TY 2017 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) STEVEN KREMS MD...................................................................... BOARD MEMBER	5.00 ................. 0.00	X			0	0	0
(2) THOMAS M PRISELAC...................................................................... CHAIR	5.00 ................. 75.00	X			0	3,627,555	1,373,150
(3) MARC H RAPAPORT...................................................................... BOARD MEMBER	5.00 ................. 18.00	X			0	0	0
(4) NICKOLAS TOMASIC MD...................................................................... BOARD MEMBER	5.00 ................. 0.00	X			0	0	0
(5) LESLIE VERMUT...................................................................... BOARD MEMBER	5.00 ................. 8.00	X			0	0	0
(6) THOMAS J WAFER JR...................................................................... BOARD MEMBER	5.00 ................. 0.00	X			0	0	0
(7) WALTER ZIFKIN...................................................................... BOARD MEMBER	5.00 ................. 0.00	X			0	0	0
(8) MARK GAVENS...................................................................... CEO	6.00 ................. 61.00		X		0	1,724,078	212,630
(9) MARY KATHRYN HAMMACK...................................................................... CFO/TREASURER	50.00 ................. 5.00		X		247,779	0	9,251
(10) PAULETTE HEITMEYER...................................................................... COO	50.00 ................. 1.00		X		0	448,894	9,583
(11) SHARON MARTINEZ...................................................................... SECRETARY	50.00 ................. 1.00		X		100,318	0	711
(12) SHAWN BOND...................................................................... PHYSICIAN ASSISTANT	50.00 ................. 0.00			X	227,831	0	7,986
(13) CATHY OHNSTAD...................................................................... CHIEF NURSING OFFICER	50.00 ................. 0.00			X	203,060	0	9,846
(14) JEFFREY WALLACE...................................................................... ASSISTANT ADMINISTRATOR	50.00 ................. 0.00			X	194,160	0	17,559
(15) PERCY CUPEN...................................................................... DIRECTOR OF QUALITY MANAGEMENT	50.00 ................. 0.00			X	201,598	0	3,149
(16) KIMBERLY BOTWIN...................................................................... DIRECTOR PHARMACY	40.00 ................. 0.00			X	201,146	0	306

(A) Name and business address	(B) Description of services	(C) Compensation
PREMIER EMERGENCY PHYSICIANS OF CA MEDIC 7032 COLLECTION CTR DR CHICAGO,IL60693	EMERGENCY DEPARTMENT COVERAGE	336,750
WATKINS SPINE INC 410 PROSPECT CIRCLE PASADENA,CA91030	SPINE CENTER MEDICAL DIRECTORS (2)	329,473
RUBEN VILLEGAS 596 S ESPLANADE STREET ORANGE,CA92869	MATERIALS MANAGEMENT DIRECTOR/CONSULTING	172,875
AMBULATORY ANESTHESIA ASSOCIATES INC 371 VAN NESS WAY SUITE 210 TORRANCE,CA90501	AMBULATORY ANESTHESIA SERVICES	106,400

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 4

- 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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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) 2019

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. 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—2018. 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—2019. 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—2018. 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) 2019

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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. 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—2018. 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) 2019

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) 2019

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) 2019

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) 2019

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, 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 2019. 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 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

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

2019

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization CFHS HOLDINGS INC

Part I Contributors	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
		$	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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization CFHS HOLDINGS INC		Employer identification number 20-1645949

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization CFHS HOLDINGS INC			Employer identification number 20-1645949
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) (2019)

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 instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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 FASB 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 FASB 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 FASB 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) 2019

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

Term 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 ....	27,560,638	3,840,204	23,720,434
c	Leasehold improvements
d	Equipment ....	15,332,824	5,865,647	9,467,177
e	Other .....	4,512,897	2,601,863	1,911,034
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				35,098,645

Schedule D (Form 990) 2019

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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	48,109,325
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) 2019

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:

THE FOLLOWING STATEMENT IS TAKEN FROM THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF CEDARS-SINAI HEALTH SYSTEM THAT INCLUDES CFHS HOLDINGS, INC. THE ORGANIZATION COMPLETED AN ANALYSIS OF ITS TAX POSITIONS, IN ACCORDANCE WITH ASC 740, INCOME TAXES, AND DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN. THE ORGANIZATION HAS RECOGNIZED NO INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. THE ORGANIZATION IS SUBJECT TO ROUTINE AUDITS BY THE TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2015.

Schedule D (Form 990) 2019

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

2019

Open to Public Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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 %

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 45000.0000000000 %

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) . . .	167,091		167,091	0.150 %
b	Medicaid (from Worksheet 3, column a) . . . . .	24,241,461	11,410,706	12,830,755	11.530 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	24,408,552	11,410,706	12,997,846	11.680 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	40,418		40,418	0.040 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	50,000		50,000	0.040 %
j	Total. Other Benefits . .	90,418		90,418	0.080 %
k	Total. Add lines 7d and 7j .	24,498,970	11,410,706	13,088,264	11.760 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	5,000	5,000	0 %
8	Workforce development
9	Other
10	Total	5,000	5,000	0 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare 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. ......

9,092,318

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).....

36,465,552

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

57,966,687

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

-21,501,135

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) 2019

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)
1	MARINA DEL REY HOSPITAL 4650 LINCOLN BLVD MARINA DEL REY,CA90292 WWW.MARINAHOSPITAL.COM 930000096	X	X	X

Schedule H (Form 990) 2019

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)

	MARINA DEL REY HOSPITAL
Name of hospital facility or letter of facility reporting group

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

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 17

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

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

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

Yes

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

Hospital facility’s website (list url): HTTPS://WWW.MARINAHOSPITAL.COM/COMMUNITY

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 17

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

Yes

If "Yes" (list url): HTTPS://WWW.MARINAHOSPITAL.COM/COMMUNITY

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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	MARINA DEL REY HOSPITAL
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 200.000000000000%
and FPG family income limit for eligibility for discounted care of 450.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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):

HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE

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

HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.MARINAHOSPITAL.COM/FINANCIAL-OVERVIEW/ASSISTANCE

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) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	MARINA DEL REY HOSPITAL
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 (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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) 2019

Page 7

Part VFacility Information (continued)

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

	MARINA DEL REY HOSPITAL
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) 2019

