TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Christopher Van Gorder...................................................................... President / CEO	58.0 ................. 2.0	X	X	4,288,837	53,166
(2) Don Goldman...................................................................... Trustee, Vice Chair	13.0 ................. 1.0	X	X	0	0
(3) Kevin T Hamilton...................................................................... Trustee, Chair	13.0 ................. 1.0	X	X	0	0
(4) Dan Feldman...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(5) Elliot A Scott...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(6) Gene H Barduson...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(7) Honorable Irma Gonzalez...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(8) Jan Caldwell...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(9) Jeff Bowman...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(10) John Boyer PhD...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(11) Nicole A Clay...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(12) Richard C Bigelow...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(13) Richard Vortmann...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(14) Robert Buell Esq...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(15) Shireen Matthews Esq...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(16) Theodore Thomas MD...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0
(17) William D Gore...................................................................... TRUSTEE	13.0 ................. 1.0	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Bradley Ellis........................................................................ Corp Sr. VP Chief Legal Officer	49.0 .......................1.0	X				1,217,297	52,990
(19) Brett Tande........................................................................ Treasurer / Exec VP, CFO	54.0 .......................1.0	X				1,271,424	55,883
(20) Mielle Schwartz........................................................................ Executive Assistant SR	40.0 .......................0	X				85,205	40,822
(21) Monique Gonzalez........................................................................ Executive Assistant to the CEO	50.0 .......................0	X				112,636	23,795
(22) Anil Keswani........................................................................ Corp EVP Chief Med & Ops Officer AMB	50.0 .......................0.0		X			1,262,283	59,584
(23) Barbara Price........................................................................ Corp Sr VP, Bus&Serv Line Dev	50.0 .......................0		X			1,176,303	65,603
(24) Carl Etter........................................................................ Chief Executive, Sr VP	50.0 .......................0		X			1,729,020	52,236
(25) Eric Cole........................................................................ Corp Sr. VP, Human Resources	50.0 .......................0		X			1,032,624	50,095
(26) Ghazala Sharieff........................................................................ Corp EVP Chief Med & Ops Officer Acute	50.0 .......................0		X			1,609,519	52,997
(27) John Engle........................................................................ Corp Sr. VP, Chief Development	50.0 .......................0		X			922,832	55,383
(28) June Komar........................................................................ Corp Exec VP, Strategy & Admin	50.0 .......................0		X			1,253,157	38,170
(29) Lisa RisserThakur........................................................................ Corp Sr. VP, Ancillary Ops (part year)	50.0 .......................0		X			1,602,599	14,713
(30) Richard Neale........................................................................ Corp Exec VP, Chief Growth Officer	40.0 .......................10.0		X			1,269,444	58,981
(31) Shane Thielman........................................................................ Corp SVP CIDO	50.0 .......................0		X			957,238	62,253
(32) Thomas Buchholz........................................................................ Corp Sr. VP, MD Anderson	50.0 .......................0		X			1,466,771	42,908
(33) Thomas Gammiere........................................................................ Chief Executive, Sr VP	50.0 .......................0		X			1,113,458	55,575
(34) Craig M Uejo........................................................................ Corp VP, Chief Quality Officer	50.0 .......................0			X		695,590	55,546
(35) Gerald Soderstrom........................................................................ Corp SVP Audit/Compliance	50.0 .......................0			X		722,139	56,099
(36) John Poole........................................................................ Corp VP, System Improvement	50.0 .......................0			X		800,718	31,325
(37) Sherman T Moore........................................................................ Corp VP, Business Development	50.0 .......................0			X		673,010	55,447
(38) Tracy Chu........................................................................ Corp VP, POP Hlth CHF EXEC/ACO	50.0 .......................0			X		789,595	34,777
(39) Richard Rothberger........................................................................ Former Officer	0.0 .......................0				X	430,289	0
(40) Shawn Forrester........................................................................ FORMER KEY EMPLOYEE	0.0 .......................0.0				X	342,211	0

(A) Name and business address	(B) Description of services	(C) Compensation
Scripps Clinic Medical Group Inc 10666 N Torrey Pines Rd La Jolla,CA92037	Physician Services	485,629,411
Scripps Coastal Medical Group 501 Washington Ave San Diego,CA92103	Physician Services	91,559,847
Scripps Health Inpatient Providers Med Group 4555 Executive Dr San Diego,CA92121	Physician Services	52,880,729
MedImpact Healthcare Systems 10181 Scripps Gateway Ct San Diego,CA92131	Pharmaceutical Services	52,218,312
DPC Construction 1450 Veterans Blvd Redwood City,CA94063	Construction Services	31,162,813
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 139

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 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

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

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

Schedule A (Form 990) 2023

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)..

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

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

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

Schedule A (Form 990) 2023

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

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer 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).

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

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

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

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

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.

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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

By reason of the relationship described in 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.

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2023

Page 6

Part V

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

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

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

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

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

Schedule A (Form 990) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2023

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization SCRIPPS HEALTH

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization SCRIPPS HEALTH		Employer identification number 95-1684089

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization SCRIPPS HEALTH			Employer identification number 95-1684089
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

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

right arrow

Complete if the organization is described below. 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

2022

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

SCRIPPS HEALTH

Employer identification number

95-1684089

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

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

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

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

Yes No

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

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

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

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

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

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

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

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

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

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

Yes

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

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

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

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

Yes

87,393

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

Yes

265,600

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

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

Yes

341,588

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

694,581

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1b	PERSONS AT SCRIPPS HEALTH EXCEEDED 5% OF TOTAL TIME SPENT ON DIRECT CONTACT WITH LEGISLATORS, STAFF AND GOVERNMENT OFFICIALS TO ENGAGE IN LOBBYING ACTIVITIES
Schedule C, Part II-B, Line 1f	DISCLOSURE OF A TRANSFER OF SCRIPPS FUNDS IN CALIFORNIA HOSPITAL ASSOCIATION (CHA) ACCOUNT TO THE CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) ACCOUNT.
Schedule C, Part II-B, Line 1g	VALUE DETERMINED UTILIZING GROSS-UP METHOD FOR DIRECT LOBBYING COSTS. LOBBYING LABOR COSTS OF PARTIAL TIME FOR (2) PERSONS AT SCRIPPS HEALTH X 175% + ALLOCABLE THIRD-PARTY COSTS (JGC CONSULTING, SD LAND LAWYERS) SPENT ON DIRECT CONTACT WITH LEGISLATORS, STAFF AND GOVERNMENT OFFICIALS TO ENGAGE IN LOBBYING ACTIVITIES ARE REFERENCED HERE.
Schedule C, Part II-B, Line 1i	OTHER ACTIVITIES APPROXIMATE VALUE CONSIDERS A PORTION OF THE DUES OF MEMBER ORGANIZATIONS SPENT ON LOBBYING IN ADDITION TO ANY TRAVEL EXPENSES OCCURRED FOR GOVERNMENT RELATIONS: SENIOR DIRECTOR, GOVERNMENT RELATIONS; DIRECTOR, COMMUNITY AND GOVERNMENT RELATIONS RELATED TO LOBBYING ACTIVITIES.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Government Relations INFORMATION AND EDUCATION SCRIPPS HEALTH ON ITS OWN BEHALF AND AS A MEMBER OF SEVERAL HOSPITAL ASSOCIATIONS AND HEALTH CARE ORGANIZATIONS PARTICIPATES IN PUBLIC AFFAIRS AND ADVOCACY ACTIVITIES. SOME ACTIVITY IS INDIVIDUALLY OR COLLECTIVELY CONDUCTED BY AND SPECIFICALLY ON BEHALF OF SCRIPPS HEALTH. OTHER ACTIVITY IS ORGANIZED BY THESE INVOLVED ORGANIZATIONS SUPPORTED BY SCRIPPS HEALTH PARTICIPATION. THIS ACTIVITY INCLUDES BRIEFING OF LEGISLATORS AND LEGISLATIVE STAFF MEMBERS (FEDERAL, STATE AND LOCAL) ON MATTERS AFFECTING HEALTH CARE AND HEALTH CARE OPERATIONS. MEETINGS OCCUR IN PUBLIC OFFICIAL OFFICES, AT SCRIPPS FACILITIES AND IN VARIOUS OTHER VENUES OF OPPORTUNITY. ACTIVITY IS ON FEDERAL, STATE AND LOCAL LEVELS AND LOCATIONS. SUCH MATTERS INCLUDE: BUDGET AND FISCAL POLICY IMPACTS; MEDICARE AND MEDICAID REIMBURSEMENT MATTERS; PROVIDER FEES AND OTHER ASSESSMENTS; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY MATTERS, HEALTH INFORMATION TECHNOLOGY, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; SITE-NEUTRAL PRICING; ACCOUNTABLE CARE ORGANIZATIONS; VIOLENCE AGAINST HEALTH CARE WORKERS; HEALTH CARE WORKERS MINIMUM WAGE; SIESMIC MANDATES; BEHAVIORAL HEALTH CLINICAL WORKFORCE AND OTHER OPERATIONAL ISSUES; HOMELESSNESS; LOCAL LAND USE ISSUES LIKE THE CONDITIONAL USE PERMITS FOR MERCY SAN DIEGO AND ENCINITAS HOSPITAL CONSTRUCTION PROJECTS. THE ORGANIZATION STAFFS A GOVERNMENT RELATIONS DEPARTMENT THAT COORDINATES INFORMATION AND EDUCATION PROGRAMS ON PUBLIC POLICY AND ADVOCACY MATTERS. ALL WORK IS FOCUSED ON ISSUES. NO ACTIVITY ADDRESSES PARTISAN MATTERS, CANDIDATES OR POLITICAL ACTIVITIES. NO CORPORATE ACTIVITY ADDRESSED PARTISAN CAMPAIGNS. DIRECT COMMUNICATION (MEETINGS, EMAIL, CALLS, LETTERS) WITH SAN DIEGO LEGISLATIVE DELEGATIONS - FEDERAL AND STATE. ON SAN DIEGO LOCAL LEVEL EMPLOYED SD LAND LAWYERS TO REPRESENT INTERESTS ON LAND DEVELOPMENT NEEDS. ON CALIFORNIA STATE LEVEL EMPLOYED LOBBY FIRM JGC GOVERNMENT RELATIONS TO REPRESENT INTERESTS ON CERTAIN MEASURES. SCRIPPS DOES NOT EMPLOY FEDERAL LOBBYISTS. LOBBY FIRM ALSO WORKED WITH OTHER HEALTH SYSTEM CONTRACT LOBBYISTS AND CALIFORNIA HOSPITAL ASSOCIATION LOBBY TEAM ON SELECTED LEGISLATION. WORKED IN CONCERT WITH STATE AND NATIONAL HEALTH CARE ORGANIZATIONS THAT CONDUCTED LOBBY PROGRAMS, INCLUDING: AMERICAN HOSPITAL ASSOCIATION, CALIFORNIA HOSPITAL ASSOCIATION, HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES, PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS, ALLIANCE OF CATHOLIC HEALTH CARE. SCRIPPS HEALTH DID NOT FILE FORM 5768 UNDER SECTION 501(H). THERE ARE TESTS FOR TAX EXEMPTION - A "SUBSTANTIAL PART TEST AN "EXPENDITURE TEST." AS A 501(C)(3) ORGANIZATION, WE CAN OPT TO FOLLOW THE GUIDELINE THAT "NO SUBSTANTIAL PART" OF OUR ACTIVITIES ARE CARRIED ON TO INFLUENCE LEGISLATION. UNDER SECTION 501(H), ELIGIBLE 501(C)(3) ORGANIZATIONS CAN ELECT TO MAKE LIMITED EXPENDITURES TO INFLUENCE LEGISLATION. THE "EXPENDITURE TEST" IS SUBJECT TO AMOUNTS PERMITTED BY THAT SECTION. WHILE OUR EXPENDITURES FALL WELL BELOW THE LIMITS, WE ALSO EXPEND WHAT IS GENERALLY CONSIDERED AS NO SUBSTANTIAL PART ON SUCH EXPENDITURES. THEREFORE, WE OPT NOT TO FILE FORM 5768, THE FORM REQUIRED UNDER SECTION 501(H). NATIONAL, STATE & LOCAL ORGANIZATIONS WITH WHICH SCRIPPS HEALTH PARTICIPATES IN PART IN LOBBY ACTIVITIES: AMERICAN HOSPITAL ASSOCIATION CALIFORNIA HOSPITAL ASSOCIATION HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS ALLIANCE FOR CATHOLIC HEALTH CARE ASSOCIATION OF ACADEMIC MEDICAL CENTERS (AAMC) SAN DIEGO REGIONAL CHAMBER OF COMMERCE NATIONAL ASSOCIATION FOR ACCOUNTABLE CARE ORGANIZATIONS (NAACOS)

Schedule C (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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

			Held at the End of the Year
a	Total number of conservation easements ......................	2a	1
b	Total acreage restricted by conservation easements ....................	2b	16.0
c	Number of conservation easements on a certified historic structure included in (a) .....	2c	1
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

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

Number of states where property subject to conservation easement is located right arrow

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

Yes No

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

327.0

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

$ 2,840

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

Yes No

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

Part III

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

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

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

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

$ 0

(ii)

Assets included in Form 990, Part X ............................... right arrow

$ 742,881

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

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

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

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	126,146,630	117,874,000	140,886,000	129,880,000	121,490,000
b	Contributions ...	47,685	208,670	1,207,385	540,474	-141,903
c	Net investment earnings, gains, and losses	25,766,761	13,935,117	-19,713,562	15,126,128	12,705,109
d	Grants or scholarships ...	0	0	0	897,549	874,375
e	Other expenditures for facilities and programs ...	4,515,635	4,548,650	3,181,443	2,574,215	2,148,726
f	Administrative expenses ....	1,329,015	1,322,507	1,324,380	1,188,838	1,150,105
g	End of year balance ......	146,116,426	126,146,630	117,874,000	140,886,000	129,880,000

