Form990
Click to see attachment
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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)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2021 , and ending 06-30-2022
BCheck if applicable:
CName of organization
DIGNITY HEALTH
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
185 BERRY STREET SUITE 200
 
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 $ 13,834,790,675
F Name and address of principal officer:
DANIEL MORISSETTE
185 BERRY STREET SUITE 200
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: AS AN AFFILIATE OF COMMONSPIRIT HEALTH (COMMONSPIRIT), DIGNITY HEALTH IS COMMITTED TO MAKING THE HEALING PRESENCE OF GOD KNOWN IN OUR WORK BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 4
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 0
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 46,034
6 Total number of volunteers (estimate if necessary) ............. 6 1,538
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 9,317,473
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 697,708,603 340,234,617
9 Program service revenue (Part VIII, line 2g) ......... 8,481,486,246 8,550,050,016
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 840,960,636 509,194,712
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 81,813,375 92,434,023
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 10,101,968,860 9,491,913,368
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 333,107,440 279,958,243
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 4,654,210,594 5,008,651,883
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).... 3,993,940,325 4,034,051,804
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 8,981,258,359 9,322,661,930
19 Revenue less expenses. Subtract line 18 from line 12....... 1,120,710,501 169,251,438
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 18,716,706,738 16,909,275,509
21 Total liabilities (Part X, line 26)............. 10,936,552,956 8,532,106,229
22 Net assets or fund balances. Subtract line 21 from line 20..... 7,780,153,782 8,377,169,280
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
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
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: SEE SCHEDULE O
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 7,968,761,350 including grants of $ 279,958,243 ) (Revenue $ 8,543,399,697 )
SEE SCHEDULE O
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 expensesMediumBullet7,968,761,350
Form 990 (2021)
Form 990 (2021)
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 Rev. Proc. 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
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
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 attachment
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 (2021)
Form 990 (2021)
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
 
No
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 the 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 line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................Click to see attachment
30
 
No
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 on 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
1,990
b
Enter the number of Forms W-2G included on 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 (2021)
Form 990 (2021)
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
46,034
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ
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 the instructions and file Form 4720, Schedule N.
15
Yes
 
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
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
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
4
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
0
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
Yes
 
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
Yes
 
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 on 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 on 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 on 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
CA
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 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 TYREN185 BERRY STREET SUITE 200   SAN FRANCISCO,CA94107 (415) 438-5500
Form 990 (2021)
Form 990 (2021)
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 the 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, Form 1099-MISC, and/or box 1 of Form 1099-NEC) 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 the 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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) LLOYD H DEAN......................................................................
CHIEF EXECUTIVE OFFICER
10.00
.................
40.00
    X       25,820,624 0 9,642,249
(2) MARVIN O'QUINN......................................................................
CHAIR/ PRESIDENT & CHIEF OPERATING OFFICER
20.00
.................
30.00
X   X       6,275,927 0 793,711
(3) CHARLES P FRANCIS......................................................................
SEVP, CHIEF STRATEGY OFFICER
10.00
.................
40.00
      X     4,313,708 0 1,380,629
(4) DANIEL J MORISSETTE CPA......................................................................
TREASURER/ SEVP, CHIEF FINANCIAL OFFICER
20.00
.................
30.00
    X       4,395,351 0 563,544
(5) ELIZABETH SHIH......................................................................
BOARD MEMBER/ SEVP, CHIEF ADMINISTRATIVE OFFICER
15.00
.................
35.00
X   X       3,702,765 0 786,814
(6) ROBERT WIEBE MD......................................................................
EVP, CHIEF MEDICAL OFFICER
10.00
.................
40.00
      X     3,629,821 0 478,691
(7) CHARLES COVA......................................................................
OPERATIONS CONSULTANT (THRU 4/2/21)
50.00
.................
0.00
        X   3,638,086 0 186,730
(8) DARRYL ROBINSON......................................................................
SEVP, CHIEF HUMAN RESOURCE OFFICER
10.00
.................
40.00
      X     3,141,963 0 433,080
(9) JULIE SPRENGEL......................................................................
SVP OPERATIONS & CEO, SOUTHERN CALIFORNIA DIVISION
40.00
.................
10.00
      X     3,087,973 0 81,074
(10) MITCH MELFI ESQ JD......................................................................
SECRETARY/ VICE CHAIR/CHIEF LEGAL OFFICER
15.00
.................
35.00
X   X       0 3,083,634 36,894
(11) LAURIE HARTING......................................................................
SYSTEM SPECIAL PROJECTS LEADER
50.00
.................
0.00
        X   2,123,379 0 951,386
(12) SUJA CHANDRASEKARAN......................................................................
SEVP, CHIEF INFORMATION AND DIGITAL OFFICER
10.00
.................
40.00
      X     0 3,020,677 48,493
(13) LINDA HUNT......................................................................
SVP OPERATIONS & CEO, SOUTHWEST DIVISION
40.00
.................
10.00
      X     2,233,083 0 521,964
(14) KATHLEEN SANFORD DBA RN FAAN FACH......................................................................
CHIEF NURSING OFFICER
10.00
.................
40.00
      X     0 2,621,374 47,852
(15) THOMAS KOPFENSTEINER STD......................................................................
CHIEF MISSION OFFICER
20.00
.................
30.00
      X     0 2,622,717 28,122
(16) THOMAS MCGINN MD MPH......................................................................
EVP, PHYSICIAN ENTERPRISE
10.00
.................
40.00
      X     0 2,378,657 39,342
(17) FRED NAJJAR......................................................................
EVP, CHIEF PHILANTHROPY OFFICER
20.00
.................
30.00
      X     2,070,754 0 312,276
Form 990 (2021)
Form 990 (2021)
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/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(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) SHELLY SCHLENKER........................................................................
EVP, CHIEF ADVOCACY OFFICER
10.00
.......................40.00
      X     1,668,865 0 691,958
(19) JOHN E PETERSDORF........................................................................
SVP OPERATIONAL EFFECTIVENESS
10.00
.......................40.00
      X     1,302,346 0 1,039,446
(20) TODD A STRUMWASSER MD........................................................................
SVP OPERATIONS & CEO, NORTHERN CALIFORNIA DIVISION
40.00
.......................10.00
      X     2,206,993 0 131,944
(21) ANTHONY SCOTT CARSWELL........................................................................
BOARD MEMBER
20.00
.......................30.00
X           1,466,951 0 775,075
(22) JON VANBOENING........................................................................
SYSTEM SPECIAL PROJECTS LEADER
50.00
.......................0.00
        X   1,846,355 0 354,864
(23) DARREN LEE........................................................................
HOSPITAL PRESIDENT (THRU 11/1/21)
50.00
.......................0.00
        X   2,057,934 0 117,887
(24) TAMMARA WILCOX........................................................................
SYSTEM SVP PAYER STRATEGY & RELATIONSHIPS
20.00
.......................30.00
      X     1,422,895 0 736,562
(25) MICHELLE COOPER........................................................................
EVP, CHIEF COMPLIANCE OFFICER
10.00
.......................40.00
      X     0 1,788,994 44,058
(26) LISA GAMSHAD ZUCKERMAN........................................................................
SYSTEM SVP TREASURY & STRATEGIC INVESTMENTS
10.00
.......................40.00
      X     1,669,964 0 149,397
(27) GARY A GREENSWEIG DO........................................................................
SYSTEM SVP CHIEF PHYSICIAN EXECUTIVE PE
50.00
.......................0.00
        X   1,537,633 0 159,542
(28) BENJIE M LOANZON........................................................................
SYSTEM SVP FINANCE AND CORPORATE CONTROLLER
20.00
.......................30.00
      X     1,475,778 0 133,961
(29) PHIL FOSTER........................................................................
SYSTEM SVP ENTERPRISE RISK MGMT
10.00
.......................40.00
      X     0 1,388,373 47,271
(30) DANIELLE WEBER........................................................................
SYSTEM SVP REVENUE CYCLE
20.00
.......................30.00
      X     0 1,304,251 35,380
(31) PAUL EDGETT III........................................................................
FORMER KEY EMPLOYEE (CHIEF BUSINESS LINES OFFICER
0.00
.......................0.00
          X 0 1,194,947 12,300
(32) ALYSSA C RIEDER........................................................................
VP, CHIEF INVESTMENT OFFICER
10.00
.......................40.00
      X     1,083,048 0 121,023
(33) PATRICIA WEBB FACHE........................................................................
FORMER OFFICER (SEVP, CHIEF ADMINISTRATIVE OFFICER
0.00
.......................0.00
          X 0 977,470 7,616
(34) TIMOTHY PANKS........................................................................
FORMER KEY EMPLOYEE (SVP, FINANCE & REVENUE CYCLE
0.00
.......................0.00
          X 197,031 0 0
(35) TESSIE GUILLERMO........................................................................
FORMER BOARD CHAIR (THRU 3/31/21)
0.00
.......................6.50
          X 0 130,000 0
(36) CHRISTOPHER LOWNEY........................................................................
FORMER BOARD VICE CHAIR (THRU3/31/21)
0.00
.......................6.00
          X 0 125,000 0
(37) KENT BRADLEY MD........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................4.00
          X 0 110,000 0
(38) MARK DEMICHELE........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................3.50
          X 0 110,000 0
(39) PETER G HANELT CPA........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................3.50
          X 0 110,000 0
(40) ANTOINETTE HARDY-WALLER MJ BSN RN........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................4.00
          X 0 110,000 0
(41) PATRICK STEELE........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................4.00
          X 0 110,000 0
(42) ANGELA ARCHON........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................1.00
          X 0 100,000 0
(43) GERALDINE BEDNASH PHD RN FAAN........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................3.00
          X 0 100,000 0
(44) JAMES P HAMILL........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................3.50
          X 0 100,000 0
(45) PHOEBE YANG........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................1.00
          X 0 100,000 0
(46) GARY R YATES MD........................................................................
FORMER BOARD MEMBER (THRU 3/31/21)
0.00
.......................3.00
          X 0 100,000 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 82,369,227 21,686,094 20,891,135
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 MediumBullet15,105
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 SERVICES 443,030,324
MEDICAL SOLUTIONS LLC

1010 N 102ND ST
OMAHA,NE68114
STAFFING SERVICES 151,732,610
GUIDANT GLOBAL INC

27777 FRANKLIN RD
SOUTHFIELD,MI48034
STAFFING SERVICES 114,700,589
CERNER CORP

2702 ROCKCREEK PKWY
KANSAS CITY,MO64117
TECHNOLOGY SERVICES 53,583,928
JE DUNN CONSTRUCTION CO

1001 LOCUST ST
KANSAS CITY,MO64106
CONTRACTORS 37,359,440
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet1,035
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 264,612,722
e Government grants (contributions)1e 65,056,504
f All other contributions, gifts, grants, and similar amounts not included above1f 10,565,391
g Noncash contributions included in lines 1a - 1f:$ 1g 861,411
h Total. Add lines 1a-1f.......MediumBullet 340,234,617
 Program Service RevenueAmt Business Code
2a PATIENT NET OF CHARITY/PRICE CONC 900099 5,387,791,675 5,387,791,675    
b MEDICARE/MEDICAID PYMNTS 900099 2,654,446,135 2,654,446,135    
c MANAGEMENT SERVICES 541610 448,978,574 448,978,574    
d MEDICAL OFFICE BLDG 621300 13,047,198 13,047,198    
e PROGRAM RENTAL INCOME 532000 3,562,629 3,562,629    
f All other program service revenue. 42,223,805 35,573,486 6,650,319  
g Total. Add lines 2a–2f .....MediumBullet 8,550,050,016
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 178,603,529     178,603,529
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   8,219,935 6a
b Less: rental expenses   216,383 6b
c Rental income or (loss)   8,003,552 6c
d Net rental income or (loss).......MediumBullet 8,003,552     8,003,552
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 2,054,143 4,559,431,835 7a
b Less: cost or other basis and sales expenses 3,277 4,230,891,518 7b
c Gain or (loss) 2,050,866 328,540,317 7c
d Net gain or (loss).........MediumBullet 330,591,183     330,591,183
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a 117,039,890
b Less: cost of goods sold .. 10b 111,766,129
c Net income or (loss) from sales of inventory..MediumBullet 5,273,761     5,273,761
Business Code Miscellaneous Revenue
11a EMPLOYEE RETENTION CREDIT 900099 23,989,979     23,989,979
b REBATES AND REFUNDS 900099 17,614,871     17,614,871
c CAFETERIA 722514 16,304,662     16,304,662
d All other revenue .... 21,247,198   2,667,154 18,580,044
e Total. Add lines 11a–11d ...... MediumBullet 79,156,710
12 Total revenue. See instructions.....MediumBullet 9,491,913,368 8,543,399,697 9,317,473 598,961,581
Form 990 (2021)
Form 990 (2021)
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 .... 275,691,863 275,691,863
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ........... 1,366,380 1,366,380
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. ............. 2,900,000 2,900,000
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 95,251,352 30,587,174 64,664,178  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 91,679   91,679  
7 Other salaries and wages........ 3,861,013,038 3,455,459,756 405,553,282  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 296,368,516 295,224,128 1,144,388  
9 Other employee benefits ....... 506,774,013 497,877,646 8,896,367  
10 Payroll taxes ........... 249,153,285 245,555,907 3,597,378  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 24,950,482   24,950,482  
c Accounting ........... 5,752,055   5,752,055  
d Lobbying ........... 1,319,074 561,409 757,665  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 16,566,548   16,566,548  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 1,213,516,860 767,158,226 446,358,634  
12 Advertising and promotion .... 84,969,233 1,955,139 83,014,094  
13 Office expenses ....... 170,613,650 110,185,968 60,427,682  
14 Information technology ...... 311,427,435 127,685,248 183,742,187  
15 Royalties ..        
16 Occupancy ........... 119,404,569 101,256,503 18,148,066  
17 Travel ............ 9,600,148 5,701,388 3,898,760  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 5,574,316 2,723,337 2,850,979  
20 Interest ........... 61,150,274 61,150,248 26  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 389,324,456 387,210,218 2,114,238  
23 Insurance ... 38,292,485 38,292,485    
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 1,169,594,651 1,168,938,100 656,551  
b MEDI-CAL PROVIDER FEE 205,431,264 205,431,264    
c MED PRVDR/OUT-OF-NTWK C 134,559,289 134,559,289    
d UNRELATED BUSINESS TAX 64,175   64,175  
e All other expenses 71,940,840 51,289,674 20,651,166  
25 Total functional expenses. Add lines 1 through 24e 9,322,661,930 7,968,761,350 1,353,900,580 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 (2021)
Form 990 (2021)
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 ........ 106,161 1 38,491
2 Savings and temporary cash investments ......... 478,042,833 2 387,060,783
3 Pledges and grants receivable, net ...... 28,818,486 3 29,180,635
4 Accounts receivable, net ............. 1,203,643,714 4 1,298,249,559
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ........... 190,105,391 7 193,807,309
8 Inventories for sale or use ............ 220,715,301 8 216,592,219
9 Prepaid expenses and deferred charges ...... 788,965,837 9 598,388,761
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 5,873,365,612
b Less: accumulated depreciation 10b 1,383,824,620 4,560,892,011 10c 4,489,540,992
11 Investments—publicly traded securities . 6,008,188,012 11 1,608,196,105
12 Investments—other securities. See Part IV, line 11 ..... 1,820,067,130 12 4,460,996,798
13 Investments—program-related. See Part IV, line 11 .. 963,935,306 13 1,237,326,538
14 Intangible assets ............... 512,790,000 14 512,790,000
15 Other assets. See Part IV, line 11 ........... 1,940,436,556 15 1,877,107,319
16 Total assets. Add lines 1 through 15 (must equal line 33)... 18,716,706,738 16 16,909,275,509
Liabilities 17 Accounts payable and accrued expenses ..... 1,481,157,390 17 1,798,342,470
18 Grants payable ...   18  
19 Deferred revenue ......... 1,137,306,629 19 39,247,559
20 Tax-exempt bond liabilities ......... 2,516,685,458 20 1,892,357,908
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties .. 3,119,926,163 23 3,212,645,442
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 2,681,477,316 25 1,589,512,850
26 Total liabilities. Add lines 17 through 25.. 10,936,552,956 26 8,532,106,229
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 .......... 7,584,219,291 27 8,105,184,226
28 Net assets with donor restrictions ........... 195,934,491 28 271,985,054
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 ........... 7,780,153,782 32 8,377,169,280
33 Total liabilities and net assets/fund balances ........ 18,716,706,738 33 16,909,275,509
Form 990 (2021)
Form 990 (2021)
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
9,491,913,368
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
9,322,661,930
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
169,251,438
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
7,780,153,782
5
Net unrealized gains (losses) on investments ...............
5
-677,080,714
6
Donated services and use of facilities .................
6
444,075
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
1,104,400,699
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
8,377,169,280
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 on
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 (2021)
Form 990 (2021)
Additional Data


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

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
2021
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) 2021

Schedule A (Form 990) 2021
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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 5 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) 2021

Schedule A (Form 990) 2021
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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on 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) 2021

Schedule A (Form 990) 2021
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
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 on 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 on 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) 2021

Schedule A (Form 990) 2021
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 on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

Schedule A (Form 990) 2021
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 0.015 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 0.035 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) 2021

Schedule A (Form 990) 2021
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 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI
). See instructions
8  
9 Distributable amount for 2021 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2021
(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990)
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
2021
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) (2021)
Schedule B (Form 990) (2021) 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
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


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

$  


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

$  


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

$  


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

$  


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

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
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) (2021)
Schedule B (Form 990) (2021)
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) (2021)
Additional Data


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

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
2021
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
$ 1,253
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
$  
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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) 2018 (b) 2019 (c) 2020 (d) 2021 (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) 2021


Schedule C (Form 990) 2021
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
 
78,714
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
Yes
 
561,408
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
447,558
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
231,394
j
Total. Add lines 1c through 1i ....................................................................................................
1,319,074
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 4A: DIGNITY HEALTH RECENTLY LEARNED THAT RBR MANAGEMENT LLC, A RELATED LLC IN WHICH DIGNITY HEALTH HAS A 50.1% MEMBER INTEREST, MADE A POLITICAL CONTRIBUTION IN 2021 IN THE AMOUNT OF $1,253. DIGNITY HEALTH HAS POLICIES AND PROCEDURES IN PLACE TO AVOID SUCH TRANSACTIONS, AND ONCE THE ORGANIZATION BECAME AWARE OF THIS SITUATION, DIGNITY HEALTH IMMEDIATELY INSTRUCTED THE LLC TO CEASE MAKING POLITICAL CONTRIBUTIONS. DIGNITY HEALTH WILL CLOSELY MONITOR THIS LLC TO ENSURE FULL COMPLIANCE GOING FORWARD. RBR MANAGEMENT LLC HAS PUT IN PLACE POLICIES TO ENSURE THIS WILL NOT OCCUR AGAIN. IN ADDITION, DIGNITY HEALTH HAS INSTRUCTED RBR MANAGEMENT LLC TO TAKE STEPS TO RECOVER THE EXPENDITURES TO THE EXTENT POSSIBLE. DIGNITY HEALTH IS ALSO PAYING THE EXCISE TAX ON FORM 4720.
PART II-B, LINE 1: LOBBYING EXPENDITURES PAID BY THE FILING ORGANIZATION FOR ANNUAL MEMBERSHIP DUES AND OTHER SUCH LOBBYING ACTIVITIES REFLECTED ON LINES 1F AND 1I. DIGNITY HEALTH 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. 340B HEALTH $2,466 ALLIANCE OF CATHOLIC HEALTHCARE $66,462 AMERICAN HOSPITAL ASSOCIATION $76,799 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES AT HOME $1,366 CALIFORNIA HOSPICE AND PALLIATIVE CARE ASSOCIATION $2,860 CATHOLIC HEALTH ASSOCIATION OF THE UNITED STATES $59,746 AMERICAN MEDICAL ASSOCIATION $5,374 CALIFORNIA MEDICAL ASSOCIATION $50,000 AMERICAN TRAUMA SOCIETY $1,147 AMERICAN ACADEMY OF FAMILY PHYSICIANS $820 GREATER OXNARD CHAMBER OF COMMERCE $200 THE GREATER LAS VEGAS CHAMBER OF COMMERCE $600 SOCIETY OF THORACIC SURGEONS $1,300 NEVADA HOSPITAL ASSOCIATION $4,863 NATIONAL ASSOCIATION OF EPILEPSY CENTERS $120 LONG BEACH AREA CHAMBER OF COMMERCE $1,137 PRIVATE ESSENTIAL ACCESS COMM HOSP INC AKA PEACH INC $127,500 FERRARI PUBLIC AFFAIRS $56,658 HEALTH SYSTEM ALLIANCE OF ARIZONA $3,886 CASSIDY & ASSOCIATES INC $220,000 AMERICAN ACADEMY OF ORTHOPAEDICS SURGEONS $113 NATIONAL ASSOCIATION OF RURAL HEALTH CLINICS, INC $194 GOODMAN SCHWARTZ LLC $107,250 RBR MANAGEMENT LLC $1,253 AMERICAN OSTEOPATHIC ASSOCIATION $112 AMERICAN SOCIETY OF HEALTH-SYSTEMS PHARMACISTS $281 VARIOUS OTHER ORGANIZATIONS UNDER $100 $296 TOTAL EXPENDITURES PAID TO ORGANIZATIONS $792,803 PART II-B, LINES 1B, 1D AND 1G: 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. DIGNITY HEALTH ENGAGED IN LETTER-WRITING CAMPAIGNS, COSPONSORSHIP CAMPAIGNS, AND OTHER LOBBYING ACTIVITIES AIMED AT INFLUENCING PUBLIC POLICY. THIS IS DONE PRIMARILY THROUGH EMPLOYED DIVISION-LEVEL ADVOCACY LEADERS WITH LEADERSHIP AND GUIDANCE FROM NATIONAL EMPLOYEES. DRAFT LETTERS WERE PROVIDED ON DIGNITY HEALTH ADVOCACY PRIORITIES; DIVISION-EMPLOYED ADVOCACY LEADERS WERE ABLE TO CREATE THEIR OWN LETTERS AS WELL. DIGNITY HEALTH COMMUNICATES WITH LEADERS OF THE SYSTEM'S HOSPITALS AND HEALTH CARE ORGANIZATIONS ON ADVOCACY ACTIVITIES PRIMARILY THROUGH E-MAIL. MOST COMMUNICATIONS WITH CONGRESS OCCUR THROUGH EMAIL AND PHONE. DIGNITY HEALTH ADVOCACY ACTIVITIES INVOLVED COMMUNICATIONS ON DIGNITY HEALTH ADVOCACY PRIORITIES, INCLUDING ISSUES RELATED TO ACCESS AND COVERAGE FOR ALL, HOSPITAL AND HEALTH PROVIDER REIMBURSEMENT, COVID-19 RELIEF FOR INDIVIDUALS AND HEALTH ENTITIES, AND SOCIAL JUSTICE ISSUES (E.G. ENVIRONMENTAL STEWARDSHIP, HOUSING). CENTRAL TO THE DIGNITY HEALTH MISSION AND VISION IS A COMMITMENT TO ADVOCATE FOR SYSTEMIC CHANGES TO IMPROVE THE HEALTH AND WELL-BEING OF INDIVIDUALS AND COMMUNITIES WITH A SPECIFIC CONCERN FOR PERSONS WHO ARE POOR AND MARGINALIZED. THE DIGNITY HEALTH ADVOCACY ACTIVITIES ARE INEXTRICABLY LINKED TO ITS FUNDAMENTAL GOAL TO BUILD HEALTHIER COMMUNITIES. ONE DIMENSION OF THE DIGNITY HEALTH ADVOCACY PROGRAM FOCUSES ON PUBLIC POLICY ADVOCACY, WHICH INCLUDES ATTENTION TO FEDERAL LEGISLATIVE AND REGULATORY MEASURES, FORMATION OF POSITIONS ON PRIORITY ISSUES, AND POLITICAL ACTIVISM. THE COMMONSPIRIT HEALTH PUBLIC POLICY AGENDA INCLUDES BOTH TRADITIONAL HEALTH CARE POLICIES (E.G., PAYMENT ISSUES, QUALITY AND SAFETY, ETC.) AS WELL AS SOCIAL JUSTICE POLICIES.
Schedule C (Form 990) 2021


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
2021
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) 2021

Schedule D (Form 990) 2021
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 .... 176,049,330 154,157,524 142,467,934 165,612,275 144,666,878
b Contributions ...   4,799,957 8,800,580 5,096,943 15,292,563
c Net investment earnings, gains, and losses   25,751,390 6,141,923 5,203,723 14,429,311
d Grants or scholarships ...   833,659 15,966 188,817  
e Other expenditures for facilities
and programs ...
176,049,330 7,825,882 2,717,368 29,408,378 8,776,477
f Administrative expenses ....     519,579 3,847,812  
g End of year balance ......   176,049,330 154,157,524 142,467,934 165,612,275
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet0 %
c
Term endowment SchDMd Bullet0 %
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)
 
No
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
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 .....   596,571,489 596,571,489
b Buildings ....   2,856,226,698 393,236,416 2,462,990,282
c Leasehold improvements   44,553,930 21,171,122 23,382,808
d Equipment ....   1,665,805,941 940,100,851 725,705,090
e Other .....   710,207,554 29,316,231 680,891,323
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 4,489,540,992
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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) CSH POOLED INVESTMENTS
4,460,996,798 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 4,460,996,798
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)INVESTMENTS IN UNCONSOLIDATED FOUNDATIONS 261,944,027 F
(2)INVESTMENTS IN HEALTH RELATED ENTITIES 777,782,286 F
(3)INVESTMENTS IN HEALTH RELATED ENTITIES 197,600,225 C
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 1,237,326,538
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1)OTHER LONG-TERM ASSETS 242,020,280
(2)DUE FROM RELATED PARTIES 1,635,087,039
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 1,877,107,319
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 8,746,572
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 1,589,512,850
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) 2021

Schedule D (Form 990) 2021
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART 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. THE ENDOWMENT FUNDS ARE NO LONGER IN THE POSSESSION OF THE ORGANIZATION. THE ENDOWMENT FUNDS WERE TRANSFERRED TO THE RELATED ORGANIZATION, COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL, LLC.
PART X, LINE 2: DIGNITY HEALTH IS INCLUDED IN COMMONSPIRIT'S FY22 CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT 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) 2021


Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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     INVESTMENTS N/A 8,677,978
CANADA     GRANTMAKING N/A 2,900,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 11,577,978
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 11,577,978
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021
Schedule F (Form 990) 2021
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)
CANADA TO FUND THE SCHOLARSHIP IMPACT PROGRAM 2,900,000 ACH PAYMENT 0 N/A N/A
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
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
0
3 Enter total number of other organizations or entities .......................MediumBullet
1
Schedule F (Form 990) 2021
Schedule F (Form 990) 2021Page 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) 2021
Schedule F (Form 990) 2021
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) 2021
Schedule F (Form 990) 2021
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
PART I, LINE 2: GRANTS ARE AWARDED TO INTERNATIONAL ORGANIZATIONS AND INDIVIDUALS 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.
PART I, LINE 3: CENTRAL AMERICA AND THE CARIBBEAN: ACCRUAL CANADA: ACCRUAL
PART III ACCOUNTING METHOD:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2021
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
2021
Open to Public Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

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

4

Yes

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

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . .
  544,838 146,928,786 0 146,928,786 1.580 %
b Medicaid (from Worksheet 3, column a) . . . . .   1,127,052 2,358,130,696 1,689,889,186 668,241,510 7.170 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .   2,016 1,198,902 231,486 967,416 0.010 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .   1,673,906 2,506,258,384 1,690,120,672 816,137,712 8.760 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 364 461,228 55,426,969 9,938,395 45,488,574 0.490 %
f Health professions education (from Worksheet 5) . . . 44 8,019 145,118,263 18,487,262 126,631,001 1.360 %
g Subsidized health services (from Worksheet 6) . . . . 16 18,624 18,784,595 5,114,601 13,669,994 0.150 %
h Research (from Worksheet 7) . 3 0 45,831,293 44,044,530 1,786,763 0.020 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 88 57,581 37,318,926 107,996 37,210,930 0.400 %
j Total. Other Benefits . . 515 545,452 302,480,046 77,692,784 224,787,262 2.420 %
k Total. Add lines 7d and 7j . 515 2,219,358 2,808,738,430 1,767,813,456 1,040,924,974 11.180 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 2 53 3,068,653 617,469 2,451,184 0.030 %
2 Economic development 0 0 0 0    
3 Community support 9 3,792 891,276 315,280 575,996 0.010 %
4 Environmental improvements 1 0 49,809 1,799 48,010 0 %
5 Leadership development and
training for community members
4 141 106,047 0 106,047 0 %
6 Coalition building 10 3,215 382,155 126,260 255,895 0 %
7 Community health improvement advocacy 3 645 32,901 18,462 14,439 0 %
8 Workforce development 11 24 3,457,693 0 3,457,693 0.040 %
9 Other   0 0 0    
10 Total 40 7,870 7,988,534 1,079,270 6,909,264 0.080 %
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
68,795,639
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
 
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
1,507,917,465
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
1,808,787,136
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-300,869,671
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 %
11 FOLSOM SIERRA ENDOSCOPY CENTER
 
SURGERY 51.000 % 0 % 49.000 %
22 SANTA CRUZ SURGERY CENTER
 
SURGERY 50.000 % 0 % 50.000 %
33 SANTA CRUZ COMPREHENSIVE IMAGING LLC
 
IMAGING 50.000 % 0 % 50.000 %
44 DOMINICAN MAGNETIC RESONANCE IMAGING CENTER
 
IMAGING 80.000 % 0 % 20.000 %
55 CBCC OUTSMARTING CANCER LLC
 
CANCER 51.000 % 0 % 49.000 %
66 MEDICAL PAVILION AT ST JOHN'S
 
REAL ESTATE (RENT/LEASE) 25.000 % 0 % 26.420 %
77 BNI MANAGEMENT LLC
 
MGMT SERVICES 26.040 % 0 % 73.960 %
88 COASTAL SURGICAL SPECIALISTS INC
 
SURGERY 51.380 % 0 % 48.620 %
99 PLAZA SURGERY CENTER LP
 
SURGERY 57.780 % 0 % 42.220 %
10
11
12
13
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?25Name, 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 CENTER
350 W THOMAS ROAD
PHOENIX,AZ85013
WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIO
H-3003
X X   X   X X     C
2 MERCY SAN JUAN MEDICAL CENTER
6501 COYLE AVENUE
CARMICHAEL,CA95608
WWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCA
030000063
X X   X     X     B
3 MARIAN REGIONAL MEDICAL CENTER ARROYO GRANDE
1400 E CHURCH STREET
SANTA MARIA,CA93454
WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/L
50000040
X X   X     X     D
4 MERCY GENERAL HOSPITAL
4001 J STREET
SACRAMENTO,CA95819
WWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCA
030000062
X X   X     X     B
5 MERCY MEDICAL CENTER REDDING
2175 ROSALINE AVENUE
REDDING,CA96001
WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOC
230000024
X X   X     X     D
6 ST ROSE DOMINICAN HOSPITAL - SIENA
3001 ST ROSE PARKWAY
HENDERSON,NV89052
WWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCAT
2969HOS-21
X X   X     X     A
7 DOMINICAN HOSPITAL
1555 SOQUEL DRIVE
SANTA CRUZ,CA95065
WWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIO
070000030
X X         X     B
8 ST BERNARDINE MEDICAL CENTER
2101 N WATERMAN AVENUE
SAN BERNARDINO,CA92404
WWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS
240000206
X X   X     X      
9 MERCY GILBERT MEDICAL CENTER
3555 S VAL VISTA DRIVE
GILBERT,AZ85297
WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIO
H-3972
X X         X     C
10 MERCY HOSPITAL (BAKERSFIELD)
2215 TRUXTUN AVENUE
BAKERSFIELD,CA93301
WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFOR
120000184
X X         X     B
11 ST MARY MEDICAL CENTER - LONG BEACH
1050 LINDEN AVENUE
LONG BEACH,CA90813
WWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS
930000012
X X   X     X     F
12 ST JOHN'S REGIONAL MEDICAL CENTER
1600 NORTH ROSE AVENUE
OXNARD,CA93030
WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/L
050000064
X X         X     E
13 MERCY MEDICAL CENTER MERCED
333 MERCY AVENUE
MERCED,CA95340
WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFOR
040000178
X X   X     X     B
14 MERCY HOSPITAL OF FOLSOM
1650 CREEKSIDE DRIVE
FOLSOM,CA95630
WWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCA
030000372
X X         X     B
15 ST MARYS MEDICAL CENTER
450 STANYAN STREET
SAN FRANCISCO,CA94117
WWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIO
220000071
X X   X     X     E
16 ST ROSE DOMINICAN HOSPITAL - SAN MARTIN
8280 WEST WARM SPRINGS ROAD
LAS VEGAS,NV89113
WWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCAT
4576HOS-6
X X         X     A
17 ST ELIZABETH COMMUNITY HOSPITAL
2550 SISTER MARY COLUMBA DRIVE
RED BLUFF,CA96080
WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOC
230000036
X X         X     D
18 ST JOHN'S HOSPITAL CAMARILLO
2309 ANTONIO AVENUE
CAMARILLO,CA93010
WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/L
050000048
X X         X     E
19 MERCY MEDICAL CENTER MT SHASTA
914 PINE STREET
MT SHASTA,CA96067
WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOC
230000015
X X     X   X     F
20 ST JOSEPH'S WESTGATE MEDICAL CENTER
7300 N 99TH AVENUE
GLENDALE,AZ85305
WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIO
H-6522
X X         X     C
21 ST ROSE DOMINICAN HOSPITAL - ROSE DE LIMA
102 E LAKE MEAD DRIVE
HENDERSON,NV89015
WWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCAT
659HOS-20
X X         X     A
22 DE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN N
1550 W CRAIG ROAD
NORTH LAS VEGAS,NV89032
WWW.STROSENH.ORG/LOCATIONS/NORTH-LAS-
8544-HOS-0
X           X X NEIGHBORHOOD HOSPITAL A
23 DE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN
4855 BLUE DIAMON ROAD
LAS VEGAS,NV89139
WWW.STROSENH.ORG/LOCATIONS/BLUE-DIAMO
8594-HOS-0
X           X X NEIGHBORHOOD HOSPITAL A
24 DE SAHARA LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN SAHARA
4890 W SAHARA AVENUE
LAS VEGAS,NV89146
WWW.STROSENH.ORG/LOCATIONS/SAHARA/
8686-HOS-0
X           X X NEIGHBORHOOD HOSPITAL A
25 DE FLAMINGO LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN WEST
9880 W FLAMINGO
LAS VEGAS,NV89147
WWW.STROSENH.ORG/LOCATIONS/WEST-FLAMI
8652-HOS-0
X           X X NEIGHBORHOOD HOSPITAL A
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP A
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP A
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP A
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP A
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) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP B
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP B
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP B
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP B
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) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP C
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP C
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP C
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP C
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) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP D
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP D
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP D
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP D
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) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP E
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP E
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP E
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP E
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) 2021
Schedule H (Form 990) 2021
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)
FACILITY REPORTING GROUP F
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
 
Yes 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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
FACILITY REPORTING GROUP F
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
FACILITY REPORTING GROUP F
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) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
FACILITY REPORTING GROUP F
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) 2021
Schedule H (Form 990) 2021
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):
 