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, 20a, 20b, 20c, 20d, 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
MARINA DEL REY HOSPITAL	PART V, SECTION B, LINE 3J: THE CHNA HELPS TO IDENTIFY THE UNMET HEALTH NEEDS OF THE COMMUNITIES SERVED BY CEDARS-SINAI MARINA DEL REY HOSPITAL AND PROVIDES A FRAMEWORK FOR PRIORITIZING HOW THE HOSPITAL WILL ADDRESS UNMET COMMUNITY NEEDS THROUGH THE PROVISION OF COMMUNITY HEALTH SERVICES.CEDARS-SINAI MARINA DEL REY'S COMMUNITY HEALTH NEEDS ASSESSMENT FOR JULY 1, 2017 THROUGH JUNE 30, 2020 WAS APPROVED BY ITS GOVERNING BODY ON MAY 23, 2018. COMMUNITY BENEFIT SERVICE AREA:CEDARS-SINAI MARINA DEL REY HOSPITAL IS LOCATED AT 4650 LINCOLN BLVD., MARINA DEL REY, CA, 90292. THE HOSPITAL'S SERVICE AREA ENCOMPASSES EIGHT ZIP CODES IN THE CITIES OF CULVER CITY, MAR VISTA, MARINA DEL REY, PLAYA DEL REY, PLAYA VISTA, SANTA MONICA, VENICE, AND WESTCHESTER. THIS AREA IS LOCATED IN LOS ANGELES COUNTY SERVICE PLANNING AREA 5 (SPA 5).COMMUNITY DEMOGRAPHICS:- THE POPULATION OF THE CEDARS-SINAI MARINA DEL REY HOSPITAL (CSMDRH) SERVICE AREA IS 230,101.- THE PERCENTAGE OF YOUTH, AGE 0-17, IN THE SERVICE AREA IS 15.5%, WHICH IS LOWER THAN THE COUNTY (23.1%) OR THE STATE (23.8%).- OVER HALF OF THE POPULATION (53.9%) IN THE HOSPITAL SERVICE AREA IS WHITE. HISPANIC OR LATINOS ACCOUNT FOR 21.8% OF THE AREA POPULATION, ASIANS 12.2% AND BLACK OR AFRICAN AMERICANS 7.1%.- TWO-THIRDS OF THE RESIDENTS IN THE SERVICE AREA SPEAK ENGLISH ONLY (66.8%), WHILE 16.9% OF THE POPULATION SPEAKS SPANISH ONLY.SOCIAL AND ECONOMIC FACTORS:- AMONG AREA RESIDENTS, 11.8% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 24.7% ARE AT 200% OF FPL OR BELOW (LOW-INCOME).- THE MEDIAN HOUSEHOLD INCOME FOR THE CSMDRH SERVICE AREA IS $81,083.- IN JULY 2017, THE UNEMPLOYMENT RATE IN THE AREA RANGED FROM 3.2% IN MARINA DEL REY TO 5.5% IN LOS ANGELES.- IN THE SERVICE AREA, 63.4% OF THE POPULATION HAS A COLLEGE DEGREE, WHICH IS HIGHER THAN THE COUNTY (37.2%) AND THE STATE (39.2%).- CULVER CITY UNIFIED (93.7%) AND SANTA MONICA-MALIBU UNIFIED (90.7%) HAVE HIGH GRADUATION RATES. THESE DISTRICTS EXCEED THE HEALTHY PEOPLE 2020 OBJECTIVE FOR HIGH SCHOOL GRADUATION OF 87%.ACCESS TO HEALTH CARE:- THE HOSPITAL SERVICE AREA REPORTS 88.2% INSURANCE COVERAGE. COVERAGE RATES RANGE FROM A LOW OF 87.5% IN CULVER CITY (ZIP CODE 90230) TO A HIGH OF 94.8% IN PLAYA VISTA (ZIP CODE 90094).- 80.7% OF RESIDENTS OF SPA 5 HAVE A REGULAR SOURCE FOR CARE, COMPARED TO 84.7% FOR THE COUNTY AND 86% FOR THE STATE.- A BARRIER TO ACCESSING CARE IS THE LACK OF SPECIALTY CARE PRACTITIONERS LOCALLY AVAILABLE.- SENIORS IN SPA 5 HAVE A USUAL SOURCE OF CARE AT A HIGHER PERCENTAGE THAN FOUND IN THE COUNTY OR STATE. HOWEVER, 12.7% OF SENIORS, AGES 65-74, REPORTED A DELAY IN CARE COMPARED TO 8.9% IN THE COUNTY AND 7.7% IN THE STATE.- COMMUNITY STAKEHOLDERS NOTED THAT THE LARGE HOMELESS POPULATION IN THE NEIGHBORHOOD HAS LIMITED ACCESS TO PREVENTIVE CARE SERVICES. LEADING CAUSES OF DEATH:- HEART DISEASE AND CANCER ARE THE TOP TWO CAUSES OF DEATH IN THE SERVICE AREA, FOLLOWED BY ALZHEIMER'S DISEASE AND STROKE.CHRONIC DISEASES:- AMONG ADULTS IN SPA 5, 10.8% IDENTIFIED THEMSELVES AS EXPERIENCING FAIR OR POOR HEALTH COMPARED TO 21.9% AT THE COUNTY LEVEL.- 6.6% OF ADULTS IN SPA 5 HAVE BEEN DIAGNOSED WITH DIABETES AND 8.7% HAVE PREDIABETES.- 5.9% OF ADULTS IN SPA 5 HAVE BEEN DIAGNOSED WITH HEART DISEASE.- A CO-MORBIDITY FACTOR FOR DIABETES AND HEART DISEASE IS HYPERTENSION (HIGH BLOOD PRESSURE). IN SPA 5, 22.4% OF RESIDENTS HAVE HIGH BLOOD PRESSURE.- 14.6% OF RESIDENTS IN SPA 5 HAVE BEEN DIAGNOSED WITH ASTHMA, WHICH IS HIGHER THAN THE COUNTY RATE OF 12.8%.HOMELESSNESS:- FROM 2016 TO 2017, SPA 5 EXPERIENCED AN 18% INCREASE IN THE NUMBER OF HOMELESS INDIVIDUALS.- THE RATE OF CHRONICALLY HOMELESS ROSE TO 32.9% IN 2017, COMPARED TO 28.4% IN 2016.- ONE-THIRD OF THE HOMELESS POPULATION (33.3%) IDENTIFY AS HAVING A MENTAL ILLNESS.- THE HOSPITAL SERVICE AREA REPORTS A HIGHER LEVEL OF HOMELESS VETERANS (18.6%) WHEN COMPARED TO HOMELESS VETERANS IN LOS ANGELES COUNTY (8%).- COMMUNITY INPUT NOTED THAT THE COMPLEXITY OF HOMELESSNESS CHALLENGES LOCAL PROVIDERS: LACK OF AFFORDABLE HOUSING, THE TRANSIENT NATURE OF THE POPULATION, MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES, COMMUNITY INTOLERANCE, AND A SHORTAGE OF WRAP-AROUND AND SUPPORT SERVICES.MENTAL HEALTH:- IN THE HOSPITAL SERVICE AREA, 5.2% OF ADULTS EXPERIENCED SERIOUS PSYCHOLOGICAL DISTRESS IN THE PAST YEAR.- STIGMA AROUND MENTAL HEALTH CONTINUES TO BE A BARRIER TO ACCESSING CARE.- 8.9% OF ADULTS IN SPA 5 HAD SERIOUSLY CONSIDERED SUICIDE, WHICH IS LOWER THAN THE COUNTY (9.5%) AND STATE (9.6%) RATES.- COMMUNITY INPUT NOTED THAT BARRIERS AROUND MENTAL HEALTH INCLUDED: A LACK OF PRACTITIONERS AND PREVENTIVE PRACTICES, AS WELL AS THE COST OF CARE, WHICH IS OFTEN NOT COVERED BY INSURANCE.OVERWEIGHT AND OBESITY:- IN THE HOSPITAL SERVICE AREA, 4.4% OF CHILDREN AND 42.6% OF TEENS ARE OVERWEIGHT. 30.5% OF SENIORS IN SPA 5 ARE OVERWEIGHT.- ALMOST THREE-QUARTERS OF LATINO RESIDENTS IN SPA 5 (74.6%) ARE OVERWEIGHT OR OBESE. 46.2% OF WHITE ADULTS AND 44.2% OF AFRICAN AMERICAN ADULTS IN SPA 5 ARE OVERWEIGHT OR OBESE. AMONG ASIANS, 17.7% ARE OVERWEIGHT OR OBESE.- IN THE HOSPITAL SERVICE AREA, 15.4% OF CHILDREN AND 15% OF ADULTS CONSUME FAST FOOD THREE OR MORE TIMES A WEEK.- 57.8% OF TEENS IN SPA 5 CONSUMED TWO OR MORE SERVINGS OF FRUIT A DAY, LESS THAN THE PERCENTAGE OF TEENS IN THE COUNTY (70.9%).- 31% OF TEENS IN SPA 5 ENGAGED IN NO PHYSICAL ACTIVITY DURING THE WEEK, COMPARED TO 16.8% OF TEENS IN LA COUNTY, AND 14.8% IN THE STATE.- A BARRIER TO ENGAGING IN OUTSIDE ACTIVITY NOTED BY THE COMMUNITY IS THE LACK OF PUBLIC GREEN OR OPEN SPACES OTHER THAN THE BEACHES.PREVENTIVE PRACTICES:- CULVER CITY UNIFIED SCHOOL DISTRICT (96.4%) AND SANTA MONICA - MALIBU UNIFIED SCHOOL DISTRICT (88.8%) OF CHILDREN ENTERED KINDERGARTEN IN THE 2015-2016 YEAR WITH UP-TO-DATE IMMUNIZATIONS, COMPARED TO COUNTY (91.4%) AND STATE (92.9%).