Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2017 , and ending 06-30-2018
BCheck if applicable:
CName of organization
DIGNITY HEALTH
 
% MARY CONNICK - FINANCE DEPT
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
185 Berry Street Suite 300
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
San Francisco, CA94107
D Employer identification number

94-1196203
E Telephone number

G Gross receipts $ 12,513,788,473
F Name and address of principal officer:
DANIEL MORISSETTE CFO
185 BERRY STREET
SAN FRANCISCO,CA94107
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.dignityhealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1954
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Dignity Health is committed to furthering the healing ministry of Jesus through the delivery of affordable health care, advocacy for the poor and community partnerships.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 12
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 54,453
6 Total number of volunteers (estimate if necessary) ............. 6 7,213
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 15,902,616
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 102,272,996 105,669,092
9 Program service revenue (Part VIII, line 2g) ......... 9,396,508,955 10,429,006,471
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 337,962,129 505,234,165
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 73,866,865 72,052,932
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 9,910,610,945 11,111,962,660
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 302,968,939 332,174,102
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) 5,160,520,523 5,316,943,143
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 4,389,047,328 4,854,548,215
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 9,852,536,790 10,503,665,460
19 Revenue less expenses. Subtract line 18 from line 12....... 58,074,155 608,297,200
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 14,330,863,885 15,517,283,824
21 Total liabilities (Part X, line 26)............. 9,223,118,019 8,914,942,403
22 Net assets or fund balances. Subtract line 21 from line 20..... 5,107,745,866 6,602,341,421
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
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Signature of officer Date
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Type or print name and title
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Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: OUR MISSION: DIGNITY HEALTH IS COMMITTED TO FURTHERING THE HEALING MINISTRY OF JESUS. WE DEDICATE OUR RESOURCES TO DELIVERING COMPASSIONATE, HIGH-QUALITY, AFFORDABLE HEALTH SERVICES; SERVING AND ADVOCATING FOR OUR SISTERS AND BROTHERS WHO ARE POOR AND DISENFRANCHISED; AND PARTNERING WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE. OUR VISION: A VIBRANT, NATIONAL HEALTH CARE SYSTEM KNOWN FOR SERVICE, CHOSEN FOR CLINICAL EXCELLENCE, STANDING IN PARTNERSHIP WITH PATIENTS, EMPLOYEES AND PHYSICIANS TO IMPROVE THE HEALTH OF ALL COMMUNITIES SERVED. OUR VALUES: DIGNITY HEALTH IS COMMITTED TO PROVIDING HIGH-QUALITY, AFFORDABLE HEALTH CARE TO THE COMMUNITIES WE SERVE. ABOVE ALL ELSE WE VALUE: DIGNITY - RESPECTING THE INHERENT VALUE AND WORTH OF EACH PERSON. COLLABORATION - WORKING TOGETHER WITH PEOPLE WHO SUPPORT COMMON VALUES AND VISION TO ACHIEVE SHARED GOALS. JUSTICE - ADVOCATING FOR SOCIAL CHANGE AND ACTING IN WAYS THAT PROMOTE RESPECT FOR ALL PERSONS AND DEMONSTRATE COMPASSION F
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code: 0 ) (Expenses $ 8,971,703,693 including grants of $ 332,174,102 ) (Revenue $ 10,418,834,402 )
Dignity Health is a California nonprofit public benefit corporation headquartered in San Francisco, California. Dignity Health, together with its subsidiary corporations, is one of the largest not-for-profit acute health care delivery systems in the United States as measured by annual revenue. Dignity Health operated 39 hospitals throughout major California markets and in the Phoenix, Arizona and Las Vegas, Nevada metropolitan markets during the year ended June 30, 2018. Dignity health and its subordinate corporations' facilities included approximately 8,300 licensed acute care beds and approximately 570 licensed skilled nursing beds as of June 30, 2018. Dignity health maintains a prominent market share in many of its service areas, and many of its hospitals rank among the finest in the nation. With a significant presence in Greater Sacramento, San Francisco Bay Area, Southern California, Central Coast, Central California, and Northern California, Dignity Health's California operations are well dispersed throughout the state. Dignity Health's hospitals operate emergency rooms that are open to all persons regardless of ability to pay; have governing bodies in which primarily independent persons representative of the community comprise a majority; engage in the training and education of healthcare professionals; and participate in Medicaid, Medicare, Tricare and/or other government-sponsored health care programs. This organization is a public benefit corporation exempt from taxation under Section 501(c)(3) of the internal revenue code.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet8,971,703,693
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
Yes
 
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
Click to see attachment......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
Yes
 
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
Yes
 
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
4,748
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
54,453
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletBR , CJ , CH , GR , ID , IS , MY , PL , KS , TW
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
12
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
AZ , CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletMARY CONNICK - FINANCE DEPT185 BERRY STREET   SAN FRANCISCO,CA94107 (415) 438-5500
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Andrew C Agwunobi MD......................................................................
Board Member
7.0
.................
0.0
X           55,500 0 0
(2) Kent Bradley MD......................................................................
Board Member
5.0
.................
0.0
X           50,500 0 0
(3) Jennie Chin Hansen......................................................................
Board Member
5.0
.................
0.0
X           50,500 0 0
(4) Caretha Coleman......................................................................
Board Member
5.0
.................
0.0
X           50,500 0 0
(5) Mark DeMichele......................................................................
Board Member
9.0
.................
0.0
X           60,500 0 0
(6) Peter G Hanelt CPA......................................................................
Board Member
7.0
.................
0.0
X           55,500 0 0
(7) Julie Hyer OP......................................................................
Board Member
7.0
.................
0.0
X           0 0 0
(8) Kavita Patel MD......................................................................
Board Member
5.0
.................
0.0
X           50,500 0 0
(9) Todd Pierce......................................................................
Board Member
7.0
.................
0.0
X           55,500 0 0
(10) Judy Carle RSM......................................................................
Board Secretary
7.0
.................
0.0
X   X       0 0 0
(11) Tessie Guillermo......................................................................
Board Chair
10.0
.................
0.0
X   X       80,500 0 0
(12) Patrick Steele......................................................................
Board Vice Chair
7.0
.................
0.0
X   X       55,500 0 0
(13) Ian Boase......................................................................
VP & Associate General Counsel
40.0
.................
0.0
    X       893,838 0 105,647
(14) Lloyd H Dean......................................................................
President /CEO
40.0
.................
0.0
    X       11,927,529 0 1,489,954
(15) Rick Grossman......................................................................
EVP, General Counsel
40.0
.................
0.0
    X       4,559,606 0 418,247
(16) Diane Lee......................................................................
VP & Associate General Counsel
40.0
.................
0.0
    X       774,728 0 64,953
(17) Daniel J Morissette......................................................................
SEVP, Chief Financial Officer
40.0
.................
0.0
    X       2,310,030 0 456,592
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W-2/1099-MISC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Marvin O'Quinn........................................................................
SEVP, Chief Operating Officer
40.0
.......................0.0
    X       4,105,855 0 658,378
(19) Elizabeth Shih........................................................................
EVP, Chief Administrative Offi
40.0
.......................0.0
    X       2,142,463 0 255,835
(20) Brian G Brannman........................................................................
SVP Operations, Nevada
40.0
.......................0.0
      X     1,189,590 0 67,687
(21) Keith Callahan........................................................................
SVP, Supp & Srvcs Resources Mg
40.0
.......................0.0
      X     1,079,665 0 116,069
(22) Mary Connick........................................................................
SVP, Finance, Corporate Contro
40.0
.......................0.0
      X     1,208,039 0 125,221
(23) Charles Cova........................................................................
SVP Operations, Central Coast
40.0
.......................0.0
      X     2,051,854 0 136,975
(24) Charles P Francis........................................................................
SEVP, Chief Strategy Officer
40.0
.......................0.0
      X     2,565,204 0 236,262
(25) Lisa Gamshad Zuckerman........................................................................
SVP Treasury & Strategic Inves
40.0
.......................0.0
      X     1,048,512 0 143,826
(26) Laurie Harting........................................................................
SVP Operations, Greater Sacram
40.0
.......................0.0
      X     1,256,499 0 144,035
(27) Linda Hunt........................................................................
SVP Operations, Arizona
40.0
.......................0.0
      X     1,657,936 0 164,675
(28) Elizabeth I Keith........................................................................
EVP/Sponsorship/Mission Integr
40.0
.......................0.0
      X     1,576,479 0 298,813
(29) Mark Korth........................................................................
SVP Operations, North State/ E
40.0
.......................0.0
      X     1,337,091 0 155,634
(30) Jeffrey W Land........................................................................
SVP, Corporate Real Estate
40.0
.......................0.0
      X     760,381 0 122,847
(31) Timothy Panks........................................................................
SVP, Finance & Revenue Cycle M
40.0
.......................0.0
      X     707,472 0 109,614
(32) Darryl Robinson........................................................................
EVP, Chief Human Resource Offi
40.0
.......................0.0
      X     2,157,198 0 409,307
(33) Karl Silberstein........................................................................
SVP, Financial Operations
40.0
.......................0.0
      X     1,241,480 0 155,880
(34) Julie Sprengel........................................................................
SVP Operation, So Cal
40.0
.......................0.0
      X     1,040,459 0 103,396
(35) Todd A Strumwasser MD........................................................................
SVP Operations, Bay Area
40.0
.......................0.0
      X     1,483,476 0 177,026
(36) Jon VanBoening........................................................................
SVP Operations, Central Valley
40.0
.......................0.0
      X     1,437,307 0 185,188
(37) Robert Wiebe MD........................................................................
EVP, Chief Medical Officer
40.0
.......................0.0
      X     3,188,099 0 368,093
(38) Tammara Wilcox........................................................................
SVP, Managed Care
40.0
.......................0.0
      X     998,995 0 130,196
(39) Deanna Wise........................................................................
EVP, Chief Information Officer
40.0
.......................0.0
      X     1,993,347 0 386,724
(40) Anthony Scott Carswell........................................................................
SVP Corporate Strategy & Growt
40.0
.......................0.0
        X   1,036,688 0 142,760
(41) Edmundo Castaneda........................................................................
Hospital President
40.0
.......................0.0
        X   952,728 0 118,649
(42) Benjie M Loanzon........................................................................
SVP Finance Transformation
40.0
.......................0.0
        X   979,169 0 140,328
(43) Bruce Swartz........................................................................
SVP Physician Integration
40.0
.......................0.0
        X   990,104 0 120,795
(44) Donald J Wiley........................................................................
Hospital President
40.0
.......................0.0
        X   1,285,511 0 114,167
(45) Steven Barron........................................................................
Former KE
0.0
.......................0.0
          X 1,247,391 0 0
(46) Bernita McTernan........................................................................
Former KE
0.0
.......................0.0
          X 163,102 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 63,912,825 0 7,823,773
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet14,636
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
OPTUM360 LLC,
11000 OPTUM CIRCLE
EDEN PRAIRIE,MN55344
Revenue Cycle SVC 367,597,410
TRIMEDX LLC,
5451 LAKEVIEW PKWY S DR
INDIANAPOLIS,IN46268
Maintenance Services 97,575,636
THE BARTECH GROUP,
17199 N LAUREL PARK DR
LIVONIA,MI48152
Staffing services 74,766,917
CERNER CORP,
2702 ROCKCREEK PKWY
KANSAS CITY,MO64117
Technology services 62,851,347
NTT DATA SERVICES LLC,
PO BOX 677956
DALLAS,TX752677956
Professional SVC 42,772,034
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1,131
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 59,163,434
e Government grants (contributions)1e 38,251,945
f All other contributions, gifts, grants, and similar amounts not included above1f 8,253,713
g Noncash contributions included in lines 1a - 1f:$ 1g 449,744
h Total. Add lines 1a-1f.......MediumBullet 105,669,092
 Program Service RevenueAmt Business Code
2a PATIENT NET OF CHARITY/BAD DEBT 900099 5,988,527,954 5,988,527,954    
b MEDICARE/MEDICAID PAYMENTS 900099 4,142,575,361 4,142,575,361    
c MANAGEMENT SERVICES 541610 214,145,816 214,145,816    
d MED OFFICE BLDG 621300 15,493,524 15,493,524    
e PROGRAM RELATED RENTAL INCOME 900099 10,049,985 10,049,985    
f All other program service revenue. 58,213,831 48,041,762 10,172,069  
g Total. Add lines 2a–2f .....MediumBullet 10,429,006,471
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 293,282,717   5,827,166 287,455,551
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 187,709     187,709
(ii) Personal (i) Real
6a Gross rents   6,362,263 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 6,362,263 6c
d Net rental income or (loss).......MediumBullet 6,362,263     6,362,263
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 65,164,411 1,548,612,850 7a
b Less: cost or other basis and sales expenses 46,266,751 1,355,559,062 7b
c Gain or (loss) 18,897,660 193,053,788 7c
d Net gain or (loss).........MediumBullet 211,951,448     211,951,448
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a 0
b Less: direct expenses ... 8b 0
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a 0
b Less: direct expenses ... 9b 0
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a CAFETERIA 900099 27,158,451     27,158,451
b OPTUM 360 REVENUE 900099 6,035,804     6,035,804
c GIFT SHOP 453220 3,298,953     3,298,953
d All other revenue .... 29,009,752 0 -96,619 29,106,371
e Total. Add lines 11a–11d ...... MediumBullet 65,502,960
12 Total revenue. See instructions.....MediumBullet 11,111,962,660 10,418,834,402 15,902,616 571,556,550
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 330,077,184 330,077,184
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 1,581,918 1,581,918
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 515,000 515,000
4 Benefits paid to or for members ....... 0  
5 Compensation of current officers, directors, trustees, and key employees ........... 65,500,122 57,137,264 8,362,858 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 334,752   334,752 0
7 Other salaries and wages........ 4,029,405,882 3,561,377,182 468,028,700 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 328,750,083 325,437,609 3,312,474 0
9 Other employee benefits ....... 614,165,409 602,835,679 11,329,730 0
10 Payroll taxes ........... 278,786,895 273,471,125 5,315,770 0
11 Fees for services (non-employees):        
a Management ...... 0     0
b Legal ......... 27,529,520 82,469 27,447,051 0
c Accounting ........... 8,150,357 68,556 8,081,801 0
d Lobbying ........... 1,589,317 504,504 1,084,813 0
e Professional fundraising services. See Part IV, line 17 0 0
f Investment management fees ...... 19,285,677 0 19,285,677 0
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,368,855,763 787,060,729 581,795,034  
12 Advertising and promotion .... 91,672,798 1,784,103 89,888,695 0
13 Office expenses ....... 185,917,561 132,938,369 52,979,192 0
14 Information technology ...... 162,879,326 90,629,733 72,249,593 0
15 Royalties .. 0      
16 Occupancy ........... 128,717,919 99,738,638 28,979,281 0
17 Travel ............ 24,923,248 14,158,444 10,764,804 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 10,877,401 5,343,344 5,534,057 0
20 Interest ........... 134,772,350 133,013,838 1,758,512 0
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 487,670,589 409,155,624 78,514,965  
23 Insurance ... 70,175,100 40,083,786 30,091,314  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 1,362,734,256 1,362,734,256    
b MEDI-CAL PROVIDER FEE 534,131,473 534,131,473    
c MEDICAL PRVDR/OUT-OF NTWRK CST 179,486,268 179,486,268    
d UNRELATED BUSINESS INC TAXES 83,978   83,978  
e All other expenses 55,095,314 28,356,598 26,738,716  
25 Total functional expenses. Add lines 1 through 24e 10,503,665,460 8,971,703,693 1,531,961,767 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 168,348 1 174,454
2 Savings and temporary cash investments ......... 2,028,223,726 2 2,530,962,065
3 Pledges and grants receivable, net ...... 27,742,641 3 32,258,727
4 Accounts receivable, net ............. 1,373,443,285 4 1,365,742,285
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 .......
700,000 5 466,667
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) ...
0 6 0
7 Notes and loans receivable, net ........... 77,502,189 7 93,147,883
8 Inventories for sale or use ............ 174,956,356 8 182,544,243
9 Prepaid expenses and deferred charges ...... 1,025,663,129 9 1,194,046,525
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 9,923,044,200
b Less: accumulated depreciation 10b 5,826,551,121 4,149,684,007 10c 4,096,493,079
11 Investments—publicly traded securities . 815,820,545 11 1,653,637,170
12 Investments—other securities. See Part IV, line 11 ..... 2,378,471,058 12 1,846,497,567
13 Investments—program-related. See Part IV, line 11 .. 2,217,557,329 13 2,414,850,978
14 Intangible assets ............... 24,980,891 14 65,550,151
15 Other assets. See Part IV, line 11 ........... 35,950,381 15 40,912,030
16 Total assets. Add lines 1 through 15 (must equal line 33)... 14,330,863,885 16 15,517,283,824
Liabilities 17 Accounts payable and accrued expenses ..... 1,981,633,915 17 1,782,451,055
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 39,143,604 19 57,985,108
20 Tax-exempt bond liabilities ......... 2,491,140,000 20 2,447,505,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
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 .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 2,701,394,205 23 2,706,821,602
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 2,009,806,295 25 1,920,179,638
26 Total liabilities. Add lines 17 through 25.. 9,223,118,019 26 8,914,942,403
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet 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 MediumBullet 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 ........... 5,107,745,866 32 6,602,341,421
33 Total liabilities and net assets/fund balances ........ 14,330,863,885 33 15,517,283,824
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
11,111,962,660
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
10,503,665,460
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
608,297,200
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
5,107,745,866
5
Net unrealized gains (losses) on investments ...............
5
129,429,002
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
756,869,353
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
6,602,341,421
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow 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
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

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) right arrow (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) right arrow (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  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

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) right arrow (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) right arrow (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

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
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2019

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:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that 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
DIGNITY HEALTH
 
Employer identification number
94-1196203
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
 
 
 
 

$  


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
(a)
No. from Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(See instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data


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

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

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

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$ 1,252
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
0

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$ 125
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$ 0
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

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

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2019

Schedule C (Form 990 or 990-EZ) 2019
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2019


Schedule C (Form 990 or 990-EZ) 2019
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
Yes
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
Yes
 
21,598
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
504,504
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
345,561
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
717,654
j
Total. Add lines 1c through 1i ....................................................................................................
1,589,317
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART I-B, LINE 4B Dignity Health has a 50.1% member interest in RBR Management LLC (RBR). RBR files Form 1065 and Schedules K-1 to its members, based on the calendar year. Dignity Health files Form 990 on a June 30th fiscal year-end. In May 2017, during the preparation of Dignity Health's FYE 6/30/16 Form 990, upon review of the 2015 Schedule K-1 from RBR, Dignity Health became aware that RBR had made political payments. Dignity Health immediately contacted RBR and requested the 2016 Schedule K-1. Dignity Health informed RBR that it must cease all political activity payments, and promptly reported both the 2015 and 2016 payments on FYE 6/30/16 Form 4720 and paid the excise tax. At that time, RBR informed Dignity Health that there would also be political payments reported on the 2017 Schedule K-1. Dignity Health reported the amounts provided by RBR which were incurred through April 2017, on FYE 6/30/17 Form 4720. However, when RBR issued the 2017 Schedule K-1 in 2018, Dignity Health discovered the actual 2017 political payments were $1,252 greater than RBR had previously reported, which represented amounts paid in May 2017 prior to the discussions noted above. Dignity Health is reporting this additional amount on Form 4720 for FYE 6/30/18. Dignity Health has had continued contact with RBR to ensure compliance with tax law that prohibits organizations exempt under IRC Section 501(c) from engaging in political activity, either directly or indirectly. Dignity Health continues to monitor RBR's activities and has instructed RBR Management LLC to take steps to recover the payments to the extent possible.
PART II-B THE ORGANIZATION PAID FEES TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES, PAID COMPENSATION TO STAFF AND MANAGEMENT IN THE PERFORMANCE OF THEIR DUTIES IN ATTEMPTING TO INFLUENCE LEGISLATION, HELD MEETINGS WITH AND CALLED GOVERNMENT OFFICIALS, AND DEVELOPED AND SENT LETTERS. IN ADDITION, THIS ORGANIZATION IS A MEMBER OF HEALTHCARE ASSOCIATIONS WHOSE PURPOSES INCLUDE DIRECTING, DEVELOPING, AND AFFECTING PUBLIC POLICY AND LEGISLATION WITH REGARD TO ISSUES AFFECTING HEALTHCARE. THE ORGANIZATION PAID ANNUAL DUES TO THESE ASSOCIATIONS, WHICH MAY BE USED FOR LOBBYING PURPOSES AS REFLECTED ON PART II-B, LINE 1I, OTHER ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
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
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under 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.
b
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 $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance .... 144,666,878 126,979,938 128,552,281 131,179,463 119,411,098
b Contributions ... 15,292,563 10,466,769 9,081,967 1,807,921 2,115,261
c Net investment earnings, gains, and losses 14,429,311 12,723,787 -1,441,121 1,754,826 12,008,691
d Grants or scholarships ... 0 170,477 75,000 81,194 184,339
e Other expenditures for facilities
and programs ...
8,776,477 5,322,053 9,134,573 5,985,052 1,121,080
f Administrative expenses .... 0 11,086 3,616 123,683 1,050,168
g End of year balance ...... 165,612,275 144,666,878 126,979,938 128,552,281 131,179,463
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet6.000 %
b
Permanent endowment SchDMd Bullet73.000 %
c
Term endowment SchDMd Bullet21.000 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
Yes
 
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment)
(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....   217,088,081 217,088,081
b Buildings ....   4,749,804,303 2,449,442,324 2,300,361,979
c Leasehold improvements   65,145,432 42,436,576 22,708,856
d Equipment ....   4,301,402,708 3,250,333,248 1,051,069,460
e Other .....   589,603,676 84,338,973 505,264,703
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 4,096,493,079
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3) Other
(A) POOLED INVESTMENTS
1,846,497,567 F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 1,846,497,567
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1)INVESTMENT IN UNCONSOLIDATED 221,884,675 F
(2)INVESTMENTS IN HEALTH RELATED 2,100,870,388 F
(3)INVESTMENTS IN HEALTH RELATED 92,095,915 C
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 2,414,850,978
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.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes 0
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,920,179,638
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

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
SCH D, Part V, Line 4 DIGNITY HEALTH HAS VARIOUS SUPPORTING 501(C)(3) FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THEY OPERATE TO RAISE FUNDS FOR THE BENEFIT OF, AND TO CARRY OUT THE PURPOSES OF, DIGNITY HEALTH'S HOSPITALS. DIGNITY HEALTH'S INTENDED USE FOR THE FUNDS IS TO INVEST IN EXPANDING ACCESS TO CARE, PURCHASE OR CONSTRUCT STATE-OF-THE-ART EQUIPMENT AND BUILDINGS, AND PROVIDE ADVANCED TRAINING AND EDUCATION TO CAREGIVERS AND PATIENTS.
SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740) FOOTNOTE DIGNITY HEALTH REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2019


Additional Data


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Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image 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
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region
(f) Total expenditures
for and investments
in the region
Central America and the Caribbean 0 0 Investments N/A 332,063
Central America and the Caribbean 0 0 Investments N/A 3,026,608,429
Europe (Including Iceland and Greenland) 0 0 Investments N/A 301,223,303
Europe (Including Iceland and Greenland) 0 0 Grantmaking N/A 500,000
South America 0 0 Grantmaking N/A 15,000
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 3,328,678,795
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 3,328,678,795
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)
(c) Region (d) Purpose of
grant
(e) Amount of
cash grant
(f) Manner of
cash
disbursement
(g) Amount
of noncash
assistance
(h) Description
of noncash
assistance
(i) Method of
valuation
(book, FMV,
appraisal, other)
Europe (Including Iceland and Greenland) GENERAL SUPPORT 500,000 WIRE TRNSFER 0 NONE NONE
South America FINANCIAL PROVIDE HEALTH SERVICES TO POOR NEIGHBORHOODS IN GUYANA THROUGH A MOBILE CLINIC. 15,000 CHECK 0 NONE NONE
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
2
3 Enter total number of other organizations or entities .......................MediumBullet
0
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant
(e) Manner of cash
disbursement
(f) Amount of
noncash
assistance
(g) Description
of noncash
assistance
(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2019
Schedule F (Form 990) 2019
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
SCHEDULE F, PART I, LINE 2 GRANTS ARE AWARDED TO INTERNATIONAL ORGANIZATIONS WHOSE MISSION IS ALIGNED WITH DIGNITY HEALTH'S MISSION. SUCH AWARDS ARE APPROVED BY A DESIGNATED COMMITTEE OR THE EXECUTIVE LEADERSHIP TEAM OF THE ORGANIZATION. SCHEDULE F, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL EUROPE (INCLUDING ICELAND AND GREENLAND): ACCRUAL SOUTH AMERICA: ACCRUAL
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2019
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet 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
DIGNITY HEALTH
 
Employer identification number

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

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
  57,065 93,458,745 7,001 93,451,744 0.890 %
b Medicaid (from Worksheet 3, column a) . . . . .   1,254,685 3,140,583,582 2,704,081,921 436,501,661 4.150 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .   13,206 17,324,443 3,657,008 13,667,435 0.130 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .   1,324,956 3,251,366,770 2,707,745,930 543,620,840 5.170 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 564 502,949 65,182,300 24,675,821 40,506,479 0.390 %
f Health professions education (from Worksheet 5) . . . 94 15,731 109,387,868 14,916,796 94,471,072 0.900 %
g Subsidized health services (from Worksheet 6) . . . . 21 25,354 7,461,830 4,242,576 3,219,254 0.030 %
h Research (from Worksheet 7) . 2 0 40,030,678 29,448,476 10,582,202 0.100 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 195 99,852 33,066,785 303,286 32,763,499 0.310 %
j Total. Other Benefits . . 876 643,886 255,129,461 73,586,955 181,542,506 1.730 %
k Total. Add lines 7d and 7j . 876 1,968,842 3,506,496,231 2,781,332,885 725,163,346 6.900 %
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing 4 54 2,826,439 1,048,604 1,777,835 0.020 %
2 Economic development 1 0 10,000 0 10,000 0 %
3 Community support 22 5,299 3,546,265 280,344 3,265,921 0.030 %
4 Environmental improvements 2 0 234,420 4,821 229,599 0 %
5 Leadership development and
training for community members
7 789 566,046 8,141 557,905 0.010 %
6 Coalition building 13 6,590 518,480 298,525 219,955 0 %
7 Community health improvement advocacy 19 2,324 397,820 51,429 346,391 0 %
8 Workforce development 5 181 925,772 0 925,772 0.010 %
9 Other   0 0 0 0 0 %
10 Total 73 15,237 9,025,242 1,691,864 7,333,378 0.070 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
94,780,965
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
0
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
1,987,346,259
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,439,047,701
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-451,701,442
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1St Joseph's Outpatie
 
Surgery 25.24 % 0 % 43.4 %
2Desert Ridge Outpati
 
Surgery 25.11 % 0 % 23 %
3Southwest Orthopedic
 
Surgery 5.96 % 0 % 88.1 %
4Surgery Center of Pe
 
Surgery 25.59 % 0 % 16.36 %
5BNI Management LLC
 
Mgmt services 26.04 % 0 % 73.96 %
6St Joseph's Cardiol
 
Mgmt services 50 % 0 % 50 %
7Parkway Surgery Cent
 
Surgery 25.68 % 0 % 48.74 %
8Folsom Sierra Endosc
 
Surgery 51 % 0 % 37.975 %
9St Joseph's Surgery
 
Surgery 79.96 % 0 % 15.04 %
10CBCC Outsmarting Can
 
Cancer 51 % 0 % 49 %
11Santa Cruz Surgery C
 
Surgery 50 % 0 % 50 %
12Santa Cruz Comprehen
 
Imaging 50 % 0 % 50 %
13Dominican Breast Cen
 
Imaging 50 % 0 % 50 %
14Dominican Magnetic R
 
Imaging 80 % 0 % 20 %
15San Francisco Cyberk
 
Cancer 26 % 0 % 21 %
16Coastal Surgical Spe
 
Surgery 50.007 % 0 % 49.993 %
17Templeton Surgery Ce
 
Surgery 61.18 % 0 % 32.94 %
18Plaza Surgery Center
 
Surgery 50.64 % 0 % 26.91 %
19Renaissance Imaging
 
Imaging 49 % 0 % 18.65 %
20Inland Endoscopy Cen
 
Surgery 24.5 % 0 % 30 %
21Medical Pavilion at
 
Real Estate (Rent/Lease) 25 % 0 % 38.92 %
22NSC Channel Islands
 
Surgery Center 26.01 % 0 % 36.56 %
23Valley Physicians Su
 
Surgery 45.58 % 0 % 54.42 %
24Orthopedic and Surgi
 
Surgery 35.91 % 0 % 23.39 %
25San Martin Surgery C
 
Surgery 33.87 % 0 % 23 %
26Surgery Center of Sc
 
Surgery 25.23 % 0 % 43.94 %
27Warner Park Surgery
 
Surgery 41.39 % 0 % 17.05 %
28Surgery Ctr Scotts-G
 
Surgery 25.23 % 0 % 43.94 %
29Surgery Ctr Scotts-G
 
Surgery 25.23 % 0 % 43.94 %
30Surgery Ctr of Scott
 
Surgery 25.23 % 0 % 43.94 %
31Physicians Surgery C
 
Surgery 25.28 % 0 % 20.93 %
32Surgical Elite of Av
 
Surgery 27.71 % 0 % 21.89 %
33Integrated Medical S
 
Physician Group 53.667 % 0 % 46.282 %
34Parkway Recovery Cen
 
Surgery 38.08 % 0 % 24 %
35Parkway Surgery Cent
 
Surgery 25.68 % 0 % 48.74 %
Schedule H (Form 990) 2019
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?41Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 St Joseph's Hospital and Medical Cent
350 W Thomas Road
Phoenix,AZ85013
www.dignityhealth.org/stjosephs
H-3003
X X   X   X X      
2 Mercy San Juan Medical Center
6501 Coyle Avenue
Carmichael,CA95608
www.dignityhealth.org/mercysanjuan
030000063
X X   X     X      
3 Mercy General Hospital
4001 J Street
Sacramento,CA95819
www.dignityhealth.org/mercygeneral
030000062
X X   X     X      
4 Marian Regional Medical Center Arroy
1400 E Church Street
Santa Maria,CA93454
www.marianmedicalcenter.org/
50000040
X X   X     X      
5 Chandler Regional MEDICAL CENTER
475 South Dobson Road
Chandler,AZ85224
www.dignityhealth.org/chandlerregional
H-3002
X X         X      
6 California Hospital Medical Center
1401 South Grand Avenue
Los Angeles,CA90015
www.dignityhealth.org/californiahospital
930000024
X X   X     X      
7 Mercy Medical Center Redding
2175 Rosaline Avenue
Redding,CA96001
www.dignityhealth.org/mercy-redding
230000024
X X   X     X      
8 St Rose Dominican Hospital - Siena
3001 St Rose Parkway
Henderson,NV89052
www.dignityhealth.org/las-vegas
2969HOS-21
X X   X     X      
9 Northridge Hospital Medical Center
18330 Roscoe Boulevard
Northridge,CA91325
www.dignityhealth.org/northridgehospital
930000114
X X   X     X      
10 Dominican Hospital
1555 Soquel Drive
Santa Cruz,CA95065
www.dominicanhospital.org
070000030
X X         X      
11 St Bernardine Medical Center
2101 N Waterman Avenue
San Bernardino,CA92404
www.dignityhealth.org/stbernardinemedica
240000206
X X         X      
12 St John's Regional Medical Center
1600 North Rose Avenue
Oxnard,CA93030
www.stjohnshealth.org/
050000064
X X         X      
13 Mercy Medical Center Merced
333 Mercy Avenue
Merced,CA95340
www.mercymercedcares.org/
040000178
X X   X     X      
14 St Mary Medical Center - Long Beach
1050 Linden Avenue
Long Beach,CA90813
www.dignityhealth.org/stmarymedical
930000012
X X   X     X      
15 Mercy Hospital (Bakersfield)
2215 Truxtun Avenue
Bakersfield,CA93301
www.mercybakersfield.org/
120000184
X X         X      
16 Methodist Hospital of Sacramento
7500 Hospital Drive
Sacramento,CA95823
www.dignityhealth.org/methodistsacrament
030000064
X X   X     X      
17 Mercy Gilbert Medical Center
3555 S Val Vista Drive
Gilbert,AZ85297
www.dignityhealth.org/mercygilbert
H-3972
X X         X      
18 Sequoia Hospital
170 Alameda de las Pulgas
Redwood City,CA94062
www.sequoiahospital.org/
220000045
X X         X      
19 Mercy Hospital of Folsom
1650 Creekside Drive
Folsom,CA95630
www.dignityhealth.org/mercyfolsom
030000372
X X         X      
20 Glendale Memorial Hospital and Health
1420 South Central Avenue
Glendale,CA91204
www.dignityhealth.org/glendalememorial
930000099
X X         X      
21 St Mary's Medical Center
450 Stanyan Street
San Francisco,CA94117
www.stmarysmedicalcenter.org/
220000071
X X   X     X      
22 Woodland Memorial Hospital
1325 Cottonwood Street
Woodland,CA95695
www.dignityhealth.org/woodland
030000115
X X         X      
23 St Rose Dominican Hospital - San Mart
8280 West Warm Springs Road
Las Vegas,NV89113
www.dignityhealth.org/las-vegas
4576HOS-6
X X         X      
24 French Hospital Medical Center
1911 Johnson Avenue
San Luis Obispo,CA93401
www.frenchmedicalcenter.org
050000031
X X         X      
25 St John's Pleasant Valley Hospital
2309 Antonio Avenue
Camarillo,CA93010
www.stjohnshealth.org/
050000048
X X         X      
26 St Elizabeth Community Hospital
2550 Sister Mary Columba Drive
Red Bluff,CA96080
www.dignityhealth.org/stelizabethhospita
230000036
X X         X      
27 St Rose Dominican Hospital - Rose de
102 E Lake Mead Drive
Henderson,NV89015
www.dignityhealth.org/las-vegas
659HOS-20
X X         X      
28 Mercy Medical Center Mt Shasta
914 Pine Street
Mt Shasta,CA96067
www.mercymtshasta.org/
230000015
X X     X   X      
29 Carondelet St Joseph's Hospital
350 S Wilmot Road
Tucson,AZ85711
www.carondelet.org/our-locations/st-jose
H7308
X X         X      
30 Carondelet St Mary's Hospital
1601 W St Marys Road
Tucson,AZ85745
www.carondelet.org/our-locations/st-mary
H7303
X X         X      
31 Southwest Orthopedic and Spine Hospit
750 North 40th Street
Phoenix,AZ85008
OASISHOSPITAL.COM
SH5128
X               Orthopedic/ Spine Hospital  
32 St Joseph's Westgate Medical Center
7300 N 99th Avenue
Glendale,AZ85305
www.dignityhealth.org/westgate
H6522
X X         X      
33 AGH LAVEEN LLC
7171 S 51st Avenue
Laveen,AZ85339
http://www.azgeneraler.com/locations
H6937
X           X X Emergency/ Urgent Care  
34 Arizona Spine and Joint Hospital
4620 E Baseline Rd
Mesa,AZ85206
www.azspineandjoint.com
SH3711
X               Orthopedic/ Spine Hospital  
35 Arizona Orthopedic Specialty Hospital
2905 West Warner Road
Chandler,AZ85224
AZOSH.COM
SH3571
X               Orthopedic Hospital  
36 DE CRAIG RANCH LLC DBA ST ROSE DOMINI
1550 W Craig Road
North Las Vegas,NV89032
www.strosenh.org/locations/north-las-veg
8544-HOS-0
X           X X Microhospital  
37 Dignity Health East Valley Rehabilita
1515 W Chandler Blvd
Chandler,AZ85224
dignityhealthevrehab.com/
SH7869
X               Rehabilitation Cntr  
38 DE BLUE DIAMOND LLC DBA ST ROSE DOMIN
4855 Blue Diamon Road
Las Vegas,NV89139
https://www.strosenh.org/locations/blue-
8594-HOS-0
X           X X Microhospital  
39 Carondelet Holy Cross Hospital
1171 W Target Range Road
Nogales,AZ85321
www.carondelet.org/our-locations/holy-cr
H7306
X       X   X      
40 DE FLAMINGO LLC DBA ST ROSE DOMINICAN
9880 W Flamingo
Las Vegas,NV89147
https://www.strosenh.org/locations/west-
8652-HOS-0
X           X X Microhospital  
41 DE SAHARA LLC DBA ST ROSE DOMINICAN
4890 W Sahara Avenue
Las Vegas,NV89146
https://www.strosenh.org/locations/sahar
8686-HOS-0
X           X X Microhospital  
Schedule H (Form 990) 2019
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)
St Joseph's Hospital and Medical Cent
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Hospital and Medical Cent
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Joseph's Hospital and Medical Cent
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Joseph's Hospital and Medical Cent
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
2
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy San Juan Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
3
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy General Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
4
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Marian Regional Medical Center Arroy
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Chandler Regional MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
5
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Chandler Regional MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Chandler Regional MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Chandler Regional MEDICAL CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
6
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
California Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
7
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Medical Center Redding
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
8
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Rose Dominican Hospital - Siena
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
9
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Northridge Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
10
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Dominican Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
11
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Bernardine Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
12
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St John's Regional Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
13
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Medical Center Merced
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
14
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Mary Medical Center - Long Beach
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
15
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Hospital (Bakersfield)
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
16
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Methodist Hospital of Sacramento
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
17
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Gilbert Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
18
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Sequoia Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
19
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Hospital of Folsom
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
20
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 16
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Glendale Memorial Hospital and Health
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
21
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Mary's Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
22
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Woodland Memorial Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
23
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Rose Dominican Hospital - San Mart
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
24
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
French Hospital Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
25
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St John's Pleasant Valley Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
26
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Elizabeth Community Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
27
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Rose Dominican Hospital - Rose de
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
28
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Mercy Medical Center Mt Shasta
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
29
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8   No
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Carondelet St Joseph's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
30
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8   No
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Carondelet St Mary's Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
31
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Southwest Orthopedic and Spine Hospit
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
32
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
St Joseph's Westgate Medical Center
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
AGH LAVEEN LLC
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
33
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
AGH LAVEEN LLC
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
AGH LAVEEN LLC
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
AGH LAVEEN LLC
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
34
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21   No
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Arizona Spine and Joint Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
35
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a Yes  
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b Yes  
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21   No
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Arizona Orthopedic Specialty Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
DE CRAIG RANCH LLC DBA ST ROSE DOMINI
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
36
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DE CRAIG RANCH LLC DBA ST ROSE DOMINI
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
DE CRAIG RANCH LLC DBA ST ROSE DOMINI
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DE CRAIG RANCH LLC DBA ST ROSE DOMINI
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Dignity Health East Valley Rehabilita
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
37
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Dignity Health East Valley Rehabilita
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13   No
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14   No
15 Explained the method for applying for financial assistance?................... 15   No
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16   No
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
 
b
 
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Dignity Health East Valley Rehabilita
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17   No
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21   No
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Dignity Health East Valley Rehabilita
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
DE BLUE DIAMOND LLC DBA ST ROSE DOMIN
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
38
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DE BLUE DIAMOND LLC DBA ST ROSE DOMIN
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
DE BLUE DIAMOND LLC DBA ST ROSE DOMIN
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DE BLUE DIAMOND LLC DBA ST ROSE DOMIN
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
39
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 17
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 17
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SECTION C
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
Carondelet Holy Cross Hospital
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
DE FLAMINGO LLC DBA ST ROSE DOMINICAN
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):
40
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DE FLAMINGO LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
DE FLAMINGO LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DE FLAMINGO LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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)
DE SAHARA LLC DBA ST ROSE DOMINICAN
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):
41
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................ 1 Yes  
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C............... 2 Yes  
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5    
6 a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C.................................. 6a    
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............
8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $0