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

Board designated or quasi-endowment right arrow

0 %

Permanent endowment right arrow

100 %

Term endowment right arrow

0 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	47,458,644	163,614,505		211,073,149
b	Buildings ....		1,897,942,935	807,082,914	1,090,860,021
c	Leasehold improvements		80,985,159	55,025,616	25,959,543
d	Equipment ....		1,355,107,771	854,001,615	501,106,156
e	Other .....		933,645,148	1,893,079	931,752,069
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					2,760,750,938

Schedule D (Form 990) 2022

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) MULTI-STRATEGY FUNDS	425,032,000	F
(B) PRIVATE EQUITY FUNDS	381,881,000	F
(C) LIMITED PARTNERSHIP	48,000,000	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	854,913,000

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

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)RIGHT OF USE - OPERATING				222,991,228
(2)PROVIDER FEE RECEIVABLE				132,402,877
(3)DEFERRED INVESTMENTS				10,839,904
(4)CONTRACT RECEIVABLES				3,389,320
(5)DEFERRED RENT RECEIVABLE				1,142,763
(6)ART INVESTMENTS				742,881
(7)OTHER LONG TERM ASSETS				31,989,194
(8)DUE FROM MEDICAL GROUPS				3,148,162
(9)TRUSTEE HELD FUNDS				133,523,184
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				540,169,513

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
TAXABLE DEBT	549,508,380
LEASE LIABILITIES	203,202,524
SELF-INSURED MALPRACTICE LIABILITY	58,629,000
SELF-INSURED WORKER'S COMPENSATION	34,640,228
ASSET RETIREMENT OBLIGATION	20,214,613
ANNUITY AND UNITRUSTS	13,338,934
DEFERRED RETIREMENT	3,023,951
PROVIDER FEE LIABILITY	53,415,145
DEPOSITS AND CONTINGENCIES	369,252
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	936,342,027
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) 2022

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
Schedule D, Part II, Line 9 Conservation easements financial reporting	THE HISTORICAL STRUCTURE THAT IS CONSIDERED TO BE A CONSERVATION EASEMENT IS REPORTED IN THE MERCY HOSPITAL ENTITY OF THE CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D, Part III, Line 4 Collections of art - description of collections	Scripps Health accepts and maintains gifts-in-kind contributions for art and sculptures ("Collections"). Collections donated with an appraised value greater than $10,000 are recorded in the general ledger and classified as Other Assets and Donor without Restriction Contributions. The Collections are maintained by Scripps Health and are publicly displayed. An annual inventory to assess condition of the Collections is performed. Scripps does not intend to sell the collections for any financial benefit. Scripps Health's Collections provides a clear contribution to make and offer opportunities in delivery of better health, wellbeing and improved experience for patients, service users and staff across the system.
Schedule D, Part V, Line 4 Intended uses of endowment funds	CONTRIBUTIONS RECEIVED FOR CAPITAL PROJECTS, INCLUDING BUILDING PROJECTS, MAJOR RENOVATIONS, AND EQUIPMENT PURCHASES: $636,131 CONTRIBUTIONS RECEIVED TO FUND GRADUATE MEDICAL EDUCATION PROGRAMS, FELLOWS, AND LECTURE SERIES: $17,026,946 CONTRIBUTIONS RECEIVED FOR USE IN THE SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS: $41,310,940 CONTRIBUTIONS RECEIVED TO COVER THE COST OF HEALTHCARE PROVIDED TO INDIVIDUALS WITHOUT INSURANCE OR THE MEANS FOR PAYING FOR THEIR CARE: $12,785,414 CONTRIBUTIONS RECEIVED TO FUND RESEARCH PROJECTS IN SPECIFIC AREAS OR DIVISIONS: $13,325,510
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	SCRIPPS HEALTH IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, SCRIPPS HEALTH IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OF BUSINESS, REGULARLY CARRIED ON, AND NOT IN THE FURTHERANCE OF THE PURPOSED FOR WHICH IT WAS GRANTED EXEMPTION. UNDER FASB ASC 740, INCOME TAXES, THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS MAY BE RECOGNIZED ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WILL BE SUSTAINED, BASED SOLELY ON ITS TECHNICAL MERITS, WITH THE TAXING AUTHORITY HAVING FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. THE ORGANIZATION RECORDS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS AS DISCRETE TAX ADJUSTMENTS IN THE FIRST INTERIM PERIOD THAT THE MORE LIKELY THAN NOT THRESHOLD IS MET. THE ORGANIZATION RECOGNIZES DEFERRED TAX ASSETS AND LIABILITIES FOR TEMPORARY DIFFERENCES BETWEEN THE FINANCIAL REPORTING BASIS AND THE TAX BASIS OF ITS ASSETS AND LIABILITIES ALONG WITH NET OPERATING LOSS AND TAX CREDIT CARRYOVERS ONLY FOR TAX POSITIONS THAT MEET THE MORE LIKELY THAN NOT RECOGNITION CRITERIA. NO SIGNIFICANT TAX LIABILITY FOR TAXES, INTEREST OR PENALTIES AND NO SIGNIFICANT TAX ASSETS FOR TAX BENEFITS WAS ACCRUED AT SEPTEMBER 30, 2024 OR 2023. SCRIPPS HEALTH CURRENTLY FILES FORM 990 (INFORMATIONAL RETURN OF ORGANIZATIONS EXEMPT FROM INCOME TAXES) AND FORM 990T (BUSINESS INCOME TAX RETURN FOR AN EXEMPT ORGANIZATION) IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. SCRIPPS HEALTH IS NOT SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2019 IN MAJOR TAX JURISDICTIONS.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right arrow

Attach to Form 990. Right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

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

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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
	North America (Canada & Mexico only)	0	23	Program Services	Reconstructive surgery	365,978
	Central America and the Caribbean	0	0	Investments		529,323,662
	Europe (Including Iceland and Greenland)	0	0	Investments		56,270,218
	East Asia and the Pacific	0	4	Program Services	Med Care & Training	13,240













3a	Sub-total ....	0	27			585,973,098
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	27			585,973,098

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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)

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2023

Schedule F (Form 990) 2023Page 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) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements	CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EAST ASIA AND THE PACIFIC-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual

Schedule F (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

2023

Open to Public Inspection

Name of the organization
SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 Candlelight Ball (event type)	(b) Event #2 Mercy Ball (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	595,704	506,245	638,307	1,740,256
2	Less: Contributions . . . .	188,581	154,608	94,180	437,369
3	Gross income (line 1 minus line 2) . . . . . .	407,123	351,637	544,127	1,302,887

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	177,967	413,983	219,829	811,779
7	Food and beverages . . .
8	Entertainment . . . .	750	14,745	12,290	27,785
9	Other direct expenses . . .	269,743	24,905	19,973	314,621
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				1,154,185
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				148,702

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	0	0	17,768,459	0	17,768,459	0.39 %
b	Medicaid (from Worksheet 3, column a) . . . . .	0	0	518,033,677	368,938,817	149,094,860	3.29 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	0	0	0	0	0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	535,802,136	368,938,817	166,863,319	3.69 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	0	0	13,126,493	2,225,030	10,901,463	0.24 %
f	Health professions education (from Worksheet 5) . . .	0	0	58,893,858	11,234,589	47,659,269	1.05 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	17,427,234	14,326,757	3,100,477	0.07 %
h	Research (from Worksheet 7) .	0	0	17,569,425	12,577,867	4,991,558	0.11 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	0	0	1,485,542	0	1,485,542	0.03 %
j	Total. Other Benefits . .	0	0	108,502,552	40,364,243	68,138,309	1.51 %
k	Total. Add lines 7d and 7j .	0	0	644,304,688	409,303,060	235,001,628	5.19 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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			42,384		42,384	0 %
2	Economic development			31,443		31,443	0 %
3	Community support			13,000		13,000	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members			106,384	25,935	80,449	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development			331,021	111,045	219,976	0 %
9	Other					0	0 %
10	Total	0	0	524,232	136,980	387,252	0.01 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

55,524,239

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

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

Section B. Medicare

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

612,958,842

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

702,551,375

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

-89,592,533

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1SCRIPPS ENCINITAS SURGERY CENTER	AMBULATORY SURGERY CENTER	57.47 %	20.11 %
2SCRIPPS MEMORIAL XIMED MEDICAL	MEDICAL OFFICE BUILDING	15.3 %	77.2 %
3SCRIPPS MERCY ASC	AMBULATORY SURGERY CENTER	82.5 %	17.5 %
4SCRIPPSUSP SURGERY CENTERS	AMBULATORY SURGERY CENTER	50 %	36 %
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?5Name, 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)							Facility reporting group
2	SCRIPPS MERCY HOSPITAL 4077 5TH AVENUE SAN DIEGO,CA92103 WWW.SCRIPPS.ORG 090000074	X	X	X	X	X	A
1	SCRIPPS MEMORIAL HOSPITAL LA JOLLA 9888 GENESEE AVENUE LA JOLLA,CA92037 WWW.SCRIPPS.ORG 080000050	X	X	X	X	X	A
4	SCRIPPS MEMORIAL HOSPITAL ENCINITAS 354 SANTA FE DRIVE SAN DIEGO,CA92034 WWW.SCRIPPS.ORG 080000148	X	X	X	X	X	A
3	SCRIPPS GREEN HOSPITAL 10666 NORTH TORREY PINES RD SAN DIEGO,CA92037 WWW.SCRIPPS.ORG 080000139	X	X	X	X		A
5	SELECT SPECIALTY HOSPITAL - SAN DIEGO 555 WASHINGTON ST SAN DIEGO,CA92103 WWW.SELECTSPECIALTYHOSPITALS.COM 090000404	X					B

Schedule H (Form 990) 2023

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)

	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

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): https://www.scripps.org/about-us/scripps-in-the-community

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

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

Yes

If "Yes" (list url): https://www.scripps.org/about-us/scripps-in-the-community

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

10b

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

12a

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

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

https://www.scripps.org/patients-and-visitors/help-paying-your-bill

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

https://www.scripps.org/patients-and-visitors/help-paying-your-bill

A plain language summary of the FAP was widely available on a website (list url):
https://www.scripps.org/patients-and-visitors/help-paying-your-bill

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	A
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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)

	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

Community Health Needs Assessment

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): https://www.selectspecialtyhospitals.com/-/media/project/selectmedical/inpatients/selectspecialty/fi

Other website (list url): https://www.scripps.org/about-us/scripps-in-the-community

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

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

Yes

If "Yes" (list url): https://www.scripps.org/about-us/scripps-in-the-community

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

10b

12a

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

12a

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

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	B
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/

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

https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/

A plain language summary of the FAP was widely available on a website (list url):
https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	B
Name of hospital facility or letter of facility reporting group

Yes

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	B
Name of hospital facility or letter of facility reporting group