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 21
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 22
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V, PAGE 8
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?............................... 12a   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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 PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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) 2021
Schedule H (Form 990) 2021
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
PART V, SECTION A: PRIMARY WEBSITE ADDRESS1. ST JOSEPH'S HOSPITAL AND MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/STJOSEPHS2. MERCY SAN JUAN MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCATIONS/MERCY-SAN-JUAN-MEDICAL-CENTER3. MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDEWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/MARIANREGIONAL4. MERCY GENERAL HOSPITALWWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCATIONS/MERCY-GENERAL-HOSPITAL5. MERCY MEDICAL CENTER REDDINGWWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-REDDING6. ST ROSE DOMINICAN HOSPITAL - SIENAWWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCATIONS7. DOMINICAN HOSPITALWWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/DOMINICAN8. ST BERNARDINE MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STBERNARDINEMEDICAL9. MERCY GILBERT MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/MERCYGILBERT10. MERCY HOSPITAL (BAKERSFIELD)WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS11. ST MARY MEDICAL CENTER - LONG BEACHWWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STMARYMEDICAL12. ST JOHN'S REGIONAL MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS13. MERCY MEDICAL CENTER MERCEDWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/MERCYMEDICAL-MERCED14. MERCY HOSPITAL OF FOLSOMWWW.DIGNITYHEALTH.ORG/SACRAMENTO/LOCATIONS/MERCY-HOSPITAL-OF-FOLSOM15. ST MARY'S MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/STMARYS16. ST ROSE DOMINICAN HOSPITAL - SAN MARTINWWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCATIONS/SAN-MARTIN17. ST ELIZABETH COMMUNITY HOSPITALWWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/STELIZABETHHOSPITAL18. ST JOHN'S HOSPITAL CAMARILLOWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS19. MERCY MEDICAL CENTER MT SHASTAWWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-MTSHASTA20. ST JOSEPH'S WESTGATE MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/WESTGATE21. ST ROSE DOMINICAN HOSPITAL - ROSE DE LIMAWWW.DIGNITYHEALTH.ORG/LAS-VEGAS/LOCATIONS22. DE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN NWWW.STROSENH.ORG/LOCATIONS/NORTH-LAS-VEGAS/23. DE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST ROSE DOMINICANWWW.STROSENH.ORG/LOCATIONS/BLUE-DIAMOND/24. DE SAHARA LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN SAHARAWWW.STROSENH.ORG/LOCATIONS/SAHARA/25. DE FLAMINGO LLC DBA DIGNITY HEALTH - ST ROSE DOMINICAN WESTWWW.STROSENH.ORG/LOCATIONS/WEST-FLAMINGO/
ST BERNARDINE MEDICAL CENTER PART V, SECTION B, LINE 5: FOR THE 2022 (TY 2021) CHNA REPORT, SECONDARY DATA WERE COLLECTED FROM LOCAL, COUNTY, AND STATE SOURCES TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL DETERMINANTS OF HEALTH, HEALTH CARE ACCESS, BIRTH INDICATORS, LEADING CAUSES OF DEATH, CHRONIC DISEASE, HEALTH BEHAVIORS, MENTAL HEALTH, SUBSTANCE USE AND MISUSE AND PREVENTIVE PRACTICES. ST. BERNARDINE MEDICAL CENTER (SBMC) CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS FROM SAN BERNARDINO COUNTY TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. TWENTY-ONE (21) INTERVIEWS WERE COMPLETED DURING SEPTEMBER AND OCTOBER 2021. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITAL WERE CONTACTED AND ASKED TO PARTICIPATE IN THE INTERVIEWS. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. SBMC CONSULTED WITH THE FOLLOWING ORGANIZATIONS AND/OR AGENCIES WITHIN THE HOSPITALS SERVICE AREAS: OFFICE OF STATE SENATOR ROSILICIE OCHOA BOGH, CALIFORNIA STATE UNIVERSITY, SAN BERNARDINO, NATIONAL CORE, FAMILY ASSISTANCE PROGRAM, EL SOL NEIGHBORHOOD EDUCATIONAL CENTER, MARY'S MERCY CENTER, INC., CITY OF SAN BERNARDINO, LESTONNAC FREE CLINIC, FIRST PRESBYTERIAN CHURCH OF SAN BERNARDINO, SAN BERNARDINO CITY UNIFIED SCHOOL DISTRICT, SAN BERNARDINO DIOCESE, MAKING HOPE HAPPEN FOUNDATION, LEGAL AID OF SAN BERNARDINO, HOUSING AUTHORITY OF THE COUNTY OF SAN BERNARDINO, CATHOLIC CHARITIES SAN BERNARDINO & RIVERSIDE COUNTIES, SAN BERNARDINO DEPARTMENT OF PUBLIC HEALTH ADMINISTRATION, YOUNG VISIONARIES YOUTH LEADERSHIP ACADEMY, FIRST PRESBYTERIAN CHURCH OF SAN BERNARDINO, AND COMMUNITY HEALTH ASSOCIATION INLAND SOUTHERN REGION.
ST BERNARDINE MEDICAL CENTER PART V, SECTION B, LINE 6A: COMMUNITY HOSPITAL OF SAN BERNARDINO
ST BERNARDINE MEDICAL CENTER PART V, SECTION B, LINE 7D: THE 2022 CHNA WAS MADE AVAILABLE TO THE COMMUNITY HOSPITAL OF SAN BERNARDINO AND ST. BERNARDINE MEDICAL CENTER COMMUNITY BENEFIT INITIATIVE COMMITTEE MEMBERS, RESPECTIVE HOSPITAL BOARD MEMBERS, AND PARTNER ORGANIZATIONS VIA ELECTRONIC AND PAPER COPY.
ST BERNARDINE MEDICAL CENTER PART V, SECTION B, LINE 11: ST. BERNARDINE MEDICAL CENTER (SBMC) INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS PRESENTED IN THE 2022 CHNA: ACCESS TO CARE, BEHAVIORAL HEALTH (SUBSTANCE USE & MENTAL HEALTH), CHRONIC DISEASES INCLUDING OVERWEIGHT AND OBESITY, HOUSING AND HOMELESSNESS, PREVENTATIVE PRACTICES, AND SAFETY AND VIOLENCE PREVENTION. SBMC WILL TAKE SEVERAL ACTIONS AND DEDICATE RESOURCES TO THESE NEEDS BY PROVIDING THE FOLLOWING PROGRAMMING AND/OR RESOURCES: FINANCIAL ASSISTANCE, COMMUNITY HEALTH NAVIGATION SERVICES, COMMUNITY HEALTH EDUCATION, EDUCATION AND RESOURCES FOR BABIES AND FAMILIES, ASSISTANCE TO DISCHARGED PATIENTS TO IDENTIFY AND SECURE A MEDICAL HOME (TRANSITIONAL CARE CLINIC), INVESTMENT FOR LOCAL COMMUNITY PARTNERS THROUGH THE COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM, GRADUATE MEDICAL EDUCATION PROGRAM, BEHAVIORAL HEALTH NAVIGATION, CULTURAL TRAUMA AND MENTAL HEALTH RESILIENCY EDUCATION, YOUTH PROGRAMMING AT THE FAMILY FOCUS CENTER AND IN PERSON AND VIRTUAL SUPPORT GROUPS.
ST BERNARDINE MEDICAL CENTER PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
PART V, SECTION B FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 6: ST ROSE DOMINICAN HOSPITAL - SIENA, - FACILITY 16: ST ROSE DOMINICAN HOSPITAL - SAN MARTIN, - FACILITY 21: ST ROSE DOMINICAN HOSPITAL - ROSE DE LIMA, - FACILITY 22: DE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST RO, - FACILITY 23: DE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST R, - FACILITY 24: DE SAHARA LLC DBA DIGNITY HEALTH - ST ROSE DO, - FACILITY 25: DE FLAMINGO LLC DBA DIGNITY HEALTH - ST ROSE
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 5: FOR THE HOSPITALS' 2022 (TY 2021) CHNA, THE NEVADA INSTITUTE FOR CHILDREN'S RESEARCH AND POLICY WORKED WITH SOUTHERN NEVADA HEALTH DISTRICT TO CONDUCT FOCUS GROUPS WITH SIX SPECIFIC PRIORITY POPULATIONS THROUGHOUT THE SOUTHERN NEVADA REGION. A TOTAL OF SEVEN FOCUS GROUP DISCUSSIONS WERE HELD WITH 70 INDIVIDUALS. AN ADDITIONAL THREE FOCUS GROUPS WERE HELD WITH A TOTAL OF 15 INDIVIDUALS, INCLUDING THOSE EXPERIENCING HOMELESSNESS, MEMBERS OF THE LGBTQ+ COMMUNITY, PARENTS OF YOUNG CHILDREN, ADULTS AGED 55 AND OLDER, PEOPLE WHO PRIMARILY SPEAK SPANISH, AND MEMBERS OF THE BLACK/AFRICAN AMERICAN COMMUNITY. THE HOSPITALS ALSO CONSULTED WITH KEY INFORMANTS FROM THE FOLLOWING ORGANIZATIONS: SOUTHERN NEVADA HEALTH DISTRICT PUBLIC HEALTH ADVISORY BOARD, OFFICE OF COMMUNICATIONS OFFICE OF EPIDEMIOLOGY & DISEASE SURVEILLANCE, THE NEVADA INSTITUTE FOR CHILDREN'S RESEARCH AND POLICY, A COMPLETE CARE SUPPORT SERVICES, AMERICAN HEART ASSOCIATION AMERICAN LUNG ASSOCIATION, BRIDGE COUNSELING ASSOCIATES, CENTER FOR BEHAVIORAL HEALTH, CENTER FOR PROGRESSIVE POLICY, CHILDREN'S HEART CENTER, CITY OF HENDERSON, CLARK COUNTY MEDICAL SOCIETY ALLIANCE, CLARK COUNTY PARKS AND RECREATION, DESERT SPRINGS HOSPITAL, COMAGINE HEALTH, COMMUNITY COUNSELING CENTER OF SOUTHERN NEVADA, DIGNITY HEALTH ST ROSE DOMINICAN, DISTRICT REP CONGRESSWOMAN DINA TITUS OFFICE, DOLCRX PHARMACY, FRESENIUS DIALYSIS, GARDEN FARMS FOUNDATION, HEALTH CARE FOR HOMELESS VETERANS, HELPING HANDS OF VEGAS VALLEY, IMMUNIZE NEVADA, LAS VEGAS HIDTA, LAS VEGAS METRO POLICE DEPARTMENT, NEVADA DRUG CARD, NEVADA MINORITY HEALTH & EQUITY COALITION, NEVADA OFFICE OF MINORITY HEALTH AND EQUITY, NEVADA STATE COLLEGE SCHOOL OF NURSING, PACT COALITION, RAPE CRISIS CENTER, REGIONAL TRANSPORTATION COMMISSION OF SOUTHERN NEVADA, ROSEMAN UNIVERSITY, SOUTHERN NEVADA ASSOCIATION OF PRIDE, THERE IS NO HERO IN HEROIN, THREE SQUARE, UNITED CITIZENS FOUNDATION, UNIVERSITY OF NEVADA, COOPERATIVE EXTENSION, UNIVERSITY OF NEVADA LAS VEGAS SCHOOL OF MEDICINE, UNIVERSITY OF NEVADA LAS VEGAS SCHOOL OF PUBLIC HEALTH, WEST CARE.
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 6A: ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS, ST. ROSE DOMINICAN HOSPITAL SIENA CAMPUS, DE CRAIG RANCH LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN NORTH LAS VEGAS, DE BLUE DIAMOND 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, DIGNITY HEALTH REHABILITATION HOSPITAL (SIENA CAMPUS)
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 6B: SOUTHERN NEVADA HEALTH DISTRICT
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 7D: THE CHNA WAS MADE WIDELY AVAILABLE BY A NUMBER OF ADDITIONAL MEANS, INCLUDING: DIGNITY HEALTH COMMUNITY HEALTH ADVISORY COMMITTEE, SOUTHERN NEVADA HEALTH DISTRICT COMMUNITY HEALTH IMPROVEMENT PLANNING COMMITTEE, SOUTHERN NEVADA HEALTH DISTRICT PRESS CONFERENCE, SOUTHERN NEVADA HEALTH DISTRICT CHA PARTNERS, RELIGIOUS LEADER SUMMIT PRESENTATIONS, UNLV INTERN PRESENTATION, HEAL WITH HUMANKINDNESS E-NEWSLETTER, PATIENT AND FAMILY ADVISORY COUNCIL, SOCIAL MEDIA POSTINGS, ST. ROSE INSIGHTS EMPLOYEE NEWSLETTER.
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 11: THE HOSPITALS ARE TAKING SEVERAL ACTIONS AND DEDICATING RESOURCES TO HELP ADDRESS ALL OF THE IDENTIFIED SIGNIFICANT NEEDS, INCLUDING: ACCESS TO CARE: NEVADA HEALTH LINK & MEDICAID ENROLLMENT, MEDICARE ASSISTANCE PROGRAM, HELPING HANDS PROGRAM, ENGELSTAD FOUNDATION RED ROSE PROGRAM NAVIGATION, PATHWAYS COMMUNITY HUB, GME FAMILY & INTERNAL MEDICINE RESIDENT CLINICS, PATIENT FINANCIAL ASSISTANCE, COMMUNITY HEALTH IMPROVEMENT GRANTEES. CHRONIC DISEASE: DIABETES LIFESTYLE CENTER, HIV PROGRAM, INNOVATIVE HEART HEALTH, COGNITIVE STIMULATION THERAPY, CHRONIC DISEASE SELF MANAGEMENT PROGRAMS, COPD BETTER BREATHERS, BREAST CANCER, PATHWAYS COMMUNITY HUB, MENTAL & BEHAVIORAL HEALTH, CHRONIC DISEASE PREVENTION PROGRAMS. TRANSPORTATION: HELPING HANDS OF HENDERSON, GOLDEN GROCERY, PATHWAYS COMMUNITY HUB, COMMUNITY HEALTH IMPROVEMENT GRANTEES. FUNDING: LEGISLATIVE ADVOCACY, PATHWAYS COMMUNITY HUB, GRANT WRITING, COLLABORATIVE PARTNERSHIPS, COMMUNITY HEALTH IMPROVEMENT GRANTEES.
FACILITY REPORTING GROUP A PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.
PART V, SECTION B FACILITY REPORTING GROUP B
FACILITY REPORTING GROUP B CONSISTS OF: - FACILITY 2: MERCY SAN JUAN MEDICAL CENTER, - FACILITY 4: MERCY GENERAL HOSPITAL, - FACILITY 7: DOMINICAN HOSPITAL, - FACILITY 10: MERCY HOSPITAL (BAKERSFIELD), - FACILITY 13: MERCY MEDICAL CENTER MERCED, - FACILITY 14: MERCY HOSPITAL OF FOLSOM
FACILITY REPORTING GROUP B PART V, SECTION B, LINE 5: MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, MERCY HOSPITAL OF FOLSOMFOR THE 2022 (TY 2021) CHNA REPORT, QUALITATIVE DATA INCLUDED INTERVIEWS WITH 87 COMMUNITY HEALTH EXPERTS, MEMBERS OF THE COUNTY'S DEPARTMENT OF PUBLIC HEALTH, SOCIAL-SERVICE PROVIDERS THAT REPRESENTED MEDICALLY UNDERSERVED POPULATIONS, AND MEDICAL PERSONNEL IN ONE-ON-ONE AND GROUP INTERVIEWS; 31 ADDITIONAL COMMUNITY SERVICE PROVIDERS GAVE INPUT THROUGH AN ONLINE SURVEY. ALL INTERVIEW PARTICIPANTS WERE GIVEN AN INFORMED CONSENT FORM PRIOR TO THEIR PARTICIPATION, WHICH PROVIDED INFORMATION ABOUT THE PROJECT, ASKED FOR PERMISSION TO RECORD THE INTERVIEW, AND LISTED THE POTENTIAL BENEFITS AND RISKS OF INVOLVEMENT IN THE INTERVIEW. ALL KEY INFORMANTS WERE ASKED TO IDENTIFY VULNERABLE POPULATIONS. FURTHER, 57 COMMUNITY RESIDENTS PARTICIPATED IN 11 FOCUS GROUPS ACROSS THE COUNTY; FOCUS GROUPS PARTICIPANTS CONSISTED OF COMMUNITY RESIDENTS LIVING IN IDENTIFIED COMMUNITIES OF CONCERN OR REPRESENTING COMMUNITIES EXPERIENCING HEALTH DISPARITIES. DUE TO THE COVID-19 PANDEMIC ALL COMMUNITY INPUT FOR THE 2022 CHNA REPORT WAS PROVIDED OVER ZOOM, AND SURVEYS WERE RECEIVED ELECTRONICALLY.DOMINICAN HOSPITALFOR THE 2022 (TY 2021) CHNA REPORT, KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED, WITH INPUT SOLICITED FROM 26 COMMUNITY LEADERS AND REPRESENTATIVES OF VARIOUS ORGANIZATIONS AND SECTORS. THESE REPRESENTATIVES EITHER WORK IN THE HEALTH FIELD OR IN A COMMUNITY BASED ORGANIZATION THAT FOCUSES ON IMPROVING HEALTH AND QUALITY OF LIFE CONDITIONS BY SERVING THOSE FROM IRS IDENTIFIED HIGH NEED TARGET POPULATIONS. ORGANIZATIONS REPRESENTED INCLUDED: SANTA CRUZ COMMUNITY HEALTH, ENCOMPASS COMMUNITY SERVICES, JANUS OF SANTA CRUZ, CENTRAL CALIFORNIA ALLIANCE FOR HEALTH, SALUD PARA LA GENTE, HOUSING MATTERS, SANTA CRUZ COUNTY HEALTH SERVICES AGENCY, COMMUNITY BRIDGES, AND COMMUNITY ACTION BOARD.MERCY HOSPITAL BAKERSFIELDFOR THE 2022 (TY 2021) CHNA REPORT, MERCY HOSPITALS CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THIRTY (30) INTERVIEWS WERE COMPLETED FROM OCTOBER TO DECEMBER 2021. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE HOSPITALS WERE CONTACTED AND ASKED TO PARTICIPATE IN THE INTERVIEWS. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. EXAMPLES OF THE ORGANIZATIONS CONSULTED INCLUDE: KERN COUNTY DEPARTMENT OF PUBLIC HEALTH, KERN HEALTH SYSTEMS, FIRST 5 KERN COUNTY, COMMUNITY ACTION PARTNERSHIP OF KERN COUNTY, KERN COUNTY SUPERINTENDENT OF SCHOOLS, BAKERSFIELD HOMELESS CENTER, AND ALZHEIMER'S ASSOCIATION, KERN COUNTY. A SURVEY WAS DISTRIBUTED TO ENGAGE COMMUNITY RESIDENTS AND OBTAIN INPUT ON HEALTH AND SOCIAL NEEDS. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT THROUGH A SURVEYMONKEY LINK, AND IN A PAPER COPY FORMAT. THE ELECTRONIC AND PAPER SURVEYS WERE AVAILABLE IN ENGLISH AND SPANISH. THE SURVEYS WERE AVAILABLE FROM SEPTEMBER 13 TO NOVEMBER 15, 2021. DURING THIS TIME, 255 USABLE SURVEYS WERE COLLECTED.MERCY MEDICAL CENTER MERCEDMERCY MEDICAL CENTER MERCED'S 2022 (TY 2021) CHNA INCLUDED OVER 250 KEY INFORMANTS, STAKEHOLDERS AND RESIDENTS IN THE COMMUNITY. A SURVEY INSTRUMENT WAS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), 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. TO ENSURE THE BEST REPRESENTATION OF THE POPULATION, A MIXED-MODE METHODOLOGY WAS IMPLEMENTED. THIS INCLUDED SURVEYS CONDUCTED VIA TELEPHONE (LANDLINE AND CELL PHONE), AS WELL AS THROUGH ONLINE QUESTIONNAIRES. THE SAMPLE DESIGN CONSISTED OF A RANDOM SAMPLE OF MERCED COUNTY RESIDENT INDIVIDUALS AGE 18 AND OLDER. ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE COUNTY'S ACTUAL POPULATION DISTRIBUTION. TO SOLICIT INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS IMPLEMENTED. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY MERCY MEDICAL CENTER MERCED AND VALLEY CHILDREN'S HOSPITAL. PARTICIPATING ORGANIZATIONS INCLUDED 32 PUBLIC HEALTH REPRESENTATIVES, 5 HEALTH CARE PROVIDERS, 25 SOCIAL SERVICE PROVIDERS, AND 7 OTHER COMMUNITY LEADERS. THE LIST OF ORGANIZATIONS IS INCLUDED IN THE CHNA REPORT.
FACILITY REPORTING GROUP B PART V, SECTION B, LINE 6A: MERCY SAN JUAN MEDICAL CENTER, MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, AND METHODIST HOSPITAL OF SACRAMENTO, UC DAVIS MEDICAL CENTER, SUTTER MEDICAL CENTER SACRAMENTO, SUTTER CENTER FOR PSYCHIATRYDOMINICAN HOSPITALSUTTER MATERNITY & SURGERY CENTERMERCY HOSPITAL BAKERSFIELDBAKERSFIELD MEMORIAL HOSPITAL, KERN MEDICAL, ADVENTIST HEALTH (BAKERSFIELD, DELANO AND TEHACHAPI VALLEY), VALLEY CHILDREN'S HEALTHCARE AND KAISER PERMANENTEMERCY MEDICAL CENTER MERCEDVALLEY CHILDREN'S HOSPITAL
FACILITY REPORTING GROUP B PART V, SECTION B, LINE 11: MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, MERCY HOSPITAL OF FOLSOM: THE SACRAMENTO HOSPITALS ARE ADDRESSING OR DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: 1) ACCESS TO MENTAL, BEHAVIORAL, AND SUBSTANCE ABUSE SERVICES, 2) ACCESS TO BASIC NEEDS, SUCH AS HOUSING, JOBS, AND FOOD, 3) ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES, 4) SYSTEM NAVIGATION, 5) INJURY AND DISEASE PREVENTION AND MANAGEMENT, 6) HEALTH EQUITY: EQUAL ACCESS TO OPPORTUNITIES TO BE HEALTHY, 7) ACTIVE LIVING AND HEALTHY EATING, 8) SAFE AND VIOLENCE-FREE ENVIRONMENT, 9) INCREASED COMMUNITY CONNECTIONS, 10) ACCESS TO SPECIALTY AND EXTENDED CARE. 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, SACRAMENTO COUNTY CRISIS NAVIGATION PROGRAM, SUBSTANCE USE NAVIGATION, MENTAL HEALTH CONSULTATIONS AND CONSERVATORSHIP SERVICES, TELE-PSYCHIATRY, CRISIS STABILIZATION UNIT, GREGORY BUNKER CARE TRANSITIONS CENTER OF EXCELLENCE (FORMERLY, INTERIM CARE PROGRAM), HOUSING WITH DIGNITY, RESOURCES FOR LOW-INCOME PATIENTS, RESOURCES FOR HOMELESS PATIENTS, HEALTHCARE AND HOMELESSNESS PILOT PROGRAM, CARE FOR HTE UNDOCUMENTED, MERCY FAMILY RESIDENCY PROGRAM, PATIENT NAVIGATOR PROGRAM, HEALTH PROFESSION EDUCATION - OTHER, HEALTH PROFESSION EDUCATION - NURSING, ONCOLOGY NURSE NAVIGATOR, HEALTHIER LIVING PROGRAM, FALLS PREVENTION PROGRAM, MERCY FAITH AND HEALTH PARTNERSHIP, DISEASE-SPECIFIC SUPPORT GROUPS, COMMUNITY BASED VIOLENCE PREVENTION PROGRAM, SACRAMENTO PHYSICIANS' INITIATIVE TO REACH OUT, INNOVATE AND TEACH (SPIRIT), SAFE KIDS PROGRAM AND DIGNITY HEALTH COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. THE HOSPITALS DO NOT HAVE THE CAPACITY OR RESOURCES TO ADDRESS ALL PRIORITY HEALTH ISSUES. THE HOSPITALS ARE NOT ADDRESSING ACCESS TO FUNCTIONAL NEEDS, ACCESS TO DENTAL CARE AND PREVENTIVE SERVICES, AND HEALTHY PHYSICAL ENVIRONMENT, AS THESE PRIORITIES ARE BEYOND THE CAPACITY AND EXPERTISE OF MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, AND MERCY GENERAL HOSPITAL. HOWEVER, THE HOSPITALS WILL LOOK FOR OPPORTUNITIES TO COORDINATE AND COLLABORATE WITH OTHER ENTITIES THAT OFFER PROGRAMS THAT ADDRESS THESE NEEDS. MOREOVER, THE HOSPITALS HAVE CONTINUOUSLY ENGAGED IN COLLABORATIVE EFFORTS FOCUSING ON DEVELOPMENT OF A BROAD CLINICAL AND SOCIOECONOMIC PLANS WITH MULTI-DISCIPLINARY PARTNERS FROM HEALTH CARE, BUSINESS, SOCIAL SERVICES, GOVERNMENT, COMMUNITY BASED ORGANIZATIONS AND WIDER SOCIETY.DOMINICAN HOSPITALTHE CHNA IDENTIFIED SIGNIFICANT HEALTH NEEDS OF: BEHAVIORAL HEALTH, HEALTH CARE ACCESS AND DELIVERY, AND ECONOMIC INSECURITY. THE HOSPITAL IS TAKING SEVERAL ACTIONS AND DEDICATED RESOURCES TO ADDRESS THESE NEEDS, INCLUDING:THE HOSPITAL'S PERSONAL ENRICHMENT PROGRAM (PEP), A RESOURCE FOR COMMUNITY HEALTH AND WELLNESS EDUCATION. PEP CLASSES AND PROGRAMS FOCUS ON TOTAL JOINT CARE, CHILDBIRTH AND PARENTING, LIFESTYLE MANAGEMENT, IMPROVING NEUROLOGICAL FUNCTION, EXERCISE AND FITNESS, CANCER RESOURCES, AND HEART HEALTH. THE HOSPITAL'S MOBILE WELLNESS CLINIC, WHICH BENEFITS FROM BILINGUAL STAFF WHO PROVIDE EVALUATION AND TREATMENT OF EPISODIC MEDICAL CONDITIONS, IDENTIFICATION OF MEDICAL HOMES FOR THOSE PATIENTS WITH CHRONIC NEEDS, AND IDENTIFICATION OF SOCIAL SERVICES AND RESOURCES IN THE COMMUNITY. THE MOBILE WELLNESS CLINIC VISITS SIX LOCATIONS EVERY WEEK, MONDAY THROUGH FRIDAY. FUNDING TO JANUS OF SANTA CRUZ, A SUBSTANCE USE DISORDER (SUD) TREATMENT CLINIC, FOR THEIR PROJECT UNITE PROGRAM. THROUGH THIS PROGRAM, A SUBSTANCE ABUSE COUNSELOR MEETS WITH HOSPITAL PATIENTS TO HELP TRANSITION THE PATIENTS TO INPATIENT/OUTPATIENT SUD TREATMENT PROGRAMS IN SANTA CRUZ. AN EMERGENCY DEPARTMENT (ED) NAVIGATOR, WHO MEETS WITH CENTRAL COAST ALLIANCE FOR HEALTH (CCAH) PATIENTS IN THE ED TO HELP CONNECT OR RECONNECT THEM WITH PATIENT CARE PROVIDERS POST HOSPITAL DISCHARGE. SERVICES ALSO INCLUDE PROVISION OF FOOD, CLOTHING, AND MEDICATIONS FOR PATIENTS WHO ARE HOMELESS. THE HOSPITAL'S MEDICAL GUIDANCE AREA, A SPECIALIZED AREA FOR PATIENTS WITH SUBSTANCE ABUSE AND MENTAL HEALTH DISORDERS. A PSYCHIATRIC REGISTERED NURSE (PSYCH RN) IS PRESENT ON THE UNIT AS PART OF THE PSYCHIATRIC RESOURCE TEAM (PRT). THE HOSPITAL'S WELLNESS CENTER ADDRESSES THE NEEDS OF CHRONICALLY ILL AND HIGH-RISK PATIENTS THROUGHOUT THE CONTINUUM OF CARE. WELLNESS CENTER SERVICES WILL PROVIDE AMBULATORY CARE AND SUPPORT TO KEEP PEOPLE OUT OF THE HOSPITAL, AND OFFER OPPORTUNITIES TO MANAGE HIGH-RISK PATIENT GROUPS. PROGRAM WILL OFFER PATIENTS THE FULL SPECTRUM OF CARE, FROM PREVENTIVE TO POST-ACUTE. THE HOSPITAL PROVIDES FINANCIAL SUPPORT TO THE TEEN KITCHEN PROJECT (TKP). TKP PROVIDES MEDICALLY-TAILORED MEALS TO INDIVIDUALS AND FAMILIES IN CRISIS DUE TO A LIFE-THREATENING ILLNESS, PARTICULARLY THOSE WHO ARE LOW INCOME, LACK A SUPPORT NETWORK OF FAMILY OR FRIENDS, OR DO NOT QUALIFY FOR OTHER FREE FOOD SERVICES. TKP'S MEAL DELIVERY SERVICE IS UNIQUE IN THAT THE PROGRAM ENGAGES TEENS (AGES 13-18) AS BOTH VOLUNTEERS AND EMPLOYEES IN PREPARING AND PACKAGING THE MEALS. FUNDING TO SECOND HARVEST FOOD BANK WHICH PROVIDES FOOD TO PEOPLE IN NEED THROUGH A VAST NETWORK OF PARTNER AGENCIES AND NONPROFITS AND DIRECTLY THROUGH FOOD DISTRIBUTION AND NUTRITION EDUCATION AT DOZENS OF PROGRAM SITES. EVERY MONTH, 85,000 LOCAL RESIDENTS COUNT ON THE SECOND HARVEST FOOD BANK TO AVOID MISSING MEALS, EMPTY STOMACHS, AND IMPOSSIBLE CHOICES BETWEEN FOOD, HOUSING, MEDICINE, AND OTHER NECESSITIES. BEYOND CLINICAL HEALTH SERVICES, THE HOSPITAL DOES NOT INTEND TO ADDRESS IDENTIFIED NEEDS OF HOUSING AND HOMELESSNESS, COMMUNITY SAFETY, HEALTH LIFESTYLES, CANCER, HEALTH DISEASE OR UNINTENDED INJURIES/ACCIDENTS. THESE NEEDS ARE NOT BEING BEYOND THE CAPACITY AND SERVICES OF THE HOSPITAL, BEING ADDRESSED BY A NUMBER OF OTHER ORGANIZATIONS IN THE COMMUNITY, OR NOT BEING PRIORITIZED DUE TO LIMITED RESOURCES. MERCY HOSPITAL BAKERSFIELDTHE CHNA SERVED AS THE RESOURCE DOCUMENT FOR THE REVIEW OF HEALTH NEEDS AS IT PROVIDED STATISTICAL DATA ON THE SEVERITY OF ISSUES AND ALSO INCLUDED COMMUNITY INPUT ON THE HEALTH NEEDS. AS WELL, THE COMMUNITY PRIORITIZATION OF THE NEEDS WAS TAKEN INTO CONSIDERATION. AS A RESULT OF THE REVIEW OF NEEDS AND APPLICATION OF THE ABOVE CRITERIA, MERCY HOSPITALS CHOSE TO FOCUS ON: ACCESS TO CARE, CHRONIC DISEASE, FOOD INSECURITY, MENTAL HEALTH, OVERWEIGHT AND OBESITY, PREVENTIVE PRACTICES, AND SUBSTANCE USE. ACCESS TO HEALTH CARE: FINANCIAL ASSISTANCE, CONNECTED COMMUNITY NETWORK, PRESCRIPTION PURCHASING, HOMEMAKER CARE PROGRAM, COMMUNITY WELLNESS PROGRAM, COMMUNITY HEALTH INITIATIVE, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. CHRONIC DISEASES: CHRONIC DISEASE SELF-MANAGEMENT PROGRAMS, COMMUNITY WELLNESS PROGRAM, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. FOOD INSECURITY: LEARNING AND OUTREACH CENTERS, CONNECTED COMMUNITY NETWORK, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. MENTAL HEALTH: ART AND SPIRITUALITY CENTER, MENTAL HEALTH SUPPORT GROUPS, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. OVERWEIGHT AND OBESITY: HEALTHY KIDS IN HEALTHY HOMES, COMMUNITY WELLNESS PROGRAM, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. PREVENTIVE PRACTICES: COMMUNITY WELLNESS PROGRAM, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. SUBSTANCE USE: ANTI-VAPING PROGRAM, EMERGENCY DEPARTMENT SUBSTANCE USE NAVIGATOR PROGRAM, COMMUNITY HEALTH IMPROVEMENT GRANTS PROGRAM. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, MERCY HOSPITALS WILL NOT DIRECTLY ADDRESS DENTAL CARE, ECONOMIC INSECURITY, ENVIRONMENTAL CONDITIONS, HOUSING AND HOMELESSNESS, PREGNANCY AND BIRTH OUTCOMES, SEXUALLY TRANSMITTED INFECTIONS, VIOLENCE PREVENTION AND UNINTENTIONAL INJURIES AS PRIORITY HEALTH NEEDS. ADDITIONALLY, THE HOSPITAL DOES NOT INTEND TO EMPHASIZE COMMUNITY COVID-19 INTERVENTIONS AT THIS POINT IN THE PANDEMIC, BUT WILL CONTINUE TO DELIVER ACUTE MEDICAL CARE TO ADDRESS COVID-19. KNOWING THERE ARE NOT SUFFICIENT RESOURCES TO ADDRESS ALL THE COMMUNITY HEALTH NEEDS, MERCY HOSPITALS CHOSE TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. THE HOSPITALS HAVE INSUFFICIENT RESOURCES TO EFFECTIVELY ADDRESS ALL THE IDENTIFIED NEEDS AND, IN SOME CASES, THE NEEDS ARE CURRENTLY ADDRESSED BY OTHERS IN THE COMMUNITY.***SEE PART V, SECTION B, LINE 11 CONTINUATION AFTER PART V, SECTION B, LINE 10A***
FACILITY REPORTING GROUP B PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
PART V, SECTION B FACILITY REPORTING GROUP C
FACILITY REPORTING GROUP C CONSISTS OF: - FACILITY 1: ST JOSEPH'S HOSPITAL AND MEDICAL CENTER, - FACILITY 9: MERCY GILBERT MEDICAL CENTER, - FACILITY 20: ST JOSEPH'S WESTGATE MEDICAL CENTER
FACILITY REPORTING GROUP C PART V, SECTION B, LINE 5: ST JOSEPH'S HOSPITAL AND MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, ST JOSEPH'S WESTGATE MEDICAL CENTERFOR THE 2022 (TY 2021) CHNA, HEALTH NEEDS WERE IDENTIFIED THROUGH THE COMBINED ANALYSIS OF PRIMARY AND SECONDARY DATA WITH FOUR ROUNDS OF COMMUNITY INPUT. PRIMARY DATA SOURCES INCLUDE COMMUNITY SURVEYS AND FOCUS GROUPS. THE HOSPITALS PARTNERED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH TO RECRUIT MEMBERS OF DIVERSE COMMUNITIES TO TAKE THE SURVEYS. IN BOTH ROUNDS OF DATA COLLECTION, FOCUS GROUPS INCLUDED REPRESENTATIVES OF MINORITY AND UNDERSERVED POPULATIONS WHO IDENTIFIED COMMUNITY CONCERNS AND ASSETS. A TOTAL OF 85 FOCUS GROUPS WERE HELD AND 26,273 COMMUNITY SURVEYS WERE COMPLETED THROUGHOUT THE PROCESS. FINALLY, A SERIES OF MEETINGS WERE HELD WITH KEY STAKEHOLDERS FROM THE HOSPITALS' PRIMARY SERVICE AREA. MEMBERS OF THE 'COMMUNITY BENEFIT AND HEALTH EQUITY COMMITTEE AND THE 'HEALTH EQUITY ALLIANCE' PROVIDED INPUT ON THE SELECTION OF DATA INDICATORS, PROVIDED FEEDBACK ON DATA COLLECTED, AND AIDED IN THE SELECTION OF FINAL PRIORITIES. MEMBERSHIP OF THE COMMITTEES AND COLLABORATIONS INTENTIONALLY REPRESENT VULNERABLE AND DISENFRANCHISED POPULATIONS INCLUDING THE HOMELESS, UNINSURED/UNDERINSURED, MEDICAID, MEDICARE, IMMIGRANT, DISABLED, MENTALLY ILL, AND ELDERLY. THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH CONTRIBUTED INPUT AS PART OF ITS WORK TO PRODUCE THE CHNA REPORT WITH THE HOSPITALS. THE HOSPITALS SOLICITED INPUT ON THE CHNA PROCESS FROM THE COMMUNITY HEALTH COMMITTEE THAT INCLUDED THE FOLLOWING AGENCIES: ABOUT CARE, HUSHABYE NURSERY, AMANDA HOPE RAINBOW ANGELS, ICAN: POSITIVE PROGRAMS FOR YOUTH, AMPLIFY PEACE, INTEL, ASTER AGING INC., LALOBOY FOUNDATION, AZCEND, LIGHTHOUSE PSYCHIATRY, CANCER SUPPORT COMMUNITY ARIZONA, MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH, CECE'S HOPE, CENTER MERCY CARE, CHANDLER CARE CENTER, MESA CHAMBER OF COMMERCE, CHANDLER CHILDREN'S MEDICAL AND DENTAL CLINIC, MISSION OF MERCY OF ARIZONA, CHANDLER UNIFIED SCHOOL DISTRICT, NOTMYKID, CHILD CRISIS ARIZONA, POSITIVE PATHS FOR WOMEN EAST VALLEY, CITY OF CHANDLER, QUEEN CREEK CHAMBER OF COMMERCE, FIRST INTERNATIONAL BANK & TRUST RAYHONS FINANCIAL, FOUNDATION FOR SENIOR LIVING, TEEN UNITY BOARD, HELP & HOPE FOR YOUTH, TOWN OF GILBERT - COUNCILMEMBER, HOPE FOR ADDICTION, UCSF.
FACILITY REPORTING GROUP C PART V, SECTION B, LINE 6A: DIGNITY HEALTH ST JOSEPH'S HOSPITAL AND MEDICAL CENTER, ST. JOSEPH'S WESTGATE MEDICAL CENTER, ARIZONA GENERAL HOSPITAL (LAVEEN AND MESA), CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, SOUTHWEST ORTHOPEDIC & SPINE HOSPITAL, ARIZONA SPINE AND JOINT HOSPITAL, ARIZONA ORTHOPEDIC SURGICAL HOSPITAL, DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL, MAYO CLINIC HOSPITAL, PHOENIX CHILDREN'S HOSPITAL, BANNER HEALTH
FACILITY REPORTING GROUP C PART V, SECTION B, LINE 6B: NATIVE HEALTH, NEIGHBORHOOD OUTREACH ACCESS TO HEALTH, VALLEYWISE HEALTH, HEALTH IMPROVEMENT PARTNERSHIP OF MARICOPA COUNTY, MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH
FACILITY REPORTING GROUP C PART V, SECTION B, LINE 11: ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, ST. JOSEPH'S WESTGATE MEDICAL CENTER: THE HOSPITAL IS ADDRESSING OR CURRENTLY DEVELOPING PARTNERSHIP INITIATIVES TO FOCUS ON SIGNIFICANT HEALTH ISSUES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDE: 1) ACCESS TO CARE, 2) CANCER, AND 3) CHRONIC DISEASE. 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: EDUCATION, ENROLLMENT AND OUTREACH ACTIVITIES, CARE NAVIGATION FOR VULNERABLE POPULATIONS, MUHAMMED ALI PARKINSON'S CENTER, PROMOTORAS/COMMUNITY HEALTH WORKERS, MOMOBILE (MATERNAL OUTREACH MOBILE UNIT), COMMUNITY CARE COORDINATION HOME VISITING, DIGNITY HEALTH COMMUNITY GRANTS, DEEP (DIABETES EDUCATION AND EMPOWERMENT PROGRAM) SELF-MANAGEMENT WORKSHOPS, STOP THE BLEED PROGRAM, ACTIVATE, BALANCE MATTERS FALLS PREVENTION PROGRAMS, HUMAN TRAFFICKING TASK FORCE, TRAUMATIC BRAIN INJURY PREVENTION PROGRAMS - BARROW BRAINBOOK AND BARROW BRAIN BALL, MEDICAL RESPITE AND TRANSITIONAL PLACEMENT, HOMELESS INITIATIVE (SB1152), WOMEN'S WELLNESS CLINIC, CANCER SUPPORT NAVIGATION, AND MEDICATION ASSISTANCE. THE HOSPITAL HAS CHOSEN NOT TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS DUE TO LIMITED CAPACITY OF HOSPITAL STAFF, LIMITED CAPACITY OF AVAILABLE HOSPITAL SERVICES, AND LIMITED RESOURCES. 1) ADDICTION / SUBSTANCE ABUSE, 2) AFFORDABLE HOUSING / HOMELESSNESS, 3) FOOD INSECURITY, 4) MENTAL HEALTH, AND 5) SAFETY & VIOLENCE. WHILE THE HOSPITAL WILL NOT DIRECTLY ADDRESS THE NEEDS LISTED ABOVE, IT WILL INDIRECTLY SUPPORT WORK BEING DONE IN THE COMMUNITY TO ADDRESS THESE NEEDS THROUGH STRATEGIC GRANT MAKING AND INVESTMENTS. THE HOSPITAL WILL ALSO SECURE AND MAINTAIN KEY PARTNERSHIPS WITH COMMUNITY-BASED ORGANIZATIONS THAT ARE ADDRESSING THOSE NEEDS.MERCY GILBERT MEDICAL CENTERTHE HOSPITAL IS DELIVERING SEVERAL PROGRAMS AND SERVICES TO HELP ADDRESS ALL OF THE IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS. THESE INCLUDE: BEHAVIORAL & MENTAL HEALTH/ SUICIDE: DIGNITY HEALTH (DH) PREGNANCY & POSTPARTUM SUPPORT GROUP/ LET'S TALK, DH ZERO SUICIDE INITIATIVE, & DH HEAVEN'S HUMMINGBIRDS SUPPORT GROUP. SUBSTANCE ABUSE: YOUTH MENTAL HEALTH COALITION, MESA PREVENTION ALLIANCE & HUSHABYE NURSERY - PEER SUPPORT. CANCER: AMANDA HOPE RAINBOW ANGELS, DESERT CANCER FOUNDATION OF AZ., AMERICAN CANCER SOCIETY OF AZ. & DH CANCER CARE CLINIC. CHRONIC DISEASE/ DIABETES/ CARDIOVASCULAR DISEASE/ OBESITY/ ORAL HEALTH: DH YOGA OF THE HEART/ WOMENHEART HEALTH SUPPORT GROUP, DH HEALTHIER LIVING PROGRAM, DH CHANDLER CHILDREN'S MEDICAL AND DENTAL CLINICS & DH FIRST TEETH FIRST PROGRAM. INJURY PREVENTION: DH STOP THE BLEED/ D4: DIGNITY DOESN'T DRIVE DISTRACTED, DH MATTER OF BALANCE PROGRAM/ WALK WITH A DOC PROGRAM & DH CAR SEAT CLINIC AND CAR SEAT DONATION. ACCESS TO CARE/ IMMUNIZATION: DH CHILDREN'S AND ADULT'S VACCINE PROGRAM, DH EAST VALLEY COMMUNITY HEALTH OUTREACH PROGRAMS, DH FSL - ACTIVATE PROGRAM, DH COMMUNITY HEALTH WORKER & DH/CSH FINANCIAL ASSISTANCE POLICY. HOUSING/ HOMELESSNESS: DH HOMELESS INITIATIVE/ TAXI VOUCHERS, ONE SMALL STEP: CLOTHING CABIN & ARIZONA ABUSE IN LATER LIFE GRANT PROJECT. VIOLENCE PREVENTION/ HUMAN TRAFFICKING: DH HEALTHY FAMILIES PROGRAM, DH HUMAN TRAFFICKING TASKFORCE, CECE'S HOPE CENTER & ARIZONA ABUSE IN LATER LIFE GRANT PROJECT. EQUITY: DH WOMENHEART HEALTH SUPPORT GROUP, DH/CSH CONNECTED COMMUNITY NETWORK (CCN), DH/CSH FINANCIAL ASSISTANCE POLICY & EAST VALLEY RESOURCE COALITION. NUTRITION/ FOOD ACCESS/ EXERCISE: MISSION OF MERCY OF AZ, DH MOMMY FIT CAMP & DH HEALTHY EATING, ACTIVE LIVING.
FACILITY REPORTING GROUP C PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.
PART V, SECTION B FACILITY REPORTING GROUP D
FACILITY REPORTING GROUP D CONSISTS OF: - FACILITY 3: MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE, - FACILITY 5: MERCY MEDICAL CENTER REDDING, - FACILITY 17: ST ELIZABETH COMMUNITY HOSPITAL
FACILITY REPORTING GROUP D PART V, SECTION B, LINE 5: MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDEFOR THE 2022 (TY 2021) CHNA REPORT, QUALITATIVE DATA WERE COLLECTED FROM PERSONS REPRESENTING BROAD INTERESTS OF THE COMMUNITY USING VARIOUS METHODS, INCLUDING AN ONLINE SURVEY, FOCUS GROUPS, AND COLLABORATIVE MEETINGS WITH SANTA BARBARA COUNTY PUBLIC HEALTH. IN ORDER TO GAIN A THOROUGH UNDERSTANDING OF THE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS LIVING IN MRMC'S PRIMARY SERVICE AREA, AN ORIGINAL COMMUNITY HEALTH SURVEY WAS DEVELOPED. A 38 QUESTION COMMUNITY HEALTH SURVEY SERVED AS A PRIMARY DATA SOURCE. THE COMMUNITY HEALTH SURVEY WAS BASED UPON SELECT QUESTIONS FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM SURVEY QUESTIONNAIRE (BRFSS) AND PREVIOUS CHNA REPORTS PREPARED BY DIGNITY HEALTH. THE FINAL SURVEY WAS DISTRIBUTED IN-PERSON IN THE COMMUNITY AND WAS AVAILABLE ONLINE, TO ADULTS AGE 18 AND OLDER, IN SPANISH, ENGLISH, AND MIXTECO. USING CONVENIENCE SAMPLING (NON-PROBABILITY) METHODS, SURVEY RESPONSES WERE COLLECTED FROM 18 DIFFERENT LOCATIONS WITHIN THE COMMUNITY, INCLUDING CHURCHES, SENIOR CENTERS, COMMUNITY EVENTS, HOMELESS SHELTERS, ETC. SURVEY LOCATIONS WERE SELECTED BASED ON THE PERCEPTION OF BEING ABLE TO ENCOUNTER THE MOST VULNERABLE POPULATIONS, INCLUDING THE MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS. A TOTAL OF 770 INDIVIDUALS INVESTED TEN MINUTES OF THEIR TIME AND COMPLETED THE HEALTH SURVEY IN HOPES OF BETTERING THEIR HEALTH AND BRINGING BETTER PROGRAMS TO THE COMMUNITY.MERCY MEDICAL CENTER REDDINGBUILDING A HEALTHY ENVIRONMENT REQUIRES MULTIPLE STAKEHOLDERS WORKING TOGETHER WITH A COMMON PURPOSE. FOR THE 2022 (TY 2021) CHNA REPORT, MERCY MEDICAL CENTER REDDING CONSULTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT THE ASSESSMENT. DATA COLLECTION INCLUDED THE COLLECTION AND ANALYSIS OF BOTH PRIMARY (QUALITATIVE) AND SECONDARY (QUANTITATIVE) DATA. QUALITATIVE DATA INCLUDED ONEONONE AND GROUP INTERVIEWS WITH 16 COMMUNITY HEALTH EXPERTS, SOCIAL SERVICE PROVIDERS, AND MEDICAL PERSONNEL. PARTICIPATING ORGANIZATIONS IN ADDITION TO THE HOSPITAL INCLUDED: SHASTA COUNTY PUBLIC HEALTH AND HHSA, SHASTA COUNTY OFFICE OF EDUCATION, HEALTH ALLIANCE OF NORTHERN CA, HILL COUNTRY COMMUNITY CLINIC, AND SHASTA COMMUNITY HEALTH CENTER. FURTHERMORE, 59 COMMUNITY RESIDENTS OR COMMUNITY SERVICE PROVIDER ORGANIZATIONS PARTICIPATED IN 7 FOCUS GROUPS ACROSS THE SERVICE AREA. ORGANIZATIONS INCLUDED: CHILDREN'S LEGACY CENTER, FIRST 5 SHASTA, NORTHERN CA CENTER, ONE SAFE PLACE, PATHWAYS TO HOPE FOR CHILDREN (PREVIOUSLY SHASTA COUNTY CHILD ABUSE COORDINATING COUNCIL, ANDERSON TEEN CENTER, HUMAN GOOD / MOUNTAIN VISTAS APARTMENTS IN REDDING, NORCAL OUTREACH, SHASTA COUNTY MIEN COMMUNITY /SHASTA COUNTY HEALTH AND HUMAN, AND SERVICES AGENCY. FINALLY, 7 COMMUNITY SERVICE PROVIDERS RESPONDED TO A COMMUNITY SERVICE PROVIDER SURVEY ASKING ABOUT HEALTH NEED IDENTIFICATION AND PRIORITIZATION. SECTORS INCLUDED CHILDREN, SENIORS, SUBSTANCE USE, TRIBAL, AND CLINICS.ST. ELIZABETH COMMUNITY HOSPITALBUILDING A HEALTHY ENVIRONMENT REQUIRES MULTIPLE STAKEHOLDERS WORKING TOGETHER WITH A COMMON PURPOSE. FOR THE 2022 (TY 2021) CHNA REPORT, ST. ELIZABETH COMMUNITY HOSPITAL (SECH) CONSULTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT THE ASSESSMENT. DATA COLLECTION INCLUDED THE COLLECTION AND ANALYSIS OF BOTH PRIMARY (QUALITATIVE) AND SECONDARY (QUANTITATIVE) DATA. QUALITATIVE DATA INCLUDED ONEONONE AND GROUP INTERVIEWS WITH 8 COMMUNITY HEALTH EXPERTS, SOCIAL SERVICE PROVIDERS, AND MEDICAL PERSONNEL. PARTICIPATING ORGANIZATIONS IN ADDITION TO THE HOSPITAL INCLUDED: RED BLUFF TEHAMA COUNTY CHAMBER, FAMILY COUNSELING CENTER, EMPOWER TEHAMA, AND TEHAMA COUNTY HEALTH SERVICES. FURTHERMORE, 12 COMMUNITY RESIDENTS OR COMMUNITY SERVICE PROVIDER ORGANIZATIONS PARTICIPATED IN FOCUS GROUPS ACROSS THE COUNTY. THIS INCLUDED: LATINA COMMUNITY MEMBERS, CORNING HEALTHCARE DISTRICT, PASSAGES, ELDER SERVICES COORDINATING COUNCIL AND FIRST 5 TEHAMA.
FACILITY REPORTING GROUP D PART V, SECTION B, LINE 11: MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDETHE FOLLOWING SIGNIFICANT COMMUNITY HEALTH NEEDS WERE DETERMINED BY THE 2022 CHNA REPORT: EDUCATIONAL ATTAINMENT; ACCESS TO PRIMARY HEALTH CARE, BEHAVIORAL HEALTH CARE, AND ORAL HEALTH; AND HEALTH PROMOTION AND PREVENTION. THE HOSPITAL INTENDS TO TAKE SEVERAL ACTIONS AND TO DEDICATE RESOURCES TO HELP ADDRESS EACH OF THESE NEEDS, INCLUDING: EDUCATIONAL ATTAINMENT; EXPANDED PHYSICIAN MENTORING PROGRAM FOR LOCAL HIGH SCHOOL STUDENTS; HEALTH PROFESSIONS EDUCATION; ACCESS TO PRIMARY HEALTH CARE, BEHAVIORAL HEALTH, AND DENTAL HEALTH; MULTIPLE COMMUNITY HEALTH OUTREACH PROGRAMS PROVIDING FREE PREVENTATIVE SCREENINGS, SUPPORT GROUPS, AND COMMUNITY HEALTH EDUCATION; SUBSTANCE USE NAVIGATION PROGRAM AND A STREET MEDICINE PROGRAM FOR UNSHELTERED INDIVIDUALS; HEALTH PROMOTION AND PREVENTION; MULTIPLE COMMUNITY HEALTH OUTREACH PROGRAMS PROVIDING FREE PREVENTATIVE SCREENINGS, SUPPORT GROUPS, AND COMMUNITY HEALTH EDUCATION. WHILE RESOURCES ARE AVAILABLE TO ADDRESS THE IDENTIFIED NEEDS OF THE COMMUNITY, THE NEEDS ARE TOO SIGNIFICANT FOR ANY ONE ORGANIZATION. MAKING A SUBSTANTIAL AND UPSTREAM IMPACT WILL REQUIRE THE COLLABORATIVE EFFORTS OF COMMUNITY ORGANIZATIONS, LOCAL GOVERNMENT, LOCAL BUSINESS LEADERS, AND OTHER INSTITUTIONS. EVERY PROGRAM IDENTIFIED WILL ENGAGE MULTIPLE, COMMUNITY, NON-GOVERNMENTAL ORGANIZATIONS TO EXECUTE THE PLANNED STRATEGY/PROGRAM SUCH AS: MARIAN FAMILY MEDICINE RESIDENCY PROGRAM, SLO NOOR FREE MEDICAL AND DENTAL CLINICS, MRMC/AGCH CARE COORDINATION AND SOCIAL WORK DEPARTMENTS, ALLIANCE FOR PHARMACEUTICAL ACCESS (APA INC.), MISSION HOPE CANCER CENTER, HEARST CANCER RESOURCE CENTER, PACIFIC CENTRAL COAST HEALTH CENTERS, MRMC COMMUNITY HEALTH DEPARTMENT, HERENCIA INDGENA, SANTA MARIA VALLEY FIGHTING BACK, SANTA BARBARA COUNTY DRUG AND ALCOHOL, GOOD SAMARITAN SHELTER, SAN LUIS COUNTY DRUG AND ALCOHOL, TRANSITIONS MENTAL HEALTH, COMMUNITY COUNSELING CENTER, COMMUNITY HEALTH CENTERS OF THE CENTRAL COAST AND TALLY FARMS. MERCY MEDICAL CENTER REDDINGIN RESPONSE TO THE 2022 CHNA, MERCY MEDICAL CENTER REDDING (MMCR) HAS PRIORITIZED THE FOLLOWING IDENTIFIED NEEDS AND OUTLINED STRATEGIES TO COMPREHENSIVELY MEET THE NEEDS OF OUR COMMUNITY: ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCEUSE SERVICES; ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES; SAFE AND VIOLENCE-FREE ENVIRONMENT. STRATEGIES, PROGRAMS AND ACTIVITIES TO COMPREHENSIVELY MEET THE NEEDS OF OUR COMMUNITY INCLUDE BUT NOT LIMITED TO: MEDICATION FOR INDIGENT PATIENTS; PROVIDE COMMUNITY GRANTS TO LOCAL NON-PROFIT ORGANIZATIONS; TRANSPORTATION SERVICES; SUBSTANCE USE NAVIGATION; COLLABORATION WITH EMPIRE RECOVERY CENTER; VIOLENCE PREVENTION & INTERVENTION; CHW NAVIGATOR (PROPOSED); AND TELE-PSYCHIATRY. MMCR WILL CONTINUE TO LEAN INTO THE ORGANIZATIONS WHO ARE ADDRESSING THE NEEDS AND CONTINUE TO BUILD CAPACITY BY STRENGTHENING PARTNERSHIPS AMONG LOCAL COMMUNITY-BASED ORGANIZATIONS. DUE TO THE MAGNITUDE OF THE NEED AND THE CAPACITY OF MMCR'S ABILITY TO ADDRESS THE NEED, THE IMPLEMENTATION STRATEGY WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS: ACCESS TO BASIC-NEEDS SUCH AS HOUSING, JOBS AND FOOD; ACCESS TO SPECIALTY AND EXTENDED CARE; INCREASED COMMUNITY CONNECTIONS; SYSTEM NAVIGATION; INJURY AND DISEASE PREVENTION MANAGEMENT; ACCESS TO FUNCTIONAL NEEDS.ST. ELIZABETH COMMUNITY HOSPITALIN RESPONSE TO THE 2022 CHNA, ST. ELIZABETH COMMUNITY HOSPITAL (SECH) HAS PRIORITIZED THE FOLLOWING IDENTIFIED NEEDS AND OUTLINED STRATEGIES TO COMPREHENSIVELY MEET THE NEEDS OF OUR COMMUNITY: ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES; ACCESS TO SPECIALTY AND EXTENDED CARE; ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCEUSE SERVICES; SAFE AND VIOLENCE-FREE ENVIRONMENT (ALTHOUGH NOT DIRECTLY IDENTIFIED AS NEED, THIS IS A REGIONAL APPROACH WITH OUR OTHER NEARBY HOSPITALS). STRATEGIES, PROGRAMS AND ACTIVITIES TO COMPREHENSIVELY MEET THE NEEDS OF OUR COMMUNITY INCLUDE BUT NOT LIMITED TO: MEDICATION FOR INDIGENT PATIENTS; PROVIDE COMMUNITY GRANTS TO LOCAL NON-PROFIT ORGANIZATIONS; TRANSPORTATION SERVICES; AD SUBSTANCE USE NAVIGATION. SECH WILL CONTINUE TO LEAN INTO THE ORGANIZATIONS WHO ARE ADDRESSING THE NEEDS AND CONTINUE TO BUILD CAPACITY BY STRENGTHENING PARTNERSHIPS AMONG LOCAL COMMUNITY-BASED ORGANIZATIONS. DUE TO THE MAGNITUDE OF THE NEED AND THE CAPACITY OF SECH'S ABILITY TO ADDRESS THE NEED, THE IMPLEMENTATION STRATEGY WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS: ACCESS TO FUNCTIONAL NEEDS; ACCESS TO BASIC NEEDS SUCH AS HOUSING, JOBS, AND FOOD; INCREASED COMMUNITY CONNECTIONS.
FACILITY REPORTING GROUP D PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
PART V, SECTION B FACILITY REPORTING GROUP E
FACILITY REPORTING GROUP E CONSISTS OF: - FACILITY 12: ST JOHN'S REGIONAL MEDICAL CENTER, - FACILITY 15: ST MARYS MEDICAL CENTER, - FACILITY 18: ST JOHN'S HOSPITAL CAMARILLO
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 5: ST JOHNS REGIONAL MEDICAL CENTERST JOHN'S HOSPITAL CAMARILLOFOR THE 2022 (TY 2021) CHNA, THE HOSPITALS CONDUCTED A COMMUNITY HEALTH ASSESSMENT SURVEY, DESIGNED AND DISSEMINATED BY THE VENTURA COUNTY COMMUNITY HEALTH IMPROVEMENT COLLABORATIVE. A TOTAL OF 3,066 RESPONSES WERE COLLECTED. OF THE TOTAL SURVEY PARTICIPANTS, 72% COMPLETED THE SURVEY IN ENGLISH, 23% COMPLETED THE SURVEY IN SPANISH AND 2% COMPLETED THE SURVEY IN MIXTECO. IN ADDITION, 15 KEY INFORMANT INTERVIEWS AND 15 FOCUS GROUP DISCUSSIONS WERE HELD. INTERVIEWEES WERE RECOGNIZED AS HAVING EXPERTISE IN PUBLIC HEALTH, SPECIAL KNOWLEDGE OF COMMUNITY HEALTH NEEDS AND/OR REPRESENTED THE BROAD INTEREST OF THE COMMUNITY SERVED BY THE HOSPITAL AND HEALTH DEPARTMENT, AND/OR COULD SPEAK TO THE NEEDS OF MEDICALLY UNDERSERVED OR VULNERABLE POPULATIONS. PUBLIC HEALTH AGENCIES PARTICIPATING INCLUDED THE CAMARILLO HEALTH CARE DISTRICT, VENTURA COUNTY PUBLIC HEALTH, LGBTQIA+ PEOPLE, CALIFORNIA STATE UNIVERSITY CHANNEL ISLANDS STUDENTS AND PACIFICA HIGH SCHOOL STUDENTS. FOCUS GROUPS WERE SOUGHT AND CREATED WHOSE MEMBERS INCLUDED PEOPLE FROM THE BLACK COMMUNITY, MONOLINGUAL SPANISH SPEAKING PEOPLE, OLDER ADULTS, LGBTQIA+ PEOPLE, STUDENTS AND THOSE ACCESSING MENTAL HEALTH AND SUBSTANCE USE TREATMENT.ST. MARY'S MEDICAL CENTERTHE DATA SOURCES FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES DATA FROM PUBLIC HEALTH DEPARTMENTS AND COMMUNITY AGENCIES; SURVEYS, FOCUS GROUPS; INTERVIEWS; REVIEW OF OTHER ASSESSMENTS; AND INPUT FROM THE HOSPITAL'S COMMUNITY. THE 2022 (TY2021) CHNA REPORT INCLUDED FIVE FOCUS GROUPS LISTED BELOW. PARTICIPANTS OF THE HEALTH EQUITY/PARITY COALITIONS WERE COMPENSATED FOR THEIR TIME. AS PART OF OUR PARTNERSHIP WITH KAISER PERMANENTE, WE SHARED THE TRANSCRIPTS FROM THE FOCUS GROUPS AND KAISER SHARED THE TRANSCRIPTS FROM THEIR 15 KEY INFORMANT INTERVIEWS. WE COORDINATED INTERVIEWEES TO ENSURE WE DID NOT REACH OUT TO THE SAME GROUP TWICE. TO ANALYZE THE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, KEY HEALTH NEEDS WERE TABULATED FROM THE INTERVIEWS AND AGGREGATED TO PULL OUT KEY HEALTH NEEDS AND ILLUSTRATIVE QUOTES. FOCUS GROUPS WERE CONDUCTED WITH THE FOLLOWING FIVE GROUPS IN THE SUMMER AND FALL OF 2021: ASIAN PACIFIC ISLANDER HEALTH PARITY COALITION (APIHPC); RAFIKI AFRICAN AMERICAN HEALTH EQUITY COALITION; CHICANO / LATINO / INDIGENA HEALTH EQUITY COALITION (CLI); FUNDERS (INCLUDING BLUE SHIELD OF CALIFORNIA FOUNDATION, CALIFORNIA HEALTHCARE FOUNDATION, HIRSCH PHILANTHROPY PARTNERS, METTA FUND, NORTHERN CALIFORNIA GRANT MAKERS, ZELLERBACH FAMILY FOUNDATION); INSURERS (INCLUDING ANTHEM, BLUE SHIELD, CANOPY HEALTH, KAISER PERMANENTE, SAN FRANCISCO HEALTH PLAN)KEY INFORMANT INTERVIEWS WERE CONDUCTED AS PART OF THE KAISER CHNA, WITH PEOPLE FROM THE FOLLOWING 15 ORGANIZATIONS: BAYVIEW YMCA; COMPASS FAMILY SERVICES; GLIDE FOUNDATION; HUCKLEBERRY YOUTH PROGRAMS; KAISER PERMANENTE GREATER SAN FRANCISCO; LA CASA DE LAS MADRES; LAVENDER YOUTH RECREATION CENTER (LYRIC); MISSION ECONOMIC DEVELOPMENT AGENCY; NEMS (NORTH EAST MEDICAL SERVICES); ON LOK/30 ST. SENIOR CENTER; RAMS (RICHMOND AREA MULTI-SERVICES); SAN FRANCISCO AIDS FOUNDATION; SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH; SAN FRANCISCO HUMAN RIGHTS COMMISSION; SAN FRANCISCO UNIFIED SCHOOL DISTRICT.
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 6A: ST JOHN'S REGIONAL MEDICAL CENTER, ST JOHN'S HOSPITAL CAMARILLOHOSPITAL MEMBERS OF THE VENTURA COUNTY COMMUNITY HEALTH IMPROVEMENT COLLABORATIVE: ADVENTIST HEALTH SIMI VALLEY, COMMUNITY MEMORIAL HOSPITAL, OJAI VALLEY COMMUNITY HOSPITAL.ST. MARY'S MEDICAL CENTERSAINT FRANCIS MEMORIAL HOSPITAL, SUTTER CPMC AND UCSF MEDICAL CENTER
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 6B: ST JOHN'S REGIONAL MEDICAL CENTERST JOHN'S HOSPITAL CAMARILLONON-HOSPITAL MEMBERS OF THE VENTURA COUNTY COMMUNITY HEALTH IMPROVEMENT COLLABORATIVE: CAMARILLO HEALTH CARE DISTRICT, CLINICAS DEL CAMINO REAL, INC., VENTURA COUNTY HEALTH CARE AGENCY, VENTURA COUNTY PUBLIC HEALTH, AND GOLD COAST HEALTH PLAN.ST. MARY'S MEDICAL CENTERSAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, ASIAN PACIFIC ISLANDER HEALTH PARITY COALITION, AFRICAN AMERICAN HEALTH EQUITY COALITION, CHICANO / LATINO / INDIGENA HEALTH EQUITY COALITION
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 7D: ST JOHN'S REGIONAL MEDICAL CENTERST JOHN'S HOSPITAL CAMARILLO PUBLIC PRESENTATIONS HAVE BEEN MADE TO LOCAL COMMUNITY SERVICE ORGANIZATIONS (E.G. SOUTH OXNARD LIONS CLUB AND CAMARILLO ROTARY CLUB). THOSE PRESENTATIONS ENCOURAGED FURTHER COMMUNITY INQUIRY.ST. MARY'S MEDICAL CENTERTHE 2022 CHNA WAS EMAILED TO COMMUNITY PARTNERS.
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 11: ST. JOHN'S REGIONAL AND CAMARILLO HOSPITALS HAVE PROGRAMS TO ADDRESS EACH OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS, AS FOLLOWS:MENTAL HEALTH AND SUBSTANCE ABUSE ACROSS THE LIFESPAN: EXPAND USE OF SUBSTANCE USE NAVIGATORS, EXPAND ACCESS TO BEHAVIORAL HEALTH SERVICES FOR MEDI-CAL PATIENTS, LEVERAGE THE COMMUNITY INFORMATION EXCHANGE TO PATIENTS IN PRIMARY CARE WITH BEHAVIORAL HEALTH PROGRAMS, HEALTH AND WELLNESS PROGRAMS FOR SENIORS. PREVENTION OF CHRONIC CONDITIONS BY PROMOTING HEALTHY LIFESTYLES: HEALTH MINISTRIES BASIC NEEDS PROGRAMS AND COMMUNITY FOOD PANTRY; HEALTH EDUCATION AND LITERACY PROGRAMS (DIABETES EDUCATION & EMPOWERMENT PROGRAM, LIVING WELL WITH DIABETES PROGRAM, LOCAL CONGESTIVE HEART FAILURE PROGRAM, CHRONIC DISEASE SELF MANAGEMENT PROGRAM). ADVANCING EQUITABLE ACCESS TO HEALTHCARE: THE CANCER CENTER OF VENTURA COUNTY AT ST. JOHN'S; PATIENT FINANCIAL ASSISTANCE PROGRAM; DIGNITY HEALTH COMMUNITY GRANTS PROGRAM.ST. MARY'S MEDICAL CENTERTHE HOSPITAL INTENDS TO TAKE ACTIONS TO HELP ADDRESS EACH OF THE SIGNIFICANT HEATH NEEDS, AS DESCRIBED BELOW. ACCESS TO WELCOMING HEALTHCARE: THE HOSPITAL IS ADDRESSING THE SIGNIFICANT HEALTH NEED BY BUILDING BRIDGES FOR OUR PATIENTS TO GET THE CARE THEY NEED. AS OVER 40% OF THE HOSPITAL'S PATIENTS ARE ON MEDI-CAL, FOCUSING ON THAT POPULATION ENSURES WE ARE DIRECTLY SERVING LOW-INCOME INDIVIDUALS. WE ARE FOCUSED ON TWO PATIENT POPULATIONS: SENIORS AND PERSONS WITH SUBSTANCE USE AND MENTAL HEALTH DISORDERS. BRIDGES INCLUDE CLEARER PATHWAYS TO HOUSING SOLUTIONS, FOLLOW UP CASE MANAGEMENT FROM A NON-PROFIT PROVIDER, POST-DISCHARGE SENIOR SERVICES, AND ADVOCACY FOR SUPPORT FOR THESE POPULATIONS. WORK WITH CARE PARTNERS TO SUPPORT PATIENTS' ACCESS TO MEDI-CAL'S CAL-AIM BENEFITS. PARTNERS AND PROGRAMS INCLUDE: STREET-BASED MEDICINE OUTREACH, SERIOUS ILLNESS PROGRAM FOR CHINESE SENIORS, COMMUNITY GRANTS PROGRAM, PATIENT FINANCIAL ASSISTANCE, AND DELANCEY STREET FOUNDATION. BEHAVIORAL HEALTH & SUBSTANCE USE: CONVENING WITH SAN FRANCISCO POLICE DEPARTMENT, SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, AND SAN FRANCISCO FIRE DEPARTMENT ON CARE FOR PATIENTS UNDER 5150 HOLDS; IMPLEMENTATION OF CAL-AIM; RALLY FAMILY SERVICES; MEDICATION ASSISTED TREATMENT; SUBSTANCE USE NAVIGATOR; AND SAN FRANCISCO HEALTH IMPROVEMENT PARTNERSHIP. ECONOMIC OPPORTUNITY: THE HIGHLIGHT OF THAT WORK IS A $3 MILLION DOLLAR FLEXIBLE HOUSING SUBSIDY POOL PROGRAM TO CREATE HOSPITAL TO HOUSING REFERRAL PROCESS DURING COVID THAT WAS SIGNIFICANTLY EXPANDED BY THE CITY AND COUNTY DUE TO ITS SUCCESS. THE HOSPITAL ALSO SUPPORTS HEALTH PROFESSIONS EDUCATION TO HELP CREATE SKILLED CAREER LADDERS, AND ENGAGES WITH THE TENDERLOIN HEALTH IMPROVEMENT PARTNERSHIP.
FACILITY REPORTING GROUP E PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
PART V, SECTION B FACILITY REPORTING GROUP F
FACILITY REPORTING GROUP F CONSISTS OF: - FACILITY 11: ST MARY MEDICAL CENTER - LONG BEACH, - FACILITY 19: MERCY MEDICAL CENTER MT SHASTA
FACILITY REPORTING GROUP F PART V, SECTION B, LINE 5: ST. MARY MEDICAL CENTER - LONG BEACHFOR THE 2022 (TY2021) CHNA REPORT, INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND FOCUS GROUPS WITH COMMUNITY RESIDENTS WERE CONDUCTED TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. TWENTY-SEVEN INTERVIEWS WERE CONDUCTED FROM SEPTEMBER 2021 TO JANUARY 2022. COMMUNITY STAKEHOLDERS IDENTIFIED BY THE LONG BEACH CHNA COLLABORATIVE WERE CONTACTED AND ASKED TO PARTICIPATE IN THE INTERVIEWS. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY. A FULL LIST OF INTERVIEWEES IS IN THE CHNA REPORT. EXAMPLES INCLUDE: CITY OF LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES, MENTAL HEALTH AMERICA LOS ANGELES, YMCA OF GREATER LONG BEACH, BLACK HEALTH EQUITY COLLABORATIVE, KHMER GIRLS IN ACTION, AND FILIPINO MIGRANT CENTER.SIX VIRTUAL FOCUS GROUPS ENGAGED 90 COMMUNITY RESIDENTS. THE FOCUS GROUPS WERE CONDUCTED FROM NOVEMBER 2021 TO FEBRUARY 2022. THE FOLLOWING POPULATION GROUPS PARTICIPATED IN THE FOCUS GROUPS: LATINX, BLACK/AFRICAN AMERICAN, CAMBODIAN/PACIFIC ISLANDER, LGBTQ+, DISABLED PERSONS/VETERANS, AND OLDER ADULTS. MERCY MEDICAL CENTER MT. SHASTABUILDING A HEALTHY ENVIRONMENT REQUIRES MULTIPLE STAKEHOLDERS WORKING TOGETHER WITH A COMMON PURPOSE. FOR THE 2022 (TY 2021) CHNA REPORT, MERCY MEDICAL CENTER MT. SHASTA IN COLLABORATION WITH FAIRCHILD MEDICAL CENTER AND SISKIYOU COUNTY PUBLIC HEALTH DEPARTMENT CONSULTED WITH COMMUNITY HEALTH INSIGHTS TO CONDUCT THE ASSESSMENT. DATA COLLECTION INCLUDED THE COLLECTION AND ANALYSIS OF BOTH PRIMARY (QUALITATIVE) AND SECONDARY (QUANTITATIVE) DATA. QUALITATIVE DATA INCLUDED ONEONONE AND GROUP INTERVIEWS WITH 16 COMMUNITY HEALTH EXPERTS, SOCIAL SERVICE PROVIDERS, AND MEDICAL PERSONNEL. PARTICIPATING ORGANIZATIONS IN ADDITION TO THE HOSPITAL AND PUBLIC HEALTH AGENCY COLLABORATORS INCLUDED: SISKIYOU COUNTY OFFICE OF EDUCATION, MOUNTAIN VALLEYS HEALTH CENTERS, HMONG COMMUNITY ACTIVIST IN SISKIYOU COUNTY, NORTHERN CA INDIAN DEVELOPMENT COUNCIL INC., FIRST 5 SISKIYOU, AND TINY MIGHTY STRONG. FURTHERMORE, 9 COMMUNITY RESIDENTS OR COMMUNITY SERVICE PROVIDER ORGANIZATIONS PARTICIPATED IN 2 FOCUS GROUPS ACROSS THE COUNTY (HOSTED BY THE TULELAKE FAMILY RESOURCE CENTER, MODOC COUNTY PUBLIC HEALTH, HAPPY CAMP COMMUNITY ACTION, INC. AND HAPPY CAMP AMBULANCE). FINALLY, FIVE COMMUNITY SERVICE PROVIDERS RESPONDED TO A COMMUNITY SERVICE PROVIDER SURVEY ASKING ABOUT HEALTH NEED IDENTIFICATION AND PRIORITIZATION. THESE INCLUDED: QUARTZ VALLEY INDIAN RESERVATION / ANAV TRIBAL HEALTH CLINIC, SHASTA CASCADE HEALTH CENTERS, MCCLOUD HEALTHCARE CLINICS INC, AND SISKIYOU FOOD ASSISTANCE.