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
DE SAHARA LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE SECTION C
b
SEE SECTION C
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
DE SAHARA LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
f
19 Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
DE SAHARA LLC DBA ST ROSE DOMINICAN
Name of hospital facility or letter of facility reporting group  
Yes No
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ............................... 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
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
SECTION B, LINE 2 - ACQUIRED OR PLACED INTO SERVICE IN CURRENT OR PRECEDING TAX YEAR DE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN NORTH LAS VEGAS THE HOSPITAL WAS ACQUIRED OR PLACED INTO SERVICE IN JUNE 2017. DE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN BLUE DIAMOND THE HOSPITAL WAS ACQUIRED OR PLACED INTO SERVICE IN JULY 2017. DE FLAMINGO LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN WEST FLAMINGO THE HOSPITAL WAS ACQUIRED OR PLACED INTO SERVICE IN AUGUST 2017. DE SAHARA LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN SAHARA THE HOSPITAL WAS ACQUIRED OR PLACED INTO SERVICE IN DECEMBER 2017. DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL THE HOSPITAL WAS ACQUIRED OR PLACED INTO SERVICE IN OCTOBER 2016.
SECTION B, LINE 5 - CHNA INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL (OASIS HOSPITAL) ST. JOSEPH'S WESTGATE MEDICAL CENTER ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (ARIZONA SPECIALTY HOSPITAL) ARIZONA GENERAL HOSPITAL LAVEEN ARIZONA SPINE AND JOINT HOSPITAL IN THE 2015 CHNA (2017 FOR ARIZONA SPINE AND JOINT HOSPITAL), THE BROAD INTERESTS OF THE COMMUNITY WERE INCORPORATED THROUGH THREE MEANS. FIRST, DATA WERE COLLECTED THROUGH FOCUS GROUPS ENGAGING MEMBERS OF UNDERSERVED POPULATIONS AND COMMUNITIES. SECOND, SURVEYS WERE CONDUCTED WITH KEY INFORMANTS WHO SERVE THE PRIMARY SERVICE AREA. FINALLY, A SERIES OF MEETINGS WERE HELD WITH KEY STAKEHOLDERS IN THE SERVICE AREA, INCLUDING THE LOCAL PUBLIC HEALTH DEPARTMENT. PARTICIPANTS INTENTIONALLY REPRESENTED VULNERABLE AND DISENFRANCHISED POPULATIONS INCLUDING THE HOMELESS, UNINSURED/UNDERINSURED, MEDICAID, MEDICARE, IMMIGRANT, DISABLED, MENTALLY ILL, AND ELDERLY. LISTS OF KEY INFORMANTS AND STAKEHOLDERS CONSULTED, AND THEIR AFFILIATIONS, ARE IN THE CHNA REPORT. A TOTAL OF TWELVE FOCUS GROUPS WERE CONDUCTED WITH 127 COMMUNITY MEMBERS FROM THE FOLLOWING GROUPS: OLDER ADULTS (65-74 YEARS OF AGE), ADULTS WITHOUT CHILDREN, ADULTS WITH CHILDREN, AMERICAN INDIAN ADULTS, LESBIAN, GAY, BISEXUAL, TRANSGENDER, AND QUESTIONING (LGBTQ) ADULTS, AFRICAN AMERICAN ADULTS, HISPANIC/LATINO ADULTS (ENGLISH), ADULTS WITH CHILDREN (SPANISH), LOW SOCIO-ECONOMIC STATUS ADULTS (SPANISH), AND YOUNG ADULTS (18-30 YEARS OF AGE). THE SURVEY WAS ADMINISTERED TO KEY INFORMANTS WHO PROVIDE SERVICES IN THE COMMUNITY, AND ASKED RESPONDENTS ABOUT FACTORS THAT WOULD IMPROVE QUALITY OF LIFE, IDENTIFY THE MOST IMPORTANT HEALTH PROBLEMS IN THE COMMUNITY, IDENTIFY RISKY BEHAVIORS OF CONCERN, AND DETERMINE THEIR OVERALL RATING OF THE HEALTH OF THE COMMUNITY. DETAILS ON FOCUS GROUP LOCATIONS AND KEY STAKEHOLDER AGENCIES REPRESENTED ARE IN THE CHNA REPORT. MERCY SAN JUAN MEDICAL CENTER MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM WOODLAND MEMORIAL HOSPITAL COMMUNITY INPUT AND PRIMARY DATA ON HEALTH NEEDS WERE OBTAINED VIA INTERVIEWS WITH SERVICE PROVIDERS AND KEY COMMUNITY INFORMANTS AND THROUGH FOCUS GROUPS IN ENGLISH AND SPANISH WITH MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. TRANSCRIPTS AND NOTES FROM INTERVIEWS AND FOCUS GROUPS WERE ANALYZED TO LOOK FOR THEMES AND TO DETERMINE IF A HEALTH NEED WAS IDENTIFIED AS SIGNIFICANT AND/OR A PRIORITY TO ADDRESS. PARTICIPANTS INCLUDED THE COUNTY PUBLIC HEALTH DEPARTMENT AND PUBLIC AND NON-PROFIT AGENCIES, COMMUNITY MEMBERS AND SERVICE PROVIDERS. A COMPLETE LIST OF KEY INFORMANT INTERVIEW DATA SOURCES, AREAS OF EXPERTISE, AND POPULATIONS SERVED, ALONG WITH LISTS OF FOCUS GROUPS WITH PARTICIPANT DEMOGRAPHIC INFORMATION IS IN THE CHNA REPORT APPENDICES. MARIAN REGIONAL MEDICAL CENTER COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED VIA A HEALTH BEHAVIOR SURVEY, FOCUS GROUPS AND INTERVIEWS. THE SURVEY WAS BASED ON QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, PREVIOUS CHNA'S PREPARED BY DIGNITY HEALTH, AND INPUT PROVIDED BY PEOPLE REPRESENTING COMMUNITY BENEFIT/OUTREACH ACTIVITIES. THE SURVEY WAS MADE AVAILABLE IN BOTH SPANISH AND ENGLISH. A TOTAL OF 1,067 SURVEYS WERE COLLECTED AT 36 DIFFERENT COMMUNITY LOCATIONS, INCLUDING THE LIBRARY, CHURCHES, SENIOR CENTERS, AND FARMS IN THE SERVICE AREA. THE COMPLETE LIST OF SURVEYED LOCATIONS AND A COPY OF THE QUESTIONNAIRE ARE IN THE CHNA REPORT. TWO FOCUS GROUPS WERE ATTENDED BY KEY INFORMANTS INCLUDING HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS REPRESENTING LOW-INCOME, MINORITY, OR MEDICALLY UNDERSERVED POPULATIONS. THE HOSPITAL INVITED BOTH THE SANTA BARBARA COUNTY PUBLIC HEALTH DEPARTMENT AND THE SAN LUIS OBISPO PUBLIC HEALTH DEPARTMENT TO PARTICIPATE. WHILE THE TIMING OF VARIOUS HOSPITAL AND PUBLIC HEALTH ASSESSMENTS DID NOT ALIGN, DATA AND INFORMATION WAS SHARED AMONG THE ORGANIZATIONS. FIVE COMMUNITY LEADER INTERVIEWS WERE CONDUCTED WITH SANTA BARBARA AND SAN LUIS OBISPO COUNTY SUPERVISORS, THE SANTA BARBARA COUNTY SHERIFF, SANTA MARIA MAYOR, AND SANTA MARIA POLICE DEPARTMENT REPRESENTATIVES. CALIFORNIA HOSPITAL MEDICAL CENTER FOR THE CHNA ADOPTED IN 2017, INPUT FROM PEOPLE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY WAS OBTAINED THROUGH INTERVIEWS AND FOCUS GROUPS WITH KEY STAKEHOLDERS, INCLUDING PATIENTS, PATIENT NAVIGATORS, COMMUNITY LIAISONS, HOSPITAL ADMINISTRATORS AND THE LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH. TWO COMMUNITY FOCUS GROUPS WERE ATTENDED BY A TOTAL OF 21 PEOPLE. FOCUS GROUP PARTICIPANTS IDENTIFIED A LIST OF THE MOST IMPORTANT HEALTH NEEDS AND CONTRIBUTING FACTORS, AND RANKED THE FIVE MOST SEVERE HEALTH OUTCOMES AND MOST SEVERE HEALTH DRIVERS. IN ADDITION TO FOCUS GROUPS, IN-DEPTH SEMI-STRUCTURED INTERVIEWS WERE CONDUCTED WITH KEY STAKEHOLDERS. PARTICIPANTS IN THE FOCUS GROUPS AND INTERVIEWS INCLUDED INDIVIDUALS IN DIABETES AND CARDIOVASCULAR CLASSES, COMMUNITY NON-PROFIT ORGANIZATIONS (E.G., KIDS' COMMUNITY CLINIC, KOREATOWN YOUTH AND COMMUNITY CENTER, AND SALVATION ARMY), AMERICAN HEART ASSOCIATION, AND PUBLIC EDUCATION. THESE GROUPS ALSO HELPED TO IDENTIFY RESOURCES POTENTIALLY AVAILABLE AND GAPS IN RESOURCES. MERCY MEDICAL CENTER REDDING (MMCR) THE HOSPITAL CONDUCTED ITS 2017 CHNA AS A CONTRIBUTING PARTICIPANT TO AND STEERING COMMITTEE MEMBER OF THE COMPREHENSIVE ASSESSMENT LED BY SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCY'S PUBLIC HEALTH BRANCH. THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIP (MAPP) MODEL WAS SELECTED AS THE CHNA'S FRAMEWORK BECAUSE OF ITS STRONG EMPHASIS ON COMMUNITY INPUT. DURING A 12-MONTH PROCESS, MAPP STEERING COMMITTEE MEMBERS ENGAGED RESIDENTS AND HEALTH SYSTEM STAKEHOLDERS TO: EXAMINE THE CURRENT HEALTH STATUS OF SHASTA COUNTY; IDENTIFY THE MOST PRESSING HEALTH ISSUES; DETERMINE WHAT RESOURCES AND OPPORTUNITIES EXIST TO ADDRESS THOSE ISSUES; AND DEVELOP A SHORT LIST OF STRATEGIC ISSUES AND GOALS FOR IMPROVING RESIDENTS' HEALTH AND WELL-BEING. COMMUNITY INPUT INCLUDED 2,850 RESPONDENTS TO A COMMUNITY SURVEY, FOUR FOCUS GROUPS, AND 30 PARTICIPANTS IN A VISIONING WORKSHOP. WORKSHOP PARTICIPANTS INCLUDED INDIVIDUALS FROM THE CITY OF REDDING, FIRST 5 SHASTA, A HEALTH PLAN, A PHILANTHROPIC FOUNDATION, PUBLIC HEALTH, PUBLIC EDUCATION, THE HEALTHY SHASTA COLLABORATIVE AND THE TRI-COUNTY COMMUNITY NETWORK. ST. ROSE DOMINICAN HOSPITAL - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA COMMUNITY INPUT WAS OBTAINED FOR THE 2015 CHNA THROUGH FOCUS GROUPS OF REPRESENTATIVES OF MINORITY AND UNDERSERVED POPULATIONS, A QUALITY OF LIFE SURVEY OF 52 KEY INFORMANTS, AND TWO COMMUNITY-WIDE MEETINGS WITH STAKEHOLDERS FROM THE COMMUNITY TO ASSIST WITH THE ANALYSIS AND INTERPRETATION OF DATA FINDINGS. ORGANIZATIONS AND SECTORS REPRESENTED INCLUDED: HISPANIC AND AFRICAN AMERICAN ORGANIZATIONS, TRANSPORTATION, EDUCATION, ENVIRONMENT, LOCAL PUBLIC HEALTH, MENTAL HEALTH, SCHOOL HEALTH, PRIMARY CARE AND OTHER HEALTH PROVIDERS AND ADVOCATES, EMERGENCY RESPONDERS, COMMUNITY ADVOCACY, HOMELESS, AND OTHERS. THESE METHODS WERE USED FOR A COMMUNITY HEALTH STATUS ASSESSMENT, A COMMUNITY THEMES AND STRENGTHS ASSESSMENT, AND A "FORCES OF CHANGE" ASSESSMENT. NORTHRIDGE HOSPITAL MEDICAL CENTER COMMUNITY INPUT FOR THE 2015 CHNA WAS COLLECTED THROUGH 36 KEY INFORMANT INTERVIEWS, 330 COMMUNITY AND STAKEHOLDER SURVEYS, SIX FOCUS GROUPS IN WHICH 91 PEOPLE PARTICIPATED, AND TWO COMMUNITY FORUMS WITH 65 PARTICIPANTS. INTERVIEW AND FORUM PARTICIPANTS INCLUDED INDIVIDUALS FROM THE LOS ANGELES COUNTY DEPARTMENTS OF PUBLIC HEALTH AND HEALTH SERVICES, PHYSICIANS AND OTHER HEALTH PROFESSIONALS, ELEMENTARY SCHOOLS, MID-VALLEY YMCA, AND A RANGE OF HEALTH AND SOCIAL SERVICES AGENCIES SERVING MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. A LIST OF THESE CONTRIBUTORS' NAMES, TITLES AND ORGANIZATIONS ARE IN THE CHNA REPORT, ALONG WITH THE SURVEY, INTERVIEW AND FOCUS GROUP QUESTIONS. DOMINICAN HOSPITAL COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED FROM 55 INDIVIDUALS VIA KEY INFORMANT INTERVIEWS WITH LOCAL HEALTH EXPERTS, AND FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES. THESE INCLUDED THE COUNTY PUBLIC HEALTH DEPARTMENT, COUNTY HOSPITAL, NON-PROFIT AGENCIES, COMMUNITY ORGANIZERS, AND THE BUSINESS, EDUCATION AND PHILANTHROPIC SECTORS. A DETAILED LIST WITH PARTICIPANTS' AFFILIATIONS, TITLES AND EXPERTISE IS IN THE CHNA REPORT APPENDIX. THE CHNA REPORT ALSO USED PRIMARY DATA COLLECTED FROM THE BIENNIAL COMMUNITY ASSESSMENT PROJECT TELEPHONE SURVEY CONDUCTED WITH A REPRESENTATIVE SAMPLE OF 700 SANTA CRUZ COUNTY RESIDENTS. THAT SURVEY ASSESSED QUALITY OF LIFE ACROSS FIVE SUBJECT AREAS: THE ECONOMY, HEALTH, PUBLIC SAFETY, THE SOCIAL ENVIRONMENT AND THE NATURAL ENVIRONMENT. ST. BERNARDINE MEDICAL CENTER COMMUNITY INPUT INTO THE 2016 CHNA WAS
MERCY MEDICAL CENTER MERCED THE 2015 CHNA OBTAINED COMMUNITY INPUT VIA A REPRESENTATIVE, WEIGHTED RANDOM SAMPLE SURVEY OF 400 COMMUNITY RESIDENTS, AND A SEPARATE KEY INFORMANT SURVEY. THE SURVEY INSTRUMENT USED IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, AS WELL AS VARIOUS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES. THE SURVEY INSTRUMENT IS SIMILAR TO THE PREVIOUS SURVEY USED IN THE REGION, ALLOWING FOR DATA TRENDING. FOR THE COMMUNITY SURVEY, A TELEPHONE INTERVIEW METHODOLOGY INCORPORATING BOTH LANDLINE AND CELL PHONE INTERVIEWS WAS EMPLOYED. SEVENTY-THREE INDIVIDUALS PARTICIPATED IN THE KEY INFORMANT SURVEY, REPRESENTING PUBLIC HEALTH, SOCIAL SERVICES, PHYSICIANS, OTHER HEALTH CARE PROVIDERS, AND COMMUNITY AND BUSINESS LEADERS. A COMPLETE LIST IS IN THE CHNA REPORT. ST. MARY MEDICAL CENTER - LONG BEACH COMMUNITY INPUT INTO THE 2015 CHNA WAS PROVIDED BY A BROAD RANGE OF COMMUNITY MEMBERS AND LEADERS THROUGH KEY INFORMANT INTERVIEWS AND RESIDENT FOCUS GROUPS. A TOTAL OF 34 KEY INFORMANT INTERVIEWS WERE CONDUCTED WITH PUBLIC HEALTH EXPERTS, REPRESENTATIVES FROM THE LOCAL PUBLIC HEALTH DEPARTMENT, AND LEADERS, REPRESENTATIVES, OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. OTHER INDIVIDUALS FROM VARIOUS SECTORS WITH EXPERTISE IN LOCAL HEALTH NEEDS WERE ALSO CONSULTED. A COMPLETE LIST OF INTERVIEW PARTICIPANTS, WITH TITLES, ORGANIZATIONS AND AREAS OF COMMUNITY REPRESENTATION, IS IN THE CHNA REPORT. EIGHT FOCUS GROUPS WERE CONDUCTED USING A NUMBER OF OUTREACH STRATEGIES TO RECRUIT COMMUNITY MEMBERS. FLYERS AND WRITTEN MATERIALS FOR THE FOCUS GROUPS WERE IN THREE LANGUAGES (ENGLISH, SPANISH AND KHMER), AND BILINGUAL-BICULTURAL FACILITATORS WERE RECRUITED SO THAT LANGUAGE WOULD NOT BE A BARRIER TO PARTICIPATION. FLYERS AND ANNOUNCEMENTS ABOUT THE FOCUS GROUPS WERE DISTRIBUTED ONLINE AND ON PAPER WITH THE HELP OF MANY COMMUNITY AGENCY PARTNERS AND 250 NEIGHBORHOOD ASSOCIATIONS. A TOTAL OF 52 COMMUNITY MEMBERS PARTICIPATED IN THE FOCUS GROUPS, INCLUDING LEADERS, REPRESENTATIVES OR MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. MERCY HOSPITAL BAKERSFIELD THE 2015 CHNA PRIMARY DATA COLLECTION PROCESS WAS DESIGNED TO IDENTIFY COMMUNITY ISSUES, SOLICIT INFORMATION ON DISPARITIES AMONG SUBPOPULATIONS, ASCERTAIN COMMUNITY ASSETS TO ADDRESS NEEDS, AND DISCOVER GAPS IN RESOURCES. INFORMATION WAS OBTAINED THROUGH A COMMUNITY SURVEY OF 935 RESIDENTS AND 33 INTERVIEWS WITH KEY COMMUNITY STAKEHOLDERS, THE PUBLIC HEALTH DEPARTMENT, SERVICE PROVIDERS, MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, AND INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS. A COMPLETE LIST OF INTERVIEWEES' NAMES, TITLES AND ORGANIZATIONS IS IN THE CHNA REPORT. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT AND IN A PAPER VERSION IN ENGLISH AND SPANISH. IT WAS DISTRIBUTED TO HOSPITAL PATIENTS, IN HOSPITAL WAITING ROOMS AND SERVICE SITES, AND THROUGH SOCIAL MEDIA INCLUDING HOSPITAL FACEBOOK PAGES. THE SURVEY WAS ALSO DISTRIBUTED TO COMMUNITY PARTNERS WHO MADE THEM AVAILABLE TO THEIR CLIENTS. THIRTY-FIVE PERCENT OF RESPONDENTS WERE ON MEDICAID OR HAD NO INSURANCE, AND 10 PERCENT HAD MEDICARE COVERAGE. SEQUOIA HOSPITAL IN THE 2015 CHNA, PRIMARY DATA WAS OBTAINED THROUGH DIRECT COMMUNITY INPUT, KEY INFORMANT INTERVIEWS WITH LOCAL HEALTH EXPERTS INCLUDING THE LOCAL PUBLIC HEALTH DEPARTMENT, FOCUS GROUPS WITH COMMUNITY LEADERS AND REPRESENTATIVES, AND RESIDENT FOCUS GROUPS. FOR THE INTERVIEWS AND COMMUNITY LEADER FOCUS GROUPS, INPUT WAS OBTAINED FROM 38 COMMUNITY REPRESENTATIVES IN THE HEALTH CARE FIELD AND IN COMMUNITY- BASED ORGANIZATIONS THAT FOCUS ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS FOR PEOPLE IN HIGH-NEED POPULATIONS. THESE INCLUDED INDIVIDUALS FROM THE COUNTY HEALTH DEPARTMENT, COUNTY HOSPITAL, COUNTY SUPERVISORS, NON-PROFIT AGENCIES, FAITH-BASED LEADERS, AND THE BUSINESS SECTOR. SPECIFIC INDIVIDUALS AND THEIR TITLES, ORGANIZATIONS AND EXPERTISE ARE IN THE CHNA REPORT APPENDIX. EIGHT RESIDENT FOCUS GROUPS WERE HELD TO REACH MEDICALLY UNDERSERVED YOUTH, MINORITY, LOW-INCOME, SPANISH-SPEAKING, HOMELESS, LGBTQI, TONGAN/SAMOAN, AND GEOGRAPHICALLY ISOLATED POPULATIONS. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER FOR THE 2016 CHNA PROCESS, COMMUNITY INPUT WAS COLLECTED FIRST BY FOCUS GROUPS WITH KEY STAKEHOLDERS, INCLUDING HEALTH CARE PROFESSIONALS, GOVERNMENT OFFICIALS, SOCIAL SERVICE PROVIDERS, COMMUNITY RESIDENTS, LEADERS, AND OTHER RELEVANT INDIVIDUALS. THE HOSPITAL THEN USED A PRIORITIZATION PROCESS INVOLVING A FACILITATED GROUP SESSION WITH KEY COMMUNITY STAKEHOLDERS IN A DISCUSSION OF SECONDARY AND PRIMARY (FOCUS GROUP) DATA. AS A FOLLOW-UP TO THIS DISCUSSION, PARTICIPANTS AND OTHER MEMBERS OF THE HOSPITAL COLLABORATIVE'S NETWORK-INCLUDING THE GLENDALE HEALTHIER COMMUNITY COALITION-COMPLETED A QUESTIONNAIRE ABOUT HEALTH NEEDS, DRIVERS, AND RESOURCES, AND RANKED EACH HEALTH NEED ACCORDING TO SEVERAL CRITERIA INCLUDING SEVERITY, CHANGE OVER TIME, RESOURCES AVAILABLE TO ADDRESS THE NEED OR DRIVER, AND COMMUNITY READINESS TO SUPPORT ACTION ON BEHALF OF ANY HEALTH NEED OR DRIVER. THE SURVEY RESULTS WERE USED TO PRIORITIZE THE HEALTH NEEDS AND DRIVERS OF HEALTH IDENTIFIED IN THE FINAL CHNA REPORT. ST. MARY'S MEDICAL CENTER THE 2015 CHNA TOOK INTO ACCOUNT COMMUNITY INPUT VIA COMMUNITY MEETINGS WITH TARGET RESIDENT POPULATIONS, IN ADDITION TO THE LEADERSHIP AND ACTIVE PARTICIPATION OF THE PUBLIC HEALTH DEPARTMENT AND MANY PUBLIC AND NON-PROFIT AGENCIES. TARGET POPULATIONS FOR THE COMMUNITY MEETINGS WERE SELECTED BASED ON FOUR FACTORS: 1) THE POPULATION HAS KNOWN HEALTH DISPARITIES, 2) LITTLE INFORMATION DESCRIBING THE HEALTH OF THE POPULATION WAS AVAILABLE, 3) THE POPULATION WAS NOT INCLUDED IN A RECENT HEALTH ASSESSMENT, AND 4) THE POPULATION WAS REACHABLE THROUGH AN EXISTING COMMUNITY GROUP. THE MAIN QUESTION ASKED OF MEETING PARTICIPANTS WAS, "WHAT ACTIONS CAN WE TAKE - INCLUDING RESIDENTS, COMMUNITY GROUPS, AND THE SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP - TO IMPROVE HEALTH?" PARTICIPANTS WERE ALSO ASKED ABOUT THE ASSETS AND BARRIERS WHICH EXIST IN THEIR COMMUNITIES REGARDING HEALTH. A TOTAL OF 127 PARTICIPANTS ATTENDED 11 MEETINGS. PARTICIPANTS CAME FROM A VARIETY OF BACKGROUNDS. THE ETHNIC GROUPS WITH THE LARGEST REPRESENTATION IN THE MEETINGS WERE LATINO (23 PERCENT), BLACK/AFRICAN AMERICAN (15 PERCENT), WHITE (17 PERCENT), AND ASIAN (12 PERCENT). OTHER SELF-REPORTED ETHNICITIES INCLUDED ARAB, FILIPINO, JEWISH, MIDDLE EASTERN, AND NATIVE AMERICAN. THE MAJORITY OF PARTICIPANTS WERE FEMALE (59 PERCENT). FRENCH HOSPITAL MEDICAL CENTER COMMUNITY INPUT FOR THE 2015 CHNA WAS OBTAINED VIA A HEALTH BEHAVIOR SURVEY, FOCUS GROUPS AND INTERVIEWS. THE SURVEY WAS BASED ON QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY, PREVIOUS CHNA'S PREPARED BY DIGNITY HEALTH, AND INPUT PROVIDED BY PEOPLE REPRESENTING COMMUNITY BENEFIT/OUTREACH ACTIVITIES. THE SURVEY WAS MADE AVAILABLE IN BOTH SPANISH AND ENGLISH. A TOTAL OF 448 SURVEYS WERE COLLECTED AT 20 DIFFERENT COMMUNITY LOCATIONS, INCLUDING CHURCHES, SENIOR HOUSING CENTERS, HOMELESS SHELTERS, SCHOOLS, AND HOUSING AUTHORITY LOCATIONS IN THE SERVICE AREA. THE COMPLETE LIST OF SURVEYED LOCATIONS AND A COPY OF THE QUESTIONNAIRE ARE IN THE CHNA REPORT. FOCUS GROUPS WERE ATTENDED BY KEY INFORMANTS REPRESENTING LOW-INCOME, MINORITY, OR MEDICALLY UNDERSERVED POPULATIONS, INCLUDING: COMMUNITY HEALTH CENTER OF THE CENTRAL COAST, SAN LUIS OBISPO COUNCIL OF GOVERNMENTS, RIDE-ON-TRANSPORTATION, TRANSITION MENTAL HEALTH ASSOCIATION, SAN LUIS OBISPO OMBUDSMAN, SAN LUIS OBISPO NOOR FOUNDATION, FIRST 5 OF SAN LUIS OBISPO, AND THE HOUSING AUTHORITY OF SAN LUIS OBISPO. THE HOSPITAL INVITED THE SAN LUIS OBISPO PUBLIC HEALTH DEPARTMENT TO PARTICIPATE IN THE CHNA. CHNA RESULTS AND THE REPORT HAVE BEEN SHARED WITH THE HEALTH DEPARTMENT AND THE LOCAL "ACTION FOR HEALTIER COMMUNITIES" COALITION IN WHICH BOTH PARTICIPATE. ST. ELIZABETH COMMUNITY HOSPITAL DATA FOR THE HOSPITAL'S 2017 NEEDS ASSESSMENT WAS OBTAINED IN PART THROUGH FOCUS GROUPS AND A SURVEY WITH ESTABLISHED COMMUNITY BODIES, TO GAIN A THOROUGH UNDERSTANDING OF THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. FOCUS GROUP MEETINGS WERE CONDUCTED WITH THE ST. ELIZABETH COMMUNITY HOSPITAL ADVISORY COUNCIL, TEHAMA COUNTY PUBLIC HEALTH DEPARTMENT AND BOARD, AND TEHAMA COUNTY ELDER SERVICES GROUP. EACH OF THESE HAS MEMBERSHIP BROADLY REPRESENTATIVE OF AND KNOWLEDGEABLE ABOUT DIFFERENT SEGMENTS OF THE COMMUNITY. A SAMPLE OF THEIR CONSTITUENT MEMBERS THAT PROVIDED INPUT INCLUDES: TEHAMA COUNTY PUBLIC HEALTH SERVICES AGENCY, RED BLUFF CHAMBER OF COMMERCE, TEHAMA COUNTY DISTRICT ATTORNEY, TEHAMA COU
SECTION B, LINE 6A- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSESSMENT ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, ST. JOSEPH'S WESTGATE MEDICAL CENTER, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL (OASIS HOSPITAL), ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (ARIZONA SPECILTY HOSPITAL), AGH LAVEEN LLC, ARIZONA SPINE AND JOINT HOSPITAL, BANNER HEALTH, MAYO HOSPITAL, PHOENIX CHILDREN'S HOSPITAL MERCY SAN JUAN MEDICAL CENTER, MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER HEALTH ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS, ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS, BOULDER CITY HOSPITAL, THE UNIVERSITY MEDICAL CENTER CALIFORNIA HOSPITAL MEDICAL CENTER - GOOD SAMARITAN HOSPITAL, ST. VINCENT MEDICAL CENTER MERCY MEDICAL CENTER REDDING - SHASTA REGIONAL MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER, COMMUNITY HOSPITAL OF SAN BERNARDINO ST. JOHN'S REGIONAL MEDICAL CENTER, ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. MARY MEDICAL CENTER - LONG BEACH, KAISER PERMANENTE SOUTH BAY, LONG BEACH MEMORIAL HOSPITAL, COMMUNITY HOSPITAL LONG BEACH, MILLER CHILDREN'S AND WOMEN'S HOSPITAL MERCY HOSPITAL BAKERSFIELD, DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE, SAN JOAQUIN COMMUNITY HOSPITAL SEQUOIA HOSPITAL - STANFORD HOSPITAL AND CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL, KAISER PERMANENTE SAN MATEO AREA GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER - GLENDALE ADVENTIST MEDICAL CENTER, USC VERDUGO HILLS HOSPITAL ST. MARY'S MEDICAL CENTER, SAINT FRANCIS MEMORIAL HOSPITAL, SUTTER HEALTH CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE SAN FRANCISCO, UCSF MEDICAL CENTER
SECTION B, LINE 6b - CHNA CONDUCTED WITH ONE OR MORE ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S WESTGATE MEDICAL CENTER ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (ARIZONA SPECIALTY HOSPITAL) ARIZONA GENERAL HOSPITAL - LAVEEN ARIZONE SPINE AND JOINT HOSPITAL MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, ADELANTE HEALTHCARE, HEALTH CARE FOR THE HOMELESS, MOUNTAIN PARK HEALTH CENTER, AND NATIVE HEALTH MERCY MEDICAL CENTER REDDING - CITY OF REDDING, FIRST 5 SHASTA, HEALTHY SHASTA COLLABORATIVE, HILL COUNTRY HEALTH AND WELLNESS, MCCONNELL FOUNDATION, PARTNERSHIP HEALTHPLAN OF CALIFORNIA, PUBLIC HEALTH ADVISORY BOARD, REACH HIGHER SHASTA COLLABORATIVE, REDDING RANCHERIA, SHASTA COMMUNITY HEALTH CENTER, SHASTA COUNTY HEALTH AND HUMAN SERVICES AGENCY, SHASTA HEALTH ASSESSMENT AND REDESIGN COLLABORATIVE, STRENGTHENING FAMILIES COLLABORATIVE DOMINICAN HOSPITAL SANTA CRUZ COUNTY COMMUNITY ASSESSMENT PROJECT STEERING COMMITTEE MEMBERS, INCLUDING: UNITED WAY OF SANTA CRUZ COUNTY, SANTA CRUZ COUNTY ALCOHOL & DRUG PROGRAM, UNIVERSITY OF CALIFORNIA-SANTA CRUZ, FIRST 5 SANTA CRUZ COUNTY, SANTA CRUZ COMMUNITY CREDIT UNION - COMMUNITY VENTURES, SOQUEL UNION ELEMENTARY SCHOOL DISTRICT, SANTA CRUZ COMMUNITY HEALTH CENTERS, COMMUNITY FOUNDATION SANTA CRUZ COUNTY, SECOND HARVEST FOOD BANK, COUNTY OF SANTA CRUZ HEALTH SERVICES AGENCY, SANTA CRUZ COUNTY PROBATION DEPARTMENT, COUNTY OF SANTA CRUZ, PAMF/SUTTER HEALTH, ECOLOGY ACTION, DIENTES COMMUNITY DENTAL CARE, SANTA CRUZ COUNTY OFFICE OF EDUCATION, HEALTH IMPROVEMENT PARTNERSHIP SANTA CRUZ COUNTY, COASTAL WATERSHED COUNCIL, CABRILLO COLLEGE, PAJARO VALLEY COMMUNITY HEALTH TRUST, COUNTY OF SANTA CRUZ HUMAN SERVICES DEPARTMENT, CULTURAL COUNCIL OF SANTA CRUZ COUNTY, SANTA CRUZ COUNTY SHERIFF'S OFFICE ST. ROSE DOMINICAN HOSPITAL - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA THE CHNA WAS CONDUCTED WITH: SOUTHERN NEVADA HEALTH DISTRICT, AMERICAN HEART ASSOCIATION, CATHOLIC CHARITIES, CENTER FOR PROGRESSIVE POLICY AND PROGRESS, CLARK COUNTY SCHOOL DISTRICT, CLARK COUNTY SOCIAL SERVICES, FEDERAL RESERVE BANK OF SAN FRANCISCO, LAS VEGAS CHAMBER OF COMMERCE, MARCH OF DIMES, NEVADA HAND, UNITED WAY OF SOUTHERN NEVADA, UNIVERSITY OF NEVADA - LAS VEGAS, THE UNIVERSITY OF NEVADA - RENO ST. MARY MEDICAL CENTER - LONG BEACH CITY OF LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND THE CHILDREN'S CLINIC SEQUOIA HOSPITAL HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY, INCLUDING: PENINSULA HEALTH CARE DISTRICT, SAN MATEO COUNTY HUMAN SERVICE AGENCY, SEQUOIA HEALTHCARE DISTRICT, HEALTH PLAN OF SAN MATEO, SAN MATEO COUNTY HEALTH DEPARTMENT, PENINSULA FAMILY YMCA, PENINSULA LIBRARY SYSTEM-COMMUNITY INFORMATION PROGRAM, SILICON VALLEY COMMUNITY FOUNDATION, YOUTH AND FAMILY ENRICHMENT SERVICES ST. MARY'S MEDICAL CENTER SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP MEMBERS INCLUDING: SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE'S COMMUNITY ENGAGEMENT AND HEALTH POLICY PROGRAM AT UCSF, SAN FRANCISCO UNIFIED SCHOOL DISTRICT, THE OFFICE OF THE MAYOR, THE ASIAN AND PACIFIC ISLANDER HEALTH PARITY COALITION, HUMAN SERVICE NETWORK, CHICANO/LATINO/INDIGENA HEALTH EQUITY COALITION, AFRICAN AMERICAN COMMUNITY HEALTH COUNCIL, COMMUNITY CLINIC CONSORTIUM, 12 OTHER COMMUNITY ENGAGEMENT PARTNERS, AND FAITH BASED AND PHILANTHROPIC PARTNERS CARONDELET ST. JOSEPH'S HOSPITAL, CARONDELET ST. MARY'S HOSPITAL - EL RIO COMMUNITY HEALTH CENTER, HEALTHY PIMA, PIMA COUNTY HEALTH DEPARTMENT, PASCUA YAQUI TRIBE
SECTION B, LINE 7a - CHNA ON HOSPITAL FACILITY'S WEB SITE ALL DIGNITY HEALTH HOSPITAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS CAN BE ACCESSED AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS. CHNA REPORT WEB SITE LOCATIONS FOR EACH HOSPITAL FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/stjosephs/about-us/communi ty-benefit/community-benefit-resources MERCY SAN JUAN MEDICAL CENTER MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM WOODLAND MEMORIAL HOSPITAL https://www.dignityhealth.org/sacramento/about-us/community-health-and-out reach/health-needs-assessment MARIAN REGIONAL MEDICAL CENTER https://www.dignityhealth.org/central-coast/locations/marianregional/about -us/community-benefits CALIFORNIA HOSPITAL MEDICAL CENTER https://www.dignityhealth.org/socal/locations/californiahospital/about-us/ community-programs/community-health-needs-assessment-plan CHANDLER REGIONAL MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/chandlerregional/about-us/ community-benefit-outreach/benefits-reports MERCY MEDICAL CENTER REDDING https://www.dignityhealth.org/north-state/locations/mercy-redding/about-us /community-benefit ST. ROSE DOMINICAN HOSPITALS - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA https://www.dignityhealth.org/las-vegas/about-us/serving-the-community NORTHRIDGE HOSPITAL MEDICAL CENTER https://www.dignityhealth.org/socal/locations/northridgehospital/about-us/ community-benefit-reports DOMINICAN HOSPITAL https://www.dignityhealth.org/bayarea/locations/dominican/about-us/communi ty-benefits/benefits-reports ST. BERNARDINE MEDICAL CENTER https://www.dignityhealth.org/socal/locations/stbernardinemedical/about-us /serving-the-community/community-health-needs-assessment-plan ST. JOHN'S REGIONAL MEDICAL CENTER https://www.dignityhealth.org/central-coast/locations/stjohnsregional/abou t-us/community-benefit MERCY MEDICAL CENTER MERCED https://www.dignityhealth.org/central-california/locations/mercymedical-me rced/about-us/community-benefit-report ST. MARY MEDICAL CENTER - LONG BEACH https://www.dignityhealth.org/socal/locations/stmarymedical/about-us/commu nity-benefits MERCY HOSPITAL BAKERSFIELD https://www.dignityhealth.org/central-california/locations/mercy-bakersfie ld/about-us/community-benefit-report-health-needs-assessment MERCY GILBERT MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/mercygilbert/about-us/comm unity-benefit-outreach/benefits-reports SEQUOIA HOSPITAL https://www.dignityhealth.org/bayarea/locations/sequoia/about-us/community -benefits ST. MARY'S MEDICAL CENTER https://www.dignityhealth.org/bayarea/locations/stmarys/about-us/community -benefit GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER https://www.dignityhealth.org/socal/locations/glendalememorial/about-us/se rving-the-community/community-health-needs-assessment-plan FRENCH HOSPITAL MEDICAL CENTER https://www.dignityhealth.org/central-coast/locations/frenchhospital/about -us/community-benefits ST. JOHN'S PLEASANT VALLEY HOSPITAL https://www.dignityhealth.org/central-coast/locations/pleasantvalley/about -us/community-benefit ST. ELIZABETH COMMUNITY HOSPITAL https://www.dignityhealth.org/north-state/locations/stelizabethhospital/ab out-us/community-benefit MERCY MEDICAL CENTER MT. SHASTA https://www.dignityhealth.org/north-state/locations/mercy-mtshasta/about-u s/community-benefit CARONDELET ST. JOSEPH'S HOSPITAL, CARONDELET ST. MARY'S HOSPITAL, CARONDELET HOLY CROSS HOSPITAL HTTPS://WWW.CARONDELET.ORG/ABOUT-US/COMMUNITY-OUTREACH SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL (OASIS) HTTP://WWW.OASISHOSPITAL.COM/ ST. JOSEPH'S WESTGATE MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/westgate/about-us/communit y-benefit ARIZONA GENERAL HOSPITAL - LAVEEN https://www.dignityhealth.org/arizona/locations/arizonageneral/about-us/co mmunity-benefit ARIZONA SPINE AND JOINT HOSPITAL https://www.azspineandjoint.com/our-facility/ ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (ARIZONA SPECIALTY HOSPITAL) HTTP://WWW.DIGNITYHEALTHAZSH.COM/COMMUNITY-BENEFITS-REPORTS
SECTION B, LINE 7b - CHNA ON OTHER WEB SITES MERCY HOSPITAL BAKERSFIELD HTTP://WWW.HEALTHYKERN.ORG/ SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG CARONDELET ST. JOSEPH'S HOSPITAL CARONDELET ST. MARY'S HOSPITAL https://webcms.pima.gov/health/resources_for_professionals/health_data_sta tistics_and_reports/ SECTION B, LINE 8 - IMPLEMENTATION STRATEGY ADOPTION CARONDELET ST. JOSEPH'S HOSPITAL CARONDELET ST. MARY'S HOSPITAL THE HOSPITALS ADOPTED A 2018 CHNA AND WILL ADOPT THE IMPLEMENTATION STRATEGY BY 11/15/2019.
SECTION B, LINE 10a - IMPLEMENTATION STRATEGIES ON WEB SITES DIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTS IMPLEMENTATION STRATEGY DOCUMENTS ARE ALSO ON EACH HOSPITAL FACILITY'S WEB SITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7A ABOVE.
SECTION B, LINE 11 - NEEDS ADDRESSED AND NOT ADDRESSED IN THE CHNA ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S WESTGATE MEDICAL CENTER ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (ARIZONA SPECIALTY HOSPITAL) ARIZONA GENERAL HOSPITAL - LAVEEN ARIZONA SPINE AND JOINT HOSPITAL THE HOSPITALS ARE ADDRESSING THE 2015 CHNA SIGNIFICANT HEALTH NEEDS OF: ACCESS TO CARE, MENTAL/BEHAVIORAL HEALTH AND SUBSTANCE ABUSE, OBESITY AND DIET-RELATED ILLNESSES, CHRONIC CONDITIONS, AND INJURY AND TRAUMA. THE HOSPITALS ARE ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THEIR IMPLEMENTATION STRATEGIES, WHICH ARE AVAILABLE TO THE PUBLIC ONLINE. ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, ARIZONA GENERAL HOSPITAL - LAVEEN AND ARIZONA SPINE AND JOINT HOSPITAL ARE SMALL, JOINT VENTURE SPECIALTY HOSPITALS THAT WORK CLOSELY WITH ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER. ACCESS TO HEALTH CARE: THE HOSPITALS OPERATE 23 ACCESS-RELATED PROGRAMS SERVING NEEDS INCLUDING TRANSITIONAL CARE, CANCER, ALZHEIMIER'S, NATIVE AMERICANS, AT-RISK FAMILIES, HOMELESS, AND OTHER TOPICS, AS WELL AS OFFERING PATIENT FINANCIAL ASSISTANCE. MENTAL AND BEHAVIORAL HEALTH: HOME-MVP, MATERNAL MOOD DISORDERS/POST-PARTUM DEPRESSION, MENTAL HEALTH FIRST AID, NATIVE COLLABORATION, SOUTHWEST BEHAVIORAL HEALTH SERVICES, TEEN PREGNANCY AND PARENTING. OBESITY: FOURTEEN PROGRAMS INCLUDING THOSE FOR CONGESTIVE HEART FAILURE, CHRONIC DISEASE AND DIABETES, AND THE WOMEN, INFANT AND CHILDREN'S PROGRAM. CHRONIC HEALTH CONDITIONS: NINETEEN PROGRAMS INCLUDING THOSE FOR PREVENTING AND ADDRESSING CANCER, CARDIOVASCULAR DISEASE, AND DIABETES. INJURY AND TRAUMA: NINETEEN PROGRAMS INCLUDING THOSE FOR PREVENTION OF HEAD INJURIES, WATER SAFETY, FALL PREVENTION, DOMESTIC VIOLENCE, ANTI-HUMAN TRAFFICKING, SENIOR DRIVING, AND PRESCRIPTION DRUG ABUSE. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER AS AN ACUTE CARE HOSPITAL IS NOT LICENSED TO PROVIDE CARE TO CHILDREN LESS THAN FIFTEEN YEARS OF AGE WITHIN THE HOSPITAL SETTING. THROUGH COLLABORATIVE ENGAGEMENT WITH PHOENIX CHILDREN'S HOSPITAL, THE HOSPITALS ARE ABLE TO MEET THE NEEDS LISTED FOR CHILDREN AND ALSO COLLABORATE WITH THE COMMUNITY WHERE AREAS OF NEED ARE UNMET. THE SERVICES THAT ARE NOT MET BY THE HOSPITALS ARE MET BY OTHER HEALTH CARE FACILITIES OR COLLABORATIVE PARTNERSHIPS WITHIN MARICOPA COUNTY. MERCY SAN JUAN MEDICAL CENTER MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM THESE GREATER SACRAMENTO HOSPITALS ARE ADDRESSING OR CURRENTLY DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: 1) ACCESS TO BEHAVIORAL HEALTH SERVICES, 2) ACTIVE LIVING AND HEALTHY EATING, 3) DISEASE PREVENTION, MANAGEMENT, AND TREATMENT, 4) ACCESS TO HIGH QUALITY HEALTH CARE AND SERVICES, 5) SAFE, CRIME AND VIOLENCE FREE COMMUNITIES, AND 6) BASIC NEEDS. INITIATIVES THAT ADDRESS THESE PRIORITIES LARGELY TARGET VULNERABLE AND AT-RISK POPULATIONS, WITH EMPHASIS ON COLLABORATION WITH OTHER DIGNITY HEALTH HOSPITALS AND COMMUNITY PARTNERS. THE HOSPITALS ARE ADDRESSING THESE NEEDS WITH NUMEROUS DIRECT SERVICE PROGRAMS, GRANT FUNDING TO THE COMMUNITY, PATIENT FINANCIAL ASSISTANCE, AND COMMUNITY PARTNERSHIPS DESCRIBED IN DETAIL IN EACH FACILITY'S IMPLEMENTATION STRATEGY, WHICH ARE AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS AT THESE HOSPITALS INCLUDE: REFERNET INTENSIVE OUTPATIENT MENTAL HEALTH PARTNERSHIP, TRIAGE NAVIGATOR PROGRAM, MENTAL HEALTH IMPROVEMENT COALITION, MENTAL HEALTH CONSULTATIONS AND CONSERVATORSHIP SERVICES, FOOD LITERACY CENTER, MACK ROAD PARTNERSHIP (METHODIST HOSPITAL ONLY), WAYUP STATION, HEALTHIER LIVING, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, DIABETES EMPOWERMENT EDUCATION PROGRAM, PATIENT NAVIGATOR PROGRAM, CANCER NURSE NAVIGATOR, SACRAMENTO PHYSICIANS' INITIATIVE TO REACH OUT, INNOVATE AND TEACH, MERCY FAMILY HEALTH CLINIC (METHODIST HOSPITAL ONLY), PEACH TREE HEALTH CAPACITY BUILDING PROJECT, MERCY CLINIC LOAVES & FISHES, SCHOOL NURSE PROGRAM, MERCY FAITH AND HEALTH PARTNERSHIP, CARE FOR THE UNDOCUMENTED, ANTI-HUMAN TRAFFICKING INITIATIVE, WEAVE WELLNESS CENTER (METHODIST HOSPITAL ONLY), INITIATIVE TO REDUCE AFRICAN AMERICAN CHILD DEATHS, PREVENT ALCOHOL AND RISK-RELATED TRAUMA IN YOUTH, SAFE KIDS PROGRAM, HOMELESS OUTREACH PROJECT, INTERIM CARE PROGRAM, AND HOUSING WITH DIGNITY HOMELESS PROGRAM. THE HOSPITALS DO NOT HAVE THE CAPACITY OR RESOURCES TO ADDRESS ALL PRIORITY HEALTH ISSUES. THE HOSPITALS ARE NOT DIRECTLY ADDRESSING AFFORDABLE AND ACCESSIBLE TRANSPORTATION OR POLLUTION-FREE LIVING AND WORKING ENVIRONMENTS. MANY OF THE CURRENT INITIATIVES INCLUDE A TRANSPORTATION COMPONENT ALTHOUGH SERVICES ARE LIMITED. THE SACRAMENTO AREA COUNCIL OF GOVERNMENTS FOCUSES ON INITIATIVES AROUND TRANSPORTATION PLANNING AND CLEAN AIR INITIATIVES. MARIAN REGIONAL MEDICAL CENTER THE PRIORITIZED SIGNIFICANT HEALTH NEEDS IN THE 2015 CHNA THAT THE HOSPITAL WILL DIRECTLY ADDRESS ARE CARDIOVASCULAR DISEASE AND STROKE AND CANCER SCREENINGS. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: COMMUNITY EDUCATION IN SPANISH AND ENGLISH, ASSESSMENT OF CARDIOVASCULAR RISK STATUS AT TARGETED LOCATIONS IN THE COMMUNITY, HEART AWARE PROGRAM, CARE TRANSITIONS PROGRAM, CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, NUTRITION PROGRAMS, CANCER AWARENESS COMMUNITY EDUCATION AT OUTREACH EVENTS AND LOCAL SCHOOLS, CANCER SCREENINGS, HEREDITARY CANCER RISK ASSESSMENT AND GENETIC COUNSELING, CANCER EXPERIENCE REGISTRY PROGRAM, MISSION HOPE CANCER REHABILITATION PROGRAM, AND CANCER SUPPORT GROUPS. EDUCATION, ACCESS TO MENTAL HEALTH, AND HOMELESSNESS/HOUSING ARE NEEDS THE HOSPITAL HAS CHOSEN NOT TO ADDRESS ALONE, BUT DOES HAVE PROGRAMS OR PLANS IN CONJUNCTION WITH OTHER ORGANIZATIONS. AMONG THE PROGRAM INITIATIVES ARE: REACH OUT AND READ PROGRAM, MATERNAL MOOD DISORDER PILOT PROGRAM, CAREGIVER WORKSHOPS AND SUPPORT GROUPS, FREE ZUMBA AND YOGA CLASSES, RESPITE CARE SERVICES, AND CASE MANAGEMENT OF CHRONICALLY HOMELESS INDIVIDUALS. THE HOSPITAL IS LIMITED IN RESOURCES TO ADDRESS EDUCATION AND HOMELESSNESS/HOUSING INDEPENDENT OF OUR COMMUNITY PARTNERS. CONSIDERABLE INVESTIGATION REVEALED EDUCATION AND HOMELESSNESS/HOUSING ARE BEING ADDRESSED BY OTHERS, BUT THERE IS STILL WORK TO BE DONE. BY INVITATION TO COMMUNITY-BASED ORGANIZATIONS, THE HOSPITAL HOPES TO FACILITATE A SEAMLESS CONTINUUM OF CARE AND DEVELOP RELATIONSHIPS THAT CAN BE ADDRESSED THROUGH THE DIGNITY HEALTH COMMUNITY GRANTS PROGRAM. THE HOSPITAL, IN PARTNERSHIP WITH THE COUNTY OF SANTA BARBARA, PLANS TO OPEN AN INPATIENT BEHAVIORAL HEALTH UNIT IN NORTH SANTA BARBARA COUNTY IN 2019 TO HELP ADDRESS THE CRITICAL MENTAL HEALTH NEEDS OF THE COMMUNITY. CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER THE HOSPITALS ARE ADDRESSING ALL SIGNIFICANT NEEDS IN THE 2015 CHNA IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. ACCESS TO HEALTH CARE: NINETEEN PROGRAMS THAT ADDRESS TRANSITIONAL CARE, SCHOOL-BASED HEALTH CARE, FREE AND LOW-COST SERVICES, HOMELESS POPULATION, TRANSPORTATION, ACCESS TO HEALTH INFORMATION, EDUCATION ABOUT INSURANCE, AND ACCESS TO HEALTHY FOOD. PROBLEMS OF AGING: SEVENTEEN PROGRAM ACTIVITIES THAT ADDRESS SUPPORT TO CAREGIVERS, ALZHEIMER'S, FALL RISKS, CHRONIC DISEASE, TRANSPORTATION, AND CONDITION-SPECIFIC SUPPORT GROUPS. MENTAL HEALTH/BEHAVIORAL HEALTH: SEVEN PROGRAMS THAT INCLUDE BEHAVIORAL HEALTH TASK FORCE PARTICIPATION, COMMUNITY EDUCATION, MENTAL HEALTH FIRST AID PROGRAM, MATERNAL POST-PARTUM DEPRESSION, AND PREGNANT AND PARENTING AND TEEN SUPPORT. DIABETES: EIGHT PROGRAM ACTIVITIES INCLUDING CENTER FOR DIABETES MANAGEMENT COMMUNITY PROGRAMS, CHRONIC DISEASE AND DIABETES SELF-MANAGEMENT WORKSHOPS, FITNESS EDUCATION AND PARTNERSHIPS, AND AN EVALUATION OF HEALTH FOOD ACCESS. INJURY PREVENTION: NINE PROGRAM ACTIVITIES ADDRESSING INJURY PREVENTION FOR BOTH CHILDREN AND ADULTS. CAR SEAT CLINICS AND THE MATTER OF BALANCE FALL PREVENTION PROGRAM ARE EXAMPLES. CANCER: PROGRAM STRATEGIES IN IMPROVED EDUCATION ON IMPORTANCE OF EARLY DETECTION AND AVAILABILITY OF RESOURCES, AND IMPROVED AWARENESS OF CANCER SCREENING EVENTS. IN ADDITION, STRONG AND EFFECTIVE COMMUNITY PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE AND SERVICES REGARDLESS OF THE NEED. CALIFORNIA HOSPITAL MEDICAL CENTER THE SIGNIFICANT COMMUNITY HEALTH NEEDS FROM THE HOSPITAL'S 2017 CHNA THAT IT IS HELPING TO ADDRESS ARE: OBESITY/OVERWEIGHT, DIABETES, ORAL HEALTH, ALCOHOL/DRUG/TOBACCO USE DISORDERS, HYPERTENSION, CARDIOVASCULAR DISEASE, CHOLESTEROL AND CANCER. PLANNED PROGRAMS AND ACTIVITIES INCLUDE THE FOLLOWING. OBESITY/OVERWEIGHT AND DIABETES: PARISH NURSE SCREENINGS OF ADULTS FOR OBESITY/OVERWEIGHT; EVIDENCE-BASED DIABETES EMPOWERMENT EDUCATION PROGRAM (DEEP) TO INCREASE SELF-EFFICACY IN PREVENTING AND MANAGING DIABETES; HEALTHY EATING AND