Yes

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

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

The hospital facility used a prospective Medicare or Medicaid method

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

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
Schedule H, Part V, Section B, Line 3E	2022 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH HEALTH CONDITIONS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED, THE MAGNITUDE/SCALE OF THE NEED; DISPARITIES OR INEQUITIES AND CHANGE OVER TIME. THOSE HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT MET THE LARGEST NUMBER OF CRITERIA WERE THEN SELECTED AS TOP PRIORITY COMMUNITY HEALTH NEEDS. THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY, LISTED BELOW IN ALPHABETICAL ORDER: -ACCESS TO HEALTH CARE -AGING CARE & SUPPORT -BEHAVIORAL HEALTH -CHILDREN & YOUTH WELLBEING -CHRONIC HEALTH CONDITIONS -COMMUNITY SAFETY -ECONOMIC STABILITY WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY: A MULTI-FACETED, MULTI-STAKEHOLDER PLAN THAT ADDRESSES COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE AND OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES.
Schedule H, Part V, Section B, Line 5 Facility A, 1	Facility A, 1 - REPORTING GROUP A. COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO SOLICIT INPUT FROM A WIDE RANGE OF STAKEHOLDERS SO THAT THE SAMPLE WAS AS REPRESENTATIVE AS POSSIBLE OF THOSE FACING INEQUITIES IN SAN DIEGO COUNTY. SPECIAL EFFORTS WERE MADE TO INCLUDE COMMUNITY MEMBERS FROM GROUPS THAT EXPERIENCE HEALTH DISPARITIES AND SERVICE PROVIDERS WHO WORK WITH THOSE VULNERABLE POPULATIONS. A TOTAL OF 841 INDIVIDUALS PARTICIPATED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. INPUT FROM THE COMMUNITY WAS GATHERED THROUGH THE FOLLOWING EFFORTS: - WORKING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS. - CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTH CARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL (KFH)-SAN DIEGO). - CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS. - DISTRIBUTING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT STAFF. THE CHNA COMMITTEE WORKED WITH COMMUNITY PARTNERS TO PLAN COMMUNITY ENGAGEMENT ACTIVITIES WITH STAKEHOLDERS REPRESENTING EVERY REGION OF SAN DIEGO COUNTY AND ALL AGE GROUPS. IN ADDITION, THE CHNA COMMITTEE EXPLICITLY SOUGHT TO ENGAGE A WIDE VARIETY OF STAKEHOLDERS REPRESENTING NUMEROUS, DIVERSE RACIAL AND ETHNIC GROUPS. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE USED TO IDENTIFY AND EXPLORE PRIORITY HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO CARE, AND COMMUNITY ASSETS AND RESOURCES, WITH INTERVIEWS AND FOCUS GROUPS CONDUCTED BETWEEN OCTOBER 2021 AND APRIL 2022. INTERVIEWERS AND FACILITATORS EMPLOYED THE QUESTIONS DEVELOPED AND APPROVED BY THE CHNA COMMITTEE TO GENERATE DISCUSSION ABOUT SPECIFIC COMMUNITY HEALTH NEEDS, AS WELL AS OPEN ENDED QUESTIONS FOR BROADER DISCUSSIONS. BROAD QUESTIONS ABOUT HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH WERE ASKED AT THE BEGINNING OF EACH DISCUSSION, FOLLOWED BY MORE SPECIFIC QUESTIONS TARGETED FOR THE PARTICIPANTS. QUESTIONS VARIED DEPENDING ON THE EXPERTISE AND/OR SPECIFIC INTERESTS OF THE PERSON OR GROUP PARTICIPATING IN EACH INTERVIEW AND FOCUS GROUP. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED VIA ZOOM. INCENTIVES, IN THE FORM OF GIFT CARDS, WERE ALSO PROVIDED WHEN THE GROUPS WERE COMPRISED OF COMMUNITY RESIDENTS. EACH INTERVIEW AND FOCUS GROUP BEGAN WITH A DISCUSSION ABOUT THE PURPOSE AND PROCESS OF THE CHNA. THE INTERVIEWER OBTAINED VERBAL AND VISUAL CONSENT TO PROCEED (AND, IN SOME CASES, RECORD) AND ASSURED PARTICIPANTS THAT THEIR PARTICIPATION WAS VOLUNTARY AND THAT THEIR FEEDBACK WOULD BE ANONYMOUS. INTERPRETATIVE AND TRANSLATION SERVICES WERE ARRANGED FOR ANY GROUP THAT REQUESTED THEM. ONE FOCUS GROUP WAS CONDUCTED IN SPANISH BY A FACILITATOR THROUGH SIMULTANEOUS ENGLISH AND SPANISH INTERPRETATION. ONLINE COMMUNITY SURVEY THE CHNA ONLINE COMMUNITY SURVEY WAS USED TO SUPPORT PRIORITIZATION OF HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH BASED ON COMMUNITY FEEDBACK ABOUT WHAT SURVEY RESPONDENTS VIEWED AS THE MOST IMPORTANT OR MOST SERIOUS CHALLENGES. THE SURVEY WAS DISTRIBUTED VIA EMAIL TO TARGETED COMMUNITY- BASED ORGANIZATIONS, SOCIAL SERVICE PROVIDERS, RESIDENT-LED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, GOVERNMENT AGENCIES, GRANTMAKING ORGANIZATIONS, AND HOSPITALS AND HEALTH SYSTEMS THAT SERVE A DIVERSE ARRAY OF PEOPLE IN SAN DIEGO COUNTY. WHEN POSSIBLE, THESE ORGANIZATIONS SHARED THE LINK TO THE SURVEY WITH THE CLIENTS THEY SERVED. EMAIL RECIPIENTS WERE ALSO ENCOURAGED TO SHARE THE SURVEY WITH THEIR COLLEAGUES. THE SURVEY - OPEN FROM FEBRUARY 14 TO MARCH 30, 2022 - WAS ALSO WIDELY SHARED THROUGH SOCIAL EMAIL AND RESHARED BY COMMUNITY-BASED ORGANIZATIONS. THE SURVEY WAS DESIGNED TO BE TAKEN BY COMMUNITY MEMBERS AND WAS TRANSLATED FROM ENGLISH INTO FIVE ADDITIONAL LANGUAGES: ARABIC, SPANISH, SOMALI, TAGALOG, AND VIETNAMESE. MIDCITY CAN, A COMMUNITY-BASED ORGANIZATION LOCATED IN CITY HEIGHTS, WAS CONTRACTED TO COMPLETE THE TRANSLATIONS. RESEARCH PARTNERS AT THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT THE SAN DIEGO STATE UNIVERSITY (SDSU) SCHOOL OF PUBLIC HEALTH (SPH) FACILITATED TWO FOCUS GROUPS WITH COMMUNITY HEALTH WORKERS (CHWS). THE IPH CONDUCTED BOTH FOCUS GROUPS THROUGH ZOOM. ALL FOCUS GROUP PARTICIPANTS WERE COMMUNITY HEALTH WORKERS WORKING FOR A COVID-19 CONTACT TRACING PROGRAM. FOCUS GROUP PARTICIPANTS WERE RECRUITED THROUGH MULTIPLE AVENUES, INCLUDING ANNOUNCEMENTS IN THE COUNTY OF SAN DIEGO HHSA'S COMMUNITY HEALTH WORKER COLLABORATIVE NEWSLETTER, DISSEMINATED BY THE COUNTY TO PROVIDE UPDATES ON COVID-19 COMMUNICATION AND OUTREACH SERVICES TO THE INDIVIDUALS WORKING ON ONE OF THE COUNTY COVID-19 CONTRACTS. IN ADDITION, EMAILS WERE DISSEMINATED DIRECTLY TO ALL CHWS ON THE COMMUNITIES FIGHTING COVID! PROJECT AT SDSU, AND EMAILS WERE SENT TO THE LEADS ON EIGHT DIFFERENT COUNTY COVID-19 CONTRACTS, REQUESTING THAT THEY DISSEMINATE THE INFORMATION TO THEIR CHWS OR OUTREACH WORKERS. THE ANNOUNCEMENT INCLUDED AN INTEREST FORM THAT ASKED FOR THE PERSON'S CONTACT INFORMATION, DAY OF THE WEEK AND TIME OF DAY THAT WORKED BEST FOR THEM, TYPE OF GIFT CARD THEY WOULD LIKE TO RECEIVE AS A THANK YOU, AND A BRIEF DESCRIPTION OF THE TYPE OF WORK THEY CURRENTLY DO. FOCUS GROUP PARTICIPANTS WERE ASKED OPEN-ENDED QUESTIONS ABOUT IDENTIFYING SPECIFIC HEALTH CONDITIONS OF CONCERN, ABOUT INEQUITIES IN THE COMMUNITY, AND ABOUT THE NEEDS OF YOUTH AND SENIORS. GIFT CARDS WERE EMAILED TWO DAYS AFTER THE FOCUS GROUP AS A THANK YOU TO ALL PARTICIPANTS. PROMOTORAS AND COMMUNITY HEALTH WORKER INTERVIEWS/ACCESS TO HEALTH CARE INTERVIEWS TO ENSURE THE REPORT INCLUDED DIRECT COMMUNITY MEMBER FEEDBACK FROM RACIAL AND ETHNIC GROUPS EXPERIENCING DISPARATE HEALTH OUTCOMES, THE CHNA COMMITTEE EMPLOYED A NEW STRATEGY TO PARTNER WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS. THE ONLINE COMMUNITY SURVEY WAS ADAPTED WITH A SUBSET OF THE SURVEY QUESTIONS FOR USE AS A DATA COLLECTION TOOL. THE SAN DIEGO REFUGEE COMMUNITIES COALITION AND THE CHICANO FEDERATION WERE SELECTED TO RECRUIT INTERESTED COMMUNITY HEALTH WORKERS AND PROMOTORAS TO CONDUCT THE INTERVIEWS. HASD&IC STAFF ATTENDED A SAN DIEGO REFUGEE COMMUNITIES COALITION WEEKLY COMMUNITY HEALTH WORKER MEETING TO PROVIDE TRAINING ON THE GOALS OF THE CHNA AND HOW TO ADMINISTER THE INTERVIEW. HASD&IC STAFF ALSO PROVIDED TRAINING TO THE CHICANO FEDERATION PROMOTORAS. PROMOTORAS AND COMMUNITY HEALTH WORKERS CONDUCTED INTERVIEWS EITHER IN PERSON OR OVER THE PHONE. INTERVIEWERS ASKED OPEN-ENDED QUESTIONS ABOUT THE FOLLOWING: HEALTH NEEDS, SOCIAL NEEDS, ACCESS TO CARE CHALLENGES, AND WHAT HOSPITALS COULD DO TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. INTERVIEWERS THEN CODED RESPONSES AND INPUT THEM IN AN ONLINE DATA COLLECTION TOOL. PRICE PHILANTHROPIES FOUNDATION GENEROUSLY PROVIDED GRANTS TO BOTH ORGANIZATIONS TO COMPENSATE PROMOTORAS AND COMMUNITY HEALTH WORKERS FOR COMPLETING INTERVIEWS.
Schedule H, Part V, Section B, Line 6a Facility A, 1	Facility A, 1 - REPORTING GROUP A. 2022 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS. THE CHNA RESPONDS TO IRS REGULATORY REQUIREMENTS THAT PRIVATE NOT-FOR-PROFIT (TAX-EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE MAJORITY OF 2022 CHNA COLLABORATIVE MEMBERS ARE HOSPITALS AND HEALTH SYSTEMS THAT ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO PARTICIPATED IN THE COLLECTIVE EFFORT TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF SAN DIEGO COMMUNITIES. PARTICIPATING HOSPITAL AND HEALTH SYSTEMS SUPPORTED THE CHNA PROCESS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY WORKGROUP, THE COMMUNITY NEEDS ASSESSMENT COMMITTEE, AND THE HASD&IC BOARD OF DIRECTORs. * ALVARADO HOSPITAL MEDICAL CENTER * ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM * AURORA BEHAVIORAL HEALTH CARE SAN DIEGO * GROSSMONT HEALTHCARE DISTRICT * KAISER PERMANENTE SAN DIEGO * PALOMAR HEALTH * PARADISE VALLEY HOSPITAL/BAYVIEW BEHAVIORAL HEALTH CAMPUS * RADY CHILDREN'S HOSPITAL - SAN DIEGO * SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL * SCRIPPS HEALTH * SHARP HEALTHCARE * TRI-CITY MEDICAL CENTER * UC SAN DIEGO HEALTH * VA SAN DIEGO HEALTHCARE SYSTEM * SELECT SPECIALTY HOSPITAL
Schedule H, Part V, Section B, Line 6b Facility A, 1	Facility A, 1 - REPORTING GROUP A. THE HOSPITAL ASSOCIATION FOR SAN DIEGO AND IMPERIAL COUNTIES(HASD&IC) CONTRACTED WITH THE FOLLOWING RESEARCH PARTNERS ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. PATRICIA SINAY FROM COMMUNITY INVESTMENT STRATEGIES (CIS) SUPPORTED THE HOSPITAL ASSOCIATION TEAM WITH QUALITATIVE RESEARCH AND REPORT WRITING. CIS PROVIDES STRATEGIC VISIONING & PLANNING, MANAGEMENT TRAINING, AND PROGRAM IMPLEMENTATION SERVICES TO NONPROFITS, BUSINESSES, GOVERNMENTS, AND PHILANTHROPY. AS A LATINA IMMIGRANT, PATRICIA SPECIALIZES IN INCLUSIVE, CROSS-SECTOR EFFORTS THAT STRENGTHEN THE GREATER GOOD FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES. HASD&IC CONTRACTED WITH THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU). IN THE LAST 20 YEARS, THE IPH HAS PARTNERED WITH OVER 70 LOCAL, STATE, NATIONAL AND INTERNATIONAL PUBLIC AND PRIVATE COMMUNITY-BASED AGENCIES AND ORGANIZATIONS REPRESENTING MORE THAN 120 MULTIPLE-YEAR CONTRACTS WITH A WIDE VARIETY OF NEEDS AND METHODOLOGIES. THE IPH HAS EXPERTISE IN QUALITATIVE AND QUANTITATIVE COMMUNITY-BASED RESEARCH METHODS. IN ADDITION, THE IPH HAS EXTENSIVE EXPERIENCE IN SUCCESSFUL COMMUNITY ENGAGEMENT WITH DIVERSE GROUPS, INCLUDING NON-ENGLISH SPEAKERS. THE IPH HAS BEEN WORKING ACROSS CULTURES AND WITH VULNERABLE POPULATIONS FOR 25 YEARS, INCLUDING PROGRAMS WITH ASIAN AND PACIFIC ISLANDER COMMUNITIES, AFRICAN-AMERICAN COMMUNITIES, EAST AFRICAN COMMUNITIES, LATINO COMMUNITIES, NATIVE AMERICAN COMMUNITIES, LOW-INCOME COMMUNITIES, GAY, BISEXUAL, TRANSGENDER INDIVIDUALS, PEOPLE LIVING WITH HIV/AIDS, INDIVIDUALS EXPERIENCING HOMELESSNESS, ADOLESCENTS WHO ARE PREGNANT OR PARENTING, AND SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, AMONG OTHERS. IPH STAFF HAVE SPECIAL EXPERTISE IN CONDUCTING CULTURALLY COMPETENT WORK AND EXPLORING SENSITIVE ISSUES. IPH COMMUNITY ENGAGEMENT EFFORTS HAVE INCLUDED PERFORMING KEY INFORMANT INTERVIEWS, LEADING FOCUS GROUPS, FACILITATING TOWN HALL MEETINGS, AND CONDUCTING PATIENT AND PROVIDER INTERVIEWS.