FACILITY REPORTING GROUP F PART V, SECTION B, LINE 6A: ST. MARY MEDICAL CENTER - LONG BEACHMEMORIALCARE LONG BEACH MEDICAL CENTER, MEMORIALCARE MILLER CHILDREN'S AND WOMEN'S HOSPITAL LONG BEACHMERCY MEDICAL CENTER MT SHASTAFAIRCHILD MEDICAL CENTER
FACILITY REPORTING GROUP F PART V, SECTION B, LINE 6B: ST. MARY MEDICAL CENTER - LONG BEACHLONG BEACH CHNA COLLABORATIVE NON-HOSPITAL PARTNERS INCLUDE THE LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES AND TCC FAMILY HEALTH.MERCY MEDICAL CENTER MT. SHASTASISKIYOU COUNTY PUBLIC HEALTH
FACILITY REPORTING GROUP F PART V, SECTION B, LINE 11: ST. MARY MEDICAL CENTER - LONG BEACHTHE HOSPITAL IS TAKING SEVERAL ACTIONS AND DEDICATING RESOURCES TO THESE NEEDS, INCLUDING: ACCESS TO HEALTHCARE: CARE PROGRAM, COMMUNITY GRANTS PROGRAM, FINANCIAL ASSISTANCE PROGRAM, FAMILIES IN GOOD HEALTH, LOW VISION CENTER. HOUSING AND HOMELESSNESS: COMMUNITY GRANTS PROGRAM. MENTAL HEALTH: CARE PROGRAM, COMMUNITY GRANTS PROGRAM, MENTAL HEALTH FIRST AID PROGRAM.PREVENTATIVE PRACTICES: BAZZENI WELLNESS CENTER, CARE PROGRAM, COMMUNITY GRANTS PROGRAM, EVERY WOMAN COUNTS, FAMILIES IN GOOD HEALTH, FOOD SYSTEMS ADVISORY COMMITTEE, MOBILE CARE UNIT. VIOLENCE AND INJURY PREVENTION: COMMUNITY GRANTS PROGRAM, FAMILIES IN GOOD HEALTH, VIOLENCE AND HUMAN TRAFFICKING RESPONSE TEAM. KEY COMMUNITY PARTNERS INCLUDE (PARTIAL LISTING): COMMUNITY HEALTH CENTERS; FAITH-BASED ORGANIZATIONS; HOUSING AND HOMELESS SERVICES; LONG BEACH CITY AGENCIES; LOS ANGELES COUNTY AGENCIES; MENTAL HEALTH AGENCIES; ORGANIZATIONS SERVING LGBTQ POPULATIONS; PUBLIC SAFETY AGENCIES; SCHOOLS AND SCHOOL DISTRICTS; SENIOR CENTERS AND SERVICE AGENCIES; AND YOUTH ORGANIZATIONS.TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, ST. MARY MEDICAL CENTER WILL NOT DIRECTLY ADDRESS ECONOMIC INSECURITY, EDUCATION, OVERWEIGHT AND OBESITY, PREGNANCY AND BIRTH OUTCOMES, AND SUBSTANCE USE AS PRIORITY HEALTH NEEDS. KNOWING THAT THERE ARE NOT SUFFICIENT RESOURCES TO ADDRESS ALL NEEDS, ST. MARY MEDICAL CENTER CHOSE TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. THE HOSPITAL HAS INSUFFICIENT RESOURCES TO EFFECTIVELY ADDRESS ALL THE IDENTIFIED NEEDS AND, IN SOME CASES, THE NEEDS ARE CURRENTLY ADDRESSED BY OTHERS IN THE COMMUNITY.MERCY MEDICAL CENTER MT. SHASTAIN RESPONSE TO THE 2022 CHNA, MERCY MEDICAL CENTER MT. SHASTA (MMCMS) HAS PRIORITIZED THE FOLLOWING IDENTIFIED NEEDS: ACCESS TO MENTAL/BEHAVIORAL HEALTH AND SUBSTANCEUSE SERVICES; ACCESS TO QUALITY PRIMARY CARE HEALTH SERVICES; INJURY AND DISEASE PREVENTION AND MANAGEMENT (ACTIVE LIVING AND HEALTHY EATING WILL BE INDIRECTLY ADDRESSED); SAFE AND VIOLENCE-FREE ENVIRONMENT. STRATEGIES, PROGRAMS AND ACTIVITIES TO COMPREHENSIVELY MEET THE NEEDS OF OUR COMMUNITY INCLUDE BUT NOT LIMITED TO: MEDICATION FOR INDIGENT PATIENTS; COMMUNITY HEALTH EDUCATION; PROVIDE COMMUNITY GRANTS TO LOCAL NON-PROFIT ORGANIZATIONS; TRANSPORTATION SERVICES; SUBSTANCE USE NAVIGATION; VIOLENCE PREVENTION & INTERVENTION; COMMUNITY HEALTH WORKER (CHW) NAVIGATOR (PROPOSED); AND COMMUNITY GRANTS. MMCMS WILL CONTINUE TO LEAN INTO THE ORGANIZATIONS WHO ARE ADDRESSING THE NEEDS AND CONTINUE TO BUILD CAPACITY BY STRENGTHENING PARTNERSHIPS AMONG LOCAL COMMUNITY-BASED ORGANIZATIONS. DUE TO THE MAGNITUDE OF THE NEED AND THE CAPACITY OF MMCMS'S ABILITY TO ADDRESS THE NEED, THE IMPLEMENTATION STRATEGY WILL NOT ADDRESS THE FOLLOWING HEALTH NEEDS: ACCESS TO BASIC-NEEDS SUCH AS HOUSING, JOBS AND FOOD; ACCESS TO SPECIALTY AND EXTENDED CARE; ACCESS TO DENTAL CARE AND PREVENTATIVE SERVICES; ACCESS TO FUNCTIONAL NEEDS; ACTIVE LIVING AND HEALTHY EATING (THIS PRIORITY WILL BE INDIRECTLY ADDRESSED BY ADDRESSING INJURY); AND DISEASE PREVENTION AND MANAGEMENT.
FACILITY REPORTING GROUP F PART V, SECTION B, LINE 13H: THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. IF APPLICABLE, PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS.THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION.PATIENT COOPERATION STANDARDS - A PATIENT MUST COOPERATE WITH THE HOSPITAL FACILITY IN PROVIDING THE INFORMATION AND DOCUMENTATION NECESSARY TO DETERMINE ELIGIBILITY. SUCH COOPERATION INCLUDES COMPLETING ANY REQUIRED APPLICATIONS OR FORMS. THE PATIENT IS RESPONSIBLE FOR NOTIFYING THE HOSPITAL FACILITY OF ANY CHANGE IN FINANCIAL SITUATION THAT WOULD IMPACT THE ASSESSMENT OF ELIGIBILITY. A PATIENT MUST EXHAUST ALL OTHER PAYMENT OPTIONS, INCLUDING PRIVATE COVERAGE, FEDERAL, STATE AND LOCAL MEDICAL ASSISTANCE PROGRAMS, AND OTHER FORMS OF ASSISTANCE PROVIDED BY THIRD PARTIES PRIOR TO BEING APPROVED. AN APPLICANT FOR FINANCIAL ASSISTANCE IS RESPONSIBLE FOR APPLYING TO PUBLIC PROGRAMS FOR AVAILABLE COVERAGE. HE OR SHE IS ALSO EXPECTED TO PURSUE PUBLIC OR PRIVATE HEALTH INSURANCE PAYMENT OPTIONS FOR CARE PROVIDED BY A COMMONSPIRIT HOSPITAL ORGANIZATION WITHIN A HOSPITAL FACILITY. A PATIENT'S AND, IF APPLICABLE, ANY GUARANTOR'S COOPERATION IN APPLYING FOR APPLICABLE PROGRAMS AND IDENTIFIABLE FUNDING SOURCES, INCLUDING COBRA COVERAGE (A FEDERAL LAW ALLOWING FOR A TIME-LIMITED EXTENSION OF EMPLOYEE HEALTHCARE BENEFITS), SHALL BE REQUIRED. IF A HOSPITAL FACILITY DETERMINES THAT COBRA COVERAGE IS POTENTIALLY AVAILABLE, AND THAT A PATIENT IS NOT A MEDICARE OR MEDICAID BENEFICIARY, THE PATIENT OR GUARANTOR SHALL PROVIDE THE HOSPITAL FACILITY WITH INFORMATION NECESSARY TO DETERMINE THE MONTHLY COBRA PREMIUM FOR SUCH PATIENT, AND SHALL COOPERATE WITH HOSPITAL FACILITY STAFF TO DETERMINE WHETHER HE OR SHE QUALIFIES FOR HOSPITAL FACILITY COBRA PREMIUM ASSISTANCE, WHICH MAY BE OFFERED FOR A LIMITED TIME TO ASSIST IN SECURING INSURANCE COVERAGE. A HOSPITAL FACILITY SHALL MAKE AFFIRMATIVE EFFORTS TO HELP A PATIENT OR PATIENT'S GUARANTOR APPLY FOR PUBLIC AND PRIVATE PROGRAMS.THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
SCHEDULE H, PART V, SECTION B, LINE 7A - CHNA ON HOSPITAL FACILITY'S WEBSITEALL DIGNITY HEALTH HOSPITAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS CAN BE ACCESSED ATHTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSCHNA REPORT WEBSITE LOCATIONS FOR EACH HOSPITAL FACILITY ARE PROVIDED BELOW.ST. ROSE DOMINICAN HOSPITAL - SIENA, ST. ROSE DOMINICAN HOSPITAL SAN MARTIN, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMAHTTPS://WWW.DIGNITYHEALTH.ORG/LAS-VEGAS/ABOUT-US/SERVING-THE-COMMUNITYDE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN NORTH LAS VEGASDE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN BLUE DIAMONDDE SAHARA LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN SAHARADE FLAMINGO LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN WEST FLAMINGOWWW.STROSENH.ORG/ABOUT/MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, MERCY HOSPITAL OF FOLSOMHTTPS://WWW.DIGNITYHEALTH.ORG/SACRAMENTO/ABOUT-US/COMMUNITY-HEALTH-AND-OUTREACH/HEALTH-NEEDS-ASSESSMENTDOMINICAN HOSPITALHTTPS://WWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/DOMINICAN/ABOUT-US/COMMUNITY-BENEFITS/BENEFITS-REPORTSMERCY HOSPITAL BAKERSFIELDHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/MERCY-BAKERSFIELD/ABOUT-US/COMMUNITY-BENEFIT-REPORT-HEALTH-NEEDS-ASSESSMENTMERCY MEDICAL CENTER MERCEDHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/MERCYMEDICAL-MERCED/ABOUT-US/COMMUNITY-BENEFIT-REPORTST. JOSEPH'S HOSPITAL AND MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/STJOSEPHS/ABOUT-US/COMMUNITY-BENEFIT/COMMUNITY-BENEFIT-RESOURCESMERCY GILBERT MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/MERCYGILBERT/ABOUT-US/COMMUNITY-BENEFITS-OUTRREACH/BENEFITS-REPORTSST. JOSEPH'S WESTGATE MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/WESTGATE/ABOUT-US/COMMUNITY-BENEFITMARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDEHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/MARIANREGIONAL/ABOUT-US/COMMUNITY-BENEFITSHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/ARROYO-GRANDE/ABOUT-US/COMMUNITY-BENEFITSMERCY MEDICAL CENTER REDDINGHTTPS://WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-REDDING/ABOUT-US/COMMUNITY-BENEFITST. ELIZABETH COMMUNITY HOSPITALHTTPS://WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/STELIZABETHHOSPITAL/ABOUT-US/COMMUNITY-BENEFITST. JOHN'S REGIONAL MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/STJOHNSREGIONAL/ABOUT-US/COMMUNITY-BENEFITST. JOHN'S HOSPITAL CAMARILLOHTTPS://WWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/PLEASANTVALLEY/ABOUT-US/COMMUNITY-BENEFITST. MARY'S MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/STMARYS/ABOUT-US/COMMUNITY-BENEFITST. MARY MEDICAL CENTER - LONG BEACHHTTPS://WWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STMARYMEDICAL/ABOUT-US/COMMUNITY-BENEFITSMERCY MEDICAL CENTER MT. SHASTAHTTPS://WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-MTSHASTA/ABOUT-US/COMMUNITY-BENEFITST. BERNARDINE MEDICAL CENTERHTTPS://WWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STBERNARDINEMEDICAL/ABOUT-US/SERVING-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-PLAN
SCHEDULE H, PART V, SECTION B, LINE 7B - CHNA ON OTHER WEBSITES FACILITY REPORTING GROUP AST. ROSE DOMINICAN HOSPITAL - SIENA, ST. ROSE DOMINICAN HOSPITAL SAN MARTIN, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMADE CRAIG RANCH LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN NORTH LAS VEGASDE BLUE DIAMOND LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN BLUE DIAMONDDE SAHARA LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN SAHARADE FLAMINGO LLC DBA DIGNITY HEALTH - ST. ROSE DOMINICAN WEST FLAMINGOHTTPS://WWW.SOUTHERNNEVADAHEALTHDISTRICT.ORG/NEWS-INFORMATION/FACILITY REPORTING GROUP EST. JOHN'S REGIONAL MEDICAL CENTERST. JOHN'S HOSPITAL CAMARILLOHTTPS://WWW.HEALTHMATTERSINVC.ORG/CONTENT/SITES/VENTURA/CHNAS/VENTURA_CHNA_2022_V4.PDFST. MARY'S MEDICAL CENTER, SAN FRANCISCOHTTP://WWW.SFHIP.ORG/
SCHEDULE H, PART V, SECTION B, LINE 10A - IMPLEMENTATION STRATEGIES ON WEBSITESDIGNITY HEALTH HOSPITAL FACILITY IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED ATHTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSIMPLEMENTATION STRATEGY DOCUMENTS ARE ALSO ON EACH HOSPITAL FACILITY'S WEBSITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7A ABOVE.
PART V, SECTION B, LINE 11 /FACILITY REPORTING GROUP B (CONT'D) MERCY MEDICAL CENTER MERCEDTHE SIGNIFICANT COMMUNITY HEALTH NEEDS THE HOSPITAL IS HELPING TO ADDRESS WERE IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). NEEDS BEING ADDRESSED BY STRATEGIES AND PROGRAMS ARE: ACCESS TO HEALTH CARE SERVICES, CANCER, DIABETES, INFANT/MATERNAL HEALTH & FAMILY PLANNING, NUTRITION, PHYSICAL ACTIVITY & WEIGHT, HEART DISEASE AND STROKE, TOBACCO USE, RESPIRATORY DISEASE (COVID-19), INJURY AND VIOLENCE, ORAL HEALTH, SOCIAL DETERMINANTS OF HEALTH. THESE NEEDS ARE BEING ADDRESSED THROUGH PROGRAMMING, STRATEGIES AND INITIATIVES THE HOSPITAL IS ALLOCATING RESOURCES AND FUNDS TOWARDS. THE HOSPITAL INTENDS TO TAKE SEVERAL ACTIONS AND TO DEDICATE RESOURCES TO THESE NEEDS, INCLUDING: FAMILY PRACTICE CLINIC; KIDS CARE PEDIATRIC CLINIC; GENERAL MEDICINE CLINIC; PATIENT FINANCIAL ASSISTANCE PROGRAM; MERCY UC DAVIS CANCER CENTER; AMERICAN CANCER SOCIETY - WIG BANK; ACCESSIBLE YOGA PROGRAM; CANCER SUPPORT GROUP; TRANSPORTATION ASSISTANCE PROGRAM; DIABETES SUPPORT GROUP AND CLASS; DIABETES EDUCATION AND EMPOWERMENT PROGRAM; NATIONAL DIABETES PREVENTION PROGRAM; CHILDBIRTH PREPARATION CLASSES; BABY CAFE; PRENATAL YOGA; STORK TOUR; PRENATAL BREASTFEEDING EDUCATION PROGRAM; ZUMBA, YOGA, WALK WITH EASE; MERCED COUNTY HUMAN TRAFFICKING COALITION; VALLEY CRISIS CENTER PARTNERSHIP/ED; MEDICAL SAFE HAVEN, YOUTH LEADERSHIP INSTITUTE - YOUTH VIOLENCE; ASTHMA SELF-MANAGEMENT PROGRAM; PROJECT CALM; CONNECTED COMMUNITY NETWORK; FREEDOM FROM SMOKING CLINICS; BHW/TZU CHI INTERNATIONAL DENTAL AND MEDICAL CLINIC; CERTIFIED PRIMARY STROKE CENTER, STROKE TELEMEDICINE, CARDIAC REHAB, STROKE SUPPORT AND RESOURCE CLASS. IN ADDITION, THE HOSPITAL IS COLLABORATING WITH MANY COMMUNITY BASED ORGANIZATIONS, BOTH PUBLIC AND PRIVATE SECTORS. THE SIGNIFICANT HEALTH NEEDS THE HOSPITAL HAS CHOSEN NOT TO ADDRESS ARE SUBSTANCE ABUSE, MENTAL HEALTH AND POTENTIALLY DISABLING CONDITIONS. SUBSTANCE ABUSE RESOURCES AND PROGRAMS ARE PROVIDED BY THE MERCED COUNTY SUBSTANCE USE DISORDER SERVICES. POTENTIALLY DISABLING CONDITIONS WILL NOT BE ADDRESSED PROGRAMMATICALLY, HOWEVER WE WILL BE ACTIVELY SCANNING FOR COMMUNITY BASED ORGANIZATIONS THAT ARE ADDRESSING THIS NEED AND WAYS TO SUPPORT OR PARTNER. MENTAL HEALTH IS BEING ADDRESSED BY MERCED COUNTY DEPARTMENT OF MENTAL HEALTH.
SCHEDULE H, PART V, SECTION B, LINE 16A, 16B AND 16C - FAP APPLICATION FORM FACILITY REPORTING GROUP AST. ROSE DOMINICAN HOSPITAL - SIENA, ST. ROSE DOMINICAN HOSPITAL SAN MARTIN, ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMAWWW.DIGNITYHEALTH.ORG/LAS-VEGAS/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEDE CRAIG RANCH LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN NORTH LAS VEGAS, DE BLUE DIAMOND LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN BLUE DIAMOND, DE SAHARA LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN SAHARA, DE FLAMINGO LLC DBA DIGNITY HEALTH ST. ROSE DOMINICAN WEST FLAMINGOWWW.STROSENH.ORG/HELPINGHANDS/FACILITY REPORTING GROUP BMERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, MERCY HOSPITAL OF FOLSOMWWW.DIGNITYHEALTH.ORG/SACRAMENTO/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/PAYMENT-ASSISTANCEDOMINICAN HOSPITALWWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/DOMINICAN/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEMERCY HOSPITAL (BAKERSFIELD)WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/MERCY-BAKERSFIELD/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEMERCY MEDICAL CENTER MERCEDWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/MERCYMEDICAL-MERCED/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEFACILITY REPORTING GROUP CST JOSEPH'S HOSPITAL AND MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/STJOSEPHS/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-PAYMENT-INFORMATION/FINANCIAL-ASSISTANCEMERCY GILBERT MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/MERCYGILBERT/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEST JOSEPH'S WESTGATE MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/ARIZONA/LOCATIONS/WESTGATE/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEFACILITY REPORTING GROUP DMARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDEWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/MARIANREGIONAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/ARROYO-GRANDE/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEMERCY MEDICAL CENTER REDDINGWWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-REDDING/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEST. ELIZABETH COMMUNITY HOSPITALWWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/STELIZABETHHOSPITAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEFACILITY REPORTING GROUP EST. JOHN'S REGIONAL MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/STJOHNSREGIONAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEST. JOHN'S HOSPITAL CAMARILLOWWW.DIGNITYHEALTH.ORG/CENTRAL-COAST/LOCATIONS/PLEASANTVALLEY/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEST. MARY'S MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/BAYAREA/LOCATIONS/STMARYS/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-AND-PAYMENT/FINANCIAL-ASSISTANCEFACILITY REPORTING GROUP FST. MARY MEDICAL CENTER - LONG BEACHWWW.DIGNITYHEALTH.ORG/SOCAL/LOCATIONS/STMARYMEDICAL/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-PAYMENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCEMERCY MEDICAL CENTER MT SHASTAHTTPS://WWW.DIGNITYHEALTH.ORG/NORTH-STATE/LOCATIONS/MERCY-MTSHASTA/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEST. BERNARDINE MEDICAL CENTERWWW.DIGNITYHEALTH.ORG/STBERNARDINEMEDICAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-AND-PAYMENTS/PAYMENT-ASSISTANCE
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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?31
Name and address Type of Facility (describe)
1 1 - DIGNITY HEALTH MEDICAL GROUP ARIZONA
500 W THOMAS RD
PHOENIX,AZ85013
MULTI-SPECIALTY CLINICS
2 2 - UNIVERSITY OF ARIZONA CANCER CENTER AT DIG
625 N 6TH STREET
PHOENIX,AZ85004
CANCER CENTER
3 3 - VENTURA COUNTY IMAGING GROUP LLC
1510 COTNER AVE
LOS ANGELES,CA90025
IMAGING CENTER
4 4 - DIGNITY HEALTH - MERCY GILBERT SLEEP CENTE
3420 MERCY RD
GILBERT,AZ85297
SLEEP CENTER
5 5 - NICU OPERATING CO OF SANTA CRUZ LLC
1555 SOQUEL DRIVE
SANTA CRUZ,CA95065
NEONATAL HEALTHCARE
6 6 - DHMGN-PAVILION URGENT CARE CLINIC
800 N GIBSON RD SUITE 101
HENDERSON,NV89011
URGENT CARE
7 7 - DIGNITY HEALTH - ASSOCIATED SURGICAL ASSOC
3367 S MERCY ROAD STE 150
GILBERT,AZ85297
WEIGHT LOSS CENTER
8 8 - HUGER MERCY LIVING CENTER
2345 W ORANGEWOOD
PHOENIX,AZ85021
ASSISTED LIVING FACILITY
9 9 - RADIATION ONCOLOGY CENTER OF VENTURA COUNT
5301 MISSION OAKS BOULEVARD SUITE A
CAMARILLO,CA93012
RADIATION / ONCOLOGY
10 10 - MERCY DAVIS CANCER CENTER LLC
333 MERCY AVENUE
MERCED,CA95340
CANCER CENTER
11 11 - USRC DIGNITY HEALTH ACUTE LLC-CHANDLER ACU
1955 W FRYE ROAD
CHANDLER,AZ85224
ACUTE CARE CLINIC
12 12 - USRC DIGNITY HEALTH ACUTE LLC-ST JOSEPH AC
350 W THOMAS ROAD
PHOENIX,AZ85013
ACUTE CARE CLINIC
13 13 - DHMGN-HENDERSON MULTI-SPECIALTY CLINIC
10001 S EASTERN AVE SUITE 203
HENDERSON,NV89052
MULTI-SPECIALTY CLINICS
14 14 - USRC DIGNITY HEALTH ACUTE LLC-MERCY ACUTES
3555 S VAL VISTA DRIVE
GILBERT,AZ85297
ACUTE CARE CLINIC
15 15 - SEVEN OAKS SURGERY CTR LLC
1801 ORANGE TREE LANE SUITE 240
REDLANDS,CA92374
SURGERY CENTER
16 16 - CBCC OUTSMARTING CANCER LLC
6501 TRUXTUN AVENUE
BAKERSFIELD,CA93309
RADIATION / ONCOLOGY INCL CYBERKNIFE
17 17 - SANTA CRUZ SURGERY CENTER
3003 PAUL SWEET ROAD
SANTA CRUZ,CA95065
SURGERY CENTER
18 18 - GENESISCARE USA-CHW LLC (REDDING)
963 BUTTE STREET
REDDING,CA96001
ONCOLOGY
19 19 - ST ROSE NEUROSURGERY CLINIC
2865 SIENA HEIGHTS DR STE 131
HENDERSON,NV89052
MULTI-SPECIALTY CLINICS
20 20 - USRC DIGNITY HEALTH ACUTE LLC-MESA ACUTE
9130 E ELLIOT RD
MESA,AZ85212
ACUTE CARE CLINIC
21 21 - SANTA CRUZ COMPREHENSIVE IMAGING LLC
1685 COMMERCIAL WAY
SANTA CRUZ,CA95065
IMAGING CENTER
22 22 - USRC DIGNITY HEALTH ACUTE LLC-WESTGATE ACU
7300 N 99TH AVE
GLENDALE,AZ85305
ACUTE CARE CLINIC
23 23 - THE BARBARA GREENSPUN WOMEN'S CARE CENTER
100 N GREEN VALLEY PKWY SUITE 330
HENDERSON,NV89074
HEALTH CENTER
24 24 - GENESISCARE USA-CHW LLC (MT SHASTA)
902 PINE STREET
MT SHASTA,CA96067
ONCOLOGY
25 25 - USRC DIGNITY HEALTH ACUTE LLC-LAVEEN ACUTE
7171 S 51ST AVE
PHOENIX,AZ85539
ACUTE CARE CLINIC
26 26 - ADVANCED AMBULATORY SURGERY CENTER LP
1901 W LUGONIA AVENUE SUITE 100
REDLANDS,CA92374
SURGERY CENTER
27 27 - DIGNITY HEALTH USP OXNARD SURGERY CENTERS
1700 N ROSE AVENUE STE 100
OXNARD,CA93030
SURGERY CENTER
28 28 - ST JOHN'S REGIONAL IMAGING CENTER LLC
1700 N ROSE AVENUE 110
OXNARD,CA93030
IMAGING CENTER
29 29 - ST ROSE CARDIOVASCULARTHORACIC SURGERY CL
7190 S CIMARRON RD
LAS VEGAS,NV89113
MULTI-SPECIALTY CLINICS
30 30 - WESTERN DIAGNOSTIC SERVICES LAB
1414 E MAIN STREET STE 102
SANTA MARIA,CA93465
LABORATORY/PATHOLOGY
31 31 - DOMINICAN MAGNETIC RESONANCE IMAGING CENTE
1545 SOQUEL DRIVE
SANTA CRUZ,CA95065
IMAGING CENTER
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: UNLESS ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE, THE FOLLOWING ELIGIBILITY CRITERIA MUST BE MET IN ORDER FOR A PATIENT TO QUALIFY FOR FINANCIAL ASSISTANCE: - THE PATIENT MUST HAVE A MINIMUM ACCOUNT BALANCE OF TEN DOLLARS ($10.00) WITH THE COMMONSPIRIT HOSPITAL ORGANIZATION. MULTIPLE ACCOUNT BALANCES MAY BE COMBINED TO REACH THIS AMOUNT. PATIENTS/GUARANTORS WITH BALANCES BELOW TEN DOLLARS ($10.00) MAY CONTACT A FINANCIAL COUNSELOR TO MAKE MONTHLY INSTALLMENT PAYMENT ARRANGEMENTS. - THE PATIENT MUST COMPLY WITH PATIENT COOPERATION STANDARDS AS DESCRIBED IN SCHEDULE H, PART V, SECTION B, LINE 13H, 3RD PARAGRAPH. - THE PATIENT MUST SUBMIT A COMPLETED FINANCIAL ASSISTANCE APPLICATION (FAA).FOR PATIENTS AND GUARANTORS WHO ARE UNABLE TO PROVIDE REQUIRED DOCUMENTATION, A HOSPITAL FACILITY MAY GRANT PRESUMPTIVE FINANCIAL ASSISTANCE BASED ON INFORMATION OBTAINED FROM OTHER RESOURCES. IN PARTICULAR, PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: - RECIPIENT OF STATE-FUNDED PRESCRIPTION PROGRAMS; - HOMELESS OR ONE WHO RECEIVED CARE FROM A HOMELESS OR FREE CARE CLINIC; - PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); - FOOD STAMP ELIGIBILITY; - ELIGIBILITY OR REFERRALS FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS (E.G., MEDICAID); - LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; OR - PATIENT IS DECEASED WITH NO KNOWN SPOUSE OR KNOWN ESTATE.CALIFORNIA HOSPITALS ONLY:THE FOLLOWING REQUIREMENTS FOR ADDITIONAL HARDSHIP DISCOUNTS IS AN ADDENDUM OF THE FINANCIAL ASSISTANCE POLICY THAT APPLY TO PATIENTS RECEIVING SERVICES AT A COMMONSPIRIT HOSPITAL ORGANIZATION IN THE STATE OF CALIFORNIA ONLY.A PATIENT WHO RECEIVES DISCOUNTED CARE, BUT (1) WHOSE LIABILITY STILL EXCEEDS 30% OF THE SUM OF (A) HIS OR HER FAMILY INCOME, AND (B) HIS OR HER MONETARY ASSETS, AND (2) WHO DOES NOT HAVE THE ABILITY TO PAY HIS OR HER BILL, AS DETERMINED BY A REVIEW OF FACTORS SUCH AS PROJECTED FAMILY INCOME FOR THE COMING YEAR AND EXISTING OR ANTICIPATED HEALTH CARE LIABILITIES MAY BE GIVEN AN ADDITIONAL HARDSHIP DISCOUNT. FOR PURPOSES OF THE DETERMINATION OF THIS HARDSHIP DISCOUNT, THE COMMONSPIRIT HOSPITAL ORGANIZATION WILL NOT CONSIDER ASSETS IN RETIREMENT PLANS QUALIFIED UNDER THE INTERNAL REVENUE CODE IN EFFECT AT THE TIME OF THE DETERMINATION OR DEFERRED COMPENSATION PLANS.IF THE PATIENT MEETS ALL ELIGIBILITY CRITERIA, THE PATIENT WILL RECEIVE A HARDSHIP DISCOUNT, WHICH WILL REDUCE THE PATIENT'S REMAINING LIABILITY TO NO MORE THAN 30% OF THE SUM OF HIS OR HER (1) PATIENT FAMILY INCOME, AND (2) MONETARY ASSETS.A PATIENT MAY ALSO RECEIVE DISCOUNTS OR WAIVERS UNDER THIS ADDENDUM IF CONSIDERED HOMELESS OR TRANSIENT OR IF THEY PARTICIPATE IN A FEDERAL, STATE, OR LOCAL MANAGED INDIGENT CARE PROGRAM.
PART I, LINE 6A: EACH TAX-EXEMPT HOSPITAL FACILITY LISTED IN SCHEDULE H, PART V, PREPARED A SEPARATE COMMUNITY BENEFIT REPORT. CALIFORNIA HOSPITALS SUBMIT THEIR REPORTS TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AND NEVADA HOSPITALS SUBMIT THEIR REPORTS TO THE NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIGNITY HEALTH IS INCLUDED IN THE CONSOLIDATED COMMUNITY BENEFIT REPORT IN COMMONSPIRIT'S 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). COMMONSPIRIT'S FINANCIAL STATEMENTS ARE POSTED ON COMMONSPIRIT'S EXTERNAL WEB SITE. THE INDIVIDUAL HOSPITALS' COMMUNITY BENEFIT REPORTS ARE MADE AVAILABLE TO THE PUBLIC ON BOTH DIGNITY HEALTH'S AND EACH HOSPITAL'S WEBSITES, AND ARE AVAILABLE BY REQUEST.
PART I, LINE 7: DIGNITY HEALTH HOSPITALS USE A COST ACCOUNTING SYSTEM OR AN ADJUSTED COST TO CHARGE RATIO (CCR) CALCULATED IN A MANNER CONSISTENT WITH WORKSHEET 2 FOR EACH REPORTING FACILITY, TO DERIVE THE REPORTED COSTS OF FINANCIAL ASSISTANCE, MEDICAID AND OTHER MEANS-TESTED PROGRAMS. WORKSHEET 3 OR THE EQUIVALENT IN THE COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY ("CBISA") SOFTWARE ARE USED TO CALCULATE EXPENSE AND REVENUE, INCLUDING WHERE APPLICABLE MEDICAID PROVIDER FEES AND PAYMENTS FROM UNCOMPENSATED CARE PROGRAMS. ACTUAL OR ESTIMATED COST AND ANY DIRECT OFFSETTING REVENUE IS REPORTED, AND SCHEDULE H WORKSHEETS OR THEIR EQUIVALENTS ARE USED, FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND DONATIONS.PART I, LINE 7B - MEDICAID:INCLUDED IN COMMUNITY BENEFIT EXPENSE FOR MEDICAID, COLUMN (C) IS $125 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 $270 MILLION IN SUPPLEMENTAL PAYMENTS RECEIVED UNDER THESE PROGRAMS.
PART I, LINE 7G: INCLUDED IN SUBSIDIZED HEALTH SERVICES IS $48,386 OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION.PART I, LINE 7I:INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $2.3 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' PUBLICLY AVAILABLE ANNUAL COMMUNITY BENEFIT REPORTS EACH DESCRIBE SPECIFIC COMMUNITY BUILDING ACTIVITIES IN A SECTION TITLED "OTHER PROGRAMS AND NON-QUANTIFIABLE BENEFITS." COMBINED WITH DIGNITY HEALTH, DIGNITY COMMUNITY CARE AND COMMONSPIRIT HEALTH, 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. THE ORGANIZATION DOES NOT INCLUDE THE VALUE OF THESE LOANS AS COMMUNITY BUILDING, BUT THE ACTIVITY DOES SERVE TO BUILD COMMUNITY.IN FY22 THE PROGRAM APPROVED 16 NEW LOANS TOTALLING $31.8 MILLION, LEVERAGING $101.9 MILLION IN OTHER FINANCING IN COMMONSPIRIT HEALTH INCLUDING DIGNITY HEALTH FOR COMMUNITY IMPROVEMENT SUCH AS AFFORDABLE HOUSING AND HEALTH CARE CLINICS, ENVIRONMENTAL AND CLIMATE CHANGE EFFORTS, AND JOB CREATION. EXAMPLES OF RECENT INVESTMENTS ARE: A $2,000,000 SECURED LOAN TO HOMELESS PRENATAL PROGRAM FOR 7 YEARS. FUNDS WILL BE USED AS PART OF A PREDEVELOPMENT LOAN TO SUPPORT THE DEVELOPMENT OF 2530 18TH STREET IN SAN FRANCISCO. CURRENTLY A 2-STORY WAREHOUSE, THE BUILDING WILL BE REPLACED WITH NEW CONSTRUCTION OF 60 UNITS OF PERMANENT SUPPORTIVE HOUSING FOR LOW-INCOME AND HOMELESS FAMILIES, AND TO EXPAND AND PROVIDE JOB TRAINING AND CHILD CARE SERVICES. IN 2022, A $5.0 MILLION LOAN WAS APPROVED TO CALVERT IMPACT CAPITAL FOR 8 YEARS. FUNDS WILL BE USED TO INCREASE ACCESS TO CAPITAL ACROSS AFFORDABLE HOUSING, COMMUNITY DEVELOPMENT, EDUCATION, ENVIRONMENTAL SUSTAINABILITY, HEALTH, MICROFINANCE, AND RENEWABLE ENERGY. IN 2022, A $2,000,000 LINE OF CREDIT WAS APPROVED TO ABODE COMMUNITIES TO FUND ACQUISITION AND PREDEVELOPMENT COSTS RELATED TO NEW DEVELOPMENT PROJECTS IN LOS ANGELES, CALIFORNIA.DIGNITY HEALTH HOSPITALS DONATE THE USE OF MEETING SPACE TO COMMUNITY GROUPS AND 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. 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 THE SUPPORT AND DEVELOPMENT OF UNDERSERVED YOUTH, DISASTER RELIEF, AND BASIC NEEDS FOR VULNERABLE POPULATIONS.COMMUNITY BUILDING - ENVIRONMENTAL IMPROVEMENTS:DIGNITY HEALTH 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:DIGNITY HEALTH FACILITIES PROVIDE REPRESENTATION ON COMMUNITY COALITIONS AND BOARDS, HELP TO STIMULATE AND AT TIMES LEAD 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 HAS ESTABLISHED A HEALTH PROFESSIONALS WORKFORCE DEVELOPMENT PARTNERSHIP WITH MOREHOUSE SCHOOL OF MEDICINE TO RECRUIT AND TRAIN BLACK CLINICIANS. 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, LINE 2: THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE PART I, LINE 7 DISCLOSURE) 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 THE FOLLOWING CATEGORIES; IN ARIZONA AND NEVADA, UP TO 200% OR 201%-400% OF THE FEDERAL POVERTY LEVEL, IN CALIFORNIA UP TO 250%, 251%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR UNINSURED PATIENT DISCOUNT AND SELF-PAY DISCOUNTS. IN CALIFORNIA, PATIENTS WHO ARE UNINSURED OR WITH HIGH MEDICAL COSTS ARE ELIGIBLE TO RECEIVE DISCOUNTED CARE IN ADDITION TO AN INTEREST-FREE EXTENDED PAYMENT PLAN THAT WILL ALLOW PAYMENT OF THE DISCOUNTED AMOUNT OVER TIME. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.
PART III, LINE 3: THE DIGNITY HEALTH FINANCIAL ASSISTANCE POLICY WAS UPDATED AND RENAMED AS COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. DIGNITY HEALTH HOSPITALS FOLLOW THIS POLICY.THE FILING ORGANIZATION MAKES EVERY EFFORT TO DETERMINE IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. COMMONSPIRIT 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. COMMONSPIRIT 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.
PART III, LINE 4: THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2022, RELATED TO PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE. THE ENTIRE FOOTNOTE CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGES 12-13.PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES.
PART III, LINE 8: COMMONSPIRIT 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 UNITS.COMMONSPIRIT HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL FOR THE CONSOLIDATED ENTITIES 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 COMMONSPIRIT 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. DIGNITY HEALTH'S SHORTFALL, AS REPORTED ON PART III, SECTION B, LINE 7, OF $301 MILLION REPRESENTS THE FILING ORGANIZATION'S MEDICARE COST REPORTS.
PART III, LINE 9B: DIGNITY HEALTH FACILITIES ENSURE THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. DIGNITY HEALTH ALSO FOLLOWS COMMONSPIRIT HEALTH'S COLLECTION POLICY. COMMONSPIRIT 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 COMMONSPIRIT 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 COMMONSPIRIT 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 COMMONSPIRIT 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: 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 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.MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDEMARIAN REGIONAL MEDICAL CENTER IS AN ACTIVE MEMBER OF THE COMMUNITY CONVERSATION HEALTH EQUITY COALITION WHICH FOCUSES ON THE BETTERMENT OF COLLABORATING ON STRATEGIES TO ADDRESS HEALTH INEQUITIES IN SANTA BARBARA COUNTY.MERCY MEDICAL CENTER REDDINGMMCR SUPPORTS AND ENHANCES REGIONAL EFFORTS IN PLACE TO PROMOTE HEALTHIER COMMUNITIES. ONE OF THE OBJECTIVES IS TO PARTNER WITH OTHER NONPROFIT AND RELIGIOUS ORGANIZATIONS THAT SHARE OUR VALUES AND PRIORITIES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITY WE SERVE. THIS IS AN INTENTIONAL EFFORT TO AVOID DUPLICATION AND LEVERAGE THE SUCCESSFUL WORK ALREADY IN EXISTENCE IN THE COMMUNITY.DOMINICAN HOSPITALDOMINICAN HOSPITAL HAS PARTNERED WITH SUTTER/PAMF AND KAISER PERMANENTE ON A SERIES OF COMMUNITY FORUMS GATHERING COMMUNITY PARTNERS AND COMMUNITY BENEFIT ORGANIZATIONS TOGETHER WITH THE GOAL OF CREATING A CONNECTED COMMUNITY NETWORK IN SANTA CRUZ COUNTY. ST. BERNARDINE MEDICAL CENTERSBMC SERVED ON THE 2022 INLAND EMPIRE COMMUNITY HEALTH ASSESSMENT STAKEHOLDER COMMITTEE COMPOSED OF OVER 40 REPRESENTATIVES ACROSS 25 COMMUNITY ORGANIZATIONS. THIS EFFORT SERVED TO UNITE COMMUNITY PARTNERS OVER THE PAST YEAR TO COLLECT AND ANALYZE THE REGION'S (INLAND EMPIRE) HEALTH AND WELLNESS DATA. COLLECTIVELY, THE COMMITTEE IDENTIFIED FOUR AT-RISK POPULATION GROUPS: SENIORS, COMMUNITIES OF COLOR, INDIVIDUALS WITH LOW INCOMES AND THOSE LIVING IN REMOTE AND RURAL AREAS, AS WELL AS SIX PRIORITY AREAS OF FOCUS: BASIC NEEDS FOR HEALTH AND SAFETY, HOUSING, MEANINGFUL WORK AND WEALTH, CARDIOVASCULAR DISEASE AND DIABETES, MATERNAL AND INFANT HEALTH AND MENTAL AND BEHAVIORAL HEALTH. A COMMUNITY HEALTH ASSESSMENT FOR THE INLAND EMPIRE WAS DEVELOPED AND DISTRIBUTED TO THE COMMUNITY DUE TO THE GROUP'S COLLABORATION. SBMC PARTNERED WITH THE SAN BERNARDINO COUNTY TRANSPORTATION AUTHORITY/SAN BERNARDINO COUNCIL OF GOVERNMENTS (SBCTA/SBCOG) TO DEVELOP VARIOUS TOOLS, INCLUDING A DATA DASHBOARD AND EQUITY TOOLKIT, TO HELP POLICYMAKERS AND COMMUNITY LEADERS ADVANCE EQUITY ACROSS SAN BERNARDINO COUNTY. SBMC WAS A PARTICIPANT ON A 2022 SBCTA/SBCOG FOCUS GROUP AND PROVIDED INSIGHT ON KEY HEALTH, ENVIRONMENTAL, AND EQUITY ISSUES IMPACTING THE HOSPITAL'S LOCAL SERVICE AREA. SBMC HAS PARTNERED WITH THE COUNTY OF SAN BERNARDINO OVER THE LAST TEN YEARS TO SUPPORT AND PROVIDE GUIDANCE ON THE COMMUNITY VITAL SIGNS INITIATIVE WHICH AIMS TO IMPROVE THE HEALTH OF ALL COUNTY RESIDENTS. SBMC HAS SERVED ON THE INTIATIVE'S STEERING COMMITTEE WHICH IS COMPOSED OF LEADERS FROM MULTIPLE SECTORS FROM THROUGHOUT THE COUNTY WHO GUIDE THE DECISION-MAKING PROCESS, LEAD IMPLEMENTATION OF EFFECTIVE GOALS, STRATEGIES, AND POLICIES, AND ADVOCATE FOR THE CONSIDERATION FOR A HEALTH IN ALL POLICIES APPROACH. SBMC IS PARTNERING WITH THE CITY OF SAN BERNARDINO TO EXPLORE OPTIONS FOR TRANSITIONAL HOUSING AND RECUPERATIVE CARE IN THE INLAND EMPIRE TO REDUCE AND ELIMINATE THE HEALTHCARE ACCESS, HOUSING, AND HOMELESSNESS CRISIS PRESENTED IN OUR LOCAL COMMUNITY. SBMC HAS SERVED ON THE INLAND EMPIRE BREASTFEEDING COALITION (IEBFC) IN AN EFFORT TO ADDRESS AND CLOSE THE EVOLVING GAPS IN PROMOTING AND SUPPORTING THE BREASTFEEDING COMMUNITY.ST. MARY'S MEDICAL CENTERTHE HOSPITAL ASSESSES HEALTH NEEDS BY FREQUENTLY CONNECTING WITH CLINICAL STAFF IN THE HOSPITAL AND COMMUNITY TO DETERMINE HOW NEEDS ARE BEST MET. ADDITIONALLY, THE HOSPITAL TRACKS HOW THE CARE LANDSCAPE CHANGES, AS FUNDING, STAFFING, AND AVAILABILITY OF SERVICES CHANGES THE HEALTH NEEDS THAT ARE MOST PREVALENT IN SAN FRANCISCO.ST ELIZABETH COMMUNITY HOSPITALSECH SUPPORTS AND ENHANCES REGIONAL EFFORTS IN PLACE TO PROMOTE HEALTHIER COMMUNITIES. ONE OF THE OBJECTIVES IS TO PARTNER WITH OTHER NONPROFIT AND RELIGIOUS ORGANIZATIONS THAT SHARE OUR VALUES AND PRIORITIES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITY WE SERVE. THIS IS AN INTENTIONAL EFFORT TO AVOID DUPLICATION AND LEVERAGE THE SUCCESSFUL WORK ALREADY IN EXISTENCE IN THE COMMUNITY.MERCY MEDICAL CENTER MT. SHASTAMMCMS SUPPORTS AND ENHANCES REGIONAL EFFORTS IN PLACE TO PROMOTE HEALTHIER COMMUNITIES. ONE OF THE OBJECTIVES IS TO PARTNER WITH OTHER NONPROFIT AND RELIGIOUS ORGANIZATIONS THAT SHARE OUR VALUES AND PRIORITIES TO IMPROVE THE HEALTH STATUS AND QUALITY OF LIFE OF THE COMMUNITY WE SERVE. THIS IS AN INTENTIONAL EFFORT TO AVOID DUPLICATION AND LEVERAGE THE SUCCESSFUL WORK ALREADY IN EXISTENCE IN THE COMMUNITY.
PART VI, LINE 3: INFORMATION ABOUT COMMONSPIRIT HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE COMMONSPIRIT HEALTH'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 FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES COMMONSPIRIT HEALTH'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION AND HOW TO REACH STAFF THAT CAN ASSIST WITH ANSWERING QUESTIONS AND GUIDE PATIENTS THROUGH THE APPLICATION PROCESS. INFORMATION CAN ALSO BE FOUND ON THE FACILITY WEBSITES.IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO 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 HOW TO CONTACT US REGARDING FINANCIAL ASSISTANCE. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF COMMONSPIRIT HEALTH REQUIRES THEY FOLLOW COMMONSPIRIT HEALTH FINANCIAL ASSISTANCE POLICY. ALSO, REFERRAL OF PATIENTS FOR FINANCIAL ASSISTANCE MAY BE MADE BY ANY MEMBER OF THE COMMONSPIRIT HOSPITAL ORGANIZATION NON MEDICAL OR MEDICAL STAFF, INCLUDING PHYSICIANS, NURSES, FINANCIAL COUNSELORS, SOCIAL WORKS, CASE MANAGERS, CHAPLAINS, AND RELIGIOUS SPONSORS. A REQUEST FOR ASSISTANCE MAY BE MADE BY THE PATIENT OR A FAMILY MEMBER, CLOSE FRIEND OR ASSOCIATE OF THE PATIENT, SUBJECT TO APPLICABLE PRIVACY LAWS.
PART VI, LINE 4: 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 LARGELY ON THE ORIGINS OF THE TOP 75 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 75% OF PATIENTS BY VOLUME. THE HOSPITAL SERVES A FEDERALLY- DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION.TOTAL POPULATION: 1,675,840 ASIAN/PACIFIC ISLANDER: 3.4%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 8.9%HISPANIC OR LATINO: 51.4%WHITE NON-HISPANIC: 30.7%ALL OTHERS: 5.6%% BELOW POVERTY: 14.2%UNEMPLOYMENT: 5.3%NO HIGH SCHOOL DIPLOMA: 21.2%MEDICAID: 27.0%UNINSURED: 11.1%OTHER AREA HOSPITALS: 48MERCY 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 14 ZIP CODES ACROSS SACRAMENTO, CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, NORTH HIGHLANDS, ANTELOPE, AND OTHER SURROUNDING NEIGHBORHOODS. THE HOSPITAL IS PART OF THE REGION HISTORICALLY KNOWN FOR ITS LACK OF SAFETY NET PROVIDERS TO SERVE LOW-INCOME AND VULNERABLE RESIDENTS. WITH AN INCREASING MEDI-CAL POPULATION THE HOSPITAL HAS SEEN AN INCREASE IN MEDI-CAL INSURED ADMISSIONS TO THE EMERGENCY DEPARTMENT SEEKING PRIMARY CARE TREATMENT FOR BASIC HEALTH NEEDS.TOTAL POPULATION: 557,283HISPANIC OR LATINO: 23.2%WHITE - NON-HISPANIC: 51.5%BLACK/AFRICAN AMERICAN: 7.0% ASIAN/PACIFIC ISLANDER: 10.1%ALL OTHER: 8.2%% BELOW POVERTY: 9.5%UNEMPLOYMENT: 5.6%NO HIGH SCHOOL DIPLOMA: 10.5%MEDICAID: 33.2%UNINSURED: 5.3%OTHER AREA HOSPITALS: 6MARIAN REGIONAL MEDICAL CENTER, ARROYO GRANDE, WHICH INCLUDES MARIAN REGIONAL MEDICAL CENTER AND ARROYO GRANDE COMMUNITY HOSPITAL, IS LOCATED IN TWO ADJACENT COUNTIES: SANTA BARBARA COUNTY AND SAN LUIS OBISPO COUNTY.ACCORDING TO THE AMERICAN COMMUNITY SURVEY (2016-2020, 5-YEAR AVERAGE), THE MARIAN REGIONAL MEDICAL CENTER (MRCM) COMMUNITY IS HOME TO 150,072 RESIDENTS, WITH THE MAJORITY (73%) RESIDING WITHIN THE CITY OF SANTA MARIA. SANTA MARIA IS THE LARGEST CITY IN SANTA BARBARA COUNTY BOTH IN LAND AREA AND POPULATION. THE MRMC COMMUNITY IS A CULTURALLY DIVERSE AREA WITH THE MAJORITY OF RESIDENTS (67.2%) CONSIDERING THEMSELVES HISPANIC OR LATINO(A) ORIGIN. IN THE MRMC COMMUNITY, 26.6% OF INDIVIDUALS OVER THE AGE OF FIVE SPEAK ENGLISH LESS THAN "VERY WELL." EDUCATIONAL ATTAINMENT FOR ADULTS AGE 25 AND OLDER CONTINUES TO BE A CHALLENGE FOR THE MRMC COMMUNITY. OVER HALF (53.2%) OF THE ADULTS (AGE 25 AND OVER) RESIDING IN ZIP CODE 93458 (SANTA MARIA), AND 44.3% OF ADULTS RESIDING IN 93434 (GUADALUPE) HAVE LESS THAN A HIGH SCHOOL EDUCATION. IN ADDITION TO THE RESIDENTS CAPTURED BY THE FORMALIZED DATA SOURCES ABOVE, THE TRANSIENT FARMWORKER POPULATION DRAWN TO WORK IN THE FIELDS OF SANTA BARBARA COUNTY AND SAN LUIS OBISPO COUNTY ARE SUPPORTED BY INDIGENOUS MIGRANTS FROM THE MEXICAN STATES OF OAXACA AND GUERRERO. THESE INDIGENOUS MIGRANTS ARE OFTEN MONOLINGUAL IN THEIR NATIVE PRE-HISPANIC INDIGENOUS LANGUAGE OF MIXTEC OR ZAPOTEC. ACCORDING TO THE NATIONAL CENTER FOR FARMWORKER HEALTH IN 2017, THERE WERE AN ESTIMATED 32,066 FARMWORKERS IN SANTA BARBARA COUNTY AND 17,771 FARMWORKERS IN SAN LUIS OBISPO COUNTY. THE 2022 POINT IN TIME COUNT FOR SANTA BARBARA COUNTY REPORTED 457 PERSONS EXPERIENCING HOMELESSNESS IN SANTA MARIA AND 2 IN GUADALUPE. THE HOMELESS POPULATION IN SANTA MARIA IN 2022 IS SIMILAR TO THE 2019 TOTAL OF 464 AND HIGHER THAN THE 2020 TOTAL OF 382. THE TABLE BELOW PROVIDES ADDITIONAL POPULATION CHARACTERISTICS FOR THE MARIAN REGIONAL MEDICAL CENTER COMMUNITY.TOTAL POPULATION: 147,176WHITE: 22.1 % BLACK/AFRICAN AMERICAN: 1.0% HISPANIC OR LATINO: 69.3 % ASIAN/PACIFIC ISLANDER: 4.1 % ALL OTHERS: 3.5 % % BELOW POVERTY 7.1 %UNEMPLOYMENT: 4.9 %NO HS DIPLOMA: 30.8%MEDICAID (HOUSEHOLD):34.6 %UNINSURED (HOUSEHOLD): 9.3 %OTHER AREA HOSPITALS: 3ARROYO GRANDE COMMUNITY HOSPITAL (AGCH) SERVES THE FIVE CITIES' COMMUNITY OF SOUTHERN SAN LUIS OBISPO COUNTY. THE FIVE CITIES' AREA CONSISTS OF THE NEIGHBORING CITIES OF ARROYO GRANDE, GROVER BEACH, NIPOMO, OCEANO, AND PISMO BEACH. THE AGCH COMMUNITY EXTENDS FROM THE NORTHERNMOST BOUNDARY OF THE MRMC COMMUNITY, AND INCLUDES THE FOLLOWING SAN LUIS OBISPO COUNTY COMMUNITIES AND ZIP CODES: 93420 (ARROYO GRANDE); 93433 (GROVER BEACH); 93444 (NIPOMO); 93445 (OCEANO); AND, 93449 (PISMO BEACH). ACCORDING TO THE U.S. CENSUS, THE MEDIAN AGE IN CALIFORNIA IS 36.7 YEARS, WHICH IS LOWER THAN THE MEDIAN AGE OF THE FIVE AGCH COMMUNITIES. THE MEDIAN AGE IN 93433 (GROVER BEACH) IS CLOSEST TO THE STATE LEVEL, HOWEVER 93420 (ARROYO GRANDE) AND 93449 (PISMO BEACH) ARE MORE THAN 10 POINTS ABOVE THE STATE MEDIAN AGE. IN 93420 (ARROYO GRANDE) NEARLY 25% OF THE POPULATION IS AGE 65 OR OVER AND IN 93449 (PISMO BEACH) THIS NUMBER INCREASES TO NEARLY 32%:TOTAL POPULATION: 119,298WHITE: 56.1 % BLACK/AFRICAN AMERICAN: 1.0% HISPANIC OR LATINO: 33.2% ASIAN/PACIFIC ISLANDER: 3.7 %ALL OTHERS: 6.0% % BELOW POVERTY: 4.4%UNEMPLOYMENT: 3.0%NO HS DIPLOMA: 8.7 %MEDICAID (HOUSEHOLD): 26.6 %UNINSURED (HOUSEHOLD): 6.5 %OTHER AREA HOSPITALS: 3MERCY GENERAL HOSPITAL:THE HOSPITAL, A TERTIARY CARE FACILITY LOCATED IN EAST SACRAMENTO, SERVES RESIDENTS FROM A BROAD GEOGRAPHIC AREA. THE HOSPITAL'S PRIMARY SERVICE AREA LIES IN THE CENTRAL DOWNTOWN AREA OF SACRAMENTO, AND INCLUDES 25 ZIP CODES. THE HOSPITAL SERVES COMMUNITIES ACROSS THREE COUNTIES INCLUDING: SACRAMENTO, YOLO AND EL DORADO. THE SERVICE AREA ENCOMPASSES A DIVERSE COMMUNITY WITH NUMEROUS NEIGHBORHOODS REFLECTING HIGHER RATES OF POVERTY, INCREASED CASES OF HOMELESSNESS, LACK OF INSURANCE AND LACK OF EDUCATION. THE HOSPITAL MUST BALANCE ITS RESPONSIBILITY CARING FOR THE ACUTELY ILL WITH AN INCREASING ROLE IT SERVES AS A SAFETY NET PROVIDER FOR THE POOR AND VULNERABLE IN THE REGION WHERE RESOURCES AND COMMUNITY CAPACITY IS LIMITED.TOTAL POPULATION: 926,836HISPANIC OR LATINO: 28.1%WHITE - NON-HISPANIC: 34.2%BLACK/AFRICAN AMERICAN: 10.5%ASIAN/PACIFIC ISLANDER: 19.6%ALL OTHER: 7.6%% BELOW POVERTY: 11.1%UNEMPLOYMENT: 6.3%NO HIGH SCHOOL DIPLOMA: 13.2%MEDICAID: 34.0%UNINSURED: 5.3%OTHER AREA HOSPITALS: 7MERCY MEDICAL CENTER REDDINGSHASTA COUNTY HAS A TOTAL AREA OF 3,847 SQUARE MILES AND COVERS THE REDDING CALIFORNIA METROPOLITAN STATISTICAL AREA. ACCORDING TO THE US CENSUS, THE COUNTY'S 2020 POPULATION WAS APPROXIMATELY 180,000 RESIDENTS. THE COUNTY SEAT IS REDDING, HOME TO APPROXIMATELY ONEHALF OF SHASTA COUNTY RESIDENTS. SITUATED ALONG THE NORTHSOUTH INTERSTATE 5 CORRIDOR THE COUNTY IS LINED WITH MOUNTAINS ON ITS NORTH, EAST, AND WEST SIDES. BEYOND REDDING, THE COUNTY IS RURAL. ONLY A SMALL PORTION OF THE MMCR SERVICE AREA DIPS INTO NORTHERN TEHAMA COUNTY. THIS AREA INCLUDES THE CITY OF RED BLUFF, WHICH IS BOTH THE TEHAMA COUNTY SEAT AND THE LARGEST CITY IN THE COUNTY, WITH A POPULATION OF JUST OVER 14 THOUSAND RESIDENTS. FOR THE PURPOSES OF THIS ASSESSMENT, THE SERVICE AREA WAS FURTHER DEFINED BY 15 ZIP CODES, 13 OF WHICH WERE LOCATED IN SHASTA AND THE REMAINING TWO IN TEHAMA. THE SHASTA COUNTY ZIP CODES INCLUDED 96001, 96002, 96003, 96007,96019, 96024, 96033, 96047, 96052, 96073, 96087, 96088, AND 96093. THE TEHAMA COUNTY ZIP CODES INCLUDED 96022 AND 96080. THE DEMOGRAPHICS DATA BELOW REPRESENTS THE TOP 75% OF MERCY MEDICAL CENTER REDDING'S DISCHARGES:TOTAL POPULATION: 165,569 ASIAN/PACIFIC ISLANDER: 3.9%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 1.2%HISPANIC OR LATINO: 12.2%WHITE NON-HISPANIC: 72.5%ALL OTHERS: 10.2%% BELOW POVERTY: 8.9%UNEMPLOYMENT: 5.5%NO HIGH SCHOOL DIPLOMA: 8.3%MEDICAID: 38.4%UNINSURED: 6.3%OTHER AREA HOSPITALS: 1*** PART VI, LINE 4 CONTINUED AFTER PART VI, LINE 7 ON PART VI, PAGE 10 ***
PART VI, LINE 5: FINANCIAL ASSISTANCE: IT IS THE POLICY OF COMMONSPIRIT HEALTH TO PROVIDE, WITHOUT DISCRIMINATION, EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY CARE IN COMMONSPIRIT HOSPITAL FACILITIES TO ALL PATIENTS, WITHOUT REGARD TO A PATIENT'S FINANCIAL ABILITY TO PAY. THIS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY THAT DESCRIBES THE ASSISTANCE PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A FINANCIAL HARDSHIP TO FULLY PAY THE EXPECTED OUT-OF-POCKET EXPENSES FOR SUCH CARE, AND WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. THE FINANCIAL ASSISTANCE POLICY, A PLAIN LANGUAGE SUMMARY AND RELATED MATERIALS ARE AVAILABLE IN MULTIPLE LANGUAGES ON THE HOSPITAL'S WEBSITE.USE OF SURPLUS FUNDS: AS A NOT-FOR-PROFIT HOSPITAL ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, THE HOSPITAL 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 THE HOSPITAL 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 INCLUDES GATHERING AND VERIFYING CREDENTIALS, ALLOWING THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND ULTIMATELY MAKING A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES ON THE BASIS OF AUTHENTIC AND VALID CREDENTIALS.ROLE OF THE BOARD: THE COMMONSPIRIT HEALTH BOARD AND SPECIFIC COMMITTEES HAVE ORGANIZATIONAL, POLICY-BASED ROLES TO OVERSEE COMMUNITY BENEFIT AND COMMUNITY HEALTH PROGRAMS, AND THEY RECEIVE REGULAR REPORTS ON ACTIVITIES AND PERFORMANCE. HOSPITAL COMMUNITY BOARDS (OR THEIR DESIGNATED COMMUNITY HEALTH OR COMMUNITY BENEFIT COMMITTEES) ARE RESPONSIBLE FOR ENSURING THAT THE HOSPITALS CONDUCT AND ADOPT COMMUNITY HEALTH NEEDS ASSESSMENTS AND IMPLEMENTATION STRATEGIES, TAKE ACTIONS TO HELP ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS WITH AN EMPHASIS ON POOR AND VULNERABLE POPULATIONS AND HEALTH EQUITY, AND MONITORING ACTIONS AND PROGRESS TOWARD IDENTIFIED GOALS.COMMUNITY GRANTS, SOCIAL INNOVATION PARTNERSHIP GRANTS, AND COMMUNITY INVESTMENT: DIGNITY HEALTH HOSPITALS, TOGETHER WITH DIGNITY COMMUNITY CARE HOSPITALS, PROVIDE MORE THAN $5.4 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 COMMUNITY INVESTMENT PROGRAM THAT PROVIDES 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. OVERALL IN FISCAL YEAR 2022, THE PROGRAM APPROVED 16 NEW LOANS TOTALLING $31.8 MILLION, LEVERAGING $101.9 MILLION IN OTHER FINANCING FOR COMMUNITY IMPROVEMENT SUCH AS AFFORDABLE HOUSING AND HEALTH CARE CLINICS, ENVIRONMENTAL AND CLIMATE CHANGE EFFORTS, AND JOB CREATION. 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 CONNECTED 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 ATHTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS , IN ADDITION TO THE WEBSITES REPORTED IN PART V, LINE 7.
PART VI, LINE 6: 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, PHOENIX, CHANDLER AND GILBERT, ARIZONA AND LAS VEGAS AND HENDERSON, NEVADA AND IN 18 ADDITIONAL STATES THROUGH THE ALLIANCE WITHIN COMMONSPIRIT HEALTH SYSTEM. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE NET OF OFFSETTING REVENUE FOR COMMONSPIRIT AND ITS AFFILIATED CORPORATIONS, WHICH INCLUDES DIGNITY HEALTH, FOR THE YEAR ENDED JUNE 30, 2022, IS $3.2 BILLION. A SUMMARY OF COMMONSPIRIT'S COMMUNITY BENEFITS CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGE 44.
PART VI, LINE 7, REPORTS FILED WITH STATES CA,NV
SCHEDULE H, PART VI, LINE 4 - COMMUNITY INFORMATION CONTINUATION ST. ROSE DOMINICAN HOSPITALS SIENA, SAN MARTIN AND DE LIMA:THE GEOGRAPHIC AREA FOR THE CHNA IS CLARK COUNTY, THE COMMON COMMUNITY FOR ALL PARTNERS PARTICIPATING IN THE CHNA COLLABORATIVE. CLARK COUNTY IS THE NATION'S 14TH LARGEST COUNTY THAT SERVES MORE THAN 2.25 MILLION CITIZENS AND MORE THAN 46 MILLION VISITORS A YEAR. CLARK COUNTY SERVES A COMMUNITY LIVING IN RURAL OR URBAN AREAS. A KEY COMPONENT OF THE COUNTY'S ECONOMY IS TOURISM, AND AMONG ITS LARGEST INDUSTRIES ARE ACCOMMODATION AND FOOD SERVICE, RETAIL TRADE AND HEALTH CARE AND SOCIAL ASSISTANCE. ALL COUNTIES WITHIN NEVADA HAVE HAD TREMENDOUS POPULATION GROWTH WITHIN THE LAST DECADE. HOWEVER, THE MAJORITY OF THE POPULATION REMAINS WITHIN CLARK COUNTY, AND IT CONTINUES TO GROW. BETWEEN 2015 AND 2021 CLARK COUNTY'S POPULATION GREW FROM 2.11 MILLION TO 2.32 MILLION. CLARK COUNTY COMPRISES ONLY 7% (8,091 SQUARE MILES) OF NEVADA'S LAND MASS (110,567 SQUARE MILES) BUT CONTAINS 72% OF THE STATE'S TOTAL POPULATION. BECAUSE OF CLARK COUNTY'S CONTRIBUTION TO THE STATE POPULATION, CAUTION SHOULD BE EXERCISED WHEN COMPARING THE COUNTY TO THE STATE:TOTAL POPULATION: 2,333,185 ASIAN/PACIFIC ISLANDER: 11.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 13.1%HISPANIC OR LATINO: 32.4%WHITE NON-HISPANIC: 36.7%ALL OTHERS: 6.8%% BELOW POVERTY: 9.7%UNEMPLOYMENT: 5.4%NO HIGH SCHOOL DIPLOMA: 13.9%MEDICAID: 24.4%UNINSURED: 10.9%OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH DOMINICAN HOSPITAL:THE HOSPITAL SERVES SANTA CRUZ COUNTY, WHICH HAS A POPULATION OF APPROXIMATELY 233,776 AND COVERS 445 SQUARE MILES. THE MEDIAN FAMILY INCOME IS $82,234. FOURTEEN PERCENT OF THE POPULATION DOES NOT HAVE A HIGH SCHOOL DIPLOMA. TWENTY-SIX PERCENT OF THE COUNTY POPULATION ARE CENTRAL CALIFORNIA ALLIANCE FOR HEALTH (CCAH) MEMBERS ENROLLED IN MEDI-CAL. THE MEDICALLY UNDERSERVED AREAS/POPULATIONS ARE WATSONVILLE, FREEDOM, AND THE CITY OF SANTA CRUZ. DOMINICAN IS ONE OF TWO ACUTE CARE HOSPITALS THAT SERVE THE SANTA CRUZ COUNTY COMMUNITY.TOTAL POPULATION: 233,776 ASIAN/PACIFIC ISLANDER: 4.4%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 0.7%HISPANIC OR LATINO: 39.5%WHITE NON-HISPANIC: 48.8%ALL OTHERS: 6.6%% BELOW POVERTY: 6.4%UNEMPLOYMENT: 4.7%NO HIGH SCHOOL DIPLOMA: 14.3%MEDICAID: 26.0%UNINSURED: 5.7%OTHER AREA HOSPITALS: 2ST. 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. SEVENTY-FIVE PERCENT 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: 487,056 ASIAN/PACIFIC ISLANDER: 3.5%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 8.5%HISPANIC OR LATINO: 74.2%WHITE NON-HISPANIC: 10.8%ALL OTHERS: 3.0%% BELOW POVERTY: 15.6%UNEMPLOYMENT: 7.7%NO HIGH SCHOOL DIPLOMA: 30.8%MEDICAID: 40.6%UNINSURED: 8.0%OTHER AREA HOSPITALS: 5MERCY GILBERT MEDICAL CENTER:THE HOSPITAL'S COMMUNITY INCLUDES THE URBAN AND SUBURBAN AREAS OF MARICOPA COUNTY, INCLUDING CHANDLER, GILBERT, QUEEN CREEK, SAN TAN VALLEY, AND MESA. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA.MERCY GILBERT MEDICAL CENTERTOTAL POPULATION: 850,465ASIAN/PACIFIC ISLANDER: 7.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 4.5%HISPANIC OR LATINO: 23.3%WHITE NON-HISPANIC: 58.7%ALL OTHERS: 6.5%% BELOW POVERTY: 5.3%UNEMPLOYMENT: 4.0%NO HIGH SCHOOL DIPLOMA: 6.7%MEDICAID: 26.3%UNINSURED: 11.0%OTHER AREA HOSPITALS: 4 IN PRIMARY SERVICE AREA, 12 SECONDARY SERVICE AREAMERCY HOSPITAL BAKERSFIELD:THE POPULATION OF THE MERCY HOSPITALS' SERVICE AREA IS 622,303. CHILDREN AND YOUTH, AGES 0-17, MAKE UP 29.5% OF THE POPULATION, 59.6% ARE ADULTS, AGES 18-64, AND 10.9% OF THE POPULATION ARE SENIORS, AGES 65 AND OLDER. ALMOST HALF OF THE POPULATION IN THE SERVICE AREA IDENTIFIES AS HISPANIC/LATINO (49.4%). 37.4% OF THE POPULATION IDENTIFIES AS WHITE/CAUCASIAN, 5.4% AS BLACK/AFRICAN AMERICAN. 4.9% AS ASIAN AND 2.2% OF THE POPULATION IDENTIFIES AS MULTIRACIAL (TWO-OR-MORE RACES), 0.5% AS AMERICAN INDIAN/ALASKAN NATIVE, AND 0.1% AS NATIVE HAWAIIAN/PACIFIC ISLANDER. AMONG THE RESIDENTS IN THE SERVICE AREA, 20.2% ARE AT OR BELOW 100% OF THE FEDERAL POVERTY LEVEL (FPL) AND 43.4% ARE AT 200% OF FPL OR BELOW. EDUCATIONAL ATTAINMENT IS A KEY DRIVER OF HEALTH. IN THE HOSPITALS' SERVICE AREA, 22.3% OF ADULTS, AGES 25 AND OLDER, LACK A HIGH SCHOOL DIPLOMA, WHICH IS HIGHER THAN THE STATE RATE (16.7%). 18.3% OF AREA ADULTS HAVE A BACHELOR'S OR HIGHER DEGREE. BAKERSFIELD IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA (MUA) AND A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR PRIMARY CARE, DENTAL HEALTH AND MENTAL HEALTH. THE DEMOGRAPHICS DATA BELOW REPRESENTS ONLY THE TOP 75% OF MERCY BAKERSFIELD HOSPITAL DISCHARGES (BASED ON ZIP CODE): TOTAL POPULATION: 548,012 ASIAN/PACIFIC ISLANDER: 6.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 5.2%HISPANIC OR LATINO: 56.2%WHITE NON-HISPANIC: 28.4%ALL OTHERS: 4.2%% BELOW POVERTY: 13.9%UNEMPLOYMENT: 7.2%NO HIGH SCHOOL DIPLOMA: 20.9%MEDICAID: 48.2%UNINSURED: 7.4%OTHER AREA HOSPITALS: 9ST. MARY MEDICAL CENTER:ST. MARY MEDICAL CENTER IS LOCATED IN LONG BEACH, CA AND IS A CITY WITHIN LOS ANGELES COUNTY. LONG BEACH IS THE 36TH LARGEST CITY IN THE NATION, THE SEVENTH LARGEST CITY IN CALIFORNIA AND THE SECOND LARGEST CITY WITHIN THE GREATER LOS ANGELES AREA. LONG BEACH IS HOME TO 528,729 PEOPLE AND ONE OF THE MOST ETHNICALLY DIVERSE COMMUNITIES IN THE US, WITH A STRONG SENSE OF COMMUNITY AND UNIQUE NEIGHBORHOODS. LONG BEACH IS KNOWN FOR LARGE CAMBODIAN, HISPANIC/LATINO AND BLACK/AFRICAN COMMUNITIES AND A GROWING POPULATION OF ADULTS 65 AND OLDER.TOTAL POPULATION: 528,729 ASIAN/PACIFIC ISLANDER: 10.9%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 12.0%HISPANIC OR LATINO: 54.3%WHITE NON-HISPANIC: 18.3%ALL OTHERS: 4.5%% BELOW POVERTY: 13.1%UNEMPLOYMENT: 5.8%NO HIGH SCHOOL DIPLOMA: 25.0%MEDICAID: 34.4%UNINSURED: 9.0%OTHER AREA HOSPITALS: 9ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S CAMARILLO HOSPITAL:IN 2022, VENTURA COUNTY'S POPULATION OF 842,465 HAD A MEDIAN AGE OF 38.5 AND A MEDIAN HOUSEHOLD INCOME OF $101,407. AMONG COUNTY RESIDENTS, 37,864 HAVE VETERAN STATUS, 37.9% OF THE PEOPLE IN VENTURA COUNTY SPEAK A NON-ENGLISH LANGUAGE, AND 21.3% ARE FOREIGN BORN. THE AVERAGE OWNER-OCCUPIED HOME/PROPERTY VALUE IN VENTURA COUNTY IS $809,953 AND THE HOMEOWNERSHIP RATE IS 63.3%. THE PERCENTAGE OF HOUSEHOLDS WITH A COMPUTER IS 91.9% AND THOSE HOUSEHOLDS WITH A BROADBAND INTERNET SUBSCRIPTION IS 89.8%. ST. JOHN'S REGIONAL MEDICAL CENTER AND ST. JOHN'S HOSPITAL CAMARILLO PRIMARILY SERVE THE COMMUNITIES OF OXNARD, PORT HUENEME, CAMARILLO AND SOMIS, WHICH ARE ZIP CODES OF 93030, 93033, 93035, 93036, 93041, 93010, 93012 AND 93066. THE POPULATION OF THESE ZIP CODES IS 209,084 WHICH REPRESENTS 24.81% OF VENTURA COUNTY'S POPULATION. VENTURA COUNTY'S FEDERAL MEDICALLY UNDERSERVED AREA SCORE IS 61 ( A SCORE BELOW 62 IS CONSIDERED A MEDICALLY UNDERSERVED AREA) THE DEMOGRAPHICS DATA BELOW REPRESENTS THE TOP 75% OF THE HOSPITALS' DISCHARGES (BASED ON ZIP CODE):TOTAL POPULATION: 209,084ASIAN/PACIFIC ISLANDER: 7.1%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 2.2%HISPANIC OR LATINO: 77.7%WHITE NON-HISPANIC: 10.8%ALL OTHERS: 2.2%% BELOW POVERTY: 9.4%UNEMPLOYMENT: 5.5%NO HIGH SCHOOL DIPLOMA: 31.3%MEDICAID: 27.0%UNINSURED: 8.5%OTHER AREA HOSPITALS: 6
