1300 S ELISEO DRIVE SUITE 101 GREENBRAE,CA94904	PRE-ADMISSION CENTER
34	34 - MARINHEALTH PRIMARY CARE 75 ROWLAND WAY SUITE 100 NOVATO,CA94945	PRIMARY CARE CENTER
35	35 - MARINHEALTH PRIMARY CARE 1100 LARKSPUR LANDING CIRCLE SUITE 10 LARKSPUR,CA94939	PRIMARY CARE CENTER
36	36 - MARINHEALTH PRIMARY CARE 4000 CIVIC CENTER DRIVE SUITE 200 SAN RAFAEL,CA94903	PRIMARY CARE CENTER
37	37 - MARINHEALTH PRIMARY CARE 3 HARBOR DRIVE SUITE 111 SAUSALITO,CA94965	PRIMARY CARE CENTER
38	38 - MARINHEALTH PRIMARY CARE 651 1ST STREET WEST SUITE H SONOMA,CA95476	PRIMARY CARE CENTER
39	39 - MARINHEALTH PSYCHIATRY 100A DRAKES LANDING ROAD SUITE 225 GREENBRAE,CA94904	PSYCHIATRY CLINIC
40	40 - MARINHEALTH PSYCHIATRY 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	PSYCHIATRY CLINIC
41	41 - MARINHEALTH RHEUMATOLOGY 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	RHEUMATOLOGY CLINIC
42	42 - MARINHEALTH RHEUMATOLOGY 2 BON AIR ROAD SUITE 150 LARKSPUR,CA94939	RHEUMATOLOGY CLINIC
43	43 - MARINHEALTH SUPPORTIVE CARE CENTER 1350 S ELISEO DRIVE SUITE 130 GREENBRAE,CA94904	SUPPORTIVE CARE CENTER
44	44 - MARINHEALTH UROGYNECOLOGY 651 1ST STREET WEST SUITE L SONOMA,CA95476	UROGYNECOLOGY CLINIC
45	45 - MARINHEALTH UROGYNECOLOGY 75 ROWLAND WAY SUITE 275 NOVATO,CA94945	UROGYNECOLOGY CLINIC
46	46 - MARINHEALTH UROGYNECOLOGY 100A DRAKES LANDING ROAD SUITE 225 GREENBRAE,CA94904	UROGYNECOLOGY CLINIC
47	47 - MARINHEALTH UROLOGY 3520 BEARD ROAD NAPA,CA94558	UROLOGY CLINIC
48	48 - MARINHEALTH UROLOGY 1240 S ELISEO DRIVE SUITE 200 GREENBRAE,CA94904	UROLOGY CLINIC
49	49 - MARINHEALTH UROLOGY 1496 PROFESSIONAL DRIVE SUITE 603 PETALUMA,CA94954	UROLOGY CLINIC
50	50 - MARINHEALTH UROLOGY 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	UROLOGY CLINIC
51	51 - MARINHEALTH UROLOGY 651 FIRST STREET WEST SUITE L SONOMA,CA95476	UROLOGY CLINIC
52	52 - MARINHEALTH VASCULAR MEDICINE 75 ROWLAND WAY SUITE 200 NOVATO,CA94945	VASCULAR MEDICINE CLINIC
53	53 - MARINHEALTH VASCULAR MEDICINE 651 FIRST STREET WEST SUITE K SONOMA,CA95476	VASCULAR MEDICINE CLINIC
54	54 - MARINHEALTH VASCULAR MEDICINE 2281 CLEVELAND AVENUE SANTA ROSA,CA95403	VASCULAR MEDICINE CLINIC
55	55 - MARINHEALTH VASCULAR MEDICINE 1100 S ELISEO DRIVE SUITE 2A GREENBRAE,CA94904	VASCULAR MEDICINE CLINIC