- OVERALL, 38% OF SPA 5 RESIDENTS OBTAINED A FLU VACCINATION IN 2015; THE HEALTHY PEOPLE 2020 OBJECTIVE IS FOR 70% OF THE POPULATION TO RECEIVE A FLU SHOT. AMONG SPA 5 RESIDENTS AGES 65 AND OLDER, 67.7% RECEIVED A FLU SHOT.- 61.2% OF SENIORS IN SPA 5 HAVE RECEIVED THE PNEUMONIA VACCINE. THE HEALTHY PEOPLE 2020 OBJECTIVE IS FOR 90% OF ADULTS AGES 65 AND OLDER TO BE VACCINATED.- IN SPA 5, 88.7% OF WOMEN OBTAINED A PAP SMEAR IN THE PAST THREE YEARS AND 85.3% OF WOMEN HAVE OBTAINED A MAMMOGRAM IN THE PAST TWO YEARS.SENIOR HEALTH:- FALLS ARE THE LEADING CAUSE OF INJURY AMONG OLDER ADULTS. 27.8% OF SENIORS IN SPA 5 REPORTED FALLING AT LEAST ONCE IN THE PAST YEAR.- COMMUNITY INPUT NOTED BARRIERS TO HEALTH CARE FOR SENIORS INCLUDED: HIGH RENTS, VULNERABILITY TO ISOLATION, LIMITED TRANSPORTATION RESOURCES, AND NOT ENOUGH RESOURCES FOR SUPPORTIVE LIVING.SUBSTANCE ABUSE:- 10.8% OF ADULTS IN SPA 5 ARE CURRENT SMOKERS, COMPARED TO 12.2% IN THE COUNTY AND 12.8% IN THE STATE.- AMONG TEENS IN SPA 5, 24% HAVE SMOKED AN ELECTRONIC (VAPORIZER) CIGARETTE, COMPARED TO 6.9% IN THE COUNTY AND 7.5% IN THE STATE.- 43.3% OF TEENS IN SPA 5 HAVE TRIED ALCOHOL, COMPARED TO 21.9% IN THE COUNTY AND 23% IN THE STATE.- BARRIERS TO CARE FOR SUBSTANCE ABUSE IDENTIFIED BY THE COMMUNITY INCLUDED: LIMITED DETOX OPTIONS AND WAIT LISTS FOR TREATMENT CENTERS.IDENTIFICATION OF SIGNIFICANT HEALTH NEEDS:THE ANALYSIS OF SECONDARY DATA YIELDED A PRELIMINARY LIST OF SIGNIFICANT HEALTH NEEDS WHICH THEN INFORMED PRIMARY DATA COLLECTION. THE PRIMARY DATA COLLECTION PROCESS HELPED TO VALIDATE SECONDARY DATA FINDINGS.THE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS WERE DETERMINED:- ACCESS TO HEALTH CARE- CHRONIC DISEASES- HOMELESSNESS- MENTAL HEALTH- OVERWEIGHT AND OBESITY- PREVENTIVE PRACTICES- SENIOR HEALTH- SUBSTANCE ABUSETHE STAKEHOLDERS WERE ASKED TO RANK THE HEALTH NEEDS ACCORDING TO HIGHEST LEVEL OF IMPORTANCE IN THE COMMUNITY. AMONG THE INTERVIEWEES, MENTAL HEALTH, HOMELESSNESS, AND ACCESS TO HEALTH CARE WERE RANKED AS THE TOP PRIORITY NEEDS IN THE SERVICE AREA.THE SIGNIFICANT HEALTH NEEDS ARE LISTED IN PRIORITY ORDER:1. MENTAL HEALTH2. HOMELESSNESS3. ACCESS TO HEALTH CARE4. SUBSTANCE ABUSE5. CHRONIC DISEASES6. OVERWEIGHT AND OBESITY7. PREVENTIVE PRACTICES8. SENIOR HEALTHPART V, SECTION B, LINE 3E: THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
MARINA DEL REY HOSPITAL	PART V, SECTION B, LINE 5: IN CONDUCTING CEDARS-SINAI MARINA DEL REY'S CHNA, THE HOSPITAL FACILITY TOOK 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.TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. INTERVIEWS WERE COMPLETED IN OCTOBER AND NOVEMBER, 2017. COMMUNITY STAKEHOLDERS IDENTIFIED BY CSMDRH WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INPUT WAS OBTAINED FROM THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. THE IDENTIFIED STAKEHOLDERS WERE INVITED BY EMAIL TO PARTICIPATE IN A PHONE INTERVIEW.
MARINA DEL REY HOSPITAL	PART V, SECTION B, LINE 11: HEALTH NEEDS WERE IDENTIFIED IN THE CHNA AND SUBSEQUENTLY PRIORITIZED BY COMMUNITY STAKEHOLDERS. FROM THE PRIORITIZED HEALTH NEEDS, CEDARS-SINAI MARINA DEL REY HOSPITAL (CSMDRH) CHOSE HEALTH FOCUS AREAS TAKING ACCOUNT CSMDRH'S CAPACITY TO IMPACT COMMUNITY NEEDS, THE STRENGTH OF COMMUNITY PARTNERSHIPS AND THE ALIGNMENT WITH CEDARS-SINAI'S ORGANIZATIONAL STRATEGIC PLANNING EFFORTS.HEALTH FOCUS AREAS:ACCESS TO CARE - COMMUNITY BENEFIT EFFORTS FOCUS ON PROGRAMS, PARTNERSHIPS AND STRATEGIES THAT INCREASE ACCESS TO PRIMARY CARE, PREVENTIVE CARE AND ACCESS TO MENTAL HEALTH CARE SERVICES.HOMELESSNESS - COMMUNITY BENEFIT EFFORTS FOCUS ON PROGRAMS, PARTNERSHIPS AND STRATEGIES THAT INCREASE ACCESS TO PRIMARY CARE, MENTAL HEALTH CARE, SUBSTANCE ABUSE SERVICES AND COMMUNITY-BASED HEALTH CARE SERVICES FOR PERSONS EXPERIENCING HOMELESSNESS. ALIGNMENT WITH PUBLIC HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN:CSMDRH IS COMMITTED TO ALIGNING ITS IMPLEMENTATION STRATEGY WITH THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH COMMUNITY HEALTH IMPROVEMENT PLAN. CSMDRH'S IMPLEMENTATION STRATEGY CONCENTRATES ON "PRIORITY AREA 1: INCREASE PREVENTION TO IMPROVE HEALTH" OF THE COMMUNITY HEALTH IMPROVEMENT PLAN FOR LOS ANGELES COUNTY. GOAL 1.2 FOR THIS PRIORITY AREA: INCREASE ACCESS TO CARE (MEDICAL, CLINICAL PREVENTIVE SERVICES, MENTAL HEALTH AND DENTAL) CORRESPONDS TO THE CSMDRH IMPLEMENTATION STRATEGY'S HEALTH FOCUS AREAS.EVALUATION OF IMPACT:THE HEALTH FOCUS AREAS IDENTIFIED ABOVE WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. DUE TO THE QUANTITY AND SCOPE OF THE COMMUNITY'S HEALTH NEEDS IDENTIFIED, IT IS NECESSARY TO IDENTIFY FOCUS AREAS AND TO ENSURE THAT THE COMMUNITY BENEFIT INITIATIVES ARE EFFECTIVE IN IMPROVING THE HEALTH OF VULNERABLE POPULATIONS. IN SUPPORT OF OUR MISSION TO IMPROVE THE HEALTH OF THE COMMUNITY, CSMDRH HAS COMMITTED TO ONGOING PROGRAM EVALUATION TO ENSURE MAXIMUM IMPACT OF OUR COMMUNITY BENEFIT STRATEGIES. CSMDRH WILL INCORPORATE EVALUATION RESULTS INTO PROGRAM STRATEGY, PLANNING AND IMPLEMENTATION.HEALTH NEEDS THE HOSPITAL WILL NOT ADDRESS:THERE WERE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA THAT DID NOT MEET THE CRITERIA FOR DEVELOPING AND IMPLEMENTING A HEALTH FOCUS AREA AND, AS A RESULT, ARE NOT ADDRESSED IN THIS IMPLEMENTATION STRATEGY. THIS IS NOT INTENDED TO MINIMIZE THE IMPORTANCE OF THOSE HEALTH NEEDS; IT IS A REALITY OF HAVING A STRATEGIC FOCUS ON EFFECTIVENESS TO IMPROVE COMMUNITY HEALTH. THE HEALTH NEEDS THAT WERE IDENTIFIED IN THE CHNA BUT NOT INCLUDED IN THE HEALTH FOCUS AREAS FOR THIS IMPLEMENTATION STRATEGY ARE: CHRONIC DISEASES, OVERWEIGHT AND OBESITY, AND SENIOR HEALTH. CSMDRH WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS WHERE WE CAN MAKE A MEANINGFUL CONTRIBUTION.