SCHEDULE H, PART VI, LINE 4 - COMMUNITY INFORMATION MERCY MEDICAL CENTER MERCED:THE CITY OF MERCED IS THE COUNTY SEAT AND IS THE LARGEST OF THE SIX INCORPORATED CITIES IN MERCED COUNTY. MERCED COUNTY ENCOMPASSES 1,935 SQUARE MILES AND HOUSES A TOTAL POPULATION OF 281,202 RESIDENTS, ACCORDING TO LATEST CENSUS ESTIMATES. BETWEEN THE 2010 AND 2020 US CENSUSES, THE POPULATION OF MERCED COUNTY INCREASED BY 25,411 PERSONS, OR 9.9%. THIS IS A GREATER PROPORTIONAL INCREASE THAN SEEN ACROSS BOTH THE STATE AND THE NATION OVERALL. MERCED COUNTY IS PREDOMINANTLY URBAN, WITH 85.7% OF THE POPULATION LIVING IN AREAS DESIGNATED AS URBAN. IN MERCED COUNTY, 29.7% OF THE POPULATION ARE CHILDREN AGE 0-17; ANOTHER 59.3% ARE AGE 18 TO 64, WHILE 11.0% ARE AGE 65 AND OLDER. MERCED COUNTY IS "YOUNGER" THAN THE STATE AND THE NATION IN THAT THE MEDIAN AGE IS LOWER. MERCED COUNTY IS LOCATED IN NORTHERN SAN JOAQUIN VALLEY SECTION OF THE CENTRAL VALLEY. IT IS LOCATED NORTH OF FRESNO COUNTY AND SOUTHEAST OF SANTA CLARA COUNTY. MERCY MEDICAL CENTER SERVES THE PRIMARY AREAS OF MERCED CITY WITH THE ZIP CODES 95340, 95341, 95348. OTHER COUNTY AREAS INCLUDE ATWATER 95301, PLANADA 95365, WINTON 95388, CHOWCHILLA 93610, LIVINGSTON 95334, LOS BAOS 93635, DOS PALOS 93620 AND MARIPOSA 95338. A SUMMARY DESCRIPTION OF THE COMMUNITY IS BELOW. ADDITIONAL DETAILS CAN BE FOUND IN THE CHNA REPORT ONLINE. A TOTAL OF 11.9% OF MERCED COUNTY POPULATION AGE 5 AND OLDER LIVE IN A HOME IN WHICH NO PERSON AGE 14 OR OLDER IS PROFICIENT IN ENGLISH (SPEAKING ONLY ENGLISH OR SPEAKING ENGLISH "VERY WELL"). THE LATEST CENSUS ESTIMATE SHOWS 21.2% OF MERCED COUNTY TOTAL POPULATION LIVING BELOW THE FEDERAL POVERTY LEVEL. AMONG JUST CHILDREN (AGES 0 TO 17), THIS PERCENTAGE IN MERCED COUNTY IS 29.8% (REPRESENTING AN ESTIMATED 23,625 CHILDREN). A TOTAL OF 30.6% OF MERCED COUNTY RESIDENTS WOULD NOT BE ABLE TO AFFORD AN UNEXPECTED $400 EXPENSE WITHOUT GOING INTO DEBT. A MAJORITY OF SURVEYED ADULTS RARELY, IF EVER, WORRY ABOUT THE COST OF HOUSING. HOWEVER, A CONSIDERABLE SHARE (40.2%) REPORT THAT THEY WERE "SOMETIMES," "USUALLY, OR "ALWAYS" WORRIED OR STRESSED ABOUT HAVING ENOUGH MONEY TO PAY THEIR RENT OR MORTGAGE IN THE PAST YEAR. A TOTAL OF 15.9% OF MERCED COUNTY RESIDENTS REPORT LIVING IN UNHEALTHY OR UNSAFE HOUSING CONDITIONS DURING THE PAST YEAR. US DEPARTMENT OF AGRICULTURE DATA SHOW THAT 18.9% OF MERCED COUNTY POPULATION (REPRESENTING OVER 48,000 RESIDENTS) HAVE LOW FOOD ACCESS, MEANING THAT THEY DO NOT LIVE NEAR A SUPERMARKET OR LARGE GROCERY STORE. OVERALL, 40.4% OF COMMUNITY RESIDENTS ARE DETERMINED TO BE "FOOD INSECURE, HAVING RUN OUT OF FOOD IN THE PAST YEAR AND/OR BEEN WORRIED ABOUT RUNNING OUT OF FOOD. THE DEMOGRAPHICS DATA BELOW REPRESENT ONLY THE TOP 75% OF HOSPITAL DISCHARGES FOR MERCY MEDICAL CENTER MERCED (BY ZIP CODE):TOTAL POPULATION: 153,059 ASIAN/PACIFIC ISLANDER: 8.3%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 4.4%HISPANIC OR LATINO: 58.6%WHITE NON-HISPANIC: 23.7%ALL OTHERS: 5.0%% BELOW POVERTY: 16.6%UNEMPLOYMENT: 10.2%NO HIGH SCHOOL DIPLOMA: 27.0%MEDICAID: 49.4%UNINSURED: 9.1%OTHER AREA HOSPITALS: 2MERCY HOSPITAL OF FOLSOM:THE PRIMARY SERVICE AREA ENCOMPASSES BOTH SUBURBAN AND RURAL AREAS OF SACRAMENTO COUNTY AND EXTENDS INTO EL DORADO COUNTY. WITHIN ITS PRIMARY SERVICE AREA, THE HOSPITAL SERVES 11 ZIP CODES IN MAJOR COMMUNITIES, INCLUDING FOLSOM, RANCHO CORDOVA, SLOUGHHOUSE, EL DORADO HILLS, RESCUE, SHINGLE SPRINGS, PLACERVILLE, ORANGEVALE, CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, AND OTHER SURROUNDING NEIGHBORHOODS. POVERTY RATES ARE OVERALL LOWER THAN OTHER PARTS OF THE COUNTY, BUT THE EXPANDED MEDI-CAL POPULATION STRUGGLES TO ACCESS CARE DUE TO THE LACK OF LOCAL MEDI-CAL PROVIDERS. THE HOSPITAL MUST BALANCE ITS RESPONSIBILITY CARING FOR THOSE ACUTELY ILL WITH AN INCREASING ROLE AS A SAFETY NET PROVIDER FOR THE VULNERABLE.TOTAL POPULATION: 486,988HISPANIC OR LATINO: 16.2% WHITE - NON-HISPANIC: 60.6%, BLACK/AFRICAN AMERICAN: 3.9% ASIAN/PACIFIC ISLANDER: 11.1%, ALL OTHERS: 8.2%.% BELOW POVERTY: 5.4%UNEMPLOYMENT: 4.7%NO HIGH SCHOOL DIPLOMA: 7.0%MEDICAID: 28.9%UNINSURED: 5.2%OTHER AREA HOSPITALS: 1ST. MARY'S MEDICAL CENTER:ST MARY'S SERVES SAN FRANCISCO AND THE GREATER BAY AREA, BUT A LARGE PORTION OF ITS PATIENT POPULATION COMES FROM THE RICHMOND, SUNSET, LAURAL HEIGHTS, AND HAIGHT ASHBURY AREAS. THE HOSPITAL SERVES A LARGE POPULATION OF SENIORS, PERSONS EXPERIENCING HOMELESS, MENTAL HEALTH AND SUBSTANCE USE CHALLENGES. IN 2022 THE NUMBER OF HOMELESS RESIDENTS IN THE PARK ABUTTING ST. MARY'S HAS INCREASED BY MORE THAN 100% FROM 83 TO 172.TOTAL POPULATION: 831,456ASIAN/PACIFIC ISLANDER: 34.6%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 5.6%HISPANIC OR LATINO: 16.1%WHITE NON-HISPANIC: 38.1%ALL OTHERS: 5.6%% BELOW POVERTY: 5.1%UNEMPLOYMENT: 3.7%NO HIGH SCHOOL DIPLOMA: 11.4%MEDICAID: 18.5%UNINSURED: 4.0%OTHER AREA HOSPITALS: 8ST. ELIZABETH COMMUNITY HOSPITAL:ST. ELIZABETH IS LOCATED IN TEHAMA COUNTY, WHICH CONSISTS OF 2,962 SQUARE MILES AND IS APPROXIMATELY MIDWAY BETWEEN SACRAMENTO AND THE OREGON BORDER AND SITUATED ALONG THE INTERSTATE 5 CORRIDOR. THE COUNTY IS SITUATED IN THE NORTHERN PORTION OF THE SACRAMENTO VALLEY AND IS DIVIDED IN HALF BY THE SACRAMENTO RIVER. THE LARGEST CITY IS RED BLUFF, BOTH A MICROPOLITAN STATISTICAL AREA AND THE COUNTY SEAT WITH A POPULATION OF JUST OVER 14,000 RESIDENTS. A SMALL PORTION OF SOUTHERN SHASTA COUNTY IS COVERED BY THE HOSPITAL'S SERVICE AREA AND INCLUDES THE COMMUNITY OF COTTONWOOD. SERVICE AREA IS DEFINED BY SIX ZIP CODES. THESE INCLUDED 96021, 96022, 96035, 96055, 96080, AND 96090. THE TOTAL POPULATION OF THE SERVICE AREA WAS 69,385.THE DEMOGRAPHICS DATA BELOW REPRESENTS THE TOP 75% OF ST. ELIZABETH'S DISCHARGES:TOTAL POPULATION: 64,068 ASIAN/PACIFIC ISLANDER: 1.9%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 0.8%HISPANIC OR LATINO: 26.8%WHITE NON-HISPANIC: 62.4%ALL OTHERS: 8.1%% BELOW POVERTY: 11.8%UNEMPLOYMENT: 8.2%NO HIGH SCHOOL DIPLOMA: 14.7%MEDICAID: 41.6%UNINSURED: 5.9%OTHER AREA HOSPITALS: 1MERCY MEDICAL CENTER MT. SHASTA:SISKIYOU COUNTY IS LOCATED IN THE NORTHERNMOST PART OF CALIFORNIA, SITUATED ALONG THE INTERSTATE 5 CORRIDOR BORDERING THE STATE OF OREGON ON THE NORTH. THE COUNTY IS RURAL IN NATURE COVERING 6,347 SQUARE MILES. THE LARGEST CITY IS YREKA, WHICH IS ALSO THE COUNTY SEAT WITH A POPULATION OF APPROXIMATELY 7,870. THE COUNTY AREA HAS A DIVERSE LANDSCAPE WITH HIGH MOUNTAIN RANGES (MT. SHASTA), DESERT PLANES, AND RIVERS WITH MAGNIFICENT WATERFALLS AND THE AMAZING FISHING. THE TOTAL POPULATION OF THE SISKIYOU COUNTY WAS 43,468 IN 2020. THE FOLLOWING ZIP CODES MAKE UP THE CORE SERVICE AREA FOR MERCY MEDICAL CENTER MT. SHASTA: 96025, 96057, 96067, AND 96094. THE DEMOGRAPHICS DATA BELOW REPRESENTS THE TOP 75% OF MERCY MEDICAL CENTER MOUNT SHASTA'S DISCHARGES:TOTAL POPULATION: 17,642 ASIAN/PACIFIC ISLANDER: 2.4%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 1.7%HISPANIC OR LATINO: 11.9%WHITE NON-HISPANIC: 75.0%ALL OTHERS: 9.0%% BELOW POVERTY: 7.9%UNEMPLOYMENT: 5.6%NO HIGH SCHOOL DIPLOMA: 7.7%MEDICAID: 37.0%UNINSURED: 6.1%OTHER AREA HOSPITALS: 1ST. JOSEPH'S WESTGATE 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 75% OF PATIENTS BY VOLUME. THE HOSPITAL SERVES A FEDERALLY- DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION:TOTAL POPULATION: 1,182,960ASIAN/PACIFIC ISLANDER: 3.5%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 7.9%HISPANIC OR LATINO: 47.4%WHITE NON-HISPANIC: 35.8%ALL OTHERS: 5.4%% BELOW POVERTY: 11.2%UNEMPLOYMENT: 5.3%NO HIGH SCHOOL DIPLOMA: 18.2%MEDICAID: 26.3%UNINSURED: 10.9%OTHER AREA HOSPITALS: 3 SHORT-TERM ACUTE; 2 PSYCHIATRIC
SCHEDULE H, PART VI, LINE 4 - COMMUNITY INFORMATION DE CRAIG RANCH LLC DBA ST. ROSE DOMINICAN - NORTH LAS VEGAS:THE GEOGRAPHIC AREA FOR THE CHNA IS CLARK COUNTY, THE COMMON COMMUNITY FOR ALL PARTNERS PARTICIPATING IN THE CHNA COLLABORATIVE. CLARK COUNTY IS THE NATION'S 14TH LARGEST COUNTY THAT SERVES MORE THAN 2.25 MILLION CITIZENS AND MORE THAN 46 MILLION VISITORS A YEAR. CLARK COUNTY SERVES A COMMUNITY LIVING IN RURAL OR URBAN AREAS. A KEY COMPONENT OF THE COUNTY'S ECONOMY IS TOURISM, AND AMONG ITS LARGEST INDUSTRIES ARE ACCOMMODATION AND FOOD SERVICE, RETAIL TRADE AND HEALTH CARE AND SOCIAL ASSISTANCE. ALL COUNTIES WITHIN NEVADA HAVE HAD TREMENDOUS POPULATION GROWTH WITHIN THE LAST DECADE. HOWEVER, THE MAJORITY OF THE POPULATION REMAINS WITHIN CLARK COUNTY, AND IT CONTINUES TO GROW. BETWEEN 2015 AND 2021 CLARK COUNTY'S POPULATION GREW FROM 2.11 MILLION TO 2.32 MILLION. CLARK COUNTY COMPRISES ONLY 7% (8,091 SQUARE MILES) OF NEVADA'S LAND MASS (110,567 SQUARE MILES) BUT CONTAINS 72% OF THE STATE'S TOTAL POPULATION. BECAUSE OF CLARK COUNTY'S CONTRIBUTION TO THE STATE POPULATION, CAUTION SHOULD BE EXERCISED WHEN COMPARING THE COUNTY TO THE STATE:TOTAL POPULATION: 2,333,185 ASIAN/PACIFIC ISLANDER: 11.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 13.1%HISPANIC OR LATINO: 32.4%WHITE NON-HISPANIC: 36.7%ALL OTHERS: 6.8%% BELOW POVERTY: 9.7%UNEMPLOYMENT: 5.4%NO HIGH SCHOOL DIPLOMA: 13.9%MEDICAID: 24.4%UNINSURED: 10.9%OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH DE BLUE DIAMOND LLC DBA ST. ROSE DOMINICAN - BLUE DIAMOND:THE GEOGRAPHIC AREA FOR THE CHNA IS CLARK COUNTY, THE COMMON COMMUNITY FOR ALL PARTNERS PARTICIPATING IN THE CHNA COLLABORATIVE. CLARK COUNTY IS THE NATION'S 14TH LARGEST COUNTY THAT SERVES MORE THAN 2.25 MILLION CITIZENS AND MORE THAN 46 MILLION VISITORS A YEAR. CLARK COUNTY SERVES A COMMUNITY LIVING IN RURAL OR URBAN AREAS. A KEY COMPONENT OF THE COUNTY'S ECONOMY IS TOURISM, AND AMONG ITS LARGEST INDUSTRIES ARE ACCOMMODATION AND FOOD SERVICE, RETAIL TRADE AND HEALTH CARE AND SOCIAL ASSISTANCE. ALL COUNTIES WITHIN NEVADA HAVE HAD TREMENDOUS POPULATION GROWTH WITHIN THE LAST DECADE. HOWEVER, THE MAJORITY OF THE POPULATION REMAINS WITHIN CLARK COUNTY, AND IT CONTINUES TO GROW. BETWEEN 2015 AND 2021 CLARK COUNTY'S POPULATION GREW FROM 2.11 MILLION TO 2.32 MILLION. CLARK COUNTY COMPRISES ONLY 7% (8,091 SQUARE MILES) OF NEVADA'S LAND MASS (110,567 SQUARE MILES) BUT CONTAINS 72% OF THE STATE'S TOTAL POPULATION. BECAUSE OF CLARK COUNTY'S CONTRIBUTION TO THE STATE POPULATION, CAUTION SHOULD BE EXERCISED WHEN COMPARING THE COUNTY TO THE STATE:TOTAL POPULATION: 2,333,185 ASIAN/PACIFIC ISLANDER: 11.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 13.1%HISPANIC OR LATINO: 32.4%WHITE NON-HISPANIC: 36.7%ALL OTHERS: 6.8%% BELOW POVERTY: 9.7%UNEMPLOYMENT: 5.4%NO HIGH SCHOOL DIPLOMA: 13.9%MEDICAID: 24.4%UNINSURED: 10.9%OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH DE SAHARA LLC DBA ST. ROSE DOMINICAN - SAHARA:THE GEOGRAPHIC AREA FOR THE CHNA IS CLARK COUNTY, THE COMMON COMMUNITY FOR ALL PARTNERS PARTICIPATING IN THE CHNA COLLABORATIVE. CLARK COUNTY IS THE NATION'S 14TH LARGEST COUNTY THAT SERVES MORE THAN 2.25 MILLION CITIZENS AND MORE THAN 46 MILLION VISITORS A YEAR. CLARK COUNTY SERVES A COMMUNITY LIVING IN RURAL OR URBAN AREAS. A KEY COMPONENT OF THE COUNTY'S ECONOMY IS TOURISM, AND AMONG ITS LARGEST INDUSTRIES ARE ACCOMMODATION AND FOOD SERVICE, RETAIL TRADE AND HEALTH CARE AND SOCIAL ASSISTANCE. ALL COUNTIES WITHIN NEVADA HAVE HAD TREMENDOUS POPULATION GROWTH WITHIN THE LAST DECADE. HOWEVER, THE MAJORITY OF THE POPULATION REMAINS WITHIN CLARK COUNTY, AND IT CONTINUES TO GROW. BETWEEN 2015 AND 2021 CLARK COUNTY'S POPULATION GREW FROM 2.11 MILLION TO 2.32 MILLION. CLARK COUNTY COMPRISES ONLY 7% (8,091 SQUARE MILES) OF NEVADA'S LAND MASS (110,567 SQUARE MILES) BUT CONTAINS 72% OF THE STATE'S TOTAL POPULATION. BECAUSE OF CLARK COUNTY'S CONTRIBUTION TO THE STATE POPULATION, CAUTION SHOULD BE EXERCISED WHEN COMPARING THE COUNTY TO THE STATE:TOTAL POPULATION: 2,333,185 ASIAN/PACIFIC ISLANDER: 11.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 13.1%HISPANIC OR LATINO: 32.4%WHITE NON-HISPANIC: 36.7%ALL OTHERS: 6.8%% BELOW POVERTY: 9.7%UNEMPLOYMENT: 5.4%NO HIGH SCHOOL DIPLOMA: 13.9%MEDICAID: 24.4%UNINSURED: 10.9%OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH DE FLAMINGO LLC DBA ST. ROSE DOMINICAN - WEST FLAMINGO:THE GEOGRAPHIC AREA FOR THE CHNA IS CLARK COUNTY, THE COMMON COMMUNITY FOR ALL PARTNERS PARTICIPATING IN THE CHNA COLLABORATIVE. CLARK COUNTY IS THE NATION'S 14TH LARGEST COUNTY THAT SERVES MORE THAN 2.25 MILLION CITIZENS AND MORE THAN 46 MILLION VISITORS A YEAR. CLARK COUNTY SERVES A COMMUNITY LIVING IN RURAL OR URBAN AREAS. A KEY COMPONENT OF THE COUNTY'S ECONOMY IS TOURISM, AND AMONG ITS LARGEST INDUSTRIES ARE ACCOMMODATION AND FOOD SERVICE, RETAIL TRADE AND HEALTH CARE AND SOCIAL ASSISTANCE. ALL COUNTIES WITHIN NEVADA HAVE HAD TREMENDOUS POPULATION GROWTH WITHIN THE LAST DECADE. HOWEVER, THE MAJORITY OF THE POPULATION REMAINS WITHIN CLARK COUNTY, AND IT CONTINUES TO GROW. BETWEEN 2015 AND 2021 CLARK COUNTY'S POPULATION GREW FROM 2.11 MILLION TO 2.32 MILLION. CLARK COUNTY COMPRISES ONLY 7% (8,091 SQUARE MILES) OF NEVADA'S LAND MASS (110,567 SQUARE MILES) BUT CONTAINS 72% OF THE STATE'S TOTAL POPULATION. BECAUSE OF CLARK COUNTY'S CONTRIBUTION TO THE STATE POPULATION, CAUTION SHOULD BE EXERCISED WHEN COMPARING THE COUNTY TO THE STATE:TOTAL POPULATION: 2,333,185 ASIAN/PACIFIC ISLANDER: 11.0%BLACK/AFRICAN AMERICAN - NON-HISPANIC: 13.1%HISPANIC OR LATINO: 32.4%WHITE NON-HISPANIC: 36.7%ALL OTHERS: 6.8%% BELOW POVERTY: 9.7%UNEMPLOYMENT: 5.4%NO HIGH SCHOOL DIPLOMA: 13.9%MEDICAID: 24.4%UNINSURED: 10.9%OTHER AREA HOSPITALS: 13 ACUTE CARE; 11 LONG TERM ACUTE, REHABILITATION, AND BEHAVIORAL HEALTH
Schedule H (Form 990) 2021
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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
2021
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) 911 AT EASE INTERNATIONAL INC
PO BOX 30363
SANTA BARBARA,CA93130
84-5130619 501(C)(3) 32,500 0     COMMUNITY HEALTH
(2) ABILITY360 INC
5025 E WASHINGTON ST NO 20
PHOENIX,AZ85034
86-0486447 501(C)(3) 13,000 0     COMMUNITY HEALTH
(3) ACE OVERCOMERS OF MERCED COUNTY
PO BOX 734
MERCED,CA95341
37-1653729 501(C)(3) 46,500 0     COMMUNITY HEALTH
(4) ACUMEN FUND INC
40 WORTH STREET
NEW YORK,NY10013
13-4166228 501(C)(3) 56,250 0     COMMUNITY HEALTH
(5) ADRIAN DOMINICAN SISTERS INC
1257 E SIENA HEIGHTS DR
ADRIAN,MI49221
84-3503684 501(C)(3) 16,600 0     COMMUNITY HEALTH
(6) ALEGENT CREIGHTON HEALTH
12809 WEST DODGE ROAD
OMAHA,NE68154
47-0757164 501(C)(3) 14,197 0     COMMUNITY HEALTH
(7) ALLAN HANCOCK COLLEGE FOUNDATION
800 S COLLEGE DR
SANTA MARIA,CA934546399
95-3143396 501(C)(3) 110,000 0     EDUCATION SUPPORT
(8) ALLIANCE FOR PHARMACEUTICAL ACCESS INC
506 E PLAZA DR
SANTA MARIA,CA93454
20-3117940 501(C)(3) 30,000 0     COMMUNITY HEALTH
(9) ALMA FAMILY SERVICES
900 CORPORATE CENTER DR
MONTEREY PARK,CA91754
95-2959331 501(C)(3) 15,000 0     COMMUNITY HEALTH
(10) ALPHA HOUSE A PLACE FOR NEW BEGINNINGS
PO BOX 712
TAFT,CA93268
77-0366593 501(C)(3) 50,792 0     COMMUNITY HEALTH
(11) ALPHA PREGNANCY HELP CENTER
700 LOUGHBOROUGH DR
MERCED,CA95348
77-0079754 501(C)(3) 69,831 0     COMMUNITY HEALTH
(12) ALS ASSOCIATION ARIZONA CHAPTER
360 E CORONADO RD
PHOENIX,AZ85004
86-0727136 501(C)(3) 9,000 0     COMMUNITY HEALTH
(13) ALZHEIMERS DISEASE AND RELATED DISORDERS ASSOCIATIONS INC DBA ALZHEIME
225 N MICHIGAN AVE
CHICAGO,IL60601
13-3039601 501(C)(3) 280,000 0     COMMUNITY HEALTH
(14) ALZHEIMER'S DISEASE ASSOCIATION OF KERN COUNTY INC
PO BOX 22108
BAKERSFIELD,CA93390
77-0017561 501(C)(3) 14,500 0     COMMUNITY HEALTH
(15) AMBULATORY SURGERY ACCESS COALITION OPERATION ACCESS
1119 MARKET ST STE 400
SAN FRANCISCO,CA941031553
94-3180356 501(C)(3) 20,000 0     COMMUNITY HEALTH
(16) AMERICAN NATIONAL RED CROSS
431 18TH ST NW
WASHINGTON,DC20006
53-0196605 501(C)(3) 50,000 0     COMMUNITY HEALTH
(17) ANGIOMA ALLIANCE
977 SEMINOLE TRAIL
CHARLOTTESVILLE,VA229012824
02-0600697 501(C)(3) 8,000 0     COMMUNITY HEALTH
(18) ARIZONA DIAMONDBACKS FOUNDATION INC
401 E JEFFERSON STREET
PHOENIX,AZ85004
86-0901615 501(C)(3) 5,833 0     COMMUNITY HEALTH
(19) ARIZONA LATIN AMERICAN MEDICAL ASSOCIATION
PO BOX 24152
TEMPE,AZ85285
86-0743958 501(C)(3) 8,500 0     COMMUNITY HEALTH
(20) ARIZONA STATE UNIVERSITY
PO BOX 876505
TEMPE,AZ852876505
86-0196696 ARIZONA 9,732,500 0     EDUCATION SUPPORT
(21) ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION
345 S HALCYON ROAD
ARROYO GRANDE,CA93420
20-3256066 501(C)(3) 704,085 0     FOUNDATION SUPPORT
(22) ASCENCIA PATH ACHIEVE GLENDALE
1851 TYBURN ST
GLENDALE,CA91204
20-4233822 501(C)(3) 25,500 0     COMMUNITY HEALTH
(23) ASSISTANCE LEAGUE OF BAKERSFIELD
1924 Q STREET
BAKERSFIELD,CA93301
95-3502393 501(C)(3) 15,000 0     COMMUNITY HEALTH
(24) ASTER AGING INC
45 W UNIVERSITY DR
MESA,AZ852015831
94-2596075 501(C)(3) 85,000 0     COMMUNITY HEALTH
(25) BAKERSFIELD KERN REGIONAL HOMELESS COLLABORATIVE
1900 E BRUNDAGE LN
BAKERSFIELD,CA93307
61-1948977 501(C)(3) 8,000 0     COMMUNITY HEALTH
(26) BAKERSFIELD RESCUE MISSION DBA THE MISSION AT KERN COUNTY
821 E 21ST ST
BAKERSFIELD,CA93305
95-1890705 501(C)(3) 9,500 0     COMMUNITY HEALTH
(27) BARROW FOUNDATION UK
350 W THOMAS ROAD
PHOENIX,AZ85013
31-1724184 501(C)(3) 26,549 0     FOUNDATION SUPPORT
(28) BARROW NEUROLOGICAL FOUNDATION
350 W THOMAS ROAD
PHOENIX,AZ850134409
86-0174371 501(C)(3) 5,255,359 0     FOUNDATION SUPPORT
(29) BAY AREA COUNCIL
201 CALIFORNIA ST
SAN FRANCISCO,CA94111
23-7325853 501(C)(4) 24,240 0     COMMUNITY HEALTH
(30) BENEVOLENT HEALTHCARE FOUNDATION
10377 E GEDDES AVE
CENTENNIAL,CO801123740
84-1568566 501(C)(3) 40,000 0     COMMUNITY HEALTH
(31) BETHANY SERVICES DBA BAKERSFIELD HOMELESS CENTER
1600 EAST TRUXTUN AVE
BAKERSFIELD,CA93305
95-2858936 501(C)(3) 10,000 0     COMMUNITY HEALTH
(32) BIG BROTHERS BIG SISTERS OF NORTHERN SIERRA
3461 ROBIN LN 2
CAMERON PARK,CA95682
94-2523254 501(C)(3) 20,000 0     COMMUNITY HEALTH
(33) BIG BROTHERS-BIG SISTERS OF THE GREATER SACRAMENTO AREA INC
1540 RIVER PARK DR STE 214
SACRAMENTO,CA958154609
94-1559853 501(C)(3) 83,423 0     COMMUNITY HEALTH
(34) BIKE LAB
110 BLUE RAVINE RD
FOLSOM,CA95630
82-0732627 501(C)(3) 20,000 0     COMMUNITY HEALTH
(35) BLACK DIRECTORS HEALTH EQUITY AGENDA INC
750 W VIRGINIA
MILWAUKEE,MI532341880
86-1980606 501(C)(3) 100,000 0     COMMUNITY HEALTH
(36) BLACK URBAN FARMERS ASSOCIATION BUFA
PO BOX 264
FRENCH CAMP,CA95231
85-2634884 501(C)(3) 67,084 0     COMMUNITY HEALTH
(37) BLUFORD HEALTHCARE LEADERSHIP INSTITUTE
7900 LEES SUMMIT RD
KANSAS CITY,MO64139
46-3328194 501(C)(3) 20,000 0     COMMUNITY HEALTH
(38) BOARD OF REGENTS-COMMUNITY COLLEGE OF SOUTHERN NEVADA
6375 W CHARLESTON BLVD
LAS VEGAS,NV89146
88-6000024 501(C)(3) 96,311 0     EDUCATION SUPPORT
(39) BOARD OF TRUSTEES OF MICHIGAN STATE UNIVERSITY
426 AUDITORIUM RD ROOM 360
EAST LANSING,MI48824
38-6005984 501(C)(3) 15,000 0     COMMUNITY HEALTH
(40) BOARD OF TRUSTEES OF THE GLIDE FOUNDATION
ONE FERRY BLDG STR 200
SAN FRANCISCO,CA941110000
94-1156481 501(C)(3) 114,014 0     COMMUNITY HEALTH
(41) BOYS AND GIRLS CLUBS OF GREATER SACRAMENTO
5212 LEMON HILL AVE
SACRAMENTO,CA95824
68-0338324 501(C)(3) 50,000 0     COMMUNITY HEALTH
(42) BRAIN INJURY ALLIANCE OF ARIZONA
5025 E WASHINGTON ST SUITE 108
PHOENIX,AZ85034
94-2937165 501(C)(3) 7,500 0     COMMUNITY HEALTH
(43) BRAIN INJURY CENTER
PO BOX 1477
CAMARILLO,CA93011
77-0491413 501(C)(3) 20,500 0     COMMUNITY HEALTH
(44) CALIFORNIA HEALTH FOUNDATION AND TRUST
1215 K STREET SUITE 800
SACRAMENTO,CA95814
94-1498697 501(C)(3) 2,299,104 0     COMMUNITY HEALTH
(45) CALIFORNIA POLYTECHNIC STATE UNIVERSITY FOUNDATION
1 GRAND AVE
SAN LUIS OBISPO,CA93407
20-4927897 501(C)(3) 62,500 0     EDUCATION SUPPORT
(46) CALIFORNIA STATE UNIVERSITY BAKERSFIELD FOUNDATION
9001 STOCKDALE HIGHWAY
BAKERSFIELD,CA93311
95-2643086 501(C)(3) 250,000 0     COMMUNITY HEALTH
(47) CANCER SUPPORT COMMUNITY AZ FKA WELLNESS COMM OF CENTRAL AZ THE
360 E PALM LN
PHOENIX,AZ85004
86-0897810 501(C)(3) 99,381 0     COMMUNITY HEALTH
(48) CANTICLE FARM
1968 36TH AVE
OAKLAND,CA94601
46-1484633 501(C)(3) 20,000 0     COMMUNITY HEALTH
(49) CATHOLIC CHARITIES CYO OF THE ARCHIOCESE OF SAN FRANCISCO
1555 39TH AVE
SAN FRANCISCO,CA94122
94-1498472 501(C)(3) 96,000 0     COMMUNITY HEALTH
(50) CATHOLIC CHARITIES OF LOS ANGELES INC
1531 JAMES M WOOD BLVD
LOS ANGELES,CA90015
95-1690973 501(C)(3) 72,510 0     COMMUNITY HEALTH
(51) CATHOLIC CHARITIES OF SOUTHERN NEVADA
1501 LAS VEGAS BLVD N
LAS VEGAS,NV89101
88-0059425 501(C)(3) 55,000 0     COMMUNITY HEALTH
(52) CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
1257 E SIENA HEIGHTS DR
ADRIAN,MI49221
84-0902211 501(C)(3) 22,500 0     COMMUNITY HEALTH
(53) CATHOLIC RELIEF SERVICES UNITED STATES CONFERENCE OF CATHOLIC BISHOPS
228 W LEXINGTON ST
BALTIMORE,MD21201
13-5563422 501(C)(3) 200,000 0     COMMUNITY HEALTH
(54) CECES HOPE CENTER
233 E SOUTHERN AVE
TEMPE,AZ85285
82-1022068 501(C)(3) 53,348 0     COMMUNITY HEALTH
(55) CENTRAL ARIZONA SHELTER SERVICES
PO BOX 18250
PHOENIX,AZ85009
86-0500753 501(C)(3) 6,862 0     COMMUNITY HEALTH
(56) CENTRAL CALAVERAS FIREFIGHTERS ASSOCIATION
PO BOX 533
MOUNTAIN RANCH,CA95246
45-2853418 501(C)(3) 19,053 0     COMMUNITY HEALTH
(57) CENTRAL COAST YOUNG MENS CHRISTIAN ASSOCIATION
600 CAMINO DEL ESTERO
MONTEREY,CA93940
77-0202335 501(C)(3) 61,017 0     COMMUNITY HEALTH
(58) CENTRAL VALLEY FARMWORKER FOUNDATION
1120 KENSINGTON ST
DELANO,CA93215
81-3960575 501(C)(3) 10,000 0     COMMUNITY HEALTH
(59) CENTRAL VALLEY LOW INCOME HOUSING CORPORATION
2431 W MARCH LN STE 350
STOCKTON,CA95207
68-0256280 501(C)(3) 472,650 0     COMMUNITY HEALTH
(60) CHANNEL ISLANDS YOUNG MENS CHRISTIAN ASSOCIATION
3111 VILLAGE AT THE PARK DR
CAMARILLO,CA93012
95-1643379 501(C)(3) 20,000 0     COMMUNITY HEALTH
(61) CHICANOS POR LA CAUSA INC
1112 E BUCKEYE
PHOENIX,AZ85034
86-0227210 501(C)(3) 80,000 0     COMMUNITY HEALTH
(62) CHILD CRISIS ARIZONA
817 N COUNYRY CLUB DR
MESA,AZ85201
86-0324144 501(C)(3) 50,000 0     COMMUNITY HEALTH
(63) CHRISTIAN MEDICAL MINSTRY TO CAMBODIA JEREMIAHS HOPE
1685 S COLORADO BLVD UNIT 313
DENVER,CO802224035
30-0249090 501(C)(3) 22,500 0     COMMUNITY HEALTH
(64) CITY OF SACRAMENTO
951 I STREET
SACRAMENTO,CA95814
94-6000410 CITY OF SACRAMENTO 1,140,000 0     COMMUNITY HEALTH
(65) CITYSERVE NETWORK
7001 AUBURN STREET
BAKERSFIELD,CA93306
82-4490879 501(C)(3) 52,575 0     COMMUNITY HEALTH
(66) CIVITAS NETWORKS FOR HEALTH
700 12TH ST NW 700
WASHINGTON,DC20005
45-1754340 501(C)(3) 50,000 0     COMMUNITY HEALTH
(67) CLARAS HOUSE INC
2715 K STREET
SACRAMENTO,CA95816
61-1591265 501(C)(3) 25,000 0     COMMUNITY HEALTH
(68) CLEO EULAU CENTER FOR CHILDREN AND ADOLESCENTS
711 COLORADO AVE
PALO ALTO,CA943033912
77-0393676 501(C)(3) 20,000 0     COMMUNITY HEALTH
(69) COMAGINE HEALTH
10700 MERIDIAN AVE N
SEATTLE,WA98133
91-1072875 501(C)(3) 294,000 0     COMMUNITY HEALTH
(70) COMMON GROUND SENIOR SERVICES
80 RIDGE ROAD
SUTTER CREEK,CA95685
68-0463039 501(C)(3) 34,454 0     COMMUNITY HEALTH
(71) COMMONSPIRIT HEALTH FOUNDATION
185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
85-3374038 501(C)(3) 1,350,148 0     FOUNDATION SUPPORT
(72) COMMUNITY ACTION AGAINST RAPE DBA THE RAPE CRISIS CENTER
801 S RANCHO DR
LAS VEGAS,NV89106
88-0135811 501(C)(3) 69,250 0     COMMUNITY HEALTH
(73) COMMUNITY ACTION PARTNERSHIP OF KERN
5005 BUSINESS PARK NORTH
BAKERSFIELD,CA93309
95-2402760 501(C)(3) 7,500 0     COMMUNITY HEALTH
(74) COMMUNITY COUNSELING CENTER OF SAN LUIS OBISPO COUNTY
1129 MARSH ST
SAN LUIS OBISPO,CA93401
95-2906369 501(C)(3) 40,000 0     COMMUNITY HEALTH
(75) COMMUNITY INITIATIVES DBA COMMUNITY INITIATIVES SF HEP B FREE BAY AREA
1000 BROADWAY
OAKLAND,CA94607
94-3255070 501(C)(3) 22,250 0     COMMUNITY HEALTH
(76) COMMUNITY SOLUTIONS INTERNATIONAL INC
60 BROAD STREET SUITE 2510-A
NEW YORK,NY10004
27-3523909 501(C)(3) 300,000 0     COMMUNITY HEALTH
(77) COUNTY OF SANTA CRUZ
PO BOX 801
SANTA CRUZ,CA950610801
94-6000534 SANTA CRUZ 50,000 0     COMMUNITY HEALTH
(78) COUNTY OF SHASTA A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA
1855 PLACER ST SUITE 201
REDDING,CA96001
94-6000535 COUNTY OF SHASTA 20,000 0     COMMUNITY HEALTH
(79) COURT APPOINTED SPECIAL ADVOCATES OF KERN COUNTY CASA OF KERN COUNTY
1717 COLUMBUS ST
BAKERSFIELD,CA93305
77-0344298 501(C)(3) 7,800 0     COMMUNITY HEALTH
(80) DIENTES COMMUNITY DENTAL CLINIC INC
1830 COMMERCIAL WAY B
SANTA CRUZ,CA950651819
77-0311752 501(C)(3) 25,000 0     COMMUNITY HEALTH
(81) DIGNITY COMMUNITY CARE
185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
81-5009488 501(C)(3) 6,294,226 0     HOSPITAL SUPPORT
(82) DIGNITY HEALTH CONNECTED LIVING
200 MERCY OAKS DRIVE
REDDING,CA96003
23-7115371 501(C)(3) 907,035 0     COMMUNITY HEALTH
(83) DIGNITY HEALTH FOUNDATION
185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
46-2037641 501(C)(3) 217,341 0     FOUNDATION SUPPORT
(84) DIGNITY HEALTH FOUNDATION EAST VALLEY
1727 WEST FRYE ROAD SUITE 230
CHANDLER,AZ85224
74-2418514 501(C)(3) 1,519,596 0     FOUNDATION SUPPORT
(85) DIGNITY HEALTH MEDICAL FOUNDATION
3400 DATA DRIVE
RANCHO CORDOVA,CA95670
68-0220314 501(C)(3) 178,270,484 0     MEDICAL FND SUPPORT
(86) DIGNITY HEATH FOUNDATION-INLAND EMPIRE
2101 NORTH WATERMAN AVE
SAN BERNARDINO,CA92404
23-7440086 501(C)(3) 569,737 0     FOUNDATION SUPPORT
(87) DOMINICAN HOSPITAL FOUNDATION
1555 SOQUEL DRIVE
SANTA CRUZ,CA95065
94-2450442 501(C)(3) 1,135,800 0     FOUNDATION SUPPORT
(88) DOWNTOWN WOMENS CENTER
442 S SAN PEDRO ST
LOS ANGELES,CA90013
31-1597223 501(C)(3) 86,654 0     COMMUNITY HEALTH
(89) ECONOMIC DEVELOPMENT CORP OF SHASTA COUNTY
777 AUDITORIUM DR
REDDING,CA96001
94-1417261 501(C)(3) 10,000 0     COMMUNITY HEALTH
(90) ELAINE
220 S 12TH AVE
PHOENIX,AZ85007
81-1989463 501(C)(3) 80,000 0     COMMUNITY HEALTH
(91) EVERYONE MATTERS MINISTRIES
1504 GROVEWOOD LANE
ROSEVILLE,CA95747
81-6225364 501(C)(3) 70,000 0     COMMUNITY HEALTH
(92) FAIRYTALE TOWN INC
3901 LAND PARK DR
SACRAMENTO,CA95822
94-1669088 501(C)(3) 6,646 0     COMMUNITY HEALTH
(93) FAITHWORKS COUMMUNITY COALITION INC
2825 WEST STREET 1
REDDING,CA96001
33-0805113 501(C)(3) 66,125 0     COMMUNITY HEALTH
(94) FAMILY ASSISTANCE PROGRAM
15075 SEVENTH ST
VICTORVILLE,CA923953810
33-0107971 501(C)(3) 40,587 0     COMMUNITY HEALTH
(95) FAMILY PROMISE OF THE VERDUGOS
PO BOX 7151
BURBANK,CA91510
26-2458342 501(C)(3) 25,000 0     COMMUNITY HEALTH
(96) FAMILY SERVICE AGENCY OF TEHAMA COUNTY
1347 GRANT ST
RED BLUFF,CA96080
94-1616456 501(C)(3) 22,600 0     COMMUNITY HEALTH
(97) FAMILY SERVICES AGENCY OF SANTA BARBARA COUNTY
123 E GUTIERREZ
SANTA BARBARA,CA93101
95-1644031 501(C)(3) 66,840 0     COMMUNITY HEALTH
(98) FOODWHAT INC
1156 HIGH ST
SANTA CRUZ,CA95064
81-2590280 501(C)(3) 50,000 0     COMMUNITY HEALTH
(99) FRIENDS FOR YOUTH INC
1741 BROADWAY ST
REDWOOD CITY,CA940632403
94-2961034 501(C)(3) 52,724 0     COMMUNITY HEALTH
(100) FRIENDS OF LAS VEGAS METROPOLITAN POLICE
7175 BERMUDA RD
LAS VEGAS,NV89119
88-0429730 501(C)(3) 5,750 0     COMMUNITY HEALTH
(101) FUTURE LEADERS OF AMERICA INC
509 W MORRISON
SANTA MARIA,CA93458
77-0071036 501(C)(3) 55,796 0     COMMUNITY HEALTH
(102) GAY AND LESBIAN COMMUNITY CENTER OF SOUTHERN NEVADA INC
401 S MARYLAND PKWY
LAS VEGAS,NV89101
94-3192750 501(C)(3) 6,000 0     COMMUNITY HEALTH
(103) GILBERT SISTERS CITIES
PO BOX 527
GILBERT,AZ85299
86-0908787 501(C)(3) 6,622 0     COMMUNITY HEALTH
(104) GLENDALE YOUTH ALLIANCE INC
1255 S CENTRAL AVE
GLENDALE,CA91204
95-4453585 501(C)(3) 52,510 0     COMMUNITY HEALTH
(105) GLOBAL LIVINGSTON INSTITUTE
1031 33RD STREET SUITE 235
DENVER,CO80205
45-4683531 501(C)(3) 22,500 0     COMMUNITY HEALTH
(106) GOOD SAMARITAN SHELTER
245 E INGER DRIVE SUITE 103B
SANTA MARIA,CA93456
77-0133375 501(C)(3) 80,000 12,911 COST FOOD COMMUNITY HEALTH
(107) GREATER REDDING CHAMBER OF COMMERCE
1321 BUTTE ST
REDDING,CA96001
94-0796320 501(C)(6) 15,000 0     COMMUNITY HEALTH
(108) GREATER SACRAMENTO AREA ECONOMIC COUNCIL
400 CAPITOL MALL BLVD
SACRAMENTO,CA95814
46-5517841 501(C)(3) 6,959 0     COMMUNITY HEALTH
(109) GRIMM FAMILY EDUCATION FOUNDATION CORP
11001 RIVER RUN BLVD
BAKERSFIELD,CA93311
27-3194151 501(C)(3) 51,625 0     COMMUNITY HEALTH
(110) HEALTH ALLIANCE OF NORTHERN CALIFORNIA
PO BOX 990834
REDDING,CA960990834
31-1580642 501(C)(3) 30,800 0     COMMUNITY HEALTH
(111) HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNTY
343 SOQUEL AVE STE 343
SANTA CRUZ,CA95062
01-0826156 501(C)(3) 20,000 0     COMMUNITY HEALTH
(112) HEALTH LEADS INC
24 SCHOOL ST
BOSTON,MA02108
45-0484533 501(C)(3) 147,591 0     COMMUNITY HEALTH
(113) HEALTHCARE ANCHOR NETWORK INC
1669 COLUMBIA RD NW
WASHINGTON,DC20009
86-2147253 501(C)(3) 275,000 0     COMMUNITY HEALTH
(114) HIP HOP FOR CHANGE INC
515 A 55TH ST
OAKLAND,CA94609
46-3005727 501(C)(3) 25,000 0     COMMUNITY HEALTH
(115) HMONG YOUTH AND PARENTS UNITED
8267 VILLAGE CREEK WAY
SACRAMENTO,CA95823
26-3840730 501(C)(3) 75,000 0     COMMUNITY HEALTH
(116) HOMEFIRST SERVICES OF SANTA CLARA COUNTY
607 VALLEY WAY
MILPITAS,CA95035
94-2684272 501(C)(3) 400,000 0     COMMUNITY HEALTH
(117) HOPE FOR ADDICTION INC
1500 S BOULDER ST UNIT D
GLENDALE,AZ85296
47-1315465 501(C)(3) 60,000 0     COMMUNITY HEALTH
(118) HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA
1215 K ST SUITE 800
SACRAMENTO,CA95814
94-1533644 501(C)(6) 8,322 0     COMMUNITY HEALTH
(119) HOUSE OF REFUGE INC
6935 E WILLIAMS FIELD RD
MESA,AZ852126300
86-0662244 501(C)(3) 10,447 0     COMMUNITY HEALTH
(120) HOUSING CALIFORNIA
1107 9TH ST
SACRAMENTO,CA95814
68-0133565 501(C)(3) 6,000 0     COMMUNITY HEALTH
(121) HOUSING MATTERS FKA HOMELESS SERVICES CENTER
115-B CORAL ST
SANTA CRUZ,CA95060
77-0126783 501(C)(3) 608,257 0     COMMUNITY HEALTH
(122) HUSHABYE NURSERY
2473 S HIGLEY RD
GILBERT,AZ852951103
82-2737849 501(C)(3) 89,035 0     COMMUNITY HEALTH
(123) INSTITUTE ON AGING
3575 GEARY BLVD
SAN FRANCISCO,CA94118
94-2978977 501(C)(3) 75,000 0     COMMUNITY HEALTH
(124) INTERNATIONAL RESCUE COMMITTEE INC
4425 W OLIVE AVE 400
GLENDALE,AZ85302
13-5660870 501(C)(3) 133,000 0     COMMUNITY HEALTH
(125) JOURNEY OUT
7136 HASKELL AVE 125
VAN NUYS,CA91406
95-3817864 501(C)(3) 52,510 0     COMMUNITY HEALTH
(126) KERN COUNTY WOUNDED HEROES FUND
3121 STANDARD ST
BAKERSFIELD,CA93308
80-0215850 501(C)(3) 56,500 0     COMMUNITY HEALTH
(127) KERN MEDICAL CENTER FOUNDATION
1700 MOUNT VERNON AVE
BAKERSFIELD,CA93306
36-4642420 501(C)(3) 60,000 0     COMMUNITY HEALTH
(128) KERN PARTNERSHIP FOR CHILDREN AND FAMILIES
100 E CALIFORNIA AVE
BAKERSFIELD,CA93307
20-5536572 501(C)(3) 29,500 0     COMMUNITY HEALTH
(129) KIDPOWER TEENPOWER FULLPOWER INTERNATIONAL
PO BOX 1212
SANTA CRUZ,CA95061
77-0226712 501(C)(3) 30,000 0     COMMUNITY HEALTH
(130) KIDS COMMUNITY DENTAL CLINIC OF BURBANK
400 W ELMWOOD AVE
BURBANK,CA91506
95-4791296 501(C)(3) 21,000 0     COMMUNITY HEALTH
(131) LA COCINA INC
2948 FOLSOM ST
SAN FRANCISCO,CA941104028
59-3838549 501(C)(3) 20,000 0     COMMUNITY HEALTH
(132) LARKIN STREET YOUTH SERVICES
134 GOLDEN GATE AVE
SAN FRANCISCO,CA94102
94-2917999 501(C)(3) 75,000 0     COMMUNITY HEALTH
(133) LEGAL AID SOCIETY OF SAN BERNARDINO
588 W SIXTH ST
SAN BERNARDINO,CA92410
95-1997024 501(C)(3) 98,430 0     COMMUNITY HEALTH
(134) LEGAL SERVICES OF NORTHERN CALIFORNIA
517 12TH ST
SACRAMENTO,CA95814
94-1384659 501(C)(3) 103,370 0     COMMUNITY HEALTH
(135) LEND-A-HAND INC
400 UTAH ST
BOULDER CITY,NV890052620
88-0250959 501(C)(3) 20,000 0     COMMUNITY HEALTH
(136) LIFEMOVES FKA INNVISION SHELTER NETWORK
181 CONSTITUTION DR
MENLO PARK,CA94025
77-0160469 501(C)(3) 20,000 0     COMMUNITY HEALTH
(137) LINKS FOR LIFE INC
1706 CHESTER AVENUE 200
BAKERSFIELD,CA93301
93-1088003 501(C)(3) 16,000 0     COMMUNITY HEALTH
(138) LITTLE MANILA FOUNDATION
2154 S SAN JOAQUIN ST
STOCKTON,CA95206
20-2661354 501(C)(3) 81,365 0     COMMUNITY HEALTH
(139) LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION
1996 EASTMAN AVE SUITE 101
VENTURA,CA93003
95-1693538 501(C)(3) 25,000 0     COMMUNITY HEALTH
(140) LOCUS IMPACT INVESTING
7814 CAROUSEL LN
RICHMOND,VA23294
26-3114011 501(C)(3) 10,000 0     COMMUNITY HEALTH
(141) LONG BEACH AREA CHAMBER OF COMMERCE
ONE WORLD TRADE CENTER SUITE 206
LONG BEACH,CA908310206
95-0944550 501(C)(6) 19,795 0     COMMUNITY HEALTH
(142) LOS OSOS CARES INC
PO BOX 6602
LOS OSOS,CA934126602
82-3047951 501(C)(3) 75,000 0     COMMUNITY HEALTH
(143) LOS RIOS COMMUNITY COLLEGE DISTRICT DBA FOLSOM LAKE COLLEGE SAC CITY COLLE
1919 SPANOS COURT
SACRAMENTO,CA95825
94-1576340 LOS RIOS DISTRICT 10,000 0     EDUCATION SUPPORT
(144) LUTHERAN SOCIAL SERVICES OF NORTHERN CALIFORNIA
1465 CIVIC CT
CONCORD,CA94520
94-1659687 501(C)(3) 59,560 0     COMMUNITY HEALTH
(145) MAKING HOPE HAPPEN FOUNDATION
777 NORTH F ST
SAN BERNARDINO,CA92410
33-0122847 501(C)(3) 261,972 0     COMMUNITY HEALTH
(146) MARIAN REGIONAL MEDICAL CENTER FOUNDATION
1400 E CHURCH STREET
SANTA MARIA,CA93454
95-3818027 501(C)(3) 1,092,626 0     FOUNDATION SUPPORT
(147) MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT
2601 E ROOSEVELT ST
PHOENIX,AZ85008
86-0830701 MARICOPA COUNTY 3,628,333 0     COMMUNITY HEALTH
(148) MARK TWAIN MEDICAL CENTER FOUNDATION
768 MOUNTAIN RANCH RD
SAN ANDREAS,CA95249
68-0023507 501(C)(3) 328,000 0     COMMUNITY HEALTH
(149) MARYS MERCY CENTER
PO BOX 7563
SAN BERNARDINO,CA92411
33-0632426 501(C)(3) 45,000 0     COMMUNITY HEALTH
(150) MEADOWLARK SERVICE LEAGUE
PO BOX 3063
CAMARILLO,CA93011
23-7170994 501(C)(3) 8,000 0     COMMUNITY HEALTH
(151) MENTAL HEALTH AMERICA OF LOS ANGELES
200 PINE AVE STE 400
LONG BEACH,CA90802
95-1881491 501(C)(3) 69,658 0     COMMUNITY HEALTH
(152) MERCED COMMUNITY COLLEGE DISTRICT
3600 M ST
MERCED,CA95348
77-0362218 MERCED COLLEGE DIST 178,393 0     EDUCATION SUPPORT
(153) MERCY COALITION OF WEST SACRAMENTO
2116 WATEREFORD ROAD
SACRAMENTO,CA958150000
81-3581571 501(C)(3) 65,589 0     COMMUNITY HEALTH
(154) MERCY FOUNDATION
3400 DATA DRIVE
RANCHO CORDOVA,CA95670
23-7072762 501(C)(3) 2,210,291 0     FOUNDATION SUPPORT
(155) MERCY FOUNDATION BAKERSFIELD DBA FRIENDS OF MERCY FOUNDATION
PO BOX 119
BAKERSFIELD,CA93302
77-0201321 501(C)(3) 795,611 0     FOUNDATION SUPPORT
(156) MERCY FOUNDATION NORTH
2400 WASHINGTON STREET SUITE 410
REDDING,CA96001
94-3136799 501(C)(3) 1,366,036 0     FOUNDATION SUPPORT
(157) MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE
DES MOINES,IA50314
23-7358794 501(C)(3) 100,000 0     COMMUNITY HEALTH
(158) MERCY HOUSE LIVING CENTERS
PO BOX 1905
SANTA ANA,CA92702
33-0315864 501(C)(3) 76,500 0     COMMUNITY HEALTH
(159) MERY MEDICAL CENTER MERCED FOUNDATION
333 MERCY AVENUE
MERCED,CA95340
77-0035928 501(C)(3) 718,526 0     FOUNDATION SUPPORT
(160) MISSION DOLORES ACADEMY
3371 16TH ST
SAN FRANCISCO,CA84114
20-2849575 501(C)(3) 24,864 0     COMMUNITY HEALTH
(161) MISSION MERCED INCORPORATED
644 W 20TH ST
MERCED,CA95340
47-1217541 501(C)(3) 100,000 0     COMMUNITY HEALTH
(162) MISSION OF MERCY INC
360 E CORONADO RD
PHOENIX,AZ85004
86-0704883 501(C)(3) 146,650 0     COMMUNITY HEALTH
(163) MONARCH SERVICES SERVICIOS MONARCA
233 E LAKE AVE
WATSONVILLE,CA95076
94-2462783 501(C)(3) 50,000 0     COMMUNITY HEALTH
(164) MOREHOUSE SCHOOL OF MEDICINE INC
720 WESTVIEW DR SW
ATLANTA,GA30310
58-1438873 501(C)(3) 19,505,000 0     COMMUNITY HEALTH
(165) MUSCULAR DYSTROPHY ASSOC INC
4500 S LAKESHORE DR
TEMPE,AZ85282
13-1665552 501(C)(3) 9,250 0     COMMUNITY HEALTH
(166) MUSEUM OF THE AFRICAN DIASPORA
685 MISSION ST
SAN FRANCISCO,CA94105
94-3338239 501(C)(3) 250,000 0     COMMUNITY HEALTH
(167) NAMI GLENDALE
1540 E COLORADO ST
GLENDALE,CA91205
95-3984872 501(C)(3) 40,000 0     COMMUNITY HEALTH
(168) NAMI LONG BEACH AREA
PO BOX 91206
LONG BEACH,CA90814
33-0141550 501(C)(3) 81,784 0     COMMUNITY HEALTH
(169) NAMI URBAN LOS ANGELES
4305 DEGNAN BLVD
LOS ANGELES,CA90008
06-1692670 501(C)(3) 96,651 0     COMMUNITY HEALTH
(170) NATIONAL ALLIANCE ON MENTAL ILLNESS SAN FERNANDO VALLEY
14545 SHERMAN CIR
VAN NUYS,CA91405
95-3952653 501(C)(3) 89,033 0     COMMUNITY HEALTH
(171) NATIONAL ASSOCIATION OF HEALTH SERVICES EXECUTIVES INC
1050 CONNECTICUT AVE
WASHINGTON,DC20036
62-1312239 501(C)(3) 93,630 0     COMMUNITY HEALTH
(172) NATIONAL COUNCIL OF YOUNG MENS CHRISTIAN ASSNS OF THE USA
101 N WACKER DR
CHICAGO,IL60606
36-3258696 501(C)(3) 62,552 0     COMMUNITY HEALTH
(173) NATIONAL HEALTH CARE FOR THE HOMELESS COUNCIL INC
604 GALLATIN AVE STE 106
NASHVILLE,TN372063489
62-1475145 501(C)(3) 500,000 0     COMMUNITY HEALTH
(174) NATIONAL HEALTH FOUNDATION
515 S FIGUEROA ST
LOS ANGELES,CA90071
23-7314808 501(C)(3) 84,000 0     COMMUNITY HEALTH
(175) NATIONAL MULTIPLE SCLEROSIS SOCIETY
5025 E WASHINGTON ST SUITE 102
PHOENIX,AZ85034
13-5661935 501(C)(3) 10,719 0     COMMUNITY HEALTH
(176) NEIGHBORHOOD WELLNESS FOUNDATION
7648 MARINA COVE DR
SACRAMENTO,CA95831
47-4874487 501(C)(3) 75,000 0     COMMUNITY HEALTH
(177) NETWORK EDUCATION PROGRAM
820 FIRST ST NE SUITE 350
WASHINGTON,DC20002
52-1307764 501(C)(3) 29,750 0     COMMUNITY HEALTH
(178) NEVADA CLINICAL SERVICES INC
3186 S MARYLAND PKWY
LAS VEGAS,NV89119
45-2211040   2,185,000 0     COMMUNITY HEALTH
(179) NEVADA COUNTY FOOD BANK INC
578 SUTTON WAY
GRASS VALLEY,CA95945
68-0083105 501(C)(3) 42,725 0     COMMUNITY HEALTH
(180) NEVADA DONOR NETWORK INC
PO BOX 30102
SALT LAKE CITY,UT84130
88-0253675 501(C)(3) 7,500 0     COMMUNITY HEALTH
(181) NO LIMITS THEATER GROUP INC
1700 LOMBARD ST
OXNARD,CA93030
95-4603048 501(C)(3) 50,000 0     COMMUNITY HEALTH
(182) NORTHERN CALIFORNIA CENTER FOR FAMILY AWARENESS
PO BOX 991473
REDDING,CA960991473
68-0363217 501(C)(3) 25,000 0     COMMUNITY HEALTH
(183) NORTHRIDGE HOSPITAL FOUNDATION
18300 ROSCOE BLVD
NORTHRIDGE,CA91328
23-7444901 501(C)(3) 14,500 0     FOUNDATION SUPPORT
(184) NOTMYKID INC
5230 E SHEA BLVD
SCOTTSDALE,AZ85254
86-0988329 501(C)(3) 87,797 0     COMMUNITY HEALTH
(185) NOURISH CALIFORNIA
1970 BROADWAY
OAKLAND,CA94612
94-3163142 501(C)(3) 20,577 0     COMMUNITY HEALTH
(186) ONE IN LONG BEACH INC DBA LGBTQ CENTER OF LONG BEACH
2017 EAST 4TH STREET
LONG BEACH,CA90814
95-3523149 501(C)(3) 7,500 0     COMMUNITY HEALTH
(187) OPPORTUNITY THROUGH ENTREPRENEURSHIP FOUNDATION
14401 S 24TH WAY
PHOENIX,AZ850489019
20-3779020 501(C)(3) 10,000 0     COMMUNITY HEALTH
(188) PARTNERS IN CARE FOUNDATION
732 MOTT ST
SAN FERNANDO,CA91340
95-3954057 501(C)(3) 121,000 0     COMMUNITY HEALTH
(189) PASTOR OF ST PHILOMENE PARISH
2320 EL CAMINO AVE
SACRAMENTO,CA95821
45-3952203 501(C)(3) 21,000 0     COMMUNITY HEALTH
(190) PASTOR OF ST ROBERT PARISH
2251 IRVIN WAY
SACRAMENTO,CA95822
45-3952067 501(C)(3) 21,000 0     COMMUNITY HEALTH
(191) PATH
2201 WESTLAKE AVE
SEATTLE,WA98121
91-1157127 501(C)(3) 250,000 0     COMMUNITY HEALTH
(192) PATHWAYS COMMUNITY HUB INSTITUTE INC
427 W DUSSEL DR
MAUMEE,OH43537
81-3738049 501(C)(3) 265,000 0     COMMUNITY HEALTH
(193) PHOENIX CHILDRENS HOSPITAL FOUNDATION
2929 E CAMELBACK RD
PHOENIX,AZ85016
74-2421549 501(C)(3) 8,736 0     COMMUNITY HEALTH
(194) POOR AND THE HOMELESS TEHAMA COUNTY COALITION
PO BOX 315
RED BLUFF,CA96080
68-0465095 501(C)(3) 21,500 0     COMMUNITY HEALTH
(195) POWERHOUSE MINISTRIES INC
PO BOX 1611
FOLSOM,CA95763
68-0020855 501(C)(3) 8,000 0     COMMUNITY HEALTH
(196) PROJECT ANGEL FOOD
922 VINE ST
LOS ANGELES,CA90038
95-4115863 501(C)(3) 69,658 0     COMMUNITY HEALTH
(197) PURPLE RIBBON COUNCIL TO CUT OUT DOMESTIC ABUSE INC DBA BLOOM365
20403 N LAKE PLEASANT RD
PEORIA,AZ85382
26-2944620 501(C)(3) 90,000 0     COMMUNITY HEALTH
(198) NEVADA CLINICAL SERVICES INC
PO BOX 1028
RED BLUFF,CA96080
94-6110315   12,500 0     COMMUNITY HEALTH
(199) RICHMOND DISTRICT NEIGHBORHOOD CENTER
741 30TH AVE
SAN FRANCISCO,CA94121
94-2684271 501(C)(3) 40,723 0     COMMUNITY HEALTH
(200) RIVER CITY FOOD BANK
PO BOX 160204
SACRAMENTO,CA95816
91-1851398 501(C)(3) 15,000 0     COMMUNITY HEALTH
(201) ROCKY MOUNTAIN ADVENTIST HEALTHCARE FOUNDATION
950 E HARVARD AVE STE 230
DENVER,CO80210
84-0745018 501(C)(3) 200,000 0     COMMUNITY HEALTH
(202) RONALD MCDONALD HOUSE CHARITIES OF SOUTHERN CALIFORNIA
420 34TH ST
BAKERSFIELD,CA93301
95-3167869 501(C)(3) 5,200 0     COMMUNITY HEALTH
(203) ROSEMAN UNIVERSITY OF HEALTH SCIENCES
11 SUNSET WY
HENDERSON,NV89014
88-0435559 501(C)(3) 24,800 0     COMMUNITY HEALTH
(204) ROTACARE BAY AREA INC
514 VALLEY WY
MILIPITAS,CA95035
77-0328723 501(C)(3) 20,000 0     COMMUNITY HEALTH
(205) SACRAMENTO FOOD BANK & FAMILY SERVICES
3333 THIRD AVE
SACRAMENTO,CA95817
94-3315566 501(C)(3) 75,000 0     COMMUNITY HEALTH
(206) SACRAMENTO LOAVES AND FISHES
1351 NORTH C ST
SACRAMENTO,CA95811
68-0189897 501(C)(3) 10,000 0     COMMUNITY HEALTH
(207) SAN FERNANDO VALLEY COMMUNITY MENTAL HEALTH CENTER
16360 ROSCOE BLVD
VAN NUYS,CA91406
95-6194487 501(C)(3) 122,805 0     COMMUNITY HEALTH
(208) SANTA CRUZ COMMUNITY HEALTH CENTERS
125 WATER ST
SANTA CRUZ,CA95060
23-7428303 501(C)(3) 360,000 0     COMMUNITY HEALTH
(209) SAVE THE FAMILY FOUNDATION OF AZ
125 E UNIVERSITY DR
MESA,AZ85201
86-0665712 501(C)(3) 5,147 0     COMMUNITY HEALTH
(210) SECOND HARVEST FOOD BANK OF SANTA CRUZ COUNTY
800 OHLONE PKWY
WATSONVILLE,CA95076
77-0326685 501(C)(3) 30,000 0     COMMUNITY HEALTH
(211) SELF HELP FOR ELDERLY
731 SANSOME ST
SAN FRANCISCO,CA94111
94-1750717 501(C)(3) 80,000 0     COMMUNITY HEALTH
(212) SELF HELP GRAPHICS & ARTS
1300 E 1ST ST
LOS ANGELES,CA90033
23-7311837 501(C)(3) 15,000 0     COMMUNITY HEALTH
(213) SENORAS OF EXCELLENCE SENORES OF DISTINCTION
36 TRAILSIDE CT
HENDERSON,NV89012
26-4252853 501(C)(3) 7,500 0     COMMUNITY HEALTH
(214) SHASTA COMMUNITY HEALTH CENTER
1035 PLACER ST
REDDING,CA96001
68-0165855 501(C)(3) 464,152 0     COMMUNITY HEALTH
(215) SHASTA COUNTY CHILD ABUSE PREVENTION COORDINATING COUNCIL
2280 BENTON DR BLDG C B
REDDING,CA96003
68-0151867 501(C)(3) 55,000 0     COMMUNITY HEALTH
(216) SHASTA COUNTY YOUNG MENS CHRISTIAN ASSOCIATION
1155 COURT ST
REDDING,CA96001
94-1212141 501(C)(3) 23,000 0     COMMUNITY HEALTH
(217) SHASTA SUPPORTIVE HOUSING AND SERVICES
1035 PLACER ST
REDDING,CA96001
87-2892533 501(C)(3) 500,000 0     COMMUNITY HEALTH
(218) SHASTA WOMENS REFUGE INC
2880-A BENTON DR
REDDING,CA96003
94-2663045 501(C)(3) 11,933 0     COMMUNITY HEALTH
(219) SIERRA SERVICES FOR THE BLIND
546 SEARLS AVE
NEVADA CITY,CA95959
94-2760029 501(C)(3) 20,000 0     COMMUNITY HEALTH
(220) SISTERS OF CHARITY OF NAZARETH
134 MAIN STREET
NAZARETH,KY40048
61-0444781 501(C)(3) 19,006 0     COMMUNITY HEALTH
(221) SISTERS OF MERCY OF THE AMERICAS INC
8403 COLESVILLE RD SUITE 400
SILVER SPRING,MD20910
52-1653282 501(C)(3) 37,000 0     COMMUNITY HEALTH
(222) SISTERS OF ST FRANCIS MT ALVERNO
1330 BREWSTER AVE
REDWOOD CITY,CA94062
23-7290790 501(C)(3) 22,500 0     COMMUNITY HEALTH
(223) SLO NOOR FOUNDATION
1428 PHILLIPS LN
SAN LUIS OBISPO,CA93401
27-1412176 501(C)(3) 55,000 0     COMMUNITY HEALTH
(224) SONRISAS DENTAL HEALTH INC
430 EL CAMINO REAL N
SAN MATEO,CA94401
94-3390196 501(C)(3) 20,000 0     COMMUNITY HEALTH
(225) ST JEANNE DE LESTONNAC FREE CLINIC
1215 E CHAPMAN AVE
ORANGE,CA928662237
95-3499011 501(C)(3) 76,500 0     COMMUNITY HEALTH
(226) ST JOHN'S HEALTHCARE FOUNDATION
1600 NORTH ROSE AVENUE
OXNARD,CA93030
20-2865781 501(C)(3) 659,835 0     FOUNDATION SUPPORT
(227) ST JOSEPH'S FOUNDATION
350 W THOMAS ROAD
PHOENIX,AZ85013
94-2941245 501(C)(3) 1,977,954 0     FOUNDATION SUPPORT
(228) ST MARY MEDICAL CENTER FOUNDATION
1045 ATLANTIC AVENUE
LONG BEACH,CA90813
23-7153876 501(C)(3) 1,370,168 0     FOUNDATION SUPPORT
(229) ST MARY'S MEDICAL CENTER FOUNDATION
450 STANYAN STREET
SAN FRANCISCO,CA94117
94-3336143 501(C)(3) 812,664 0     FOUNDATION SUPPORT
(230) ST ROSE DOMINICAN HEALTH FOUNDATION
3001 ST ROSE PARKWAY
HENDERSON,NV89052
88-0349432 501(C)(3) 2,219,667 0     FOUNDATION SUPPORT
(231) ST VINCENT DE PAUL STORE INC
300 BAKER ST
BAKERSFIELD,CA93305
95-1853364 501(C)(3) 25,000 0     COMMUNITY HEALTH
(232) ST VINCENT DE PAUL
420 W WATKINS RD
PHOENIX,AZ85003
86-0096789 501(C)(3) 0 15,819 COST MEDICAL SUPPLIES COMMUNITY HEALTH
(233) STATEWIDE CALIFORNIA COALITION
465 MARKET STREET
SAN FRANCISCO,CA94104
87-1957964 501(C)(4) 250,000 0     COMMUNITY HEALTH
(234) STUDENT HEALTH SERVICES SUPPORT FUND DBA LOS ANGELES TRUST FOR CHILDRENS HE
333 S BEAUDRY AVE 29TH FL
LOS ANGELES,CA90017
95-4262448 501(C)(3) 78,634 0     COMMUNITY HEALTH
(235) STUDENTS SUPPORTING BRAIN TUMOR RESEARCH
8390 E VIA DE VENTURA SUITE F-110
SCOTTSDALE,AZ85258
20-0345903 501(C)(3) 5,344 0     COMMUNITY HEALTH
(236) SUCCEED ACADEMY OF THE DIOCESE OF SACRAMENTO
2110 BROADWAY
SACRAMENTO,CA95818
27-0470430 501(C)(3) 21,000 0     COMMUNITY HEALTH
(237) SUNFLOWER COMMUNITY FUND INC
415 WATER ST
CELEBRATION,FL34747
85-0725542 501(C)(3) 25,000 0     COMMUNITY HEALTH
(238) TEEN CHALLENGE OF SOUTHERN CALIFORNIA
PO BOX 1011
BAKERSFIELD,CA93302
95-2683852 501(C)(3) 30,000 0     COMMUNITY HEALTH
(239) TEEN KITCHEN PROJECT
PO BOX 1853
SOQUEL,CA95073
27-0524692 501(C)(3) 50,000 0     COMMUNITY HEALTH
(240) THE ANTI-RECIDIVISM COALITION
1302 E 7TH ST
LOS ANGELES,CA90021
46-2140915 501(C)(3) 100,000 0     COMMUNITY HEALTH
(241) THE COMMONWEALTH CLUB OF CALIFORNIA
110 THE EMBARCADERO
SAN FRANCISCO,CA94105
94-0399260 501(C)(3) 75,000 0     COMMUNITY HEALTH
(242) THE COMMUNITY SERVICE EDUCATION AND RESEARCH FUND
5380 ELVAS AVE
SACRAMENTO,CA95819
23-7003581 501(C)(3) 41,800 0     COMMUNITY HEALTH
(243) THE EDIBLE SCHOOLYARD PROJECT
343 E MAIN ST
STOCKTON,CA95202
94-3248671 501(C)(3) 100,000 0     COMMUNITY HEALTH
(244) THE KINGDOM CENTER
PO BOX 654
OXNARD,CA93032
27-2142998 501(C)(3) 20,000 0     COMMUNITY HEALTH
(245) THE LEVERAGE NETWORK INC
200 S WACKER DR
CHICAGO,IL60606
47-3517179 501(C)(3) 285,850 0     COMMUNITY HEALTH
(246) THE RACE AND GENDER EQUITY PROJECT
8153 ELK GROVE BLVD
ELK GROVE,CA95758
81-1533033 501(C)(3) 100,000 0     COMMUNITY HEALTH
(247) THE ROMAN CATHOLIC BISHOP OF LAS VEGAS
2300 SUNRIDGE HEIGHTS PKWY
HENDERSON,NV89052
88-0059349 501(C)(3) 5,750 0     COMMUNITY HEALTH
(248) THE SALVATION ARMY SOUTHERN CALIFORNIA DIVISON HEADQUARTERS
180 E OCEAN BLVD
LONG BEACH,CA90802
94-1156347 501(C)(3) 494,700 0     COMMUNITY HEALTH
(249) THE SHADE TREE INCORPORATED
PO BOX 669
LAS VEGAS,NV89125
88-0253276 501(C)(3) 73,465 0     COMMUNITY HEALTH
(250) THE SHAQUILLE ONEAL FOUNDATION
10845 GRIFFITH PEAK DR
LAS VEGAS,NV89135
84-2488384 501(C)(3) 10,000 0     COMMUNITY HEALTH
(251) THE SHARE FOUNDATION
2425 COLLEGE AVE
BERKELEY,CA94704
52-1241597 501(C)(3) 10,200 0     COMMUNITY HEALTH
(252) THE UTILITY REFORM NETWORK
268 BUSH STREET 3933
SAN FRANCISCO,CA94104
23-7351081 501(C)(3) 350,000 0     COMMUNITY HEALTH
(253) TIDES CENTER
1012 TORNEY AVE
SAN FRANCISCO,CA94129
94-3213100 501(C)(3) 135,000 0     COMMUNITY HEALTH
(254) TIPPING POINT COMMUNITY
220 MONTGOMERY
SAN FRANCISCO,CA94104
20-2121739 501(C)(3) 2,000,000 0     COMMUNITY HEALTH
(255) UMANA FOUNDATION
2247 W CHICAGO AVE
CHICAGO,IL60622
36-4125107 501(C)(3) 70,000 0     COMMUNITY HEALTH
(256) UNITED WAY OF MERCED COUNTY INC
658 W MAIN ST
MERCED,CA95348
94-2633265 501(C)(3) 25,995 0     COMMUNITY HEALTH
(257) UNITED WAY OF NORTHERN CALIFORNIA
2280 BENTON DR BLDG B
REDDING,CA96003
94-1251675 501(C)(3) 27,660 0     COMMUNITY HEALTH
(258) UNITED WAY WORLDWIDE
701 N FAIRFAX ST
ALEXANDRIA,VA22314
13-1635294 501(C)(3) 135,000 0     COMMUNITY HEALTH
(259) UNITED WAYS OF CALIFORNIA
1107 FAIR OAKS AVE 12
SOUTH PASADENA,CA91030
94-1646369 501(C)(3) 105,211 0     COMMUNITY HEALTH
(260) UNIVERSITY OF ARIZONA
PO BOX 3520
TUCSON,AZ857223520
74-2652689 ARIZONA 3,942,917 0     EDUCATION SUPPORT
(261) UNIVERSITY OF ARIZONA ALUMNI ASSOCIATION
1515 N CAMPBELL AVE
TUCSON,AZ85724
86-6052716 501(C)(3) 3,714,583 0     COMMUNITY HEALTH
(262) UNIVERSITY OF NEVADA LAS VEGAS FOUNDATION DBA UNLV FOUNDATION
4505 MARYLAND PKWY
LAS VEGAS,NV89154
94-2790134 501(C)(3) 27,500 0     EDUCATION SUPPORT
(263) UNIVERSITY OF SAN FRANCISCO
2130 FULTON ST
SAN FRANCISCO,CA94117
94-1156628 501(C)(3) 10,000 0     EDUCATION SUPPORT
(264) URBAN ALCHEMY
1035 MARKET ST
SAN FRANCISCO,CA94103
82-5408579 501(C)(3) 25,000 0     COMMUNITY HEALTH
(265) VALLEY OF THE SUN YOUNG MENS CHRISTIAN ASSOCIATION
350 N 1ST AVE
PHOENIX,AZ850031513
86-0096799 501(C)(3) 90,000 0     COMMUNITY HEALTH
(266) VISION TO LEARN
12100 WILSHIRE BLVD
LOS ANGELES,CA90025
45-3457853 501(C)(3) 10,000 0     COMMUNITY HEALTH
(267) VOLUNTEERS IN MEDICINE DBA CLINIC BY THE BAY
4877 MISSION ST
SAN FRANCISCO,CA94112
26-2593712 501(C)(3) 10,000 0     COMMUNITY HEALTH
(268) WELLSPACE HEALTH INC
777 12TH ST
SACRAMENTO,CA95814
94-1713704 501(C)(3) 91,458 0     COMMUNITY HEALTH
(269) WESTMINSTER FREE CLINIC
2673 SAN MIGUEL CIR
THOUSAND OAKS,CA91377
77-0563241 501(C)(3) 60,000 0     COMMUNITY HEALTH
(270) WOMENS RESOURCE CENTERS OF SOUTHERN NEVADA
1701 W CHARLESTON BLVD
LAS VEGAS,NV89102
94-2944732 501(C)(3) 6,500 0     COMMUNITY HEALTH
(271) YMCA OF SUPERIOR CALIFORNIA
1926 V ST
SACRAMENTO,CA95818
94-1156634 501(C)(3) 40,000 0     COMMUNITY HEALTH
(272) YOUNG MENS CHRISTIAN ASSOCIATION OF GREATER LONG BEACH
3605 LONG BEACH BLD 210
LONG BEACH,CA90807
95-1643396 501(C)(3) 59,121 0     COMMUNITY HEALTH
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
265
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
7
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2021