NORTHRIDGE HOSPITAL MEDICAL CENTER THE HOSPITAL IS TAKING STEPS TO HELP ADDRESS EACH OF THE 10 SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: DIABETES SELF-MANAGEMENT PROGRAM, DIABETES EMPOWERMENT EDUCATION PROGRAM, MEET EACH NEED WITH DIGNITY, CHOOSE HEALTH LA KIDS, SCHOOL WELLNESS INITIATIVE, SOS MENTOR HEALTHY KIDS KINDNESS, EMERGENCY DEPARTMENT INITIATIVE, ACTIVATE YOUR HEART, COMMUNITY CHOLESTEROL SCREENINGS, FINANCIAL ASSISTANCE FOR THE UNINSURED, LOAN TO THE LA FAMILY HOUSING CORPORATION, PATIENT NAVIGATOR PROGRAM, FAMILY MEDICINE CENTER & RESIDENCY PROGRAM, SHAPE UP YOUR HEART, CENTER FOR ASSAULT TREATMENT SERVICES, COALITION TO ABOLISH SLAVERY AND TRAFFICKING, AND ESTABLISHMENT OF A FREE CLINIC CREATING CAPACITY FOR AN ADDITIONAL 36 FREE ADULT DENTAL APPOINTMENTS PER MONTH. DOMINICAN HOSPITAL THE 2015 CHNA IDENTIFIED AND PRIORITIZED THE SIGNIFICANT HEALTH NEEDS OF: INTEGRATED BEHAVIORAL HEALTH, ECONOMIC SECURITY (INCOME & EMPLOYMENT/HOUSING & HOMELESSNESS), AND A CONTINUUM OF CARE APPROACH TO ACCESS & DELIVERY. THE HOSPITAL IS IMPLEMENTING PROGRAMS TO HELP ADDRESS EACH OF THESE PRIORITIZED NEEDS. PROGRAMS INCLUDE: PSYCHIATRIC RESOURCE TEAM TO PROVIDE CASE MANAGEMENT, SOCIAL SERVICES TO PROVIDE REFERRALS TO INDIVIDUALS WITH SUBSTANCE USE DISORDERS, ENCOMPASS COMMUNITY SERVICES WHICH OPERATES A STATE FUNDED PRESCHOOL PROVIDING HIGH QUALITY EARLY CHILDHOOD EDUCATION AT THE STARLIGHT CENTER, A HIGH UTILIZERS GROUP INITIATIVE WHICH CONVENES COMMUNITY PROVIDERS INTO A NETWORK SERVING THE HIGH NEED, HIGH COST PATIENTS IN SANTA CRUZ FOR BOTH HEALTH AND HEALTH-RELATED SOCIAL NEEDS, SUPPORT OF THE ROTACARE FREE HEALTH CLINIC, MOBILE WELLNESS CLINIC, HOMELESS RECUPERATIVE CARE PROGRAM, LUNG AND COLORECTAL CANCER SCREENING PROGRAMS, AND EVERY WOMAN COUNTS PROGRAM. THE HOSPITAL COLLABORATES WITH MULTIPLE PUBLIC AND NON-PROFIT AGENCIES TO DELIVER THESE PROGRAMS. PROGRAMS AND COLLABORATIONS ARE DESCRIBED IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. ST. BERNARDINE MEDICAL CENTER THE HOSPITAL IS ADDRESSING THE FOLLOWING IDENTIFIED SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTH CARE/PREVENTIVE PRACTICES, BIRTH INDICATORS, CHRONIC DISEASES/OVERWEIGHT AND OBESITY, HOMELESSNESS, AND YOUTH DEVELOPMENT FOR AT-RISK YOUTH, INCLUDING SAFETY AND VIOLENCE PREVENTION. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN ITS IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. ACCESS TO HEALTH CARE/PREVENTIVE PRACTICES: PATIENT FINANCIAL ASSISTANCE, DIGNITY HEALTH COMMUNITY GRANTS PROGRAM, FREE COMMUNITY HEALTH EDUCATION, HEALTH PROFESSIONS EDUCATION PROGRAM, COMMUNITY HEALTH NAVIGATOR, FREE FLU SHOTS. BIRTH INDICATORS: BABY AND FAMILY CENTER, SWEET SUCCESS PROGRAM FOR GESTATIONAL DIABETIC WOMEN, STATUS AS A BABY-FRIENDLY ACUTE CARE HOSPITAL. CHRONIC DISEASES/OVERWEIGHT AND OBESITY: CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, COMMUNITY GRANTS PROGRAM, FREE HEART CARE CLINIC SERVICES, SWEET SUCCESS, COMMUNITY HEALTH EDUCATION AND SUPPORT GROUPS. HOMELESSNESS: COMMUNITY GRANTS PROGRAM, COMMUNITY HEALTH NAVIGATOR TO CONNECT HOMELESS PATIENTS WITH SUPPORTIVE SOCIAL SERVICES, INCLUDING HOUSING SUPPORT. YOUTH DEVELOPMENT: FAMILY FOCUS CENTER, STEPPING STONES HEALTH CARE CAREER EXPOSURE AND MENTORING. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, THE HOSPITAL WILL NOT DIRECTLY ADDRESS THE FOLLOWING IDENTIFIED NEEDS: MENTAL HEALTH, SEXUALLY TRANSMITTED INFECTIONS, AND SUBSTANCE ABUSE. THE HOSPITAL CANNOT ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY. THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. ST. JOHN'S REGIONAL MEDICAL CENTER SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA INCLUDED: OBESITY AND OVERWEIGHT, ACCESS TO HEALTH CARE, HOMELESS HEALTH ISSUES, LACK OF ADEQUATE MENTAL HEALTH RESOURCES, DIABETES AND PREDIABETES, CARDIOVASCULAR HEALTH, CANCERS, AND SOCIAL DETERMINANTS OF POOR HEALTH. THE HOSPITAL DOES NOT PLAN TO ADDRESS LACK OF MENTAL HEALTH RESOURCES, DUE TO A LACK OF RESOURCES, BUT WILL EXPLORE FUTURE COLLABORATIVE OPPORTUNITIES TO HELP ADDRESS IT. THE HOSPITAL PLANS TO ADDRESS ALL OTHER SIGNIFICANT NEEDS BOTH DIRECTLY AND THROUGH GREATER COLLABORATION BETWEEN THE HOSPITALS IN VENTURA COUNTY AND VENTURA COUNTY PUBLIC HEALTH. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: INCREASED HEALTH EDUCATION, ESPECIALLY OF YOUTH, TO CHANGE LIFE STYLE BEHAVIOR PATTERNS, SENIOR WELLNESS & WALKING PROGRAM, HEALTH FAIRS AND COMMUNITY SCREENING EVENTS, MOBILE FLU IMMUNIZATION CLINICS, EXPANDING MOTHER-INFANT FACILITIES, INTEGRATION OF COMMUNITY HEALTH ACTIVITIES THAT ARE OFFERED WITH DIGNITY HEALTH MEDICAL FOUNDATION AND OTHER PHYSICIAN AFFILIATIONS, CREATION OF THE DIGNITY HEALTH CARE CORRIDOR IN VENTURA COUNTY, DIGNITY HEALTH COMMUNITY GRANT FOR HOMELESS RESPITE PROGRAM, DIABETES EMPOWERMENT EDUCATION PROGRAM, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, KNOW YOUR NUMBERS, ST. JOHN'S CANCER CENTER OF VENTURA COUNTY (EDUCATION/PREVENTION SEMINARS AND LECTURES, SUPPORT GROUPS, CANCER NURSE NAVIGATOR, CANCER DIETICIAN SPECIALIST SERVICES, MOBILE SKIN CANCER SCREENINGS), HEALTH MINISTRIES PROGRAM (COMMUNITY FOOD PANTRY, COMMUNITY CLOTHES CLOSET, BASIC NEEDS FINANCIAL LOAN ASSISTANCE, COUNSELING/BUDGETING EDUCATION, SOCIAL WORK ASSISTANCE) AND PATIENT FINANCIAL ASSISTANCE. MERCY MEDICAL CENTER MERCED MERCY MEDICAL CENTER MERCED IS ADDRESSING THE FOLLOWING IDENTIFIED SIGNIFICANT HEALTH NEEDS: ACCESS TO HEALTH SERVICES, CANCER, DIABETES, HEART DISEASE & STROKE, IMMUNIZATION & INFECTIOUS DISEASES, INFANT HEALTH, MENTAL HEALTH, RESPIRATORY DISEASES, AND NUTRITION, PHYSICAL ACTIVITY AND WEIGHT. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS DELIVERED OR SUPPORTED INCLUDE: FINANCIAL ASSISTANCE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS, FAMILY PRACTICE CENTER, KIDS CARE AND GENERAL MEDICINE, CLINIC RURAL HEALTH CARE OUTPATIENT CLINICS, EMERGENCY DEPARTMENT PHYSICIAN SERVICES FOR INDIGENT PATIENTS, COMMUNITY GRANTS PROGRAM FUNDING OF HOPE RESPITE CARE, ALPHA CRISIS PREGNANCY PROGRAM, MERCED COUNTY WHOLE HEALTH PARTNERSHIP, CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, DIABETES SELF-MANAGEMENT PROGRAM, LIVING WELL WITH DIABETES, LABOR OF LOVE CHILDBIRTH PREPARATION, MERCY YOGA AND ZUMBA CLASSES, STROKE SUPPORT GROUP AND EDUCATION, BI-NATIONAL WEEK HEALTH ACTIVITIES, AND CANCER CENTER COMMUNITY PROGRAMS. SIGNIFICANT NEEDS IDENTIFIED BUT NOT BEING ADDRESSED BY THE HOSPITAL ARE: FAMILY PLANNING, DEMENTIA INCLUDING ALZHEIMER'S DISEASE, INJURY AND VIOLENCE, POTENTIALLY DISABLING CONDITIONS, AND SUBSTANCE ABUSE. SERVICES FOR THESE HEALTH PRIORITIES ARE BEING PROVIDED IN THE COMMUNITY BY OTHER ENTITIES AND THE HOSPITAL DOES NOT HAVE EXPERTISE IN THESE AREAS. ST. MARY MEDICAL CENTER - LONG BEACH AMONG THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA, THE HOSPITAL IS ADDRESSING: INACCESS TO CARE, CHRONIC DISEASES, OVERWEIGHT AND DIABETES, PREGNANCY AND BIRTH OUTCOMES, AND PREVENTIVE CARE. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: PATIENT FINANCIAL ASSISTANCE, C.A.R.E. PROGRAM, AN HIV MEDICAL AND PSYCHOSOCIAL SERVICE PROGRAM, FAMILY CLINIC OF LONG BEACH, FAMILIES IN GOOD HEALTH, MEDICAL TRANSPORTATION PROGRAM, BAZZENI WELLNESS CENTER, CHRONIC DISEASE SELF- MANAGEMENT PROGRAM IN ENGLISH AND SPANISH, FAMILY CLINIC OF LONG BEACH, ST. MARY OUTPATIENT DIABETES PROGRAM, EVERY WOMAN COUNTS, MOBILE CARE UNIT, WELCOME BABY, AND MARY HILTON FAMILY HEALTH CENTER. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, ST. MARY MEDICAL CENTER WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: MENTAL HEALTH, ENVIRONMENTAL HEALTH, ECONOMIC SECURITY, ACCESS TO HOUSING, EDUCATION, CRIME AND VIOLENCE, ORAL HEALTH AND SUBSTANCE ABUSE. THE HOSPITAL CANNOT ADDRESS ALL THE SOCIAL DETERMINANTS OF HEALTH OR THE HEALTH NEEDS PRESENT IN THE COMMUNITY, THEREFORE, IT WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. MERCY HOSPITAL BAKERSFIELD AMONG THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA, THE HOSPITAL IS ADDRESSING: OVERWEIGHT AND OBESITY, ACCESS TO HEALTH CARE, CHRONIC DISEASES (ASTHMA/LUNG DISEASE, CANCER, CARDIOVASCULAR DISEASE, DIABETES), AND BASIC NEEDS SERVICES. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEG
GLENDALE MEMORIAL HOSPITAL and HEALTH CENTER THE 2016 CHNA IDENTIFIED NINE SIGNIFICANT COMMUNITY HEALTH NEEDS. THE HOSPITAL IS ADDRESSING EIGHT OF THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN ITS IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. MENTAL HEALTH: BEHAVIORAL HEALTH UNIT, COMMUNITY GRANTS PROGRAM AWARDS FOR MENTAL HEALTH, HOMELESSNESS SERVICES, AND YOUTH DEVELOPMENT. OVERWEIGHT AND OBESITY: SENIOR COMMUNITY WALKING PROGRAM, EXERCISE AND HEALTHY LIFESTYLES CLASSES, HEALTH EDUCATION AND SCREENINGS, AND COMMUNITY GRANT SUPPORT FOR YOUTH PHYSICAL ACTIVITY WITH THE GLENDALE PARKS AND OPEN SPACE FOUNDATION. SUBSTANCE ABUSE: COMMUNITY GRANT PROGRAM AWARDS. DIABETES: DISEASE MANAGEMENT EDUCATION FOR PATIENTS AND THE WIDER COMMUNITY, BREASTFEEDING RESOURCE CENTER, COMMUNITY GRANT SUPPORT FOR CHRONICALLY HOMELESS INDIVIDUALS. CARDIOVASCULAR DISEASE: SENIOR COMMUNITY WALKING PROGRAM, EXERCISE AND HEALTHY LIFESTYLES CLASSES, HEALTH EDUCATION AND SCREENINGS, AND COMMUNITY GRANT SUPPORT FOR YOUTH PHYSICAL ACTIVITY WITH THE GLENDALE PARKS AND OPEN SPACE FOUNDATION. CANCER: COMMUNITY CANCER EDUCATION. STROKE: DISEASE MANAGEMENT EDUCATION.COMMUNICABLE/INFECTIOUS DISEASES: COMMUNITY HEALTH EDUCATION. THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE SEXUAL HEALTH/STDS IDENTIFIED NEED, PRIMARILY DUE TO LIMITED RESOURCES AND AN ADEQUATE NUMBER OF EXISTING COMMUNITY RESOURCES. ST. MARY'S MEDICAL CENTER AFTER REVIEW BY MEMBERS OF THE COMMUNITY BENEFIT PLANNING COMMITTEE OF THE HOSPITAL'S COMMUNITY BOARD OF DIRECTORS, AND AN ASSESSMENT OF THE HOSPITAL'S INSTITUTIONAL CAPACITY TO RESPOND, IT WAS DECIDED TO FOCUS ON ADDRESSING THE 2015 CHNA SIGNIFICANT HEALTH NEEDS OF: HEALTHY EATING, ACCESS TO COORDINATED, CULTURALLY, AND LINGUISTICALLY APPROPRIATE SERVICES ACROSS THE CONTINUUM, AND PHYSICAL ACTIVITY. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: SISTER MARY PHILIPPA HEALTH CENTER, WHICH PROVIDES A MEDICAL HOME AND IMPROVES APPROPRIATE ACCESS TO HEALTH CARE, THE DIABETES PROGRAM, SENIOR SERVICES PROGRAM, HIV/AIDS PROGRAM, GRADUATE MEDICAL EDUCATION, LOW COST MEALS FOR SENIORS IN THE HOSPITAL CAFETERIA, CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, SENIOR MALL WALKERS, SENIOR YOGA, SHARING THE JOY FOOD VOUCHERS PROVIDED TO CLINIC PATIENTS, FOOD VOUCHER DISTRIBUTION, COMMUNITY GRANT TO SELF-HELP FOR THE ELDERLY COLLABORATING WITH KIMOCHI INC., ASIAN WOMEN'S RESOURCE CENTER TO ADDRESS OBESITY AND DIABETES AMONG ASIAN SENIORS AND CHILDREN, FINANCIAL ASSISTANCE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS, COMMUNITY GRANT TO THE SAN FRANCISCO CARE AND JUSTICE ALLIANCE (SHANTI, THE JUSTICE AND DIVERSITY CENTER OF THE BAR ASSOCIATION AND THE AIDS LEGAL REFERRAL PANEL) TO PROVIDE INTENSIVE CARE NAVIGATION AND LEGAL SERVICES TO PERSONS LIVING WITH HIV/AIDS AND HEPATITIS C VIRUS, HEALTH FAIR SCREENINGS AND EDUCATION, FLU VACCINES PROVIDED TO SENIORS, VARIOUS HEALTH SCREENINGS AT HEALTH FAIRS, CLINIC MAMMOGRAPHY PROJECT, BREAST CANCER SECOND OPINION PANEL, BREAST CANCER SUPPORT GROUP, AND DRUG ASSISTANCE PROGRAM. ST. MARY'S WILL NOT DIRECTLY ADDRESS THE SIGNIFICANT CHNA NEEDS OF: PSYCHOSOCIAL HEALTH, SAFETY AND VIOLENCE PREVENTION, HOUSING INSTABILITY AND HOMELESSNESS, OR SUBSTANCE ABUSE. THESE NEEDS ARE BEYOND THE HOSPITAL'S INSTITUTIONAL AND RESOURCE CAPACITY, AND ARE BEING ADDRESSED BY OTHERS IN THE COMMUNITY. WOODLAND MEMORIAL HOSPITAL WOODLAND MEMORIAL IS ADDRESSING OR DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: ACTIVE LIVING AND HEALTHY EATING, ACCESS TO BEHAVIORAL HEALTH SERVICES, DISEASE PREVENTION, MANAGEMENT, AND TREATMENT, SAFE, CRIME AND VIOLENCE FREE COMMUNITIES, AND ACCESS TO HIGH QUALITY HEALTH CARE AND SERVICES. INITIATIVES THAT ADDRESS THESE PRIORITIES LARGELY TARGET VULNERABLE AND AT-RISK POPULATIONS, WITH EMPHASIS ON COLLABORATION WITH OTHER DIGNITY HEALTH HOSPITALS AND COMMUNITY PARTNERS. THE HOSPITAL IS ADDRESSING THESE NEEDS WITH NUMEROUS DIRECT SERVICE PROGRAMS, GRANT FUNDING TO THE COMMUNITY, PATIENT FINANCIAL ASSISTANCE, AND COMMUNITY PARTNERSHIPS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS AT THE HOSPITAL INCLUDE: FARMERS MARKET, NUTRITION EDUCATION AND COUNSELING, COMMIT2FIT, INPATIENT MENTAL HEALTH SERVICES, MENTAL HEALTH CONTINUUM OF CARE PARTNERSHIP, HEALTHY LIVES (VIDA SANA), DIABETES CARE MANAGEMENT PROGRAM, YOUR LIFE/TAKE CARE, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, MULTIPLE SCLEROSIS SUPPORT GROUP, ANTI-HUMAN TRAFFICKING INITIATIVE, YOLO CRISIS NURSERY, EMPOWER YOLO, YOLO ADULT DAY HEALTH CENTER, YOLO HEALTHY AGING ALLIANCE, COMMUNICARE CAPACITY BUILDING, BABY AND ME SUPPORT GROUP, RESOURCE CONNECTION, RISE INC., MIGRANT CENTER VISITS, HEALTHY LIVING OUTREACH AND SCREENINGS, CANCER NURSE NAVIGATOR, SCHOOL NURSE PROGRAM, MERCY FAITH AND HEALTH PARTNERSHIP, FINANCIAL ASSISTANCE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS, AND DIGNITY HEALTH COMMUNITY GRANTS PROGRAM. WOODLAND MEMORIAL DOES NOT HAVE THE CAPACITY OR RESOURCES TO DIRECTLY ADDRESS OTHER IDENTIFIED NEEDS, ALTHOUGH THE HOSPITAL IS AN ACTIVE PARTNER IN COLLABORATIVE PROGRAMS IN PLACE TO ASSIST COMMUNITY RESIDENTS. THE HOSPITAL IS NOT ADDRESSING AFFORDABLE AND ACCESSIBLE TRANSPORTATION AND POLLUTION-FREE LIVING AND WORKING ENVIRONMENTS, AS THESE PRIORITIES ARE BEYOND THE CAPACITY AND EXPERTISE OF WOODLAND MEMORIAL. FRENCH HOSPITAL MEDICAL CENTER THE SIGNIFICANT COMMUNITY HEALTH NEEDS IDENTIFIED BY THE 2015 CHNA THAT THE HOSPITAL IS PRIMARILY ADDRESSING ARE: ACCESS TO HEALTH CARE, INCLUDING BEHAVIORAL HEALTH, HOUSING, CANCER SCREENINGS, AND CARDIOVASCULAR DISEASE AND STROKE. THE HOSPITAL IS ADDRESSING THESE NEEDS IN NUMEROUS WAYS DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: SUPPORT GROUPS FOR CANCER, DIABETES, STROKE AND GRIEF, PATIENT FINANCIAL ASSISTANCE, ALLIANCE FOR PHARMACEUTICAL ACCESS, TRANSPORTATION VOUCHERS FOR DISCHARGED PATIENTS, CANCER AWARENESS COMMUNITY EDUCATION, CANCER SCREENINGS (COLONOSCOPIES, MAMMOGRAM, AND CERVICAL), HEREDITARY CANCER RISK ASSESSMENT AND GENETIC COUNSELING, CANCER EXPERIENCE REGISTRY PROGRAM, CANCER SUPPORT GROUPS, COMMUNITY EDUCATION IN SPANISH AND ENGLISH ON FACTORS FOR HEART ATTACK AND STROKE, ASSESSMENT OF CARDIOVASCULAR RISK STATUS, HEART AWARE PROGRAM, CARE TRANSITIONS PROGRAM, CHRONIC DISEASE SELF-MANAGEMENT PROGRAM, NUTRITION PROGRAMS, HEART HEALTHY DIET EDUCATION, CASE MANAGEMENT OF CHRONICALLY HOMELESS INDIVIDUALS, FRENCH HOSPITAL ANDERSON HOTEL HOMELESS RESPITE CARE PROGRAM, AND DONATIONS OF AMENITY BAGS CONTAINING PERSONAL HYGIENE PRODUCTS TO PRADO DAY HOMELESS SHELTER AND EL CAMINO HOMELESS ORGANIZATION SHELTER. THE HOSPITAL WILL NOT DIRECTLY ADDRESS BEHAVIORAL HEALTH OR HOMELESSNESS APART FROM THE ABOVE PROGRAMS IN COLLABORATION WITH PARTNERS. THE HOSPITAL IS LIMITED IN RESOURCES TO ADDRESS THESE ISSUES, AND THEY ARE BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THE HOSPITAL WILL REMAIN ENGAGED ON THESE ISSUES TO HELP FACILITATE A SEAMLESS CONTINUUM OF CARE IN THE COMMUNITY. ST. JOHN'S PLEASANT VALLEY HOSPITAL SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2015 CHNA INCLUDE: OBESITY AND OVERWEIGHT, LACK OF MENTAL HEALTH RESOURCES, FAMILY CAREGIVER SUPPORT AND RESPITE, DIABETES AND PREDIABETES, CARDIOVASCULAR HEALTH, CANCERS, AND ARTHRITIS. THE HOSPITAL DOES NOT PLAN TO ADDRESS LACK OF MENTAL HEALTH RESOURCES OR FAMILY CAREGIVER SUPPORT AND RESPITE, DUE TO A LACK OF RESOURCES, BUT WILL EXPLORE FUTURE COLLABORATIVE AND GRANT OPPORTUNITIES TO HELP ADDRESS THESE. THE HOSPITAL IS ADDRESSING ALL OTHER SIGNIFICANT NEEDS IN NUMEROUS WAYS, BOTH DIRECTLY AND THROUGH GREATER COLLABORATION BETWEEN THE HOSPITALS IN VENTURA COUNTY AND VENTURA COUNTY PUBLIC HEALTH. THE PROGRAMS BELOW ARE DESCRIBED IN DETAIL IN THE IMPLEMENTATION STRATEGY, WHICH IS AVAILABLE TO THE PUBLIC ONLINE. PROGRAMS INCLUDE: INCREASED HEALTH EDUCATION, ESPECIALLY OF YOUTH, TO CHANGE LIFESTYLE BEHAVIOR PATTERNS, HEALTH FAIRS WHEN BMI SCREENINGS INDICATE EDUCATION IS APPROPRIATE, SENIOR WELLNESS & WALKING PROGRAM, DIABETES EMPOWERMENT EDUCATION PROGRAM, CONGESTIVE HEART ACTIVE MANAGEMENT PROGRAM, KNOW YOUR NUMBERS, ONE-ON-ONE HEALTH EDUCATION, SENIOR WELLNESS PROGRAM, AND "MOVE FREE" ARTHRITIS CLASSES IN COLLABORATION WITH THE ARTHRITIS FOUNDATION OF VENTURA COUNTY. ST. ELIZABETH COMMUNITY HOSPITAL THE SIGNIFICANT COMMUNITY HEALTH NEEDS FROM THE HOSPITAL'S 2017 CHNA WHICH IT IS HELPING TO ADDRESS ARE: ACCESS TO CARE, CHILD ABUSE AND NEGLECT, AND DIABETES. PLANNED PROGRAMS AND ACTIVITIES INCLUDE THE FOLLOWING: ACCESS TO CARE: CONTINUE PROVIDING CHARITY CARE FOR UNINSURED/UNDERINSURED AND LOW INCOME RESIDENTS; OPERATE RURAL HEALTH CLINICS OFFERING SLIDING FEE SCALE FOR PATIENTS WHO DO NOT QUALIFY FOR INSURANCE; MAINTAIN PHYSICIAN RECRUITMENT EFF
SECTION B, LINE 13 - ELIGIBILITY FOR FINANCIAL ASSISTANCE DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL THE HOSPITAL IS CURRENTLY DEVELOPING A FINANCIAL ASSISTANCE PROGRAM. THE OPERATING AGREEMENT WITH THIS JOINT VENTURE REQUIRES COMPLIANCE WITH SECTION 501(R), INCLUDING THE ADOPTION OF A FINANCIAL ASSISTANCE AND EMERGENCY MEDICAL CARE POLICY. SCHEDULE H, PART V, SECTION B, LINE 13H - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA CARONDELET ST. JOSEPH'S HOSPITAL CARONDELET ST. MARY'S HOSPITAL CARONDELET HOLY CROSS HOSPITAL PATIENTS QUALIFY FOR DISCOUNTED CARE IF GROSS FAMILY INCOME IS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LEVEL AT THE TIME OF THE APPLICATION, AND HOSPITAL CHARGES IN THE PAST SIX MONTHS EXCEED TWICE THE PATIENT'S GROSS ANNUAL FAMILY INCOME. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PATIENTS WITH PATIENT FAMILY INCOME ABOVE 200% BUT AT OR BELOW 500% OF FPL WHO RECEIVE A DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY WILL ALSO BE PROVIDED AN EXTENDED PAYMENT PLAN WHICH ALLOW FOR THE PAYMENT OF THE DISCOUNTED AMOUNT OVER NOT MORE THAN A 30-MONTH PERIOD. ARIZONA SPINE AND JOINT HOSPITAL UPON REQUEST, PATIENTS WITH PATIENT FAMILY INCOME ABOVE 200% BUT AT OR BELOW 500% OF FPL WHO RECEIVE A DISCOUNT UNDER THE FINANCIAL ASSISTANCE POLICY WILL ALSO BE PROVIDED AN EXTENDED PAYMENT PLAN.
SECTION B, LINE 16A, 16B AND 16C - FAP APPLICATION FORM WEBSITE ST JOSEPH'S HOSPITAL AND MEDICAL CENTER WWW.DIGNITYHEALTH.ORG/STJOSEPHS/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING -AND-PAYMENT-INFORMATION/PAYMENT-ASSISTANCE MERCY SAN JUAN MEDICAL CENTER MERCY GENERAL HOSPITAL METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM WOODLAND MEMORIAL HOSPITAL WWW.DIGNITYHEALTH.ORG/SACRAMENTO/PATIENTS-VISITORS/FOR-PATIENTS/BILLING-IN FORMATION/PAYMENT-ASSISTANCE MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE WWW.DIGNITYHEALTH.ORG/MARIANREGIONAL/PATIENTS-AND-VISITORS/PATIENTS/BILLIN G-INFORMATION/PAYMENT-ASSISTANCE CHANDLER REGIONAL HOSPITAL WWW.DIGNITYHEALTH.ORG/CHANDLERREGIONAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/ BILLING-AND-PAYMENT-SERVICES/PAYMENT-ASSISTANCE-PROGRAMS CALIFORNIA HOSPITAL MEDICAL CENTER WWW.DIGNITYHEALTH.ORG/CALIFORNIAHOSPITAL/PATIENTS-AND-VISITORS/PATIENTS/BI LLING-AND-PAYMENT/PAYMENT-ASSISTANCE MERCY MEDICAL CENTER REDDING WWW.DIGNITYHEALTH.ORG/MERCY-REDDING/PATIENTS-AND-VISITORS/PATIENTS/BILLING -INFORMATION/PAYMENT-ASSISTANCE-PROGRAMS ST. ROSE DOMINICAN HOSPITALS - SIENA ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA WWW.DIGNITYHEALTH.ORG/LAS-VEGAS/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING -INFORMATION/PAYMENT-ASSISTANCE NORTHRIDGE HOSPITAL MEDICAL CENTER https://www.dignityhealth.org/socal/locations/northridgehospital/patients- and-visitors/for-patients/billing-and-payment/financial-assistance DOMINICAN HOSPITAL WWW.DIGNITYHEALTH.ORG/DOMINICAN/PATIENTS-AND-VISITORS/PATIENTS/BILLING/PAY MENT-ASSISTANCE ST. BERNARDINE MEDICAL CENTER WWW.DIGNITYHEALTH.ORG/STBERNARDINEMEDICAL/PATIENTS-AND-VISITORS/PATIENTS/B ILLING-AND-PAYMENTS/PAYMENT-ASSISTANCE ST. JOHN'S REGIONAL MEDICAL CENTER HTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/STJOHNSREGIONAL/PATI ENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCE MERCY MEDICAL CENTER MERCED WWW.DIGNITYHEALTH.ORG/MERCYMEDICAL-MERCED/PATIENTS-AND-VISITORS/PATIENTS/B ILLING-INFORMATION/PAYMENT-ASSISTANCE-PROGRAMS ST. MARY MEDICAL CENTER - LONG BEACH HTTPS://WWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STMARYMEDICAL/PATIENTS-AND-V ISITORS/FOR-PATIENTS/BILLING-PAYMENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTAN CE MERCY HOSPITAL (BAKERSFIELD) WWW.DIGNITYHEALTH.ORG/MERCY-BAKERSFIELD/PATIENTS-AND-VISITORS/PATIENTS/BIL LING-INFORMATION/PAYMENT-ASSISTANCE MERCY GILBERT MEDICAL CENTER https://www.dignityhealth.org/arizona/locations/mercygilbert/patients-and- visitors/for-patients/billing-and-payment/financial-assistance SEQUOIA HOSPITAL WWW.DIGNITYHEALTH.ORG/SEQUOIA/PATIENTS-AND-VISITORS/PATIENTS/BILLING/PAYME NT-ASSISTANCE GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER WWW.DIGNITYHEALTH.ORG/GLENDALEMEMORIAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/ BILLING-PAYMENT-AND-FINANCIAL-SERVICES/PAYMENT-ASSISTANCE-PROGRAMS ST. MARY'S MEDICAL CENTER WWW.DIGNITYHEALTH.ORG/STMARYS/PATIENTS-AND-VISITORS/PATIENTS/BILLING/PAYME NT-ASSISTANCE FRENCH HOSPITAL MEDICAL CENTER WWW.DIGNITYHEALTH.ORG/FRENCHHOSPITAL/PATIENTS-AND-VISITORS/PATIENTS/BILLIN G-INFORMATION/PAYMENT-ASSISTANCE ST. JOHN'S PLEASANT VALLEY HOSPITAL WWW.DIGNITYHEALTH.ORG/PLEASANTVALLEY/PATIENTS-AND-VISITORS/PATIENTS/BILLIN G-AND-PAYMENT-INFORMATION/PAYMENT-ASSISTANCE ST. ELIZABETH COMMUNITY HOSPITAL WWW.DIGNITYHEALTH.ORG/STELIZABETHHOSPITAL/PATIENTS-AND-VISITORS/PATIENTS/B ILLING-INFORMATION/PAYMENT-ASSISTANCE-PROGRAMS MERCY MEDICAL CENTER MT SHASTA WWW.DIGNITYHEALTH.ORG/MERCY-MTSHASTA/PATIENTS-AND-VISITORS/PATIENTS/BILLIN G-INFORMATION/PAYMENT-ASSISTANCE-PROGRAMS CARONDELET ST. JOSEPH'S HOSPITAL CARONDELET ST. MARY'S HOSPITAL CARONDELET HOLY CROSS HOSPITAL HTTPS://WWW.CARONDELET.ORG/FOR-PATIENTS/INSURANCE-FINANCIAL-SUPPORT/BILLIN G-INSURANCE-QUESTIONS SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL (OASIS/SOSH) http://www.oasishospital.com/oasis-hospital-patient-portal/ ST JOSEPH'S WESTGATE MEDICAL CENTER HTTPS://WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/WESTGATE/PATIENTS-AND-VISI TORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCE ARIZONA GENERAL HOSPITAL - LAVEEN HTTPS://AZGENERALER.COM/FINANCIAL-ASSISTANCE ARIZONA SPINE AND JOINT HOSPITAL HTTPS://WWW.AZSPINEANDJOINT.COM/FINANCIAL-ASSISTANCE ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL (AOSH) HTTP://DIGNITYHEALTHAZSH.COM/FINANCIAL-ASSISTANCE DE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN NORTH LAS VEGAS DE BLUE FLAMINGO LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN BLUE DIAMOND DE FLAMINGO LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN WEST FLAMINGO DE SAHARA LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN SAHARA HTTPS://WWW.STROSENH.ORG/HELPINGHANDS/
SECTION B, LINE 16J - OTHER MEASURES TO PUBLICIZE THE POLICY FOR ALL HOSPITALS THAT MARKED BOX 16J ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, A COPY OF THE FINANCIAL ASSISTANCE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, AND CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION. THE FACILITY'S WEB SITE ALSO CONTAINS THE FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY OF THE POLICY, APPLICATION, BILLING AND COLLECTION POLICY, A DESCRIPTION OF THE AMOUNT GENERALLY BILLED AND A LISTING OF PROVIDERS AT EACH FACILITY THAT ARE COVERED AND NOT COVERED BY THE FINANICAL ASSISTANCE POLICY. CONTACT INFORMATION CAN ALSO BE FOUND ON EACH FACILITY'S WEB PAGE. THE AVAILABILITY OF PATIENT FINANCIAL ASSISTANCE AND THE PLAIN LANGUAGE SUMMARY OF THE POLICY ARE ALSO INCLUDED IN EACH FACILITY'S ANNUAL COMMUNITY BENEFIT REPORT, WHICH IS ON EACH FACILITY'S WEB PAGE.
SECTION B, LINE 22 FAP-ELIGIBLE INDIVIDUALS DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL WAS ACQUIRED IN OCTOBER 2016. THE FAP WAS NOT IN PLACE DURING FISCAL YEAR 2018. THE ORGANIZATION IS CURRENTLY DEVELOPING A PROCESS TO PUT IN PLACE.
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
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?138
Name and address Type of Facility (describe)
1 NSC Channel Islands LLC
2030 Wankel Way
Oxnard,CA93030
Surgery Center
2 Carondelet Medical Group Inc
PO Box 204539 Dallas
Dallas,TX753204539
Medical Group
3 Dignity Health Medical Group Arizona
500 W Thomas Rd
Phoenix,AZ85013
Multi-specialty clinics
4 NICU Operating CO of Santa Cruz LLC
1555 Soquel Drive
Santa Cruz,CA95065
Neonatal Healthcare
5 USP LV Surgery Center - Parkway
100 N Green Valley Pkwy 125
Henderson,NV89074
Surgery Center
6 USP LV Surgery Center - Durango (San Mar
8530 W Sunset Road
Las Vegas,NV89113
Surgery Center
7 USP Phx-St Joseph's Outpatient Surgery C
240 West thomas Road
Phoenix,AZ85013
Surgery Center
8 Mercy Davis Cancer Center LLC
333 Mercy Avenue
Merced,CA95340
Cancer Center
9 Folsom Sierra Endoscopy Center
1600 Creekside Drive
Folsom,CA95630
Endoscopy Center
10 Dignity Health Arizona General ER-Glenda
8310 W Camelback Rd
Glendale,AZ85305
Emergency/Urgent Care Centers
11 Dignity Health Arizona General ER-Glenda
5171 West Olive Ave
Glendale,AZ85302
Emergency/Urgent Care Centers
12 USP Phx-Chandler Endoscopy Center
2095 W Pecos Road Suite 1
Chandler,AZ85224
Surgery Center
13 USP Phx-Surgery Center of Scottsdale (Ma
8962 East Desert Cove Drive
Scottsdale,AZ85260
Surgery Center
14 USP Phx-Surgical Elite of Avondale LLC
10815 W McDowell Road Suite 101
Avondale,AZ85392
Surgery Center
15 Dignity Health Arizona General ER-Ahwatu
4328 E Chandler Blvd
Phoenix,AZ85048
Emergency/Urgent Care Centers
16 Simon Med - Greenfield
1425 S Greenfield Bldg 2 Ste 114
Mesa,AZ85206
Imaging Center
17 Dominican Magnetic Resonance Imaging Cen
1545 Soquel Drive
Santa Cruz,CA95065
Imaging Center
18 Dignity Health Arizona General ER-Goodye
251 N Estrella Pkwy
Goodyear,AZ85338
Emergency/Urgent Care Centers
19 Dignity Health Arizona General ER-Surpri
14267 West Bell Rd
Surprise,AZ82374
Emergency/Urgent Care Centers
20 USP Phx-Physicians Surgery Center of Tem
1940 E Southern Ave
Tempe,AZ85282
Surgery Center
21 Coastal Surgical Specialist Inc
921 Oak Park Boulevard 100B
Pismo Beach,CA93449
Surgery Center
22 Simon Med - Thunderbird III & III
5410 W Thunderbird Road Suites 100/
Glendale,AZ85306
Imaging Center
23 USP Phx-Metro Surgery Center LP
3131 W Peoria Avenue
Phoenix,AZ95381
Surgery Center
24 USP Phx-Desert Ridge Outpatient Surgery
20940 North Tatum Boulevard Suite 1
Phoenix,AZ85050
Surgery Center
25 Dignity Health Arizona General ER-Chandl
2977 E Germann Rd
Chandler,AZ85286
Emergency/Urgent Care Centers
26 USP LV Surgery Center - Parkway-Horizon
10561 Jeffreys Street Suite 130
Henderson,NV89052
Surgery Center
27 USP Phx-Surgery Center of ScottsdaleGil
2450 E Guadalupe Rd Suite 101
Gilbert,AZ85234
Surgery Center
28 USP Phx-Surgery Center of Peoria
13260 North 94th Drive Suite 200
Peoria,AZ85381
Surgery Center
29 Dignity Health Arizona General ER-Mesa P
1833 N Power Rd
Mesa,AZ85205
Emergency/Urgent Care Centers
30 Simon Med - Phoenix
2620 N 3rd St 102
Phoenix,AZ85004
Imaging Center
31 21st Century Oncology (Redding)
963 Butte Street
Redding,CA96001
Oncology
32 OMG Arizona LLC
2201 E Camelback Road Suite 101A
Phoenix,AZ85016
Multi-specialty clinics
33 CBCC Outsmarting Cancer LLC
6501 Truxtun Avenue
Bakersfield,CA93309
Radiation / Oncology incl Cyberknife
34 Simon Med - Dobson III
235 S Dobson Stes 1 1870 W Frye R
Chandler,AZ85224
Imaging Center
35 USP Phx-Warner Park Ambulatory Surgical
604 West Warner Road Bldg A
Chandler,AZ85225
Surgery Center
36 Dignity Health Arizona General ER-Chandl
1064 E Ray Rd
Chandler,AZ85225
Emergency/Urgent Care Centers
37 Dignity Health Arizona General ER-Gilber
4760 Germann Rd
Gilbert,AZ85926
Emergency/Urgent Care Centers
38 Dignity Health Arizona General ER-Mesa B
1910 S Gilbert Rd
Mesa,AZ85204
Emergency/Urgent Care Centers
39 Simon Med - Avondale
10815 W McDowell Rd Suite 102
Avondale,AZ85323
Imaging Center
40 Simon Med - Spectrum
2680 S Val Vista Drive Bldg 7 Suite
Gilbert,AZ85295
Imaging Center
41 Renaissance Imaging Center at Northridge
18436 Roscoe Boulevard
Northridge,CA91328
Imaging Center
42 USP Phx-Surgery Center of ScottsdaleGle
18555 N 79th Avenue Suite C104
Glendale,AZ853088370
Surgery Center
43 Simon Med - Mountain View
9201 E Mountain View Road Ste 137
Scottsdale,AZ85258
Imaging Center
44 NICU Sequoia Lucile Packard Children Hos
170 Alameda de las Pulgas
Redwood City,CA94062
Neonatal Healthcare
45 Simon Med - Mesa Desert
1111 S Dobson Road
Mesa,AZ85202
Imaging Center
46 Simon Med - Arrowhead
6320 W Union Hills Bldg A 120
Glendale,AZ85308
Imaging Center
47 Plaza Surgery Center
525 E Plaza 100
Santa Maria,CA93454
Surgery Center
48 Huger Mercy Living Center
2345 W Orangewood
Phoenix,AZ85021
Assisted Living Facility
49 Simon Med - Fashion Square
6740 E Camelback Road Ste 100
Scottsdale,AZ85251
Imaging Center
50 Santa Cruz Surgery Center
3003 Paul Sweet Road
Santa Cruz,CA95065
Surgery Center
51 Glendale Advanced Imaging Center LLC
1510 Cotner Ave
Los Angeles,CA90025
Imaging Center
52 USRC Dignity Health Acute LLC (US Renal
5851 Legacy Circle Ste 900
Plano,TX75024
Acute Care Clinic
53 Radiation Oncology Center of Ventura Cou
5301 Mission Oaks Boulevard Suite A
Camarillo,CA93012
Surgery Center
54 Simon Med - Sun City Peoria
9403 W Thunderbird Road
Peoria,AZ95381
Imaging Center
55 Simon Med - Stadium Village
14823 W Bell Road Suite 110
Surprise,AZ85374
Imaging Center
56 Templeton Surgery Center
1310 Las Tables Road Suite 104
Templeton,CA93465
Surgery Center
57 Simon Med - Queen Creek
36297 N Gantzel Road Suite 101
Queen Creek,AZ85140
Imaging Center
58 Simon Med - San Francisco
325 Sacramento Street
San Francisco,CA94104
Imaging Center
59 Simon Med - Baywood
130 S 63rd Street Ste 123
Mesa,AZ85206
Imaging Center
60 Dignity Health Medical Group Nevada LLC
8205 W Warm Springs Rd Suite 210
Las Vegas,NV89113
Multi-specialty clinics
61 Simon Med - Daly City
455 Hickey Blvd Suite 200
Daly City,CA94015
Imaging Center
62 Simon Med - North Gilbert Superstition
875 N Greenfield Road Suite 107
Gilbert,AZ85234
Imaging Center
63 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 101
Henderson,NV89052
Multi-specialty clinics
64 St John's Regional Imaging Center LLC
1700 N Rose Avenue 110
Oxnard,CA93030
Imaging center
65 Simon Med - Sun City West
13624 W Camino Del Sol Suite 300
Sun City West,AZ85375
Imaging Center
66 Simon Med - Ahwatukee
15810 S 45th Street Suite 110
Phoenix,AZ85048
Imaging Center
67 Simon Med - Palm Valley II
13657 W McDowell Rd Ste 111
Goodyear,AZ85338
Imaging Center
68 Simon Med - San Francisco - MRI
50 Francisco Street Suite 105
San Francisco,CA94133
Imaging Center
69 Simon Med - Prescott Valley
3033 N Windsong Drive Suite 102
Prescott Valley,AZ86314
Imaging Center
70 Simon Med - Biltmore
2502 E Camelback Rd 160
Phoenix,AZ85016
Imaging Center
71 Simon Med - Paradise Valley
4219 E Bell Rd
Phoenix,AZ85032
Imaging Center
72 Dominican Breast Center
1661 Soquel Drive Bldg G
Santa Cruz,CA95065
Oncology
73 Simon Med - Deer Valley
20414 N 27th Avenue Ste 150
Phoenix,AZ85027
Imaging Center
74 Simon Med - Desert Ridge
20830 N Tatum Blvd Suite 190
Phoenix,AZ85050
Imaging Center
75 Woodland Adult Day Health
20 N Cottonwood Street
Woodland,CA95695
Health Center
76 Simon Med - 19th Avenue
6707 N 19th Avenue Suite 108 101
Phoenix,AZ85015
Imaging Center
77 Simon Med - Phoenix High Field
1331 N 7th Street Suite 150
Phoenix,AZ85006
Imaging Center
78 St Rose Neurosurgery Clinic
2865 Siena Heights Dr Ste 131
Henderson,NV89052
NEUROSURGERY clinics
79 USP Phx-Surgery Center of ScottsdalePHX
3131 West Peoria Avenue
Phoenix,AZ85029
Surgery Center
80 Simon Med - Apache Junction
2080 W Southern Ave Bldg C
Apache Junction,AZ85120
Imaging Center
81 Simon Med - Wilmont (Academy)
310 N Wilmot Rd 302
Tucson,AZ85711
Imaging Center
82 St Rose CardiovascularThoracic Surgery
7190 S Cimarron Rd
Las Vegas,NV89113
CARDIOVASCULAR CLINICS
83 Simon Med - Chandler South
725 S Dobson Road Suite A105
Chandler,AZ85224
Imaging Center
84 Simon Med - Prescott
790 Gail Gardner Way
Prescott,AZ86305
Imaging Center
85 USP LV Surgery Center - Parkway Recovery
100 N Green Valley Pkwy Ste 330
Henderson,NV89074
Surgery Center
86 GoHealth Urgent Care Mangement LLC - San
5555 Glenride Connector Ste 700
Atlanta,GA30342
Clinic
87 Simon Med - Monterey
665 Munras Avenue 109
Monterey,CA93940
Imaging Center
88 Simon Med - Orange Grove LLC
1845 W Orange Grove Rd Bldg 5 Suite
Tucson,AZ85704
Imaging Center
89 Simon Med - Sun Lakes
10440 East Riggs Road 110 120
Chandler,AZ85248
Imaging Center
90 Simon Med - Buckeye
818 S Watson Rd Ste 102
Buckeye,AZ85326
Imaging Center
91 Simon Med - Estrella
8921 W Thomas Road Suite 101
Phoenix,AZ85037
Imaging Center
92 GoHealth Urgent Care Mangement LLC - Seq
5555 Glenride Connector Ste 700
Atlanta,GA30342
Clinic
93 Santa Cruz Comprehensive Imaging LLC
1685 Commercial Way
Santa Cruz,CA95065
Imaging Center
94 Simon Med - Los Gatos
14651 S Bascom
Los Gatos,CA95032
Imaging Center
95 Simon Med - Redwood City
345 Convention Way Suite D1
Redwood City,CA94063
Imaging Center
96 Dignity Health Medical Group Nevada LLC
8689 W Charleston Blvd Suite 105
Las Vegas,NV89117
Multi-specialty clinics
97 Simon Med - Casa Grande
1664 E Florence Blvd Suite 18
Casa Grande,AZ85222
Imaging Center
98 Simon Med - Mountain View
105 South Drive St 100/110
Mountain View,CA94040
Imaging Center
99 Simon Med - Mesa Drive
456 N Mesa Drive
Mesa,AZ85201
Imaging Center
100 Carondelet Imaging Center
6567 E Carondelet Dr Suite 105
Tucson,AZ85710
Imaging Center
101 Simon Med - Thompson Peak
7304 E Deer Valley Road Ste 105
Scottsdale,AZ85255
Imaging Center
102 Simon Med - St Mary's
1313 W Saint Marys Rd
Tucson,AZ85745
Imaging Center
103 Dignity Health Medical Group Nevada LLC
1050 W Galleria Dr
Henderson,NV89011
Multi-specialty clinics
104 Simon Med - Anthem
3618 W Anthem Way Suite D104 D1
Anthem,AZ85086
Imaging Center
105 Simon Med - Stand Up MRI of Beverly Hill
8370 Wilshire Blvd Suite 110
Beverly Hills,CA90211
Imaging Center
106 Simon Med - Metro II
3201 W Peoria Ave Ste B402
Phoenix,AZ85029
Imaging Center
107 Carondelet Medical Mall at Green Valley
400 W Camino Casa Verde Suite 200
Green Valley,AZ85614
Imaging Center
108 Simon Med - Peoria Plaza
9139 W Thunderbird Rd 112
Peoria,AZ85381
Imaging Center
109 Dignity Health Medical Group Nevada LLC
400 S Rampart Blvd 240
Las Vegas,NV89145
Multi-specialty clinics
110 The Barbara Greenspun Women's Care Cente
100 N Green Valley Pkwy Suite 330
Henderson,NV89074
Health Center
111 DHMGN Multi-Specialty clinic
10001 S Eastern Ave Suite 203
Henderson,NV89052
Multi-specialty clinics
112 Simon Med - Ahwatukee North
13838 S 46th Pl Ste 200
Phoenix,AZ85044
Imaging Center
113 Valley Physicians Surgery Center
18330 Roscoe Boulevard
Northridge,CA91325
Imaging Center
114 Simon Med - Goodyear
13555 W McDowell Rd Ste 100
Goodyear,AZ85395
Imaging Center
115 Simon Med - San Rafael
4144 Redwood Highway Suite B
San Rafael,CA94903
Imaging Center
116 Dignity Health Medical Group Nevada LLC
1701 Green Valley Pkwy 10A
Henderson,NV89074
Multi-specialty clinics
117 Cyberknife (Redwood City)
170 Alameda de las Pulgas
Redwood City,CA94062
Oncology
118 Cyberknife (San Francisco)
450 Stanyan Street
San Francisco,CA94117
Oncology
119 Simon Med - Fountains
5620 W Thunderbird Rd A
Glendale,AZ85306
Imaging Center
120 Trinity Care Infusion Services
18440 Roscoe Boulevard
Northridge,CA91325
Infusion Center
121 Carondelet River Stone Imaging Center
4892 N Stone Ave Suite 180
Tucson,AZ85704
Imaging Center
122 DHMGN Urgent Care
800 N Gibson Rd Suite 101
Henderson,NV89011
Urgent Care
123 Southwest Lithotripsy
100 W Third Ave Suite 350
Columbus,OH43201
Lithotripsy
124 Dignity Health Medical Group Nevada LLC
10001 S Eastern Ave Suite 209
Henderson,NV89052
Multi-specialty clinics
125 Simon Med - Camelback
2141 E Camelback Rd 110
Phoenix,AZ85016
Imaging Center
126 21st Century Oncology (Mt Shasta)
902 Pine Street
Mt Shasta,CA96067
Oncology