Schedule H (Form 990) 2019

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?3
Name and address		Type of Facility (describe)
1	1 - MARINA DEL REY HOSPITAL 4658 LINCOLN BLVD MARINA DEL REY,CA90292	OUTPATIENT SERVICES - GEN/LAB/RADIOLOGY/MRI/CT SCANNER
2	2 - MARINA DEL REY HOSPITAL 4640 ADMIRALTY WAY STE 600 MARINA DEL REY,CA90292	OUTPATIENT SERVICES - SPINE CENTER
3	3 - MARINA DEL REY HOSPITAL 4644 LINCOLN BLVD STE 450 MARINA DEL REY,CA90292	OUTPATIENT SERVICES - BARIATRICS CENTER
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

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 7:	FINANCIAL ASSISTANCE AND MEDI-CAL COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL FINANCIAL ASSISTANCE AND MEDI-CAL REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2018.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE HOSPITAL IS INVOLVED IN COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. COMMUNITY CONCERNS, SUCH AS HEALTH IMPROVEMENT, ARE ADDRESSED. THE HOSPITAL WORKS WITH OTHER TAX-EXEMPT ORGANIZATIONS TO PROMOTE HEALTH AND WELLNESS AND DISEASE PREVENTION. THESE ACTIVITIES ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H.
PART III, LINE 2:	PATIENT SERVICE REVENUE, NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, IS REDUCED BY THE PROVISION FOR BAD DEBTS, AND ACCOUNTS RECEIVABLE IS REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANY FACTORS, INCLUDING PAYER MIX, AGE OF RECEIVABLES, HISTORICAL CASH COLLECTION EXPERIENCE, AND OTHER RELEVANT INFORMATION. A SIGNIFICANT PORTION OF THE HOSPITAL'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR SERVICES PROVIDED, AND A SIGNIFICANT PORTION OF THE HOSPITAL'S INSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR CO-PAYMENTS AND DEDUCTIBLES. THUS, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS RELATED TO THESE INSURED AND UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. THE HOSPITAL WRITES DOWN THE EXPECTED REIMBURSEMENT AFTER REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED.
PART III, LINE 4:	AUDITED FINANCIAL STATEMENTS - PAGE 13PART III, LINE 6: MEDICARE ALLOWABLE COSTS AS A PERCENTAGE OF TOTAL HOSPITAL EXPENSES WERE DETERMINED BASED ON THE RATIO OF TOTAL MEDICARE REVENUE OVER TOTAL CHARGES DURING THE FISCAL YEAR ENDING ON 6/30/2018.
PART III, LINE 8:	IT IS OUR BELIEF THAT ALL OF THE $21,501,135 SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. CARING FOR MEDICARE PATIENTS FULFILLS A COMMUNITY NEED AND RELIEVES A GOVERNMENT BURDEN AS THESE PATIENTS TYPICALLY HAVE LOW AND/OR FIXED INCOMES. MEDICARE DOES NOT PROVIDE SUFFICIENT REIMBURSEMENT TO COVER THE COST OF PROVIDING CARE FOR THESE PATIENTS.
PART III, LINE 9B:	REASONABLE EFFORTS BASED ON BILLING STATEMENT NOTIFICATION AND AMOUNTS NOT ELIGIBLE:THE HOSPITAL NOTIFIES PATIENTS OF ITS FINANCIAL ASSISTANCE PROGRAMS BEFORE INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS. THE HOSPITAL REFRAINS FROM INITIATING EXTRAORDINARY COLLECTION ACTIONS FOR AT LEAST 120 DAYS FROM THE DATE THE HOSPITAL BILLS FOR THE CARE IF THE PATIENT HAS NOT SUBMITTED AN APPLICATION OR THE HOSPITAL HAS DETERMINED THE PATIENT IS NOT ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON THE PATIENT'S APPLICATION.AT LEAST 30 DAYS BEFORE FIRST INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS, THE HOSPITAL PROVIDES THE PATIENT WITH A WRITTEN NOTICE INDICATING FINANCIAL ASSISTANCE IS AVAILABLE, IDENTIFYING THE EXTRAORDINARY COLLECTION ACTION THAT THE HOSPITAL INTENDS TO INITIATE TO OBTAIN PAYMENT, AND STATING A DEADLINE AFTER WHICH SUCH EXTRAORDINARY COLLECTION ACTIONS MAY BE INITIATED (WHICH DATE IS NOT EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED). THE NOTICE INCLUDES A PLAIN LANGUAGE SUMMARY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.IN ADDITION TO ALL WRITTEN NOTICES, PRIOR TO INITIATING ANY EXTRAORDINARY COLLECTION ACTIONS, THE HOSPITAL MAKES A REASONABLE EFFORT TO VERBALLY NOTIFY THE PATIENT ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND ABOUT HOW THE PATIENT MAY OBTAIN ASSISTANCE THROUGH THE APPLICATION PROCESS.
PART VI, LINE 2:	A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN FISCAL YEAR ENDED 6/30/18. SEE NARRATIVE FOR SCHEDULE H, PART V, SECTION B, LINE 3J.
PART VI, LINE 3:	THE HOSPITAL PROVIDES THE FOLLOWING NOTICES REGARDING FULL AND PARTIAL FINANCIAL ASSISTANCE FOR THE FINANCIALLY QUALIFIED PATIENTS:A) POSTED SIGNAGE - NOTICE OF THE FINANCIAL ASSISTANCE POLICY IS POSTED IN THE FOLLOWING LOCATIONS: THE EMERGENCY DEPARTMENT, THE ADMITTING DEPARTMENT, CENTRALIZED AND DECENTRALIZED REGISTRATION AREAS AND OTHER OUTPATIENT SETTINGS.B) NOTICES HAND-DELIVERED TO PATIENTS - DURING THE REGISTRATION OR ADMISSION PROCESS (OR OTHERWISE PRIOR TO DISCHARGE), PATIENTS ARE PROVIDED A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY AND CEDARS-SINAI MARINA DEL REY'S FINANCIAL ASSISTANCE PROGRAMS. PATIENTS ARE ASKED TO ACKNOWLEDGE RECEIPT OF THIS VIA AN ELECTRONIC SIGNATURE.C) PATIENT STATEMENT NOTICES - ON THE PATIENT BILLING STATEMENTS, THE HOSPITAL PROVIDES A DESCRIPTION OF ITS FINANCIAL ASSISTANCE POLICY AND PROGRAMS, ALONG WITH INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:	PLEASE SEE COMMUNITY SERVICE AREA AND DEMOGRAPHICS INFORMATION IN THE NARRATIVE FOR SCHEDULE H, PART V, SECTION B, LINE 3J. IN ADDITION, THERE ARE FIVE OTHER HOSPITALS THAT SERVE THE SAME COMMUNITY AS CEDARS-SINAI MARINA DEL REY HOSPITAL.
PART VI, LINE 5:	CEDARS-SINAI MARINA DEL REY HOSPITAL IS DRIVEN BY ITS MISSION TO STRIVE TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY BY GIVING BACK TO THE COMMUNITY IN THE FORM OF HEALTH CARE AND OTHER COMMUNITY SERVICES. THE HOSPITAL PROVIDES BOTH QUANTIFIABLE AND NON-QUANTIFIABLE CONTRIBUTIONS TO THE COMMUNITY, SUCH AS INCREASING PARTICIPATION IN LOCAL EFFORTS TO COMBAT HOMELESSNESS IN THE COMMUNITY AND INCURRING UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED OF THE COMMUNITY. IN ADDITION, THE HOSPITAL DISTRIBUTED GRANTS TO ST. JOSEPH'S CENTER AND VENICE FAMILY CLINIC, BOTH SIGNIFICANT COMMUNITY PROVIDERS OF HOMELESS SERVICES IN THE MARINA DEL REY SERVICE AREA. ANY SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION TO FURTHER SUPPORT THE COMMUNITY.
PART VI, LINE 6:	THE HOSPITAL IS AN AFFILIATE OF CEDARS-SINAI HEALTH SYSTEM. THE 133-BED SURGICAL HOSPITAL IS FULLY ACCREDITED THROUGH THE JOINT COMMISSION FOR SAFE AND EFFECTIVE QUALITY CARE. BY CONCENTRATING FOUR AREAS OF EXPERTISE: SPINE, WEIGHT LOSS, ORTHOPEDICS, AND MINIMALLY INVASIVE SURGERY, THE HOSPITAL IS ABLE TO PROVIDE EXCELLENT CARE IN AN INTIMATE, PERSONAL AND CONVENIENT SETTING.THE HOSPITAL IS COMMITTED TO THE FOLLOWING:* COMMITMENT TO THE COMMUNITY: PROVIDING EXCELLENT AND PROMPT ACUTE MEDICAL SERVICES AND 24/7 EMERGENCY ROOM CARE. * TALENTED CUSTOMER SERVICE-DRIVEN TEAM: BELIEVES KINDNESS IS JUST AS IMPORTANT AS STATE-OF-THE-ART MEDICAL TECHNOLOGY. * NATIONALLY RECOGNIZED PHYSICIANS: RECOGNIZED FOR CLINICAL EXCELLENCE AND DEVOTED TO DELIVERING COMPASSIONATE, RESPONSIVE CARE.THE HOSPITAL'S MISSION:* TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE FOR RESIDENTS IN MARINA DEL REY AND SURROUNDING BEACH COMMUNITIES AND THE WESTSIDE OF LOS ANGELES * TO BE RECOGNIZED FOR MEDICAL EXCELLENCE IN SPINE, ORTHOPEDICS, SURGICAL WEIGHT LOSS, MINIMALLY INVASIVE SURGERY, NON-INVASIVE CARDIOLOGY AND GENERAL ACUTE MEDICAL CARE THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES ORGANIZATIONAL LEADERSHIP IN FOSTERING THE COMMITMENT TO COMMUNITY BENEFIT. THE BOARD OF DIRECTORS FUNCTIONS AS AN OVERSIGHT AND POLICY-MAKING BODY FOR THE HOSPITAL'S COMMUNITY BENEFIT COMMITMENTS, EFFORTS AND STRATEGIC ALIGNMENT WITH COMMUNITY NEEDS. DURING THE TAX YEAR, THE HOSPITAL'S COMMUNITY BENEFIT EXPENSE TOTALED $13,088,264 DIVIDED AMONG THE FOLLOWING CATEGORIES:* UNREIMBURSED COST OF DIRECT MEDICAL CARE FOR THE POOR AND UNDERSERVED - $12,997,846 (CHARITY CARE - $167,091; UNREIMBURSED COST: CARING FOR MEDI-CAL PATIENTS - $12,830,755) (EXCLUDES THE UNREIMBURSED COST OF CARING FOR MEDICARE PATIENTS) COMMUNITY BENEFIT PROGRAMS, INCLUDING CHARITABLE DONATIONS - $90,418DURING THE TAX YEAR, TORRANCE MEMORIAL OFFICIALLY JOINED THE AFFILIATION. TORRANCE MEMORIAL INCLUDES THE 470-BED TORRANCE MEMORIAL MEDICAL CENTER, A MULTISPECIALTY PHYSICIAN GROUP, AN INDEPENDENT PHYSICIAN ASSOCIATION, AND AN ACCOUNTABLE CARE ORGANIZATION, WHICH COLLECTIVELY INCLUDE MORE THAN 500 PHYSICIANS. IT ALSO HAS SEVERAL OUTPATIENT CENTERS LOCATED THROUGHOUT THE SOUTH BAY REGION. THE AFFILIATION ENABLES EACH INSTITUTION TO CONTINUE THE UNIQUE RELATIONSHIPS EACH HAS WITH THE COMMUNITIES IT SERVES, WHILE PROVIDING A PLATFORM FOR A WIDE VARIETY OF COLLABORATIONS TO BETTER SERVE THE REGION.
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2019