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	TO BE ELIGIBLE FOR FREE CARE THE ORGANIZATION USES THE FEDERAL POVERTY GUIDELINE (FPG) FOR FAMILY INCOMES THAT ARE AT OR BELOW 400% OF FPG. IN ADDITION, THE FOLLOWING DISCOUNTS APPLY TO UNINSURED PATIENTS: 1) SPECIAL CIRCUMSTANCES CHARITY CARE: A COMPLETE OR PARTIAL WRITE-OFF IN CIRCUMSTANCES INCLUDING BUT NOT LIMITED TO BANKRUPTCY, HOMELESSNESS, DECEASED, INELIGIBLE FOR MEDICARE/MEDI-CAL, OR IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING THE HOSPITAL'S CHARITY CARE ELIGIBILITY CRITERIA. 2) CATASTROPHIC CHARITY CARE: FULL WRITE-OFF WHEN THE FINANCIAL RESPONSIBILITY EXCEEDS 10% OF PATIENT'S FAMILY INCOME.3) UNINSURED PATIENT DISCOUNT: A WRITE-OFF OF A PORTION OF COVERED SERVICES NO GREATER THAN THE CURRENT AVERAGE COMMERCIAL FEE-FOR-SERVICE DISCOUNT WITH MANAGED CARE PAYERS FOR PATIENTS WHOSE BENEFITS UNDER INSURANCE OR A GOVERNMENT PROGRAM HAVE BEEN EXHAUSTED PRIOR TO ADMISSION. 4) PROMPT PAYMENT DISCOUNT: ADDITIONAL DISCOUNT FOR PATIENTS RECEIVING THE UNINSURED DISCOUNT OF AT LEAST 10% WHO PAYS ESTIMATED BILL PRIOR TO DISCHARGE.
PART I, LINE 7:	A COST-TO-CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS ON LINES 7B, AND 7C. COST ACCOUNTING WAS USED TO DETERMINE THE AMOUNTS ON LINES 7A, 7E, 7F, AND 7I.
PART II, COMMUNITY BUILDING ACTIVITIES:	ECONOMIC DEVELOPMENT: MARINHEALTH MEDICAL CENTER IS A MEMBER OF THE SAN RAFAEL CHAMBER OF COMMERCE, AND DONATED $6,000 TO THE ORGANIZATION IN 2018. THE SAN RAFAEL CHAMBER OF COMMERCE IS ONE OF MARIN COUNTY'S LEADING BUSINESS ADVOCATES. THEY ARE STRONG CHAMPIONS FOR LOCAL BUSINESS INTERESTS AND WORK VIGOROUSLY TO MAINTAIN A HEALTHY ECONOMY. ADDITIONALLY, DURING 2018, MARINHEALTH MEDICAL CENTER CONTRIBUTED $10,000 TO THE MARIN ECONOMIC FORUM, A 501(C)(3) ORGANIZATION WHO STRIVES TO PROVIDE INFORMATION AND OPPORTUNITIES FOR IMPROVING MARIN COUNTY'S ECONOMIC VITALITY, WHILE SEEKING TO INCREASE SOCIAL EQUITY AND ENVIRONMENTAL PROTECTION.COALITION BUILDING: MARINHEALTH MEDICAL CENTER WORKS WITH THE AGRICULTURAL INSTITUTE OF MARIN AND HEALTH COUNCIL OF MARIN TO PROMOTE HEALTHY INITIATIVES IN THE COMMUNITY. EXPENSES COULD NOT BE QUANTIFIED.COMMUNITY HEALTH IMPROVEMENT ADVOCACY: MARINHEALTH MEDICAL CENTER PARTICIPATES ON A COMMUNITY COMMITTEE THROUGH THE MARIN MOBILITY CONSORTIUM FOUNDATION THAT IS WORKING TO DEVELOP A PROGRAM TO COORDINATE RIDES FOR SENIORS, DISABLED, AND PARATRANSIT PERSONS.
PART III, LINE 2:	THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 4:	MHMC'S AUDITED FINANCIAL STATEMENTS DOES NOT HAVE A SEPARATE BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE FOOTNOTE WHICH ADDRESSES "NET PATIENT ACCOUNTS RECEIVABLE AND "ALLOWANCE FOR DOUBTFUL ACCOUNTS" CAN BE FOUND ON PAGES 9 AND 10 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE ORGANIZATION DID NOT COUNT THE MEDICARE SHORTFALL AS A COMMUNITY BENEFIT. ALL MEDICARE REVENUE AND COST WAS INCLUDED IN THE ORGANIZATION'S MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO.
PART III, LINE 9B:	THE MEDICAL CENTER INCLUDES AN EXTENDED PAYMENT PLAN TO ALLOW PAYMENT OF THE DISCOUNTED PRICE OVER TIME. THE MEDICAL CENTER AND THE PATIENT MAY NEGOTIATE THE TERMS OF THE PAYMENT PLAN. THE MEDICAL CENTER WILL NOT CHARGE INTEREST ON THE EXTENDED PAYMENT PLAN DEBT. AN EXTENDED PAYMENT PLAN MAY BE NEGOTIATED WITH THE PATIENT IF THE PATIENT FAILS TO MAKE ALL CONSECUTIVE PAYMENTS DURING A 90-DAY PERIOD. PRIOR TO DECLARING AN EXTENDED PAYMENT PLAN INOPERABLE THE PATIENT MUST BE: 1. CONTACTED OR ATTEMPTED TO BE CONTACTED BY TELEPHONE (LAST KNOWN NUMBER)2. GIVEN NOTICE IN WRITING THAT THE PLAN MAY BE INOPERABLE (LAST KNOWN ADDRESS)3. INFORMED THAT THERE IS AN OPPORTUNITY TO RE-NEGOTIATE THE PAYMENT PLAN.UNTIL THE PAYMENT PLAN IS DECLARED INOPERABLE, NO REPORT MAY BE MADE TO A CONSUMER CREDIT REPORTING AGENCY AND NO CIVIL ACTION MAY COMMENCE. ANY ADVANCING OF DEBT FOR COLLECTION OR REPORTING REQUIRES THE APPROVAL OF EACH PATIENT BY THE DIRECTOR OF PATIENT FINANCIAL SERVICES. ADVANCING OF DEBT COLLECTION SHALL OCCUR AFTER 150 DAYS OF AN INOPERABLE PAYMENT PLAN. CREDIT REPORTING SHALL NOT OCCUR UNTIL AFTER 150 DAYS OF THE PAYMENT PLAN BEING INOPERABLE.IF A COLLECTION AGENCY IDENTIFIES A PATIENT MEETING MARINHEALTH MEDICAL CENTER'S CHARITY CARE ELIGIBILITY CRITERIA, THE PATIENT ACCOUNT MAY BE CONSIDERED CHARITY CARE, EVEN IF THEY WERE ORIGINALLY CLASSIFIED FOR COLLECTION OR AS A BAD DEBT. COLLECTION AGENCY PATIENT ACCOUNTS MEETING CHARITY CARE CRITERIA SHOULD BE RETURNED TO MARINHEALTH MEDICAL CENTER'S BILLING OFFICE AND REVIEWED FOR CHARITY CARE ELIGIBILITY
PART VI, LINE 2:	IN ADDITION TO THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT, HEALTH NEEDS ARE MONITORED AS FOLLOWS: (I) MARIN HEALTHCARE DISTRICT BOARD MEETINGS, WHICH INCLUDE PUBLIC COMMENTS AND WHICH THE HOSPITAL CEO ATTENDS AND SHARES COMMUNITY INPUT WITH HOSPITAL STAFF AS APPROPRIATE; (II) HOSPITAL BOARD MEMBERS ARE ALL COMMUNITY RESIDENTS AND SHARE COMMUNITY HEALTH CONCERNS WHEN APPROPRIATE; (III) COMMUNITY COMMENTS ON THE TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY ARE COLLECTED ON THE HOSPITAL WEBSITE AND ARE MONITORED BY THE COMMUNITY RELATIONS DEPARTMENT.