127 Simon Med - Greenbrae Women's Center
1375 S Eiseo Dr Ste G
Greenbrae,CA94904
Imaging Center
128 Simon Med - Tucson-Catalina
4566 1st Ave 89
Tucson,AZ85718
Imaging Center
129 Simon Med - Burlingame
1860 El Camino Real Suite 101
Burlingame,CA94010
Imaging Center
130 Simon Med - McCormick Ranch
8630 E Via De Ventura St 208
Scottsdale,AZ85258
Imaging Center
131 Carondelet Medical Mall at Rita Ranch Im
8290 S Houghton Rd Suite 100
Tucson,AZ85747
Imaging Center
132 Simon Med - Missouri
5501 N 19th Ave 111
Phoenix,AZ85012
Imaging Center
133 Dignity Health Medical Group Nevada LLC
102 E Lake Mead Pkwy Suite 104
Henderson,NV89015
Multi-specialty clinics
134 Dignity Health USP Oxnard Surgery Center
1700 N Rose Avenue Ste 100
Oxnard,CA93030
Surgery Center
135 Radiation Oncology Center of Ventura Cou
1700 N Rose Avenue 120
OxnardCamarillo,CA93030
Imaging Center
136 DH Nevada Imaging Center Siena
861 Coronada Center Drive 101
Henderson,NV89052
Imaging Center
137 Western Diagnostic Services Lab
1414 E Main Street Ste 102
Santa Maria,CA93465
Laboratory/Pathology
138 USP Phx-OrthoArizona Surgery Center Gilb
2940 E Banner Gateway Dr Suite 200
Gilbert,AZ85234
Surgery Center
Schedule H (Form 990) 2019
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, LINES 6A & 6B - COMMUNITY BENEFIT EACH TAX-EXEMPT HOSPITAL FACILITY LISTED IN SCHEDULE H, PART V, EXCEPT FOR THOSE LISTED BELOW, PREPARED A SEPARATE COMMUNITY BENEFIT REPORT. CALIFORNIA HOSPITALS SUBMIT THEIR REPORTS TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AND NEVADA HOSPITALS SUBMIT THEIR REPORTS TO THE NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIGNITY HEALTH INCLUDES A CONSOLIDATED COMMUNITY BENEFIT REPORT IN ITS ANNUAL AUDITED FINANCIAL STATEMENTS FOR ITS HOSPITALS AND THE HOSPITALS OF RELATED ORGANIZATIONS THAT ARE CONSOLIDATED FOR FINANCIAL REPORTING PURPOSES (SEE PART VI, LINE 6). DIGNITY HEALTH'S FINANCIAL STATEMENTS ARE POSTED ON DIGNITY HEALTH'S EXTERNAL WEB SITE. THE INDIVIDUAL HOSPITALS' COMMUNITY BENEFIT REPORTS ARE MADE AVALABLE TO THE PUBLIC ON BOTH DIGNITY HEALTH'S AND EACH HOSPITAL'S WEB SITES, AND ARE AVAILABLE BY REQUEST. THE FOLLOWING HOSPITALS DID NOT PREPARE A SEPARATE COMMUNITY BENEFIT REPORT: ARIZONA ORTHOPEDIC SURGICAL HOSPITAL (ARIZONA SPECIALTY HOSPITAL), SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, ARIZONA GENERAL HOSPITAL - LAVEEN, ARIZONA SPINE AND JOINT HOSPITAL, DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL, CARONDELET ST. JOSEPH'S HOSPITAL, CARONDELET ST. MARY'S HOSPITAL, CARONDELET HOLY CROSS HOSPITAL, DE CRAIG RANCH LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN NORTH LAS VEGAS, DE BLUE DIAMOND LLC DBDA DIGNITY HEALTH ST. ROSE DOMINICAN BLUE DIAMOND, DE FLAMINGO LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN WEST FLAMINGO, AND DE SAHARA LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN SAHARA
Part I, Line 7 - FINANCIAL ASSISTANCE & CERTAIN OTHER COMMUNITY BENEFITS A COSTING METHODOLOGY IS USED TO CALCULATE FINANCIAL ASSISTANCE FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE. DIGNITY HEALTH USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO PATIENTS. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL HOSPITAL WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE CALCULATION ON WORKSHEET 2 OF THE INSTRUCTIONS FOR FORM 990, SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN AGGREGATED FOR EACH PATIENT BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH SERVICES PROVIDED TO EACH PATIENT. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF PAYMENT ASSISTANCE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR PAYMENT ASSISTANCE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH AND CASH AND IN-KIND DONATIONS. SCHEDULE H, PART I, LINE 7B - MEDICAID INCLUDED IN COMMUNITY BENEFIT EXPENSE FOR MEDICAID, COLUMN (C) IS $504.5 MILLION OF QUALITY ASSURANCE FEES ASSESSED TO DIGNITY HEALTH IN ACCORDANCE WITH THE CALIFORNIA PROVIDER FEE PROGRAMS. INCLUDED IN DIRECT OFFSETTING REVENUE FOR MEDICAID, COLUMN (D), IS $995.3 MILLION IN SUPPLEMENTAL PAYMENTS RECEIVED UNDER THESE PROGRAMS. SCHEDULE H, PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES INCLUDED IN SUBSIDIZED HEALTH SERVICES IS $174 THOUSAND OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION. SCHEDULE H, PART I, LINE 7I INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $17.8 MILLION IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT"). CHFT WAS ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA, CONSISTENT WITH CHFT'S MISSION OF SUPPORTING HEALTH CARE, ACCESS TO HEALTH CARE, RESEARCH AND EDUCATION.
Part II - COMMUNITY BUILDING ACTIVITIES DIGNITY HEALTH'S WORK TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED EXTENDS BEYOND PROVIDING HEALTH CARE AND COMMUNITY HEALTH IMPROVEMENT SERVICES. DIGNITY HEALTH TAKES A PROACTIVE APPROACH TO ADDRESSING THE SOCIAL, ECONOMIC AND ENVIRONMENTAL BARRIERS TO GOOD HEALTH, AND SUPPORTS THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH AS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. IN ADDITION TO THE EXAMPLES BELOW, DIGNITY HEALTH HOSPITALS' ANNUAL COMMUNITY BENEFIT REPORTS EACH DESCRIBE THEIR SPECIFIC COMMUNITY BUILDING ACTIVITIES IN A SECTION TITLED "OTHER PROGRAMS AND NON-QUANTIFIABLE BENEFITS." THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM HAS PROVIDED, SINCE 1990, LOW INTEREST LOANS AND LINES OF CREDIT TO NON-PROFIT ORGANIZATIONS THAT ARE ADDRESSING SOCIAL DETERMINANTS OF HEALTH, INCLUDING AFFORDABLE HOUSING, ACCESS TO HEALTH CARE, HEALTHY FOOD AND SOCIAL SERVICES VITAL TO A COMMUNITY'S HEALTH, ALONG WITH CLIMATE CHANGE MITIGATION AND SMALL BUSINESS DEVELOPMENT IN DISTRESSED COMMUNITIES. DIGNITY HEALTH INVESTS DIRECTLY IN INDIVIDUAL PROJECTS AND THROUGH COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS. IN FISCAL YEAR 2018, THE PROGRAM HAD 70 APPROVED LOANS WITH $92.9 MILLION PROVIDED TO 55 ORGANIZATIONS. AMONG RECENT INVESTMENTS ARE: $5 MILLION TO THE LOS ANGELES CHRISTIAN HEALTH CENTERS TO DEVELOP A NEW 26,000 SQUARE FOOT FEDERALLY QUALIFIED HEALTH CENTER IN THE SKID ROW NEIGHBORHOOD OF DOWNTOWN LOS ANGELES; $5 MILLION TO TIPPING POINT COMMUNITY TO DEVELOP AFFORDABLE HOUSING FOR FORMERLY HOMELESS INDIVIDUALS IN SAN FRANCISCO; A $500,000 LINE OF CREDIT TO THE BRIGHTER WAY INSTITUTE TO EXPAND THE PROVISION OF DENTAL CLINICS IN PHOENIX AVAILABLE TO ALL WITHOUT REGARD TO ABILITY TO PAY; $1 MILLION TO CHICANOS POS LA CAUSA FOR THE DEVELOPMENT OF 187 UNITS OF MIXED-INCOME AND MIXED-USE HOUSING IN MESA, ARIZONA; AND $1 MILLION TO THE IDAHO-NEVADA CDFI AS LENDING CAPITAL TO BUILD AFFORDABLE MULTI-FAMILY AND SENIOR HOUSING IN NEVADA. DIGNITY HEALTH HOSPITALS OPEN THEIR DOORS TO COMMUNITY GROUPS AND ALSO SERVE AS MEMBERS OF COALITIONS THAT FOCUS ON THE WELL-BEING OF THEIR RESPECTIVE COMMUNITIES. DIGNITY HEALTH ADVOCACY REPRESENTATIVES WORK TO IMPROVE ACCESS TO HEALTH CARE, PROMOTE THE HEALTH OF THE PUBLIC, AND ADVOCATE FOR SOCIAL JUSTICE, HUMAN RIGHTS AND A CLEAN AND HEALTHY ENVIRONMENT AS PART OF MISSION-DRIVEN ADVOCACY. IN MEDICALLY UNDERSERVED AREAS, EFFORTS TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS ARE ONGOING, AS ARE PARTNERSHIPS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS HEALTH CARE WORK-FORCE SHORTAGES. A NUMBER OF DIGNITY HEALTH HOSPITALS OFFER HEALTH CAREER MENTORING PROJECTS AND PROVIDE SCHOOL-BASED AND COMMUNITY PROGRAMS THAT DRIVE ENTRY INTO HEALTH CAREERS. COMMUNITY BUILDING - PHYSICAL IMPROVEMENTS AND HOUSING EXAMPLES OF PHYSICAL IMPROVEMENTS AND HOUSING INCLUDE LOW-INTEREST LOANS FOR NEW DEVELOPMENT AND REHAB OF AFFORDABLE HOUSING THROUGH THE COMMUNITY INVESTMENT PROGRAM AND SUBSIDIZING LOW INCOME HOUSING UNITS IN SANTA CRUZ. FORTY-FIVE PERCENT OF THE $97 MILLION IN APPROVED LOANS AT THE END OF FY18 WERE IN TRANSITIONAL OR AFFORBABLE HOUSING. COMMUNITY BUILDING - ECONOMIC DEVELOPMENT ACTIVITIES INCLUDE THE PARTICIPATION OF LEADERSHIP STAFF OF SEVERAL DIGNITY HEALTH FACILITIES IN CHAMBERS OF COMMERCE AND VARIOUS CIVIC ORGANIZATIONS, AND CHARITABLE CONTRIBUTIONS AIMED AT ENSURING THE ECONOMIC DEVELOPMENT, VITALITY AND STABILITY OF LOCAL, LOW-INCOME COMMUNITIES. COMMUNITY BUILDING - COMMUNITY SUPPORT DIGNITY HEALTH FACILITIES LEAD AND/OR COLLABORATE WITH OTHER COMMUNITY-BASED ORGANIZATIONS TO SUPPORT THE HEALTHY DEVELOPMENT AND SUCCESS OF CHILDREN, YOUTH AND FAMILIES, WHICH ENGAGES AND STRENGTHENS THE COMMUNITIES SERVED. DIGNITY HEALTH ALSO MAKES CHARITABLE DONATIONS TO ORGANIZATIONS FOR SUPPORT AND DEVELOPMENT OF UNDERSERVED YOUTH, DISASTER RELIEF, AND BASIC NEEDS FOR VULNERABLE POPULATIONS. COMMUNITY BUILDING - ENVIRONMENTAL IMPROVEMENTS DIGNITY HEATH IS ENGAGED IN ONGOING EFFORTS TO REDUCE COMMUNITY ENVIRONMENTAL HAZARDS IN THE AIR, WATER AND GROUND, AND THE SAFE REMOVAL OF OTHER TOXIC WASTE PRODUCTS, IN PART THROUGH SUSTAINABILITY AND IN PART THROUGH ADVOCACY. THE COMMITMENT OF DIGNITY HEALTH TO IMPROVE AND SUSTAIN THE ENVIRONMENT IS CODIFIED BY POLICIES, INCLUDING AN ENVIRONMENTALLY PREFERABLE PURCHASING POLICY WHICH PURSUES MULTIPLE ENVIRONMENTAL GOALS TO REDUCE WASTE AT ITS SOURCE AND TO REDUCE THE AMOUNT OF VIRGIN MATERIALS PURCHASED. DIGNITY HEALTH'S INVESTMENT POLICY SCREENS TO EXCLUDE FROM THE PORTFOLIO COMPANIES THAT EXTRACT AND/OR BURN THERMAL COAL, A PRODUCT WHICH HAS IMPACT ON THE HEALTH OF PERSONS, COMMUNITIES AND THE EARTH MAKES IT CONTRARY TO DIGNITY HEALTH'S HEALING MISSION. DIGNITY HEALTH ATTEMPTS TO PURCHASE GOODS WITH RECYCLED CONTENT AND REDUCED PLASTIC CONTENT, AND ONCE PURCHASES REACH THE END OF THEIR INITIAL USE, DIGNITY HEALTH FOCUSES ON REUSE WITHIN THE HOSPITAL, TRANSFER TO OTHER USERS (SUCH AS COMMUNITY ORGANIZATIONS), RECYCLING, AND FINALLY, PROPER WASTE DISPOSAL. DIGNITY HEALTH HAS TRANSITIONED TO PRODUCTS THAT ARE FREE OF POLYVINYL CHLORIDE (PVC) AND DI (2-ETHYLHEXYL) PHTHALATE (DEHP) AND HAS ELIMINATED THE USE OF MERCURY. COMMUNITY BUILDING - LEADERSHIP DEVELOPMENT/TRAINING FOR COMMUNITY MEMBERS DIGNITY HEALTH HOSPITALS ARE COMMITTED TO BUILDING HEALTHIER COMMUNITIES THROUGH PARTICIPATION IN AND CHARITABLE CONTRIBUTIONS TO LEADERSHIP DEVELOPMENT, PARTICULARLY OF ADOLESCENT, TEEN AND YOUNG ADULT LEADERSHIP, AND CAREER DEVELOPMENT FOR VULNERABLE POPULATIONS. COMMUNITY BUILDING - COALITION BUILDING THE DIGNITY HEALTH MISSION STATEMENT SPECIFICALLY CALLS UPON US "TO PARTNER WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE." IN THIS REGARD, DIGNITY HEALTH FACILITIES PROVIDE REPRESENTATION ON COMMUNITY COALITIONS AND BOARDS, AND IN COLLABORATIVE PARTNERSHIPS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY, AND HOST AND/OR PARTICIPATE IN COMMUNITY COALITION MEETINGS AND SPECIFIC PROJECTS AND INITIATIVES. COMMUNITY BUILDING - ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT STAFF AT DIGNITY HEALTH HOSPITALS AND THE DIGNITY HEALTH SYSTEM ADVOCATE ON BEHALF OF THE POOR AND DISENFRANCHISED, PARTICULARLY FOR IMPROVED ACCESS TO HEALTH CARE SERVICES AS WELL AS FOR ENVIRONMENTAL IMPROVEMENTS TO BENEFIT HEALTH. DIGNITY HEALTH ALSO ADVOCATES FOR SOCIAL JUSTICE AND HUMAN RIGHTS THROUGH DUES AND GIFTS TO ORGANIZATIONS THAT SUPPORT SOCIAL JUSTICE, AND BY ADVOCATING FOR SOCIAL JUSTICE, ENVIRONMENTAL RESPONSIBILITY AND HUMAN RIGHTS THROUGH INVESTMENTS AS A SHAREHOLDER. COMMUNITY BUILDING - WORKFORCE DEVELOPMENT DIGNITY HEALTH IS COMMITTED TO THE DEVELOPMENT OF THE HEALTH CARE WORKFORCE, AND ACTIVELY ENGAGES IN THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN MEDICALLY UNDERSERVED AREAS. DIGNITY HEALTH SUPPORTS THE TRAINING AND RECRUITMENT OF UNDERREPRESENTED MINORITIES AND PARTICIPATES IN COMMUNITY WORKFORCE BOARDS AND PARTNERSHIPS. SEVERAL DIGNITY HEALTH FACILITIES, AS WELL AS THE ORGANIZATION ITSELF, PARTNER WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORKFORCE SHORTAGE AND ACTIVELY ENGAGE IN HEALTH CAREER MENTORING PROGRAMS.
Part III - BAD DEBT, MEDICARE, & COLLECTION PRACTICES SCHEDULE H, PART III, SECTION A, LINE 2 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED. THE FILING ORGANIZATION PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 200%, 201%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS AT ALL DIGNITY HEALTH FACILITIES RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 30%. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 3 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT AS COMMUNITY BENEFIT THE FILING ORGANIZATION MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE ARE NOT REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. SCHEDULE H, PART III, SECTION A, LINE 4 - BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE FOLLOWING ARE EXCERPTS FROM DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2018, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. DIGNITY HEALTH REGULARLY REVIEWS ACCOUNTS AND CONTRACTS AND PROVIDES APPROPRIATE CONTRACTUAL ALLOWANCES AND RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS, A SIGNIFICANT PORTION OF DIGNITY HEALTH'S UNINSURED PATIENTS WILL BE UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, DIGNITY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBT RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. SCHEDULE H, PART III, SECTION B, LINE 8 - COMMUNITY BENEFIT AND METHODOLOGY FOR DETERMINING MEDICARE COSTS DIGNITY HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1 AND PRM 15-2 CHAPTER 40 (TRANSMITTAL 13). AS SUCH, THE FOLLOWING LANGUAGE PER PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNIT. DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL OF $1.2 BILLION FOR THE CONSOLIDATED ENTITIES, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY DIGNITY HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $451.7 MILLION REPORTED ON PART III, SECTION B, LINE 7, AS REPORTED ON THE FILING ORGANIZATION'S MEDICARE COST REPORTS. SCHEDULE H, PART III, SECTION C, LINE 9B - COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE DIGNITY HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. DIGNITY HEALTH'S BILLING AND COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR FINANCIAL ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE DIGNITY HEALTH FACILITY, OR BILLING COMPANY RETAINED BY DIGNITY HEALTH, IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, DIGNITY HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY DIGNITY HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, DIGNITY HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
PART VI, LINE 2 - NEEDS ASSESSMENT IN ADDITION TO CHNAS REPORTED IN PART V, SECTION B IN ADDITION TO EACH LICENSED HOSPITAL CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT AT LEAST EVERY THREE YEARS, DIGNITY HEALTH AND ITS HOSPITALS ASSESS THE HEALTH NEEDS OF THE COMMUNITIES THEY SERVE BY WORKING COLLABORATIVELY WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, OTHER NON-PROFIT CLINICS, PUBLIC HEALTH DEPARTMENTS, AND OTHER HEALTH, SOCIAL SERVICE AND COMMUNITY DEVELOPMENT ORGANIZATIONS TO IDENTIFY AND SERVE THE NEEDS OF VULNERABLE POPULATIONS. DIGNITY HEALTH OBTAINS AND MAINTAINS KNOWLEDGE OF HEALTH NEEDS IN PART THROUGH REFERRAL RELATIONSHIPS, SERVICE PLANNING ACTIVITIES, COMMUNITY HEALTH PARTNERSHIPS, AND LOCAL ADVOCACY CONDUCTED IN CONJUNCTION WITH COMMUNITY PARTNERS. THE HOSPITALS UTILIZE DATABASES AND PLANNING TOOLS TO EVALUATE CHANGES IN CURRENT AND PROJECTED COMMUNITY NEED FOR HEALTH CARE SERVICES, INCLUDING PHYSICIANS. DIGNITY HEALTH HOSPITALS CREATE AND MAKE AVAILABLE TO THE PUBLIC ANNUAL COMMUNITY BENEFIT REPORTS THAT SUMMARIZE IDENTIFIED HEALTH NEEDS, UPDATE COMMUNITY DEMOGRAPHIC INFORMATION, AND REPORT ON RECENT AND PLANNED COMMUNITY HEALTH PROGRAMS, INCLUDING GOALS, OBJECTIVES AND MEASURABLE RESULTS. DIGNITY HEALTH, IN PARTNERSHIP WITH TRUVEN HEALTH ANALYTICS, DEVELOPED A COMMUNITY NEED INDEX (CNI) WHICH PROVIDES AN AGGREGATE SCORE OF THE SOCIOECONOMIC BARRIERS THAT PUT RESIDENTS AT GREATER RISK OF NEEDING HEALTH CARE SERVICES. THE CNI AGGREGATES NINE INDICATORS INTO FIVE SOCIOECONOMIC FACTORS KNOWN TO CONTRIBUTE TO HEALTH DISPARITY. THE FIVE ARE INCOME, CULTURE/LANGUAGE, EDUCATION, HOUSING STATUS, AND INSURANCE COVERAGE. THE INDEX IS CALCULATED ANNUALLY FOR EVERY ZIP CODE IN THE UNITED STATES. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATION FOR MANAGABLE CONDITIONS AS COMMUNITIES WITH THE LOWEST CNI SCORES. THE CNI PROVIDES COMPELLING EVIDENCE FOR ADDRESSING SOCIOECONOMIC BARRIERS WHEN CONSIDERING HEALTH POLICY AND LOCAL HEALTH PLANNING. THE TOOL HIGHLIGHTS HEALTH CARE DISPARITIES AND ENABLES HEALTH CARE PROVIDERS, POLICYMAKERS, AND OTHERS TO TARGET RESOURCES WHERE THEY ARE MOST NEEDED. ADDITIONAL INFORMATION ABOUT THE CNI IS ACCESSIBLE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS.
PART VI, LINE 3 - PATIENT EDUCATION ON ELIGIBILITY FOR ASSISTANCE COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC FOR DIGNITY HEALTH'S HOSPITALS: INFORMATION ABOUT DIGNITY HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE DIGNITY HEALTH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES DIGNITY HEALTH'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS RECEIVE AN UNINSURED DISCOUNT OF 30%, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION OR WITH PROMPT PAYMENT. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON DIGNITY HEALTH'S WEBSITE AT WWW.DIGNITYHEALTH.ORG. AT THE POINT OF REGISTRATION, BROCHURES ARE MADE AVAILABLE TO ALL PATIENTS EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. COPIES OF THE FINANCIAL ASSISTANCE APPLICATION ARE MADE AVAILABLE TO ALL UNINSURED PATIENTS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THAT THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF DIGNITY HEALTH REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE DIGNITY HEALTH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4 - COMMUNITY INFORMATION DIGNITY HEALTH HOSPITALS DELIVER CARE TO DIVERSE COMMUNITIES ACROSS ARIZONA, CALIFORNIA AND NEVADA. FOLLOWING ARE BRIEF DESCRIPTIONS AND DEMOGRAPHIC SUMMARIES OF THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS. DIGNITY HEALTH HOSPITALS DEFINE THE COMMUNITY AS THE PRIMARY GEOGRAPHIC AREA SERVED BY THE HOSPITAL, BASED ON THE ORIGINS OF THE TOP 75-80 PERCENT OF HOSPITAL DISCHARGES. FOR CHNA PURPOSES, SOME HOSPITALS USE THE COUNTY IN WHICH THEY ARE LOCATED AS THEIR COMMUNITY DEFINITION. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER THE HOSPITAL IS LOCATED IN PHOENIX, ARIZONA WITHIN THE COUNTY OF MARICOPA. IT SERVES ALL OF MARICOPA COUNTY AND AREAS BEYOND, BUT ITS PRIMARY SERVICE AREA IS BASED ON 84 ZIP CODES REPRESENTING THE TOP 80% OF PATIENTS BY VOLUME. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION: 3,504,582 RACE/ETHNICITY: WHITE - NON-HISPANIC 49.8%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 5.9%; HISPANIC OR LATINO 36.0%; ASIAN/PACIFIC ISLANDER 4.0%; ALL OTHERS 4.3% MEDIAN INCOME: $59,473 UNEMPLOYMENT: 4.2% NO HIGH SCHOOL DIPLOMA: 15.8% MEDICAID: 20.6% UNINSURED: 10.4% OTHER AREA HOSPITALS: 48 MERCY SAN JUAN MEDICAL CENTER THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES A BROAD SUBURBAN AREA IN THE NORTHERN PORTION OF SACRAMENTO COUNTY AND EXTENDS INTO SOUTH PLACER COUNTY. WITHIN ITS PRIMARY SERVICE AREA, THE HOSPITAL SERVES SACRAMENTO, CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, NORTH HIGHLANDS, ANTELOPE, AND OTHER SURROUNDING NEIGHBORHOODS. TOTAL POPULATION: 1,094,981 RACE/ETHNICITY: WHITE - NON-HISPANIC 57.5%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 6.4%; HISPANIC OR LATINO 20.2%; ASIAN/PACIFIC ISLANDER 10.7%; ALL OTHERS 5.2% MEDIAN INCOME: $69,895 UNEMPLOYMENT: 5.3% NO HIGH SCHOOL DIPLOMA: 10.5% MEDICAID: 26.9% UNINSURED: 7.9% OTHER AREA HOSPITALS: 6 MERCY GENERAL HOSPITAL THE HOSPITAL, A TERTIARY CARE FACILITY, SERVES RESIDENTS FROM A BROAD GEOGRAPHIC AREA. THE HOSPITAL'S PRIMARY SERVICE AREA LIES IN THE CENTRAL DOWNTOWN AREA OF SACRAMENTO, AND INCLUDES 43 ZIP CODES. TOTAL POPULATION: 1,596,829 RACE/ETHNICITY: WHITE - NON-HISPANIC 45.3%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 9.2%; HISPANIC OR LATINO 23.4%; ASIAN/PACIFIC ISLANDER 16.4%; ALL OTHERS 5.7% MEDIAN INCOME: $68,932 UNEMPLOYMENT: 5.7% NO HIGH SCHOOL DIPLOMA: 12.8% MEDICAID: 29.6% UNINSURED: 8.8% OTHER AREA HOSPITALS: 7 MARIAN REGIONAL MEDICAL CENTER THE HOSPITAL IS LOCATED IN SANTA MARIA, CALIFORNIA, IN NORTHERN SANTA BARBARA COUNTY WITH THE SANTA MARIA VALLEY AS THE LARGEST REGION IN ITS SERVICE AREA. THE LARGEST COMMUNITIES IN MARIAN'S PRIMARY SERVICE AREA INCLUDE THE CITIES OF SANTA MARIA AND GUADALUPE, WITH THE SECONDARY SERVICE AREA BEING NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION IN PRIMARY SERVICE AREA: 176,449 RACE/ETHNICITY: WHITE - NON-HISPANIC 30.0%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 1.2%; HISPANIC OR LATINO 61.6%; ASIAN/PACIFIC ISLANDER 4.8%; ALL OTHERS 2.4% MEDIAN INCOME: $66,018 UNEMPLOYMENT: 4.3% NO HIGH SCHOOL DIPLOMA: 29.8% MEDICAID: 23.7% UNINSURED: 5.4% OTHER AREA HOSPITALS: 3 THE ARROYO GRANDE COMMUNITY HOSPITAL CAMPUS OF THE LICENSED MARIAN REGIONAL MEDICAL CENTER SERVES THE SOUTHERN PART OF SAN LUIS OBISPO COUNTY INCLUDING THE CITIES OF ARROYO GRANDE, GROVER BEACH, OCEANO, PISMO BEACH AND SHELL BEACH AND THE NORTHERN PART OF THE CITY OF NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. TOTAL POPULATION: 72,445 RACE/ETHNICITY: WHITE - NON-HISPANIC 62.7%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 0.6%; HISPANIC OR LATINO 29.4%; ASIAN/PACIFIC ISLANDER 3.8%; ALL OTHERS 3.5% MEDIAN INCOME: $73,042 UNEMPLOYMENT: 3.3% NO HIGH SCHOOL DIPLOMA: 11.2% MEDICAID: 17.2% UNINSURED: 6.1% OTHER AREA HOSPITALS: 3 CHANDLER REGIONAL MEDICAL CENTER THE HOSPITAL'S COMMUNITY INCLUDES 24 ZIP CODES IN CITIES IN MARICOPA AND PINAL COUNTIES, ARIZONA. THE CITIES ARE: CHANDLER, GILBERT, MESA, TEMPE, AWHATUKEE, SACATON, APACHE JUNCTION, CASA GRANDE, QUEEN CREEK, COOLIDGE, GILA RIVER INDIAN RESERVATION, AND PHOENIX. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION IN SEVERAL ZIP CODES OF THE SERVICE AREA. TOTAL POPULATION: 1,059,974 RACE/ETHNICITY: WHITE - NON-HISPANIC 57.2%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 5.1%; HISPANIC OR LATINO 25.7%; ASIAN/PACIFIC ISLANDER 6.2%; ALL OTHERS 5.8% MEDIAN INCOME: $71,261 UNEMPLOYMENT: 3.8% NO HIGH SCHOOL DIPLOMA: 10.3% MEDICAID: 13.9% UNINSURED: 7.5% OTHER AREA HOSPITALS: 3 IN THE PRIMARY SERVICE AREA, 12 IN THE SECONDARY SERVICE AREA CALIFORNIA HOSPITAL MEDICAL CENTER WHILE THE HOSPITAL IS LOCATED IN SERVICE PLANNING AREA (SPA) 4 OF METRO LOS ANGELES, ITS SERVICE AREA ALSO INCLUDES PARTS OF SPA 6 (SOUTH) AND SPA 8 (SOUTH BAY). THE PRIMARY SERVICES AREA IS 31 ZIP CODES IN LOS ANGELES. CALIFORNIA HOSPITAL MEDICAL CENTER IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION: 1,699,916 RACE/ETHNICITY: WHITE - NON-HISPANIC 6.1%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 17.1%; HISPANIC OR LATINO 66.8%; ASIAN/PACIFIC ISLANDER 8.2%; ALL OTHERS 1.8% MEDIAN INCOME: $40,705 UNEMPLOYMENT: 6.3% NO HIGH SCHOOL DIPLOMA: 38.0% MEDICAID: 48.3% UNINSURED: 12.8% OTHER AREA HOSPITALS: 6 MERCY MEDICAL CENTER REDDING THE HOSPITAL SERVES AN AREA COMPRISED OF ZIP CODES IN REDDING AND SURROUNDING COMMUNITIES IN SHASTA, TEHAMA AND TRINITY COUNTIES. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 205,030 RACE: WHITE 78.4%; BLACK/AFRICAN AMERICAN 1.0%; HISPANIC OR LATINO: 11.6%; ASIAN/PACIFIC ISLANDER 3.1%; ALL OTHERS 5.9% MEDIAN INCOME: $49,658 UNEMPLOYMENT: 4.1% NO HIGH SCHOOL DIPLOMA: 10.5% MEDICAID: 30.9% UNINSURED: 9.9% OTHER AREA HOSPITALS: 1 ST. ROSE DOMINICAN HOSPITALS - DE LIMA, SAN MARTIN, AND SIENA SERVE THE AREAS SURROUNDING THE THREE ACUTE CARE FACILITIES IN THE SOUTHERN PORTION OF THE LAS VEGAS VALLEY, AS WELL AS CLARK COUNTY AS A WHOLE. THIS AREA ENCOMPASSES URBAN AND SUBURBAN AREAS WITH DIVERSE SOCIOECONOMIC CONDITIONS. THE HOSPITALS SERVE A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION: 2,217,048 RACE/ETHNICITY: WHITE - NON-HISPANIC 42.6%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 11.0%; HISPANIC OR LATINO 31.3%; ASIAN/PACIFIC ISLANDER 10.8%; ALL OTHERS 4.3% MEDIAN INCOME: $57,611 UNEMPLOYMENT: 5.6% NO HIGH SCHOOL DIPLOMA: 15.1% MEDICAID: 16.3% UNINSURED: 12.1% OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH NORTHRIDGE HOSPITAL MEDICAL CENTER THE HOSPITAL'S SERVICE AREA INCLUDES PARTS OF THE SAN FERNANDO AND SANTA CLARITA VALLEYS OF LOS ANGELES COUNTY, AND A PORTION OF THE CITY OF SIMI VALLEY IN VENTURA COUNTY. THE HOSPITAL IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION: 1,581,789 RACE/ETHNICITY: WHITE - NON-HISPANIC 33.5%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 3.6%; HISPANIC OR LATINO 48.6%; ASIAN/PACIFIC ISLANDER 11.4%; ALL OTHERS 2.9% MEDIAN INCOME: $73,611 UNEMPLOYMENT: 4.9% NO HIGH SCHOOL DIPLOMA: 20.5% MEDICAID: 27.6% UNINSURED: 6.9% OTHER AREA HOSPITALS: 7 DOMINICAN HOSPITAL THE PRIMARY SERVICE AREA IS SANTA CRUZ COUNTY WHICH COVERS 441 SQUARE MILES, AND IS A RELATIVELY ISOLATED COMMUNITY. THE TWO MAJOR CITIES ARE SANTA CRUZ, LOCATED ON THE NORTHERN SIDE OF THE MONTEREY BAY, AND WATSONVILLE, SITUATED IN THE SOUTHERN PART OF THE COUNTY. OTHER INCORPORATED AREAS IN THE COUNTY INCLUDE THE CITIES OF SCOTTS VALLEY AND CAPITOLA. APPROXIMATELY 51% OF THE POPULATION LIVES IN THE UNINCORPORATED PARTS OF THE COUNTY, INCLUDING THE TOWNS OF APTOS, DAVENPORT, FREEDOM, SOQUEL, FELTON, BEN LOMOND AND BOULDER CREEK, AND DISTRICTS SUCH AS THE SAN LORENZO VALLEY, LIVE OAK AND PAJARO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. TOTAL POPULATION: 295,600 RACE/ETHNICITY: WHITE - NON-HISPANIC 55.2%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 1.0%; HISPANIC OR LATINO 35.5%; ASIAN/PACIFIC ISLANDER 4.6%; ALL OTHERS 3.7% MEDIAN INCOME: $72,657 UNEMPLOYMENT: 3.7% NO HIGH SCHOOL DIPLOMA: 16.1% MEDICAID: 26.1% UNINSURED: 8.2% OTHER AREA HOSPITALS: 2 ST. BERNARDINE MEDICAL CENTER THE HOSPITAL SERVES A BROAD AND DIVERSE POPULATION. WHILE A FEW OF THE COMMUNITIES ENJOY A HIGHER STANDARD OF LIVING, THE MAJORITY OF THE COMMUNITIES ARE HIGH NEED. EIGHTY PERCENT (80%) OF DISCHARGES COME FROM THE FOLLOWING CITIES: BANNING, BEAUMONT, BLOOMINGTON, COLTON, CRESTLINE, FONTANA, HEMET, HESPERIA, HIGHLAND, RANCHO CUCAMONGA, REDLANDS, RIALTO, SAN BERNARDINO, VICTORVILLE AND YUCAIPA. MANY OF THE NEIGHBORHOODS SERVED HAVE BEEN FEDERALLY-DESIGNATED AS MEDICALLY UNDERSERVED AREAS. TOTAL POPULATION: 1,027,971 RACE/ETHNICITY: WHITE - NON-HISPANIC 22.5%; BLACK/AFRICAN AMERICAN - NON-HISPANIC 8.3%; HISPANIC OR LATINO 61.5%; ASIAN/PAC
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, DIGNITY HEALTH REINVESTS ALL OF ITS SURPLUS FUNDS FROM OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR DIGNITY HEALTH TO DELIVER ON ITS MISSION, INCLUDING HELPING TO ENSURE THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTH CARE. OPEN MEDICAL STAFF: MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS GATHERS AND VERIFIES CREDENTIALS, ALLOWS THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND TO ULTIMATELY MAKE A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS. THE ROLE OF THE BOARD: THE DIGNITY HEALTH BOARD OF DIRECTORS AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO SET PRIORITIES AND TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. DIGNITY HEALTH HOSPITAL COMMUNITY BOARDS, WHICH ARE RATIFIED BY THE DIGNITY HEALTH BOARD, ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS DEVELOP PROGRAMS TO ADDRESS THE DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS OF THE COMMUNITIES THE HOSPITALS SERVE, FOR CONDUCTING AND ADOPTING COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS AND IMPLEMENTATION STRATEGIES, AND FOR PRODUCING AND MAKING WIDELY AVAILABLE TO THE PUBLIC ANNUAL COMMUNITY BENEFIT REPORTS. COMMUNITY BOARDS ENSURE THE DEVELOPMENT OF COMMUNITY HEALTH INITIATIVES TO PROMOTE THE HEALTH OF THE COMMUNITY, WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS. IN FULFILLING THESE RESPONSIBILITIES, THE COMMUNITY BOARDS MAY DESIGNATE A COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEE TO INCLUDE AT LEAST TWO BOARD MEMBERS, WITH REPRESENTATION FROM A RANGE OF COMMUNITY STAKEHOLDERS WHO HAVE KNOWLEDGE OF THE COMMUNITY. THE COMMUNITY BOARD OR BOARD COMMITTEE PARTICIPATES IN THE PROCESS OF ESTABLISHING PROGRAM PRIORITIES BASED ON COMMUNITY HEALTH NEEDS ASSESSMENTS, DEVELOPING THE HOSPITAL'S IMPLEMENTATION STRATEGY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS. IF APPLICABLE, MEMBERS OF THE COMMITTEE ENSURE THAT THE COMMUNITY BOARD IS REGULARLY BRIEFED ON ACTIVITIES AND DEVELOPMENTS, AND THAT THE COMMITTEE HAS INFORMATION FROM THE COMMUNITY BOARD AND MANAGEMENT NEEDED TO MAKE INFORMED DECISIONS. COMMUNITY GRANTS, SOCIAL INNOVATION PARTNERSHIP GRANTS, AND COMMUNITY INVESTMENT: DIGNITY HEALTH HOSPITALS PROVIDE MORE THAN $5 MILLION IN FINANCIAL GRANTS ANNUALLY TO LOCAL COMMUNITY ORGANIZATIONS TO ADDRESS SIGNIFICANT HEALTH NEEDS FROM LOCAL CHNAS. GRANTEES SET PERFORMANCE GOALS AND REPORT SEMI-ANNUALLY ON PROGRESS AND RESULTS. DIGNITY HEALTH OPERATES A SOCIAL INNOVATION PARTNERSHIP GRANT PROGRAM TO SPUR NEW APPROACHES AND SOLUTIONS TO ENHANCING HEALTH AND HEALTH CARE NEEDS IN THE COMMUNITIES SERVED BY ITS HOSPITALS. DIGNITY HEALTH OPERATES A $100 MILLION COMMUNITY INVESTMENT PROGRAM THAT HELPS BUILD CAPACITY OF NON-PROFIT ORGANIZATIONS TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH, INCLUDING HOUSING FOR VULNERABLE POPULATIONS, SUPPORT FOR PRIMARY CARE, AND MORE. MORE INFORMATION ABOUT EACH OF THESE INITIATIVES IS ONLINE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH. DIGNITY HEALTH HOSPITALS ARE IMPLEMENTING A FORMAL REFERRAL SYSTEM OF PATIENTS TO HEALTH IMPROVEMENT PROGRAMS AND SOCIAL SUPPORT SERVICES IN THEIR COMMUNITIES. THIS TECHNOLOGY-SUPPORTED SYSTEM INCLUDES COMMUNITY HEALTH STAFF, CARE COORDINATORS AND SOCIAL WORKERS IN THE HOSPITALS, PLUS SELECT COMMUNITY-BASED PARTNER ORGANIZATIONS. THIS COORDINATED COMMUNITY NETWORK INITIATIVE ADDRESSES THE NEEDS OF ALL PATIENTS, WITH A FOCUS ON HIGH-NEED AND VULNERABLE INDIVIDUALS, BEYOND ACUTE MEDICAL CARE. DIGNITY HEALTH PROVIDES HOSPITAL SERVICES AND CARRIES OUT ITS MISSION AT THE HOSPITAL FACILITIES LISTED IN PART V, SECTION A. FOR DETAILED INFORMATION ON THE SERVICES AND COMMUNITY BENEFITS PROVIDED AT THESE FACILITIES, AS WELL AS COPIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENTS, IMPLEMENTATION STRATEGIES AND COMMUNITY BENEFIT REPORTS FOR EACH FACILITY, VISIT THE DIGNITY HEALTH WEBSITE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-P ROGRAMS-AND-REPORTS, IN ADDITION TO THE WEBSITES REPORTED IN PART V, LINE 7. ARIZONA ORTHOPEDIC SURGICAL HOSPITAL (ARIZONA SPECIALTY HOSPITAL), SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, ARIZONA GENERAL HOSPITAL LAVEEN, ARIZONA SPINE AND JOINT HOSPITAL, DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL - THE HOPSITALS PARTICIPATE ON THE COMMUNITY HEALTH INTEGRATION NETWORK OF ST. JOSEPH'S HOPSITAL AND MEDICAL CNETER, WHERE COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND PARTNERSHIPS ARE DISCUSSED, SHARED AND COORDINATED. CARONDELET ST. JOSEPH'S HOSPITAL, CARONDELET ST. MARY'S HOSPITAL AND CARONDELET HOLY CROSS HOSPITAL HAVE ACTIVE WELLNESS COMMITTEES THAT OFFER AND DEVELOP COMMUNITY-BASED EVENTS TO PROMOTE COMMUNITY HEALTH AND WELLNESS, INCLUDING IN THE AREAS OF EXERCISE, SAFETY AND INJURY PREVENTION, AND FUNDRAISING TO ADDRESS DISEASES. THE HOSPITALS INVEST FUNDS TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING AND EDUCATION. MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS GATHERS AND VERIFIES CREDENTIALS, ALLOWS THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND TO ULTIMATELY MAKE A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM AFFILIATES OF DIGNITY HEALTH ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, AND GRASS VALLEY/NEVADA CITY, CALIFORNIA. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE FOR DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS FOR THE YEAR ENDED JUNE 30, 2018, IS AS FOLLOWS. Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 85,916 108,592,000 0.8% Unpaid Costs of Medicaid/Medi-Cal 1,739,745 555,935,000 4.1% Other Means-tested Programs 13,398 13,971,000 0.1% Community Services: Community Health Services 317,655 23,099,000 0.2% Health Professions Education 14 209,000 0.0% Subsidized Health Services 26,310 3,432,000 0.0% Donations 100,355 39,204,000 0.3% Community Building Activities 2,657 4,468,000 0.0% Community Benefit Operations 1,446 9,166,000 0.1% Total Community Services for the poor 448,437 79,578,000 0.6% Total Benefits for the Poor 2,287,496 758,076,000 5.6% Benefits for the Broader Community: Community Services: Community Health Services 235,185 12,634,000 0.1% Health Professions Education 18,906 98,392,000 0.7% Subsidized Health Services 418 631,000 0.0% Research 284 10,954,000 0.1% Donations 32,055 3,204,000 0.1% Community Building Activities 13,295 3,702,000 0.0% Community Benefit Operations 4,836 1,028,000 0.0% Total Benefits for the Broader Community 304,979 130,545,000 0.9% Total Community Benefits 2,592,475 888,621,000 6.5% Unpaid Costs of Medicare 1,412,924 1,213,419,000 8.9% Total Community Benefits including Unpaid Cost of Medicare 4,005,399 2,102,040,000 15.4%
Schedule H (Form 990) 2019
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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
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
(if applicable)
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
noncash assistance
(h) Purpose of grant
or assistance
(1) 18 REASONS
3150 18TH ST SUITE 135
SAN FRANCISCO,CA94110
45-3059509 501(c)(3) 25,005 0 N/A N/A Community Health
(2) ABOKIN INC
1332 CRESTVIEW RD
REDLANDS,CA92374
33-0080739 501(c)(3) 16,479 0 N/A N/A Community Health
(3) ADRIAN DOMINICAN SISTERS
1257 E SIENA HEIGHTS DR
ADRIAN,MI49221
38-1879966 501(c)(3) 25,000 0 N/A N/A Community Health
(4) AIM HIGH FOR HIGH SCHOOL
PO BOX 410715
SAN FRANCISCO,CA94110
94-3296338 501(c)(3) 9,800 0 N/A N/A Education Support
(5) Allan Hancock College Foundation
800 S COLLEGE Drive
SANTA MARIA,CA934546399
95-3143396 501(c)(3) 221,900 0 N/A N/A Education Support
(6) ALLIANCE FOR PHARMACEUTICAL ACCESS INC
237 TOWN CENTER WEST 122
SANTA MARIA,CA93458
20-3117940 501(c)(3) 80,000 0 N/A N/A Community Health
(7) ALPHA HOUSE A PLACE FOR NEW BEGINNINGS
PO BOX 712
TAFT,CA93268
77-0366593 501(c)(3) 75,000 0 N/A N/A Community Health
(8) ALZHEIMERS DISEASE AND RELATED DISORDERS ASSOCIATI
225 N MICHIGAN AVE STE 1700
CHICAGO,IL60601
13-3039601 501(c)(3) 207,500 0 N/A N/A Community Health
(9) ALZHEIMERS DISEASE ASSOCIATION OF KERN COUNTY INC
4203 BUENA VISTA RD
BAKERSFIELD,CA93311
77-0017561 501(c)(3) 26,401 0 N/A N/A Community Health
(10) AMERICAN CANCER SOCIETY INC
250 WILLIAMS ST STE 400
PHOENIX,AZ85032
46-5439010 501(c)(3) 63,140 0 N/A N/A Community Health
(11) AMERICAN HEART ASSOCIATION WESTERN STATES AFFILIAT
7425 W PALMS BLUFFS AVE
FRESNO,CA93711
13-5613797 501(c)(3) 405,640 0 N/A N/A Community Health
(12) AMERICAN LIVER FOUNDATION
4545 E SHEA BLVD STE 246
PHOENIX,AZ85028
36-2883000 501(c)(3) 7,888 0 N/A N/A Community Health
(13) AMERICAN NATIONAL RED CROSS
431 18TH ST NW
WASHINGTON,DC20006
53-0196605 501(c)(3) 163,376 0 N/A N/A Community Health
(14) AMERICAN RIVER PARKWAY FOUNDATION INC
5700 ARDEN WY
CARMICHAEL,CA956085971
94-2881344 501(c)(3) 50,516 0 N/A N/A Community Health
(15) ARIZONA BRIDGE TO INDEPENDENT LIVING PHX HEAT WHEE
5031 E WASHINGTON ST
PHOENIX,AZ85034
86-0486447 501(c)(3) 8,875 0 N/A N/A Community Health
(16) ARIZONA DIAMONDBACKS FOUNDATION INC
401 E JEFFERSON STREET
PHOENIX,AZ85004
86-0901615 501(c)(3) 8,500 0 N/A N/A Community Health
(17) ARIZONA LATIN AMERICAN MEDICAL ASSOCIATION
PO BOX 24152
TEMPE,AZ85285
86-0743958 501(c)(3) 8,500 0 N/A N/A Community Health
(18) ARIZONA STATE UNIVERSITY
PO BOX 876505
TEMPE,AZ852876505
86-0196696 GOVT 11,000,000 0 N/A N/A Education Support
(19) ARIZONA STATE UNIVERSITY FOUNDATION FOR A NEW AMER
300 E UNIVERSITY DR
TEMPE,AZ85281
86-6051042 501(c)(3) 66,900 0 N/A N/A Education Support
(20) Arroyo Grande Community Hospital Foundation
345 S Halcyon Road
Arroyo Grande,CA93420
20-3256066 501(c)(3) 657,119 0 N/A N/A Foundation Support
(21) ASCENCIA
1851 TYBURN ST
GLENDALE,CA91204
20-4233822 501(c)(3) 28,820 0 N/A N/A Community Health
(22) BAKERSFIELD SENIOR CENTER INC
530 4TH ST
BAKERSFIELD,CA93304
77-0013149 501(c)(3) 30,000 0 N/A N/A Community Health
(23) BAKERSFIELD SYMPHONY ORCHESTRA INC
1328 34TH ST SUITE A
BAKERSFIELD,CA93301
95-6001765 501(c)(3) 15,000 0 N/A N/A Community Health
(24) Barrow Foundation UK
350 W Thomas Road
Phoenix,AZ85013
31-1724184 501(c)(3) 46,234 0 N/A N/A Foundation Support
(25) Barrow Neurological Foundation
350 W Thomas Road
Phoenix,AZ850134409
86-0174371 501(c)(3) 4,282,288 0 N/A N/A Foundation Support
(26) BAY AREA COUNCIL FOUNDATION
201 CALIFORNIA ST SUITE 1450
SAN FRANCISCO,CA94111
20-1826827 501(c)(3) 24,050 0 N/A N/A Community Health
(27) BAY SCHOLARS
465 CALIFORNIA ST 16TH FLOOR
SAN FRANCISCO,CA94104
46-3467919 501(c)(3) 100,000 0 N/A N/A Community Health
(28) BOY SCOUTS OF AMERICA
1550 CHESS DR