Schedule H, Part V, Section B, Line 11 Facility A, 1	Facility A, 1 - REPORTING GROUP A. SCRIPPS HEALTH IMPLEMENTATION STRATEGY SUMMARY AND COMMUNITY NEEDS IDENTIFIED. WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY: A MULTI-FACETED, MULTI-STAKEHOLDER PLAN THAT ADDRESSES COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE OBJECTIVES THAT CAN BE CONDUCTED TO IMPROVE COMMUNITY HEALTH OUTCOMES. THIS THREE-YEAR IMPLEMENTATION STRATEGY (FY23-FY25) ADDRESSES THE NEEDS IDENTIFIED IN THE 2022 CHNA, WITH FY24 REPRESENTING THE SECOND YEAR OF REPORTING. EVALUATION OF ACTIVITIES SCRIPPS EVALUATES THE IMPLEMENTATION STRATEGY ANNUALLY TO ENSURE A FLEXIBLE APPROACH FOR ADDRESSING NEEDS IDENTIFIED IN THE CHNA. THIS EVALUATION ASSESSES RESOURCES, INTERVENTIONS, AND PROGRESS TOWARD ACHIEVING THE STRATEGY'S GOALS AND OUTCOME MEASURES, ADJUSTING AS NECESSARY. MONITORING PLANS ARE CUSTOMIZED FOR EACH OBJECTIVE AND INVOLVE COLLECTING TRACKING MEASURES, SUCH AS PARTICIPATION RATES, SATISFACTION LEVELS, GOAL COMPLETION, PEOPLE SERVED, AND FINANCIAL CONTRIBUTIONS TO ASSESS REACH AND PROGRESS. WHERE FEASIBLE, SCRIPPS WILL ALSO EVALUATE OUTCOME METRICS TO MEASURE THE IMPACT OF INITIATIVES ON HEALTH-RELATED OUTCOMES. CHALLENGES ENCOUNTERED ARE DOCUMENTED, AND ADJUSTMENTS ARE MADE AS NEEDED. ADDITIONALLY, SCRIPPS HEALTH FILES THE IMPLEMENTATION STRATEGY ANNUALLY WITH THE IRS VIA FORM 990 SCHEDULE H. RESOURCE COMMITMENTS TO EFFECTIVELY IMPLEMENT THESE STRATEGIES AND ACTIVITIES. SCRIPPS WILL COMMIT FINANCIAL AND IN-KIND RESOURCES, SUCH AS SPECIFIC PROGRAMS AND SERVICES AND STAFF TIME AS APPROPRIATE. COMMUNITY NEEDS SCRIPPS IS ADDRESSING THE HEALTH FOCUS AREAS IDENTIFIED WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS, AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. SCRIPPS IS ADDRESSING ACCESS TO CARE, AGING CARE & SUPPORT, BEHAVIORAL HEALTH, CHILDREN & YOUTH WELLBEING, CHRONIC HEALTH CONDITIONS WHICH INCLUDES CARDIOVASCULAR DISEASE, CANCER AND DIABETES, COMMUNITY SAFETY AND ECONOMIC STABILITY IN THE FY23-FY25 IMPLEMENTATION STRATEGY. SCRIPPS ADDRESSES MANY OF THE SOCIAL DETERMINANTS OF HEALTH WITHIN THE HEALTH CONDITIONS IDENTIFIED SUCH AS, COMMUNITY AND SOCIAL SUPPORT, FOOD INSECURITY, TRANSPORTATION, EDUCATION, AND HOMELESSNESS. COMMUNITY NEEDS SCRIPPS IS NOT DIRECTLY ADDRESSING HOMELESSNESS AND HOUSING INSTABILITY ARE IDENTIFIED AS IMPORTANT FACTORS WITHIN THE CHNA FINDINGS. HOMELESSNESS AND HOUSING ARE NOT DIRECTLY ADDRESSED IN THE SCRIPPS IMPLEMENTATION STRATEGY AS WE FOCUS OUR RESOURCES ON MORE DIRECT HEALTH ISSUES AND CONDITIONS IN ACCORDANCE WITH OUR EXPERTISE AND MISSION. SCRIPPS HAS NOT DIRECTLY DEVELOPED PROGRAMS THAT SPECIFICALLY ADDRESS HOUSING INSECURITY, BUT THIS IS ADDRESSED AS PART OF OUR CARE TO PATIENTS. WHEN PATIENTS' HOUSING NEEDS ARE IDENTIFIED, THE SCRIPPS MULTIDISCIPLINARY TEAM WORKS TO ADDRESS THE NEED. ADDITIONALLY, THE SCRIPPS HEALTH SYSTEM HAS SOCIAL WORK AND CASE MANAGEMENT RESOURCES IN PLACE THROUGHOUT THE INPATIENT SETTING THAT ADDRESS THIS UNMET NEED BY CONNECTING PATIENTS TO MORE PERMANENT SOURCES OF INCOME, HOUSING, AND OTHER SELF-RELIANCE MEASURES. SCRIPPS WORK TO ADDRESS HOUSING INSECURITY IS LARGELY DONE VIA COLLABORATION AND REFERRALS TO COMMUNITY PARTNERS. IN ADDITION TO THE ABOVE INDIRECT MEASURES, SCRIPPS IS ALSO ADDRESSING THESE COMMUNITY NEEDS IN ACCORDANCE WITH CALIFORNIA'S REGULATIONS, SUCH AS SB 1152 DISCHARGE PLANNING FOR HOMELESS PATIENTS. THIS 2019 REGULATION REQUIRES HOSPITALS TO IMPLEMENT A SET OF REQUIREMENTS REGARDING DISCHARGE PLANNING FOR THEIR HOMELESS PATIENTS. SCRIPPS IS FULFILLING THIS REQUIREMENT BY PROVIDING PACKAGED MEALS, WEATHER-APPROPRIATE CLOTHING, TRANSPORTATION, DISCHARGE MEDICATIONS AND/OR PRESCRIPTIONS, INFECTIOUS DISEASE SCREENINGS AND VACCINATIONS, REFERRALS FOR BEHAVIORAL HEALTH AND OTHER REFERRALS TO SHELTERS OR HOUSING. SCRIPPS HEALTH REMAINS COMMITTED TO THE CARE AND IMPROVEMENT OF HEALTH FOR ALL SAN DIEGANS AND WILL LOOK TO CONTINUE THE SEARCH OF NEW OPPORTUNITIES AND NEW PARTNERSHIPS TO ADDRESS THESE AND FUTURE NEEDS. DETAIL ON THE STRATEGIES, INITIATIVES, MEASURES OF IMPLEMENTATION AND METRICS USED TO EVALUATE THE EFFECTIVENESS OF THE COMMUNITY NEEDS IS IDENTIFIED THROUGH SCRIPPS SPECIALTY HOSPITAL 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS CORRESPONDING IMPLEMENTATION STRATEGY. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC FY23-FY25 IMPLEMENTATION STRATEGY REPORT AT SCRIPPS.ORG.
Schedule H, Part V, Section B, Line 13 Facility A, 1	Facility A, 1 - REPORTING GROUP A. * FINANCIAL ASSISTANCE (CHARITY CARE): FOR PATIENTS WITHOUT INSURANCE WHO EARN LESS THAN 200% OF THE FEDERAL POVERTY LEVEL, WE WILL FULLY FORGIVE THE ENTIRE BILL. * DISCOUNTED PAYMENT: FOR PATIENTS WHO EARN BETWEEN 201% AND 400% OF THE FEDERAL POVERTY LEVEL, WE WILL FORGIVE A PORTION OF YOUR BILL. SCRIPPS WILL NOT BILL QUALIFIED PATIENTS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE MORE THAN THE AMOUNT WE GENERALLY BILL PATIENTS HAVING MEDICARE COVERAGE * WHENEVER POSSIBLE, ELIGIBILITY DETERMINATION IS MADE WITHIN 20 BUSINESS DAYS OF RECEIVING DOCUMENTATION INCLUDING LANGUAGE TRANSLATIONS IF NECESSARY. THE SENIOR DIRECTOR OF PATIENT FINANCIAL SERVICES IS THE AUTHORITY FOR DETERMINING THAT THE HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. * PATIENTS ARE INFORMED OF THE ASSISTANCE DETAILS. THE ELIGIBILITY DETERMINATION IS VALID FOR SIX MONTHS FROM THE DATE OF DETERMINATION UNLESS CIRCUMSTANCES CHANGE.
Schedule H, Part V, Section B, Line 16 Facility A, 1	Facility A, 1 - REPORTING GROUP A. * POSTERS ALERTING INDIVIDUALS TO SCRIPPS FINANCIAL ASSISTANCE AND CHARITY CARE PROGRAMS ARE DISPLAYED IN REGISTRATION AREAS IN THE HOSPITALS, INCLUDING THE EMERGENCY DEPARTMENTS, OUTPATIENT SETTINGS, AND MAIN ADMISSION AREAS. * SCRIPPS WORKS WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO INFORM THOSE LIKELY TO NEED FINANCIAL HELP. THE SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS AVAILABLE AT COMMUNITY EVENTS AND IS PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. * SCRIPPS WEBSITE PROMINENTLY DISPLAYS LINKS TO "HELPING PAY YOUR BILL". INFORMATION AND RESOURCES ARE AVAILABLE IN MULTIPLE LANGUAGES. INFORMATION INCLUDES BUT IS NOT LIMITED TO; FINANCIAL ASSISTANCE OPTIONS, LANGUAGE ASSISTANCE, CONSUMER ASSISTANCE, AND GOVERNMENT SPONSORED PROGRAMS AND SCRIPPS RESOURCES CAN BE FOUND. * SCRIPPS FINANCIAL ASSISTANCE POLICIES AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW.
Schedule H, Part V, Section B, Line 3E	2022 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH HEALTH CONDITIONS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED, THE MAGNITUDE/SCALE OF THE NEED; DISPARITIES OR INEQUITIES AND CHANGE OVER TIME. THOSE HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT MET THE LARGEST NUMBER OF CRITERIA WERE THEN SELECTED AS TOP PRIORITY COMMUNITY HEALTH NEEDS. THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY, LISTED BELOW IN ALPHABETICAL ORDER: - ACCESS TO HEALTH CARE - AGING CARE & SUPPORT - BEHAVIORAL HEALTH - CHILDREN & YOUTH WELLBEING - CHRONIC HEALTH CONDITIONS - COMMUNITY SAFETY - ECONOMIC STABILITY
Schedule H, Part V, Section B, Line 5 Facility B, 1	Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. COMMUNITY ENGAGEMENT THE PRIMARY OBJECTIVE OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO GATHER INPUT FROM A DIVERSE RANGE OF STAKEHOLDERS TO ENSURE THAT THE SAMPLE REPRESENTED THOSE EXPERIENCING HEALTH INEQUITIES IN SAN DIEGO COUNTY AS COMPREHENSIVELY AS POSSIBLE. SPECIAL EFFORTS WERE MADE TO INCLUDE COMMUNITY MEMBERS FROM DEMOGRAPHIC GROUPS FACING HEALTH DISPARITIES AND SERVICE PROVIDERS WORKING WITH VULNERABLE POPULATIONS. IN TOTAL, 841 INDIVIDUALS PARTICIPATED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY INPUT WAS COLLECTED THROUGH VARIOUS METHODS, INCLUDING: - COLLABORATING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS. - ORGANIZING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH A BROAD SPECTRUM OF STAKEHOLDERS, INCLUDING COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTHCARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL - SAN DIEGO). - HOSTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS. - ADMINISTERING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT PERSONNEL. THE EXTENSIVE PROCESS UNDERTAKEN FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT ENSURED THE GATHERING OF INPUT AND INSIGHTS FROM A WIDE ARRAY OF PERSPECTIVES, THUS CONTRIBUTING TO A MORE COMPREHENSIVE UNDERSTANDING OF THE HEALTH NEEDS AND DISPARITIES WITHIN THE SAN DIEGO COUNTY COMMUNITY. TO ACHIEVE THIS, THE CHNA COMMITTEE COLLABORATED WITH COMMUNITY PARTNERS TO PLAN COMMUNITY ENGAGEMENT ACTIVITIES THAT INVOLVED STAKEHOLDERS FROM EVERY REGION OF SAN DIEGO COUNTY AND ACROSS ALL AGE GROUPS. FURTHERMORE, THE COMMITTEE ACTIVELY SOUGHT TO ENGAGE A BROAD SPECTRUM OF STAKEHOLDERS REPRESENTING DIVERSE RACIAL AND ETHNIC GROUPS. THIS INCLUSIVE AND THOROUGH APPROACH TO COMMUNITY ENGAGEMENT HELPED ENSURE THAT THE ASSESSMENT ACCURATELY REPRESENTED THE HEALTH-RELATED CONCERNS AND DISPARITIES EXPERIENCED BY THE ENTIRE COMMUNITY. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS PLAYED A CRUCIAL ROLE IN IDENTIFYING AND EXPLORING PRIORITY HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO CARE, AND COMMUNITY ASSETS AND RESOURCES. THESE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED BETWEEN OCTOBER 2021 AND APRIL 2022. THE INTERVIEWERS AND FACILITATORS UTILIZED QUESTIONS DEVELOPED AND APPROVED BY THE CHNA COMMITTEE TO GUIDE DISCUSSIONS ON SPECIFIC COMMUNITY HEALTH NEEDS. OPEN-ENDED QUESTIONS WERE ALSO USED TO FACILITATE BROADER CONVERSATIONS. THE QUESTIONS ASKED DURING THESE INTERVIEWS AND FOCUS GROUPS VARIED DEPENDING ON THE EXPERTISE AND INTERESTS OF THE PARTICIPANTS. THESE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED THROUGH VIRTUAL MEETINGS ON ZOOM. INCENTIVES, TYPICALLY IN THE FORM OF GIFT CARDS, WERE PROVIDED TO PARTICIPANTS WHEN THEY WERE COMMUNITY RESIDENTS. EACH INTERVIEW AND FOCUS GROUP BEGAN WITH AN INTRODUCTION TO THE PURPOSE AND PROCESS OF THE CHNA. PARTICIPANTS PROVIDED VERBAL AND VISUAL CONSENT TO PROCEED, AND IN SOME CASES, RECORDINGS WERE MADE. PARTICIPANTS WERE ASSURED THAT THEIR INVOLVEMENT WAS VOLUNTARY, AND THEIR FEEDBACK WOULD REMAIN ANONYMOUS. INTERPRETATIVE AND TRANSLATION SERVICES WERE ARRANGED FOR GROUPS THAT REQUESTED THEM, ENSURING THAT LANGUAGE BARRIERS DID NOT HINDER PARTICIPATION. FOR INSTANCE, ONE FOCUS GROUP WAS CONDUCTED IN SPANISH WITH A FACILITATOR PROVIDING SIMULTANEOUS ENGLISH AND SPANISH INTERPRETATION TO ACCOMMODATE A DIVERSE PARTICIPANT BASE. ONLINE COMMUNITY SURVEY THE CHNA ONLINE COMMUNITY SURVEY WAS USED TO SUPPORT PRIORITIZATION OF HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH BASED ON COMMUNITY FEEDBACK ABOUT WHAT SURVEY RESPONDENTS VIEWED AS THE MOST IMPORTANT OR MOST SERIOUS CHALLENGES. THE SURVEY WAS DISTRIBUTED VIA EMAIL TO TARGETED COMMUNITY- BASED ORGANIZATIONS, SOCIAL SERVICE PROVIDERS, RESIDENT-LED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, GOVERNMENT AGENCIES, GRANTMAKING ORGANIZATIONS, AND HOSPITALS AND HEALTH SYSTEMS THAT SERVE A DIVERSE ARRAY OF PEOPLE IN SAN DIEGO COUNTY. WHEN POSSIBLE, THESE ORGANIZATIONS SHARED THE LINK TO THE SURVEY WITH THE CLIENTS THEY SERVED. EMAIL RECIPIENTS WERE ALSO ENCOURAGED TO SHARE THE SURVEY WITH THEIR COLLEAGUES. THE SURVEY - OPEN FROM FEBRUARY 14 TO MARCH 30, 2022 - WAS ALSO WIDELY SHARED THROUGH SOCIAL EMAIL AND RESHARED BY COMMUNITY- BASED ORGANIZATIONS. THE SURVEY WAS DESIGNED TO BE TAKEN BY COMMUNITY MEMBERS AND WAS TRANSLATED FROM ENGLISH INTO FIVE ADDITIONAL LANGUAGES: ARABIC, SPANISH, SOMALI, TAGALOG, AND VIETNAMESE. MID- CITY CAN, A COMMUNITY-BASED ORGANIZATION LOCATED IN CITY HEIGHTS, WAS CONTRACTED TO COMPLETE THE TRANSLATIONS. RESEARCH PARTNERS AT THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT THE SAN DIEGO STATE UNIVERSITY (SDSU) SCHOOL OF PUBLIC HEALTH (SPH) FACILITATED TWO FOCUS GROUPS WITH COMMUNITY HEALTH WORKERS (CHWS). THE IPH CONDUCTED BOTH FOCUS GROUPS THROUGH ZOOM. ALL FOCUS GROUP PARTICIPANTS WERE COMMUNITY HEALTH WORKERS WORKING FOR A COVID-19 CONTACT TRACING PROGRAM. FOCUS GROUP PARTICIPANTS WERE RECRUITED THROUGH MULTIPLE AVENUES, INCLUDING ANNOUNCEMENTS IN THE COUNTY OF SAN DIEGO HHSA'S COMMUNITY HEALTH WORKER COLLABORATIVE NEWSLETTER, DISSEMINATED BY THE COUNTY TO PROVIDE UPDATES ON COVID-19 COMMUNICATION AND OUTREACH SERVICES TO THE INDIVIDUALS WORKING ON ONE OF THE COUNTY COVID-19 CONTRACTS. IN ADDITION, EMAILS WERE DISSEMINATED DIRECTLY TO ALL CHWS ON THE COMMUNITIES FIGHTING COVID! PROJECT AT SDSU, AND EMAILS WERE SENT TO THE LEADS ON EIGHT DIFFERENT COUNTY COVID-19 CONTRACTS, REQUESTING THAT THEY DISSEMINATE THE INFORMATION TO THEIR CHWS OR OUTREACH WORKERS THE ANNOUNCEMENT INCLUDED AN INTEREST FORM THAT ASKED FOR THE PERSON'S CONTACT INFORMATION, DAY OF THE WEEK AND TIME OF DAY THAT WORKED BEST FOR THEM, TYPE OF GIFT CARD THEY WOULD LIKE TO RECEIVE AS A THANK YOU, AND A BRIEF DESCRIPTION OF THE TYPE OF WORK THEY CURRENTLY DO. FOCUS GROUP PARTICIPANTS WERE ASKED OPEN-ENDED QUESTIONS ABOUT IDENTIFYING SPECIFIC HEALTH CONDITIONS OF CONCERN, ABOUT INEQUITIES IN THE COMMUNITY, AND ABOUT THE NEEDS OF YOUTH AND SENIORS. GIFT CARDS WERE EMAILED TWO DAYS AFTER THE FOCUS GROUP AS A THANK YOU TO ALL PARTICIPANTS. PROMOTORAS AND COMMUNITY HEALTH WORKER INTERVIEWS/ACCESS TO HEALTH CARE INTERVIEWS TO ENSURE THE REPORT INCLUDED DIRECT COMMUNITY MEMBER FEEDBACK FROM RACIAL AND ETHNIC GROUPS EXPERIENCING DISPARATE HEALTH OUTCOMES, THE CHNA COMMITTEE EMPLOYED A NEW STRATEGY TO PARTNER WITH COMMUNITY BASED ORGANIZATIONS THAT WORK WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS. THE ONLINE COMMUNITY SURVEY WAS ADAPTED WITH A SUBSET OF THE SURVEY QUESTIONS FOR USE AS A DATA COLLECTION TOOL. THE SAN DIEGO REFUGEE COMMUNITIES COALITION AND THE CHICANO FEDERATION WERE SELECTED TO RECRUIT INTERESTED COMMUNITY HEALTH WORKERS AND PROMOTORAS TO CONDUCT THE INTERVIEWS. HASD&IC STAFF ATTENDED A SAN DIEGO REFUGEE COMMUNITIES COALITION WEEKLY COMMUNITY HEALTH WORKER MEETING TO PROVIDE TRAINING ON THE GOALS OF THE CHNA AND HOW TO ADMINISTER THE INTERVIEW. HASD&IC STAFF ALSO PROVIDED TRAINING TO THE CHICANO FEDERATION PROMOTORAS. PROMOTORAS AND COMMUNITY HEALTH WORKERS CONDUCTED INTERVIEWS EITHER IN PERSON OR OVER THE PHONE. INTERVIEWERS ASKED OPEN-ENDED QUESTIONS ABOUT THE FOLLOWING: HEALTH NEEDS, SOCIAL NEEDS, ACCESS TO CARE CHALLENGES, AND WHAT HOSPITALS COULD DO TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. INTERVIEWERS THEN CODED RESPONSES AND INPUT THEM IN AN ONLINE DATA COLLECTION TOOL. PRICE PHILANTHROPIES FOUNDATION GENEROUSLY PROVIDED GRANTS TO BOTH ORGANIZATIONS TO COMPENSATE PROMOTORAS AND COMMUNITY HEALTH WORKERS FOR COMPLETING INTERVIEWS.