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

2019

Open to Public
Inspection

Name of the organization
CFHS HOLDINGS INC

Employer identification number
20-1645949

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) VENICE FAMILY CLINIC 604 ROSE AVE VENICE,CA90291	95-2769432	501(C)(3)	25,000	GRANT FOR INTEGRATED MOBILE HEALTH TEAM
(2) ST JOSEPH CENTER 204 HAMPTON DRIVE VENICE,CA90291	95-3874381	501(C)(3)	25,000	GRANT FOR COMMUNITY HOMELESS SERVICES
(3)				GRANT FOR COMMUNITY HOMELESS SERVICES

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) 2019

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)
(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:	THE ORGANIZATION CONTRIBUTES TO WELL ESTABLISHED EXEMPT ORGANIZATIONS AND RELIES ON THE GOVERNING BODY OF EACH OF THESE ORGANIZATIONS TO ENSURE THAT GRANT FUNDS DONATED TO EACH AND EVERY ORGANIZATION ARE USED FOR PROPER PURPOSES AND NOT OTHERWISE DIVERTED FROM THE INTENDED USE.

Schedule I (Form 990) 2019

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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

2019

Open to Public Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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 on 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 on 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? .........

Yes

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

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

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) 2019

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)
1THOMAS M PRISELAC CHAIR	(i) (ii)	0 ------------- 1,571,779	0 ------------- 1,248,768	0 ------------- 807,008	0 ------------- 1,347,100	0 ------------- 26,050	0 ------------- 5,000,705	0 ------------- 400,000
2MARK GAVENS CEO	(i) (ii)	0 ------------- 974,424	0 ------------- 473,131	0 ------------- 276,523	0 ------------- 176,135	0 ------------- 36,495	0 ------------- 1,936,708	0 ------------- 0
3MARY KATHRYN HAMMACK CFO/TREASURER	(i) (ii)	212,239 ------------- 0	35,540 ------------- 0	0 ------------- 0	6,425 ------------- 0	2,826 ------------- 0	257,030 ------------- 0	0 ------------- 0
4PAULETTE HEITMEYER COO	(i) (ii)	0 ------------- 292,024	0 ------------- 101,323	0 ------------- 55,547	0 ------------- 8,100	0 ------------- 1,483	0 ------------- 458,477	0 ------------- 0
5SHAWN BOND PHYSICIAN ASSISTANT	(i) (ii)	227,406 ------------- 0	425 ------------- 0	0 ------------- 0	6,856 ------------- 0	1,130 ------------- 0	235,817 ------------- 0	0 ------------- 0
6CATHY OHNSTAD CHIEF NURSING OFFICER	(i) (ii)	188,097 ------------- 0	14,963 ------------- 0	0 ------------- 0	5,746 ------------- 0	4,100 ------------- 0	212,906 ------------- 0	0 ------------- 0
7JEFFREY WALLACE ASSISTANT ADMINISTRATOR	(i) (ii)	176,835 ------------- 0	17,325 ------------- 0	0 ------------- 0	15,785 ------------- 0	1,774 ------------- 0	211,719 ------------- 0	0 ------------- 0
8PERCY CUPEN DIRECTOR OF QUALITY MANAGEMENT	(i) (ii)	182,941 ------------- 0	18,657 ------------- 0	0 ------------- 0	830 ------------- 0	2,319 ------------- 0	204,747 ------------- 0	0 ------------- 0
9KIMBERLY BOTWIN DIRECTOR PHARMACY	(i) (ii)	198,321 ------------- 0	2,825 ------------- 0	0 ------------- 0	0 ------------- 0	306 ------------- 0	201,452 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 3

THE CEO OF CFHS HOLDINGS, INC.(DBA CEDARS-SINAI MARINA DEL REY HOSPITAL) IS COMPENSATED BY CEDARS-SINAI MEDICAL CENTER, A RELATED TAX-EXEMPT ORGANIZATION. CEDARS-SINAI MEDICAL CENTER USED THE FOLLOWING METHODS IN ESTABLISHING THE CFHS HOLDINGS, INC. CEO'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) WRITTEN EMPLOYMENT CONTRACT; 4) COMPENSATION SURVEY OR STUDY; AND 5) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

PART I, LINE 4B

THERE ARE TWO NONQUALIFIED DEFERRED COMPENSATION PLANS IN WHICH ONE OR MORE OF THE LISTED PERSONS PARTICIPATE. THE FIRST PLAN IS A DEFERRED COMPENSATION PLAN. THIS IS A "GRANDFATHERED" TRADITIONAL DEFINED BENEFIT PLAN (NO NEW PARTICIPANTS HAVE BEEN ADDED SINCE 1986). THE BENEFIT FORMULA IS A PERCENTAGE OF THE HIGHEST FIVE YEARS AVERAGE ANNUAL SALARY TIMES THE NUMBER OF YEARS OF ELIGIBLE SERVICE, WITH A MAXIMUM CREDITED SERVICE OF 30 YEARS. THE SECOND PLAN IS A SUPPLEMENTAL RETIREMENT ALLOWANCE THAT IS PAYABLE DIRECTLY TO THE PARTICIPANTS EACH QUARTER. THE BENEFIT FORMULA FOR THIS PLAN HAS ANNUAL CONTRIBUTIONS THAT ARE EITHER A PERCENTAGE OF SALARY, OR ARE DESIGNED TO FUND A PERCENTAGE OF THE ESTIMATED FINAL 5-YEAR AVERAGE SALARY. THE FOLLOWING LISTED PERSONS RECEIVED PAYMENTS DURING THE YEAR ENDED DECEMBER 31, 2017 RELATED TO ONE OR BOTH OF THE PLANS REFERENCED ABOVE. THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II AND ARE NOT INCREMENTAL PAYMENTS. THOMAS M. PRISELAC 708,909 MARK GAVENS 250,973 PAULETTE HEITMEYER 53,280