FOSTER CITY,CA94404
94-1156483 501(c)(3) 8,950 0 N/A N/A Community Health
(29) BOYS CLUBS OF BAKERSFIELD
801 NILES ST
BAKERSFIELD,CA93305
95-2462246 501(c)(3) 27,100 0 N/A N/A Community Health
(30) BRAIN INJURY CENTER
PO BOX 1477
CAMARILLO,CA93011
77-0491413 501(c)(3) 75,000 0 N/A N/A Community Health
(31) CABRILLO COLLEGE FOUNDATION
6500 SOQUEL DR
APTOS,CA95003
94-6121953 501(c)(3) 22,000 0 N/A N/A Education Support
(32) Cal Poly Corporation
1 GRAND AVE
SAN LUIS OBISPO,CA93407
95-1648180 501(c)(3) 6,650 0 N/A N/A Education Support
(33) CALIFORNIA CENTER FOR PUBLIC HEALTH ADVOCACY
1201 Clayton St
SAN FRANCISCO,CA94114
95-4723901 501(c)(3) 7,500 0 N/A N/A Community Health
(34) CALIFORNIA FORWARD
127 UNIVERSITY AVENUE
BERKELEY,CA94710
26-0566540 501(c)(3) 30,000 0 N/A N/A Community Health
(35) California Health Foundation and Trust
1215 K Street Suite 800
Sacramento,CA95814
94-1498697 501(c)(3) 17,845,125 0 N/A N/A Community Health
(36) CALIFORNIA HISTORICAL SOCIETY
678 MISSION ST
SAN FRANCISCO,CA94105
94-0385620 501(c)(3) 9,390 0 N/A N/A Community Health
(37) California Hospital Medical Center Foundation
1401 South Grand Avenue
Los Angeles,CA90015
95-4000909 501(c)(3) 2,998,482 0 N/A N/A Foundation Support
(38) CALIFORNIA POLYTECHNIC STATE UNIVERSITY FOUNDATION
1 GRAND AVE
SAN LUIS OBISPO,CA93407
20-4927897 501(c)(3) 480,417 0 N/A N/A Education Support
(39) CALIFORNIA STATE BAKERSFIELD FOUNDATION
9001 STOCKDALE HWY
BAKERSFIELD,CA933111099
95-2643086 501(c)(3) 152,750 0 N/A N/A Education Support
(40) Connect 2 Ministries
2635 Brindle Ct
Simi ValleY,CA93063
26-4365043 501(c)(3) 0 7,000 Cost Medical supplies/equ Community Health
(41) CAMEROON ARIZONA PARTNERSHIP
3831 EAST NOWATA DR
PHOENIX,AZ85044
47-5041490 501(c)(3) 20,000 0 N/A N/A Community Health
(42) CANCER SUPPORT COMMUNITY ARIZONA
360 E PALM LN
PHOENIX,AZ85004
86-0897810 501(c)(3) 30,000 0 N/A N/A Community Health
(43) CANTICLE FARM
1968 36TH AVE
OAKLAND,CA94601
46-1484633 501(c)(3) 10,000 0 N/A N/A Community Health
(44) CAREGIVERS VOLUNTEERS ASSISTING THE ELDERLY
1765 GOODYEAR AVE SUITE 205
VENTURA,CA93003
77-0081692 501(c)(3) 50,000 0 N/A N/A Community Health
(45) CATHOLIC CHARITIES COMMUNITY SERVICES
6250 SOUTHSIDE DR
PHOENIX,AZ85013
86-0223999 501(c)(3) 78,300 0 N/A N/A Community Health
(46) CATHOLIC CHARITIES CYO DBA CATHOLIC CHARITIES OF S
990 EDDY ST
SAN FRANCISCO,CA94109
94-1498472 501(c)(3) 47,250 0 N/A N/A Community Health
(47) CATHOLIC CHARITIES DIOCESE OF MONTEREY
922 HILBY AVE STE C
SEASIDE,CA93955
77-0042961 501(c)(3) 52,310 0 N/A N/A Community Health
(48) CATHOLIC CHARITIES OF SOUTHERN NEVADA
1501 N LAS VEGAS BLVD
LAS VEGAS,NV89101
88-0059425 501(c)(3) 81,095 0 N/A N/A Community Health
(49) CATHOLIC CHARITIES OF THE DIOCESE OF FRESNO
149 N FULTON ST
FRESNO,CA937011607
94-1678938 501(c)(3) 48,524 0 N/A N/A Community Health
(50) CATHOLIC CHARITIES REGIONAL AGENCY
144 W WOOD ST
YOUNGSTOWN,OH44503
34-0714330 501(c)(3) 119,976 0 N/A N/A Community Health
(51) CELEBRITY FIGHT NIGHT FOUNDATION
2425 E CAMELBACK RD STE 150
PHOENIX,AZ85016
86-0903119 501(c)(3) 112,000 0 N/A N/A Community Health
(52) CENTRAL CITY ASSOCIATION OF LA
626 WILSHIRE BLVD STE 200
LOS ANGELES,CA90017
95-0691090 501(c)(6) 7,036 0 N/A N/A Community Health
(53) CENTRAL NEIGHBORHOOD HEALTH FOUNDATION
714-W OLYMPIC BLVD STE 801
LOS ANGELES,CA90015
75-2986675 501(c)(3) 187,500 0 N/A N/A Community Health
(54) CENTRAL VALLEY COMMUNITY FOUNDATION
5260 N PALM AVE STE 122
FRESNO,CA93704
77-0478025 501(c)(3) 25,000 0 N/A N/A Community Health
(55) CERES INC
99 Chauncy St Sixth Floor
BOSTON,MA02111
22-3053747 501(c)(3) 15,000 0 N/A N/A Community Health
(56) CHANDLER EDUCATION FOUNDATION
1525 W FRYE RD
CHANDLER,AZ85224
86-0589677 501(c)(3) 6,000 0 N/A N/A Community Health
(57) CHANNEL ISLANDS YOUNG MENS CHRISTIAN ASSOCIATION
3760 TELEGRAPH RD
VENTURA,CA93003
95-1643379 501(c)(3) 65,000 0 N/A N/A Community Health
(58) CHINATOWN COMMUNITY DEVELOPMENT CENTER INC
1525 GRANT AVE
SAN FRANCISCO,CA94133
94-2514053 501(c)(3) 8,800 0 N/A N/A Community Health
(59) CITY OF LOS ANGELES
FILE 57065
LOS ANGELES,CA900747065
95-6000735 GOVT 165,500 0 N/A N/A Community Health
(60) CITY YEAR INC
287 COLUMBUS AVE
BOSTON,MA02116
22-2882549 501(c)(3) 9,120 0 N/A N/A Community Health
(61) CLARA'S HOUSE
2715 K STREET STE D
SACRAMENTO,CA95816
61-1591265 501(c)(3) 15,000 0 N/A N/A Community Health
(62) CLEAN PRODUCTION ACTION INC
1310 BROADWAY STE 101
SOMERVILLE,MA02144
45-3560728 501(c)(3) 9,000 0 N/A N/A Community Health
(63) COALITION FOR CLEAN AIR
800-WILSHIRE BLVD STE 1010
LOS ANGELES,CA90017
23-7120567 501(c)(3) 21,133 0 N/A N/A Community Health
(64) COLLEGE OF SOUTHERN NEVADA FOUNDATION INC
6375 W CHARLESTON BLVD WCE310
LAS VEGAS,NV891461164
94-2889686 501(c)(3) 10,000 0 N/A N/A Education Support
(65) COLORECTAL CANCER ALLIANCE INC
1025 VERMONT AVE NW
WASHINGTON,DC20005
86-0947831 501(c)(3) 9,240 0 N/A N/A Community Health
(66) COMMUNICARE HEALTH CENTERS
PO BOX 1260
DAVIS,CA95617
94-2188574 501(c)(3) 20,000 0 N/A N/A Community Health
(67) COMMUNITY ACTION PARTNERSHIP OF KERN
5005 BUSINESS PARK NORTH
BAKERSFIELD,CA93309
95-2402760 501(c)(3) 25,081 0 N/A N/A Community Health
(68) COMMUNITY ACTION PARTNERSHIP OF SAN LUIS OBISPO CO
1030 SOUTHWOOD DR
SAN LUIS OBISPO,CA93401
95-2410253 501(c)(3) 96,000 0 N/A N/A Community Health
(69) COMMUNITY AGAINST SEXUAL HARM
3101 1ST AVE
SACRAMENTO,CA95817
46-1498182 501(c)(3) 101,000 0 N/A N/A Community Health
(70) COMMUNITY ALLIANCE AGAINST FAMILY ABUSE
185 N APACHE TRAIL
APACHE JUNCTION,AZ85220
86-0912044 501(c)(3) 25,275 0 N/A N/A Community Health
(71) COMMUNITY INITIATIVES
1000 BROADWAY STE 480
OAKLAND,CA94607
94-3255070 501(c)(3) 23,750 0 N/A N/A Community Health
(72) COMMUNITY MEDICAL CENTERS INC
7210 MURRAY DRIVE
STOCKTON,CA952103339
94-2437106 501(c)(3) 27,749 0 N/A N/A Community Health
(73) COMMUNITY RECOVERY RESOURCES
PO BOX 6028
AUBURN,CA95604
94-2275091 501(c)(3) 77,983 0 N/A N/A Community Health
(74) CORPORATION FOR SUPPORTIVE HOUSING
800 S FIGUEROA STE 800
LOS ANGELES,CA90017
13-3600232 501(c)(3) 65,000 0 N/A N/A Community Health
(75) COUNTY OF SANTA CRUZ
PO BOX 801
SANTA CRUZ,CA950610801
94-6000534 GOVT 70,000 0 N/A N/A Community Health
(76) COURT APPOINTED SPECIAL ADVOCATES OF KERN COUNTY
1717 COLUMBUS ST
BAKERSFIELD,CA93305
77-0344298 501(c)(3) 7,500 0 N/A N/A Community Health
(77) CREIGHTON UNIVERSITY
2500 CALIFORNIA PLAZA
OMAHA,NE68178
47-0376583 501(c)(3) 232,466 0 N/A N/A Education Support
(78) Cuesta College Foundation
PO BOX 8106
SAN LUIS OBISPO,CA93403
23-7225601 501(c)(3) 9,120 0 N/A N/A Education Support
(79) DIENTES COMMUNITY DENTAL CARE
1830 COMMERCIAL WY
SANTA CRUZ,CA95065
77-0311752 501(c)(3) 20,000 0 N/A N/A Community Health
(80) DIGITAL NEST INC
340 SOQUEL AVE STE 205
SANTA CRUZ,CA95062
46-5757256 501(c)(3) 20,000 0 N/A N/A Community Health
(81) DIGNITY HEALTH CONNECTED LIVING
200 Mercy Oaks Drive
Redding,CA96003
23-7115371 501(c)(3) 799,012 0 N/A N/A Community Health
(82) Dignity Health Foundation East Valley
1727 West Frye Road Suite 230
Chandler,AZ85224
74-2418514 501(c)(3) 1,885,759 0 N/A N/A Foundation Support
(83) Dignity Health Foundation
185 Berry Street Suite 300
San Francisco,CA94107
46-2037641 501(c)(3) 1,647,121 16,251 Book Medical supplies/equ Foundation Support
(84) Dignity Health Medical Foundation
3400 Data Drive
Rancho Cordova,CA95670
68-0220314 501(c)(3) 240,249,887 0 N/A N/A Medical Fnd Support
(85) Dominican Hospital Foundation
1555 Soquel Drive
Santa Cruz,CA95065
94-2450442 501(c)(3) 1,108,474 0 N/A N/A Foundation Support
(86) DREAM MOUNTAIN CHRISTIAN CAMP INC
PO BOX 1422
MURPHYS,CA95247
27-0643800 501(c)(3) 32,701 0 N/A N/A Community Health
(87) DRESS FOR SUCCESS BAKERSFIELD
1416 17TH STREET
BAKERSFIELD,CA93301
90-0846187 501(c)(3) 8,000 0 N/A N/A Community Health
(88) EAST VALLEY ADULT RESOURCES INC
45 W UNIVERSITY DR STE A
MESA,AZ852015831
94-2596075 501(c)(3) 60,000 0 N/A N/A Community Health
(89) ECONOMIC DEVELOPMENT CORPORATION OF SHASTA COUNTY
4300 CATERPILLAR RD
REDDING,CA960031422
94-1417261 501(c)(3) 20,000 0 N/A N/A Community Health
(90) ECONOMIC VITALITY CORPORATION OF SAN LUIS OBISPO C
735 TANK FARM RD SUITE 264
SAN LUIS OBISPO,CA93401
77-0402681 501(c)(3) 17,500 0 N/A N/A Community Health
(91) EMPIRE HOTEL ALCOHOLIC REHABILITATION CENTER
1237 CALIFORNIA ST
REDDING,CA960010618
94-2326975 501(c)(3) 100,000 0 N/A N/A Community Health
(92) EMPOWER TEHAMA
PO BOX 135
RED BLUFF,CA96080
68-0330191 501(c)(3) 21,504 0 N/A N/A Community Health
(93) ENCOMPASS COMMUNITY SERVICES
195 HARVEY WEST BLVD
SANTA CRUZ,CA95060
23-7275290 501(c)(3) 30,000 0 N/A N/A Community Health
(94) ENTERPRISE COMMUNITY PARTNERS
101 MONTGOMERY ST
STE 1350
SAN FRANCISCO,CA94104
52-1231931 501(c)(3) 120,000 0 N/A N/A Community Health
(95) FACING HISTORY & OURSELVES
24301 SOUTHLAND DR SUITE 207
HAYWARD,CA94545
04-2761636 501(c)(3) 95,500 0 N/A N/A Community Health
(96) FAMILY ASSISTANCE PROGRAM
15075 SEVENTH ST
VICTORVILLE,CA923953810
33-0107971 501(c)(3) 82,500 0 N/A N/A Community Health
(97) FAMILY INVOLVEMENT CENTER
5333 N 7TH STREET
PHOENIX,AZ85014
71-0890534 501(c)(3) 85,000 0 N/A N/A Community Health
(98) FAMILY PROMISE OF THE VERDUGOS
10153 1/2 RIVERSIDE DR
TOLUCA LAKE,CA916022561
26-2458342 501(c)(3) 20,000 0 N/A N/A Community Health
(99) FELLOWSHIP OF CHRISTIAN ATHLETES
9530 HAGEMAN RD SUITE B163
BAKERSFIELD,CA93312
44-0610626 501(c)(3) 14,500 0 N/A N/A Community Health
(100) FINANCIAL WOMENS ASSOCIATION OF SAN FRANCISCO SCHO
PO BOX 26143
SAN FRANCISCO,CA94126
03-0475636 501(c)(3) 8,730 0 N/A N/A Community Health
(101) FOLDED FLAG FOUNDATION INC
1701 VILLAGE CENTER CIRCLE
LAS VEGAS,NV89134
46-5371845 501(c)(3) 25,000 0 N/A N/A Community Health
(102) FOLSOM ECONOMIC DEVELOPMENT CORPORATION DBA FEDCOR
200 WOOL ST
FOLSOM,CA95630
68-0377492 501(c)(3) 10,000 0 N/A N/A Community Health
(103) FOOD BANK OF SANTA BARBARA
490 W Foster Road
SANTA MARIA,CA93455
77-0169214 501(c)(3) 31,000 0 N/A N/A Community Health
(104) FOOD LITERACY CENTER FKA CALIFORNIA FOOD LITERACY
2973 3RD AVE
SACRAMENTO,CA95817
45-3973268 501(c)(3) 100,000 0 N/A N/A Community Health
(105) FOUNDATION FOR PUBLIC RELATIONS RESEARCH AND EDUCA
PO BOX 11840
GAINESVILLE,FL326118400
13-6161619 501(c)(3) 10,000 0 N/A N/A Community Health
(106) French Hospital Medical Center Foundation
1911 Johnson Avenue
San Luis Obispo,CA93401
20-3256125 501(c)(3) 980,669 0 N/A N/A Foundation Support
(107) FUSE CORPS
1202 RALSTON AVE SUITE 1B
SAN FRANCISCO,CA94129
27-5469219 501(c)(3) 34,100 0 N/A N/A Community Health
(108) GIANT COMMUNITY FUND
24 WILLIE MAYS PLZ
SAN FRANCISCO,CA94107
94-3200061 501(c)(3) 12,580 0 N/A N/A Community Health
(109) GIFTS TO SHARE INC
1231 I STREET 400
SACRAMENTO,CA95814
94-2985546 501(c)(3) 10,000 0 N/A N/A Community Health
(110) GILBERT CHAMBER OF COMMERCE FOUNDATION INC
119 N GILBERT RD STE 101
GILBERT,AZ85234
81-5012148 501(c)(3) 5,896 0 N/A N/A Community Health
(111) GILBERT EDUCATION FOUNDATION INC
PO BOX 2461
GILBERT,AZ852992461
86-1023126 501(c)(3) 11,760 0 N/A N/A Community Health
(112) Girl Scouts Southern Nevada
2941 HARRIS AVE
LAS VEGAS,NV89101
88-0060273 501(c)(3) 6,000 0 N/A N/A Community Health
(113) GLENDALE FIRE FOUNDATION
372 W ARDEN AVE SUITE 103
GLENDALE,CA91203
46-3958585 501(c)(3) 60,000 0 N/A N/A Community Health
(114) GLENDALE KIWANIS FOUNDATION
PO BOX 10545
GLENDALE,CA912093545
95-6225168 501(c)(3) 10,000 0 N/A N/A Community Health
(115) Glendale Memorial Health Foundation
1420 S Central Avenue
Glendale,CA91204
95-3625651 501(c)(3) 1,193,785 0 N/A N/A Foundation Support
(116) GLENDALE PARKS & OPEN SPACE FOUNDATION
613 E BROADWAY RM 120
GLENDALE,CA91204
27-0676361 501(c)(3) 33,420 0 N/A N/A Community Health
(117) GLOBAL GENES
28 ARGONAUT STE 150
ALISO VIEJO,CA92656
26-3331487 501(c)(3) 8,400 0 N/A N/A Community Health
(118) GOLDEN VALLEY HEALTH CENTERS FOUNDATION
737 W CHILDS AVE
MERCED,CA95341
47-4773124 501(c)(3) 6,000 0 N/A N/A Community Health
(119) GOOD SAMARITAN SHELTER
PO BOX 5908
SANTA MARIA,CA93456
77-0133375 501(c)(3) 76,200 26,990 Cost Food Community Health
(120) GOSPEL CENTER RESCUE MISSION INC
445 S SAN JOAQUIN ST
STOCKTON,CA95203
94-1375835 501(c)(3) 100,000 0 N/A N/A Community Health
(121) GREAT NORTHERN SERVICES
PO BOX 20
WEED,CA96094
94-2562423 501(c)(3) 26,203 0 N/A N/A Community Health
(122) GREATER SACRAMENTO URBAN LEAGUE
3725 MARYSVILLE BLVD
SACRAMENTO,CA95838
94-1686314 501(c)(3) 24,400 0 N/A N/A Community Health
(123) GREENLING INSTITUTE
360 14TH STREET 2ND FLOOR
OAKLAND,CA94612
94-3173571 501(c)(3) 100,000 0 N/A N/A Community Health
(124) HABITAT FOR HUMANITY GREATER SAN FRANCISCO INC
645 HARRISON ST STE 201
SAN FRANCISCO,CA94107
94-3088881 501(c)(3) 9,648 0 N/A N/A Community Health
(125) HAMILTON FAMILIES
1631 HAYES ST
SAN FRANCISCO,CA94117
94-3055602 501(c)(3) 125,000 0 N/A N/A Community Health
(126) Harold Pump Foundation
13636 Ventura Blvd Suite 416
Sherman Oaks,CA91423
95-4807001 501(c)(3) 41,000 0 N/A N/A Community Health
(127) HEALTH ALLIANCE OF NORTHERN CALIFORNIA
2280 BENTON DR BLDG C
REDDING,CA96003
31-1580642 501(c)(3) 9,600 0 N/A N/A Community Health
(128) Health Communication Research Institute Inc
5025 J ST SUITE 311
SACRAMENTO,CA95819
68-0195121 501(c)(3) 100,000 0 N/A N/A Community Health
(129) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNT
1800 GREEN HILLS RD STE 101
SCOTTS VALLEY,CA95066
01-0826156 501(c)(3) 141,250 0 N/A N/A Community Health
(130) HEALTHCARE FOUNDATION OF NORTHERN & CENTRAL CALIFO
1215 K ST STE 730
SACRAMENTO,CA95814
86-1174825 501(c)(3) 368,045 0 N/A N/A Community Health
(131) HEALTHCARE WITHOUT HARM
12355 SUNRISE VALLEY DR STE 680
RESTON,VA20191
52-2358837 501(c)(3) 140,000 0 N/A N/A Community Health
(132) HEALTHRIGHT360
1735 MISSION STREET STE 2001
SAN FRANCISCO,CA941032417
94-6129071 501(c)(3) 120,294 0 N/A N/A Community Health
(133) Healthy Community Forum For The Greater Sacramento
8928 VOLUNTEER LN SUITE 220
SACRAMENTO,CA958263238
68-0377256 501(c)(3) 1,705,000 0 N/A N/A Community Health
(134) HOFFMANN HOSPICE OF THE VALLEY INC
8501 BRIMHALL RD STE 100
BAKERSFIELD,CA93312
77-0386207 501(c)(3) 20,667 0 N/A N/A Community Health
(135) HOMELESS SERVICES CENTER
115-B CORAL ST
SANTA CRUZ,CA95060
77-0126783 501(c)(3) 140,104 0 N/A N/A Community Health
(136) HOMEWARD BOUND
2302 W COLTER ST
PHOENIX,AZ85015
86-0660875 501(c)(3) 51,000 0 N/A N/A Community Health
(137) HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA
1215 K ST SUITE 800
SACRAMENTO,CA95814
94-1533644 501(c)(6) 10,350 0 N/A N/A Community Health
(138) HOUSE OF REFUGE INC
6935 E WILLIAMS FIELD RD
MESA,AZ852126300
86-0662244 501(c)(3) 11,280 0 N/A N/A Community Health
(139) I C A N IMPROVING CHANDLER AREA NEIGHBORHOODS
650 E MORELOS ST
CHANDLER,AZ85225
86-0761030 501(c)(3) 70,000 0 N/A N/A Community Health
(140) ILLUMINATION FOUNDATION
2691 RICHTER AVE STE 107
IRVINE,CA92606
71-1047686 501(c)(3) 112,500 0 N/A N/A Community Health
(141) IMMANUEL PRESBYTERIAN CHURCH
3300 WILSHIRE BLVD
LOS ANGELES,CA900101702
95-1643330 501(c)(3) 65,000 0 N/A N/A Community Health
(142) INTERFACE CHILDREN FAMILY SERVICES
1305 DEL NORTE RD 200
CAMARILLO,CA93010
95-2944459 501(c)(3) 52,000 0 N/A N/A Community Health
(143) INTERNATIONAL SOCIETY FOR CARDIOVASCULAR TRASLATIO
5580 LA JOLLA BLVD 605
LA JOLLA,CA92037
77-0682420 501(c)(3) 15,000 0 N/A N/A Community Health
(144) JANUS OF SANTA CRUZ
200 7TH AVE STE 150
SANTA CRUZ,CA950624669
94-2739130 501(c)(3) 48,424 0 N/A N/A Community Health
(145) JDRF INTERNATIONAL
1111 S ARROYO PKWY STE 400
PASADENA,CA91105
23-1907729 501(c)(3) 5,050 0 N/A N/A Community Health
(146) JMJ MATERNITY HOMES
435 W 21ST ST
MERCED,CA95340
20-5611546 501(c)(3) 20,000 0 N/A N/A Community Health
(147) JOURNEY OUT
7136 HASKELL AVE 125
VAN NUYS,CA91406
95-3817864 501(c)(3) 62,012 0 N/A N/A Community Health
(148) JUMA VENTURES
131 STEUART ST STE 201
SAN FRANCISCO,CA94105
94-3203203 501(c)(3) 20,000 0 N/A N/A Community Health
(149) JUSTICE IN AGING
1444 EYE STREET NW STE 1100
WASHINGTON,DC20005
95-3132674 501(c)(3) 12,500 0 N/A N/A Community Health
(150) Keep Memory Alive
888 W BONNEVILLE AVE
LAS VEGAS,NV89106
88-0515534 501(c)(3) 8,000 0 N/A N/A Community Health
(151) KIDS COMMUNITY CLINIC OF BURBANK
400 W ELMWOOD AVE
BURBANK,CA91506
95-4791296 501(c)(3) 20,000 0 N/A N/A Community Health
(152) L A FAMILY HOUSING CORPORATION
7843 LANKERSHIM
HOLLYWOOD,CA91601
95-3920560 501(c)(3) 50,000 0 N/A N/A Community Health
(153) LA CASA DE LAS MADRES
1663 MISSION ST STE 225
SAN FRANCISCO,CA941032400
94-2330864 501(c)(3) 30,005 0 N/A N/A Community Health
(154) LAS VEGAS CHIPS
201 LAS VEGAS BLVD S 1533
LAS VEGAS,CA891010000
38-3971994 501(c)(3) 60,000 0 N/A N/A Community Health
(155) Las Vegas Philharmonic
1412 S JONES BLVD
LAS VEGAS,NV89146
88-0398092 501(c)(3) 5,625 0 N/A N/A Community Health
(156) LATIN CHAMBER OF COMMERCE OF NEVADA INC
300 N 13TH ST
LAS VEGAS,NV891014156
88-0142780 501(c)(6) 5,350 0 N/A N/A Community Health
(157) LEGAL AID SOCIETY OF SAN BERNARDINO
588 W SIXTH ST
SAN BERNARDINO,CA92410
95-1997024 501(c)(3) 75,000 0 N/A N/A Community Health
(158) LEND A HAND OF BOULDER CITY
400 UTAH ST
BOULDER CITY,NV890052620
88-0250959 501(c)(3) 25,000 0 N/A N/A Community Health
(159) LEUKEMIA & LYMPHOMA SOCIETY INC
6280 S VALLEY VIEW SUITE 342
LAS VEGAS,NV89118
13-5644916 501(c)(3) 21,000 0 N/A N/A Community Health
(160) LIFE SKILLS TRAINING AND EDUCATIONAL PROGRAMS INC
4041 BRIDGE ST
FAIR OAKS,CA95628
33-0720982 501(c)(3) 90,000 0 N/A N/A Community Health
(161) LIFEMOVES
181 CONSTITUTION DR
MENLO PARK,CA94025
77-0160469 501(c)(3) 45,000 0 N/A N/A Community Health
(162) LINKS FOR LIFE INC
1706 CHESTER AVENUE 200
BAKERSFIELD,CA93301
93-1088003 501(c)(3) 50,000 0 N/A N/A Community Health
(163) Long Beach Poly High School
1600 Atlantic Ave
Long Beach,CA90813
95-6001886 501(C)(3) 145,681 0 N/A N/A Education Support
(164) LUTHERAN SOCIAL SERVICES OF SOUTHERN CALIFORNIA
435 W ORANGE SHOW LN
SAN BERNARDINO,CA92408
95-2225798 501(c)(3) 80,000 0 N/A N/A Community Health
(165) MAGGIES PLACE INC
4001 N 30TH STREET
PHOENIX,AZ85016
86-0972675 501(c)(3) 79,450 0 N/A N/A Community Health
(166) MARCH OF DIMES FOUNDATION
3550 N CENTRAL AVE SUITE 610
PHOENIX,AZ85012
13-1846366 501(c)(3) 53,950 5,105 cost food Community Health
(167) Marian Regional Medical Center Foundation
1400 E CHURCH Street
SANTA MARIA,CA93454
95-3818027 501(c)(3) 1,025,177 0 N/A N/A Foundation Support
(168) MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
2601 E ROOSEVELT ST
PHOENIX,AZ85008
86-0830701 GOVT 854,167 0 N/A N/A Community Health
(169) MARYS MERCY CENTER
PO BOX 7563
SAN BERNARDINO,CA92411
33-0632426 501(c)(3) 30,300 0 N/A N/A Community Health
(170) MEDSHARE INTERNATIONAL
3240 CLIFTON SPRINGS RD
DECATUR,GA30034
58-2433968 501(c)(3) 50,000 58,448 Cost Medical supplies/equ Community Health
(171) MERCED COMMUNITY COLLEGE DISTRICT
3600 M ST
MERCED,CA95348
77-0362218 GOVT 134,009 0 N/A N/A Education Support
(172) MERCED COUNTY RESUCE MISSION
PO BOX 3319
MERCED,CA95344
77-0284849 501(c)(3) 100,000 0 N/A N/A Community Health
(173) MERCY BEYOND BORDERS
1885 DE LA CRUZ BLVD SUITE 101
SANTA CLARA,CA950503000
26-0323282 501(c)(3) 10,000 0 N/A N/A Community Health
(174) Mercy Foundation
3400 Data Drive
RANCHO CORDOVA,CA95670
23-7072762 501(c)(3) 2,056,258 0 N/A N/A Foundation Support
(175) Mercy Foundation Bakersfield dba Friends of Mercy
PO Box 119
Bakersfield,CA93302
77-0201321 501(c)(3) 1,198,071 0 N/A N/A Foundation Support
(176) Mercy Foundation North
2400 Washington Street Suite 410
Redding,CA96001
94-3136799 501(c)(3) 1,123,021 0 N/A N/A Foundation Support
(177) MERCY HIGH SCHOOL SAN FRANCISCO
3250 Nineteenth Avenue
SAN FRANCISCO,CA94132
94-1231000 501(c)(3) 1,709,250 0 N/A N/A Education Support
(178) MERCY HOUSING INC
4802 E RAY RD SUITE 23
PHOENIX,AZ85044
47-0646706 501(c)(3) 297,500 0 N/A N/A Community Health
(179) Mercy Medical Center Merced Foundation
333 Mercy Avenue
Merced,CA95340
77-0035928 501(c)(3) 605,269 0 N/A N/A Foundation Support
(180) MERCY RETIREMENT CARE CENTER
3431 FOOTHILL BLVD
OAKLAND,CA94601
94-1156579 501(c)(3) 10,000 0 N/A N/A Community Health
(181) MICHIGAN STATE UNIVERSITY
426 AUDITORIUM RD RM 360
EAST LANSING,MI488242600
38-6005984 501(c)(3) 10,000 0 N/A N/A Education Support
(182) MISSION DOLORES ACADEMY
3371 16TH ST
SAN FRANCISCO,CA84114
20-2849575 501(c)(3) 19,400 0 N/A N/A Education Support
(183) MOREHOUSE COLLEGE
830 Westview Dr Sw
ATLANTA,GA30314
58-0566205 501(c)(3) 20,000 0 N/A N/A Education Support
(184) MUSEUM OF THE AFRICAN DIASPORA
685 MISSION ST
SAN FRANCISCO,CA94105
94-3338239 501(c)(3) 175,000 0 N/A N/A Community Health
(185) NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORE
1215 K STREET SUITE 1609
SACRAMENTO,CA95814
95-4617376 501(c)(4) 18,000 0 N/A N/A Community Health
(186) NATIONAL BRAIN TUMOR SOCIETY INC
55 CHAPEL STREET SUITE 200
NEWTON,MA02458
04-3068130 501(c)(3) 15,000 0 N/A N/A Community Health
(187) NATIONAL HEALTH FOUNDATION
515 S FIGUEROA ST SUITE 1300
LOS ANGELES,CA90071
23-7314808 501(c)(3) 240,500 0 N/A N/A Community Health
(188) NATIONAL KIDNEY FOUNDATION INC
30 E 33RD ST
NEW YORK,NY10016
13-1673104 501(c)(3) 11,030 0 N/A N/A Community Health
(189) NATIONAL MULTIPLE SCLEROSIS SOCIETY
5025 E WASHINGTON ST STE 102
PHOENIX,AZ85034
13-5661935 501(c)(3) 21,450 0 N/A N/A Community Health
(190) NEIGHBORS WHO CARE INC
10450 E RIGGS RD SUITE 113
SUN LAKES,AZ85248
86-0966061 501(c)(3) 70,000 0 N/A N/A Community Health
(191) NEURO AND BRAIN COMMUNITY FOUNDATION INC
433 W MONTE CIRLCE
MESA,AZ85210
81-2518553 501(c)(3) 10,000 0 N/A N/A Community Health
(192) NEVADA CLINICAL SERVICES INC
3186 S MARYLAND PKWY
LAS VEGAS,NV89119
45-2211040 N/A 2,896,992 0 N/A N/A Community Health
(193) NORTHERN CALIF CENTER FOR FAMILY AWARENESS
PO BOX 991473
REDDING,CA96003
68-0363217 501(C)(3) 30,000 0 N/A N/A Community Health
(194) NORTHERN SANTA BARBARA COUNTY UNITED WAY
PO BOX 947
SANTA MARIA,CA93456
95-6006513 501(c)(3) 62,771 0 N/A N/A Community Health
(195) Northridge Hospital Foundation
18300 Roscoe Boulevard
Northridge,CA91328
23-7444901 501(c)(3) 1,328,862 0 N/A N/A Foundation Support
(196) ONE DEGREE
2370 MARKET ST STE 162
SAN FRANCISCO,CA941141524
36-4729392 501(c)(3) 75,000 0 N/A N/A Community Health
(197) One In Long Beach Inc
2017 EAST FOURTH STREET
LONG BEACH,CA90814
95-3523149 501(c)(3) 6,000 0 N/A N/A Community Health
(198) ONEGENERATION
17400 VICTORY BLVD
VAN NUYS,CA91406
95-4066979 501(c)(3) 25,000 0 N/A N/A Community Health
(199) OPENHOUSE
1800 MARKET ST PMB 93
SAN FRANCISCO,CA94102
94-3337955 501(c)(3) 9,200 0 N/A N/A Community Health
(200) OPPORTUNITY THROUGH ENTREPRENEURSHIP FOUNDATION
14401 S 24TH WAY
PHOENIX,AZ850489019
20-3779020 501(c)(3) 6,000 0 N/A N/A Community Health
(201) PANETTA INSTITUTE FOR PUBLIC POLICY
100 CAMPUS CENTER BLD 86E
SEASIDE,CA93955
77-0495799 501(c)(3) 12,750 0 N/A N/A Community Health
(202) PARKINSON NETWORK OF ARIZONA INC
240 W THOMAS RD SUITE 302
PHOENIX,AZ85013
45-0545869 501(c)(3) 5,200 0 N/A N/A Community Health
(203) PARTNERS IN ACTION INC
3233 W PEORIA AVE STE 211
PHOENIX,AZ85029
86-0558130 501(c)(3) 20,000 0 N/A N/A Community Health
(204) PARTNERS IN CARE FOUNDATION INC
732 MOTT ST STE 150
SAN FERNANDO,CA91340
95-3954057 501(c)(3) 13,000 0 N/A N/A Community Health
(205) PATHWAYS VOLUNTEER HOSPICE
3701 MICHELSON ST
LAKEWOOD,CA90712
33-0241726 501(c)(3) 65,000 0 N/A N/A Community Health
(206) PEDIATRIC AND FAMILY MEDICAL CENTER
1530 S OLIVE ST
LOS ANGELES,CA90015
95-1690966 501(c)(3) 112,500 0 N/A N/A Community Health
(207) PENINSULA CONFLICT RESOLUTION CENTER
1670 S AMPHLETT BLVD STE 115
SAN MATEO,CA94402
77-0144000 501(c)(3) 21,000 0 N/A N/A Community Health
(208) PENINSULA VOLUNTEERS INC
800 MIDDLE AVE
MENLO PARK,CA94025
94-1294939 501(c)(3) 46,153 0 N/A N/A Community Health
(209) People's Kitchen
186 Moore Ln
Arroyo Grande,CA93420
77-0305498 501(c)(3) 0 6,111 Cost Food Community Health
(210) PHILANTHROPIC VENTURES FOUNDATION
1222 PRESERVATION PARK WAY
OAKLAND,CA94612
94-3136771 501(c)(3) 10,000 0 N/A N/A Community Health
(211) PHOENIX CHILDRENS HOSPITAL FOUNDATION
2929 E CAMELBACK RD STE122
PHOENIX,AZ85016
74-2421549 501(c)(3) 6,250 0 N/A N/A Community Health
(212) PHOENIX SYMPHONY ASSOCIATION
ONE NORTH FIRST ST SUITE 200
PHOENIX,AZ85004
86-6000134 501(c)(3) 15,000 0 N/A N/A Community Health
(213) POOR AND THE HOMELESS TEHAMA COUNTY COALITION
PO BOX 135
RED BLUFF,CA96080
68-0465095 501(c)(3) 7,000 0 N/A N/A Community Health
(214) POSITIVE PATHS
1525 S GREENFIELD RD
MESA,AZ85206
46-4943070 501(c)(3) 9,250 0 N/A N/A Community Health
(215) PROJECT MANA
PO BOX 3824
INCLINE VILLAGE,NV89450
94-3149718 501(c)(3) 10,000 0 N/A N/A Community Health
(216) PUBLIC HEALTH INSTITUTE
1700 TRIBUTE RD
SACRAMENTO,CA958154402
94-1646278 501(c)(3) 45,000 0 N/A N/A Community Health
(217) RED BLUFF ROUND-UP ASSN
PO BOX 1028
RED BLUFF,CA96080
94-6110315 N/A 25,000 0 N/A N/A Community Health
(218) Regents of the University of California at Berkele
2195 Hearts Ave Rm 120
Berkeley,CA94720
94-6002123 501(C)(3) 6,000 0 N/A N/A Education Support
(219) RIGHTCARE FOUNDATION INC
3120 W CAREFREE HWY STE 1-222
PHOENIX,AZ85086
80-0667676 501(c)(3) 50,000 0 N/A N/A Community Health
(220) ROMAN CATHOLIC ARCHBISHOP OF LOS ANGELES A Corpora
3424 WILSHIRE BLVD
LOS ANGELES,CA900102241
95-1642382 501(c)(3) 46,000 0 N/A N/A Community Health
(221) ROTACARE BAY AREA INC
514 Valley Way
MILPITAS,CA95035
77-0328723 501(c)(3) 25,000 0 N/A N/A Community Health
(222) RURAL COMMUNITY ASSISTANCE
3120 FREEBOARD DR SUITE 201
W SACRAMENTO,CA95691
94-2512284 501(c)(3) 22,500 0 N/A N/A Community Health
(223) SACRAMENTO LOAVES AND FISHES
1351 NORTH C ST
SACRAMENTO,CA95811
68-0189897 501(c)(3) 10,000 0 N/A N/A Community Health
(224) SACRAMENTO SELF HELP HOUSING INC
PO BOX 188445
SACRAMENTO,CA95818
68-0217383 501(c)(3) 102,760 0 N/A N/A Community Health
(225) SAN FRANCISCO FORTY NINERS FOUNDATION
4949 MARIE P DEBARTOLO WY
SANTA CLARA,CA95054
77-0287514 501(c)(3) 19,448 0 N/A N/A Community Health
(226) SAN FRANCISCO GENERAL HOSPITAL FOUNDATION
2789 25TH ST SUITE 2028
SAN FRANCISCO,CA94110
94-3189424 501(c)(3) 49,250 0 N/A N/A Community Health
(227) SAN FRANCISCO STATE UNIVERSITY FOUNDATION
1600 HOLLOWAY AVE
SAN FRANCISCO,CA94132
26-1169717 501(c)(3) 25,000 0 N/A N/A Education Support
(228) SENORAS OF EXCELLENCE SENORES OF DISTINCTION
1709 SHADOW MOUNTAIN PL
LAS VEGAS,NV89108
26-4252853 501(c)(3) 6,720 0 N/A N/A Community Health
(229) Sequoia Hospital Foundation
170 Alameda De Las Pulgas
REDWOOD CITY,CA940622799
94-2909990 501(c)(3) 1,457,753 0 N/A N/A Foundation Support
(230) SERVICIO INTERNACIONAL PARA LA PAZ
PO BOX 20067
STANFORD,CA94309
77-0560688 501(c)(3) 10,000 0 N/A N/A Community Health
(231) SHANTI PROJECT
730 POLK ST
SAN FRANCISCO,CA941097813
94-2297147 501(c)(3) 67,005 0 N/A N/A Community Health
(232) SHASTA COUNTY YOUNG MENS CHRISTIAN ASSOCIATION
1155 COURT ST
REDDING,CA96001
94-1212141 501(c)(3) 20,000 0 N/A N/A Community Health
(233) SIERRA HEALTH FOUNDATION CENTER FOR HEALTH PROGRAM
1321 GARDEN HWY 210
SACRAMENTO,CA958339754
45-5282243 501(c)(3) 75,000 0 N/A N/A Community Health
(234) SILICON VALLEY COMMUNITY FOUNDATION
2440 W EL CAMINO REAL
MOUNTAIN VIEW,CA94040
20-5205488 501(c)(3) 22,750 0 N/A N/A Community Health
(235) Simpson College Foundation
2211 COLLEGE VIEW DR
REDDING,CA96003
68-0274677 501(c)(3) 50,000 0 N/A N/A Education Support
(236) SISTERS OF MERCY BURLINGAME
2300 Adeline Drive
BURLINGAME,CA94010
26-2400800 501(c)(3) 17,000 0 N/A N/A Community Health
(237) SISTERS OF MERCY OF THE AMERICAS CCASA COMMUNITY I
8380 COLESVILLE RD STE 300
SILVER SPRING,MD209106264
26-2486726 501(c)(3) 15,000 0 N/A N/A Community Health
(238) Sisters of St Dominic Congregation of the Most Hol
1520 GRAND AVE
SAN RAFAEL,CA949012236
94-6080138 501(c)(3) 25,000 0 N/A N/A Community Health
(239) SISTERS OF ST FRANCIS-MOUNT ALVERNO
1330 BREWSTER AVE
REDWOOD CITY,CA940621312
23-7290790 501(c)(3) 46,100 0 N/A N/A Community Health
(240) SLO NOOR FOUNDATION
1428 PHILLIPS LN SUITE B-4
SAN LUIS OBISPO,CA93401
27-1412176 501(c)(3) 80,000 0 N/A N/A Community Health
(241) SOCIETY OF ST VINCENT DE PAUL PARTICULAR COUNCIL O
50 NORTH B ST
SAN MATEO,CA94401
94-1375833 501(c)(3) 10,000 0 N/A N/A Community Health
(242) SOUTHERN NEVADA AIDS RESEARCH & EDUCATION SOCIETY
6114 W CHARLESTON BLVD
LAS VEGAS,NV89146
88-0388181 501(c)(3) 25,000 0 N/A N/A Community Health
(243) SOUTHERN NEVADA PUBLIC TELEVISION
3050 E FLAMINGO RD
LAS VEGAS,NV89121
23-7169328 501(c)(3) 25,000 0 N/A N/A Community Health
(244) SOUTHWEST HUMAN DEVELOPMENT
2850 N 24TH ST
PHOENIX,AZ85008
86-0407179 501(c)(3) 80,000 0 N/A N/A Community Health
(245) Special Olympics Arizona Inc
2100 S 75th Ave
Phoenix,AZ85043
86-0307564 501(c)(3) 0 5,105 Cost Food Community Health
(246) SPONSORS FOR EDUCATIONAL OPPORTUNITY INC
2030 HARRISON ST 3RD FLR
SAN FRANCISCO,CA94110
13-2578670 501(c)(3) 10,000 0 N/A N/A Community Health
(247) SPUR (SF BAY AREA PLANNING AND URBAN RESEARCH ASSO
654 Mission St
SAN FRANCISCO,CA94105
94-1498232 501(c)(3) 50,000 0 N/A N/A Community Health
(248) ST ALBERTS COLLEGE CORP DBA DOMINICAN SCHOOL OF PH
2301 VINE ST
BERKELEY,CA94708
94-1270354 501(c)(3) 9,150 0 N/A N/A Education Support
(249) ST ANTHONY FOUNDATION
150 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-1513140 501(C)(3) 10,000 0 N/A N/A Community Health
(250) St Bernardine Medical Foundation
2101 N Waterman Avenue
San Bernardino,CA92404
23-7440086 501(c)(3) 740,021 0 N/A N/A Foundation Support
(251) ST JEANNE DE LESTONNAC FREE CLINIC
1215 E CHAPMAN AVE
ORANGE,CA928662237
95-3499011 501(c)(3) 100,750 0 N/A N/A Community Health
(252) St John's Healthcare Foundation
1600 North Rose Avenue
OXNARD,CA93030
20-2865781 501(c)(3) 864,607 0 N/A N/A Foundation Support
(253) ST JOHN'S SEMINARY
5012 SEMINARY RD
CAMARILLO,CA93012
95-1642384 501(c)(3) 13,680 0 N/A N/A Community Health
(254) St Joseph's Foundation
350 W Thomas Road
Phoenix,AZ85013
94-2941245 501(c)(3) 1,622,081 0 N/A N/A Foundation Support
(255) St Mary Medical Center Foundation
1045 Atlantic Avenue
Long Beach,CA90813
23-7153876 501(c)(3) 1,919,682 0 N/A N/A Foundation Support
(256) St Mary's Medical Center Foundation
450 Stanyan Street
San Francisco,CA94117
94-3336143 501(c)(3) 856,058 0 N/A N/A Foundation Support
(257) ST Rose Dominican Health Found
3001 St Rose Parkway
Henderson,NV89052
88-0349432 501(c)(3) 2,850,366 0 N/A N/A Foundation Support
(258) ST VINCENT DE PAUL STORE INC
300 BAKER ST
BAKERSFIELD,CA93305
95-1853364 501(c)(3) 70,880 0 N/A N/A Community Health
(259) STAND UP PLACER INC
PO BOX 5462
AUBURN,CA95604
94-2578871 501(c)(3) 100,000 0 N/A N/A Community Health
(260) STUDENT HEALTH SERVICES SUPPORT FUND
333 S BEAUDRY AVE
LOS ANGELES,CA90017
95-4262448 501(c)(3) 25,000 0 N/A N/A Community Health
(261) STUDENTS SUPPORTING BRAIN TUMOR RESEARCH
8390 E VIA DE VENTURA SUITE F-110
SCOTTSDALE,AZ85258
20-0345903 501(c)(3) 5,360 0 N/A N/A Community Health
(262) SURFING FOR HOPE FOUNDATION
1304 WOODSIDE
SAN LUIS OBISPO,CA93401
36-4762809 501(c)(3) 15,950 0 N/A N/A Community Health
(263) TEHAMA COUNTY
PO BOX 689
RED BLUFF,CA96080
94-6000543 GOVT 5,200 0 N/A N/A Community Health
(264) TEMPE COMMUNITY ACTION AGENCY INC
2146 E APACHE BLVD
TEMPE,AZ85281
86-0254820 501(c)(3) 71,500 0 N/A N/A Community Health
(265) THE COMMONWEALTH CLUB OF CALIFORNIA
555 POST ST
SAN FRANCISCO,CA94102
94-0399260 501(c)(3) 24,000 0 N/A N/A Community Health
(266) THE COMMUNITY SERVICE EDUCATION AND RESEARCH FUND
5380 ELVAS AVE
SACRAMENTO,CA95819
23-7003581 501(c)(3) 35,000 0 N/A N/A Community Health
(267) The Diocese of Monterey Parish and School Operatin
501 Fair Oaks Ave
Arroyo Grande,CA93421
94-1658139 501(c)(3) 0 8,095 Cost Food Community Health
(268) THE GUBBIO PROJECT INC
133 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-2992645 501(c)(3) 10,000 0 N/A N/A Community Health
(269) THE HISTORYMAKERS
1900 S MICHIGAN AVE
CHICAGO,IL60616
36-4328170 501(c)(3) 23,000 0 N/A N/A Community Health
(270) THE LEVERAGE NETWORK INC
200 S WACKER DR STE 3100
CHICAGO,IL60606
47-3517179 501(c)(3) 225,000 0 N/A N/A Community Health
(271) THE NATIONAL COALITION OF 100 BLACK WOMEN INC OAKL
PO BOX 24231
OAKLAND,CA946231231
94-3298877 501(c)(3) 14,400 0 N/A N/A Community Health
(272) The San Francisco Foundation
One Embarcadero Center Suite 1400
SAN FRANCISCO,CA94111
01-0679337 501(c)(3) 100,000 0 N/A N/A Community Health
(273) THIRD BAPTIST FOUNDATION INC
1399 MCALLISTER ST
SAN FRANCISCO,CA94115
32-0021535 501(c)(3) 25,000 0 N/A N/A Community Health
(274) THORN
200 PARK AVE S 8TH FL
NEW YORK,NY10003
27-0943677 501(c)(3) 100,000 0 N/A N/A Community Health
(275) TIDES CENTER
1014 TORNEY AVE
SAN FRANCISCO,CA94129
94-3213100 501(c)(3) 50,000 0 N/A N/A Community Health
(276) TIPPING POINT COMMUNITY
220 MONTGOMERY ST SUITE 850
SAN FRANCISCO,CA94104
20-2121739 501(c)(3) 301,100 0 N/A N/A Community Health
(277) TLCS INC
650 HOWE AVE BLDG 400-A
SACRAMENTO,CA95825
94-2777955 501(c)(3) 100,000 0 N/A N/A Community Health
(278) TOGETHER WE CAN INCORPORATED
715 N TONOPAH DR
LAS VEGAS,NV89106
27-1727391 501(c)(3) 99,503 0 N/A N/A Community Health
(279) TRI COUNTY COMMUNITY NETWORK
37477 MAIN ST
BURNEY,CA96013
91-1841029 501(c)(3) 50,000 0 N/A N/A Community Health
(280) TRIUMPH FOUNDATION
17186 HICKORY RIDGE CT
CANYON COUNTRY,CA91387
26-3295161 501(C)(3) 21,500 0 N/A N/A Community Health
(281) TURNING POINT COMMUNITY PROGRAM
3440 VIKING DR SUITE 114
SACRAMENTO,CA95827
94-2609766 501(c)(3) 100,000 0 N/A N/A Community Health
(282) TYLER ROBINSON FOUNDATION INC
222 S MAIN 5TH FLOOR
SALT LAKE CITY,UT84101
46-2570835 501(c)(3) 8,500 0 N/A N/A Community Health
(283) UNITED NEGRO COLLEGE FUND INC
220 MONTGOMERY ST SUITE 1120
SAN FRANCISCO,CA94104
13-1624241 501(c)(3) 24,150 0 N/A N/A Education Support
(284) UNITED STATES OF CARE CAMPAIGN
PO BOX 32025
WASHINGTON,DC20007
82-2860302 501(c)(3) 100,000 0 N/A N/A Community Health
(285) UNITED STATES VETERANS INITIATIVE
800 W 6TH ST SUITE 1505
LOS ANGELES,CA90017
95-4382752 501(c)(3) 50,000 0 N/A N/A Community Health
(286) UNITED THROUGH EDUCATION
555 BRYANT ST NUM 923
PALO ALTO,CA943011704
81-2483202 501(c)(3) 10,000 0 N/A N/A Community Health
(287) UNITED WAY INC
1150 S OLIVE ST
LOS ANGELES,CA90015
95-2274801 501(c)(3) 25,000 0 N/A N/A Community Health
(288) UNITED WAY OF NORTHERN CALIFORNIA
2280 BENTON DR BLDG B
REDDING,CA96003
94-1251675 501(c)(3) 67,700 0 N/A N/A Community Health
(289) UNITED WAY OF SANTA CRUZ COUNTY
4450 CAPITOLA RD STE 106
CAPITOLA,CA950103570
94-1422471 501(c)(3) 78,787 0 N/A N/A Community Health
(290) University of Arizona
Po Box 3520
Tucson,AZ857223520
74-2652689 GOVT 5,103,405 0 N/A N/A Education Support
(291) UNIVERSITY OF CALIFORNIA SAN FRANCISCO FOUNDATION
220 MONTGOMERY ST
SAN FRANCISCO,CA941430248
94-2829914 501(C)(3) 73,750 0 N/A N/A Education Support
(292) University of Nevada Las Vegas Foundation
4505 MARYLAND PKWY MAIL STOP 451301
LAS VEGAS,NV89154
94-2790134 501(c)(3) 188,420 0 N/A N/A Education Support
(293) URU THE RIGHT TO BE INC
PO BOX 26295
WEST HAVEN,CT065160968
56-2520642 501(c)(3) 15,000 0 N/A N/A Community Health
(294) VALLE DEL SOL INCORPORATED
3807 N 7TH ST
PHOENIX,AZ85014
86-0251255 501(c)(3) 101,560 0 N/A N/A Community Health
(295) VALLEY OF THE SUN UNITED WAY
1515 OSBORN RD
PHOENIX,AZ850145386
86-0104419 501(c)(3) 56,600 0 N/A N/A Community Health
(296) VISION Y COMPROMISO
2536 EDWARSD AVE
EL CERRITO,CA94530
32-0071651 501(c)(3) 55,484 0 N/A N/A Community Health
(297) VMSN INC DBA VOLUNTEERS IN MEDICINE OF SOUTHERN NE
1240 N MARTIN LUTHER KING BLVD
LAS VEGAS,NV89106
39-2072453 501(c)(3) 6,000 0 N/A N/A Community Health
(298) VOLUNTEERS IN MEDICINE SAN FRANCISCO
4877 MISSION ST
SAN FRANCISCO,CA94112
26-2593712 501(c)(3) 9,750 0 N/A N/A Community Health
(299) WEAVE INCORPORATED
1900 K ST
Sacramento,CA95814
94-2493158 501(c)(3) 50,000 0 N/A N/A Community Health
(300) WELLNESS WORKS COMMUNITY HEALTH CENTER
540 W BROADWAY AVE
GLENDALE,CA91204
95-4554824 501(c)(3) 33,160 0 N/A N/A Community Health
(301) Westminster Free Clinic
1000 E Janss Rd
Thousand Oaks,CA91360
77-0563241 501(c)(3) 0 8,249 Cost Medical supplies/equ Community Health
(302) Women's Resource Medical Centers of Southern Nevad
2915 W CHARLESTON BLVD
SUITE 1
LAS VEGAS,NV89102
94-2944732 501(c)(3) 5,300 0 N/A N/A Community Health
(303) Woodland Memorial Hospital Foundation
1321 Cottonwood Street
Woodland,CA95695
94-6167964 501(c)(3) 466,259 0 N/A N/A Foundation Support
(304) YOLO COMMUNITY CARE CONTINUUM
PO BOX 1101
DAVIS,CA95617
94-2623205 501(c)(3) 115,560 0 N/A N/A Community Health
(305) YOLO CRISIS NURSERY INC
1477 DREW AVENUE STE 103
DAVIS,CA95618
47-1006055 501(c)(3) 32,717 0 N/A N/A Community Health
(306) YOLO HEALTHY AGING ALLIANCE
600 A STREET STE C
DAVIS,CA95616
46-1075195 501(c)(3) 15,000 0 N/A N/A Community Health
(307) YOUNG MENS CHRISTIAN ASSOCIATION OF SAN FRANCISCO
50 CALIFORNIA ST STE 650
SAN FRANCISCO,CA94111
94-0997140 501(c)(3) 15,000 0 N/A N/A Community Health
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
301
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
6
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2019