Schedule H, Part V, Section B, Line 6a Facility B, 1	Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. 2022 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS THE CHNA RESPONDS TO IRS REGULATORY REQUIREMENTS THAT PRIVATE NOT-FOR-PROFIT (TAX- EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE MAJORITY OF 2022 CHNA COLLABORATIVE MEMBERS ARE HOSPITALS AND HEALTH SYSTEMS THAT ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO PARTICIPATED IN THE COLLECTIVE EFFORT TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF SAN DIEGO COMMUNITIES. PARTICIPATING HOSPITAL AND HEALTH SYSTEMS SUPPORTED THE CHNA PROCESS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY WORKGROUP, THE COMMUNITY NEEDS ASSESSMENT COMMITTEE, AND THE HASD&IC BOARD OF DIRECTORS. - ALVARADO HOSPITAL MEDICAL CENTER - ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM - AURORA BEHAVIORAL HEALTH CARE SAN DIEGO - GROSSMONT HEALTHCARE DISTRICT - KAISER PERMANENTE SAN DIEGO - PALOMAR HEALTH - PARADISE VALLEY HOSPITAL/BAYVIEW BEHAVIORAL HEALTH CAMPUS - RADY CHILDREN'S HOSPITAL - SAN DIEGO - SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL - SCRIPPS HEALTH - SHARP HEALTHCARE - TRI-CITY MEDICAL CENTER - UC SAN DIEGO HEALTH - VA SAN DIEGO HEALTHCARE SYSTEM - SELECT SPECIALTY HOSPITAL
Schedule H, Part V, Section B, Line 6b Facility B, 1	Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. THE HOSPITAL ASSOCIATION FOR SAN DIEGO AND IMPERIAL COUNTIES(HASD&IC) CONTRACTED WITH THE FOLLOWING RESEARCH PARTNERS ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. PATRICIA SINAY FROM COMMUNITY INVESTMENT STRATEGIES (CIS) SUPPORTED THE HOSPITAL ASSOCIATION TEAM WITH QUALITATIVE RESEARCH AND REPORT WRITING. CIS PROVIDES STRATEGIC VISIONING & PLANNING, MANAGEMENT TRAINING, AND PROGRAM IMPLEMENTATION SERVICES TO NONPROFITS, BUSINESSES, GOVERNMENTS, AND PHILANTHROPY. AS A LATINA IMMIGRANT, PATRICIA SPECIALIZES IN INCLUSIVE, CROSS-SECTOR EFFORTS THAT STRENGTHEN THE GREATER GOOD FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES. HASD&IC CONTRACTED WITH THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU). IN THE LAST 20 YEARS, THE IPH HAS PARTNERED WITH OVER 70 LOCAL, STATE, NATIONAL AND INTERNATIONAL PUBLIC AND PRIVATE COMMUNITY-BASED AGENCIES AND ORGANIZATIONS REPRESENTING MORE THAN 120 MULTIPLE-YEAR CONTRACTS WITH A WIDE VARIETY OF NEEDS AND METHODOLOGIES. THE IPH HAS EXPERTISE IN QUALITATIVE AND QUANTITATIVE COMMUNITY-BASED RESEARCH METHODS. IN ADDITION, THE IPH HAS EXTENSIVE EXPERIENCE IN SUCCESSFUL COMMUNITY ENGAGEMENT WITH DIVERSE GROUPS, INCLUDING NON-ENGLISH SPEAKERS. THE IPH HAS BEEN WORKING ACROSS CULTURES AND WITH VULNERABLE POPULATIONS FOR 25 YEARS, INCLUDING PROGRAMS WITH ASIAN AND PACIFIC ISLANDER COMMUNITIES, AFRICAN-AMERICAN COMMUNITIES, EAST AFRICAN COMMUNITIES, LATINO COMMUNITIES, NATIVE AMERICAN COMMUNITIES, LOW-INCOME COMMUNITIES, GAY, BISEXUAL, TRANSGENDER INDIVIDUALS, PEOPLE LIVING WITH HIV/AIDS, INDIVIDUALS EXPERIENCING HOMELESSNESS, ADOLESCENTS WHO ARE PREGNANT OR PARENTING, AND SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, AMONG OTHERS. IPH STAFF HAVE SPECIAL EXPERTISE IN CONDUCTING CULTURALLY COMPETENT WORK AND EXPLORING SENSITIVE ISSUES. IPH COMMUNITY ENGAGEMENT EFFORTS HAVE INCLUDED PERFORMING KEY INFORMANT INTERVIEWS, LEADING FOCUS GROUPS, FACILITATING TOWN HALL MEETINGS, AND CONDUCTING PATIENT AND PROVIDER INTERVIEWS
Schedule H, Part V, Section B, Line 11 Facility B, 1	Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. SCRIPPS HEALTH AND SELECT HOSPITAL IMPLEMENTATION STRATEGY SUMMARY AND COMMUNITY NEEDS IDENTIFIED. WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH AND SELECT HOSPITAL HAVE DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY; A MULTI-FACETED, MULTI- STAKEHOLDER PLAN THAT ADDRESSES THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. SCRIPPS AND SELECT SPECIALTY HOSPITAL EVALUATES THE IMPLEMENTATION STRATEGY ANNUALLY BECAUSE A FLEXIBLE APPROACH IS WELL-SUITED TO DEVELOPING A RESPONSE TO THE SCRIPPS CHNA. THE EVALUATION OF THE IMPLEMENTATION STRATEGY ASSESSES AVAILABLE RESOURCES AND INTERVENTIONS AND ADJUSTS AS NEEDED TO ACHIEVE THE IMPLEMENTATION STRATEGY'S STATED GOALS AND OUTCOME MEASURES. PLANS TO MONITOR THE IMPLEMENTATION STRATEGY ARE ALSO TAILORED TO EACH OBJECTIVE AND INCLUDE THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES. SCRIPPS AND SELECT DESCRIBE ANY CHALLENGES ENCOUNTERED TO ACHIEVE THE OUTCOMES AND MAKES MODIFICATIONS AS NEEDED. IN ADDITION, SCRIPPS HEALTH IMPLEMENTATION STRATEGY IS FILED ANNUALLY WITH THE INTERNAL REVENUE SERVICE USING FORM 990 SCHEDULE H. COMMUNITY NEEDS SCRIPPS IS ADDRESSING THE HEALTH FOCUS AREAS IDENTIFIED WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS, AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. SCRIPPS IS ADDRESSING ACCESS TO CARE, AGING CARE & SUPPORT, BEHAVIORAL HEALTH, CHILDREN & YOUTH WELLBEING, CHRONIC HEALTH CONDITIONS WHICH INCLUDES CARDIOVASCULAR DISEASE, CANCER AND DIABETES, COMMUNITY SAFETY AND ECONOMIC STABILITY IN THE FY23-25 IMPLEMENTATION STRATEGY. SCRIPPS ADDRESSES MANY OF THE SOCIAL DETERMINANTS OF HEALTH WITHIN THE HEALTH CONDITIONS IDENTIFIED SUCH AS, COMMUNITY AND SOCIAL SUPPORT, FOOD INSECURITY, TRANSPORTATION, EDUCATION, AND HOMELESSNESS. COMMUNITY NEEDS SCRIPPS IS NOT DIRECTLY ADDRESSING HOMELESSNESS AND HOUSING INSTABILITY ARE IDENTIFIED AS IMPORTANT FACTORS WITHIN THE CHNA FINDINGS. HOMELESSNESS AND HOUSING ARE NOT DIRECTLY ADDRESSED IN THE SCRIPPS IMPLEMENTATION STRATEGY AS WE FOCUS OUR RESOURCES ON MORE DIRECT HEALTH ISSUES AND CONDITIONS IN ACCORDANCE WITH OUR EXPERTISE AND MISSION. SCRIPPS HAS NOT DIRECTLY DEVELOPED PROGRAMS THAT SPECIFICALLY ADDRESS HOUSING INSECURITY, BUT THIS IS ADDRESSED AS PART OF OUR CARE TO PATIENTS. WHEN PATIENTS' HOUSING NEEDS ARE IDENTIFIED, THE SCRIPPS MULTIDISCIPLINARY TEAM WORKS TO ADDRESS THE NEED. ADDITIONALLY, THE SCRIPPS HEALTH SYSTEM HAS SOCIAL WORK AND CASE MANAGEMENT RESOURCES IN PLACE THROUGHOUT THE INPATIENT SETTING THAT ADDRESS THIS UNMET NEED BY CONNECTING PATIENTS TO MORE PERMANENT SOURCES OF INCOME, HOUSING, AND OTHER SELF-RELIANCE MEASURES. SCRIPPS WORK TO ADDRESS HOUSING INSECURITY IS LARGELY DONE VIA COLLABORATION AND REFERRALS TO COMMUNITY PARTNERS. IN ADDITION TO THE ABOVE INDIRECT MEASURES, SCRIPPS IS ALSO ADDRESSING THESE COMMUNITY NEEDS IN ACCORDANCE WITH CALIFORNIA'S REGULATIONS, SUCH AS SB 1152 DISCHARGE PLANNING FOR HOMELESS PATIENTS. THIS 2019 REGULATION REQUIRES HOSPITALS TO IMPLEMENT A SET OF REQUIREMENTS REGARDING DISCHARGE PLANNING FOR THEIR HOMELESS PATIENTS. SCRIPPS IS FULFILLING THIS REQUIREMENT BY PROVIDING PACKAGED MEALS, WEATHER-APPROPRIATE CLOTHING, TRANSPORTATION, DISCHARGE MEDICATIONS AND/OR PRESCRIPTIONS, INFECTIOUS DISEASE SCREENINGS AND VACCINATIONS, REFERRALS FOR BEHAVIORAL HEALTH AND OTHER REFERRALS TO SHELTERS OR HOUSING. SCRIPPS HEALTH REMAINS COMMITTED TO THE CARE AND IMPROVEMENT OF HEALTH FOR ALL SAN DIEGANS AND WILL LOOK TO CONTINUE THE SEARCH OF NEW OPPORTUNITIES AND NEW PARTNERSHIPS TO ADDRESS THESE AND FUTURE NEEDS. DETAIL ON THE STRATEGIES, INITIATIVES, MEASURES OF IMPLEMENTATION AND METRICS USED TO EVALUATE THE EFFECTIVENESS OF THE COMMUNITY NEEDS IS IDENTIFIED THROUGH SCRIPPS SPECIALTY HOSPITAL 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS CORRESPONDING IMPLEMENTATION STRATEGY. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTPS://WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE-COMMUNITY__ASSESSING-COMMUNITY-NEEDS
Schedule H, Part V, Section B, Line 16 Facility B, 1	Facility B, 1 - REPORTING GROUP B. SELECT SPECIALTY HOSPITAL SAN DIEGO PROVIDES FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE TO PATIENTS WHO ARE UNABLE TO PAY. THE FOLLOWING IS A SUMMARY OF FINANCIAL ASSISTANCE AVAILABLE AT SELECT SPECIALTY HOSPITAL SAN DIEGO. FINANCIAL ASSISTANCE OFFERED IF YOU DO NOT HAVE INSURANCE, WE PROVIDE FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE. ELIGIBLE CARE INCLUDES MEDICALLY NECESSARY SERVICES AS DEFINED BY MEDICARE (SERVICES OR ITEMS REASONABLE AND NECESSARY FOR THE DIAGNOSIS OR TREATMENT OF ILLNESS OR INJURY). TO RECEIVE FINANCIAL ASSISTANCE, YOU MUST MEET ONE OF THE FOLLOWING CRITERIA: (A) ARE A U.S. CITIZEN; OR (B) CARRY A UNITED STATES PERMANENT RESIDENT CARD (USCIS FORM I-551); OR (C) LIVE WITHIN 50 MILES OF THE FACILITY. YOU WILL RECEIVE FREE CARE, OR 100% WRITE OFF OF PATIENT LIABILITY AFTER INSURANCE HAS PAID, IF YOUR FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY INCOME GUIDELINES. WRITE OFF OF THE DISCOUNTED FINANCIAL ASSISTANCE AMOUNT WHICH IS CALCULATED AS A PERCENTAGE OF TOTAL GROSS CHARGES MAY ALSO BE AVAILABLE FOR UNINSURED AND CERTAIN OTHER PATIENTS WITH FAMILY INCOME UP TO 400% OF THE FEDERAL POVERTY INCOME GUIDELINES. IF FAMILY INCOME IS OVER 400% OF FEDERAL POVERTY INCOME GUIDELINES, FINANCIAL ASSISTANCE MAY STILL BE CONSIDERED. ALL APPLICANTS WILL BE SCREENED FOR MEDICAID COVERAGE AND MUST COOPERATE WITH THE MEDICAID REPRESENTATIVES TO BE CONSIDERED FOR FINANCIAL ASSISTANCE. ADDITIONAL WAYS TO QUALIFY IF YOU DO NOT MEET THE INCOME CRITERIA ABOVE, REGARDLESS OF YOUR INSURANCE STATUS, YOU WILL BE CONSIDERED ON A CASE-BY-CASE BASIS FOR FINANCIAL ASSISTANCE. CONTACT US TO DISCUSS EXCEPTIONAL PERSONAL OR FINANCIAL CIRCUMSTANCES, OR IF THERE ARE SPECIAL MEDICAL CIRCUMSTANCES WHERE TREATMENT CAN ONLY BE PROVIDED BY SELECT SPECIALTY HOSPITAL SAN DIEGO MEDICAL STAFF. WHAT YOU WILL BE CHARGED IF YOU RECEIVE FINANCIAL ASSISTANCE UNDER OUR POLICY, YOU WILL NOT BE CHARGED MORE FOR MEDICALLY NECESSARY CARE THAN THE AMOUNT WE GENERALLY BILL PATIENTS HAVING MEDICARE COVERAGE. HOW TO OBTAIN COPIES OF OUR POLICY AND APPLICATION. YOU MAY OBTAIN A COPY OF OUR FULL FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY, AND APPLICATION FORM FREE OF CHARGE IN ANY OF THE FOLLOWING WAYS: IN OUR ADMISSIONS AREAS OF OUR FACILITY AT 555 WASHINGTON STREET, SAN DIEGO, CA 92103; ONLINE AT HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/PATIENTS-AND-CAREGIVERS/FINANCIAL-ASSISTANCE OR BY CALLING OUR ADMISSIONS DEPARTMENT AT 619-686-4525. HOW TO APPLY AND OBTAIN ASSISTANCE YOU MAY APPLY AT ANY POINT IN THE ADMISSION OR BILLING PROCESS BY COMPLETING AND SUBMITTING AN APPLICATION, AND PROVIDING INCOME INFORMATION. ALL FINANCIAL ASSISTANCE APPLICATIONS, WHETHER COMPLETED IN PERSON, ONLINE, DELIVERED OR MAILED, WILL BE FORWARDED TO OUR CENTRAL BUSINESS OFFICE FOR EVALUATION AND PROCESSING. IF YOU NEED ANY HELP IN APPLYING, PLEASE CONTACT OUR ADMISSIONS DEPARTMENT AT THE FACILITY OR CALL OUR CENTRAL BUSINESS OFFICE AT 888.868.1103. COPIES OF OUR FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND THIS SUMMARY ARE AVAILABLE IN ENGLISH AND SPANISH.
Schedule H, Part V, Section B, Line 20 Facility B, 1	Facility B, 1 - Reporting Group B. Select Specialty Hospital does not make presumptive eligibility determinations. Reasonable efforts to determine eligibility include: notification to the patient of the Policy upon admission and in written and oral communications with the patient regarding the patient's bill, an effort to notify the individual by telephone about the Policy and the process for applying for assistance at least 30 days before taking action to initiate any lawsuit, and a written response to any financial assistance application for assistance under this Policy submitted within 240 days of the first billing statement with respect to the unpaid balance or, if later, the date on which a collection agency working on behalf of Select Specialty Hospital San Diego returns the unpaid balance to the Hospital.