Schedule I (Form 990) 2021
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 131 64,763      
(2) FINANCIAL ASSISTANCE TO PATIENTS/NEEDY 7168 872,389      
(3) SCHOLARSHIP 20 24,990      
(4) DONATION OF CLOTHING/OTHER TO PATIENTS/NEEDY 23107   195,080 COST CLOTHING, SLEEPING BAGS, TENTS, SCHOOL SUPPLIES, HYGIENE KITS, WIGS, FLOWERS TOYS
(5) MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS 138   16,122 COST DURABLE MEDICAL EQUIPMENT AND SUPPLIES
(6) PHARMACY CHARITY PRESCRIPTION 166   96,502 COST PHARMACEUTICALS, MEDICATION, PRESCRIPTIONS
(7) PROVISION OF FOOD/MEALS 15148   96,534 COST FOOD, MEALS
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: INCLUDED IN PART II ABOVE IS $6,137,510 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 PHARMACY COSTS, ROOM AND BOARD/LODGING AND SHELTERED MEALS FOR INDIGENT PATIENTS. THE GRANTS ARE APPROVED BY THE HOSPITAL'S ADMINISTRATION DEPARTMENT OR A DESIGNATED COMMITTEE.
PART II $2,299,104 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 2022. $3,942,917 IN GRANT PAYMENTS WERE PROVIDED TO THE UNIVERSITY OF ARIZONA, A GOVERNMENT INSTITUTION, TO SUPPORT THE DEVELOPMENT OF EDUCATION, TRAINING AND CLINICAL RESEARCH PROGRAMS. $9,732,500 IN GRANT PAYMENTS WERE PROVIDED TO 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) 2021