PART VI, LINE 3:	A) CHARITY CARE INFORMATION PROVIDED AT PATIENT INTAKE: EXCEPT IN THE CASE OF EMERGENCY SERVICES, MARINHEALTH MEDICAL CENTER SHALL PROVIDE PATIENTS WITH INFORMATION REGARDING CHARITY CARE AND DISCOUNT PAYMENTS DURING THE PATIENT INTAKE PROCESS. MARINHEALTH MEDICAL CENTER SHALL ALSO PROVIDE PATIENTS WITH CONTACT INFORMATION FOR A MARINHEALTH MEDICAL CENTER EMPLOYEE OR OFFICE FROM WHICH THE PATIENT MAY OBTAIN FURTHER INFORMATION ABOUT CHARITY CARE AND DISCOUNT PAYMENTS. THE INFORMATION PROVIDED SHALL BE IN THE PRIMARY LANGUAGE(S) OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. A LANGUAGE IS A PRIMARY LANGUAGE OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA IF 5% OR MORE OF MARINHEALTH MEDICAL CENTER'S LOCAL POPULATION SPEAKS THE LANGUAGE. B) CHARITY CARE INFORMATION PROVIDED AT ALL OTHER TIMES: MARINHEALTH MEDICAL CENTER SHALL PROVIDE PATIENTS WITH INFORMATION REGARDING CHARITY CARE AND DISCOUNT PAYMENTS DURING THE INTAKE PROCESS, OR AT ANY OTHER TIME UPON PATIENT REQUEST. MARINHEALTH MEDICAL CENTER SHALL PROVIDE UNINSURED PATIENTS WITH THE MARINHEALTH MEDICAL CENTER CHARITY CARE APPLICATION FORM, THE "STATEMENT OF FINANCIAL CONDITION," IMMEDIATELY UPON PATIENT REQUEST. THE INFORMATION PROVIDED SHALL BE IN THE PRIMARY LANGUAGE(S) OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA AND IN A MANNER CONSISTENT WITH ALL APPLICABLE FEDERAL AND STATE LAWS AND REGULATIONS. A LANGUAGE IS A PRIMARY LANGUAGE OF MARINHEALTH MEDICAL CENTER'S SERVICE AREA IF 5% OR MORE OF MARINHEALTH MEDICAL CENTER'S LOCAL POPULATION SPEAKS THE LANGUAGE. C) PUBLIC NOTICE AND POSTING: PUBLIC NOTICE OF THE AVAILABILITY OF ASSISTANCE THROUGH THIS POLICY SHOULD BE MADE BY POSTING NOTICES IN A VISIBLE MANNER IN LOCATIONS WHERE THERE IS A HIGH VOLUME OF INPATIENT OR OUTPATIENT ADMITTING/REGISTRATION. NOTICES MUST BE POSTED IN AT LEAST THE EMERGENCY DEPARTMENTS, BILLING OFFICES, ADMITTING OFFICES, AND MEDICAL CENTER OUTPATIENT SERVICE SETTINGS. POSTED NOTICES SHALL BE IN LANGUAGES REFLECTING THAT SPOKEN IN THE SERVICE AREA IS 5% OR MORE OF THE POPULATIONS SPEAK THIS LANGUAGE. POSTED NOTICES SHALL CONTAIN THE FOLLOWING INFORMATION: 1) A STATEMENT INDICATING THAT MARINHEALTH MEDICAL CENTER HAS A FINANCIAL ASSISTANCE POLICY FOR LOW-INCOME UNINSURED PATIENTS WHO MAY NOT BE ABLE TO PAY THEIR BILL AND THAT THIS POLICY PROVIDES FOR FULL OR PARTIAL CHARITY CARE WRITE-OFF.2) IDENTIFICATION OF A MEDICAL CENTER CONTACT PHONE NUMBER THAT THE PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND ABOUT HOW TO APPLY FOR ASSISTANCE.D) INCLUDE POLICY INFORMATION ON BILLS AND STATEMENTS SENT TO PATIENTS INDICATING:1) IF THE PATIENT MEETS CERTAIN INCOME REQUIREMENTS THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED PROGRAM OR QUALIFY FOR CHARITY CARE OR DISCOUNT PAYMENT FROM MARINHEALTH MEDICAL CENTER. THE INCOME REQUIREMENTS SHALL BE STATED ON THE NOTICE.2) NOTIFICATION TO THE PATIENT THAT EMERGENCY PHYSICIANS ARE REQUIRED TO HAVE A DISCOUNT POLICY TO UNINSURED AND HIGH MEDICAL COST PATIENTS WHICH MAY HAVE DIFFERENT ELIGIBILITY CRITERIA THAN THAT OF THE MEDICAL CENTER BUT AT LEAST AT 350% OF THE FPL. 3) A MEDICAL CENTER PHONE NUMBER THAT PATIENTS MAY CALL FOR FURTHER INFORMATION. 4) POSTING NOTICE OF THE AVAILABILITY OF ASSISTANCE AND A CONTACT PHONE NUMBER ON MARINHEALTH MEDICAL CENTER'S WEB SITE. 5) PROVIDING UNINSURED PATIENTS A DOCUMENT OUTLINING THE TYPES OF FINANCIAL ASSISTANCE AVAILABLE.
PART VI, LINE 4:	COMMUNITY INFORMATION: MARINHEALTH MEDICAL CENTER DEFINES THE COMMUNITY SERVED BY THE HOSPITAL AS THOSE INDIVIDUALS RESIDING WITHIN ITS HOSPITAL SERVICE AREA. A HOSPITAL SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW-INCOME OR UNDERSERVED POPULATIONS. THE MARINHEALTH MEDICAL CENTER SERVICE AREA INCLUDES ALL OF MARIN COUNTY. THE CITIES INCLUDED ARE: BELVEDERE, CORTE MADERA, FAIRFAX, LARKSPUR, MILL VALLEY, NOVATO, ROSS, SAN ANSELMO, SAN RAFAEL, SAUSALITO, TIBURON, AND THE COASTAL TOWNS OF STINSON BEACH, BOLINAS, POINT REYES, INVERNESS, MARSHALL, AND TOMALES. CERTAIN SPECIALTY PROGRAMS, INCLUDING ITS TRAUMA SERVICE, SERVE A BROADER POPULATION, INCLUDING PATIENTS FROM SONOMA COUNTY, THE BROADER SAN FRANCISCO BAY AREA AND BEYOND.THE KEY DRIVERS OF HEALTH STATUS ARE INCOME, EDUCATION AND HEALTH INSURANCE. WHILE MARIN COUNTY COMPARES WELL WITH THE STATE, THERE ARE CLEAR VULNERABLE POPULATIONS WHOSE HEALTH STATUS IS MOST AT RISK: 19.4% OF RESIDENTS ARE LIVING BELOW 200% FEDERAL POVERTY LEVEL (FPL); 17.8% OF CHILDREN ARE LIVING BELOW 200% FPL; 8.9% OF RESIDENTS ARE UNINSURED; 7.6% OF RESIDENTS ARE WITHOUT A HIGH SCHOOL DIPLOMA; 15.5% OF RESIDENTS ARE HISPANIC/LATINO; 2.9% OF RESIDENTS ARE BLACK AND 5.6% OF RESIDENTS ARE ASIAN.MARIN COUNTY IS A HEALTHY AND AFFLUENT COUNTY, ESPECIALLY WHEN COMPARED TO CALIFORNIA AS A WHOLE. HOWEVER, MARIN IS ALSO AN AGING COUNTY WITH SUBSTANTIAL DISPARITIES IN SOCIOECONOMIC STATUS. THESE ISSUES PRESENT CHALLENGES FOR THE HEALTH OF MARIN COUNTY RESIDENTS.
PART VI, LINE 5:	MARINHEALTH MEDICAL CENTER IS THE ONLY FULL SERVICE ACUTE CARE HOSPITAL IN THE COUNTY AND THE ONLY HOSPITAL WITH AN OBSTETRICAL SERVICE OR IN PATIENT BEHAVIORAL HEALTH SERVICE. IT SERVES AS THE TRAUMA CENTER FOR MARIN COUNTY AND SURROUNDING AREAS. THE BOARD OF DIRECTORS IS COMPOSED OF UNCOMPENSATED COMMUNITY RESIDENTS. ALL FUNDS ARE USED TO IMPROVE HEALTH CARE SERVICES, MAINTAIN UP-TO-DATE FACILITIES, AND SUPPORT TRAINING PROGRAMS FOR HEALTH PROFESSIONALS IN AREAS SUCH AS NURSING, PHARMACY, RADIOLOGY, RESPIRATORY THERAPY, REHABILITATION SERVICES AND BEHAVIORAL HEALTH. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS.
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2018