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) DIRECT CASH ASSISTANCE 31 26,000 0 n/a n/a
(2) FINANCIAL ASSISTANCE FOR COMMUNITY PROGRAMS 161 135,055 0 n/a n/a
(3) FINANCIAL ASSISTANCE TO PATIENTS/NEEDY 7762 726,063 0 n/a n/a
(4) SCHOLARSHIP 87 242,840 0 n/a n/a
(5) DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY 9755 0 53,236 cost clothing, car seats
(6) MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS 151 0 14,979 cost medical supplies
(7) PHARMACY CHARITY PRESCRIPTION 443 0 38,134 cost pharmaceuticals
(8) PROVISION OF FOOD/MEALS 49763 0 345,611 cost food/meals
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Part I, line 1 INCLUDED IN PART II ABOVE IS $5,442,609 RELATED TO The Dignity Health Community Grants program. THIS PROGRAM IS one way in which Dignity Health supports and enhances the advocacy, social justice and healthier communities efforts of its hospitals and the religious sponsors of our Catholic hospitals. Begun in 1990, the program's initial objectives were: (1) to strengthen the bonds among our member hospitals; and (2) to partner with other nonprofit organizations that share our values and work to improve the health status and quality of life in the communities we serve. Each of the grant recipients is required to submit an annual accountability report to Dignity Health. The reports reflect activities performed, objectives, and outcomes reached by the grant recipientS. All organizations that apply for these grants are required to be 501(c)(3) organizations. OTHER GRANTS ARE PROVIDED BY Dignity Health (AND ITS MEMBER HOSPITALS) TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER Dignity Health'S EXEMPT PURPOSE. GRANTS ARE ALSO PROVIDED TO THE FUNDRAISING FOUNDATIONS THAT SUPPORT Dignity Health AND ITS MEMBER HOSPITALS TO FUND THE OPERATIONS OF THOSE FOUNDATIONS. Several grants are provided to other organizations in which Dignity Health supports community effort, and for operational support of the medical foundation and clinics. In addition, grants are provided to individuals, primarily patients, due to financial need or urgent, unforeseen occurrences requiring immediate action. Examples of assistance include transportation costs to a hospital for treatment, pharmacy costs for indigent patients, and sheltered meals. The grants are approved by the hospital's Administration department or a designated committee.
Part II $17,845,125 IN GRANT PAYMENTS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST, A 501(C)(3) PUBLIC BENEFIT CHARITY ESTABLISHED TO SPONSOR AND SUPPORT HEALTH CARE, WERE RECOGNIZED IN CONNECTION WITH THE CALIFORNIA PROVIDER FEE PROGRAMS IN FISCAL YEAR 2018. $5,103,405 IN GRANT PAYMENTS WERE PROVIDED TO THE UNIVERSITY OF ARIZONA, A GOVERNMENT INSTITUTION, TO SUPPORT THE DEVELOPMENT OF EDUCATION, TRAINING AND CLINICAL RESEARCH PROGRAMS. $11,000,000 IN GRANT PAYMENTS WERE PROVIDED TO THE ARIZONA STATE UNIVERSITY, A GOVERNMENT INSTITUTION, TO SUPPORT THE EDUCATION, TRAINING AND RESEARCH IN THE ADVANCEMENT OF IMAGING TECHNOLOGY AND DESIGN, BUILDING A HEALTHY CLINICAL FORCE AND ADVANCING THE UNDERSTANDING OF IMMUNOLOGY IN TRANSPLANTATION MEDICINE.
Schedule I (Form 990) 2019