Schedule J (Form 990) 2019

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

2019

Open to Public
Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	CEDARS-SINAI MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF CFHS HOLDINGS, INC. DOING BUSINESS AS CEDARS-SINAI MARINA DEL REY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	CEDARS-SINAI MEDICAL CENTER, AS THE SOLE CORPORATE MEMBER, ELECTS THE BOARD OF DIRECTORS OF CEDARS-SINAI MARINA DEL REY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	RESERVED RIGHTS OF CEDARS-SINAI MEDICAL CENTER, THE SOLE CORPORATE MEMBER OF CEDARS-SINAI MARINA DEL REY HOSPITAL ("THE HOSPITAL"). THE FOLLOWING ACTIONS MUST BE APPROVED OR ACTED UPON BY CEDARS-SINAI MEDICAL CENTER BEFORE BECOMING EFFECTIVE: (A) ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE HOSPITAL; (B) ANY AMENDMENT TO THE HOSPITAL'S PURPOSE OR MISSION; (C) ANY CHANGE IN THE MEMBERSHIP OR MEMBERSHIP POWERS OF THE HOSPITAL OR ITS SUBSIDIARY; (D) HIRING, ELECTING, REMOVING, OR TERMINATING ANY OF THE OFFICERS OF THE HOSPITAL; (E) REMOVAL AND APPOINTMENT OF DIRECTORS OF THE HOSPITAL; (F) CHANGING THE NUMBER OF DIRECTORS ON THE BOARD OF DIRECTORS; (G) SELECTION AND APPOINTMENT OF THE AUDITORS AND LEGAL COUNSEL OF THE HOSPITAL; (H) ANY SALE OR OTHER DISPOSITION OF ALL OR A SUBSTANTIAL PORTION OF THE ASSETS OF THE HOSPITAL; (I) MERGER, CONSOLIDATION, REORGANIZATION, DIVESTITURE, AFFILIATION, LIQUIDATION, OR DISSOLUTION; (J) BORROWING MONEY AND INCURRING INDEBTEDNESS ON BEHALF OF THE HOSPITAL; (K) APPROVING THE HOSPITAL'S ANNUAL OPERATING AND CAPITAL BUDGETS; (L) DECLARING OR CONSENTING TO THE FILING OF PROCEEDINGS TO DECLARE BANKRUPTCY.
FORM 990, PART VI, SECTION B, LINE 11B	THE REVIEW OF THE FORM 990 INVOLVES VARIOUS MANAGEMENT PERSONNEL INCLUDING THE HOSPITAL'S TREASURER, AND A BIG FOUR ACCOUNTING FIRM. THE FORM 990 IS PRESENTED AT A BOARD OF DIRECTORS' MEETING ALLOWING THE ENTIRE BOARD THE OPPORTUNITY TO DISCUSS THE INFORMATION REPORTED.
FORM 990, PART VI, SECTION B, LINE 12C	THE PURPOSE OF THE CONFLICTS OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF THE HOSPITAL WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE HOSPITAL OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE STATE LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO THE HOSPITAL. PROCEDURES: DUTY TO DISCLOSE - IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS RELATING THERETO, AND AFTER ANY DISCUSSION THEREOF, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ANNUAL STATEMENTS: EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, B) HAS READ AND UNDERSTANDS THE POLICY, C) HAS AGREED TO COMPLY WITH THE POLICY, AND D) UNDERSTANDS THE HOSPITAL IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. PERIODIC REVIEWS: TO ENSURE THAT THE HOSPITAL OPERATES IN A MANNER CONSISTENT WITH CHARITABLE PURPOSES AND DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS TAX-EXEMPT STATUS, THE HOSPITAL SHALL CONDUCT PERIODIC REVIEWS OF THE IMPLEMENTATION OF THE POLICY. THE PERIODIC REVIEWS SHALL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A) WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S-LENGTH BARGAINING, B) WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS, IF ANY, CONFORM TO THE HOSPITAL'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENTS FOR GOODS AND SERVICES, FURTHER CHARITABLE PURPOSES, AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. USE OF OUTSIDE EXPERTS: WHEN CONDUCTING PERIODIC REVIEWS, THE HOSPITAL MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. IF OUTSIDE ADVISORS ARE USED, THEIR USE SHALL NOT RELIEVE THE BOARD OF ITS RESPONSIBILITY FOR ENSURING PERIODIC REVIEWS ARE CONDUCTED.
FORM 990, PART VI, SECTION B, LINE 15	THE HOSPITAL'S CHIEF EXECUTIVE OFFICER IS COMPENSATED BY THE HOSPITAL'S SOLE CORPORATE MEMBER, CEDARS-SINAI MEDICAL CENTER. THE EXECUTIVE PERSONNEL COMMITTEE OF CEDARS-SINAI MEDICAL CENTER REVIEWS AND APPROVES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION. SINCE THE HOSPITAL DOES NOT COMPENSATE ITS CHIEF EXECUTIVE OFFICER, THE RESPONSE TO THIS QUESTION IS NO, IN ACCORDANCE WITH SPECIFIC INSTRUCTIONS FROM THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE ATTACHED TO ITS FORM 990. THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART XII, LINE 2C:	THE HOSPITAL'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH ITS PARENT FOR FISCAL YEAR ENDED JUNE 30, 2018. THE OVERSIGHT OF THE AUDIT WAS PERFORMED BY ITS PARENT'S AUDIT COMMITTEE.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

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

2019

Open to Public Inspection

Name of the organization

CFHS HOLDINGS INC

Employer identification number

20-1645949

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)CEDARS-SINAI MEDICAL CENTER 8700 BEVERLY BOULEVARD LOS ANGELES,CA90048 95-1644600	ACUTE-CARE, TEACHING AND RESEARCH HOSPITAL	CA	501 (C) (3)	LINE 3	CEDARS-SINAI HEALTH SYSTEM	Yes
(2)CALIFORNIA HEART CENTER FOUNDATION 15821 VENTURA BLVD STE 520 ENCINO,CA91436 95-4772979	PROMOTE, SUPPORT, AND DEVELOP EDUCATIONAL, AND SCIENTIFIC RESEARCH	CA	501 (C) (3)	LINE 7	CEDARS-SINAI MEDICAL CENTER	Yes
(3)CEDARS-SINAI MEDICAL CARE FOUNDATION 15821 VENTURA BLVD STE 520 ENCINO,CA91436 95-4457756	PROVISION OF MEDICAL CARE, TEACHING, AND RESEARCH	CA	501 (C) (3)	LINE 12A, I	CEDARS-SINAI MEDICAL CENTER	Yes
(4)KERLAN-JOBE ORTHOPAEDIC FOUNDATION 6801 PARK TERRACE STE 500 LOS ANGELES,CA90045 95-4707606	EDUCATION AND RESEARCH RELATED TO ORTHOPEDIC MEDICINE	CA	501 (C) (3)	LINE 7	CEDARS-SINAI MEDICAL CARE FOUNDATION	Yes
(5)SANTA MONICA ORTHOPAEDIC & SPORTS MED RESEARCH FDN 2020 SANTA MONICA BLVD 4TH FL SANTA MONICA,CA90404 95-4789926	EDUCATION AND RESEARCH RELATED TO ORTHOPEDIC AND NEUROLOGIC CONDITIONS	CA	501 (C) (3)	PF	CEDARS-SINAI MEDICAL CARE FOUNDATION	Yes
(6)CEDARS-SINAI HEALTH SYSTEM 8700 BEVERLY BLVD LOS ANGELES,CA90048 30-0990905	SUPPORT SPECIFIED NONPROFIT HEALTHCARE ORGANIZATIONS	CA	501 (C) (3)	LINE 12C, III-FI	N/A		No
(7)TORRANCE MEMORIAL MEDICAL CENTER HEALTH CARE FOUNDATION 3330 LOMITA BLVD TORRANCE,CA90505 95-3528452	FUNDRAISING	CA	501 (C) (3)	LINE 7	TORRANCE HEALTH ASSOCIATION	Yes
(8)TORRANCE MEMORIAL MEDICAL CENTER 3330 LOMITA BLVD TORRANCE,CA90505 95-1644042	HEALTH SERVICES	CA	501 (C) (3)	LINE 3	TORRANCE HEALTH ASSOCIATION	Yes
(9)TORRANCE HEALTH ASSOCIATION 3330 LOMITA BLVD TORRANCE,CA90505 33-0073515	HEALTH SERVICES	CA	501 (C) (3)	LINE 12B, II	CEDARS-SINAI HEALTH SYSTEM	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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 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) CEDARS-SINAI BH ASC LLC 200 N ROBERTSON BLVD 101 BEVERLY HILLS,CA90211 81-2266744	HOLDING COMPANY	CA	N/A
(2) CS-BH ASC HOLDINGS LLC 200 N ROBERTSON BLVD 101 BEVERLY HILLS,CA90211 81-2246488	HOLDING COMPANY	CA	N/A
(3) DEL REY SURGERY CENTER LLC 4640 ADMIRALTY WAY 1020 MARINA DEL REY,CA90292 46-2305372	AMBULATORY SURGERY CENTER	CA	N/A
(4) DEL REY SURGERY INVESTORS LLC 8700 BEVERLY BLVD LOS ANGELES,CA90048 36-4756208	INVESTMENT IN AMBULATORY SURGERY CENTER	DE	N/A
(5) ENDOSCOPY CENTER OF SANTA MONICA LLC 2001 SANTA MONICA 360W SANTA MONICA,CA90404 11-3652210	ENDOSCOPIES AND THE RELATED PROCEDURES	CA	N/A
(6) ISS ASC HOLDINGS LLC 27271 LAS RAMBLAS 350 MISSION VIEJO,CA92691 47-1890805	INVESTMENT IN HEALTHCARE SERVICES	CA	N/A
(7) INTERNATIONAL SPINE & ORTHOPEDIC INSTITUTE LLC 8500 W 110TH ST OVERLAND PARK,KS66210 26-3738893	SPINE AND ORTHOPEDIC INSTITUTE	DE	N/A
(8) SANTA MONICA IMAGING GROUP LLC 200 N ROBERTSON BLVD 101 BEVERLY HILLS,CA90211 82-0760657	IMAGING CENTER	CA	N/A
(9) TORRANCE MEMORIAL SUGICAL CENTER LLC 23560 CRENSHAW BLVD STE 104 TORRANCE,CA90505 46-5259260	OUTPATIENT SURGICAL SERVICES	CA	N/A
(10) TORRANCE SURGERY CENTER LP 1A BURTON HILLS BLVD NASHVILLE,TN37215 33-0932093	SURGICAL SERVICES	TN	N/A
(11) 3565 DEL AMO ASSOCIATES 2175 PARK PLACE EL SEGUNDO,CA90245 33-0554737	RENTAL REAL ESTATE	CA	N/A