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
MARIN GENERAL HOSPITAL

Employer identification number
94-2823538

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" 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	(h) Purpose of grant or assistance
(1) ANGELO & GARNETS CONSULTING 18 PLUMAS AVENUE SAN ANSELMO,CA94960	27-1095059		13,300	GENERAL SUPPORT
(2) EVENTS MANAGEMENT INC 2525 16TH STREET 311 SAN FRANCISCO,CA94103	68-0009465		5,500	GENERAL SUPPORT
(3) MARIN ECONOMIC FORUM 1050 NORTHGATE DRIVE SUITE 54 SAN RAFAEL,CA94903	45-4194417	501(C)(3)	10,000	GENERAL SUPPORT
(4) MARIN HEALTHCARE DISTRICT 100B DRAKES LANDING SUITE 250 GREENBRAE,CA94904	91-1886269	STATE OF CA	15,412,258	1206B CLINIC FUNDING
(5) PRIMA MEDICAL FOUNDATION 9 COMMERCIAL BOULEVARD SUITE 200 NOVATO,CA94949	27-1376321	501(C)(3)	11,708,214	GENERAL SUPPORT
(6) REDWOOD SPORTS & ENTERTAINMENT GROUP LLC 1201 2ND STREET SAN RAFAEL,CA94901	46-1411643		15,000	GENERAL SUPPORT
(7) SAN RAFAEL CHAMBER OF COMMERCE 817 MISSION AVENUE SAN RAFAEL,CA94901	94-0839470	501(C)(6)	6,000	GENERAL SUPPORT
(8) THE CALIFORNIA FILM INSTITUTE 1001 LOOTENS PLACE SUITE 220 SAN RAFAEL,CA94901	94-2498062	501(C)(3)	15,000	GENERAL SUPPORT

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2018

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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) PATIENT ASSISTANCE	75	62,580
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	FOR GRANTS TO INDIVIDUALS, THE ORGANIZATION PRE-SCREENS THE INDIVIDUALS FOR ELIGIBILITY. GRANTS ARE PAID DIRECTLY TO THE PROVIDER OF SERVICES TO PATIENTS. THE HOSPITAL DOES NOT REQUIRE ACCOUNTING OF THE USE OF GRANT FUNDS PROVIDED. IN THE CASES OF GENERAL PURPOSE GRANTS, THE GRANTEE'S CHARITABLE PURPOSE IS REVIEWED PRIOR TO THE ISSUANCE OF THE GRANT.

Schedule I (Form 990) 2018

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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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

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

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

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

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

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

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

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

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:

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

Yes

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2018

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1LEE DOMANICO CEO/EX-OFFICIO VOTING BOARD MEMBER	(i) (ii)	925,952 ------------- 0	297,814 ------------- 0	217,559 ------------- 0	22,630 ------------- 0	0 ------------- 0	1,463,955 ------------- 0	0 ------------- 0
2JAMES P MCMANUS CHIEF FINANCIAL OFFICER	(i) (ii)	502,122 ------------- 0	109,561 ------------- 0	65,133 ------------- 0	14,903 ------------- 0	28,616 ------------- 0	720,335 ------------- 0	0 ------------- 0
3JON D FRIEDENBERG CHIEF OPERATING OFFICER	(i) (ii)	525,857 ------------- 0	114,752 ------------- 0	67,633 ------------- 0	19,720 ------------- 0	28,616 ------------- 0	756,578 ------------- 0	0 ------------- 0
4MARK ZIELAZINSKI CHIEF INFO & TECH OFFICER	(i) (ii)	377,116 ------------- 0	77,962 ------------- 0	46,031 ------------- 0	18,454 ------------- 0	9,441 ------------- 0	529,004 ------------- 0	0 ------------- 0
5JOEL SKLAR MD CHIEF MEDICAL OFFICER	(i) (ii)	436,973 ------------- 0	77,761 ------------- 0	53,915 ------------- 0	19,427 ------------- 0	9,441 ------------- 0	597,517 ------------- 0	0 ------------- 0
6LINDA LANG CHIEF HUMAN RESOURCES OFFICER	(i) (ii)	336,514 ------------- 0	70,672 ------------- 0	50,610 ------------- 0	15,298 ------------- 0	9,441 ------------- 0	482,535 ------------- 0	0 ------------- 0
7KARIN REESE RN MS CHIEF NURSING OFFICER	(i) (ii)	349,119 ------------- 0	73,156 ------------- 0	53,671 ------------- 0	14,903 ------------- 0	9,857 ------------- 0	500,706 ------------- 0	0 ------------- 0
8ELIZABETH KOLCUN CHIEF DEVELOPMENT OFFICER	(i) (ii)	277,662 ------------- 0	79,257 ------------- 0	44,634 ------------- 0	14,368 ------------- 0	29,932 ------------- 0	445,853 ------------- 0	0 ------------- 0
9ERIC PIFER MD CHIEF MEDICAL INFORMATION OFFICER	(i) (ii)	180,576 ------------- 0	5,000 ------------- 0	0 ------------- 0	0 ------------- 0	8,933 ------------- 0	194,509 ------------- 0	0 ------------- 0
10GREGORY LEE CARD CATH TECHNICIAN IV	(i) (ii)	483,855 ------------- 0	0 ------------- 0	0 ------------- 0	39,060 ------------- 0	10,099 ------------- 0	533,014 ------------- 0	0 ------------- 0
11SANDY D AUGUSTUS RN CLINICAL REGISTERED NURSE III	(i) (ii)	408,237 ------------- 0	100 ------------- 0	0 ------------- 0	31,345 ------------- 0	29,932 ------------- 0	469,614 ------------- 0	0 ------------- 0
12MARGARET M ROBERTS RN CLINICAL REGISTERED NURSE III	(i) (ii)	366,231 ------------- 0	0 ------------- 0	0 ------------- 0	73,250 ------------- 0	21,248 ------------- 0	460,729 ------------- 0	0 ------------- 0
13CHUN LI MD CHIEF CLINICAL PHYSICIST	(i) (ii)	329,309 ------------- 0	37,150 ------------- 0	0 ------------- 0	70,174 ------------- 0	10,099 ------------- 0	446,732 ------------- 0	0 ------------- 0
14SUSAN S CUMMING MD MEDICAL DIRECTOR, PATIENT EXPERIENCE	(i) (ii)	351,707 ------------- 0	0 ------------- 0	0 ------------- 0	19,799 ------------- 0	29,932 ------------- 0	401,438 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINES 6A AND 7:	THE CALCULATION OF BONUSES IS DEPENDENT ON MANY FACTORS THAT ARE ASSIGNED VARIOUS WEIGHTS, SOME OF WHICH MIGHT ALSO INVOLVE THE USE OF INDIVIDUAL DISCRETION. THESE FACTORS INCLUDE: (I) PATIENT SATISFACTION SCORES; (II) EMPLOYEE SATISFACTION SCORES; (III) PHYSICIAN SATISFACTION SCORES; (IV) EXCESS OF REVENUE OVER EXPENSES; (V) COMMUNITY BENEFIT PROGRAMS, AND (VI) QUALITY AND SAFETY RESULTS.
PART II, COLUMN (B)(III)	THE OTHER REPORTABLE COMPENSATION RECEIVED BY CERTAIN MEMBERS OF THE EXECUTIVE TEAM REPRESENTS HEALTH AND WELFARE BENEFITS, DEFINED BENEFIT RETIREMENT PLAN, DISABILITY, LONG-TERM CARE INSURANCE, LIFE INSURANCE, AND ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE, WHICH WAS ALL INCLUDED IN THEIR FORM W-2 AS TAXABLE COMPENSATION.

Schedule J (Form 990) 2018

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
MARIN GENERAL HOSPITAL

Employer identification number
94-2823538

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY	68-0164610	13080SUG7	05-23-2018	100,032,761	CONSTRUCT NEW HOSPITAL FACILITY/AMBULATORY SERVICES BLDG/PARKING STRUCTURE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	100,875,275
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,132,761
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	6,397,046
11 Other spent proceeds .............
12 Other unspent proceeds .............	93,345,468
13 Year of substantial completion .............
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

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
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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

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

Schedule K (Form 990) 2018

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

Part Ⅵ

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

Return Reference	Explanation
PART I, COLUMN (E) AND PART II, LINE 4:	THE DIFFERENCE BETWEEN THE "ISSUE PRICE" REPORTED IN PART I, COLUMN (E) AND THE "TOTAL PROCEEDS OF ISSUE" REPORTED IN PART II, LINE 3 PERTAINS TO NET INVESTMENT EARNINGS ON UNSPENT PROCEEDS.