Schedule H (Form 990) 2023

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?45
Name and address		Type of Facility (describe)
1	Scripps Clinic - Torrey Pines 10666 N Torrey Pines Rd La Jolla,CA92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
2	Scripps Clinic - Rancho Bernardo 15004 Innovation Dr San Diego,CA92128	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
3	Scripps Clinic - Carmel Valley 3811 Valley Center Dr San Diego,CA92130	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
4	Scripps Medical Lab 9235 Waples St 150 San Diego,CA92121	LABORATORY SERVICES
5	Scripps Clinic - Jefferson 2205 Vista Way Oceanside,CA92054	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
6	Scripps Clinic - Anderson Medical Pavilion 9898 Genesse Ave La Jolla,CA92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
7	Scripps Clinic - Encinitas 310 Santa Fe Dr Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
8	Scripps Clinic - Mission Valley 7565 Mission Valley Rd San Diego,CA92108	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
9	Scripps Hospital Medical Services 10140 Campus Point Dr San Diego,CA92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
10	Scripps Clinic - La Jolla Memorial Campus 9850 Genesee Ave Ximed Bldg 600 San Diego,CA92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
11	SCMC - Encinitas 477 N El Camino Real Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
12	SCMC - Jefferson 2205 Vista Way Oceanside,CA92054	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
13	SCMC Hillcrest 501 Washington St San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
14	Scripps Clinic - Rancho San Diego 10862 Calle Verde La Mesa,CA91941	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
15	SCMC - Carlsbad 2176 Salk Ave Carlsbad,CA92008	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
16	SCMC - Oceanside 4318 Mission Ave Oceanside,CA92057	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
17	Scripps CL Radiation Therapy Ctr - Vista 916 Sycamore Ave 100 Vista,CA92082	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
18	Mercy ASC 550 Washington St 1st Fl San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
19	Scripps Clinic - Del Mar 12395 El Camino Real 317 Del Mar,CA92130	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
20	La Jolla Radiology - La Jolla 9888 Genesee Ave La Jolla,CA92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
21	SCMC - Cedar 130 Cedar Rd Vista,CA92083	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
22	Scripps Clinic - Encinitas OP Rehab Clinical 1092 El Camino Real Encinitas,CA92024	REHABILITATION SERVICES
23	SCMC - Encinitas OBGYN 332 Santa Fe Dr 115 Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
24	Encinitas Surgery Center LLC 320 Santa Fe Dr LL1-2 Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
25	La Jolla Radiology - Encinitas 354 Sant Fe Dr Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
26	SCMC - Eastlake 971 Lane Ave Chula Vista,CA91914	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
27	Scripps Clinic - Mercy Campus 4020 Fifth Ave 401 San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
28	Scripps Cardio&Thor Surg Ctr - La Jolla 9850 Genesee Ave 560 La Jolla,CA92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
29	SCMC - San Marcos 111 Campus Way Ste 301 San Marcos,CA92078	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
30	Scripps Clinic - Santee 278 Town Center Pkwy 105 Santee,CA92071	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
31	Scripps Clinic - Liberty Station 2445 Truxtun Rd San Diego,CA92106	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
32	Scripps Clinic - San Diego OBGYN 2918 Fifth Ave San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
33	Scripps Clinic - La Jolla OBGYN 9850 Genesee Ave 170 San Diego,CA92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
34	SCMC - Solana Beach 380 Steven Ave 100 Solana Beach,CA92075	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
35	Scripps Clinic - MD Anderson Cancer Ctr 10670 John Jay Hopkins Drive La Jolla,CA92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
36	Scripps Clinic - Hillcrest Surgery 4060 Fourth Ave 330 San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
37	Scripps Cardio&Thor Surg Ctr - Hillcrest 501 Washington St 525 San Diego,CA92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
38	Scripps CL Radiation Therapy Ctr - Encinitas 477 N El Camino Real D100 Encinitas,CA92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
39	Scripps Clinic - Eastlake Specialty 971 Lane Ave Chula Vista,CA91914	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
40	Scripps Clinic - Coronado 1317 A Ynes Place Coronado,CA92118	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
41	Scripps Clinic - Cedar Specialty 130 Cedar Rd Vista,CA92083	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
42	Scripps Clinic - Chula Vista 450 Fourth Ave Chula Vista,CA91910	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
43	Scripps Clinic - UTC 9333 Genesee Ave 170 San Diego,CA92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
44	Scripps Home Health Services 9619 Chesapeake Dr 300 San Diego,CA92123	HOME HEALTH SERVICES
45	Scripps USP Surgery Centers LLC 15305 Dallas Pkwy Addison,TX75001	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT

Schedule H (Form 990) 2023

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
Schedule H, Part I, Line 3c	AT LEAST ONE OF THE FOLLOWING CRITERIA MUST BE MET TO QUALIFY FOR FINANCIAL ASSISTANCE FOR FULL OR PARTIAL BILL COVERAGE: * THE PAYMENT AMOUNT IS NOT COVERED OR REIMBURSED BY MEDI-CAL, MEDICARE OR ANY OTHER THIRD-PARTY INSURANCE. * IN THE PAST 12 MONTHS, THE DOCUMENTED ANNUAL OUT-OF-POCKET MEDICAL EXPENSES AFTER INSURANCE COVERAGE WAS HIGHER THAN 10% OF THE FAMILY INCOME. * THE PATIENT HAS HIGH MEDICAL COSTS AS DEFINED BY STATE AND FEDERAL REGULATIONS. * INCOME IS BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL). * PATIENTS DETERMINED TO BE "HOMELESS NOT PARTICIPATING IN ANOTHER FINANCIAL ASSISTANCE PROGRAM WILL BE GRANTED 100 PERCENT FINANCIAL ASSISTANCE. IF THE HOSPITAL IS UNABLE TO OBTAIN ADEQUATE INFORMATION AFTER ATTEMPTS TO ESTABLISH ABILITY TO PAY, THE PATIENT MAY BE GRANTED FINANCIAL ASSISTANCE ONLY AFTER BILLING AND/OR OTHER ATTEMPTS TO COLLECT INFORMATION HAVE BEEN MADE.
Schedule H, Part I, Line 6a SCHEDULE H, PART I, LINE 6A	THE 2024 COMMUNITY BENEFIT REPORT WAS ADOPTED BY THE SCRIPPS BOARD ON MARCH 2024 AND MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. SCRIPPS HEALTH COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN FISCAL YEAR 2022 AS REQUIRED BY STATE AND FEDERAL LAW. THE SCRIPPS HEALTH BOARD AND SELECT HOSPITAL MANAGEMENT COMMITTEE APPROVED AN AMENDED 2022 CHNA AND A FY23-FY25 IMPLEMENTATION STRATEGY IN DECEMBER 2023 AND JANUARY 2024, RESPECTIVELY. THE REVISIONS NOW INCLUDE SELECT HOSPITAL IN THE PLAN. THE CHNA WAS MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY.
Schedule H, Part II DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY	F8-WORKFORCE DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 8. MANA DE SAN DIEGO (MANASD) SCRIPPS PROVIDED SPONSORSHIP MEMBERSHIP ANNUAL FEES. MANA DE SAN DIEGO (MANASD) IS THE LARGEST CHAPTER OF A NATIONAL LATINA ORGANIZATION. ESTABLISHED IN 1986, ITS MISSION IS TO TRANSFORM COMMUNITIES BY EMPOWERING LATINAS TO ACHIEVE UPWARD MOBILITY AND A BETTER QUALITY OF LIFE. MANA SHORT FOR "HERMANA," THE SPANISH WORD FOR SISTER, IS A DYNAMIC SISTERHOOD OF LATINAS BOUND TOGETHER BY COMMON CULTURE AND GOALS. IN THIRTY-EIGHT YEARS, MANASD HAS BUILT A BELOVED COMMUNITY OF SUPPORT TO EMPOWER LATINAS THROUGH EDUCATION, LEADERSHIP DEVELOPMENT, COMMUNITY SERVICE, AND ADVOCACY. FROM ITS FLAGSHIP HERMANITAS PROGRAM SERVING LATINA MIDDLE AND HIGH SCHOOL STUDENTS, TO THE LATINA SUCCESS LEADERSHIP PROGRAM FOCUSED ON MID-LEVEL PROFESSIONALS, MANASD SERVES LATINAS AT EVERY STAGE OF THEIR LIVES. THROUGH MANASD PROGRAMS, LATINAS REACH THEIR GOALS AND GAIN THE RESOURCES TO NOT ONLY PROVIDE FOR THEMSELVES AND THEIR FAMILIES BUT TO RECIPROCATE AND PAY IT FORWARD IN A VARIETY OF WAYS THAT CONTRIBUTE TO THRIVING COMMUNITIES THROUGHOUT OUR REGION. WHEN A LATINA SUCCEEDS, SHE CREATES GENERATIONAL CHANGE THAT BENEFITS OUR ENTIRE REGION. NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION SCRIPPS SPONSORED A FUNDRAISER FOR THE NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION. SUPPORT PROVIDES SCHOLARSHIP FUNDS FOR THE NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION (NCAAWA) TO SUPPORT GIRLS AND WOMEN OF AFRICAN AMERICAN DESCENT. THE PROGRAM HAS HELPED HUNDREDS OF WOMEN RECEIVE CAREER, VOCATIONAL AND TECHNICAL EDUCATION, IN ADDITION TO LIFE SKILLS AND HEALTH AWARENESS. NCAAWA HAS BEEN ASSISTING WOMEN REENTERING THE WORKFORCE AND GRADUATING SENIORS TO ACHIEVE THEIR EDUCATIONAL GOALS THROUGH FUNDRAISING EFFORTS. PROGRAM EFFORTS HAVE ENABLED HUNDREDS OF WOMEN TO LEAD HEALTHY, FULFILLING, AND SELF-SUFFICIENT LIVES. UNIVERSITY CITY HIGH SCHOOL EXPLORATION PROGRAM SCRIPPS PARTNERS WITH UC HIGH SCHOOL EXPLORATION PROGRAM TO PROVIDE OPPORTUNITIES FOR STUDENTS TO LEARN ABOUT CAREERS IN HEALTHCARE. SCRIPPS AND THE CENTER FOR LEARNING & INNOVATION PARTNERED WITH UC HIGH SCHOOL HEALTH ESSENTIALS TO PROVIDE WORKFORCE PREPAREDNESS IN A HEALTHCARE SETTING AS AN EXTENSION OF THEIR CLASSROOM LEARNING EXPERIENCE. TWO EVENTS WERE HELD IN SEPTEMBER. THE FIRST WAS AN ED/TRAUMA TOUR AND SECOND WAS A BIOMED PANEL PRESENTATION TO THE STUDENTS. BOTH EVENTS HELD 67 STUDENTS AND SCRIPPS STAFF CONTRIBUTED A TOTAL OF 20 HOURS TO THE EVENTS. YOUNG LEADERS IN HEALTHCARE PROGRAM SCRIPPS ENCINITAS HOSTED THE YOUNG LEADERS IN HEALTH CARE PROGRAM FOR LOCAL HIGH SCHOOL STUDENTS DURING THE 2023-2024 SCHOOL YEAR. THE PROGRAM INCLUDED 9 MEETINGS WITH OVER 590 PARTICIPANTS IN TOTAL, COVERING VARIOUS HEALTH-RELATED TOPICS AND PRESENTATIONS. AFTER COMPLETING THIS INITIATIVE, STUDENTS CAN APPLY FOR THE HIGH SCHOOL EXPLORER SUMMER INTERNSHIP PROGRAM. SCRIPPS HIGH SCHOOL EXPLORATION INTERNSHIP PROGRAM SCRIPPS HEALTH INITIATED THE SCRIPPS HIGH SCHOOL EXPLORATION INTERNSHIP PROGRAM TO ENGAGE YOUNG INDIVIDUALS AND CULTIVATE THEIR INTEREST IN HEALTHCARE PROFESSIONS FACING A SHORTAGE OF SKILLED PROFESSIONALS. TWENTY-FIVE STUDENTS GAINED EXPOSURE TO VARIOUS HOSPITAL DEPARTMENTS, INCLUDING THE EMERGENCY ROOM AND SURGERY, ALLOWING THEM TO EXPLORE DIFFERENT CAREER POSSIBILITIES IN HEALTHCARE WHILE ALSO ACQUIRING VALUABLE INSIGHTS INTO HEALTH AND HEALING. SCRIPPS SCHOOL TO HEALTH CAREER PATHWAY PROGRAMS SCRIPPS MERCY HOSPITAL CHULA VISTA INTRODUCED A DIVERSE ARRAY OF YOUTH INTO HEALTH PROFESSIONS ACTIVITIES, BENEFITING over 1,600+ YOUNG INDIVIDUALS. THESE ACTIVITIES ENCOMPASS MENTORING PROGRAMS, CLASSROOM PRESENTATIONS BY HEALTH PROFESSIONALS, SURGICAL OBSERVATIONS, PARTICIPATION IN THE CRISTO REY WORK STUDY PROGRAM, AND INVOLVEMENT IN THE SCRIPPS HEALTH CAREERS OPPORTUNITY CAMP.
Schedule H, Part VI, Line 2 NEEDS ASSESSMENT (CONTINUATION)	QUANTITATIVE DATA INCLUDED: * CALIFORNIA'S DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) LIMITED DATA SETS, 2017-2019 SPEEDTRACK * COMMUNITY NEED INDEX (CNI) * PUBLIC HEALTH ALLIANCE OF SOUTHERN CALIFORNIA HEALTHY PLACES INDEX (HPI) * DATA FROM NATIONAL AND STATE -WIDE DATA SETS WERE ANALYZED INCLUDING SAN DIEGO MORTALITY AND MORBIDITY DATA, AND DATA RELATED TO SOCIAL DETERMINANTS OF HEALTH. THE HPI AND THE CNI WERE USED TO IDENTIFY THE MOST UNDER-RESOURCED GEOGRAPHIC COMMUNITIES. THIS INFORMATION HELPED GUIDE THE COMMUNITY ENGAGEMENT PROCESS, INCLUDING SELECTING COMMUNITIES FROM WHICH TO SOLICIT INPUT AND DEVELOPING RELEVANT AND MEANINGFUL ENGAGEMENT TOPICS AND QUESTIONS. DATA FROM THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY, INCLUDING THE FOLLOWING REPORTS AND DASHBOARDS WERE ALSO USED: REPORTS * COUNTY OF SAN DIEGO COMMUNITY HEALTH STATISTICS * HEALTH DISPARITIES EXECUTIVE SUMMARY REPORT * RACIAL EQUITY: FRAMEWORK AND OUTCOMES BRIEF * SAN DIEGO COUNTY SELF-SUFFICIENCY STANDARD, HOUSEHOLD WITH TWO ADULTS, ONE PRESCHOOL-AGE CHILD, AND ONE SCHOOL-AGE CHILD, 2021 * OVERDOSE DATA TO ACTION (OD2A) COMMUNITY HEALTH STATISTICS DASHBOARDS * LGBTQ HEALTH AND WELL-BEING DASHBOARDS * HEALTH EQUITY DASHBOARD SERIES: RACIAL EQUITY DASHBOARDS * SAN DIEGO COUNTY SELF-SUFFICIENCY STANDARD DASHBOARD * COVID-19 IN SAN DIEGO COUNTY QUALITATIVE DATA - COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO SOLICIT INPUT FROM A WIDE RANGE OF STAKEHOLDERS SO THAT THE SAMPLE WAS AS REPRESENTATIVE AS POSSIBLE OF THOSE FACING INEQUITIES IN SAN DIEGO COUNTY. A TOTAL OF 841 INDIVIDUALS PARTICIPATED IN THE 2022 CHNA. INPUT FROM THE COMMUNITY WAS GATHERED THROUGH THE FOLLOWING DISCUSSIONS: * WORKING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS * CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTH CARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL (KFH)-SAN DIEGO) * CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS * DISTRIBUTING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT STAFF FOUNDATIONAL CHALLENGES THE 2022 CHNA RECOGNIZED HEALTH DISPARITIES AND WORKFORCE SHORTAGES AS FOUNDATIONAL CHALLENGES THAT ARE CONTRIBUTING TO THE GROWTH OF EVERY HEALTH NEED. HEALTH DISPARITIES DECADES OF RESEARCH HAS DEMONSTRATED THAT EVEN IN PRE-PANDEMIC TIMES, SOME COMMUNITIES AND POPULATIONS HAVE MUCH POORER HEALTH CARE AND OUTCOMES THAN OTHER COMMUNITIES OR POPULATIONS. THESE MAY BE ISSUES OF ACCESS ROOTED IN GEOGRAPHY, ISSUES OF FINANCE AND INSURANCE COVERAGE, OR SYSTEMIC ISSUES ROOTED IN RACISM AND DISCRIMINATION. FOR EXAMPLE, "FRONTLINE" WORKERS (PEOPLE WHO ARE MOST INVOLVED IN DIRECT CUSTOMER CONTACT) COULD NOT WORK FROM HOME DURING THE PANDEMIC AND WERE AT HIGHER RISK OF COVID EXPOSURE. THIS CONTRIBUTED TO DISPROPORTIONATELY HIGHER MORTALITY RATES COMPARED TO GROUPS THAT COULD WORK FROM HOME OR QUIT WORK. IN ADDITION, THE HEALTH OF SAN DIEGANS WHO WERE VULNERABLE BEFORE THE PANDEMIC - SUCH AS PEOPLE EXPERIENCING HOMELESSNESS, ISOLATED SENIORS, LGBTQ+ YOUTH, AND CHILDREN WITH SPECIAL NEEDS - DETERIORATED MORE ACUTELY AS THEY LOST ACCESS TO CRITICAL SERVICES AND FACED NEW BARRIERS TO THEIR SAFETY AND ECONOMIC STABILITY. WORKFORCE SHORTAGES COMMUNITY ENGAGEMENT PARTICIPANTS IN PREVIOUS CHNAS OFTEN MENTIONED THE NEED FOR MORE HEALTH CARE PROVIDERS, MOSTLY WITH A VIEW TOWARD BOLSTERING WORKFORCE PIPELINES. IN THE 2022 CHNA FOCUS GROUPS AND INTERVIEWS, WORKFORCE SHORTAGES WERE CONSISTENTLY AT THE FRONT OF DISCUSSIONS. IN MOST OCCUPATIONS, WORKERS ARE EXPERIENCING EXHAUSTION, EMOTIONAL TRAUMA, AND A SENSE OF "FEELING BURNED OUT AFTER OVER TWO YEARS OF THE COVID PANDEMIC." CLINICAL WORKERS AND SOCIAL WORK STAFF AT ALL LEVELS OF HEALTH CARE DELIVERY FACED THE SAME CHALLENGES AND FRUSTRATIONS, AS WORKFORCE SHORTAGES AND THE INCREASED MEDICAL DEMANDS OF COVID STRESSED HEALTH CARE SERVICES ACROSS THE REGION. KEY UNDERLYING THEMES STIGMA AS IN OUR 2019 CHNA FINDINGS, STIGMA AND THE BARRIERS IT CREATES AROSE ACROSS COMMUNITY ENGAGEMENT DISCUSSIONS IN 2022. STIGMA IMPACTS THE WAY PEOPLE ACCESS NEEDED SERVICES (CALFRESH, MEDI-CAL, OTHER ECONOMIC SUPPORT) THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. THIS IMPACTS THE ABILITY OF PEOPLE TO IMPROVE AND SUCCESSFULLY MANAGE HEALTH CONDITIONS. COMMUNITY ENGAGEMENT PARTICIPANTS EXPRESSED CONCERNS ABOUT THE IMPACT OF STIGMA IN RELATION TO SPECIFIC POPULATIONS INCLUDING LGBTQ+ COMMUNITIES, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE OF COLOR, SENIORS, MEDI-CAL BENEFICIARIES, AND SURVIVORS OF DOMESTIC VIOLENCE AND HUMAN TRAFFICKING. STIGMA WAS ALSO DISCUSSED IN RELATION TO SPECIFIC HEALTH CONDITIONS SUCH AS BEHAVIORAL HEALTH, CANCER, DIABETES, AND OBESITY. TRAUMA TRAUMA AND VICARIOUS TRAUMA , WERE CITED AS FACTORS CONTRIBUTING TO