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet 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
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes 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 .........
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1Ian Boase
VP & Associate General Counsel
(i)

(ii)
370,317
-------------
0
277,328
-------------
0
246,193
-------------
0
59,629
-------------
0
46,018
-------------
0
999,485
-------------
0
230,375
-------------
0
2Lloyd H Dean
President /CEO
(i)

(ii)
1,787,802
-------------
0
7,604,203
-------------
0
2,535,524
-------------
0
1,385,625
-------------
0
104,329
-------------
0
13,417,483
-------------
0
2,492,734
-------------
0
3Rick Grossman
EVP, General Counsel
(i)

(ii)
662,298
-------------
0
1,463,337
-------------
0
2,433,971
-------------
0
343,394
-------------
0
74,853
-------------
0
4,977,853
-------------
0
2,419,526
-------------
0
4Diane Lee
VP & Associate General Counsel
(i)

(ii)
168,858
-------------
0
248,421
-------------
0
357,449
-------------
0
41,232
-------------
0
23,721
-------------
0
839,681
-------------
0
313,108
-------------
0
5Daniel J Morissette
SEVP, Chief Financial Officer
(i)

(ii)
941,800
-------------
0
1,361,599
-------------
0
6,631
-------------
0
409,527
-------------
0
47,065
-------------
0
2,766,622
-------------
0
0
-------------
0
6Marvin O'Quinn
SEVP, Chief Operating Officer
(i)

(ii)
1,192,534
-------------
0
2,445,622
-------------
0
467,699
-------------
0
591,218
-------------
0
67,160
-------------
0
4,764,233
-------------
0
348,151
-------------
0
7Elizabeth Shih
EVP, Chief Administrative Offi
(i)

(ii)
803,846
-------------
0
1,217,362
-------------
0
121,255
-------------
0
168,652
-------------
0
87,183
-------------
0
2,398,298
-------------
0
21,528
-------------
0
8Brian G Brannman
SVP Operations, Nevada
(i)

(ii)
182,326
-------------
0
412,120
-------------
0
595,144
-------------
0
47,437
-------------
0
20,250
-------------
0
1,257,277
-------------
0
0
-------------
0
9Keith Callahan
SVP, Supp & Srvcs Resources Mg
(i)

(ii)
404,356
-------------
0
439,804
-------------
0
235,505
-------------
0
75,712
-------------
0
40,357
-------------
0
1,195,734
-------------
0
193,532
-------------
0
10Mary Connick
SVP, Finance, Corporate Contro
(i)

(ii)
427,189
-------------
0
463,139
-------------
0
317,711
-------------
0
78,836
-------------
0
46,385
-------------
0
1,333,260
-------------
0
307,671
-------------
0
11Charles Cova
SVP Operations, Central Coast
(i)

(ii)
519,793
-------------
0
618,834
-------------
0
913,227
-------------
0
98,544
-------------
0
38,431
-------------
0
2,188,829
-------------
0
878,937
-------------
0
12Charles P Francis
SEVP, Chief Strategy Officer
(i)

(ii)
813,687
-------------
0
1,232,844
-------------
0
518,673
-------------
0
170,973
-------------
0
65,289
-------------
0
2,801,466
-------------
0
500,875
-------------
0
13Lisa Gamshad Zuckerman
SVP Treasury & Strategic Inves
(i)

(ii)
455,752
-------------
0
586,256
-------------
0
6,504
-------------
0
91,067
-------------
0
52,759
-------------
0
1,192,338
-------------
0
0
-------------
0
14Laurie Harting
SVP Operations, Greater Sacram
(i)

(ii)
637,489
-------------
0
574,920
-------------
0
44,090
-------------
0
103,890
-------------
0
40,145
-------------
0
1,400,534
-------------
0
0
-------------
0
15Linda Hunt
SVP Operations, Arizona
(i)

(ii)
629,319
-------------
0
641,380
-------------
0
387,237
-------------
0
108,939
-------------
0
55,736
-------------
0
1,822,611
-------------
0
353,031
-------------
0
16Elizabeth I Keith
EVP/Sponsorship/Mission Integr
(i)

(ii)
567,471
-------------
0
800,547
-------------
0
208,461
-------------
0
245,245
-------------
0
53,568
-------------
0
1,875,292
-------------
0
0
-------------
0
17Mark Korth
SVP Operations, North State/ E
(i)

(ii)
576,677
-------------
0
666,346
-------------
0
94,068
-------------
0
106,376
-------------
0
49,258
-------------
0
1,492,725
-------------
0
0
-------------
0
18Jeffrey W Land
SVP, Corporate Real Estate
(i)

(ii)
360,792
-------------
0
392,298
-------------
0
7,291
-------------
0
67,836
-------------
0
55,011
-------------
0
883,228
-------------
0
0
-------------
0
19Timothy Panks
SVP, Finance & Revenue Cycle M
(i)

(ii)
380,389
-------------
0
321,137
-------------
0
5,946
-------------
0
63,521
-------------
0
46,093
-------------
0
817,086
-------------
0
0
-------------
0
20Darryl Robinson
EVP, Chief Human Resource Offi
(i)

(ii)
703,726
-------------
0
1,391,589
-------------
0
61,883
-------------
0
358,273
-------------
0
51,034
-------------
0
2,566,505
-------------
0
0
-------------
0
21Karl Silberstein
SVP, Financial Operations
(i)

(ii)
606,222
-------------
0
608,712
-------------
0
26,546
-------------
0
104,372
-------------
0
51,508
-------------
0
1,397,360
-------------
0
0
-------------
0
22Julie Sprengel
SVP Operation, So Cal
(i)

(ii)
625,735
-------------
0
402,025
-------------
0
12,699
-------------
0
89,463
-------------
0
13,933
-------------
0
1,143,855
-------------
0
0
-------------
0
23Todd A Strumwasser MD
SVP Operations, Bay Area
(i)

(ii)
604,407
-------------
0
860,887
-------------
0
18,182
-------------
0
124,078
-------------
0
52,948
-------------
0
1,660,502
-------------
0
0
-------------
0
24Jon VanBoening
SVP Operations, Central Valley
(i)

(ii)
594,532
-------------
0
608,434
-------------
0
234,341
-------------
0
103,196
-------------
0
81,992
-------------
0
1,622,495
-------------
0
181,650
-------------
0
25Robert Wiebe MD
EVP, Chief Medical Officer
(i)

(ii)
796,718
-------------
0
1,142,093
-------------
0
1,249,288
-------------
0
334,733
-------------
0
33,360
-------------
0
3,556,192
-------------
0
1,237,178
-------------
0
26Tammara Wilcox
SVP, Managed Care
(i)

(ii)
473,981
-------------
0
516,004
-------------
0
9,010
-------------
0
86,563
-------------
0
43,633
-------------
0
1,129,191
-------------
0
0
-------------
0
27Deanna Wise
EVP, Chief Information Officer
(i)

(ii)
651,457
-------------
0
1,334,986
-------------
0
6,904
-------------
0
351,979
-------------
0
34,745
-------------
0
2,380,071
-------------
0
0
-------------
0
28Anthony Scott Carswell
SVP Corporate Strategy & Growt
(i)

(ii)
498,274
-------------
0
524,644
-------------
0
13,770
-------------
0
89,229
-------------
0
53,531
-------------
0
1,179,448
-------------
0
0
-------------
0
29Edmundo Castaneda
Hospital President
(i)

(ii)
496,762
-------------
0
440,088
-------------
0
15,878
-------------
0
82,111
-------------
0
36,538
-------------
0
1,071,377
-------------
0
0
-------------
0
30Benjie M Loanzon
SVP Finance Transformation
(i)

(ii)
522,268
-------------
0
442,485
-------------
0
14,416
-------------
0
84,835
-------------
0
55,493
-------------
0
1,119,497
-------------
0
0
-------------
0
31Bruce Swartz
SVP Physician Integration
(i)

(ii)
467,663
-------------
0
495,135
-------------
0
27,306
-------------
0
84,476
-------------
0
36,319
-------------
0
1,110,899
-------------
0
0
-------------
0
32Donald J Wiley
Hospital President
(i)

(ii)
434,456
-------------
0
312,207
-------------
0
538,848
-------------
0
67,652
-------------
0
46,515
-------------
0
1,399,678
-------------
0
515,242
-------------
0
33Steven Barron
Former KE
(i)

(ii)
0
-------------
0
0
-------------
0
1,247,391
-------------
0
0
-------------
0
0
-------------
0
1,247,391
-------------
0
241,596
-------------
0
34Bernita McTernan
Former KE
(i)

(ii)
0
-------------
0
0
-------------
0
163,102
-------------
0
0
-------------
0
0
-------------
0
163,102
-------------
0
163,102
-------------
0
Schedule J (Form 990) 2019

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
Sch J, PART I, LINES 1A, 4A, & 4B PART I, 1A First class and charter travel and upgrades to such are treated on an exception basis according to Dignity Health policy. Such first class and charter travel were provided to four officers and three key employees. No amounts have been included as reportable compensation as these travel expenses were incurred for business purposes. Tax gross-up payments were provided to eight board members, two board members/officers, five officers and six key employees. These gross up payments were included as taxable compensation to the listed persons. Housing allowance was provided to one highest paid employee. This payment was included as taxable compensation to the listed person. Club dues have been paid by Dignity Health for business use by three key employees. No amount has been paid for club dues for officers. Dignity Health does not pay or reimburse for any health club memberships. No amounts have been reported as income. Security services, including vehicles and drivers, are provided to an officer pursuant to a qualified security assessment. No amounts have been reported as income. PART I, 4A Dignity Health's key employees and officers and certain highly compensated employees participate in a severance plan that provides market-standard compensation, ranging from payments of 1 to 2 years of base compensation, depending on the executive's position, in the event of a position elimination or other involuntary termination, in accordance with the guidelines of the plan. Payments pursuant to the plan arrangement for one current key employee and one former key employee occurred during 2017 include B. Brannman, $497,846 and S. Barron, $1,005,795. PART I, 4B Certain officers and key employees participate in the Dignity Health Excess Benefit Plan, a nonqualified supplemental benefit plan limited to participants in the Dignity Health Retirement Plan whose benefits are affected by the limitations imposed by sections 401(a)(17) and 415 of the Internal Revenue Code. Benefit service under this plan was frozen as of January 1, 2008. Payment pursuant to the plan arrangement for one former key employee occurred during 2017 include S. Barron, $231,857. Dignity Health's key employees and certain officers and highly compensated employees are eligible to participate in non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. Benefits vest under this 457(f) plan at the later of the date the participant attains age 62 or is credited with 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service. The plan also allows for special awards. Payments pursuant to the plan arrangements for five officers, six key employees, one highest compensated employee and one former key employee occurred during 2017 include I. Boase, $80,043; L. Dean, $2,492,734; R. Grossman, $2,286,892; D. Lee, $313,108; M. O'Quinn, $348,151; K. Callahan, $193,532; M. Connick, $307,671, C. Cova, $878,937; L. Hunt, $241,160; J. VanBoening, $181,650; R. Weibe, $1,237,178; D. Wiley, $187,924 and S. Barron, $9,739. Certain listed persons participate in the Dignity Health Key Employee Share Option Plan (KeySOP), which was frozen in May 2002. The KeySOP program was established in 2001 with the purpose of providing income deferral opportunities to employees eligible for the company's key employee retention program. Payments pursuant to the plan for two officers, one key employee, one highest compensated employee and one former key employee occurred during 2017 include I. Boase, $150,332; R. Grossman, $132,634; L. Hunt, $111,872; D. Wiley, $327,318 and B. McTernan, $163,102. Certain officers and key employees participate in the Dignity Health Supplemental Executive Retention/Retirement Plan, a nonqualified supplemental benefit plan which in 2002 was offered to members of the executive management team by the Dignity Health Board of Directors and would be paid only if the executives stayed with the organization for a specified number of years as the primary purpose of this plan is to provide for the retention and retirement of the participants. The executive management team is recruited from stable careers in organizations from across the country and from various industries. Duties are both extensive and complex and require substantial and diverse experience and skill sets to execute successfully. The calculation for the payments to each executive are based on the value of a final average pay annuity benefit based on retirement age and service years to the organization. Distribution occurs each July 1 if the plan formula warrants a payment. Payments made during 2017 pursuant to this plan include E. Shih; $21,528; and C. Francis, $500,875. Compensation amounts for the supplemental nonqualified retirement plans discussed above are reported as deferred compensation in the year accrued (Schedule J, Part II, column C) and are reflected again as reportable compensation in the year paid (Schedule J, Part II, column B(iii)).
Sch J - PART II Dignity Health's executive compensation philosophy is designed to assist Dignity Health in attracting and retaining the caliber of executives required to enable Dignity Health to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities Dignity Health serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain healthcare quality standards and Dignity Health's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size, revenues and complexity. Payments pursuant to a long-term financial performance goal were paid in calendar year 2017.
Schedule J (Form 990) 2019

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PRT VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.220 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.920 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2016, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY FINANCING AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS, AND IN NOVEMBER 2009 THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41 WHICH DID NOT TREAT THE EXCHANGE AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2014, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2009, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND T: CUSIP 13032ULN6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CSCDA 2007 SERIES KL (ISSUED APRIL 26, 2007); CSCDA 2007 SERIES GHIJ (EXCHANGED TO CSCDA 2008 SERIES ABDE BONDS ON MAY 16, 2008).
Schedule K (Form 990) 2019

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PRT VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.220 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.920 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2016, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY FINANCING AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS, AND IN NOVEMBER 2009 THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41 WHICH DID NOT TREAT THE EXCHANGE AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2014, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2009, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND T: CUSIP 13032ULN6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CSCDA 2007 SERIES KL (ISSUED APRIL 26, 2007); CSCDA 2007 SERIES GHIJ (EXCHANGED TO CSCDA 2008 SERIES ABDE BONDS ON MAY 16, 2008).
Schedule K (Form 990) 2019

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PRT VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.220 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.920 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2016, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY FINANCING AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS, AND IN NOVEMBER 2009 THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41 WHICH DID NOT TREAT THE EXCHANGE AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2014, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2009, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND T: CUSIP 13032ULN6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CSCDA 2007 SERIES KL (ISSUED APRIL 26, 2007); CSCDA 2007 SERIES GHIJ (EXCHANGED TO CSCDA 2008 SERIES ABDE BONDS ON MAY 16, 2008).
Schedule K (Form 990) 2019

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

SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number
94-1196203
Part
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FRT9 04-28-2004 470,300,483 BOND A: CUSIP 13033FRT9-SEE PRT VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1598225 13033FTN0 05-19-2004 150,000,000 BOND B: CUSIP 13033FTN0-SEE PRT VI   X   X X  
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033FYE4 11-10-2005 200,000,000 BOND C: CUSIP 13033FYE4-SEE PRT VI   X   X X  
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507GL3 11-10-2005 224,000,000 BOND D: CUSIP 040507GL3-SEE PRT VI   X   X X  
CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E: CUSIP 130795DH7-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JJ4 05-14-2009 127,153,706 BOND K: CUSIP 566816JJ4-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LEQ6 11-12-2009 235,106,175 BOND L: CUSIP 13033LEQ6-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MJ1 11-12-2009 75,689,293 BOND M: CUSIP 040507MJ1-SEE PRT VI X     X   X
THE INDUSTRIAL DEVLPMT AUTH OF CNTY OF MARICOPA AZ
 
86-0445263 566816JL9 07-14-2011 115,008,059 BOND N: CUSIP 566816JL9-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PRT VI X     X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MU6 11-09-2011 125,000,601 BOND P: CUSIP 040507MU6-SEE PRT VI X     X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PRT VI   X   X   X
ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 040507MV4-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PRT VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PRT VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 395,000 0 0 0
2 Amount of bonds legally defeased .............. 441,080,000 0 0 0
3 Total proceeds of issue .................. 473,074,676 143,120,259 162,665,635 224,006,108
4 Gross proceeds in reserve funds ............. 0 0 0 0
5 Capitalized interest from proceeds ............. 6,640,000 0 0 0
6 Proceeds in refunding escrows ............... 0 0 0 0
7 Issuance costs from proceeds ............... 4,074,727 0 0 0
8 Credit enhancement from proceeds ............. 25,069,705 0 0 0
9 Working capital expenditures from proceeds ............. 7,774,340 0 0 0
10 Capital expenditures from proceeds ............. 0 143,120,259 162,665,635 224,006,108
11 Other spent proceeds ............. 429,515,904 0 0 0
12 Other unspent proceeds ............. 0 0 0 0
13 Year of substantial completion ............. 2004 2007 2010 2007
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue of tax-exempt
bonds (or, if issued prior to 2018, a current refunding issue)? ........
               
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2018, an advance refunding issue)? ........
               
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
Part
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ............... X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 2
Part
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? ............. X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? ............. X   X   X   X  
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? X   X   X   X  
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....SchKMediumBullet 0 % 1.220 % 1.500 % 0.800 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government ......... SchKMediumBullet 0 % 0.700 % 1.300 % 0 %
6 Total of lines 4 and 5 ............. 0 % 1.920 % 2.800 % 0.800 %
7 Does the bond issue meet the private security or payment test? ...   X   X   X   X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. .. 0 % 0 % 0 % 0 %
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   X   X  
Part
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...   X   X   X   X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X   X
b Exception to rebate? ........   X   X   X   X
c No rebate due? ......... X   X   X   X  
If "Yes" to line 2c, provide in Part the date the rebate
computation was performed ......
3 Is the bond issue a variable rate issue? ..... X   X   X   X  
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X     X   X   X
b Name of provider .......... CITIGROUP & JPMORGAN
 
0
 
0
 
0
 
c Term of hedge ......... 2120 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
Schedule K (Form 990) 2019

Schedule K (Form 990) 2019
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? X     X   X   X
b Name of provider .......... LEHMAN BROTHERS
 
0
 
0
 
0
 
c Term of GIC ......... 2220 %      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........ X              
6 Were any gross proceeds invested beyond an available temporary period? X   X   X   X  
7 Has the organization established written procedures to monitor the requirements of section 148? ... X   X   X   X  
Part
Procedures To Undertake Corrective Action
--------------------------------------------------------------------------------------------------------------- A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
BOND A: CUSIP 13033FRT9 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY ("CHFFA") 1988 AB (ISSUED JUNE 23, 1988) CHFFA 1992 A (ISSUED SEPTEMBER 1, 1992); CHFFA (ST. JOSEPH'S) 1993 A (ISSUED JANUARY 4, 1994); CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITIES ("CSCDA") 1993 A CERTIFICATES OF PARTICIPATION ("COPS") (ISSUED AUGUST 12, 1993); CHFFA 1994 AB (ISSUED JANUARY 27, 1994); CHFFA 1996 B (ISSUED MAY 30, 1996); CHFFA 1996 CD (ISSUED MAY 30, 1996); CHFFA 1996 F (ISSUED DECEMBER 12, 1996); CHFFA 1997 ABC (ISSUED OCTOBER 15, 1997); CHFFA 1998 A (ISSUED DECEMBER 3, 1998). PART I, COLUMN (G) $4.1 MILLION OF THE CHFFA 2004 H WAS DEFEASED IN 2005. THE FIRST CALL DATE WAS 7/1/2011. THESE BONDS WERE DEFEASED WITH A TAXABLE LINE OF CREDIT. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO EACH SUCH SERIES, SUCH HEDGES WERE DEEMED TERMINATED APRIL 25, 2008 (NV 2005 SERIES A BONDS WERE RETIRED WITH A DRAW ON A TAXABLE LINE OF CREDIT), MAY 16, 2008 (CHFFA 2004 SERIES B BONDS AND CHFFA 2005 SERIES ABCEF BONDS WERE EXCHANGED WITHOUT A REISSUANCE WITH FIXED RATE BONDS) AND NOVEMBER 12, 2009 (UPON REFINANCING OF THE CHFFA 2005 SERIES D WHICH WERE LATER EXCHANGED FOR CHFFA 2008 SERIES F AND AHFA 2005 SERIES A WHICH WERE EXCHANGED FOR AHFA 2008 SERIES D) AS A RESULT OF EITHER THE REFINANCING OF ONE OR MORE OF THESE SERIES OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF ONE OR MORE OF THESE SERIES INTO LONG-TERM FIXED RATE BONDS. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH (FORMERLY CATHOLIC HEALTHCARE WEST), WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED. PART IV, LINE 5C ALTHOUGH THE DEBT SERVICE RESERVE FUNDS FOR THE ABOVE SERIES WERE INVESTED IN GICS WITH LEHMAN BROTHERS AS PROVIDER, THE GICS WITH LEHMAN BROTHERS WERE SUBSEQUENTLY TERMINATED. AS A RESULT, THE DEBT SERVICE RESERVE FUNDS ARE NO LONGER INVESTED IN GICS.
BOND B: CUSIP 13033FTN0 PART I, COLUMN (C) THE CHFFA 2004 SERIES J BONDS WERE EXCHANGED IN NOVEMBER 2009 FOR THE CHFFA 2009 SERIES H BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN MAY 2013, ALL OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $143,112,407 TO FINANCE THE CONSTRUCTION/RENOVATION OF FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2016, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND C: CUSIP 13033FYE4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 IN OCTOBER 2012, CERTAIN LOANS ORIGINATED WITH PROCEEDS OF THE BONDS MATURED AND WERE REPAID TO THE ISSUER. OF SUCH REPAYMENTS, DIGNITY HEALTH BORROWED THE SUM OF $147,665,635 TO FINANCE THE CONSTRUCTION/RENOVATION OF THE FACILITIES AND THE ACQUISITION OF MEDICAL EQUIPMENT AT VARIOUS HOSPITALS. ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF A LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND D: CUSIP 040507GL3 PART I, COLUMN (C) THE ARIZONA HEALTH FACILITY FINANCING AUTHORITY (AHFA) 2005 SERIES CDE BONDS WERE EXCHANGED IN MAY 2008 FOR THE AHFA 2008 SERIES ABC BONDS, AND IN NOVEMBER 2009 THE AHFA 2008 SERIES C BONDS WERE EXCHANGED PURSUANT TO NOTICE 2008-41 WHICH DID NOT TREAT THE EXCHANGE AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. AHFA 2005 SERIES BCDE, OF WHICH AHFA 2005 SERIES CDE WERE EXCHANGED FOR AHFA 2008 SERIES ABC, OF WHICH AHFA 2008 SERIES C WAS EXCHANGED FOR AHFA 2009 SERIES F. THE CUSIP NUMBER NOTED ON SCHEDULE K '040507GL3' IS THE CUSIP FROM THE ORIGINAL FORM 8038 FILED FOR THE 2005 SERIES BCDE BONDS, ALL OF WHICH WERE ISSUED ON NOVEMBER 10, 2005. ON MAY 16, 2008, THE AHFA 2005 CDE BONDS WERE EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR AHFA 2008 SERIES ABC. THE AHFA 2008 SERIES C BONDS WERE LATER EXCHANGED, PURSUANT TO IRS NOTICE 2008-41, WITHOUT CAUSING A REISSUANCE, FOR THE AHFA 2009 SERIES F BONDS ON NOVEMBER 12, 2009. ALL THE SERIES NOTED ABOVE HAVE THE SAME MATURITY OF JULY 1, 2035. THE CUSIPS OF THE OUTSTANDING BONDS ARE AHFA 2005 SERIES B '040507GM1', AHFA 2008 A '040507JT3', AHFA 2008 B '040507JU0AHFA 2009 SERIES F '040507MK8.' PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS PRIMARILY A RESULT OF THE FACT THAT THE COMPOSITE BOND ISSUE WAS A POOLED FINANCING ISSUE, THE FULL ISSUE PRICE OF WHICH IS SHOWN IN PART I, COLUMN (E). IN COMPARISON, THE AMOUNT OF PROCEEDS SHOWN ON PART II, LINE 3 REFLECTS ONLY THE PORTION OF THE BOND ISSUE BORROWED BY DIGNITY HEALTH AND CURRENTLY OUTSTANDING. A SMALL PART OF THE DIFFERENCE BETWEEN THE ISSUE PRICE AND PROCEEDS IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE THE ACQUISITION OF MEDICAL EQUIPMENT AND CONSTRUCTION AND RENOVATION OF HOSPITAL FACILITIES. PART II, LINE 3 ALTHOUGH THE FACILITIES ORIGINALLY FINANCED WITH PROCEEDS OF THE BONDS WERE SUBSTANTIALLY COMPLETED IN THE YEAR INDICATED, REPAYMENTS OF THE LOANS ORIGINATED WITH PROCEEDS OF THE BONDS WERE AND/OR WILL BE RECYCLED INTO NEWLY ORIGINATED LOANS CONTINGENT ON DEMAND BY PARTICULAR BORROWERS AT THE TIME OF THE LOAN REPAYMENT. COMPLETION DATES OF PROJECTS FINANCED OR TO BE FINANCED WITH SUCH RECYCLED AMOUNTS ARE NOT INDICATED. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 1/28/2015, IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND E: CUSIP 130795DH7 PART I, COLUMN (C) THE CSCDA 2007 SERIES ABC BONDS WERE EXCHANGED IN MAY 2008 FOR THE CSCDA 2008 SERIES CFG BONDS IN AN EXCHANGE PURSUANT TO NOTICE 2008-41 THAT WAS NOT TREATED AS A NEW ISSUANCE FOR PURPOSES OF SECTIONS 103 AND 141-150 OF THE INTERNAL REVENUE CODE. PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND PRIOR BOND ISSUES - CA 1995 SERIES A (ISSUED MAY 25, 1995); CA 1996 SERIES A (ISSUED MAY 30, 1996); AND CA 1999 SERIES A (ISSUED DECEMBER 9, 1999); AND TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE. PART IV, LINE 4A ALTHOUGH AT THE TIME OF SALE OF THE ABOVE SERIES OF BONDS, HEDGES WERE PROPERLY IDENTIFIED WITH RESPECT TO CSCDA 2007 SERIES ABC, SUCH HEDGES WERE DEEMED TERMINATED MAY 16, 2008 (CSCDA 2007 SERIES A WERE LATER EXCHANGED FOR CSCDA 2008 SERIES C FIXED RATE BONDS), MAY 14, 2009 (CSCDA 2007 SERIES C WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES G AND LATER REFINANCED TO CHFFA 2009 SERIES A FIXED RATE BONDS) AND NOVEMBER 12, 2009 (CSCDA 2007 SERIES B WERE EXCHANGED WITHOUT A REISSUANCE FOR CSCDA 2008 SERIES F AND LATER REFINANCED WITH CHFFA 2009 SERIES G PUT BONDS) AS A RESULT OF EITHER THE REFINANCING OF THESE BONDS OR THE EXCHANGE (WITHOUT A REISSUANCE) AND CONVERSION OF THESE BONDS INTO LONG-TERM FIXED-RATE BONDS. THE CSCDA DEF BONDS ARE STILL OUTSTANDING AND CONTINUE TO HAVE HEDGES ASSOCIATED WITH THEM. PART IV, LINE 4E ALTHOUGH NONE OF THE INTEREST RATE SWAPS (EACH A "SWAPCOLLECTIVELY THE "SWAPS") ENTERED INTO WITH RESPECT TO CERTAIN OF THE BOND ISSUES SET FORTH IN SCHEDULE K WERE ACTUALLY TERMINATED BY EITHER DIGNITY HEALTH, WHICH WAS THE PARTY TO THE SWAP, OR BY THE COUNTERPARTY TO THE PARTICULAR SWAP, EACH SWAP WAS DEEMED TERMINATED PURSUANT TO SECTION 1.148-4(H)(3)(IV)(A) OF THE TREASURY REGULATIONS AT THE TIME SUCH SWAP CEASED TO BE A "QUALIFIED HEDGE" WITH RESPECT TO THE BONDS WITH WHICH IT WAS ASSOCIATED.
BOND K: CUSIP 566816JJ4 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFINANCE TAXABLE LINE OF CREDIT USED TO REFINANCE INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2004 SERIES B BONDS ISSUED ON APRIL 28, 2004. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2014, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND L: CUSIP 13033LEQ6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 2008 SERIES ABF; AND CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2008 SERIES F BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND M: CUSIP 040507MJ1 PART I, COLUMN (F) REFUND ARIZONA HEALTH FACILITIES AUTHORITY 2008 SERIES D BONDS ISSUED ON MAY 16, 2008. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2011, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND N: CUSIP 566816JL9 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1992 SERIES A BONDS ISSUED ON SEPTEMBER 1, 1992 AND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. PART IV, LINE 2C AS OF THIS BOND ISSUE'S PRIOR REBATE COMPUTATION DATE OF 6/30/2009, IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT.
BOND P: CUSIP 040507MU6 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) TO FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND Q: CUSIP 13033LUD7 PART I, COLUMN (F) REFUND CHFFA 2009 SERIES BC BONDS ISSUED ON MAY 14, 2009 AND CHFFA 2009 SERIES G BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND R: CUSIP 040507MV4 PART I, COLUMN (F) REFUND INDUSTRIAL DEVELOPMENT AUTHORITY OF MARICOPA COUNTY ARIZONA 2009 SERIES B BONDS ISSUED ON MAY 14, 2009 AND ARIZONA HEALTH FACILITIES FINANCING AUTHORITY 2009 SERIES E BONDS ISSUED ON NOVEMBER 12, 2009. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 6/30/2018, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
BOND S: CUSIP 13033L4V6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CHFFA 2005 SERIES BCDEF (EXCHANGED TO CHFFA 2008 SERIES HIJKL BONDS IN MAY 16, 2008), CURRENT REFUND PRIOR BOND ISSUES - CHFFA 2004 SERIES G AND REFINANCE AMOUNTS ON A BANK LINE OF CREDIT THAT WERE USED TO PAY OFF CHFFA 2004 SERIES I, CHFFA 2009 SERIES D AND CHFFA 2009 SERIES F PUT BONDS. THE ADVANCED REFUNDED BONDS REFUNDED PRIOR BOND ISSUES - CHFFA 1988 SERIES A (ISSUED DECEMBER 3, 1998); CHFFA 1995 SERIES H (ISSUED MAY 25, 1995); CHFFA 1997 SERIES A (ISSUED OCTOBER 15, 1997); CHFFA 1998 SERIES A (ISSUED DECEMBER 3, 1998); CSCDA 1999 (ISSUED DECEMBER 9, 1999) AND FINANCE CAPITAL EXPENDITURES AT VARIOUS HOSPITAL FACILITIES.
BOND T: CUSIP 13032ULN6 PART I, COLUMN (F) ADVANCE REFUNDED PRIOR BOND ISSUES - CSCDA 2007 SERIES KL (ISSUED APRIL 26, 2007); CSCDA 2007 SERIES GHIJ (EXCHANGED TO CSCDA 2008 SERIES ABDE BONDS ON MAY 16, 2008).
Schedule K (Form 990) 2019

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
(1) ELIZABETH KEITH KEY EMPLOYEE RECRUITMENT/RELOCATI   X 400,000 200,000   No   No Yes  
(2) MARK KORTH KEY EMPLOYEE RECRUITMENT/RELOCATI   X 400,000 266,667   No   No Yes  
Total ...............Small Bullet $ 466,667
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2019
Schedule L (Form 990 or 990-EZ) 2019
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) Wade Dean Family member of L Dean, OFFICER 62,226 Employment   No
(2) Allison Cova Family member of C Cova, KEY EMPLOYEE 179,074 Employment   No
(3) Angela DeMichele Family membr, M DeMichele, BOD 93,452 Employement   No
(4) E-lead Resources Inc Family member of L Dean, OFFICER 1,864,521 Marketing products & services   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2019


Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)


Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageGo to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Part I
Types of Property
(a)
Check if applicable
(b)
Number of contributions or items contributed
(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g
(d)
Method of determining
noncash contribution amounts
1 Art—Works of art .... X 6 40,580 COMPARABLE SALE
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 9,250 RESALE VALUE
5 Clothing and household
goods .......
X 29,460 RESALE VALUE
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests ....
       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures .....
       
14 Qualified conservation
contribution—Other ...
       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( OFFICE EQUIPMENT ) X 65 237,837 COMPARABLE SALE
26 Other Right pointing arrow large image ( MEDICAL EQUIPMENT ) X 24 43,424 COMPARABLE SALE
27 Other Right pointing arrow large image ( COGNITIVE TEST TOOL ) X 5 42,810 COST
28 Other Right pointing arrow large image ( TOYS ) X 33 21,063 COMPARABLE SALE
Other Right pointing arrow large image ( LUMBER ) X 1 9,003 COMPARABLE SALE
Other Right pointing arrow large image ( NATIVITY SCENE ) X 2 6,450 COMPARABLE SALE
Other Right pointing arrow large image ( JEWELRY ) X 1 3,200 COMPARABLE SALE
Other Right pointing arrow large image ( FOOD AND WINE ) X 9 3,001 COMPARABLE SALE
Other Right pointing arrow large image ( GIFT CERTIFICATES/ TICKETS ) X 4 1,275 COMPARABLE SALE
Other Right pointing arrow large image ( ELECTRONICS ) X 3 1,058 COMPARABLE SALE
Other Right pointing arrow large image ( WALKER, PORT-O-POTTY, WIGS, TREES, CRYSTALS ) X 6 1,333 COMPARABLE SALE
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2019)
Schedule M (Form 990) (2019)
Page 2
Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
SCH M, PART I-EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS ART - WORKS OF ART: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OFFICE EQUIPMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. MEDICAL EQUIPMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. COGNITIVE TEST TOOL: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. LUMBER: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. NATIVITY SCENE: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. JEWELRY: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. FOOD AND WINE: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. GIFT CERTIFICATES/TICKETS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. ELECTRONICS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. WALKER, PORT-O-POTTY, WIGS, TREES, HANGING CRYSTALS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED.
SCH M, LINE 32B DIGNITY HEALTH IS SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS SOLICIT AND PROCESS NON-CASH CONTRIBUTIONS ON BEHALF OF DIGNITY HEALTH'S HOSPITALS.
Schedule M (Form 990) (2019)

Additional Data


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

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

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Return Reference Explanation
FORM 990, PARTS I, V & VI FORM 990, PART I, LINE 7A Part I line 7a includes Section 512(a)(7) qualified transportation fringe benefit amounts that are not revenue and therefore not reported as such on Form 990. FORM 990, PART V, LINE 4B - NAME OF FOREIGN COUNTRIES (CONT'D) THAILAND AND TURKEY. FORM 990, PART VI, SECTION A, LINE 2 Business relationships among members of the Boards of Directors or other governing bodies of subsidiaries and joint ventures of Dignity Health: L. Hunt, M O'Quinn K. Silberstein, L. Harting, M. Korth T. Wilcox, J. VanBoening D. Morissette, P. Hanelt K. Silberstein, D. Wise K. Bradley, E. Shih E. Shih, M. O'Quinn, R. Grossman, C. Francis, D. Morissette R. Grossman, R. Wiebe, D. Morissette, C. Cova, Sr. J. Hyer L. Zuckerman, K. Bradley FORM 990, PART VI, SECTION A, LINE 7B The corporation has committed in its bylaws to continue a healing ministry based on the life and works of Jesus in the provision of healthcare services in the communities it serves ("the healing ministry"). To further the healing ministry, rights have been reserved to the religious founding co-sponsors of Dignity Health as follows, pursuant to the bylaws: A Sponsorship Council, comprised of members of the co-sponsoring organizations, is responsible for overseeing and acting upon issues of Catholic identity for Catholic-sponsored facilities, and informing the healing ministry of the corporation, including both Catholic-sponsored and non-Catholic sponsored facilities, through the right to appoint three of seven members of the Mission Integrity Committee of the Board of Directors and to approve any changes in the Statement of Common Values. The Mission Integrity Committee is responsible for evaluation and resolution of management, operational, and patient care issues that impact conformance with the mission and values of the healing ministry in the operations of the corporation; approving policies and procedures with respect to implementation and conformance to the mission and values of the healing ministry; establishing and maintaining systems for monitoring compliance with the mission and values of the healing ministry, the operational integrity of the Statement of Common Values and the Ethical and Religious Directives; the operational integrity of mission integration standards; pastoral care and education programs; and ministry leadership formation programs. In addition, the Mission Integrity Committee has the power and responsibility to review and monitor the system's labor practices and pension administration. The Mission Integrity Committee may propose changes to the Statement of Common Values, provided the proposal is first reviewed with the Sponsorship Council, which has the sole power to veto any such changes before they are presented to the corporation's Board of Directors for final approval. In addition to working through the Sponsorship Council, at least two members of the Dignity Health Board of Directors continue to be women religious, serving as individuals, not as representatives of their congregations. Also, each individual sponsoring congregation continues to have the right to approve the sale or closure of its sponsored Catholic hospitals or disposition of its other stable patrimony, or the change of name of such Catholic hospital. FORM 990, PART VI, SECTION B, LINE 11B The organization's VP/Financial Services and Reporting, Tax Manager, and the outside accounting firm engaged by Dignity Health to review the return, reviewed each section of the final draft of this Form 990 with the SEVP/Chief Financial Officer and the SVP/Finance and Corporate Controller. The review included an explanation of each schedule of the Form 990 and the pertinent information contained on each schedule. The EVP/General Counsel reviewed governance and conflict of interest schedules, and compensation schedules and disclosures were reviewed with the EVP, Chief Human Resources Officer. The complete copy of the Form 990 was provided to the entire Board of Directors before the return was filed. FORM 990, PART VI, SECTION B, LINE 12C Dignity Health's Board of Directors has promulgated policies for the disclosure and management of confilcts of interest (the "COI Policies"). Under such policies, the EVP/General Counsel is designated as the organization's Filing Officer and is responsible for collecting, reviewing and validating annual disclosures of all covered persons including the members of Dignity Health's governing bodies including its Board of Directors and Board Committees, as well as Dignity Health's officers and executive leaders, key employees, management personnel at the vice president level and above, and any other personnel designated by the Filing Officer ("Covered Persons"). All Covered Persons are required to disclose actual or potential conflicts arising from the business, ownership, financial and personal interests held by such Covered Persons or their family members. Covered Persons are required to disclose to their supervisors and to relevant decision makers any interest that may present a conflict of interest, or the appearance of a conflict of interest. Such disclosure is required on a transactional basis at the time such conflicts arise, when an individual becomes a Covered Person (e.g. upon hiring or upon promotion), and annually thereafter. As part of the annual Disclosure Survey conducted pursuant to the COI Policies, each Covered Person is required to certify that he/she: (1) has received a copy of the COI Policy or COI Policies applicable to his/her position; (2) has read the COI Policy and understands said policy; and (3) agrees to comply with all requirements of the COI Policy, including completing the conflicts of interest Disclosure Survey as required by the COI policies. Using the information from the annual Disclosure Survey, the Filing Officer prepares annual reports of reported conflicts of interest and distributes those reports to the governing body chairs, including the chair of the Board of Directors and the chair of Dignity Health Board Committees, as well as to key leaders of the organization to enable the responsible individuals to monitor and manage disclosed conflicts of interest and assure decisions are made in the organization's best interests. The procedures for addressing a conflict of interest related to a proposed transaction in the case of governing bodies include, but are not limited to: (1) the actual or potential conflict of interest is fully disclosed to the applicable governing body and any other relevant decision-makers; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the interested person may be excluded from the discussion and must be excused from the meeting prior to and during the approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) the transaction or action is approved by a majority of disinterested members of the governing bodies, consistent with any requirements of bylaws and COI Policies; and (6) any conflicting issues arising during the course of a governing body meeting which cannot be resolved may be referred to an independent committee of the applicable governing body. There are similar conflicts of interest provisions under Dignity Health's Standards of Conduct, which are applicable to all employees and which are administered by the VP/Corporate Compliance Officer who has reporting responsibility to the President/CEO as well as to the Audit and Compliance Committee of the Board of Directors.
FORM 990, PART VI, SECTION B, LINE 15A & 15B The Board of Directors appoints a Human Resources and Compensation Committee, comprised exclusively of independent directors, who are accountable for setting reasonable compensation packages for each officer and certain key employees (including the President/CEO). The Human Resources and Compensation Committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for officers and key executives. The Human Resources and Compensation Committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the Committee are documented in meeting minutes which are approved at the next Committee meeting and provided to the Board of Directors. The documentation of the deliberations includes (a) the terms of the transaction approved and the date approved; (b) the members of the Committee who were present during discussion of the approved transaction and those who voted on it; and (c) the comparability data obtained and relied upon by the Committee and how the data was obtained.
FORM 990, PART XI, Line 9 - Reconciliation of Net Assets CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY; 372,520,000 REVENUE FROM HEALTH-RELATED ACTIVITIES ORGANIZED AS CORPORATIONS/EXEMPT ORGANIZATIONS; 123,028,089 MARK-TO-MARKET ON INTEREST RATE SWAPS; 2,682,936 INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATION/RELATED ENTITES; 37,122,475 OTHER FUND BALANCE TRANSFERS; 221,515,853
FORM 990, PART XII, Line 3a - Financial Statements AND Reporting The organization's federal awards were included in dignity health and subordinate corporations' consolidated OMB Circular A-133 audited schedule of federal expenditures.
SAFE HARBOR ELECTION DISCLOSURE TANGIBLE PROPERTY REGULATION STATEMENT SECTION 1.263(A)-1(F) DE MINIMIS SAFE HARBOR ELECTION TAXPAYER IS MAKING THE DE MINIMIS SAFE HARBOR ELECTION UNDER TREASURY REGULATION 1.263(A)-1(F) FOR ALL ELIGIBLE AMOUNTS PAID OR INCURRED DURING THE TAXABLE YEAR.
FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL FEES TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REVENUE CYCLE SERVICE TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:PROF FEES/CONSULTING TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:REPAIRS/MAINTENANCE TOTAL FEES:XXX-XX-XXXX
FORM 990 PART IX LINE 11G DESCRIPTION:LAUNDRY/LINEN SERVICE TOTAL FEES:25160408
FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:XXX-XX-XXXX
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