Schedule K (Form 990) 2018

Additional Data

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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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 4	THE ORGANIZATION AMENDED ITS BYLAWS IN 2018; THE SIGNIFICANT CHANGES TO THOSE AMENDMENTS INCLUDE: (I) THE ADDITION OF "THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ON BEHALF OF UCSF HEALTH" AS A "SPECIAL MEMBER" TO MHMC; (II) PROVISIONS ALLOWING THE SPECIAL MEMBER TO NOMINATE TWO MEMBERS OF THE BOARD OF DIRECTORS; (III) INCREASING THE MAXIMUM ALLOWABLE NUMBER OF BOARD MEMBERS FROM THIRTEEN TO FIFTEEN; AND (IV) PROVIDING THAT THE SPECIAL MEMBER SHALL RECEIVE FROM MHMC, INCIDENT TO ANY DISSOLUTION OR WINDING UP OF MHMC OCCURRING DURING THE TERM OF THE MASTER ALLIANCE AGREEMENT WITH THE SPECIAL MEMBER AND WHILE THE MASTER ALLIANCE AGREEMENT REMAINS IN EFFECT, AN AMOUNT EQUAL TO FIVE AND SIX TENTHS PERCENT (5.6%) OF THE VALUE OF THE ASSETS OF MHMC REMAINING AFTER THE MAKING OF PAYMENT OR PROVISION FOR PAYMENT OF ALL OTHER DEBTS AND LIABILITIES OF MHMC.
FORM 990, PART VI, SECTION A, LINE 6	MARINHEALTH MEDICAL CENTER (MHMC) HAS ONE GENERAL MEMBER, MARIN HEALTHCARE DISTRICT (MHD), A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA. IN ADDITION, THE BYLAWS PROVIDE FOR A "SPECIAL MEMBER" (WITH THE POWER TO NOMINATE 2 MEMBERS OF THE BOARD OF DIRECTORS): THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ON BEHALF OF UCSF HEALTH.
FORM 990, PART VI, SECTION A, LINE 7A	MARIN HEALTHCARE DISTRICT (THE "GENERAL MEMBER") DOES NOT HAVE THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY; HOWEVER, THE GENERAL MEMBER DOES HAVE THE RIGHT TO REJECT ALL APPOINTEES TO THE BOARD OF DIRECTORS. THE REGENTS OF THE UNIVERSITY OF CALIFORNIA ON BEHALF OF UCSF HEALTH (THE "SPECIAL MEMBER") MAY NOMINATE TWO MEMBERS OF THE BOARD OF DIRECTORS, WHO MUST ALSO BE APPROVED BY THE GENERAL MEMBER.
FORM 990, PART VI, SECTION A, LINE 7B	NEITHER THE BOARD NOR ANY OFFICER OR EMPLOYEE OF MHMC MAY TAKE ANY OF THE FOLLOWING ACTIONS, OR APPROVE A SUBSIDIARY OR AN AFFILIATE TAKING THE FOLLOWING ACTIONS, WITHOUT THE PRIOR APPROVAL, OR ANY OF THE SPECIFIED ACTIONS, OF THE GENERAL MEMBER: (A) ANY CORPORATE MERGER, CONSOLIDATION, REORGANIZATION, OR DISSOLUTION OF THIS CORPORATION THAT WOULD CHANGE THE GENERAL MEMBER'S STATUS AS SOLE CORPORATE MEMBER OR OWNER OF THE LAND AND ASSETS LEASED BY THIS CORPORATION; (B) ANY TRANSACTION REQUIRING THE CONSENT OR APPROVAL OF THE GENERAL MEMBER PURSUANT TO THE LEASE OF THE MHMC CAMPUS AND FACILITIES BY THE GENERAL MEMBER TO THIS CORPORATION, COMMENCING DECEMBER 2, 2015, AS IT HAS BEEN OR MAY BE AMENDED ("THE LEASE"). (C) ANY MATERIAL TRANSFER BY SALE, LEASE, DEBT OR ENCUMBRANCE, OR OTHER DISPOSITION, OF ANY OF THE ASSETS OF THE CORPORATION, REAL OR PERSONAL, OUTSIDE THE ORDINARY COURSE OF HOSPITAL BUSINESS. NOTWITHSTANDING THE FOREGOING, THE FOLLOWING WILL NOT REQUIRE THE PRIOR APPROVAL OF THE GENERAL MEMBER: (I) ANY TRANSACTION AMOUNTING TO A TRANSFER OF LESS THAN TEN PERCENT (10%) OF THE ASSETS OF THE CORPORATION, AS OF THE MONTH IMMEDIATELY PRECEDING THE TRANSACTION, TO ANOTHER LEGAL ENTITY IN CONNECTION WITH AN AFFILIATION OR JOINT VENTURE INVESTMENT OR SERVICE OPERATION OFF THE MHMC CAMPUS; (II) A FINANCING TRANSACTION, INCLUDING, BUT NOT LIMITED TO, DEBT FINANCING OR BORROWINGS, EQUITY FINANCINGS, CAPITALIZED LEASES AND INSTALLMENT CONTRACTS, EXPECTED TO AMOUNT IN TOTAL PRINCIPAL VALUE TO LESS THAN TEN PERCENT (10%) OF NET PATIENT SERVICES REVENUE, AS OF THE MONTH IMMEDIATELY PRECEDING THE TRANSACTION; (III) THE GENERAL MEMBER SHALL IN ITS DISCRETION CONSIDER EXTENDING THE ABOVE THRESHOLD REQUIREMENTS BASED ON ADDITIONAL PERCENTAGES OF TOTAL ASSETS OR PATIENT REVENUE, AND ANY SUCH ALLOWANCE SHALL COMPLY WITH APPLICABLE CALIFORNIA LAWS OR REGULATIONS GOVERNING TRANSFERS OF ASSETS OF A HEALTHCARE DISTRICT (E.G., HEALTH & SAFETY CODE SECTION 32121 (P)). (D) IN ADDITION TO THRESHOLDS FOR APPROVALS REQUIRED FOR INDIVIDUAL TRANSACTIONS DESCRIBED IN SUBSECTION (C) ABOVE, APPROVAL OF THE GENERAL MEMBER SHALL BE REQUIRED FOR ANY TRANSACTION WHICH, ON A PROFORMA BASIS, WOULD CAUSE THE CORPORATION TO BE IN VIOLATION OF ANY FINANCIAL LOAN OR BOND COVENANT, AS THEY EXIST AT THE TIME OF THE TRANSACTION, OR THAT WOULD CAUSE THE CORPORATION'S DEBT TO CAPITALIZATION RATIO TO EXCEED 50%. (E) ANY TRANSACTIONS WITH LONG-TERM (MORE THAN THREE-YEAR) LAND OR FACILITY IMPACTS (E.G., NEW CONSTRUCTION OR RENOVATION) REQUIRING GENERAL MEMBER APPROVAL PURSUANT TO THE LEASE OR COSTING THE EQUIVALENT OF TEN PERCENT (10%) OR MORE OF MHMC THEN EXISTING TOTAL ASSETS (APPROXIMATELY $27 MILLION AT DECEMBER 31, 2015). (F) ANY LONG-TERM CAMPUS DEVELOPMENT PLAN THAT RESTRICTS FUTURE LAND USE OPTIONS OR REQUIRES REGULATORY CHANGES TO LAND USE PERMITS/DESIGNATIONS WILL REQUIRE GENERAL MEMBER APPROVAL. (G) ANY TRANSACTION THAT CAUSES OR IS ANTICIPATED TO CAUSE A DOWNGRADE IN BOND RATING BY A STANDARD RATING AGENCY REQUIRES GENERAL MEMBER APPROVAL REGARDLESS OF SIZE OF THE TRANSACTION. (H) THE GENERAL MEMBER SHALL RETAIN AN INDEPENDENT AUDIT FIRM CONSISTENT WITH STANDARD INDUSTRY FINANCIAL PRACTICE ON BEHALF OF THE CORPORATION. THE AUDIT FIRM WILL THEN PROVIDE SERVICES TO MHMC'S MANAGEMENT AND ITS BOARD AS OVERSEEN BY THE MHMC BOARD AUDIT SUBCOMMITTEE. FINAL AUDIT REPORTS WILL BE PRESENTED TO THE GENERAL MEMBER (SUBJECT TO PUBLIC REVIEW), THE BOARD, AND MANAGEMENT OF MHMC. (I) CONTRACTING WITH AN UNRELATED THIRD PARTY FOR ALL, OR SUBSTANTIALLY ALL (50 PERCENT OR GREATER), OF THE MANAGEMENT OF THE ASSETS OR OPERATIONS OF THIS CORPORATION OR ANY SUBSIDIARY OR AFFILIATE ENTITY. (J) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION. (K) BYLAW APPROVALS (L) ANY CHANGES TO THE MISSION STATEMENT OF THE CORPORATION FOR MHMC. (M) ANY CHANGES TO THE CORPORATE DISSOLUTION RIGHTS (INITIATION OF DISSOLUTION AND DISPOSITION OF ASSETS) OF THE GENERAL MEMBER. (N) APPROVAL OF INDIVIDUALS FOR BOARD MEMBERSHIP. IN ADDITION, THE SPECIAL MEMBER SHALL HAVE THE FOLLOWING RIGHTS AND PRIVILEGES: (A) TO NOMINATE INDIVIDUALS TO SERVE ON THE BOARD OF DIRECTORS AS "SPECIAL MEMBER NOMINEES; (B) TO APPROVE CERTAIN AMENDMENTS TO THE BYLAWS; AND
FORM 990, PART VI, SECTION B, LINE 11B	MHMC'S TAX ADVISOR PROVIDES AND PREPARES THE RETURN IN CONSULTATION WITH THE ORGANIZATION'S INTERNAL ACCOUNTING DEPARTMENT. THE INFORMATION IS THEN REVIEWED BY MHMC'S CHIEF FINANCIAL OFFICER. A COPY OF THE FORM IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BOARD FOR THEIR REVIEW PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	EACH INDIVIDUAL BOARD MEMBER AND OFFICER HAS TO SIGN AN ACKNOWLEDGEMENT FORM THAT THEY HAVE READ THE POLICY. A DISCLOSURE STATEMENT IS COMPLETED BY ALL OFFICERS AND BOARD MEMBERS ANNUALLY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH LEGAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED TRUSTEE MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE TRUSTEE TO LEAVE THE ROOM OR NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED TRUSTEE SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15	THE EXECUTIVE COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ASSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE EXECUTIVE COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF THE HOSPITAL'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL AND REGIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS MHMC ARE MOST APPROPRIATE. ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION UNDERGO A REVIEW ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19	THE HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 22,710,381. MANAGEMENT AND GENERAL EXPENSES 9,744,262. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,454,643. PROFESSIONAL FEES - PHYSICIANS: PROGRAM SERVICE EXPENSES 16,973,265. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,973,265.
FORM 990, PART XI, LINE 9:	CHANGE IN RETIREMENT BENEFIT PLAN VALUE -2,519,535.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