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
2021
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) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1LLOYD H DEAN
CHIEF EXECUTIVE OFFICER
(i)

(ii)
2,679,974
-------------
0
16,982,400
-------------
0
6,158,250
-------------
0
9,476,825
-------------
0
165,424
-------------
0
35,462,873
-------------
0
6,101,062
-------------
0
2MARVIN O'QUINN
CHAIR/ PRESIDENT & CHIEF OPERATING O
(i)

(ii)
1,717,376
-------------
0
4,097,012
-------------
0
461,539
-------------
0
704,233
-------------
0
89,478
-------------
0
7,069,638
-------------
0
425,001
-------------
0
3CHARLES P FRANCIS
SEVP, CHIEF STRATEGY OFFICER
(i)

(ii)
1,101,216
-------------
0
2,260,516
-------------
0
951,976
-------------
0
1,297,958
-------------
0
82,671
-------------
0
5,694,337
-------------
0
926,185
-------------
0
4DANIEL J MORISSETTE CPA
TREASURER/ SEVP, CHIEF FINANCIAL OFF
(i)

(ii)
1,406,997
-------------
0
2,977,013
-------------
0
11,341
-------------
0
517,062
-------------
0
46,482
-------------
0
4,958,895
-------------
0
0
-------------
0
5ELIZABETH SHIH
BOARD MEMBER/ SEVP, CHIEF ADMINISTRA
(i)

(ii)
1,056,903
-------------
0
2,157,760
-------------
0
488,102
-------------
0
683,779
-------------
0
103,035
-------------
0
4,489,579
-------------
0
436,130
-------------
0
6ROBERT WIEBE MD
EVP, CHIEF MEDICAL OFFICER
(i)

(ii)
1,105,165
-------------
0
2,260,500
-------------
0
264,156
-------------
0
438,522
-------------
0
40,169
-------------
0
4,108,512
-------------
0
247,601
-------------
0
7CHARLES COVA
OPERATIONS CONSULTANT (THRU 4/2/21)
(i)

(ii)
171,795
-------------
0
768,635
-------------
0
2,697,656
-------------
0
184,445
-------------
0
2,285
-------------
0
3,824,816
-------------
0
1,052,658
-------------
0
8DARRYL ROBINSON
SEVP, CHIEF HUMAN RESOURCE OFFICER
(i)

(ii)
960,981
-------------
0
1,952,247
-------------
0
228,735
-------------
0
375,706
-------------
0
57,374
-------------
0
3,575,043
-------------
0
216,600
-------------
0
9JULIE SPRENGEL
SVP OPERATIONS & CEO, SOUTHERN CALIF
(i)

(ii)
1,196,469
-------------
0
1,874,124
-------------
0
17,380
-------------
0
62,912
-------------
0
18,162
-------------
0
3,169,047
-------------
0
0
-------------
0
10MITCH MELFI ESQ JD
SECRETARY/ VICE CHAIR/CHIEF LEGAL OF
(i)

(ii)
0
-------------
951,216
0
-------------
1,952,250
0
-------------
180,168
0
-------------
17,100
0
-------------
19,794
0
-------------
3,120,528
0
-------------
0
11LAURIE HARTING
SYSTEM SPECIAL PROJECTS LEADER
(i)

(ii)
556,589
-------------
0
1,027,949
-------------
0
538,841
-------------
0
902,221
-------------
0
49,165
-------------
0
3,074,765
-------------
0
510,246
-------------
0
12SUJA CHANDRASEKARAN
SEVP, CHIEF INFORMATION AND DIGITAL
(i)

(ii)
0
-------------
983,019
0
-------------
2,035,726
0
-------------
1,932
0
-------------
19,497
0
-------------
28,996
0
-------------
3,069,170
0
-------------
0
13LINDA HUNT
SVP OPERATIONS & CEO, SOUTHWEST DIVI
(i)

(ii)
804,687
-------------
0
1,134,451
-------------
0
293,945
-------------
0
440,039
-------------
0
81,925
-------------
0
2,755,047
-------------
0
236,940
-------------
0
14KATHLEEN SANFORD DBA RN FAAN FACH
CHIEF NURSING OFFICER
(i)

(ii)
0
-------------
814,284
0
-------------
1,667,443
0
-------------
139,647
0
-------------
17,100
0
-------------
30,752
0
-------------
2,669,226
0
-------------
0
15THOMAS KOPFENSTEINER STD
CHIEF MISSION OFFICER
(i)

(ii)
0
-------------
805,339
0
-------------
1,646,884
0
-------------
170,494
0
-------------
17,275
0
-------------
10,847
0
-------------
2,650,839
0
-------------
0
16THOMAS MCGINN MD MPH
EVP, PHYSICIAN ENTERPRISE
(i)

(ii)
0
-------------
1,003,111
0
-------------
1,370,002
0
-------------
5,544
0
-------------
7,596
0
-------------
31,746
0
-------------
2,417,999
0
-------------
0
17FRED NAJJAR
EVP, CHIEF PHILANTHROPY OFFICER
(i)

(ii)
582,377
-------------
0
1,212,450
-------------
0
275,927
-------------
0
269,962
-------------
0
42,314
-------------
0
2,383,030
-------------
0
246,955
-------------
0
18SHELLY SCHLENKER
EVP, CHIEF ADVOCACY OFFICER
(i)

(ii)
528,151
-------------
0
1,128,875
-------------
0
11,839
-------------
0
640,529
-------------
0
51,429
-------------
0
2,360,823
-------------
0
0
-------------
0
19JOHN E PETERSDORF
SVP OPERATIONAL EFFECTIVENESS
(i)

(ii)
567,167
-------------
0
724,500
-------------
0
10,679
-------------
0
975,658
-------------
0
63,788
-------------
0
2,341,792
-------------
0
0
-------------
0
20TODD A STRUMWASSER MD
SVP OPERATIONS & CEO, NORTHERN CALIF
(i)

(ii)
898,479
-------------
0
1,285,887
-------------
0
22,627
-------------
0
74,490
-------------
0
57,454
-------------
0
2,338,937
-------------
0
0
-------------
0
21ANTHONY SCOTT CARSWELL
BOARD MEMBER
(i)

(ii)
633,501
-------------
0
819,000
-------------
0
14,450
-------------
0
713,755
-------------
0
61,320
-------------
0
2,242,026
-------------
0
0
-------------
0
22JON VANBOENING
SYSTEM SPECIAL PROJECTS LEADER
(i)

(ii)
627,101
-------------
0
1,050,240
-------------
0
169,014
-------------
0
336,782
-------------
0
18,082
-------------
0
2,201,219
-------------
0
151,894
-------------
0
23DARREN LEE
HOSPITAL PRESIDENT (THRU 11/1/21)
(i)

(ii)
415,086
-------------
0
284,748
-------------
0
1,358,100
-------------
0
76,138
-------------
0
41,749
-------------
0
2,175,821
-------------
0
0
-------------
0
24TAMMARA WILCOX
SYSTEM SVP PAYER STRATEGY & RELATION
(i)

(ii)
621,502
-------------
0
787,500
-------------
0
13,893
-------------
0
683,013
-------------
0
53,549
-------------
0
2,159,457
-------------
0
0
-------------
0
25MICHELLE COOPER
EVP, CHIEF COMPLIANCE OFFICER
(i)

(ii)
0
-------------
528,784
0
-------------
1,099,718
0
-------------
160,492
0
-------------
17,100
0
-------------
26,958
0
-------------
1,833,052
0
-------------
0
26LISA GAMSHAD ZUCKERMAN
SYSTEM SVP TREASURY & STRATEGIC INVE
(i)

(ii)
634,133
-------------
0
1,022,298
-------------
0
13,533
-------------
0
91,562
-------------
0
57,835
-------------
0
1,819,361
-------------
0
0
-------------
0
27GARY A GREENSWEIG DO
SYSTEM SVP CHIEF PHYSICIAN EXECUTIVE
(i)

(ii)
558,381
-------------
0
951,900
-------------
0
27,352
-------------
0
77,346
-------------
0
82,196
-------------
0
1,697,175
-------------
0
0
-------------
0
28BENJIE M LOANZON
SYSTEM SVP FINANCE AND CORPORATE CON
(i)

(ii)
648,147
-------------
0
819,000
-------------
0
8,631
-------------
0
69,861
-------------
0
64,100
-------------
0
1,609,739
-------------
0
0
-------------
0
29PHIL FOSTER
SYSTEM SVP ENTERPRISE RISK MGMT
(i)

(ii)
0
-------------
585,900
0
-------------
744,491
0
-------------
57,982
0
-------------
17,275
0
-------------
29,996
0
-------------
1,435,644
0
-------------
0
30DANIELLE WEBER
SYSTEM SVP REVENUE CYCLE
(i)

(ii)
0
-------------
540,213
0
-------------
712,168
0
-------------
51,870
0
-------------
17,275
0
-------------
18,105
0
-------------
1,339,631
0
-------------
0
31PAUL EDGETT III
FORMER KEY EMPLOYEE (CHIEF BUSINESS
(i)

(ii)
0
-------------
134,272
0
-------------
915,940
0
-------------
144,735
0
-------------
12,300
0
-------------
0
0
-------------
1,207,247
0
-------------
0
32ALYSSA C RIEDER
VP, CHIEF INVESTMENT OFFICER
(i)

(ii)
543,610
-------------
0
532,649
-------------
0
6,789
-------------
0
63,906
-------------
0
57,117
-------------
0
1,204,071
-------------
0
0
-------------
0
33PATRICIA WEBB FACHE
FORMER OFFICER (SEVP, CHIEF ADMINIST
(i)

(ii)
0
-------------
0
0
-------------
977,470
0
-------------
0
0
-------------
7,616
0
-------------
0
0
-------------
985,086
0
-------------
0
34TIMOTHY PANKS
FORMER KEY EMPLOYEE (SVP, FINANCE &
(i)

(ii)
0
-------------
0
0
-------------
0
197,031
-------------
0
0
-------------
0
0
-------------
0
197,031
-------------
0
197,031
-------------
0
35TESSIE GUILLERMO
FORMER BOARD CHAIR (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
130,000
0
-------------
0
0
-------------
0
0
-------------
130,000
0
-------------
0
36CHRISTOPHER LOWNEY
FORMER BOARD VICE CHAIR (THRU3/31/21
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
125,000
0
-------------
0
0
-------------
0
0
-------------
125,000
0
-------------
0
37KENT BRADLEY MD
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
38MARK DEMICHELE
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
39PETER G HANELT CPA
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
40ANTOINETTE HARDY-WALLER MJ BSN RN
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
41PATRICK STEELE
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
0
-------------
0
0
-------------
110,000
0
-------------
0
42ANGELA ARCHON
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
43GERALDINE BEDNASH PHD RN FAAN
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
44JAMES P HAMILL
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
45PHOEBE YANG
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
46GARY R YATES MD
FORMER BOARD MEMBER (THRU 3/31/21)
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
0
-------------
0
0
-------------
100,000
0
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A FIRST CLASS AND CHARTER TRAVEL AND UPGRADES TO SUCH ARE TREATED ON AN EXCEPTION BASIS ACCORDING TO COMMONSPIRIT HEALTH POLICY (SEE SCHEDULE O). SUCH FIRST CLASS TRAVEL WAS PROVIDED TO TWO BOARD MEMBERS/OFFICERS, AND TWO 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 THREE HIGHEST COMPENSATED EMPLOYEES. THESE GROSS-UP PAYMENTS WERE INCLUDED AS TAXABLE COMPENSATION TO THE LISTED PERSONS. CLUB DUES HAVE BEEN PAID BY DIGNITY HEALTH FOR BUSINESS USE BY ONE KEY EMPLOYEE AND ONE HIGHEST COMPENSATED EMPLOYEE. NO AMOUNTS HAVE BEEN REPORTED AS INCOME AS NO CLUB DUES HAVE BEEN REIMBURSED FOR PERSONAL PURPOSES. DIGNITY HEALTH DOES NOT PAY OR REIMBURSE FOR ANY HEALTH CLUB MEMBERSHIPS. SECURITY SERVICES, INCLUDING VEHICLES AND DRIVERS, ARE PROVIDED TO AN OFFICER PURSUANT TO A QUALIFIED SECURITY ASSESSMENT, AND AS SUCH, NO AMOUNTS HAVE BEEN REPORTED AS INCOME.
PART I, LINE 3 DURING THE TAX YEAR, DIGNITY HEALTH USED THE FOLLOWING TO ESTABLISH THE CEO'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT HEALTH ("COMMONSPIRIT") BOARD OF STEWARDSHIP TRUSTEES ("BOARD"); (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. IN EARLY 2019, COMMONSPIRIT, OBTAINED AN INDEPENDENT, OUTSIDE REVIEW OF THE APPROPRIATE ANNUAL STIPEND TO BE PROVIDED TO ITS BOARD AND BOARD COMMITTEE MEMBERS. THE REVIEW INCLUDED COMPARABILITY DATA AND REPORTED OUT ON REASONABLE AND APPROPRIATE STIPEND RANGES. THE SPONSORSHIP AND GOVERNANCE COMMITTEE OF THE COMMONSPIRIT BOARD CONSIDERED THE DATA AND RANGES AND MADE A RECOMMENDATION TO THE COMMONSPIRIT BOARD AS TO REASONABLE AND APPROPRIATE STIPEND LEVELS, WHICH THE BOARD APPROVED.
PART I, LINES 4A-B PART I, 4A: IN ACCORDANCE WITH AN EXECUTIVE SEVERANCE POLICY, DIGNITY HEALTH'S LISTED PERSONS ARE PROVIDED WITH MARKET-STANDARD COMPENSATION RANGING FROM PAYMENTS OF 18-24 MONTHS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION. THE FOLLOWING REPORTABLE INDIVIDUALS RECEIVED SEVERANCE PAYMENTS FROM DIGNITY HEALTH DURING THE 2021 CALENDAR YEAR, AND THESE SEVERANCE PAYMENTS WERE INCLUDED IN THE INDIVIDUALS' W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): C. COVA, $1,633,142 AND D. LEE, $1,351,284. PART I, 4B: CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT FOR ONE HIGHEST COMPENSATED EMPLOYEE OCCURRED DURING 2021 INCLUDE: C. COVA $1,011,320. THE FOLLOWING FORMER KEY EMPLOYEE, WHO TERMINATED HIS EMPLOYMENT WITH DIGNITY HEALTH IN 2019, RECEIVED THE DIGNITY HEALTH EXCESS BENEFIT PLAN PAYMENT FROM DIGNITY HEALTH DURING 2021 CALENDAR YEAR, AND THIS PAYMENT WAS INCLUDED IN THE INDIVIDUAL'S W-2 INCOME AND REPORTABLE COMPENSATION ON PART VII AND SCHEDULE J, PART II, COLUMN (B)(III): T. PANKS, $197,031. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE. THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR TWO BOARD MEMBERS/OFFICERS, ONE OFFICER, FIVE KEY EMPLOYEES AND THREE HIGHEST COMPENSATED EMPLOYEE OCCURRED DURING 2021 INCLUDE M. O'QUINN, $425,001; E. SHIH, $436,130; L. DEAN, $6,101,062; C. FRANCIS, $926,185; L. HUNT, $236,940; F. NAJJAR, $246,955; D. ROBINSON, $216,600; R. WIEBE, $247,601; C. COVA, $41,338; L. HARTING, $510,246 AND J. VANBOENING, $151,894. CERTAIN LISTED PERSONS EMPLOYED BY DIGNITY HEALTH 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 THEIR ROLES 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. NO PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT OCCURRED DURING 2021. DURING THE 2021 CALENDAR YEAR, COMMONSPIRIT MAINTAINED A SUPPLEMENTAL NON-QUALIFIED DEFERRED COMPENSATION PLAN FOR DIVISION CEOS/PRESIDENTS AND OTHER DESIGNATED COMMONSPIRIT EXECUTIVES AT THE LEVEL OF SENIOR VICE PRESIDENT AND ABOVE. NO REPORTABLE INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE COMMONSPIRIT DEFERRED COMPENSATION PLAN DURING 2021; HOWEVER, DUE TO THE "SUPER" VESTING RULES UNDER THE DEFERRED COMPENSATION PLAN, PARTICIPANTS WHO HAVE MET CERTAIN REQUIREMENTS SUCH AS INVOLUNTARY TERMINATION WITHOUT CAUSE, AGE, A COMBINATION OF AGE AND YEARS OF SERVICE, OR MORE THAN 5 YEARS OF PLAN PARTICIPATION ARE ELIGIBLE TO RECEIVE THEIR 2021 CONTRIBUTIONS IN CASH. DURING 2021, THE FOLLOWING PAYMENTS WERE MADE PURSUANT TO THE SUPER VESTING RULES: MICHELLE COOPER, $52,336; PHILIP FOSTER, $54,370; THOMAS KOPFENSTEINER, $159,826; MITCH MELFI, $174,625; KATHLEEN SANFORD, $128,979 AND DANIELLE WEBER, $49,938. 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 OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J, PART II DIGNITY HEALTH FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST COMMONSPIRIT AND ITS RELATED ORGANIZATIONS IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE ORGANIZATION 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 IT 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 THE ORGANIZATION'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 2021.
Schedule J (Form 990) 2021

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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
2021
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 CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E:CUSIP 130795DH7-SEE PART VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PART VI X     X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PART VI   X   X   X
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 04057MV4-SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 160,000,000 350,005,000 4,000,000 8,200,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 415,050,133 515,275,288 140,000,000 75,000,000
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds ............. 1,538,212 17,885,926    
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 3,068,236      
8 Credit enhancement from proceeds ............. 14,157,815      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 289,056,921 207,176,334    
11 Other spent proceeds ............. 107,228,949 290,213,028 140,000,000 75,000,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2010 2014 2014 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 2020, a current refunding issue)? ........
X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
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  
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 1.000 % 1.070 % 0.970 % 0.860 %
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 % 0.130 % 0 %  
6 Total of lines 4 and 5 ............. 1.000 % 1.200 % 0.970 % 0.860 %
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. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   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
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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
 
 
 
 
 
 
c Term of hedge ......... 3420.0000000000 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period? X     X   X   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
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2020 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/01/2022 ISSUER NAME: ARIZONA HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/01/2022 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2019 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2021
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 IRS REBATE CALCULATATION DATE IS 7/1/2025. THE MOST RECENT REBATE COMPUTATION DATE WAS 7/1/2022, 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 "SWAP AND COLLECTIVELY 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 O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C IRS REBATE COMPUTATION DATE WAS 7/1/2021, AS OF WHICH IT WAS DETERMINED $729,936.62 REBATE LIABILITY TO IRS AND WAS PAID IN AUGUST 2021.
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 IRS REBATE COMPUTATION DATE WAS 3/1/2022, 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 IRS REBATE COMPUTATION DATE WAS 03/01/2022, 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. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 7/1/2019, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
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). PART IV, LINE 2C THE MOST RECENT IRS REBATE COMPUTATION DATE WAS 7/1/2021, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
Schedule K (Form 990) 2021

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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
2021
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 CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY
 
68-0164610 130795DH7 04-26-2007 400,000,000 BOND E:CUSIP 130795DH7-SEE PART VI X     X   X
B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LSZ1 11-09-2011 515,217,012 BOND O: CUSIP 13033LSZ1-SEE PART VI X     X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033LUD7 06-27-2012 140,000,000 BOND Q: CUSIP 13033LUD7-SEE PART VI   X   X   X
D ARIZONA HEALTH FACILITIES AUTHORITY
 
86-0453292 040507MV4 06-27-2012 75,000,000 BOND R: CUSIP 04057MV4-SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13033L4V6 10-15-2014 294,763,279 BOND S: CUSIP 13033L4V6-SEE PART VI   X   X   X
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
 
52-1643828 13032ULN6 12-06-2016 270,095,000 BOND T: CUSIP 13032ULN6-SEE PART VI   X   X   X
Part
Proceeds
A B C D
1 Amount of bonds retired .................. 160,000,000 350,005,000 4,000,000 8,200,000
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 415,050,133 515,275,288 140,000,000 75,000,000
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds ............. 1,538,212 17,885,926    
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 3,068,236      
8 Credit enhancement from proceeds ............. 14,157,815      
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 289,056,921 207,176,334    
11 Other spent proceeds ............. 107,228,949 290,213,028 140,000,000 75,000,000
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2010 2014 2014 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 2020, a current refunding issue)? ........
X   X   X   X  
15 Were the bonds issued as part of an advance refunding issue of taxable
bonds (or, if issued prior to 2020, an advance refunding issue)? ........
X     X   X   X
16 Has the final allocation of proceeds been made? .......... X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 2
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  
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 1.000 % 1.070 % 0.970 % 0.860 %
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 % 0.130 % 0 %  
6 Total of lines 4 and 5 ............. 1.000 % 1.200 % 0.970 % 0.860 %
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. ..        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? ........
X   X   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
Schedule K (Form 990) 2021

Schedule K (Form 990) 2021
Page 3
Part
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
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
 
 
 
 
 
 
c Term of hedge ......... 3420.0000000000 %      
d Was the hedge superintegrated? ......   X            
e Was the hedge terminated? ........ X              
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?   X   X   X   X
b Name of provider ..........  
 