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
(1) CENTINELA FREEMAN HOLDINGS INC 4650 LINCOLN BLVD MARINA DEL REY,CA90292 59-3811890	REAL ESTATE RENTALS	CA	N/A	C			Yes
(2) OPTIMATRIX HEALTH SOLUTIONS INC 6500 WILSHIRE BLVD 9TH FLOOR LOS ANGELES,CA90048 95-4522779	INACTIVE	CA	N/A	C			Yes
(3) OTOHARMONICS CORPORATION 411 SW 6TH AVE PORTLAND,OR97204 46-1119421	HEALTHCARE PRODUCT DEVELOPMENT	DE	N/A	C			Yes

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

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

Yes

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

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

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

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

Yes

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

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

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) CENTINELA FREEMAN HOLDINGS INC	K	2,263,729	FAIR MARKET VALUE
(2) CENTINELA FREEMAN HOLDINGS INC	Q	2,366,394	FAIR MARKET VALUE

Schedule R (Form 990) 2019

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) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE COMPASSIONATE, HIGH QUALITY HEALTHCARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	802
6	Total number of volunteers (estimate if necessary) .............	6	6
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	185,609

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,814,768	2,508,408
9	Program service revenue (Part VIII, line 2g) .........	93,101,152	106,396,752
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	8,957	665
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	376,227	420,091
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	95,301,104	109,325,916
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	38,000	55,000
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)	56,488,992	53,341,459
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)....	50,104,942	57,927,477
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	106,631,934	111,323,936
19	Revenue less expenses. Subtract line 18 from line 12.......	-11,330,830	-1,998,020
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	70,051,453	71,606,899
21	Total liabilities (Part X, line 26).............	54,681,706	58,235,172
22	Net assets or fund balances. Subtract line 21 from line 20.....	15,369,747	13,371,727