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

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet 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
DIGNITY HEALTH
 
Employer identification number

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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) CHMC Hope Street Family Center Property
1401 South Grand Avenue
Los Angeles,CA90015
27-0967098
Real Property CA 57,383 9,524,935 DIGNITY HLTH
 
(2) Dignity Health Medical Group Nevada LLC
3001 St Rose Parkway
Henderson,NV89052
46-2574491
CLINICS NV 6,936,200 4,971,948 DIGNITY HLTH
 
(3) Dignity Health Nevada Imaging Company LL
5495 South Rainbow Blvd Suite 203
Las Vegas,NV89118
26-3322792
Imaging SVC NV 0 0 DIGNITY HLTH
 
(4) Dignity Health Provider Resources LLC
4550 California Avenue Suite 100
Bakersfield,CA93309
47-3373662
Holding Compa CA 0 4,864,756 DIGNITY HLTH
 
(5) Dignity Health Purchasing Network LLC
3033 North Third Avenue
Phoenix,AZ85013
45-5555133
Group Purchas AZ 8,127,759 7,939,870 DIGNITY HLTH
 
(6) Dignity Health USP Oxnard Surgery Center
1700 N ROSE AVENUE STE 100
OXNARD,CA93030
20-0707388
OP Surgery CA 0 0 DIGNITY HLTH
 
(7) Sequoia Quality Care Network LLC
170 Alameda de las Pulgas
Redwood City,CA94062
47-2083870
Care Network CA 60,640 172,658 DIGNITY HLTH
 
(8) Southern California Integrated Care Netw
2101 NORTH WATERMAN AVENUE
San Bernardino,CA92404
45-5566171
Care Network CA 1,001,650 524,228 DIGNITY HLTH
 
(9) St Francis Foundation LLC
112 E Victoria Street
Santa Barbara,CA93101
42-1691710
Leasing CA 0 1,425,294 DIGNITY HLTH
 
(10) St John's Regional Imaging Center LLC
1700 N ROSE AVENUE STE 110
Oxnard,CA93030
77-0483564
OP Radiology CA 1,687,957 5,796,749 DIGNITY HLTH
 
(11) St Rose Quality Care Network LLC
102 E Lake Mead Drive
Henderson,NV89015
46-2147857
Care Network NV -1,393 167,848 DIGNITY HLTH
 
(12) Trinity Care LLC
901 Corporate Center Drive Suite 40
Monterey Park,CA91754
33-0805338
Health care CA 5,603 0 DIGNITY HLTH
 
(13) Valley Integrated Provider Network LLC
420 34th Street
Bakersfield,CA93301
47-2094529
Care Network CA 55,323 256,248 DIGNITY HLTH
 
(14) North State Quality Care Network LLC
2175 Rosaline Avenue
Redding,CA96001
81-0973771
Care Network CA 3,160 205,927 DIGNITY HLTH
 
(15) Dignity Health Management Services Organ
10901 Gold Center Drive Suite 300
Rancho Cordova,CA95670
81-3117046
Mgmt Svcs Org CA 10,381,512 4,140,727 DIGNITY HLTH
 
(16) SLO Health Pavilion LLC
1911 Johnson Avenue
San Luis Obispo,CA93401
47-1441310
REAL PROPERTY CA 471,360 7,146,052 Dignity Hlth
 
(17) MedProvidex LLC
1980 Orange Tree Lane Ste 200
Redlands,CA92374
33-0578944
HLTHCARE MGMT CA 0 0 DHHC
 
(18) Dignity Health International LLC
185 Berry Street Suite 300
SAN FRANCISCO,CA94107
35-2549412
CONSULTATION DE 0 0 DHHC
 
(19) Managed Care Systems LLC
4550 California Avenue Suite 500
BAKERSFIELD,CA93309
03-0412082
HLTHCARE MGMT CA 0 0 MPV LLC
 
(20) San Joaquin Quality Care Network LLC
1800 North California Street
Stockton,CA95204
82-2076390
CARE NETWORK CA 80 29,862 DIGNITY HLTH
 
(21) AGH PHOENIX LLC
3030 N Central Avenue Suite 14012
PHOENIX,AZ85012
47-1584330
HOLDING CO AZ 0 0 DIGNITY HLTH
 
(22) AGH Laveen LLC
3030 N Central Avenue Suite 14012
PHOENIX,AZ85012
47-1587223
hospital AZ 4,647,020 57,960,908 AGH PHX LLC
 
(23) AGH Mesa LLC
3030 N Central Avenue Suite 14012
PHOENIX,AZ85012
38-3990879
hospital AZ 0 2,326,184 AGH PHX LLC
 
Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

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

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

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

San Francisco,CA94107
94-3006034
Administratio CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(4)Dignity Health Insurance Nevada Ltd
185 Berry Street

San Francisco,CA94107
81-3800752
Self Ins Fund NV 501(c)(3) 12A-I Dignity Heal
 
Yes
 
(5)Dignity Health Medical Foundation
3400 Data Drive

Rancho Cordova,CA95670
68-0220314
Multi-sp clin CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(6)Dignity Health Workers' Comp Self-Insura
185 Berry Street

San Francisco,CA94107
94-6612446
Administratio CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(7)Dominican Health Services
1555 Soquel Drive

Santa Cruz,CA95065
77-0056778
Community Hea CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(8)Dominican Oaks Corporation
1555 Soquel Drive

Santa Cruz,CA95065
77-0127719
Sr Housing CA 501(c)(3) 9 DHS
 
Yes
 
(9)Dignity Health Connected Living
200 Mercy Oaks Drive

Redding,CA96003
23-7115371
Senior ctr CA 501(c)(3) 7 DIGNITY HLTH
 
Yes
 
(10)Dignity Community Care
185 Berry Street Suite 300

San Francisco,CA94107
81-5009488
Hospital CO 501(c)(3) 3 NA
 
 
No
(11)Mark Twain Medical Center
768 Mountain Ranch Road

San Andreas,CA95249
68-0127677
Hospital CA 501(c)(3) 3 NA
 
 
No
(12)Mercy McMahon Terrace
3865 J Street

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

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

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

San Francisco,CA94109
94-1156295
Hospital CA 501(c)(3) 3 DIGNITY HLTH
 
Yes
 
(16)Sierra Nevada Memorial-Miners Hospital
155 Glasson Way

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

Santa Barbara,CA93103
77-0022302
INACTIVE CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(18)St Mary Catholic Housing Corporation
1050 Linden Avenue

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

Long Beach,CA90813
23-7373088
office space CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(20)Arroyo Grande Community Hospital Foundat
345 S Halcyon Rd

Arroyo Grande,CA93420
20-3256066
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(21)Barrow Foundation UK
16 OLD BAILEY
  LONDONEC4M 7EG
UK
31-1724184
FNDRSING FND UK 501(c)(3) NFI NA
 
 
No
(22)Barrow Neurological Foundation
350 West Thomas Road

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

Los Angeles,CA90015
95-4000909
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(24)Community Hospital San Bernardino Founda
1805 Medical Center Drive

San Bernardino,CA92411
95-3051931
FNDRSING FND CA 501(c)(3) 12A-I CHSB
 
Yes
 
(25)Dignity Health Foundation
185 Berry Street Suite 300

San Francisco,CA94107
46-2037641
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(26)Dignity Health Foundation East Valley
475 South Dobson Road

Chandler,AZ85224
74-2418514
FNDRSING FND AZ 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(27)Dominican Hospital Foundation
1555 Soquel Drive

Santa Cruz,CA95065
94-2450442
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(28)French Hospital Medical Center Foundatio
1911 Johnson Avenue

San Luis Obispo,CA93401
20-3256125
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(29)Glendale Memorial Health Foundation
1420 South Central Avenue

Glendale,CA91204
95-3625651
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(30)Marian Regional Medical Center Foundatio
1400 E Church Street

Santa Maria,CA93454
95-3818027
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(31)Mercy Foundation Bakersfield
PO Box 119

Bakersfield,CA93302
77-0201321
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(32)Mercy Foundation Sacramento
3400 Data Drive 3rd Flr

Rancho Cordova,CA95670
23-7072762
FNDRSING FND CA 501(c)(3) 12A-I NA
 
 
No
(33)Mercy Medical Center Merced Foundation
301 E 13th Street

Merced,CA95340
77-0035928
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(34)Northridge Hospital Foundation
18300 Roscoe Blvd

Northridge,CA91328
23-7444901
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(35)San Gabriel Valley Medical Center Founda
438 West Las Tunas Drive

San Gabriel,CA91776
95-3430341
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(36)Sequoia Hospital Foundation
170 Alameda de las Pulgas

Redwood City,CA94062
94-2909990
FNDRSING FND CA 501(c)(3) 12C-III-FI NA
 
 
No
(37)DIGNITY HEALTH FOUNDATION-INLAND EMPIRE
2101 N Waterman Avenue

San Bernardino,CA92404
23-7440086
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(38)St Francis Foundation of Santa Barbara
2323 De La Vina St Suite 104

Santa Barbara,CA93105
23-7137119
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(39)St John's Healthcare Foundation
1600 North Rose Avenue

Oxnard,CA93030
20-2865781
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(40)St Joseph's Foundation
350 West Thomas Road

Phoenix,AZ85013
94-2941245
FNDRSING FND AZ 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(41)St Joseph's Foundation of San Joaquin
1800 N California Street

Stockton,CA95204
51-0432777
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(42)St Mary Medical Center Foundation
1050 Linden Avenue

Long Beach,CA90813
23-7153876
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(43)St Mary's Medical Center Foundation
450 Stanyan Street

San Francisco,CA94117
94-3336143
FNDRSING FND CA 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(44)St Rose Dominican Health Foundation
3001 St Rose Parkway

Henderson,NV89052
88-0349432
FNDRSING FND NV 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(45)The Congenital Heart Foundation
350 W Thomas Road

Phoenix,AZ85013
26-3342554
FNDRSING FND AZ 501(c)(3) 12A-I DIGNITY HLTH
 
Yes
 
(46)Woodland Memorial Hospital Foundation
1321 Cottonwood Street 305

Woodland,CA95695
94-6167964
FNDRSING FND CA 501(c)(3) 7 NA
 
 
No
(47)Mercy Foundation North
2625 Edith Avenue Suite E

REDDING,CA96001
94-3136799
FNDRSING FND CA 501(C)(3) 12A-1 NA
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
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



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) AGH Phoenix LLC

7171 51st Avenue
Laveen Village,AZ85339
47-1584330
HOLDING COMPANY AZ Dignity Health
 
Related -13,044,475 9,524,979   No 0   No 50.100 %
(2) Arizona Care Network LLC

350 W Thomas Rd
Phoenix,AZ85013
45-4494682
Care Network AZ Dignity Health
 
Related -1,498,169 2,054,653   No 0 Yes   50.000 %
(3) CBCC Outsmarting Cancer LLC

6501 Truxtun Avenue
Bakersfield,CA93309
46-1602286
Radiation/Onc CA Dignity Health
 
Related -452,091 13,827,584   No 0 Yes   51.000 %
(4) DHRT Holdings LLC

185 Berry Street Suite 300
San Francisco,CA94107
35-2484591
Holding Compa DE Dignity Health
 
Related 14,193,351 130,800,408   No 0 Yes   33.870 %
(5) DignityAbrazo Health Network LLC dba AC

3030 N Central Avenue Suite 1402
Phoenix,AZ85012
46-5477985
Management Sv AZ Dignity Health
 
Related 1,711,011 4,745,801   No 0   No 50.000 %
(6) DIGNITYUSP LAS VEGAS SURGERY CENTERS LL

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-2999237
Surgery TX Dignity Health
 
Related 399,707 7,948,574   No 0   No 50.100 %
(7) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
13-4248908
Surgery TX Dignity Health
 
Related 4,513,894 24,201,285   No 0   No 50.100 %
(8) Dominican Magnetic Resonance Imaging Cen

1545 Soquel Drive
Santa Cruz,CA94065
77-0095477
Imaging Cente CA Dignity Health
 
Related -266,017 385,963   No 0 Yes   80.000 %
(9) Folsom Sierra Endoscopy Center LP

1650 Creekside Drive 1600
Folsom,CA95630
68-0482416
Endoscopy CA Dignity Health
 
Related 2,673,278 2,086,830   No 0 Yes   51.000 %
(10) Mercy Davis Cancer Center Management Co

2740 M Street
Merced,CA95340
94-3358445
Mgmt of Cance CA Dignity Health
 
Related -188,851 4,355,661   No 0 Yes   50.000 %
(11) NICU Operating CO of Santa Cruz LLC

1555 Soquel Drive
Santa Cruz,CA95065
46-0502935
Neonatal Heal CA Dignity Health
 
Related 6,176,401 12,111,856   No 0   No 51.000 %
(12) NSC Channel Islands LLC

3000 Riverchase Galleria Suite 500
Birmingham,AL35244
77-0418197
Ambulatory su CA Dignity Health
 
Related 359,242 2,463,891   No 0 Yes   51.000 %
(13) Plaza Surgery Center LP

525 E Plaza Drive Suite 100
Santa Maria,CA93454
77-0573567
Surgery CA HSPCC Inc
 
Related 0 0   No 0 Yes   50.640 %
(14) Radiation Oncology Centers of Ventura Co

1700 N ROSE AVENUE SUITE 120
OXNARD,CA93030
77-0191706
IMAGING CA Dignity Health
 
Related 317,200 700,682   No 0 Yes   50.000 %
(15) RBR Management LLC

91 Corporate Park Drive Suite 120
Henderson,NV89074
27-1466450
Ambulance NV Dignity Health
 
Related 829,740 2,503,903   No 0   No 50.100 %
(16) Santa Cruz Land & Building LP

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

6740 E Camelback Road Suite 101
Scottsdale,AZ85251
26-4000683
Imaging Cente CA Dignity Health
 
Related -3,841,011 42,946,918   No 0   No 54.070 %
(18) St Joseph's Surgery Center LP

15305 Dallas Parkway Suite 1600 LB
Addison,TX75001
20-1019390
Surgery TX Dignity Health
 
Related 1,800,733 3,326,938   No 0 Yes   79.960 %
(19) Templeton Surgery Center LLC

1310 Las Tablas Road Suite 104
Templeton,CA94365
20-2246616
Surgery CA Dignity Health
 
Related 170,496 1,168,943   No 0 Yes   61.180 %
(20) THE MEDICAL PAVILLION AT ST JOHN'S

1700 ROSE AVENUE
OXNARD,CA93030
77-0332349
REAL ESTATE CA DIGNITY HEALTH
 
Related 37,596 1,548,504   No 0 Yes   25.000 %
(21) OMG Arizona LLC

130 Sutter Street 2nd Flr
San Francisco,CA94104
47-1708588
Medical Offic AZ Dignity Health
 
Related -801,855 5,262,302   No 0   No 56.900 %
(22) Valley Physicians Surgery Center At Nort

18330 Roscoe Blvd
Northridge,CA91328
80-0864336
Surgery CA Dignity Health
 
Related -175,379 1,997,767   No 0 Yes   45.580 %
(23) Gemcare Mercy Memorial Health System

4550 California Avenue Suite 500
Bakersfield,CA93309
47-0484764
Admin Svcs CA Dignity Health
 
Related -12,735 0   No 0   No 87.150 %
(24) Oncoverse LLC

350 Sansome Street Suite 800
San Francisco,CA94104
81-0881471
Virtual onlin CA Dignity Health
 
Related -35,086 0   No 0 Yes   44.670 %
(25) Dignity- GoHealth Urgent Care Management

5555 Glenridge Connector Suite 700
Atlanta,GA30342
35-2548698
Management Se DE Dignity Health
 
Related -3,458,490 5,366,998   No 0   No 50.100 %
(26) Santa Cruz Comprehensive Imaging LLC

1661 Soquel Drive Suite G
Santa Cruz,CA95065
01-0550623
imaging CA Dignity Health
 
Related -16,517 102,272   No 0   No 50.000 %
(27) DE JV LLC

8686 New trails drive
The Woodlands,TX77381
32-0496548
emergency car NV DIGNITY HEALTH
 
Related -4,721,584 10,994,989   No 0   No 51.000 %
(28) Santa Cruz Surgery Center LLC

3003 PAUL SWEET ROAD
SANTA CRUZ,CA95065
77-0194916
SURGERY CA DIGNITY HEALTH
 
Related 90,209 306,677   No 0 Yes   50.000 %
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Coastal Surgical Specialists Inc

921 Oak Park Blvd Suite 101
Pismo Beach,CA93449
74-3000596
AMBULATORY SURGER CA DIGNITY HEALTH
 
S Corp 1,842,879 4,762,889 50.330 % Yes  
(2) Dignity Health Insurance Ltd

PO Box 1051
  Grand Cayman IslaKY1-1102
CJ
98-1065338
Self Ins Fund CJ DIGNITY HEALTH
 
C Corp 1,307,323 63,254,091 100.000 % Yes  
(3) Dignity Health Provider Resources Inc

185 Berry Street Suite 300
San Francisco,CA94107
47-3366764
Health Plan CA DIGNITY HEALTH
 
C Corp 65,254,455 5,993,760 100.000 % Yes  
(4) MedProvidex INC (FKA IHO)

1980 Orange Tree Lane Ste 200
Redlands,CA92374
33-0578944
HLTH CARE MGMT CA DIGNITY HEALTH
 
C Corp -207,492 0 100.000 % Yes  
(5) Management Services Organization of Sant

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

1400 E Church Street
Santa Maria,CA93454
77-0074057
HEALTH SERVICES CA DIGNITY HEALTH
 
C Corp 260,244 2,063,302 100.000 % Yes  
(7) Millenium Surgery Center Inc

9300 Stockdale Hwy 200
Bakersfield,CA93311
77-0513445
OP SURGERY SVCS CA Bakersfield Mem
 
S Corp 1,680,043 14,888,201 57.768 % Yes  
(8) St Mary Health Ventures Inc

1050 Linden Avenue
Long Beach,CA90813
95-1912528
RETAIL PHARMACY CA DIGNITY HEALTH
 
C Corp 1,370,629 2,812,427 100.000 % Yes  
(9) Trinity Care Infusion Services

18440 Roscoe Boulevard
Northridge,CA91325
33-0828794
HOME CARE MED SVC CA DIGNITY HEALTH
 
C Corp 223,262 0 100.000 % Yes  
(10) Dignity Health Holding Corporation

185 Berry Street Suite 300
San Francisco,CA94107
46-0675371
HOLDING COMPANY NV DIGNITY HEALTH
 
C Corp 28,832,415 810,365,261 100.000 % Yes  
(11) USHW Holding Corporation

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

25124 Springfield Court Suite 200
Valencia,CA91355
58-2420844
OCCUPATNL MED SVC CA US Healthworks
 
C Corp 2,607,050 537,903,510 100.000 % Yes  
(13) US HealthWorks Medical Group of Alaska L

25124 Springfield Court Suite 200
Valencia,CA91355
63-1219117
OCCUPATNL MED SVC AK US Healthworks
 
C Corp 17,898,551 3,343,147 100.000 % Yes  
(14) USHW of California Inc

25124 Springfield Court Suite 200
Valencia,CA91355
95-4585828
OCCUPATNL MED SVC CA US Healthworks
 
C Corp 294,251,863 74,450,780 100.000 % Yes  
(15) US HealthWorks Medical Group of Florida

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654983
OCCUPATNL MED SVC FL US Healthworks
 
C Corp 36,370,468 26,837,600 100.000 % Yes  
(16) US HealthWorks of Indiana Inc

25124 Springfield Court Suite 200
Valencia,CA91355
35-1991196
OCCUPATNL MED SVC IN US Healthworks
 
C Corp 19,723,887 18,568,951 100.000 % Yes  
(17) US HealthWorks Medical Group of Maine In

25124 Springfield Court Suite 200
Valencia,CA91355
58-2654976
OCCUPATNL MED SVC ME US Healthworks
 
C Corp 1,945,706 855,967 100.000 % Yes  
(18) US HealthWorks of New Jersey Inc

25124 Springfield Court Suite 200
Valencia,CA91355
04-3323869
OCCUPATNL MED SVC NJ US Healthworks
 
C Corp 11,074,827 3,007,808 100.000 % Yes  
(19) US HealthWorks of North Carolina Inc

25124 Springfield Court Suite 200
Valencia,CA91355
56-2029468
OCCUPATNL MED SVC NC US Healthworks
 
C Corp 4,757,424 1,755,387 100.000 % Yes  
(20) US HealthWorks of Pennsylvania Inc

25124 Springfield Court Suite 200
Valencia,CA91355
58-2660955
OCCUPATNL MED SVC PA US Healthworks
 
C Corp 3,979,946 2,379,754 100.000 % Yes  
(21) USHW of Texas Inc

25124 Springfield Court Suite 200
Valencia,CA91355
74-2785392
OCCUPATNL MED SVC TX US Healthworks
 
C Corp 26,965,284 10,831,071 100.000 % Yes  
(22) US HealthWorks of Washington Inc

25124 Springfield Court Suite 200
Valencia,CA91355
91-1173613
OCCUPATNL MED SVC WA US Healthworks
 
C Corp 47,511,244 10,570,797 100.000 % Yes  
(23) RUSHWINC Properties Inc

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

25124 Springfield Court Suite 200
Valencia,CA91355
45-2494357
OCCUPATNL MED SVC MN US Healthworks
 
C Corp 7,453,255 4,748,691 100.000 % Yes  
(25) US HealthWorks of Tennessee Inc

25124 Springfield Court Suite 200
Valencia,CA91355
45-2697510
OCCUPATNL MED SVC TN US Healthworks
 
C Corp 4,201,097 1,089,464 100.000 % Yes  
(26) US HealthWorks of Illinois Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384805
OCCUPATNL MED SVC IL US Healthworks
 
C Corp 7,361,576 6,750,211 100.000 % Yes  
(27) US HealthWorks of Wisconsin Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-1384564
OCCUPATNL MED SVC WI US Healthworks
 
C Corp 7,340,100 8,619,274 100.000 % Yes  
(28) US HealthWorks of Kansas City Inc

25124 Springfield Court Suite 200
Valencia,CA91355
46-2754415
OCCUPATNL MED SVC KS US Healthworks
 
C Corp 15,876,037 16,916,260 100.000 % Yes  
(29) US HealthWorks Medical Group of Arizona

25124 Springfield Court Suite 200
Valencia,CA91355
58-2625710
OCCUPATNL MED SVC AZ US Healthworks
 
C Corp 7,190,720 2,289,071 100.000 % Yes  
(30) US HealthWorks Medical Group of Georgia

25124 Springfield Court Suite 200
Valencia,CA91355
58-2625714
OCCUPATNL MED SVC GA US Healthworks
 
C Corp 11,455,169 22,541,187 100.000 % Yes  
(31) US HealthWorks Medical Group of Ohio Inc

25124 Springfield Court Suite 200
Valencia,CA91355
31-1540841
OCCUPATNL MED SVC OH US Healthworks
 
C Corp 12,012,542 4,430,712 100.000 % Yes  
(32) US HealthWorks Medical Group of Kentucky

25124 Springfield Court Suite 200
Valencia,CA91355
47-3277440
OCCUPATNL MED SVC KY US Healthworks
 
C Corp 6,659,154 4,843,201 100.000 % Yes  
(33) US HealthWorks of Colorado Inc

25124 Springfield Court Suite 200
Valencia,CA89434
81-1053593
OCCUPATNL MED SVC CO US Healthworks
 
C Corp 5,162,760 7,988,910 100.000 % Yes  
(34) St Mary's Multi Specialty Clinic

1625 Prater Way Suite 102
Sparks,NV89434
11-3763590
Urgent Care CLINI NV Dignity Health
 
C Corp 0 165,304 100.000 % Yes  
Schedule R (Form 990) 2019
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
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) Community Hospital San Bernardino

a 10,395,000 SEE PART VII
(2) Dignity Health Connected Living

a 402,350 SEE PART VII
(3) Dignity Health Holding Corporation

a 9,771,667 SEE PART VII
(4) Dignity Health Medical Foundation

a 4,602,920 SEE PART VII
(5) Dominican Magnetic Resonance Imaging Center

a 98,116 SEE PART VII
(6) Pacific Central Coast Health Centers

a 105,253 SEE PART VII
(7) Port City Operating Company LLC

a 3,882,710 SEE PART VII
(8) Sierra Nevada Memorial Miners Hospital

a 121,539 SEE PART VII
(9) SMI Imaging LLC

a 14,305 SEE PART VII
(10) St Mary Health Ventures Inc

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

b 657,119 SEE PART VII
(12) California Hospital Medical Center Foundation

b 2,998,482 SEE PART VII
(13) Community Hospital San Bernardino Foundation

b 239,270 SEE PART VII
(14) DE JV LLC

b 5,457,000 SEE PART VII
(15) Dignity- GoHealth Urgent Care Management LLC

b 1,812,457 SEE PART VII
(16) Dignity Health Connected Living

b 799,012 SEE PART VII
(17) Dignity Health Foundation

b 1,663,372 SEE PART VII
(18) Dignity Health Foundation - Inland Empire

b 740,021 SEE PART VII
(19) Dignity Health Foundation East Valley

b 1,906,455 SEE PART VII
(20) Dignity Health Medical Foundation

b 239,789,247 SEE PART VII
(21) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

b 427,589 SEE PART VII
(22) Dominican Hospital Foundation

b 1,108,474 SEE PART VII
(23) Dominican Magnetic Resonance Imaging Center

b 160,000 SEE PART VII
(24) French Hospital Medical Center Foundation

b 980,669 SEE PART VII
(25) Glendale Memorial Health Foundation

b 1,193,785 SEE PART VII
(26) Health Services of Pacific Central Coast

b 2,716,415 SEE PART VII
(27) Marian Regional Medical Center Foundation

b 1,025,177 SEE PART VII
(28) Mercy Foundation Bakersfield

b 1,198,071 SEE PART VII
(29) Mercy Medical Center Merced Foundation

b 605,269 SEE PART VII
(30) Northridge Hospital Foundation

b 1,328,862 SEE PART VII
(31) Pacific Central Coast Health Centers

b 50,411,541 SEE PART VII
(32) St John's Healthcare Foundation

b 864,607 SEE PART VII
(33) St Joseph's Foundation

b 1,622,081 SEE PART VII
(34) St Mary Medical Center Foundation

b 1,919,682 SEE PART VII
(35) St Mary's Medical Center Foundation

b 856,058 SEE PART VII
(36) St Rose Dominican Health Foundation

b 2,850,366 SEE PART VII
(37) Trinity Care Infusion Services

b 5,283,029 SEE PART VII
(38) Woodland Memorial Hospital Foundation

b 466,259 SEE PART VII
(39) Arroyo Grande Community Hospital Foundation

c 1,523,482 SEE PART VII
(40) Bakersfield Memorial Hospital

c 1,347,378 SEE PART VII
(41) California Hospital Medical Center Foundation

c 3,163,717 SEE PART VII
(42) Community Hospital San Bernardino

c 567,584 SEE PART VII
(43) Community Hospital San Bernardino Foundation

c 274,759 SEE PART VII
(44) Dignity Health Foundation

c 1,487,781 SEE PART VII
(45) Dignity Health Foundation - Inland Empire

c 1,216,399 SEE PART VII
(46) Dignity Health Foundation East Valley

c 1,309,246 SEE PART VII
(47) Dignity Health Medical Foundation

c 1,401,757 SEE PART VII
(48) Dominican Health Services

c 158,110 SEE PART VII
(49) Dominican Hospital Foundation

c 2,900,295 SEE PART VII
(50) French Hospital Medical Center Foundation

c 2,067,815 SEE PART VII
(51) Glendale Memorial Health Foundation

c 1,041,428 SEE PART VII
(52) Marian Regional Medical Center Foundation

c 2,415,344 SEE PART VII
(53) Mercy Foundation Bakersfield

c 1,500,486 SEE PART VII
(54) Mercy Medical Center Merced Foundation

c 690,091 SEE PART VII
(55) Northridge Hospital Foundation

c 3,600,991 SEE PART VII
(56) St John's Healthcare Foundation

c 2,296,640 SEE PART VII
(57) St Joseph's Foundation

c 4,617,653 SEE PART VII
(58) St Mary Medical Center Foundation

c 3,461,124 SEE PART VII
(59) St Mary's Medical Center Foundation

c 297,193 SEE PART VII
(60) St Rose Dominican Health Foundation

c 5,639,574 SEE PART VII
(61) Woodland Memorial Hospital Foundation

c 1,144,056 SEE PART VII
(62) Dignity Health Holding Corporation

d 249,999 SEE PART VII
(63) Coastal Surgical Specialists Inc

k 149,802 SEE PART VII
(64) Folsom Sierra Endoscopy Center LP

k 103,655 SEE PART VII
(65) Arroyo Grande Community Hospital Foundation

l 82,966 SEE PART VII
(66) Bakersfield Memorial Hospital

l 56,686,205 SEE PART VII
(67) California Hospital Medical Center Foundation

l 329,606 SEE PART VII
(68) Community Hospital San Bernardino

l 23,274,136 SEE PART VII
(69) Community Hospital San Bernardino Foundation

l 135,839 SEE PART VII
(70) Dignity Health Connected Living

l 110,984 SEE PART VII
(71) Dignity Health Foundation

l 547,722 SEE PART VII
(72) Dignity Health Foundation - Inland Empire

l 346,330 SEE PART VII
(73) Dignity Health Foundation East Valley

l 115,981 SEE PART VII
(74) Dignity Health Hospital Prof Liab Self-Insura

l 9,654,430 SEE PART VII
(75) Dignity Health Medical Foundation

l 57,604,872 SEE PART VII
(76) Dignity Health Provider Resources Inc

l 394,088 SEE PART VII
(77) Dignity Health Workers' Comp Self-Insurance T

l 846,783 SEE PART VII
(78) DignityUSP Las Vegas Surgery Center LLC

l 386,239 SEE PART VII
(79) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

l 1,099,522 SEE PART VII
(80) Dignity-Abrazo Health Network LLC

l 2,171,549 SEE PART VII
(81) Dominican Hospital Foundation

l 593,991 SEE PART VII
(82) Dominican Oaks Corporation

l 1,123,431 SEE PART VII
(83) Folsom Sierra Endoscopy Center LP

l 1,922,237 SEE PART VII
(84) French Hospital Medical Center Foundation

l 108,688 SEE PART VII
(85) Gemcare Mercy Memorial Health System

l 6,280,862 SEE PART VII
(86) Glendale Memorial Health Foundation

l 110,012 SEE PART VII
(87) Marian Regional Medical Center Foundation

l 287,559 SEE PART VII
(88) Mercy Davis Cancer Center Management Co LLC

l 1,036,179 SEE PART VII
(89) Mercy Foundation Bakersfield

l 491,699 SEE PART VII
(90) Mercy McMahon Terrace

l 134,512 SEE PART VII
(91) Mercy Medical Center Merced Foundation

l 278,159 SEE PART VII
(92) NICU Operating CO of Santa Cruz LLC

l 11,912,664 SEE PART VII
(93) Northridge Hospital Foundation

l 696,241 SEE PART VII
(94) NSC Channel Islands LLC

l 227,870 SEE PART VII
(95) OMG Arizona LLC

l 50,000 SEE PART VII
(96) Pacific Central Coast Health Centers

l 12,622,581 SEE PART VII
(97) Port City Operating Company LLC

l 43,639,774 SEE PART VII
(98) Saint Francis Memorial Hospital

l 20,182,500 SEE PART VII
(99) Sierra Nevada Memorial Miners Hospital

l 16,239,226 SEE PART VII
(100) St John's Healthcare Foundation

l 570,588 SEE PART VII
(101) St Joseph Foundation of San Joaquin

l 460,145 SEE PART VII
(102) St Joseph's Foundation

l 825,571 SEE PART VII
(103) St Mary Health Ventures Inc

l 4,024,441 SEE PART VII
(104) St Mary Medical Center Foundation

l 935,969 SEE PART VII
(105) St Mary's Medical Center Foundation

l 483,582 SEE PART VII
(106) St Rose Dominican Health Foundation

l 374,257 SEE PART VII
(107) Woodland Memorial Hospital Foundation

l 56,354 SEE PART VII
(108) Dignity Health Hospital Prof Liab Self-Insura

m 69,910,602 SEE PART VII
(109) Dignity Health Medical Foundation

m 4,149,166 SEE PART VII
(110) Dignity Health Workers' Comp Self-Insurance T

m 47,235,283 SEE PART VII
(111) Folsom Sierra Endoscopy Center LP

m 7,308,008 SEE PART VII
(112) Managed Care Systems LLC

m 2,252,128 SEE PART VII
(113) Medprovidex LLC

m 769,576 SEE PART VII
(114) Millenium Surgery Center Inc

m 857,736 SEE PART VII
(115) Pacific Central Coast Health Centers

m 6,179,109 SEE PART VII
(116) Port City Operating Company LLC

m 6,047,539 SEE PART VII
(117) RBR Management LLC

m 7,638,217 SEE PART VII
(118) CBCC Outsmarting Cancer LLC

s 1,020,000 SEE PART VII
(119) Coastal Surgical Specialists Inc

s 1,600,464 SEE PART VII
(120) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

s 2,505,000 SEE PART VII
(121) Folsom Sierra Endoscopy Center LP

s 2,590,800 SEE PART VII
(122) NICU Operating CO of Santa Cruz LLC

s 2,069,973 SEE PART VII
(123) NSC Channel Islands LLC

s 250,807 SEE PART VII
(124) Oncoverse LLC

s 299,949 SEE PART VII
(125) Plaza Surgery Center LP

s 198,610 SEE PART VII
(126) RBR Management LLC

s 104,082 SEE PART VII
(127) Santa Cruz Land & Building LP

s 150,000 SEE PART VII
(128) Santa Cruz Surgery Center LLC

s 195,000 SEE PART VII
(129) St Joseph's Surgery Center LP

s 1,947,874 SEE PART VII
Schedule R (Form 990) 2019
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)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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


Yes No Yes No Yes No






























Schedule R (Form 990) 2019
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, Part V, Line 2 column (c) PART V, LINE 1A - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT TO CERTAIN RELATED ORGANIZATIONS (WHOLLY-OWNED ORGANIZATIONS, MEDICAL FOUNDATIONS AND JOINT VENTURES). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE AMOUNTS CHARGED FOR SUCH AGREEMENTS. SUCH CHARGES REPRESENT FAIR MARKET VALUE OF THE AMOUNTS CHARGED UNDER THESE AGREEMENTS. DIGNITY HEALTH PROVIDES LOANS TO RELATED ORGANIZATIONS (HOSPITALS, JOINT VENTURES AND WHOLLY-OWNED ORGANIZATIONS). AMOUNTS REPORTED AS TRANSACTION TYPE "A" REPRESENT THE INTEREST PAYMENTS CHARGED FOR THESE LOANS. PART V, LINE 1B, AND 1C - DIGNITY HEALTH AND ITS HOSPITAL FACILITIES ARE SUPPORTED BY VARIOUS FUNDRAISING FOUNDATIONS. AS SUPPORTING ORGANIZATIONS, THE FOUNDATIONS OPERATE FOR THE BENEFIT OF, TO RAISE FUNDS FOR, OR TO CARRY OUT THE PURPOSES OF DIGNITY HEALTH AND ITS HOSPITALS. AS A RESULT, PAYMENTS ARE MADE DIRECTLY TO DIGNITY HEALTH FROM THE FOUNDATIONS OR DIRECTLY TO THE FOUNDATIONS FROM DIGNITY HEALTH. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" INCLUDE FUNDS EXPENDED BY DIGNITY HEALTH ON BEHALF OF THE FOUNDATIONS FOR OPERATIONAL EXPENSES. AMOUNTS REPORTED AS TRANSACTION TYPE "C" REPRESENT FUNDS RECEIVED AS GRANTS BY DIGNITY HEALTH HOSPITALS FROM THE FOUNDATIONS. AMOUNTS REPORTED UNDER TRANSACTION TYPE "B" ALSO INCLUDE FUNDING SUPPORT TO DIGNITY HEALTH MEDICAL FOUNDATION (DHMF), WHICH OPERATES CLINICS IN THE COMMUNITIES SERVED BY DIGNITY HEALTH HOSPITALS THROUGHOUT CALIFORNIA. DIGNITY HEALTH ALSO PROVIDES FUNDING SUPPORT TO OTHER EXEMPT ORGANIZATIONS THAT PROVIDE SERVICES TO COMMUNITIES SERVED BY DIGNITY HEALTH FACILITIES WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". DIGNITY HEALTH ALSO PROVIDES CAPITAL FUNDING TO CERTAIN RELATED ORGANIZATIONS, WHICH IS INCLUDED UNDER TRANSACTION TYPE "B". PART V, LINE 1D - DIGNITY HEALTH MADE LOANS TO AND LOAN GUARANTEES ON BEHALF OF VARIOUS RELATED ORGANIZATIONS. AMOUNTS REPORTED AS TRANSACTION TYPE "D" REPRESENT THE FAIR MARKET VALUE OF THE LOANS ISSUED DURING THE YEAR AND GUARANTEE FEES RECORDED DURING THE YEAR. PART V, LINE 1K - DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT FROM CERTAIN RELATED ORGANIZATIONS (JOINT VENTURES). AMOUNTS REPORTED AS TRANSACTION TYPE "K" REPRESENT THE AMOUNTS PAID FOR SUCH AGREEMENTS. PART V, LINE 1L - DIGNITY HEALTH FACILITIES PERFORM VARIOUS SERVICES FOR OTHER RELATED ORGANIZATIONS. BELOW IS A SUMMARY OF THE TRANSACTIONS AMONG RELATED ORGANIZATIONS FOR SUCH ACTIVITIES. DIGNITY HEALTH'S CONTROLLED ENTITIES ARE ASSESSED AN AMOUNT TO COVER THE SYSTEM OFFICE OPERATIONS. IN ADDITION, AN EXPENSE IS ALSO ASSESSED TO COVER CENTRALIZED INFORMATION TECHNOLOGY COSTS OF THE ORGANIZATION, CENTRALIZED ACCOUNTS PAYABLE, PAYROLL, ACCOUNTING, DECISION SUPPORT, AND CERTAIN OTHER MANAGEMENT SERVICES. IN FY18, DIGNITY HEALTH HOSPITALS ALSO PERFORMED OPERATIONAL SERVICES FOR OTHER RELATED ORGANIZATIONS SUCH AS PLANT MAINTENANCE, LAUNDRY SERVICES AND OTHER SERVICES AS DEEMED NECESSARY. THE SERVICES PERFORMED ARE REIMBURSED AT COST. PART V, LINE 1M - PHYSICIAN CLINIC SUPPORT SERVICES ARE PROVIDED TO DIGNITY HEALTH HOSPITALS BY DHMF. DHMF OPERATES CLINICS WITH LOCATIONS THROUGHOUT CALIFORNIA. AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE PAYMENTS MADE TO DHMF FOR THE HOSPITALISTS AND RISK POOL PROGRAMS. DIGNITY HEALTH IS SELF-INSURED FOR WORKERS' COMPENSATION BENEFITS AND FOR HOSPITAL PROFESSIONAL AND GENERAL LIABILITY RISKS. DIGNITY HEALTH MAINTAINS SEPARATE TRUSTS FOR THESE PROGRAMS FROM WHICH CLAIMS AND RELATED EXPENSES AND COSTS OF ADMINISTERING THE PLANS ARE PAID. DIGNITY HEALTH HOSPITALS FUND THE TRUSTS, SUCH THAT OVER TIME, ASSETS HELD EQUAL LIABILITIES FOR CLAIMS INCURRED. THE AMOUNTS REPORTED UNDER TRANSACTION TYPE "M" INCLUDE THE CASH TRANSFERRED FROM DIGNITY HEALTH TO THE TRUSTS FOR THE FY18 FUNDING OF THE SELF-INSURANCE PROGRAMS. PART V, LINE 1S - AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS AND TRANSFERS OF ASSETS FROM RELATED ORGANIZATION.
Schedule R (Form 990) 2019

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