MARIN GENERAL HOSPITAL

Employer identification number

94-2823538

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)MARIN HEALTHCARE DISTRICT 100B DRAKES LANDING ROAD SUITE 250 GREENBRAE,CA94904 91-1886269	HEALTH CARE	CA			N/A		No
(2)MARIN GENERAL HOSPITAL FOUNDATION 100B DRAKES LANDING ROAD SUITE 250 GREENBRAE,CA94904 94-6127213	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	MARIN GENERAL HOSPITAL	Yes
(3)PRIMA MEDICAL FOUNDATION 4 HAMILTON LANDING SUITE 100 NOVATO,CA94949 27-1376321	PHYSICIAN MEDICAL FOUNDATION	CA	501(C)(3)	LINE 10	MARIN GENERAL HOSPITAL	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) MGHSCA LLC 100B DRAKES LANDING ROAD SUITE 190 GREENBRAE,CA94904 38-3861395	OUTPATIENT SURGERY CENTER	CA	MARIN GENERAL HOSPITAL	RELATED	579,334	2,975,826		No		Yes		51.000 %
(2) MARIN MAGNETIC RESONANCE IMAGING CENTER PO BOX 6102 NOVATO,CA94948 68-0055977	OUTPATIENT IMAGING	CA	MARIN GENERAL HOSPITAL	RELATED	167,096			No		Yes		51.000 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

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

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) MARIN GENERAL HOSPITAL FOUNDATION	C	11,542,945	BOOK VALUE
(2) MARIN GENERAL HOSPITAL FOUNDATION	O	763,539	BOOK VALUE
(3) PRIMA MEDICAL FOUNDATION	B	11,708,214	BOOK VALUE
(4) PRIMA MEDICAL FOUNDATION	D	2,000,000	LOAN GAURANTEE AMOUNT
(5) PRIMA MEDICAL FOUNDATION	Q	1,154,000	CASH RECEIPTS
(6) MGHSCA LLC	S	432,392	BOOK VALUE
(7) MARIN MAGNETIC RESONANCE IMAGING CENTER LLC	R	389,842	BOOK VALUE
(8) MARIN MAGNETIC RESONANCE IMAGING CENTER LLC	S	1,272,391	BOOK VALUE

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

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

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE EXCEPTIONAL HEALTH CARE SERVICES IN A COMPASSIONATE AND HEALING ENVIRONMENT.
2	Check this box
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 2018 (Part V, line 2a) ......	5	2,009
6	Total number of volunteers (estimate if necessary) .............	6	250
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	55,911
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	319,813

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,746,311	11,742,945
9	Program service revenue (Part VIII, line 2g) .........	416,405,394	421,348,805
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	1,379,144	1,974,234
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-486,276	-1,192,106
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	424,044,573	433,873,878
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	19,209,860	27,300,515
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)	219,240,307	231,307,681
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	163,466,772	161,355,966
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	401,916,939	419,964,162
19	Revenue less expenses. Subtract line 18 from line 12.......	22,127,634	13,909,716
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	304,859,973	447,573,316
21	Total liabilities (Part X, line 26).............	173,292,395	308,610,123
22	Net assets or fund balances. Subtract line 21 from line 20.....	131,567,578	138,963,193

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 379,805,327 including grants of $ 27,300,515 ) (Revenue $ 421,348,805 )
	MARIN GENERAL HOSPITAL DBA MARINHEALTH MEDICAL CENTER IS A 235-BED INDEPENDENT HOSPITAL WITH DEEP ROOTS IN THE COMMUNITY. WE HAVE BEEN MEETING THE HEALTHCARE NEEDS OF THE NORTH BAY SINCE FIRST OPENING OUR DOORS AS MARIN GENERAL HOSPITAL IN 1952. AS MARIN'S ONLY FULL-SERVICE, ACUTE CARE HOSPITAL, WE PROVIDE COMPREHENSIVE CARE ACROSS ALL MAJOR SERVICE LINES. OUR LEVEL III TRAUMA CENTER AND EMERGENCY DEPARTMENT RECEIVE 70% OF THE COUNTY'S AMBULANCE TRAFFIC, AND WE PROVIDE LIFE-SAVING CARE FOR OUR STROKE AND HEART ATTACK PATIENTS. WE ALSO OFFER THE ONLY HOSPITAL-BASED LABOR & DELIVERY UNIT IN MARIN. ADDITIONAL SERVICES PROVIDED INCLUDE: BEHAVIORAL HEALTH; CANCER CARE; CRITICAL CARE; EMERGENCY & TRAUMA; IMAGING & RADIOLOGY; STROKE CARE; SPINE & BRAIN CARE; AND SURGERY & PROCEDURES, AMONGST MANY OTHER SPECIALTIES.AS A DISTRICT HOSPITAL, OWNED BY MARIN HEALTHCARE DISTRICT, WE ANSWER ONLY TO THE COMMUNITY WE SERVE. THIS GIVES US THE FLEXIBILITY TO PLAN CARE THAT TRULY MEETS OUR COMMUNITY'S NEEDS. BUILDING ON A DECADES-LONG RELATIONSHIP, MARINHEALTH AND UCSF HEALTH FORMED A STRATEGIC ALLIANCE IN 2018 THAT EXPANDS ACCESS TO HIGH-QUALITY CLINICAL CARE IN MARIN COUNTY AND THROUGHOUT THE NORTH BAY.