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 90,667,574 including grants of $ 55,000 ) (Revenue $ 106,816,843 )
	CFHS HOLDINGS, INC., DOING BUSINESS AS CEDARS-SINAI MARINA DEL REY HOSPITAL ("THE HOSPITAL"), IS A 133-BED NONPROFIT HOSPITAL AND AFFILIATE OF CEDARS-SINAI. THE HOSPITAL IS FULLY ACCREDITED WITH THE NATIONALLY RECOGNIZED JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS (TJC) FOR SAFE AND EFFECTIVE QUALITY CARE. WE HAVE THE FOLLOWING INPATIENT AND OUTPATIENT SERVICES: 24-HOUR EMERGENCY CARE INCLUDING TELESTROKE SERVICES IN COLLABORATION WITH CEDARS-SINAI NEUROSURGEONS, ICU, TELEMETRY, INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES, AND THE MOST ADVANCED SURGICAL TECHNOLOGY AVAILABLE, CAREFULLY PRACTICED UNDER THE SUPERVISION AND SKILLED HANDS OF OUR WORLD-CLASS PHYSICIANS, NURSES, AND ALLIED HEALTH CARE PROFESSIONALS.(SEE SCHEDULE O FOR CONTINUATION)(CONTINUED FROM PAGE 2)HOSPITAL SERVICES:-24-HOUR EMERGENCY CARE-TELEMEDICINE STROKE PROGRAM IN THE EMERGENCY DEPARTMENT-INTENSIVE CARE UNIT-TELEMETRY/MEDICAL SURGICAL UNITS (CARDIAC MONITORED BEDS)-INPATIENT AND OUTPATIENT CARE-INPATIENT AND OUTPATIENT DIAGNOSTIC SERVICES - IMAGING, GASTROINTESTINAL, LABORATORY, AND CARDIOLOGY-OUTPATIENT BARIATRIC CLINIC-OUTPATIENT SPINE CLINIC-MINIMALLY INVASIVE SURGICAL SERVICES UTILIZING THE MAKO STRYKER ORTHOPAEDIC ROBOT AND THE DA VINCI ROBOT (FOR HERNIA, APPENDECTOMY, GALLBLADDER, COLON, ANTI-REFLUX, BARIATRIC, SPINE, TOTAL HIP, TOTAL KNEE CASES) HOSPITAL STATISTICS:EMPLOYEES 802PHYSICIANS WITH HOSPITAL PRIVILEGES 433SURGEONS WITH HOSPITAL PRIVILEGES 185NUMBER OF SURGERIES ANNUALLY 4,078NUMBER OF ER VISITS ANNUALLY 32,097PAYOR % - HMO/PPO (50%); MEDICARE (35%); MEDI-CAL (4%); COMMERCIAL/OTHER (8%); SELF-PAY/CHARITY (3%)HOSPITAL OPERATIONS:CEDARS-SINAI MARINA DEL REY HOSPITAL UPGRADED THE CLINICAL ELECTRONIC MEDICAL RECORD SYSTEM AND CONVERTED TO EPIC IN MAY OF 2017. THERE WERE CONTINUED ENHANCEMENTS TO THE REPORTING CAPABILITIES IN 2018 AND THE UPGRADED TECHNOLOGY AND REPORTING CAPABILITIES HAVE IMPROVED THE PHYSICIANS AND CLINICAL STAFF ABILITY TO VIEW PRIOR VISIT RECORDS, ENHANCE PATIENT SAFETY VIA ALERTS, INCREASE DATA ANALYSIS AND DECREASED THE AMOUNT OF LABOR FOR SCANNING OF PAPER DOCUMENTS AND ANALYSIS OF DATA. COMMUNITY SUPPORT AND ENGAGEMENT HIGHLIGHTS:- OUR TWO OUTPATIENT CLINICS ARE NATIONALLY RECOGNIZED AS LEADING SURGICAL CENTERS OF CARE. THE MARINA SPINE CENTER IS A MULTIDISCIPLINARY CENTER OFFERING COMPREHENSIVE SPINE SERVICES, FROM EVALUATION AND DIAGNOSIS TO SURGERY AND REHABILITATION. AN ADDITIONAL SPINE SURGEON WAS ADDED TO THE CLINIC STAFF IN 2018. OUR MARINA WEIGHT LOSS CENTER, WHICH HAS A TOTAL OF 12 SURGEONS, IS ACCREDITED BY THE METABOLIC AND BARIATRIC SURGERY ACCREDITATION AND QUALITY IMPROVEMENT PROGRAM (MBSAQIP) FOR EXCELLENCE.- CEDARS-SINAI MARINA DEL REY HOSPITAL IS THE ONLY HOSPITAL LOCATED WITHIN LOS ANGELES' 11TH DISTRICT, AND WE ARE ACTIVELY INVOLVED IN COUNCILMAN MIKE BONIN'S HOMELESS INITIATIVE, VENICE FORWARD. IN ADDITION, WE HAVE JOINED FORCES WITH OUR COMMUNITY PARTNERS (VENICE FAMILY CLINIC, ST. JOSEPH CENTER, AND OPCC THE PEOPLE CONCERN) TO HELP STEM THE HOMELESS CRISIS ON THE WESTSIDE. PLANS FOR FY2019 INCLUDE IMPLEMENTING A HOMELESS FACILITATOR/NAVIGATOR IN THE EMERGENCY ROOM AT MDRH THROUGH COLLABORATION WITH "THE PEOPLE CONCERN AND CSMC TO FACILITATE AND COORDINATE THE POST-DISCHARGE HOMELESS PATIENTS' MEDICAL AND HOUSING NEEDS. - CEDARS-SINAI MARINA DEL REY HOSPITAL LEADERSHIP ENGAGES WITH THE COMMUNITY IN A VARIETY OF WAYS. FACILITY STAFF REPRESENT THE HOSPITAL AT THE FOLLOWING LOCAL COMMUNITY EVENTS AND COLLABORATIVES: HOST COMMUNITY DANCE FITNESS CLASSES ON SITE HOST COMMUNITY YOGA CLASSES ON SITE HOST COMMUNITY TAI CHI CLASSES ON SITE PARTICIPATE IN THE LOCAL ROTARY AND CHAMBER OF COMMERCE PARTICIPATE IN L.A. COUNCIL MEMBER MIKE BONIN'S VENICE FORWARD COLLABORATIVE VENICE FAMILY CLINIC VENICE MARINA COUNCIL DEL REY NEIGHBORHOOD COUNCIL AND DEL REY HEALTH FAIR PACIFIC DIVISION BLOCK CAPTAINS MEETING VENICE NEIGHBORHOOD COUNCIL - BOARD MEETING MAR VISTA NEIGHBORHOOD FAIR THE PEOPLE CONCERN (FORMERLY OPCC) ST. JOSEPH CENTER - CES (COORDINATED ENTRY SYSTEM) LAX COASTAL CHAMBER OF COMMERCE *4TH OF JULY COMMUNITY PARADE IN WESTCHESTERSPECIFIC HOSPITAL STAFF ATTEND MONTHLY OR QUARTERLY MEETINGS IN ADDITION TO THE SPECIAL EVENTS.- CEDARS-SINAI MARINA DEL REY HOSPITAL ADOPTS FAMILIES DURING THE HOLIDAY SEASON THROUGH SEVERAL OF THE ABOVE AGENCIES AND HOSPITAL LEADERSHIP ACTIVELY PARTICIPATES IN OTHER FUND-RAISING COMMUNITY EVENTS THROUGH BOTH MONETARY AND EMPLOYEE SUPPORT.PROGRAM ACCOMPLISHMENTS/DEVELOPMENT:- CEDARS-SINAI MARINA DEL REY HOSPITAL IN COLLABORATION WITH CEDARS-SINAI MEDICAL CENTER (CSMC) NEUROLOGY DEPARTMENT HAS BEEN UTILIZING TELEMEDICINE IN THE EMERGENCY ROOM SINCE FEBRUARY 2017 TO SUCCESSFULLY DIAGNOSE STROKE, EXPEDITE DIAGNOSIS AND TREATMENT. IN 2018, AN ADDITIONAL TELEMEDICINE ROBOT WAS ADDED TO THE FACILITY ICU TO ENHANCE NEURO SERVICES IN COLLABORATION WITH CEDARS NEUROLOGY DEPARTMENT. SINCE INCEPTION OF THE PROGRAM IN 2017 AND THROUGH 2018, 91 PATIENTS EXHIBITING ACUTE STROKE SYMPTOMS HAVE RECEIVED TELE-STROKE CONSULTATIONS VIA THE INTOUCH CAMERA. 34 OF THOSE PATIENTS WERE TRANSFERRED TO CSMC FOR HIGHER LEVEL OF CARE (15 WERE IDENTIFIED AS HAVING AN ACUTE STROKE, RECEIVED TPA, AND WERE TRANSFERRED TO CSMC). 53 REMAINED AT MDRH FOR TREATMENT. MDRH, IN COLLABORATION WITH CSMC, IS SEEKING TO OBTAIN THE AMERICAN HEART/AMERICAN STROKE ASSOCIATION AND THE JOINT COMMISSION PRIMARY STROKE CENTER CERTIFICATION WITH A TARGET GOAL FOR SUBMISSION IN 2019.-ADDITIONAL SPECIALTY PHYSICIANS ARE ROTATING THROUGH A SPECIALTY CLINIC ADJACENT TO THE HOSPITAL TO COVER SPECIALTIES NOT PREVIOUSLY OFFERED AT CEDARS-SINAI MARINA DEL REY HOSPITAL. THESE SERVICES PROVIDED BY CEDARS FOUNDATION PHYSICIANS INCLUDE ENT, GYN, CARDIOLOGY, GI, AND NEUROLOGY. THE SPECIALISTS ALTERNATE DAYS OF THE WEEK MAKING FOLLOW-UP APPOINTMENTS FOR PATIENTS SEEN AS INPATIENTS IN THE HOSPITAL EASIER WHICH ALSO HELPS REDUCE READMISSIONS AND IS CONVENIENT FOR THE PATIENTS IN OUR COMMUNITY.-THE HOSPITAL PARTICIPATED IN THE COMPREHENSIVE JOINT PROGRAM INITIATIVE WITH OUR ORTHO PHYSICIANS AND STAFF. PATIENT EDUCATION PROGRAMS WERE DEVELOPED TO IMPROVE THE PATIENT EXPERIENCE. FEEDBACK FROM THE COMMUNITY HAS BEEN POSITIVE.-THE HOSPITAL IN COLLABORATION WITH CEDARS SINAI MEDICAL FOUNDATION EAR, NOSE, AND THROAT PHYSICIANS (DR. GENE LIU) PURCHASED SPECIALIZED ENT SURGICAL EQUIPMENT TO PROVIDE THOSE SERVICES TO OUR COMMUNITY BEGINNING IN 2017 AND EXPANDED THE INSTRUMENTATION IN 2018.

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 expenses90,667,574

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,375,892	5,800,527	1,644,171

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,508,408

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		2,508,408

		Business Code
2a	NET PATIENT REVENUE	622110	61,592,917	61,592,917
b	MEDICARE AND MEDICAL	622110	41,031,376	41,031,376
c	QAF REVENUE	622110	3,772,459	3,772,459
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		106,396,752

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds			665			665
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	OTHER REVENUE		622110	420,091	420,091
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			420,091
12	Total revenue. See instructions.....			109,325,916	106,816,843	0	665

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	55,000	55,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	359,011	261,360	97,651
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........	37,312,667	27,019,184	10,293,483
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	448,416	324,711	123,705
9	Other employee benefits .......	11,812,554	8,553,813	3,258,741
10	Payroll taxes ...........	3,408,811	2,468,419	940,392
11	Fees for services (non-employees):
a	Management ......	5,188,993	4,151,194	1,037,799
b	Legal .........	1,478		1,478
c	Accounting ...........	1,635		1,635
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	9,819,596	8,087,754	1,731,842
12	Advertising and promotion ....	325,123	243,842	81,281
13	Office expenses .......
14	Information technology ......	1,887,738	1,321,417	566,321
15	Royalties ..
16	Occupancy ...........
17	Travel ............	98,164	24,541	73,623
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	12,270	6,258	6,012
20	Interest ...........	12,702		12,702
21	Payments to affiliates .......	295,963	295,963
22	Depreciation, depletion, and amortization ..	5,870,045	4,696,036	1,174,009
23	Insurance ...	1,114,333	835,750	278,583
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	PROSTHESIS/IMPLANTS	8,535,921	8,535,921
b	QAF EXPENSES	7,503,760	7,503,760
c	OTHER MEDICAL SUPPLIES	7,260,842	7,260,842
d	DRUGS/PHARMACEUTICALS	2,551,955	2,551,955
e	All other expenses	7,446,959	6,469,854	977,105
25	Total functional expenses. Add lines 1 through 24e	111,323,936	90,667,574	20,656,362	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 ........			4,865,994	1	7,247,732
2	Savings and temporary cash investments .........			291,267	2	736,853
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			13,513,907	4	12,739,866
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			1,355,955	8	1,388,178
9	Prepaid expenses and deferred charges ......			11,500,292	9	14,395,625
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	47,406,359
b	Less: accumulated depreciation	10b	12,307,714	38,524,038	10c	35,098,645
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			70,051,453	16	71,606,899

17	Accounts payable and accrued expenses .....	15,211,037	17	8,822,603
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	1,996,743	23	1,303,244
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	37,473,926	25	48,109,325
26	Total liabilities. Add lines 17 through 25..	54,681,706	26	58,235,172

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	15,369,747	32	13,371,727
33	Total liabilities and net assets/fund balances ........	70,051,453	33	71,606,899