 
 
 
 
 
 
c Term of GIC .........        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........                
6 Were any gross proceeds invested beyond an available temporary period? X     X   X   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
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: CA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2020 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/01/2022 ISSUER NAME: ARIZONA HEALTH FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 03/01/2022 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2019 ISSUER NAME: CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 07/01/2021
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 IRS REBATE CALCULATATION DATE IS 7/1/2025. THE MOST RECENT REBATE COMPUTATION DATE WAS 7/1/2022, 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 "SWAP AND COLLECTIVELY 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 O: CUSIP 13033LSZ1 PART I, COLUMN (E) THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART I, COLUMN (E) AND PART II, LINE 3 IS DUE TO INVESTMENT EARNINGS. PART I, COLUMN (F) REFUND CHFFA 1993 SERIES A BONDS ISSUED ON MARCH 17, 1993, CHFFA 1996 SERIES E BONDS ISSUED ON DECEMBER 12, 1996, CHFFA 1997 SERIES A BONDS ISSUED ON OCTOBER 15, 1997 AND CHFFA 1998 SERIES A BONDS ISSUED ON DECEMBER 3, 1998. REPAY LINE OF CREDIT USED TO RETIRE CHFFA 2004 SERIES H BONDS ISSUED ON APRIL 28, 2004. FINANCE CAPITAL PROJECTS AT VARIOUS HOSPITAL FACILITIES. PART II, LINE 11 BOND PROCEEDS WERE USED TO PAY OFF THE CHFFA 2004 SERIES H PUT BOND THAT CAME DUE ON 7/1/2011. THESE WERE FINANCED WITH A DRAW ON THE WORKING LINE OF CREDIT. PART IV, LINE 2C IRS REBATE COMPUTATION DATE WAS 7/1/2021, AS OF WHICH IT WAS DETERMINED $729,936.62 REBATE LIABILITY TO IRS AND WAS PAID IN AUGUST 2021.
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 IRS REBATE COMPUTATION DATE WAS 3/1/2022, 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 IRS REBATE COMPUTATION DATE WAS 03/01/2022, 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. PART IV, LINE 2C THE MOST RECENT REBATE COMPUTATION DATE WAS 7/1/2019, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
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). PART IV, LINE 2C THE MOST RECENT IRS REBATE COMPUTATION DATE WAS 7/1/2021, AS OF WHICH IT WAS DETERMINED THAT NO REBATE WAS DUE.
Schedule K (Form 990) 2021

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990)
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
2021
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
Total ...............Small Bullet $  
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) 2021
Schedule L (Form 990) 2021
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 91,679 EMPLOYMENT   No
(2) E-LEAD RESOURCES INC
 
FAMILY MEMBER OF L DEAN, OFFICER 2,637,151 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) 2021


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
2021
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 2 9,500 COMPARABLE SALE
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications .. X 4,200 RESALE VALUE
5 Clothing and household
goods .......
X 157,674 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 . X 8 161,093 COMPARABLE SALE
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( COVID FOOD/MED SUPPLIES ) X 33 236,122 COST
26 Other Right pointing arrow large image ( MEDICAL EQUIPMENT ) X 6 112,399 COMPARABLE SALE
27 Other Right pointing arrow large image ( FOOD AND WINE ) X 36 104,463 COMPARABLE SALE
28 Other Right pointing arrow large image ( ELECTRONICS ) X 2 28,439 COMPARABLE SALE
Other Right pointing arrow large image ( TOYS ) X 12 27,058 COMPARABLE SALE
Other Right pointing arrow large image ( GIFT CERTIFICATES/TICKETS (ENTERTAINMENT) ) X 18 17,345 COMPARABLE SALE
Other Right pointing arrow large image ( OFFICE EQUIPMENT ) X 2 3,000 COMPARABLE SALE
Other Right pointing arrow large image ( TARPS ) X 1 118 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) (2021)
Schedule M (Form 990) (2021)
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
PART I, COLUMN (B): ART: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. DRUGS AND MEDICAL SUPPLIES: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. COVID FOOD AND MEDICAL SUPPLIES: 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. FOOD AND WINE: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. ELECTRONICS: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. GIFT CERTIFICATES/TICKETS/ENTERTAINMENT: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OFFICE EQUIPMENT: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED. TARPS: THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED.
PART I, 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) (2021)

Additional Data


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

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
2021
Open to Public
Inspection
Name of the organization
DIGNITY HEALTH
 
Employer identification number

94-1196203
Return Reference Explanation
FORM 990, PART III, LINE 1: OUR MISSION: AS COMMONSPIRIT HEALTH, WE MAKE THE HEALING PRESENCE OF GOD KNOWN IN OUR WORLD BY IMPROVING THE HEALTH OF THE PEOPLE WE SERVE, ESPECIALLY THOSE WHO ARE VULNERABLE, WHILE WE ADVANCE SOCIAL JUSTICE FOR ALL. OUR VISION: A HEALTHIER FUTURE FOR ALL INSPIRED BY FAITH, DRIVEN BY INNOVATION, AND POWERED BY OUR HUMANITY. OUR VALUES: COMPASSION: CARE WITH LISTENING, EMPATHY AND LOVE. ACCOMPANY AND COMFORT THOSE IN NEED OF HEALING. INCLUSION: CELEBRATE EACH PERSON'S GIFTS AND VOICE. RESPECT THE DIGNITY OF ALL. INTEGRITY: INSPIRE TRUST THROUGH HONESTY. DEMONSTRATE COURAGE IN THE FACE OF INEQUITY. EXCELLENCE: SERVE WITH FULLEST PASSION, CREATIVITY, AND STEWARDSHIP. EXCEED EXPECTATIONS OF OTHERS AND OURSELVES. COLLABORATION: COMMIT TO THE POWER OF WORKING TOGETHER. BUILD AND NURTURE MEANINGFUL RELATIONSHIPS.
FORM 990, PART III, LINE 4A: DIGNITY HEALTH IS A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. DIGNITY HEALTH OWNS AND OPERATES 22 HOSPITALS THROUGHOUT MAJOR CALIFORNIA DIVISIONS AND IN THE ARIZONA AND NEVADA DIVISIONS DURING THE YEAR ENDED JUNE 30, 2022. DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' FACILITIES INCLUDED APPROXIMATELY 5,169 LICENSED ACUTE CARE BEDS AND APPROXIMATELY 169 LICENSED SKILLED NURSING BEDS AS OF JUNE 30, 2022. DIGNITY HEALTH MAINTAINS A PROMINENT MARKET SHARE IN MANY OF ITS DIVISIONAL 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 COMMUNITY BOARDS 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.
FORM 990, PART VI, SECTION A, LINE 1A THE DIGNITY HEALTH BYLAWS PROVIDE THAT THE REQUIREMENTS AND PROVISIONS RELATING TO COMMITTEES OF THE BOARD SHALL BE THAT THE BOARD, AT ITS DISCRETION, MAY ESTABLISH STANDING OR AD HOC COMMITTEES FROM TIME TO TIME, AS NEEDED, PROVIDED HOWEVER, NO COMMITTEE THAT INCLUDES PERSONS WHO ARE NOT DIRECTORS OF THE BOARD MAY EXERCISE THE AUTHORITY OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 2 CERTAIN REPORTABLE INDIVIDUALS HAVE BUSINESS RELATIONSHIPS WITH DIGNITY HEALTH (INCLUDING FOR-PROFIT SUBSIDIARIES OR JOINT VENTURES) AS A RESULT OF SERVING AS OFFICERS OR BOARD MEMBERS OF THOSE ENTITIES AT THE DIRECTION OF DIGNITY HEALTH. OFFICERS AND BOARD MEMBERSHIP ON THE GOVERNING BODIES OF THOSE RELATED ENTITIES ARE AS FOLLOWS. DIGNITY-GOHEALTH URGENT CARE MANAGEMENT LLC T. MCGINN, T. STRUMWASSER DIGNITY HEALTH GLOBAL EDUCATION LTD. - M. O'QUINN, K. SANFORD BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD. - B. LOANZON, E. SHIH DIGNITY HEALTH HOLDING CORPORATION - E. SHIH, D. MORISSETTE, C. FRANCIS, M. O'QUINN, M. MELFI DIGNITY HEALTH INSURANCE LTD. P. FOSTER, M. MELFI, D. MORISSETTE, M. O'QUINN, J. SPRENGEL, R. WIEBE DIGNITY HEALTH PROVIDER RESOURCES, INC. T. WILCOX, T. MCGINN CONSOLIDATED HEALTH SERVICES - M. MELFI, M. O'QUINN FRANCISCAN SERVICES INC - M. MELFI, T. KOPFENSTEINER CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH R. WIEBE, M. O'QUINN, T. MCGINN TOP TO LIFE - M. MELFI, D. MORISSETTE, M. O'QUINN
FORM 990, PART VI, SECTION A, LINE 6 THE FILING ORGANIZATION HAS A SOLE CORPORATE MEMBER, COMMONSPIRIT, A 501(C)(3) EXEMPT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A DIGNITY HEALTH IS SUBJECT TO THE RESERVED RIGHTS OF THE SOLE CORPORATE MEMBER, COMMONSPIRIT, AS SET FORTH IN THE SYSTEM GOVERNANCE MATRIX AND THE BYLAWS, THE ACTIVITIES AND AFFAIRS OF THIS CORPORATION SHALL BE CONDUCTED AND ALL CORPORATE POWERS SHALL BE EXERCISED BY OR UNDER THE DIRECTION OF THE BOARD. THE BOARD OF DIRECTORS OF THE FILING ORGANIZATION MAY SELECT NOMINEES QUALIFIED TO SERVE ON THE ORGANIZATION'S BOARD. COMMONSPIRIT, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, MAY APPOINT OR REFUSE EACH NOMINEE IN ACCORDANCE WITH THE SYSTEM GOVERNANCE MATRIX AND WITH THE RECOMMENDATION OF COMMONSPIRIT'S PRESIDENT AND CHIEF OPERATING OFFICER (OR DESIGNEE). COMMONSPIRIT MAY UNILATERALLY APPOINT ONE OR MORE INDIVIDUALS TO THE ORGANIZATION'S BOARD WHETHER OR NOT THE BOARD FURNISHES THE MEMBER WITH A LIST OF INDIVIDUALS QUALIFIED TO SERVE ON THE BOARD IN ACCORDANCE WITH WITH THE BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7B COMMONSPIRIT, AS THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH, HAS SPECIFIC RESERVED RIGHTS AS SET FORTH IN THE SYSTEM GOVERNANCE MATRIX WITH RESPECT TO CERTAIN CORPORATE ACTIONS OF THE FILING ORGANIZATION AND ITS SUBSIDIARIES. THOSE RESERVED RIGHTS INCLUDE THE RIGHT TO: -APPROVE A SUBSTANTIAL CHANGE IN MISSION OR PHILOSOPHICAL DIRECTION OF DIGNITY HEALTH -CLOSURE OF A HOSPITAL BY DIGNITY HEALTH -APPROVE AMENDMENT OF THE ARTICLES AND BYLAWS OF DIGNITY HEALTH -APPROVE INCURRENCE OF DEBT BY DIGNITY HEALTH, INCLUDING WITHOUT LIMITATION, BORROWINGS, LOANS, ENCUMBRANCES, OPERATING LEASES AND CAPITAL LEASES, IN EXCESS OF THRESHOLDS AND WITHIN LIMITS ESTABLISHED BY COMMONSPIRIT HEALTH -APPROVE A JOINT VENTURE OR PARTNERSHIP HAVING DIGNITY HEALTH AS A PARTY -APPROVE AN INCREASE OR DECREASE TO AN EXISTING JOINT VENTURE OR PARTNERSHIP INTEREST BY DIGNITY HEALTH -APPROVE CREATION OF A NEW CORPORATION OR LIMITED LIABILITY COMPANY BY DIGNITY HEALTH -APPROVE MERGER OR CONSOLIDATION OF DIGNITY HEALTH -APPROVE DISSOLUTION OF DIGNITY HEALTH -SELL OR DISPOSE OF (I) ASSETS IN EXCESS OF THRESHOLDS ESTABLISHED BY COMMONSPIRIT OR (II) ALL OR SUBSTANTIALLY ALL OF AN OPERATING UNIT OF THE ASSETS OF DIGNITY HEALTH -APPROVE AN ACQUISITION OF, OR NEW DIRECT INVESTMENT IN, AN ENTERPRISE BUSINESS LINE OR OTHER SUCH COMPANY OR CORPORATE ENTITY BY DIGNITY HEALTH -APPROVE AN INCREASE OR DECREASE IN AN EXISTING DIRECT INVESTMENT IN AN ENTERPRISE BUSINESS LINE OR OTHER SUCH COMPANY OR CORPORATE ENTITY BY DIGNITY HEALTH -APPOINTMENT OR TERMINATION OF A CEO BY DIGNITY HEALTH -ADOPT LONG RANGE AND STRATEGIC PLANS BY DIGNITY HEALTH -ADOPT CONSOLIDATED HEALTHCARE SYSTEM OPERATING AND CAPITAL BUDGET FOR DIGNITY HEALTH -ADOPT VARIATIONS FROM OPERATING AND/OR CAPITAL BUDGET IN EXCESS OF THRESHOLD ESTABLISHED BY COMMONSPIRIT BY DIGNITY HEALTH IN ADDITION, COMMONSPIRIT HAS RETAINED RIGHTS CONCERNING APPROVAL OF COMPENSATION PHILOSOPHY, INCENTIVE COMPENSATION DESIGN AND ESTABLISHMENT OF ANNUAL AND LONG TERM INCENTIVE GOALS, EXECUTIVE COMPENSATION PLANS AND REVIEW OF TOTAL REMUNERATION FOR REASONABLENESS.
FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S SYSTEM VICE PRESIDENT OF FINANCE-DIGNITY HEALTH CONTROLLER AND THE TAX MANAGER REVIEWED THE FINAL DRAFT OF THIS FORM 990 WITH THE SVP/FINANCE AND CORPORATE CONTROLLER OF COMMONSPIRIT. THE SVP/FINANCE AND CORPORATE CONTROLLER OF COMMONSPIRIT REVIEWED THE DRAFT OF THIS FORM 990 WITH THE SEVP/CHIEF FINANCIAL OFFICER. THE REVIEWS INCLUDED AN EXPLANATION OF EACH SCHEDULE OF THE FORM 990 AND THE PERTINENT INFORMATION CONTAINED ON EACH SCHEDULE. COMPENSATION SCHEDULES AND DISCLOSURES WERE REVIEWED WITH THE SEVP, CHIEF HUMAN RESOURCES OFFICER AND THE COMMONSPIRIT BOARD HUMAN RESOURCES AND COMPENSATION COMMITTEE. THE COMPLETE COPY OF THE FORM 990 WAS PROVIDED TO THE ENTIRE BOARD OF DIRECTORS BEFORE THE RETURN WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A CONFLICTS OF INTEREST ("COI") POLICY (THE "POLICY") IN PLACE TO PROTECT THE INTERESTS OF COMMONSPIRIT IN CIRCUMSTANCES THAT MAY RESULT IN A CONFLICT BETWEEN PERSONAL INTERESTS OF A PERSON AND THE INTERESTS OF THE ORGANIZATION AND THOSE IT SERVES. COMMONSPIRIT'S COI POLICY APPLIES TO COMMONSPIRIT, ITS DIRECT AFFILIATES AND SUBSIDIARIES AND ANY RELATED ENTITY THE GOVERNING DOCUMENTS OF WHICH REQUIRE THE ENTITY TO COMPLY WITH COMMONSPIRIT POLICY (COLLECTIVELY THE "SYSTEM ENTITIES"). THE FOLLOWING PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT LEAST ANNUALLY (VIA A FORMAL SYSTEM-ADMINISTERED SURVEY) IF THE PERSON'S AFFILIATION WITH COMMONSPIRIT CONTINUES: - MEMBERS OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES AND DBA'S, RESPECTIVELY - MEMBERS OF COMMITTEES OF CORPORATE AND COMMUNITY BOARDS OF SYSTEM ENTITIES - MEMBERS OF THE EXECUTIVE LEADERSHIP TEAM ("ELT") OF COMMONSPIRIT - CORPORATE OFFICERS OF SYSTEM ENTITIES - KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES AS SPECIFIED BY THE INTERNAL REVENUE SERVICE FOR FORM 990 PURPOSES WHO ARE NOT OTHERWISE INCLUDED IN THE CATEGORIES ABOVE - EMPLOYEES OF SYSTEM ENTITIES AT THE VICE PRESIDENT LEVEL AND ABOVE - ALL INDIVIDUALS ENGAGED IN RESEARCH AT INSTITUTIONS OWNED OR OPERATED BY A SYSTEM ENTITY - SELECT EMPLOYEES AS DETERMINED FROM TIME TO TIME BY LEADERSHIP DISCLOSURE, REVIEW, AND MANAGEMENT OF PERCEIVED, POTENTIAL, OR ACTUAL CONFLICTS OF INTEREST ARE ACCOMPLISHED THROUGH A DEFINED COI DISCLOSURE REVIEW PROCESS. EACH PERSON IS REQUIRED TO PROMPTLY AND FULLY DISCLOSE ANY SITUATION OR CIRCUMSTANCE THAT MAY CREATE A CONFLICT OF INTEREST AS SOON AS SHE/HE BECOMES AWARE OF IT. IN ADDITION, AT THE INCEPTION OF AN INDIVIDUAL'S RELATIONSHIP WITH COMMONSPIRIT (E.G. HIRING, BOARD APPOINTMENT), AND FOR CERTAIN POSITIONS, ANNUALLY THEREAFTER, WRITTEN CONFLICT OF INTEREST DISCLOSURE FORMS MUST BE COMPLETED. A FAILURE TO DISCLOSE MAY RESULT IN DISCIPLINARY OR CORRECTIVE ACTIONS. REPORTED POTENTIAL OR ACTUAL CONFLICTS OF INTEREST ARE INITIALLY REVIEWED BY LEGAL, CORPORATE RESPONSIBILITY OR RESEARCH INTEGRITY STAFF. IF NECESSARY, A CONFLICT OF INTEREST MANAGEMENT PLAN IS DEVELOPED, WHICH PLAN SHALL BE SUBJECT TO ACCEPTANCE BY THE APPROPRIATE DIRECT MANAGER, SUPERVISOR, MEDICAL STAFF OFFICE, BOARD OR BOARD COMMITTEE (FOR BOARD, BOARD COMMITTEE, ELT OR CORPORATE OFFICER CONFLICTS), OR OTHER APPROPRIATE INDIVIDUAL OR BODY. ONCE ACCEPTED, THE CONFLICT OF INTEREST MANAGEMENT PLAN IS COMMUNICATED TO THE PERSON WITH THE ACTUAL OR POTENTIAL CONFLICT AND THE INDIVIDUAL MUST CONDUCT THEMSELVES IN CONFORMITY WITH THE PLAN. IN THE EVENT THAT A TRANSACTIONAL CONFLICT OF INTEREST ARISES IN CONNECTION WITH A SYSTEM ENTITY BOARD MEETING, THE CONFLICTED INDIVIDUAL MUST DISCLOSE THAT CONFLICT PRIOR TO OR AT THE BEGINNING OF THE MEETING IN WHICH THE MATTER IS TO BE CONSIDERED. THE CONFLICTED INDIVIDUAL IS EXCLUDED FROM VOTING ON THE TRANSACTION AND IS PROHIBITED FROM USING PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, BUT IS NOT PROHIBITED FROM PROVIDING INPUT IF REQUESTED TO DO SO.
FORM 990, PART VI, SECTION B, LINE 15 COMMONSPIRIT'S BOARD OF STEWARDSHIP TRUSTEES APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF INDEPENDENT MEMBERS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR EACH OFFICER AND CERTAIN KEY EMPLOYEES OF DIGNITY HEALTH (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 AN INDEPENDENT CONSULTANT 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 AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT 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 VI, SECTION C, LINE 19 FEDERAL TAX LAWS DO NOT REQUIRE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND POLICIES RELATED TO CONFLICTS OF INTEREST BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE AND UPON REQUEST. THE FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990.
PART VII, SECTION A, COLUMN (A): PRESENTATION OF COMPLETE NAMES AND TITLES OF CERTAIN INDIVIDUALS LISTED IN PART VII, SECTION A: (2) MARVIN O'QUINN CHAIR/ PRESIDENT & CHIEF OPERATING OFFICER (4) DANIEL J MORISSETTE, CPA TREASURER/ SEVP CHIEF FINANCIAL OFFICER (5) ELIZABETH SHIH BOARD MEMBER/ SEVP CHIEF ADMINISTRATIVE OFFICER (9) JULIE SPRENGEL SVP OPERATIONS & CEO SOUTHWEST DIVISION (10) MITCH MELFI, ESQ, JD SECRETARY/ VICE CHAIR/CHIEF LEGAL OFFICER (12) SUJA CHANDRASEKARAN SEVP CHIEF INFORMATION AND DIGITAL OFFICER (13) LINDA HUNT SVP OPERATIONS & CEO ARIZONA DIVISION (14) KATHLEEN SANFORD, DBA, RN, FAAN, FACHE CHIEF NURSING OFFICER (20) TODD A STRUMWASSER, MD SVP OPERATIONS & CEO NORTHERN CALIFORNIA DIVISION (24) TAMMARA WILCOX SYSTEM SVP PAYER STRATEGY & RELATIONSHIPS (26) LISA GAMSHAD (ZUCKERMAN) SYSTEM SVP TREASURY & STRATEGIC INVESTMENTS (27) GARY A. GREENSWEIG, DO SYSTEM SVP CHIEF PHYSICIAN EXECUTIVE PHYSICIAN ENTERPRISE (28) BENJIE M LOANZON SYSTEM SVP FINANCE AND CORPORATE CONTROLLER (31) PAUL EDGETT, III CHIEF BUSINESS LINES OFFICER (THRU 12/31/20) (33) PATRICIA WEBB, FACHE SEVP CHIEF ADMINISTRATIVE OFFICER (THRU 12/31/20) (46) TIMOTHY PANKS FORMER KEY EMPLOYEE (SVP, FINANCE & REVENUE CYCLE MANAGEMENT (THRU 6/30/19)) ANTHONY SCOTT CARSWELL IS COMPENSATED BY THE FILING ORGANIZATION AS AN EMPLOYEE AND NOT FOR SERVING AS A BOARD MEMBER.
FORM 990, PART IX, LINE 11G MEDICAL FEES: PROGRAM SERVICE EXPENSES 486,083,418. MANAGEMENT AND GENERAL EXPENSES 21,475,935. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 507,559,353. REVENUE CYCLE SERVICES: PROGRAM SERVICE EXPENSES 236,759,498. MANAGEMENT AND GENERAL EXPENSES 3,085,207. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 239,844,705. PROFESSIONAL FEES/CONSULTING: PROGRAM SERVICE EXPENSES 13,977,037. MANAGEMENT AND GENERAL EXPENSES 133,034,817. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,011,854. REPAIRS/MAINTENANCE/DEMOLITION: PROGRAM SERVICE EXPENSES 11,876,365. MANAGEMENT AND GENERAL EXPENSES 113,040,408. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 124,916,773. OUTSOURCED MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 2,525,041. MANAGEMENT AND GENERAL EXPENSES 24,033,586. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,558,627. LAUNDRY & LINEN: PROGRAM SERVICE EXPENSES 1,954,251. MANAGEMENT AND GENERAL EXPENSES 18,600,758. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 20,555,009. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 13,982,616. MANAGEMENT AND GENERAL EXPENSES 133,087,923. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 147,070,539.
FORM 990, PART XI, LINE 9: CHANGE IN ADDITIONAL MINIMUM PENSION LIABILITY 845,266,533. REVENUE FROM HEALTH-RELATED ACIVITIES ORGANIZED AS CORPS/EXEMPT ORGS 64,537,857. CHANGE IN INTEREST IN NET ASSETS OF UNCONSOLIDATED FOUNDATION/RELATED ORGS 76,353,111. GAIN ON ADOPTION OF ASU 2017-17 145,297,494. CHANGE IN EQUITY INTEREST IN JOINT VENTURES -28,404,472. ADJUSTMENT TO INVESTMENT TRANSFERS TO A JOINT VENTURE 1,114,042. OTHER FUND BALANCE TRANSFERS 236,134.
FORM 990, PART XII, LINE 2C: THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.
FORM 990, PART XII, LINE 3B - FINANCIAL STATEMENTS AND REPORTING: THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN COMMONSPIRIT'S CONSOLIDATED UNIFORM GUIDANCE AUDITED SCHEDULE OF FEDERAL EXPENDITURES FOR THE PERIOD OF JULY 1, 2021 TO JUNE 30, 2022.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


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
2021
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) DIGNITY HEALTH PURCHASING NETWORK LLC
3033 NORTH THIRD AVENUE
PHOENIX,AZ85013
45-5555133
GROUP PURCHASING AZ 337,214 5,030,180 DIGNITY HEALTH
 
(2) DIGNITY HEALTH USP OXNARD SURGERY CENTERS LLC
1700 N ROSE AVENUE STE 100
OXNARD,CA93030
20-0707388
OP SURGERY CA 0 0 DIGNITY HEALTH
 
(3) ST FRANCIS FOUNDATION LLC
112 E VICTORIA STREET
SANTA BARBARA,CA93101
42-1691710
LEASING CA 0 0 DIGNITY HEALTH
 
(4) ST JOHN'S REGIONAL IMAGING CENTER LLC
1700 N ROSE AVENUE STE 110
OXNARD,CA93030
77-0483564
OP RADIOLOGY CA 0 0 DIGNITY HEALTH
 
(5) DIGNITY HEALTH INVESTMENTS LLC
185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
94-1196203
INACTIVE DE 0 0 DIGNITY HEALTH
 


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)ALEGENT CREIGHTON CLINIC
12809 W DODGE RD

OMAHA,NE68154
47-0765154
HOSPITAL NE 501(C)(3) LINE 3 ACH
 
 
No
(2)ALEGENT CREIGHTON HEALTH
12809 W DODGE RD

OMAHA,NE68154
47-0757164
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(3)ALEGENT HEALTH-BERGAN MERCY HEALTH SYSTEM
7500 MERCY RD

OMAHA,NE68124
47-0484764
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(4)ALEGENT HEALTH-COMM MEM HOSPITAL OF MO VALLEY IA
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-0776568
HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(5)ALEGENT HEALTH-IMMANUEL MEDICAL CENTER
6901 N 72ND ST

OMAHA,NE68122
47-0376615
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(6)ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER
104 W 17TH ST

SCHUYLER,NE68661
47-0399853
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(7)ALEGENT HEALTH-MERCY HOSPITAL CORNING IOWA
PO BOX 368

CORNING,IA50841
42-0782518
HOSPITAL IA 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(8)ALVERNA APARTMENTS
300 SE 8TH AVE

LITTLE FALLS,MN56345
41-1351177
LTERM CARE MN 501(C)(3) LINE 10 CSH
 
 
No
(9)APPLETREE COURT
601 OAK ST

BRECKENRIDGE,MN56520
41-1850500
SENIOR LIVING MN 501(C)(3) LINE 10 SFH
 
 
No
(10)ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION
345 S HALCYON RD

ARROYO GRANDE,CA93420
20-3256066
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(11)BAKERSFIELD MEMORIAL HOSPITAL
420 34TH STREET

BAKERSFIELD,CA93301
95-1802779
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(12)BARROW FOUNDATION UK
13 CHURCH STREET
NUNNEY,ENGLANDBA11 4LW
UK
31-1724184
FUNDRAISING FOUNDATION UK 501(C)(3) LINE 12D, III-O N/A
 
No
(13)BARROW NEUROLOGICAL FOUNDATION
350 WEST THOMAS ROAD

PHOENIX,AZ85013
86-0174371
FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 7 DIGNITY HEALTH
 
 
No
(14)BAYLOR ST LUKE'S HEALTH VENTURES
17200 ST LUKES WAY STE 170

THE WOODLANDS,TX77384
27-4499340
PHYSICIANS TX 501(C)(3) LINE 12A, I SLHS
 
 
No
(15)BAYLOR ST LUKE'S MEDICAL GROUP
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0458535
PHYSICIANS TX 501(C)(3) LINE 3 BSLHV
 
 
No
(16)BORNEMANN HEALTHCARE CORPORATION
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
23-2187242
INACTIVE PA 501(C)(3) LINE 12A, I CSH
 
 
No
(17)BRAZOSPORT HEALTH FOUNDATION INC
100 MEDICAL DRIVE

LAKE JACKSON,TX77566
76-0080110
FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I TCHB
 
 
No
(18)BRAZOSPORT REGIONAL PHYSICIAN SERVICES
100 MEDICAL DRIVE

LAKE JACKSON,TX77566
80-0240261
PHYSICIANS TX 501(C)(3) LINE 3 TCHB
 
 
No
(19)BURLESON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2759890
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(20)BURLESON ST JOSEPH MANOR
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2913931
REHABILITATION TX 501(C)(3) LINE 10 SJSC
 
 
No
(21)CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION
1401 SOUTH GRAND AVENUE

LOS ANGELES,CA90015
95-4000909
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE
 
 
No
(22)CARRINGTON HEALTH CENTER
800 N 4TH ST

CARRINGTON,ND58421
45-0227311
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(23)CATHOLIC HEALTH INITIATIVES - COLORADO
9100 EAST MINERAL CIRCLE

CENTENNIAL,CO80112
84-0405257
HOSPITAL CO 501(C)(3) LINE 3 CSH
 
 
No
(24)CATHOLIC HEALTH INITIATIVES - IOWA CORP
1111 6TH AVE

DES MOINES,IA50314
42-0680448
HOSPITAL IA 501(C)(3) LINE 3 CSH
 
 
No
(25)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION
9100 EAST MINERAL AVE

CENTENNIAL,CO80112
84-0902211
FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CHIC
 
 
No
(26)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION
1150 KELLY JOHNSON BLVD 204

COLORADO SPRINGS,CO80920
27-0930004
FUNDRAISING FOUNDATION CO 501(C)(3) LINE 12A, I CSH
 
 
No
(27)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
46-0992796
TELEHEALTH CO 501(C)(3) LINE 12A, I CHI NS
 
 
No
(28)CENTENNIAL MEDICAL GROUP INC
2700 STEWART PKWY

ROSEBURG,OR97471
26-3946191
SURGERY CENTER OR 501(C)(3) LINE 10 MMC - ROSEBURG
 
 
No
(29)CENTRAL CALIFORNIA HEALTH CENTERS
300 OLD RIVER ROAD STE 200

BAKERSFIELD,CA93311
84-4171789
CLINIC CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(30)CENTRAL KANSAS MEDICAL CENTER
3515 BROADWAY

GREAT BEND,KS67530
48-0543724
INACTIVE KS 501(C)(3) LINE 3 CSH
 
 
No
(31)CHI HEALTH CONNECT AT HOME - FARGO
4816 AMBER VALLEY PKWY S

FARGO,ND58104
27-1966847
SENIOR LIVING MN 501(C)(3) LINE 10 CSH
 
 
No
(32)CHI HEALTH FOUNDATION
12809 W DODGE RD

OMAHA,NE68154
47-0648586
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 ACH
 
 
No
(33)CHI KENTUCKY INC
3900 OLYMPIC BLVD STE 400

ERLANGER,KY41018
20-2741651
INVESTMENTS KY 501(C)(3) LINE 12A, I CSH
 
 
No
(34)CHI LIVING COMMUNITIES
930 S WYNN ROAD

OREGON,OH43616
34-1892096
SENIOR LIVING OH 501(C)(3) LINE 12A, I SFH-OH
 
 
No
(35)CHI MEMORIAL HOSPITAL - GEORGIA
100 GROSS CRESCENT CIRCLE

FORT OGLETHORPE,GA30742
82-2748395
HOSPITAL GA 501(C)(3) LINE 3 MHCS
 
 
No
(36)CHI NATIONAL HOME CARE
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-1261716
HOME HEALTH CO 501(C)(3) LINE 10 CHI NS
 
 
No
(37)CHI NATIONAL SERVICES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-2532084
HOLDING CO CO 501(C)(3) LINE 12A, I CSH
 
 
No
(38)CHI NEBRASKA
12809 WEST DODGE ROAD

OMAHA,NE68510
36-3233121
HOLDING CO NE 501(C)(3) LINE 12A, I CSH
 
 
No
(39)CHI ST JOSEPH CHILDREN'S HEALTH
1929 LINCOLN HWY E STE 150

LANCASTER,PA17602
23-2342997
HEALTHCARE PA 501(C)(3) LINE 12A, I CSH
 
 
No
(40)CHI ST JOSEPH'S CHILDREN
1516 5TH ST NW

ALBUQUERQUE,NM87102
71-0897107
COMMUNITY NM 501(C)(3) LINE 12A, I CSH
 
 
No
(41)CHI ST VINCENT HOSPITAL HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
71-0236913
HOSPITAL AR 501(C)(3) LINE 3 CHI-SVHS
 
 
No
(42)CHI ST VINCENT HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125064
HOLDING CO AR 501(C)(3) LINE 12A, I SVIMC
 
 
No
(43)CHI ST VINCENT MEDICAL GROUP HOT SPRINGS
300 WERNER ST

HOT SPRINGS,AR71913
26-1125131
PHYSICIANS AR 501(C)(3) LINE 3 CHI-SVHS
 
 
No
(44)COMMONSPIRIT HEALTH
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
47-0617373
HEALTHCARE CO 501(C)(3) LINE 12A, I N/A
 
No
(45)COMMONSPIRIT HEALTH FOUNDATION
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
85-3374038
FUNDRAISING FOUNDATION CO 501(C)(3) LINE 7 CSH
 
 
No
(46)COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC
185 BERRY STREET STE 200

SAN FRANCISCO,CA94107
85-0919176
OPERATING INVESTMENTS DE 501(C)(3) LINE 12A, I CSH
 
 
No
(47)COMMONSPIRIT HEALTH RESEARCH INSTITUTE
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
27-1050565
RESEARCH CO 501(C)(3) LINE 12A, I CSH
 
 
No
(48)COMMUNITY HOSPITAL OF SAN BERNARDINO
1805 MEDICAL CENTER DRIVE

SAN BERNARDINO,CA92411
95-1643373
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(49)COMMUNITY LIMITED CARE DIALYSIS CENTER
625 EDEN PARK DRIVE 7TH FLOOR

CINCINNATI,OH45202
23-7419853
HOLDING CO OH 501(C)(2)   GSH
 
 
No
(50)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION
631 N 8TH ST

MISSOURI VALLEY,IA51555
42-1294399
FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AH-CMHMV
 
 
No
(51)CONTINUING CARE HOSPITAL
ONE SAINT JOSEPH DRIVE

LEXINGTON,KY40504
61-1400619
HOSPITAL KY 501(C)(3) LINE 3 SJHS
 
 
No
(52)DIGNITY COMMUNITY CARE
185 BERRY STREET STE 200

SAN FRANCISCO,CA94107
81-5009488
HOSPITAL CO 501(C)(3) LINE 3 CSH
 
 
No
(53)DIGNITY HEALTH CONNECTED LIVING
200 MERCY OAKS DRIVE

REDDING,CA96003
23-7115371
SENIOR CENTER SERVICES CA 501(C)(3) LINE 7 DIGNITY HEALTH
 
Yes
 
(54)DIGNITY HEALTH FOUNDATION
185 BERRY STREET STE 200

SAN FRANCISCO,CA94107
46-2037641
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(55)DIGNITY HEALTH FOUNDATION - INLAND EMPIRE
2101 N WATERMAN AVENUE

SAN BERNARDINO,CA92404
23-7440086
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(56)DIGNITY HEALTH FOUNDATION EAST VALLEY
475 SOUTH DOBSON ROAD

CHANDLER,AZ85224
74-2418514
FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(57)DIGNITY HEALTH MEDICAL FOUNDATION
3400 DATA DRIVE

RANCHO CORDOVA,CA95670
68-0220314
MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE
 
 
No
(58)DOMINICAN HEALTH SERVICES
1555 SOQUEL DRIVE

SANTA CRUZ,CA95065
77-0056778
COMMUNITY HEALTH SYSTEM CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(59)DOMINICAN HOSPITAL FOUNDATION
1555 SOQUEL DRIVE

SANTA CRUZ,CA95065
94-2450442
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(60)DOMINICAN OAKS CORPORATION
1555 SOQUEL DRIVE

SANTA CRUZ,CA95065
77-0127719
OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS CA 501(C)(3) LINE 10 DOMINICAN HEALTH SERVICES
 
 
No
(61)EAST TEXAS CLINICAL SERVICES
101 VISION PARK SUITE 100

SHENANDOAH,TX77384
45-4736213
HEALTHCARE TX 501(C)(3) LINE 12A, I SLHS
 
 
No
(62)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION
1455 BATTERSBY AVE

ENUMCLAW,WA98022
91-0715805
HOSPITAL WA 501(C)(3) LINE 3 FHS
 
 
No
(63)FLAGET HEALTHCARE INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
61-1345363
HOSPITAL KY 501(C)(3) LINE 3 KOH
 
 
No
(64)FLAGET MEMORIAL HOSPITAL FOUNDATION INC
4305 NEW SHEPHERDSVILLE RD

BARDSTOWN,KY40004
56-2351341
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I FH
 
 
No
(65)FRANCISCAN CARE CENTER
4111 N HOLLAND-SYLVANIA RD

TOLEDO,OH43623
34-1931806
HEALTHCARE OH 501(C)(3) LINE 10 CHILC
 
 
No
(66)FRANCISCAN FOUNDATION
1717 SOUTH J ST

TACOMA,WA98405
91-1145592
FUNDRAISING FOUNDATION WA 501(C)(3) LINE 10 FHS
 
 
No
(67)FRANCISCAN HEALTH SYSTEM
1717 SOUTH J ST

TACOMA,WA98405
91-0564491
HOSPITAL WA 501(C)(3) LINE 3 CSH
 
 
No
(68)FRANCISCAN MEDICAL GROUP
1313 BROADWAY STE 200

TACOMA,WA98402
91-1939739
PHYSICIANS WA 501(C)(3) LINE 10 FHS
 
 
No
(69)FRENCH HOSPITAL MEDICAL CENTER FOUNDATION
1911 JOHNSON AVENUE

SAN LUIS OBISPO,CA93401
20-3256125
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE
 
 
No
(70)GARRISON MEMORIAL HOSPITAL
407 THIRD AVENUE SOUTHEAST

GARRISON,ND58540
45-0227752
HOSPITAL ND 501(C)(3) LINE 3 SAMC
 
 
No
(71)GLENDALE MEMORIAL HEALTH FOUNDATION
1420 SOUTH CENTRAL AVENUE

GLENDALE,CA91204
95-3625651
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE
 
 
No
(72)GLOBAL HEALTH INITIATIVES
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
20-1536108
INACTIVE CO 501(C)(3) LINE 12A, I CSH
 
 
No
(73)GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE
625 EDEN PARK DRIVE 7TH FLOOR

CINCINNATI,OH45202
31-1778403
EDUCATION OH 501(C)(3) LINE 2 GSH
 
 
No
(74)GOOD SAMARITAN HOSPITAL
PO BOX 1990

KEARNEY,NE68848
47-0379755
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(75)GOOD SAMARITAN HOSPITAL FOUNDATION
111 W 31ST ST

KEARNEY,NE68847
47-0659443
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 GSH-KN
 
 
No
(76)GOOD SAMARITAN HOSPITAL FOUNDATION OF CINCINNATI INC
625 EDEN PARK DRIVE 7TH FLOOR

CINCINNATI,OH45202
31-1206047
FUNDRAISING FOUNDATION OH 501(C)(3) LINE 12A, I GSH
 
 
No
(77)HARRISON MEDICAL CENTER
2520 CHERRY AVE

BREMERTON,WA98310
91-0565546
HOSPITAL WA 501(C)(3) LINE 3 FHS
 
 
No
(78)HEALTHCARE AND WELLNESS FOUNDATION
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
76-0761782
FUNDRAISING FOUNDATION MN 501(C)(3) LINE 12A, I SFMC-MN
 
 
No
(79)HOUSE OF MERCY
1111 6TH AVE

DES MOINES,IA50314
42-1323808
ASSISTED LIVING IA 501(C)(3) LINE 7 CHI-IA CORP
 
 
No
(80)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC
ONE SAINT JOSEPH DRIVE

LEXINGTON,KY40504
61-1029768
HOSPITAL KY 501(C)(3) LINE 3 KOH
 
 
No
(81)KENTUCKYONE HEALTH MEDICAL GROUP INC
100 E LIBERTY ST STE 800

LOUISVILLE,KY40202
61-1352729
PHYSICIANS KY 501(C)(3) LINE 10 JHSMH
 
 
No
(82)KENTUCKYONE HEALTH INC
ONE SAINT JOSEPH DRIVE

LEXINGTON,KY40504
61-1029769
HEALTHCARE KY 501(C)(3) LINE 12A, I CSH
 
 
No
(83)LAKEWOOD HEALTH CENTER
600 MAIN AVE S

BAUDETTE,MN56623
41-0758434
HOSPITAL MN 501(C)(3) LINE 3 CSH
 
 
No
(84)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION
600 MAIN AVE S

BAUDETTE,MN56623
41-1893795
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 7 LHC
 
 
No
(85)LEGACY FOUNDATION OF KENTUCKIANA INC
1451 HARRODSBURG RD STE D-308

LEXINGTON,KY40504
83-2170324
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I KOH
 
 
No
(86)LISBON AREA HEALTH SERVICES
905 MAIN ST

LISBON,ND58054
82-0558836
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(87)LUFKIN VISION ACQUISITIONS
PO BOX 1447

LUFKIN,TX75901
82-0563768
PROPERTY MGMT TX 501(C)(3) LINE 12A, I MHSET
 
 
No
(88)MADISON ST JOSEPH HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2761145
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(89)MADONNA MANOR INC
2344 AMSTERDAM ROAD

VILLA HILLS,KY51017
61-0654635
ASSISTED LIVING KY 501(C)(3) LINE 10 CHILC
 
 
No
(90)MARIAN REGIONAL MEDICAL CENTER FOUNDATION
1400 E CHURCH STREET

SANTA MARIA,CA93454
95-3818027
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(91)MARK TWAIN MEDICAL CENTER
768 MOUNTAIN RANCH ROAD

SAN ANDREAS,CA95249
68-0127677
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(92)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-1839548
FUNDRAISING FOUNDATION TN 501(C)(3) LINE 7 MHCS
 
 
No
(93)MEMORIAL HEALTH CARE SYSTEM INC
2525 DE SALES AVE

CHATTANOOGA,TN37404
62-0532345
HOSPITAL TN 501(C)(3) LINE 3 CSH
 
 
No
(94)MEMORIAL HEALTH PARTNERS FOUNDATION INC
5600 BRAINERD RD STE 500

CHATTANOOGA,TN37411
03-0417049
HEALTHCARE TN 501(C)(3) LINE 10 MHCS
 
 
No
(95)MEMORIAL HEALTH SYSTEM OF EAST TEXAS
PO BOX 1447

LUFKIN,TX75902
75-0755367
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(96)MEMORIAL MEDICAL CENTER-LIVINGSTON
PO BOX 1447

LUFKIN,TX75902
76-0436439
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(97)MEMORIAL MEDICAL CENTER-SAN AUGUSTINE
PO BOX 1447

LUFKIN,TX75902
75-2663904
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(98)MEMORIAL MULTISPECIALTY ASSOCIATES
1201 FRANK AVE

LUFKIN,TX75904
75-2721155
PHYSICIANS TX 501(C)(3) LINE 12A, I MHSET
 
 
No
(99)MEMORIAL SPECIALTY HOSPITAL
PO BOX 1447

LUFKIN,TX75902
75-2492741
INACTIVE TX 501(C)(3) LINE 3 MHSET
 
 
No
(100)MERCY AUXILIARY OF CENTRAL IOWA
1111 6TH AVE

DES MOINES,IA50314
42-6076069
AUXILIARY IA 501(C)(3) LINE 12A, I MF-DM IA
 
 
No
(101)MERCY CLINICS INC
1111 6TH AVE

DES MOINES,IA50314
42-1193699
PHYSICIANS IA 501(C)(3) LINE 10 CHI-IA CORP
 
 
No
(102)MERCY COLLEGE OF HEALTH SCIENCES
1111 6TH AVE

DES MOINES,IA50314
42-1511682
EDUCATION IA 501(C)(3) LINE 2 CHI-IA CORP
 
 
No
(103)MERCY FOUNDATION BAKERSFIELD
PO BOX 119

BAKERSFIELD,CA93302
77-0201321
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(104)MERCY FOUNDATION NORTH
2625 EDITH AVENUE SUITE E

REDDING,CA96001
94-3136799
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I N/A
 
No
(105)MERCY FOUNDATION OF DES MOINES IA
1111 6TH AVE

DES MOINES,IA50314
23-7358794
FUNDRAISING FOUNDATION IA 501(C)(3) LINE 7 CHI-IA CORP
 
 
No
(106)MERCY FOUNDATION INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-6088946
FUNDRAISING FOUNDATION OR 501(C)(3) LINE 7 MMC - ROSEBURG
 
 
No
(107)MERCY FOUNDATION SACRAMENTO
3400 DATA DRIVE 3RD FLR

RANCHO CORDOVA,CA95670
23-7072762
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I N/A
 
No
(108)MERCY HEALTH CARE FOUNDATION
PO BOX 368

CORNING,IA50841
42-1461064
FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AHMH-CORNING
 
 
No
(109)MERCY HEALTHCARE FOUNDATION
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0435338
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I MHVC
 
 
No
(110)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS
800 MERCY DR

COUNCIL BLUFFS,IA51503
42-1178204
FUNDRAISING FOUNDATION IA 501(C)(3) LINE 12A, I AHBMHS
 
 
No
(111)MERCY HOSPITAL OF DEVILS LAKE
1031 7TH ST NE

DEVILS LAKE,ND58301
45-0227012
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(112)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION
1031 7TH ST NE

DEVILS LAKE,ND58301
35-2367360
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 7 MHDL
 
 
No
(113)MERCY HOSPITAL OF VALLEY CITY
570 CHAUTAUQUA BLVD

VALLEY CITY,ND58072
45-0226553
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(114)MERCY MCMAHON TERRACE
3865 J STREET

SACRAMENTO,CA95816
68-0117340
SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES CA 501(C)(3) LINE 10 DIGNITY HEALTH
 
Yes
 
(115)MERCY MEDICAL CENTER
1301 15TH AVE WEST

WILLISTON,ND58801
45-0231183
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(116)MERCY MEDICAL CENTER - CENTERVILLE
ONE ST JOSEPHS DRIVE

CENTERVILLE,IA52544
42-0680308
HOSPITAL IA 501(C)(3) LINE 3 CHI-IA CORP
 
 
No
(117)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER
204 N 4TH AVE E

NEWTON,IA50314
42-1470935
HOSPITAL IA 501(C)(3) LINE 3 CHI-IA CORP
 
 
No
(118)MERCY MEDICAL CENTER MERCED FOUNDATION
301 E 13TH STREET

MERCED,CA95340
77-0035928
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(119)MERCY MEDICAL CENTER INC
2700 STEWART PKWY

ROSEBURG,OR97471
93-0386868
HOSPITAL OR 501(C)(3) LINE 3 CSH
 
 
No
(120)MERCY MEDICAL FOUNDATION
1301 15TH AVE WEST

WILLISTON,ND58801
45-0381803
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I MMC WILLISTON
 
 
No
(121)NEBRASKA HEART HOSPITAL
7500 S 91ST ST

LINCOLN,NE68526
39-2031968
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(122)NORTHLAND HEALTHCARE ALLIANCE
2223 EAST ROSSER AVENUE

BISMARCK,ND58501
91-1845296
MANAGEMENT ND 501(C)(3) LINE 7 SAMC
 
 
No
(123)NORTHRIDGE HOSPITAL FOUNDATION
18300 ROSCOE BLVD

NORTHRIDGE,CA91328
23-7444901
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY COMMUNITY CARE
 
 
No
(124)OAKES COMMUNITY HOSPITAL
1200 N 7TH ST

OAKES,ND58474
45-0231675
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(125)OAKES COMMUNITY HOSPITAL FOUNDATION
1200 N 7TH ST

OAKES,ND58474
71-0966606
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I OCH
 
 
No
(126)PACIFIC CENTRAL COAST HEALTH CENTERS
1400 E CHURCH STREET

SANTA MARIA,CA93454
77-0447575
CLINIC CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(127)PINEYWOODS MEDICAL DEVELOPMENT CORP
PO BOX 1447

LUFKIN,TX75902
75-2493116
PROPERTY MGMT TX 501(C)(3) LINE 12A, I MHSET
 
 
No
(128)PORT CITY OPERATING COMPANY LLC
3400 DATA DRIVE

RANCHO CORDOVA,CA95670
46-5322209
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY HEALTH
 
Yes
 
(129)PROVIDENCE CARE CENTER
2025 HAYES AVENUE

SANDUSKY,OH44870
34-1658625
LTERM CARE OH 501(C)(3) LINE 10 CHILC
 
 
No
(130)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION
5055 PROVIDENCE DRIVE

SANDUSKY,OH44870
34-1896807
LIVING COMM OH 501(C)(3) LINE 10 CHILC
 
 
No
(131)SAINT CLARE'S COMMUNITY CARE INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
22-2876836
INACTIVE NJ 501(C)(3) LINE 12B, II SCHS
 
 
No
(132)SAINT CLARE'S HEALTH SERVICES INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
22-3639733
INACTIVE NJ 501(C)(3) LINE 10 CSH
 
 
No
(133)SAINT CLARE'S HOSPITAL INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
22-3319886
INACTIVE NJ 501(C)(3) LINE 3 SCHS
 
 
No
(134)SAINT ELIZABETH FOUNDATION
555 S 70TH ST

LINCOLN,NE68510
47-0625523
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 SERMC
 
 
No
(135)SAINT ELIZABETH HEALTH SERVICES
555 S 70TH ST

LINCOLN,NE68510
36-3233120
INACTIVE NE 501(C)(3) LINE 3 SERMC
 
 
No
(136)SAINT ELIZABETH REGIONAL MEDICAL CENTER
555 S 70TH ST

LINCOLN,NE68510
47-0379836
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(137)SAINT FRANCIS MEDICAL CENTER
2620 W FAIDLEY

GRAND ISLAND,NE68803
47-0376601
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(138)SAINT FRANCIS MEDICAL CENTER FOUNDATION
PO BOX 9804

GRAND ISLAND,NE68802
47-0630267
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 SFMC-NE
 
 
No
(139)SAINT FRANCIS MEMORIAL HOSPITAL
900 HYDE STREET

SAN FRANCISCO,CA94109
94-1156295
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(140)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC
305 ESTILL ST

BEREA,KY40403
26-0152877
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS
 
 
No
(141)SAINT JOSEPH HEALTH SYSTEM INC
ONE ST JOSEPHS DRIVE

LEXINGTON,KY40504
61-1334601
HOSPITAL KY 501(C)(3) LINE 3 KOH
 
 
No
(142)SAINT JOSEPH HOSPITAL FOUNDATION INC
701 BOB OLINK DR 200

LEXINGTON,KY40504
61-1159649
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 12A, I SJHS
 
 
No
(143)SAINT JOSEPH LONDON FOUNDATION INC
1001 SAINT JOSEPH LANE

LONDON,KY40741
26-0438748
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS
 
 
No
(144)SAINT JOSEPH MOUNT STERLING FOUNDATION INC
225 FALCON DR

MOUNT STERLING,KY40353
27-2884584
FUNDRAISING FOUNDATION KY 501(C)(3) LINE 7 SJHS
 
 
No
(145)SAINT JOSEPH'S HOSPITAL FOUNDATION
2500 FAIRWAY STREET

DICKINSON,ND58601
36-3418207
FUNDRAISING FOUNDATION ND 501(C)(3) LINE 12A, I SJHHC
 
 
No
(146)SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION
438 WEST LAS TUNAS DRIVE

SAN GABRIEL,CA91776
95-3430341
INACTIVE CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(147)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC
104 W 17TH ST