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 expenses379,805,327

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) MARK ZIELAZINSKI........................................................................ CHIEF INFO & TECH OFFICER	48.00 .......................2.00	X		501,109	0	27,895
(19) JOEL SKLAR MD........................................................................ CHIEF MEDICAL OFFICER	50.00 .......................0.00	X		568,649	0	28,868
(20) LINDA LANG........................................................................ CHIEF HUMAN RESOURCES OFFICER	50.00 .......................0.00	X		457,796	0	24,739
(21) KARIN REESE RN MS........................................................................ CHIEF NURSING OFFICER	50.00 .......................0.00	X		475,946	0	24,760
(22) ELIZABETH KOLCUN........................................................................ CHIEF DEVELOPMENT OFFICER	4.00 .......................0.00	X		401,553	0	44,300
(23) ERIC PIFER MD........................................................................ CHIEF MEDICAL INFORMATION OFFICER	50.00 .......................0.00	X		185,576	0	8,933
(24) GREGORY LEE........................................................................ CARD CATH TECHNICIAN IV	40.00 .......................0.00		X	483,855	0	49,159
(25) SANDY D AUGUSTUS RN........................................................................ CLINICAL REGISTERED NURSE III	40.00 .......................0.00		X	408,337	0	61,277
(26) MARGARET M ROBERTS RN........................................................................ CLINICAL REGISTERED NURSE III	40.00 .......................0.00		X	366,231	0	94,498
(27) CHUN LI MD........................................................................ CHIEF CLINICAL PHYSICIST	40.00 .......................0.00		X	366,459	0	80,273
(28) SUSAN S CUMMING MD........................................................................ MEDICAL DIRECTOR, PATIENT EXPERIENCE	40.00 .......................0.00		X	351,707	0	49,731

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	7,393,601	0	608,918

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	11,742,945
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		11,742,945

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	375,495,001	375,495,001
b	CAPITATION REVENUE	622110	35,874,583	35,874,583
c	OTHER OPERATING REVENUE	622110	9,403,118	9,403,118
d	PROGRAM RELATED INVESTMENT INCOME	621400	576,103	576,103
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		421,348,805

3 Investment income (including dividends, interest, and othersimilar amounts) ......			1,207,876			1,207,876
4 Income from investment of tax-exempt bond proceeds			842,514			842,514
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		905,274
b	Less: rental expenses		3,135,629
c	Rental income or (loss)		-2,230,355
d	Net rental income or (loss)......			-2,230,355			-2,230,355
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses	76,156
c	Gain or (loss)	-76,156
d	Net gain or (loss).....			-76,156			-76,156
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA		722514	982,338			982,338
b	MANAGEMENT FEES		900099	55,911		55,911
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			1,038,249
12	Total revenue. See Instructions......			433,873,878	421,348,805	55,911	726,217

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	27,237,935	27,237,935
2	Grants and other assistance to domestic individuals. See Part IV, line 22	62,580	62,580
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	5,690,991	1,821,738	3,869,253
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	170,445,608	153,873,637	16,571,971
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,920,013	8,791,470	1,128,543
9	Other employee benefits .......	32,536,413	28,869,138	3,667,275
10	Payroll taxes ...........	12,714,656	11,164,942	1,549,714
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	2,948,629	2,948,629
c	Accounting ...........	457,180		457,180
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	394,880		394,880
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	49,427,908	39,683,646	9,744,262
12	Advertising and promotion ....	1,383,834	1,383,834
13	Office expenses .......	1,649,469	1,582,294	67,175
14	Information technology ......	1,301,188	1,166,515	134,673
15	Royalties ..
16	Occupancy ...........	9,072,516	8,421,461	651,055
17	Travel ............	152,788	152,788
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	4,004,871	4,004,871
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	15,447,690	15,447,690
23	Insurance ...	1,444,025	1,299,622	144,403
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	52,134,756	52,134,756
b	REPAIRS	12,516,018	11,196,729	1,319,289
c	LICENSES & TAXES	2,280,173	2,280,173
d	RENTAL EQUIPMENT	1,833,742	1,833,742
e	All other expenses	4,906,299	4,447,137	459,162
25	Total functional expenses. Add lines 1 through 24e	419,964,162	379,805,327	40,158,835	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			66,966,101	1	67,842,880
2	Savings and temporary cash investments .........			430,032	2	12,420,444
3	Pledges and grants receivable, net ......			1,071,805	3	391,143
4	Accounts receivable, net .............			65,397,552	4	68,530,778
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			5,574,439	8	5,995,173
9	Prepaid expenses and deferred charges ......			6,921,256	9	6,124,591
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	303,424,838
b	Less: accumulated depreciation	10b	206,790,488	87,003,675	10c	96,634,350
11	Investments—publicly traded securities .			47,673,372	11	163,992,375
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			10,267,012	13	8,421,703
14	Intangible assets ...............			1,280,000	14	2,326,007
15	Other assets. See Part IV, line 11 ...........			12,274,729	15	14,893,872
16	Total assets. Add lines 1 through 15 (must equal line 34)...			304,859,973	16	447,573,316

17	Accounts payable and accrued expenses .....	56,273,357	17	55,665,931
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20	98,673,346
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..	76,213,063	23	88,903,981
24	Unsecured notes and loans payable to unrelated third parties ..		24	1,644,750
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	40,805,975	25	63,722,115
26	Total liabilities. Add lines 17 through 25..	173,292,395	26	308,610,123

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	131,567,578	27	138,963,193
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	131,567,578	33	138,963,193
34	Total liabilities and net assets/fund balances ........	304,859,973	34	447,573,316