SCHUYLER,NE68661
36-3630014
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 12A, I AHMHS
 
 
No
(148)SEQUOIA HOSPITAL FOUNDATION
170 ALAMEDA DE LAS PULGAS

REDWOOD CITY,CA94062
94-2909990
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 7 N/A
 
No
(149)SIERRA NEVADA MEMORIAL-MINERS HOSPITAL
155 GLASSON WAY

GRASS VALLEY,CA95945
94-1439787
HOSPITAL CA 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(150)SJRMC JOPLIN MISSOURI
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
44-0545809
INACTIVE MO 501(C)(3) LINE 3 CSH
 
 
No
(151)ST FRANCIS FOUNDATION OF SANTA BARBARA
2323 DE LA VINA ST SUITE 104

SANTA BARBARA,CA93105
23-7137119
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(152)ST FRANCIS HOSPITAL SUPPORT CORPORATION
601 E MICHELTORENA STREET

SANTA BARBARA,CA93103
77-0022302
INACTIVE CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(153)ST JOHNS HEALTHCARE FOUNDATION
1600 NORTH ROSE AVENUE

OXNARD,CA93030
20-2865781
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(154)ST JOSEPHS FOUNDATION
350 WEST THOMAS ROAD

PHOENIX,AZ85013
94-2941245
FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(155)ST JOSEPHS FOUNDATION OF SAN JOAQUIN
1800 N CALIFORNIA STREET

STOCKTON,CA95204
51-0432777
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(156)ST MARY MEDICAL CENTER FOUNDATION
1050 LINDEN AVENUE

LONG BEACH,CA90813
23-7153876
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(157)ST MARY PROFESSIONAL BUILDING INC
1050 LINDEN AVENUE

LONG BEACH,CA90813
23-7373088
INACTIVE CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(158)ST MARYS MEDICAL CENTER FOUNDATION
450 STANYAN STREET

SAN FRANCISCO,CA94117
94-3336143
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(159)ST ROSE DOMINICAN HEALTH FOUNDATION
3001 ST ROSE PARKWAY

HENDERSON,NV89052
88-0349432
FUNDRAISING FOUNDATION NV 501(C)(3) LINE 12A, I DIGNITY HEALTH
 
Yes
 
(160)ST ALEXIUS MEDICAL CENTER
900 EAST BROADWAY AVENUE

BISMARCK,ND58501
45-0226711
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(161)ST ANNE OC
1145 BROADWAY PLAZA STE 1200

TACOMA,WA98402
86-3590968
INACTIVE WA 501(C)(3) LINE 10 FHS
 
 
No
(162)ST ANTHONY HOSPITAL
2801 ST ANTHONY WAY

PENDLETON,OR97801
93-0391614
HOSPITAL OR 501(C)(3) LINE 3 CSH
 
 
No
(163)ST ANTHONY HOSPITAL FOUNDATION
2801 ST ANTHONY WAY

PENDLETON,OR97801
93-0992727
FUNDRAISING FOUNDATION OR 501(C)(3) LINE 12A, I SAH
 
 
No
(164)ST ANTHONY'S HOSPITAL ASSOCIATION
FOUR HOSPITAL DR

MORRILTON,AR72110
71-0245507
HOSPITAL AR 501(C)(3) LINE 3 SVIMC
 
 
No
(165)ST CATHERINE HOSPITAL
401 EAST SPRUCE ST

GARDEN CITY,KS67846
48-0543721
HOSPITAL KS 501(C)(3) LINE 3 CSH
 
 
No
(166)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION
401 EAST SPRUCE ST

GARDEN CITY,KS67846
20-0598702
FUNDRAISING FOUNDATION KS 501(C)(3) LINE 12A, I SCH
 
 
No
(167)ST CLARE COMMONS
12469 FIVE POINT ROAD

TOLEDO,OH43551
27-0163752
LIVING COMM OH 501(C)(3) LINE 10 CHILC
 
 
No
(168)ST DOMINIC OF ONTARIO OREGON
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
93-0433692
INVESTMENTS OR 501(C)(4)   CSH
 
 
No
(169)ST FRANCIS HOME
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0729978
LTERM CARE MN 501(C)(3) LINE 10 CSH
 
 
No
(170)ST FRANCIS LIFE CARE CORPORATION
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
22-2536017
INACTIVE NJ 501(C)(3) LINE 8 SCHS
 
 
No
(171)ST FRANCIS MEDICAL CENTER
2400 ST FRANCIS DR

BRECKENRIDGE,MN56520
41-0695598
HOSPITAL MN 501(C)(3) LINE 3 CSH
 
 
No
(172)ST JOSEPH FOUNDATION OF BRYAN TEXAS
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2351158
FUNDRAISING FOUNDATION TX 501(C)(3) LINE 12A, I SJSC
 
 
No
(173)ST JOSEPH MANOR
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2847594
LTERM CARE TX 501(C)(3) LINE 10 SJSC
 
 
No
(174)ST JOSEPH MEDICAL CENTER INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
52-0591461
INACTIVE MD 501(C)(3) LINE 3 CSH
 
 
No
(175)ST JOSEPH PHYSICIAN ASSOCIATES
2801 FRANCISCAN DRIVE

BRYAN,TX77802
20-3159302
PHYSICIANS TX 501(C)(3) LINE 3 SJSC
 
 
No
(176)ST JOSEPH PHYSICIAN ENTERPRISE INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
52-1311775
INACTIVE MD 501(C)(3) LINE 12A, I SJMC
 
 
No
(177)ST JOSEPH REGIONAL HEALTH CENTER
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-1282696
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(178)ST JOSEPH REGIONAL HEALTH PARTNERS
2801 FRANCISCAN DRIVE

BRYAN,TX77802
45-4088170
HOSPITAL TX 501(C)(3) LINE 3 SJSC
 
 
No
(179)ST JOSEPH REGIONAL HEALTH PARTNERS ACO
2801 FRANCISCAN DRIVE

BRYAN,TX77802
46-3265423
HEALTHCARE TX 501(C)(3) LINE 10 SJSC
 
 
No
(180)ST JOSEPH SERVICES CORPORATION
2801 FRANCISCAN DRIVE

BRYAN,TX77802
74-2455161
MANAGEMENT TX 501(C)(3) LINE 12A, I SLHS
 
 
No
(181)ST JOSEPH'S AREA HEALTH SERVICES
600 PLEASANT AVE

PARK RAPIDS,MN56470
41-0695603
HOSPITAL MN 501(C)(3) LINE 3 CSH
 
 
No
(182)ST JOSEPH'S HOSPITAL AND HEALTH CENTER
2500 FAIRWAY ST

DICKINSON,ND58601
45-0226429
HOSPITAL ND 501(C)(3) LINE 3 CSH
 
 
No
(183)ST LEONARD
8100 CLYO ROAD

CENTERVILLE,OH45458
34-1940863
LIVING COMM OH 501(C)(3) LINE 10 CHILC
 
 
No
(184)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-1947374
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(185)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-0335902
HOSPITAL TX 501(C)(3) LINE 3 SLHS
 
 
No
(186)ST LUKE'S COMMUNITY HEALTH SERVICES
6624 FANNIN ST STE 1100

HOUSTON,TX77030
76-0536234
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(187)ST LUKE'S FOUNDATION
1213 HERMANN DRIVE STE 855

HOUSTON,TX77004
45-3811485
FUNDRAISING FOUNDATION TX 501(C)(3) LINE 7 SLHS
 
 
No
(188)ST LUKE'S HEALTH CLINICAL OPERATIONS
6624 FANNIN ST STE 2505

HOUSTON,TX77030
27-3733278
HOSPITAL TX 501(C)(3) LINE 3 SLHS
 
 
No
(189)ST LUKE'S HEALTH SYSTEM CORP
PO BOX 20269

HOUSTON,TX77225
76-0536232
MANAGEMENT TX 501(C)(3) LINE 12A, I CSH
 
 
No
(190)ST LUKE'S HOSPITAL AT THE VINTAGE
6624 FANNIN ST STE 2505

HOUSTON,TX77030
26-3734606
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(191)ST LUKE'S PROPERTIES CORPORATION
1213 HERMANN DRIVE STE 855

HOUSTON,TX77004
76-0531716
PROPERTY MGMT TX 501(C)(3) LINE 12A, I SLHS
 
 
No
(192)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION
6624 FANNIN ST STE 2505

HOUSTON,TX77030
45-4120549
PROPERTY MGMT TX 501(C)(3) LINE 12A, I SLCDC-SL
 
 
No
(193)ST MARY'S COMMUNITY HOSPITAL
1301 GRUNDMAN BOULEVARD

NEBRASKA CITY,NE68410
47-0443636
HOSPITAL NE 501(C)(3) LINE 3 CHI NEBRASKA
 
 
No
(194)ST MARY'S HOSPITAL FOUNDATION
1301 GRUNDMAN BLVD

NEBRASKA CITY,NE68410
47-0707604
FUNDRAISING FOUNDATION NE 501(C)(3) LINE 7 SMCH
 
 
No
(195)ST VINCENT FOUNDATION
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
51-0169537
FUNDRAISING FOUNDATION AR 501(C)(3) LINE 12A, I SVIMC
 
 
No
(196)ST VINCENT INFIRMARY MEDICAL CENTER
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0236917
HOSPITAL AR 501(C)(3) LINE 3 CSH
 
 
No
(197)ST VINCENT MEDICAL GROUP
TWO ST VINCENT CIRCLE

LITTLE ROCK,AR72205
71-0830696
PHYSICIANS AR 501(C)(3) LINE 10 SVIMC
 
 
No
(198)SYLVANIA FRANCISCAN HEALTH
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
34-1412964
HOLDING CO OH 501(C)(3) LINE 12A, I CSH
 
 
No
(199)SYLVANIA FRANCISCAN HEALTH FOUNDATION
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
45-5357161
INACTIVE OH 501(C)(3) LINE 12A, I SFH-OH
 
 
No
(200)THE COMMONS OF PROVIDENCE
5000 PROVIDENCE DRIVE

SANDUSKY,OH44870
34-1826097
ASSISTED LIVING OH 501(C)(3) LINE 10 CHILC
 
 
No
(201)THE COMMUNITY HOSPITAL OF BRAZOSPORT
100 MEDICAL DRIVE

LAKE JACKSON,TX77566
74-1385192
HOSPITAL TX 501(C)(3) LINE 3 SLH-CO
 
 
No
(202)THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH
625 EDEN PARK DRIVE 7TH FLOOR

CINCINNATI,OH45202
31-0537486
HOSPITAL OH 501(C)(3) LINE 3 CSH
 
 
No
(203)THE PHYSICIAN NETWORK
2000 Q ST STE 500

LINCOLN,NE68503
47-0780857
PHYSICIANS NE 501(C)(3) LINE 12A, I CHI NEBRASKA
 
 
No
(204)TOTAL HEALTHCARE
9100 E MINERAL CIRCLE

CENTENNIAL,CO80112
84-0927232
INACTIVE CO 501(C)(3) LINE 3 CHIC
 
 
No
(205)TRINITY HEALTH FOUNDATION
380 SUMMIT AVENUE

STEUBENVILLE,OH43952
31-1329423
FUNDRAISING FOUNDATION OH 501(C)(3) LINE 12A, I THS
 
 
No
(206)TRINITY HEALTH SYSTEM
380 SUMMIT AVENUE

STEUBENVILLE,OH43952
34-1818681
HEALTHCARE OH 501(C)(3) LINE 12A, I N/A
 
No
(207)TRINITY HOSPITAL TWIN CITY
819 NORTH FIRST STREET

DENNISON,OH44621
27-5401105
HOSPITAL OH 501(C)(3) LINE 3 THS
 
 
No
(208)TRI-STATE HEALTH SERVICES INC
ONE ROSS PARK BLVD

STEUBENVILLE,OH43952
34-1522484
ASSISTED LIVING OH 501(C)(3) LINE 7 THS
 
 
No
(209)UNITY FAMILY HEALTHCARE
815 SE 2ND ST

LITTLE FALLS,MN56345
41-0721642
HOSPITAL MN 501(C)(3) LINE 3 CSH
 
 
No
(210)VILLA NAZARETH INC
801 PAGE DR

FARGO,ND58103
45-0226714
LTERM CARE ND 501(C)(3) LINE 10 CSH
 
 
No
(211)VISITING NURSE ASSOCIATION OF ST CLARE'S INC
198 INVERNESS DRIVE WEST

ENGLEWOOD,CO80112
22-1768334
INACTIVE NJ 501(C)(3) LINE 10 SCHS
 
 
No
(212)WOODLAND MEMORIAL HOSPITAL FOUNDATION
1321 COTTONWOOD STREET 305

WOODLAND,CA95695
94-6167964
FUNDRAISING FOUNDATION CA 501(C)(3) LINE 7 N/A
 
No
(213)YAVAPAI COMMUNITY HOSPITAL ASSOCIATION
1003 WILLOW CREEK ROAD

PRESCOTT,AZ86301
86-0098923
HOSPITAL AZ 501(C)(3) LINE 3 DIGNITY COMMUNITY CARE
 
 
No
(214)YAVAPAI REGIONAL MEDICAL CENTER FOUNDATION
1003 WILLOW CREEK ROAD

PRESCOTT,AZ86301
86-1038463
FUNDRAISING FOUNDATION AZ 501(C)(3) LINE 12A, I YCHA DBA YRMC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) AMERICAN MERCY HOME CARE LLC

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
83-0486150
HOME HEALTH OH N/A
N/A       No     No  
(2) ARIZONA CARE NETWORK - NEXT LLC

4222 E THOMAS RD STE 400
PHOENIX,AZ85018
47-4696671
CARE NETWORK AZ N/A
N/A       No     No  
(3) ARIZONA CARE NETWORK LLC (ACN LLC)

4222 E THOMAS RD STE 400
PHOENIX,AZ85013
45-4494682
CARE NETWORK AZ N/A
N/A       No     No  
(4) ARIZONA DIAGNOSTIC RADIOLOGY GROUP LLC

1510 COTNER AVENUE
LOS ANGELES,CA90025
85-1067265
DIAGNOSTIC SERVICES CA N/A
N/A       No     No  
(5) AUDUBON LAND COMPANY LLC

630 SOUTHPOINTE COURT 200
COLORADO SPRINGS,CO80906
84-1513085
REAL ESTATE CO N/A
N/A       No     No  
(6) BAYLOR CHI ST LUKES HEALTH SERVICES LLC

3100 MAIN STE 566
HOUSTON,TX77002
47-2079184
HEALTHCARE SRVC TX N/A
N/A       No     No  
(7) BERGAN MERCY SURGERY CENTER LLC

7500 MERCY RD STE 4300
OMAHA,NE68124
20-8671994
AMBUL SURG CTR NE N/A
N/A       No     No  
(8) BERYWOOD OFFICE PROPERTIES LLC

2501 CITICO AVENUE
CHATTANOGA,TN37404
62-1875199
PHYS OFFICE TN N/A
N/A       No     No  
(9) BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD

709 WING ON PLAZA 62 MODY ROAD TS
HONG KONG    
CH
HEALTH SERVICES CH N/A
N/A       No     No  
(10) BLUEGRASS REGIONAL IMAGING CENTER

1218 SOUTH BROADWAY STE 310
LEXINGTON,KY40504
61-1386736
DIAGNOSTIC IMAGING KY N/A
N/A       No     No  
(11) CBCC OUTSMARTING CANCER LLC

6501 TRUXTUN AVENUE
BAKERSFIELD,CA93309
46-1602286
RADIATION / ONCOLOGY CA DIGNITY HEALTH
 
RELATED -678,075 8,105,790   No   Yes   51.000 %
(12) CENTRAL NEBRASKA REHABILITATION SVCS LLC

3004 W FAIDLEY AVE
GRAND ISLAND,NE68803
81-0653461
PHYSICAL THERAPY NE N/A
N/A       No     No  
(13) CENTURA SUMMIT ORTHOPEDICS LLC

68 SCHOOL RD
FRISCO,CO80443
87-1308304
HEALTHCARE SRVC CO N/A
N/A       No     No  
(14) CHICAMSURG SURGERY CENTERS LLC

1A BURTON HILLS BLVD
NASHVILLE,TN37215
46-5683027
SURGERY CENTER CO N/A
N/A       No     No  
(15) COLORADO SPRINGS CK LEASING LLC

630 SOUTHPOINTE COURT 200
COLORADO SPRINGS,CO80906
26-2982714
REAL ESTATE CO N/A
N/A       No     No  
(16) COMMUNITY MERCY HOME CARE OF SPRINGFLD LLC

6281 TRI RIDGE BLVD 300
LOVELAND,OH45150
31-1746556
HOME HEALTH OH N/A
N/A       No     No  
(17) DE JV LLC

8686 NEW TRAILS DRIVE
THE WOODLANDS,TX77381
32-0496548
EMERGENCY CARE NV DIGNITY HEALTH
 
RELATED 5,739,267 14,218,548   No     No 51.000 %
(18) DHHP SURGERY CENTERS LLC

1513 S GRAND AVENUE STE 350
LOS ANGELES,CA90015
83-1847466
SURGERY DE N/A
N/A       No     No  
(19) DHRT HOLDINGS LLC

185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
35-2484591
HOLDING COMPANY DE DIGNITY HEALTH
 
RELATED 266,255,620 44,846,337   No   Yes   71.220 %
(20) DIGNITY- GOHEALTHURGENT CARE MANAGEMENT LLC

5555 GLENRIDGE CONNECTOR SUITE 700
ATLANTA,GA30342
35-2548698
MANAGEMENT SERVICES DE N/A
N/A       No     No  
(21) DIGNITY HEALTH AT HOME LLC

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
82-4674115
HEALTHCARE SRVC DE N/A
N/A       No     No  
(22) DIGNITY HEALTH SPECIALTY PHARMACY LLC

185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
32-0589462
SPECIALTY PHARMACY SERVICES DE N/A
N/A       No     No  
(23) DIGNITY HOME RECOVERY CARE LLC

49 MUSIC SQUARE WEST SUITE 401
NASHVILLE,TN37203
83-2832522
HOME RECOVERY PROGRAM DE N/A
N/A       No     No  
(24) DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC

14201 DALLAS PARKWAY
DALLAS,TX75254
20-2999237
SURGERY TX N/A
N/A       No     No  
(25) DIGNITYUSP NORCAL SURGERY CENTERS LLC

14201 DALLAS PARKWAY
DALLAS,TX75254
20-2468509
SURGERY TX N/A
N/A       No     No  
(26) DIGNITYUSP PHOENIX SURGERY CENTERS LLC

14201 DALLAS PARKWAY
DALLAS,TX75254
13-4248908
SURGERY TX N/A
N/A       No     No  
(27) DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC

14201 DALLAS PARKWAY
DALLAS,TX75254
35-2584991
SURGERY TX N/A
N/A       No     No  
(28) DIGNITY-ABRAZO HEALTH NETWORK LLC

4222 E THOMAS RD STE 400
PHOENIX,AZ85018
46-5477985
MANAGEMENT SERVICES AZ N/A
N/A       No     No  
(29) DOMINICAN MAGNETIC RESONANCE IMAGING CENTER

1545 SOQUEL DRIVE
SANTA CRUZ,CA94065
77-0095477
IMAGING CENTER CA DIGNITY HEALTH
 
RELATED -330,993 143,520   No   Yes   80.000 %
(30) ECCS ACQUISITION COMPANY LLC

2940 NORTH CIRCLE DRIVE
COLORADO SPRINGS,CO80909
35-2656413
AMBUL SURG CTR CO N/A
N/A       No     No  
(31) ENDOSCOPY CENTER OF ARKANSAS

1024 NORTH UNIVERSITY AVE
LITTLE ROCK,AR72207
20-1337002
DIAGNOSTIC SERVICES AR N/A
N/A       No     No  
(32) FOLSOM SIERRA ENDOSCOPY CENTER LP

1671 CREEKSIDE DRIVE SUITE 100
FOLSOM,CA95630
68-0482416
ENDOSCOPY CA DIGNITY HEALTH
 
RELATED -4,903 293,275   No   Yes   51.000 %
(33) FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC

6622 WOLLOCHET DR NW
GIG HARBOR,WA98335
46-3494108
REAL ESTATE WA N/A
N/A       No     No  
(34) FRANCISCAN SPECIALTY CARE LLC

330 SEVEN SPRINGS WAY
BRENTWOOD,TN37027
81-3725123
HEALTHCARE SRVC WA N/A
N/A       No     No  
(35) GOLDEN RIDGE SURGERY CENTER LLC

660 GOLDEN RIDGE RD 100
GOLDEN,CO80401
84-1498087
HEALTHCARE SRVC CO N/A
N/A       No     No  
(36) GOOD SAMARITAN HOME CARE SVCS OF VINCENNE LLC

6281 TRI RIDGE BLVD 300
LOVELAND,OH45150
20-1792869
HOME HEALTH OH N/A
N/A       No     No  
(37) HC SL VINTAGE I LLC

1400 N WATER ST STE 500
MILWAUKEE,WI53202
27-0453767
PROPERTY HOLDING WI N/A
N/A       No     No  
(38) HEALTHCARE SUPPORT SERVICES LLC

PO BOX 9804
GRAND ISLAND,NE68802
72-1546196
LAUNDRY NE N/A
N/A       No     No  
(39) HEARTLAND ONCOLOGY LLC

2337 E CRAWFORD ST
SALINA,KS67402
46-4265403
ONCOLOGY KS N/A
N/A       No     No  
(40) LAKESIDE AMBULATORY SURGICAL CENTER LLC

17030 LAKESIDE HILLS PLAZA STE 110
OMAHA,NE68130
20-4267902
AMBUL SURG CTR NE N/A
N/A       No     No  
(41) LAKESIDE ENDOSCOPY CENTER LLC

17001 LAKESIDE HILLS PLZ STE 201
OMAHA,NE68130
20-5544496
ENDOSCOPY SRVC NE N/A
N/A       No     No  
(42) LEXINGTON MBO PARTNERS LTD

5050 SOUTH SYRACUSE ST STE 800
DENVER,CO80237
65-1132855
REAL ESTATE CO N/A
N/A       No     No  
(43) LINCOLN CK LEASING LLC

555 SOUTH 70TH STREET
LINCOLN,NE68510
26-2496856
REAL ESTATE NE N/A
N/A       No     No  
(44) MEMORIAL MEDICAL PLAZA

3838 SAN DIMAS SUITE B 201
BAKERSFIELD,CA93301
36-4510880
REAL ESTATE CA N/A
N/A       No     No  
(45) MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC

2740 M STREET
MERCED,CA95340
94-3358445
MANAGEMENT OF CANCER CENTER CA DIGNITY HEALTH
 
RELATED 2,134,355 8,830,055   No   Yes   50.000 %
(46) MERCY REHABILITATION HOSPITAL LLC

330 SEVEN SPRINGS WAY
BRENTWOOD,TN37027
81-4437201
HEALTHCARE SRVC TX N/A
N/A       No     No  
(47) MILITARY ROAD PROPERTIES LLC

18229 TERRACE COURT SW
NORMANDY PARK,WA98166
91-2067879
REAL ESTATE WA N/A
N/A       No     No  
(48) NEBRASKA SPINE HOSPITAL LLC

6901 N 72ND ST STE 20300
OMAHA,NE68122
27-0263191
SPINE HOSPITAL NE N/A
N/A       No     No  
(49) NICU OPERATING CO OF SANTA CRUZ LLC

1555 SOQUEL DRIVE
SANTA CRUZ,CA95065
46-0502935
NEONATAL HEALTHCARE CA DIGNITY HEALTH
 
RELATED 5,256,218 22,596,965   No     No 51.000 %
(50) NORTH RIVER SURGERY CENTER LLC

2209 WILDWOOD AVE
SHERWOOD,AR72120
71-0799771
AMBUL SURG CTR AR N/A
N/A       No     No  
(51) NORTHERN PLAINS LABORATORY LLC

401 N 9 STREET
BISMARK,ND58501
84-1641341
DIAGNOSTIC SERVICES ND N/A
N/A       No     No  
(52) NSC CHANNEL ISLANDS LLC

569 BROOKWOOD VILLAGE SUITE 901
BIRMINGHAM,AL35209
77-0409291
AMBULATORY SURGICAL CENTER CA DIGNITY HEALTH
 
RELATED 364,166 744,543   No   Yes   51.000 %
(53) ORTHOCOLORADO LLC

11650 WEST 2ND PLACE
LAKEWOOD,CO80228
37-1577105
ORTHO HOSPITAL CO N/A
N/A       No     No  
(54) PARK RAPIDS AREA HEALTH CARE

600 PLEASANT AVENUE S
PARK RAPIDS,MN56470
20-4926259
HEALTHCARE SRVC MN N/A
N/A       No     No  
(55) PENINSULA RADIATION ONCOLOGY CENTER LLC

4230 BRIDGEPORT WAY W STE B
UNIVERSITY PLACE,WA98466
87-0808610
HEALTHCARE SRVC WA N/A
N/A       No     No  
(56) PENRAD IMAGING LLC

1390 KELLY JOHNSON BLVD
COLORADO SPRINGS,CO80920
84-1072619
MEDICAL IMAGING CO N/A
N/A       No     No  
(57) PERFORMANCE MED EQUIP & RESPIR SVSC LLC

19625 62ND AVE SOUTH 101
KENT,WA98032
45-2901632
HOLDING COMPANY WA N/A
N/A       No     No  
(58) PLAZA SURGERY CENTER LP

525 E PLAZA DRIVE SUITE 100
SANTA MARIA,CA93454
77-0573567
SURGERY CA N/A
N/A       No     No  
(59) PMC HOSPITAL LLC

3100 MAIN ST STE 500
HOUSTON,TX77002
27-3280598
HOSPITAL TX N/A
N/A       No     No  
(60) PRECISION MEDICINE ALLIANCE LLC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
35-2569159
DIAGNOSTIC SERVICES CO N/A
N/A       No     No  
(61) RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY

1700 N ROSE AVENUE SUITE 120
OXNARD,CA93030
77-0191706
IMAGING CA DIGNITY HEALTH
 
RELATED 125,640 514,888   No   Yes   50.000 %
(62) RBR MANAGEMENT LLC

91 CORPORATE PARK DRIVE SUITE 120
HENDERSON,NV89074
27-1466450
AMBULANCE NV DIGNITY HEALTH
 
RELATED 1,855,950 6,071,606   No     No 50.100 %
(63) REID-ANC HOME CARE SERVICES LLC

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
37-1454747
HOME HEALTH IN N/A
N/A       No     No  
(64) SAINT JOSEPH - SCA HOLDINGS LLC

1451 HARRODSBURG RD
LEXINGTON,KY40503
45-3801157
INACTIVE DE N/A
N/A       No     No  
(65) SAINT JOSEPH HEALTH ASC LLC

ONE SAINT JOSEPH DRIVE
LEXINGTON,KY40504
85-2155230
SURGERY KY N/A
N/A       No     No  
(66) SAINT JOSEPH-ANC HOME CARE SERVICES

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
26-3330545
HOME HEALTH KY N/A
N/A       No     No  
(67) SANTA CRUZ COMPREHENSIVE IMAGING LLC

1661 SOQUEL DRIVE SUITE G
SANTA CRUZ,CA95065
01-0550623
IMAGING CA DIGNITY HEALTH
 
RELATED 76,071 35,485   No   Yes   50.000 %
(68) SANTA CRUZ LAND & BUILDING LP

1555 SOQUEL DRIVE
SANTA CRUZ,CA95065
77-0285236
REAL ESTATE CA N/A
N/A       No     No  
(69) SANTA CRUZ SURGERY CENTER LLC

3003 PAUL SWEET ROAD
SANTA CRUZ,CA95065
77-0194916
SURGERY CA DIGNITY HEALTH
 
RELATED 622,844 371,306   No   Yes   50.000 %
(70) SEVEN OAKS SURGERY CENTER LLC

1801 ORANGE TREE LANE SUITE 200
REDLANDS,CA92374
85-1559544
SURGERY CA DIGNITY HEALTH
 
RELATED -796,171 336,137   No   Yes   25.000 %
(71) SOUTHEASTERN HOME CARE LLC

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
27-1219638
HOME HEALTH OH N/A
N/A       No     No  
(72) ST JOSEPH'S SURGERY CENTER LP

15305 DALLAS PARKWAY SUITE 1600 LB
ADDISON,TX75001
20-1019390
SURGERY TX N/A
N/A       No     No  
(73) ST ELIZABETH HOME CARE SERVICES LLC

6281 TRI RIDGE BLVD STE 300
LOVELAND,OH45150
26-1236191
HOME HEALTH KY N/A
N/A       No     No  
(74) ST FRANCIS LAND COMPANY

5390 N ACADEMY BLVD STE 300
COLORADO SPRINGS,CO80918
26-3134100
REAL ESTATE CO N/A
N/A       No     No  
(75) ST LUKE'S DIAGNOSTIC CATH LAB LLP

6624 FANNIN ST STE 800
HOUSTON,TX77030
71-0959365
DIAGNOSTIC SERVICES TX N/A
N/A       No     No  
(76) ST LUKE'S LAKESIDE HOSPITAL LLC

6624 FANNIN STE 2505
HOUSTON,TX77030
30-0427437
HOSPITAL TX N/A
N/A       No     No  
(77) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC

6624 FANNIN STE 800
HOUSTON,TX77030
46-2795726
DIAGNOSTIC SERVICES TX N/A
N/A       No     No  
(78) TEMPLETON SURGERY CENTER LLC

1310 LAS TABLAS ROAD SUITE 104
TEMPLETON,CA94365
20-2246616
SURGERY CA N/A
N/A       No     No  
(79) THE MEDICAL PAVILION AT ST JOHN'S

1600 ROSE AVENUE
OXNARD,CA93030
77-0332349
REAL ESTATE CA DIGNITY HEALTH
 
RELATED 19,483 1,612,836   No   Yes   25.000 %
(80) THREE SPRING IMAGING LLC

1 MERCADO ST STE 200A
DURANGO,CO81301
81-3571570
HEALTHCARE SRVC CO N/A
N/A       No     No  
(81) TIA ARIZONA LLC

3030 N CENTRAL AVENUE SUITE 1402
PHOENIX,AZ85012
86-3158670
CLINIC AZ N/A
N/A       No     No  
(82) VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC

18330 ROSCOE BLVD
NORTHRIDGE,CA91328
80-0864336
SURGERY CA N/A
N/A       No     No  
(83) WEST LAKES SURGERY CENTER LLC

12499 UNIVERSITY AVE STE 100
CLIVE,IA50325
20-5345295
HEALTHCARE SRVC IA N/A
N/A       No     No  
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) ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SVCS INC

12809 WEST DODGE RD
OMAHA,NE68154
47-0802396
MANAGED CARE NE N/A
C         No
(2) ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC

2801 FRANCISCAN DRIVE
BRYAN,TX77802
74-2466914
HEALTHCARE TX N/A
C         No
(3) ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
84-1112049
MANAGEMENT SERVICES CO N/A
C         No
(4) AMERICAN NURSING CARE INC

1700 EDISON DR
MILFORD,OH45150
31-1085414
HOME HEALTH OH N/A
C         No
(5) AMERIMED INC

1700 EDISON DR
MILFORD,OH45150
31-1158699
HOME HEALTH OH N/A
C         No
(6) BC HOLDING COMPANY INC

1850 BLUEGRASS AVE
LOUISVILLE,KY40215
31-1542851
INACTIVE KY N/A
C         No
(7) BRAZOSPORT HEALTH ALLIANCE

1 WEST WAY COURT
LAKE JACKSON,TX77566
76-0518376
HEALTHCARE TX N/A
C         No
(8) CADUCEUS MEDICAL ASSOCIATES INC

5600 BRAINERD ROAD STE 500
CHATTANOOGA,TN37411
62-1570736
HEALTHCARE TN N/A
C         No
(9) CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
27-2269511
INACTIVE CO N/A
C         No
(10) CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC

1201 W FRANK AVE
LUFKIN,TX75904
83-4184717
CONDO ASSOC TX N/A
C         No
(11) COASTAL SURGICAL SPECIALISTS INC

921 OAK PARK BLVD SUITE 101
PISMO BEACH,CA93449
74-3000596
AMBULATORY SURGERY CENTER CA DIGNITY HEALTH
 
S 2,648,221 1,642,814 50.710 % Yes  
(12) COMCARE SERVICES INC

9100 E MINERAL CIRCLE
CENTENNIAL,CO80112
84-0904813
INACTIVE CO N/A
C         No
(13) CONSOLIDATED HEALTH SERVICES

1700 EDISON DR
MILFORD,OH45150
31-1378212
HOME HEALTH OH N/A
C         No
(14) DES MOINES MEDICAL CENTER INC

1111 6TH AVE
DES MOINES,IA50314
42-0837382
REAL ESTATE IA N/A
C         No
(15) DIGNITY HEALTH HOLDING CORPORATION

185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
46-0675371
HOLDING CO NV N/A
C         No
(16) DIGNITY HEALTH INSURANCE LTD

PO BOX 1051 GRAND CAYMAN ISL
GRAND CAYMAN ISL    
CJ
98-1065338
CAPTIVE INSURANCE CJ DIGNITY HEALTH
 
C 7,540,875 58,902,559 100.000 % Yes  
(17) DIGNITY HEALTH PROVIDER RESOURCES INC

185 BERRY STREET SUITE 200
SAN FRANCISCO,CA94107
47-3366764
HEALTH PLAN CA N/A
C         No
(18) DIVERSIFIED HEALTH RESOURCES INC

100 MEDICAL DRIVE
LAKE JACKSON,TX77566
76-0222679
HEALTHCARE TX N/A
C         No
(19) FRANCISCAN CITY URGENT CARE SERVICES PS

C/O CPGUSA 1345 AVE OF THE AMERICAS
NEW YORK,NY10105
81-2174959
INACTIVE NY N/A
C         No
(20) FRANCISCAN SERVICES INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
23-2487967
HOLDING CO CO N/A
C         No
(21) GALLERIA PAVILION OWNERS' ASSOCIATION

800 N GIBSON RD
HENDERSON,NV89011
82-4275367
REAL ESTATE NV DIGNITY HEALTH
 
C 131,182 75,341 65.440 % Yes  
(22) GOOD SAMARITAN OUTREACH SERVICES

PO BOX 1990
KEARNEY,NE68848
47-0659440
MEDICAL CLINIC NE N/A
C         No
(23) HARVESTPLAINS HEALTH OF IOWA

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
47-3451750
INSURANCE WA N/A
C         No
(24) HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC

1400 E CHURCH STREET
SANTA MARIA,CA93454
77-0074057
HEALTH SERVICES CA N/A
C         No
(25) HEALTH SYSTEMS ENTERPRISES INC

PO BOX 1990
KEARNEY,NE68848
47-0664558
MGMT NE N/A
C         No
(26) HEALTHCARE MGMT SERVICES ORGANIZATION INC

1149 MARKET ST
TACOMA,WA98402
91-1865474
INACTIVE WA N/A
C         No
(27) HEARTLANDPLAINS HEALTH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4368223
INSURANCE NE N/A
C         No
(28) HIGHLINE MEDICAL GROUP

1717 S J STREET
TACOMA,WA98405
91-1407026
MEDICAL SERVICES WA N/A
C         No
(29) INTEGRATED MEDICAL SERVICES

9250 N 3RD STREET SUITE 4010
PHOENIX,AZ85020
86-0783428
MULTI-SPECIALTY PHYSICIANS GROUP AZ N/A
C         No
(30) MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC

300 WERNER ST
HOT SPRINGS,AR71913
71-0720429
REAL ESTATE AR N/A
C         No
(31) MEDQUEST

1301 15TH AVENUE WEST
WILLISTON,ND58801
45-0392137
SALE OF DME ND N/A
C         No
(32) MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC

1201 W FRANK AVE
LUFKIN,TX75904
46-3622849
INACTIVE TX N/A
C         No
(33) MERCY PARK APARTMENTS LTD

1111 6TH AVE
DES MOINES,IA50314
42-1202422
INACTIVE IA N/A
C         No
(34) MERCY SERVICES CORP

2700 STEWART PARKWAY
ROSEBURG,OR97471
93-0824308
RETAIL SALES OR N/A
C         No
(35) MHI CLINICAL SERVICES

1201 W FRANK AVE
LUFKIN,TX75904
46-1967952
HEALTHCARE TX N/A
C         No
(36) MILLENNIUM SURGERY CENTER INC

9300 STOCKDALE HWY 200
BAKERSFIELD,CA93311
77-0513445
OUTPAITENT SURGERY SERVICES CA N/A
S         No
(37) MOUNTAIN MANAGEMENT SERVICES INC

6028 SHALLOWFORD RD
CHATTANOOGA,TN37421
62-1570739
MGMT SVC ORG TN N/A
C         No
(38) NORTH CENTRAL HEALTH CARE ALLIANCE

PO BOX 5538
BISMARK,ND58506
45-0439894
HEALTHCARE ND N/A
C         No
(39) QUALCHOICE ADVANTAGE

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
47-3433912
INSURANCE WA N/A
C         No
(40) QUALCHOICE HEALTH PLAN SERVICES INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-1224037
ADMIN SERVICES CO N/A
C         No
(41) QUALCHOICE HEALTH INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-1222808
HOLDING CO CO N/A
C         No
(42) QUALCHOICE HOLDINGS INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
27-4075520
HOLDING CO AR N/A
C         No
(43) QUALCHOICE OF NEBRASKA

2401 S 73RD ST
OMAHA,NE68124
81-0738827
INACTIVE NE N/A
C         No
(44) RIVERLINK HEALTH

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4380824
INSURANCE OH N/A
C         No
(45) RIVERLINK HEALTH OF KENTUCKY INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
46-4828332
INSURANCE KY N/A
C         No
(46) ROSS PARK PHARMACY INC

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1832654
PHARMACY OH N/A
C         No
(47) SAINT CLARE'S PRIMARY CARE INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
22-2441202
INACTIVE NJ N/A
C         No
(48) SJH SERVICES CORPORATION

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
23-2307408
INACTIVE CO N/A
C         No
(49) SJL PHYSICIAN MANAGEMENT SERVICES INC

424 LEWIS HARGETT CR STE 160
LEXINGTON,KY40503
27-0164198
INACTIVE KY N/A
C         No
(50) SOUNDPATH HEALTH INC

32129 WEYERHAEUSER WAY S STE 201
FEDERAL WAY,WA98001
42-1720801
INSURANCE WA N/A
C         No
(51) ST MARY HEALTH VENTURES INC

1050 LINDEN AVENUE
LONG BEACH,CA90813
95-1912528
RETAIL PHARMACY CA DIGNITY HEALTH
 
C 1,503,301 15,459,549 100.000 % Yes  
(52) ST ANTHONY DEVELOPMENT COMPANY

1415 SOUTHGATE
PENDLETON,OR97801
93-1216943
ATHLETIC CLUB OR N/A
C         No
(53) ST JOSEPH DEVELOPMENT COMPANY INC

1717 SOUTH J ST
TACOMA,WA98405
91-1480569
RENTAL WA N/A
C         No
(54) ST LUKE'S HEALTH SYSTEM HOLDINGS INC

6624 FANNIN STE 800
HOUSTON,TX77030
76-0637138
HOLDING CO TX N/A
C         No
(55) ST VINCENT COMMUNITY HEALTH SERVICES INC

TWO ST VINCENT CIRCLE
LITTLE ROCK,AR72205
71-0710785
HEALTHCARE AR N/A
C         No
(56) STE HOLDINGS

12809 WEST DODGE RD
OMAHA,NE68154
82-2383629
HOLDING CO NE N/A
C         No
(57) SUGAR LAND DOCTOR GROUP

1317 LAKE POINT PARKWAY
SUGAR LAND,TX77478
45-4270163
INACTIVE TX N/A
C         No
(58) TOWSON MANAGEMENT INC

198 INVERNESS DRIVE WEST
ENGLEWOOD,CO80112
52-1710750
INACTIVE MD N/A
C         No
(59) TRINITY MANAGEMENT SERVICES ORGANIZATION

380 SUMMIT AVE
STEUBENVILLE,OH43952
34-1471026
MGMT SERVICES OH N/A
C         No
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
 
No
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) DIGNITY HEALTH CONNECTED LIVING

A 392,466 SEE PART VII
(2) DOMINICAN MAGNETIC RESONANCE IMAGING CENTER

A 102,341 SEE PART VII
(3) PORT CITY OPERATING COMPANY LLC

A 3,136,452 SEE PART VII
(4) ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION

B 704,085 SEE PART VII
(5) DIGNITY HEALTH CONNECTED LIVING

B 907,035 SEE PART VII
(6) DIGNITY HEALTH FOUNDATION

B 217,341 SEE PART VII
(7) DIGNITY HEALTH FOUNDATION - INLAND EMPIRE

B 569,737 SEE PART VII
(8) DIGNITY HEALTH FOUNDATION EAST VALLEY

B 1,519,596 SEE PART VII
(9) DOMINICAN HOSPITAL FOUNDATION

B 1,135,800 SEE PART VII
(10) MARIAN REGIONAL MEDICAL CENTER FOUNDATION

B 1,092,626 SEE PART VII
(11) MERCY FOUNDATION BAKERSFIELD

B 795,611 SEE PART VII
(12) MERCY MEDICAL CENTER FOUNDATION MERCED

B 718,526 SEE PART VII
(13) ST JOHN'S HEALTHCARE FOUNDATION

B 659,835 SEE PART VII
(14) ST JOSEPH'S FOUNDATION

B 1,977,954 SEE PART VII
(15) ST MARY MEDICAL CENTER FOUNDATION

B 1,370,168 SEE PART VII
(16) ST MARY'S MEDICAL CENTER FOUNDATION

B 812,664 SEE PART VII
(17) ST ROSE DOMINICAN HEALTH FOUNDATION

B 2,219,667 SEE PART VII
(18) ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION

C 476,247 SEE PART VII
(19) DIGNITY HEALTH FOUNDATION

C 7,989,350 SEE PART VII
(20) DIGNITY HEALTH FOUNDATION - INLAND EMPIRE

C 1,717,206 SEE PART VII
(21) DIGNITY HEALTH FOUNDATION EAST VALLEY

C 1,645,272 SEE PART VII
(22) DOMINICAN HOSPITAL FOUNDATION

C 2,566,239 SEE PART VII
(23) MARIAN REGIONAL MEDICAL CENTER FOUNDATION

C 2,890,890 SEE PART VII
(24) MERCY FOUNDATION BAKERSFIELD

C 1,809,740 SEE PART VII
(25) MERCY MEDICAL CENTER FOUNDATION MERCED

C 610,653 SEE PART VII
(26) PORT CITY OPERATING COMPANY LLC

C 550,929 SEE PART VII
(27) ST JOHN'S HEALTHCARE FOUNDATION

C 2,348,708 SEE PART VII
(28) ST JOSEPH'S FOUNDATION

C 4,872,756 SEE PART VII
(29) ST MARY MEDICAL CENTER FOUNDATION

C 3,971,684 SEE PART VII
(30) ST MARY'S MEDICAL CENTER FOUNDATION

C 1,756,791 SEE PART VII
(31) ST ROSE DOMINICAN HEALTH FOUNDATION

C 2,753,596 SEE PART VII
(32) COASTAL SURGICAL SPECIALISTS INC

K 113,967 SEE PART VII
(33) ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION

L 328,986 SEE PART VII
(34) DIGNITY HEALTH CONNECTED LIVING

L 290,793 SEE PART VII
(35) DIGNITY HEALTH FOUNDATION

L 173,580 SEE PART VII
(36) DIGNITY HEALTH FOUNDATION-INLAND EMPIRE

L 529,264 SEE PART VII
(37) DIGNITY HEALTH FOUNDATION EAST VALLEY

L 830,830 SEE PART VII
(38) DOMINICAN HOSPITAL FOUNDATION

L 679,217 SEE PART VII
(39) DOMINICAN OAKS CORPORATION

L 157,076 SEE PART VII
(40) MARIAN REGIONAL MEDICAL CENTER FOUNDATION

L 543,424 SEE PART VII
(41) MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC

L 2,011,056 SEE PART VII
(42) MERCY FOUNDATION BAKERSFIELD

L 425,893 SEE PART VII
(43) MERCY MCMAHON TERRACE

L 64,232 SEE PART VII
(44) MERCY MEDICAL CENTER FOUNDATION MERCED

L 380,489 SEE PART VII
(45) NICU OPERATING CO OF SANTA CRUZ LLC

L 4,897,240 SEE PART VII
(46) PORT CITY OPERATING COMPANY LLC

L 48,739,548 SEE PART VII
(47) ST FRANCIS FOUNDATION OF SANTA BARBARA

L 96,240 SEE PART VII
(48) ST JOHN'S HEALTHCARE FOUNDATION

L 468,388 SEE PART VII
(49) ST JOSEPH FOUNDATION OF SAN JOAQUIN

L 386,680 SEE PART VII
(50) ST JOSEPH'S FOUNDATION

L 1,148,381 SEE PART VII
(51) ST MARY HEALTH VENTURES

L 2,301,712 SEE PART VII
(52) ST MARY MEDICAL CENTER FOUNDATION

L 929,597 SEE PART VII
(53) ST MARY'S MEDICAL CENTER FOUNDATION

L 436,430 SEE PART VII
(54) ST ROSE DOMINICAN HEALTH FOUNDATION

L 1,085,936 SEE PART VII
(55) COASTAL SURGICAL SPECIALISTS INC

M 58,582 SEE PART VII
(56) RBR MANAGEMENT LLC

M 2,758,799 SEE PART VII
(57) CBCC OUTSMARTING CANCER LLC

S 331,500 SEE PART VII
(58) COASTAL SURGICAL SPECIALISTS INC

S 2,989,358 SEE PART VII
(59) DE JV LLC

S 4,600,200 SEE PART VII
(60) DHRT HOLDINGS LLC

S 319,515,172 SEE PART VII
(61) NICU OPERATING CO OF SANTA CRUZ LLC

S 846,847 SEE PART VII
(62) NSC CHANNEL ISLANDS LLC

S 322,009 SEE PART VII
(63) RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY

S 350,000 SEE PART VII
(64) RBR MANAGEMENT LLC

S 803,206 SEE PART VII
(65) SANTA CRUZ SURGERY CENTER LLC

S 450,000 SEE PART VII
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021
Schedule R (Form 990) 2021
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, TRANSACTION TYPE A DIGNITY HEALTH LEASES FACILITIES AND/OR EQUIPMENT TO CERTAIN RELATED ORGANIZATIONS (WHOLLY-OWNED ORGANIZATIONS 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, TRANSACTION TYPE B AND C 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 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, TRANSACTION TYPE K DIGNITY HEALTH LEASES FACILITY SPACE FROM A JOINT VENTURE FOR THE HOSPITAL'S CANCER PROGRAM. AMOUNTS REPORTED AS TRANSACTION TYPE "K" REPRESENT THE AMOUNTS PAID FOR SUCH AGREEMENTS. PART V, TRANSACTION TYPE L DIGNITY HEALTH FACILITIES PERFORM VARIOUS SERVICES FOR OTHER RELATED ORGANIZATIONS. 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 FISCAL YEAR 2022, DIGNITY HEALTH HOSPITALS ALSO PERFORMED OPERATIONAL SERVICES FOR OTHER RELATED ORGANIZATIONS INCLUDING PLANT MAINTENANCE, LAUNDRY SERVICES AND OTHER SERVICES AS DEEMED NECESSARY. THE SERVICES PERFORMED ARE REIMBURSED AT COST. PART V, TRANSACTION TYPE M LABORATORY SUPPORT SERVICES ARE PROVIDED TO DIGNITY HEALTH HOSPITALS BY PORT CITY OPERATING COMPANY LLC. A RELATED JOINT VENTURE PROVIDES AMBULANCE SERVICES TO DIGNITY HEALTH HOSPITALS LOCATED IN NEVADA. PART V, TRANSACTION TYPE S AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS AND TRANSFERS OF ASSETS FROM RELATED ORGANIZATIONS.
Schedule R (Form 990) 2021

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