COMPASSION FATIGUE AND WORKFORCE BURNOUT IN COMMUNITY INTERVIEWS AND FOCUS GROUPS. TRAUMA OCCURS BOTH AT WORK AND AT HOME, AND CONSEQUENTLY, THERE MAY BE NO ESCAPE AND DOWNTIME FROM TRAUMATIC EXPERIENCES. TRAUMATIZED COMMUNITY MEMBERS ARE SEEKING ASSISTANCE FROM HEALTH CARE PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS WHO THEMSELVES HAVE EXPERIENCED GREAT STRESS SINCE THE START OF THE PANDEMIC. COMMUNITY VOICE AND EXPERIENCES THE FINDINGS OF THE 2022 CHNA ATTEMPT TO RESPOND TO THE SAN DIEGO COMMUNITY NEEDS AND CONCERNS, AS IDENTIFIED THROUGH FOCUS GROUPS, KEY INFORMANT INTERVIEWS, INTERVIEWS REGARDING ACCESS TO CARE, AND AN ONLINE SURVEY. THE QUANTITATIVE RESEARCH AND THE COMMUNITY ENGAGEMENT CONFIRMED THE INTERCONNECTEDNESS OF THE SEVEN IDENTIFIED NEEDS. WHEN DISCUSSING THE FINDINGS, THE CHNA HIGHLIGHTS HOW THEY MAY DIFFER FOR SAN DIEGANS BASED ON THEIR EXPERIENCES. THESE DIFFERING EXPERIENCES MAY INCLUDE HOMELESSNESS, IMMIGRATION STATUS, GENDER AND SEXUAL ORIENTATION, AGE AND POVERTY. COMMUNITY RECOMMENDATIONS DURING THE ACCESS TO CARE INTERVIEWS AND IN THE ONLINE COMMUNITY SURVEY, WE ASKED "WHAT ARE THE MOST IMPORTANT THINGS THAT HOSPITALS AND HEALTH SYSTEMS COULD DO TO IMPROVE HEALTH AND WELL-BEING IN OUR COMMUNITY?" OVERWHELMINGLY, RESPONDENTS AGREED THAT THERE IS A CRITICAL NEED TO HELP PATIENTS NAVIGATE AVAILABLE SERVICES THAT WILL HELP IMPROVE THEIR HEALTH AND WELL-BEING. IN BOTH THE INTERVIEWS AND THE SURVEYS, OPTIONS THAT CENTERED AROUND IMPROVED PATIENT CARE ROSE TO THE TOP. MOST RESPONSES FELL INTO FOUR CATEGORIES: NAVIGATION AND SUPPORT, CULTURALLY APPROPRIATE, WORKFORCE DEVELOPMENT, AND COMMUNITY COLLABORATION. NEXT STEPS THE CHNA REPORT IS MADE AVAILABLE AS A RESOURCE TO THE BROADER COMMUNITY AND IS INTENDED TO SERVE AS A USEFUL RESOURCE TO BOTH RESIDENTS AND HEALTH CARE PROVIDERS TO FURTHER COMMUNITYWIDE HEALTH IMPROVEMENT EFFORTS. HASD&IC AND THE CHNA COMMITTEE ARE PROUD OF THEIR COLLABORATIVE RELATIONSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS AND ARE COMMITTED TO REGULARLY SEEKING INPUT FROM THE COMMUNITY TO INFORM COMMUNITY HEALTH STRATEGIES. ADDITIONALLY, THE CHNA COMMITTEE IS ACTIVELY INVOLVED IN PLANNING THE 2025 CHNA, DEMONSTRATING THEIR COMMITMENT TO ONGOING ASSESSMENTS AND IMPROVEMENTS IN COMMUNITY HEALTH. THIS COMMITMENT ENSURES THAT THE ASSESSMENT REMAINS UP-TO-DATE AND RESPONSIVE TO THE EVOLVING NEEDS OF THE COMMUNITY.
Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT	SCRIPPS HEALTH COMMUNITY BENEFIT PLAN AND REPORT CAN BE FOUND AT:HTTP://WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE-COMMUNITY. THE FAP AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW.
Schedule H, Part I, Line 7g Subsidized Health Services	SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED, WHICH IF NO LONGER OFFERED WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION. SUBSIDIZED SERVICES DO NOT INCLUDE ANCILLARY SERVICES THAT SUPPORT LINES, SUCH AS LAB AND RADIOLOGY (IF THESE SERVICES ARE PROVIDED TO LOW-INCOME PERSONS, THEY ARE REPORTED AS CHARITY CARE/FINANCIAL ASSISTANCE). THE TOTAL EXPENSE FOR SUBSIDIZED HEALTH SERVICES FOR SCRIPPS MERCY FISCAL YEAR 2024 WAS $3,100,477. SUBSIDIZED HEALTH ONLY INCLUDES SCRIPPS INPATIENT BEHAVIORAL HEALTH. THE COSTS ASSOCIATED WITH THE SCRIPPS RESIDENT CLINIC AT FAMILY HEALTH CENTERS OF SAN DIEGO WAS MOVED TO THE PROFESSIONAL EDUCATION CATEGORY. SCRIPPS OFFERS INPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL, SAN DIEGO CAMPUS. THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM ALSO ACTIVELY SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINES 7G. SCRIPPS HEALTH OFFERS INPATIENT BEHAVIORAL HEALTH CARE FOR ADULTS ADMITTED THROUGH OUR EMERGENCY DEPARTMENTS OR URGENT CARE CENTERS. OUR OUTPATIENT BEHAVIORAL HEALTH SERVICES ARE AVAILABLE THROUGH PARTNERSHIPS WITH VARIOUS COMMUNITY ORGANIZATIONS. LIKE MANY BEHAVIORAL HEALTH PROGRAMS NATIONWIDE, FUNDING REMAINS A CHALLENGE, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE ACTUAL COST OF CARE. IN FISCAL YEAR 2024, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM REPORTED A TOTAL OPERATIONAL LOSS OF $8.3 MILLION, WITH $5 MILLION ATTRIBUTED TO MEDI-CAL, OR OTHER MEANS TESTED GOVERNMENT PROGRAMS AND CHARITY CARE. NOTABLY, 1.1% OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED, UNDERSCORING THE FINANCIAL PRESSURES FACED BY THESE PROGRAMS.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	SCRIPPS UNCOMPENSATED CARE METHODOLOGY FISCAL YEAR 2024. SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES TO PROVIDING LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. THE COSTS OF PROVIDING THESE SERVICES ARE NOT FULLY REIMBURSED. DURING FISCAL YEAR 2024, SCRIPPS CONTRIBUTED $587,766,140 IN UNCOMPENSATED HEALTH CARE, INCLUDING $17,768,458 IN CHARITY CARE, $562,399,773 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $7,597,909 IN BAD DEBT. SCHEDULE H METHODOLOGY - BAD DEBT AND MEDICARE SHORTFALLS ARE REPORTABLE UNDER THE SCHEDULE H GUIDELINES BUT DO NOT COUNT TOWARDS THE COMMUNITY BENEFIT TOTALS. THUS, THE CATEGORIES ARE REPORTED IN A SPECIFIC ORDER/HIERARCHY. CHARITY CARE AND UNDER-REIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS ARE COUNTED FIRST. CHARITY CARE METHODOLOGY - UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS CHARITY ADJUSTMENTS. THE FOLLOWING COSTS ARE EXCLUDED: COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. TRADITIONAL CHARITY CARE IS INCLUDED IN THE INTERNAL REVENUE SERVICE (IRS) FORM 990 SCHEDULE H PART I LINE 7A. MEDI-CAL SHORTFALL - THE SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE, MEDICARE PPO, MEDICARE HMO, MEDICARE CAPITATED PROGRAM AT THE HOSPITALS, MEDI-CAL, MEDI-CAL HMO, AND CMS PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS REVENUE FROM UNCOMPENSATED CARE POOLS INCLUDING MEDI-CAL DSH UNTIL JULY 2024. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE SYNTELLIS PERFORMANCE SOLUTIONS. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY ADJUSTMENTS AT COST FOR MEDI-CAL PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINE 7B. IN THE STATE OF CALIFORNIA, THE MEDICAID PROGRAM IS CALLED MEDI-CAL. MEDICARE AND MEDICARE HMO HOSPITALS - SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE AND MEDICARE SENIOR PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE CAPITATION ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS OTHER REVENUE INCLUDING. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE MCKESSON HPM COST ACCOUNTING SYSTEM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION B. BAD DEBT METHODOLOGY - UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO- COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD DEBT ADJUSTMENTS LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION A. SHORTFALL METHODOLOGY CLINICS - SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE AND MEDICARE SENIOR PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE CAPITATION ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS OTHER REVENUE INCLUDING. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE MCKESSON HPM COST ACCOUNTING SYSTEM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION B. SELECT HOSPITAL - SCRIPPS HAS A 24.5% OWNERSHIP PERCENTAGE WITH SELECT HOSPITAL. THEREFORE, SCRIPPS REPORTED AMOUNTS IN SCHEDULE H, PARTS I THROUGH III, FROM SELECT HOSPITAL BASED ON SCRIPPS OWNERSHIP PERCENTAGE.
Schedule H, Part II Community Building Activities	F1 - PHYSICAL IMPROVEMENTS AND HOUSING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 1 LEADERSHIP RETREAT VOLUNTEER SERVICE DAY SCRIPPS MERCY HOSPITAL ORGANIZED A LEADERSHIP RETREAT THAT OFFERED LEADERS THE OPPORTUNITY TO CONTRIBUTE TO COMMUNITY SERVICE INITIATIVES BY PAINTING, CLEANING, AND IMPROVING FACILITIES OPERATED BY NOT-FOR-PROFIT HOMELESS SERVICE PROVIDERS. THESE PROJECTS WERE CONDUCTED IN COLLABORATION WITH ORGANIZATIONS SUCH AS CASA DE MISERICORDIA, FATHER JOE'S VILLAGE, MAMA'S KITCHEN, MERCY HOUSING & GARDENS, AND RESCUE MISSION. F2 - ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP: COMMUNITY BOARDS AND ORGANIZATIONS SCRIPPS PARTICIPATED ON VARIOUS COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS, REPRESENTING THE ORGANIZATION'S POSITIONS ON HEALTH ISSUES AND ADDRESSING MATTERS CONCERNING HEALTH AND SAFETY WITHIN THE COMMUNITY. MERCY SAN DIEGO: COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS SCRIPPS MERCY SAN DIEGO PARTICIPATED ON VARIOUS COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS, INCLUDING THE SAN DIEGO DOWNTOWN PARTNERSHIP, SAN DIEGO REGIONAL TASK FORCE ON HOMELESSNESS, HILLCREST BUSINESS ASSOCIATION (HBA) IN SUPPORT OF ADVOCATING FOR SCRIPPS MERCY'S MISSION IN THE COMMUNITY. F3 - COMMUNITY SUPPORT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 3. THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL) SCRIPPS SPONSORED THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL) ANNUAL CONFERENCE. FOUNDED IN 2001, THE SOHL IS AN OFFICIAL COMBINED CHAPTER OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES (ACHE), AN INTERNATIONAL PROFESSIONAL SOCIETY OF MORE THAN 49,000 HEALTHCARE EXECUTIVES. SAN DIEGO LGBT PRIDE INC SCRIPPS SPONSORED THE ANNUAL SAN DIEGO LGBTQ PRIDE PARADE. SCRIPPS EMPLOYEES PARTICIPATED IN THE PARADE AND 5K WALK PRESENTED BY FRONT RUNNERS & WALKERS SAN DIEGO. SAN DIEGO PRIDE INCORPORATED AS A 501(C)(3) NONPROFIT ORGANIZATION IN 1994, AND TODAY IT CONTINUES TO BRING TOGETHER THE SKILLS, TALENTS, AND VISIONS OF OUR DIVERSE COMMUNITY THROUGH NUMEROUS PROGRAMS. CHICANO FEDERATION SCRIPPS SPONSORED THE "UNITY LUNCHEON "CESAR CHAVEZ DAY OF SERVICE". THE CHICANO FEDERATION OF SAN DIEGO COUNTY IS A NONPROFIT, COMMUNITY-BASED ORGANIZATION THAT OFFERS A RANGE OF FAMILY, CHILDCARE, HOUSING, COMMUNITY DEVELOPMENT AND ADVOCACY. SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP". AS PART OF THE ONGOING WORKPLACE VIOLENCE PREVENTION EFFORTS, SCRIPPS LA JOLLA HELD "COFFEE WITH A COP," AN OPEN DIALOGUE SESSION WITH THE SAN DIEGO POLICE DEPARTMENT. SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP". AS PART OF THE ONGOING WORKPLACE VIOLENCE PREVENTION EFFORTS, SCRIPPS MERCY HELD "COFFEE WITH A COP," AN OPEN DIALOGUE SESSION WITH THE SAN DIEGO POLICE DEPARTMENT TO BUILD RELATIONSHIPS. MERCY SD INITIALLY MET WITH THE POLICE CHIEF LIAISON AND THE ASSISTANT POLICE CHIEF WITH THE NEXT STEPS TO HOST A SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP." TO BUILD RELATIONSHIPS WITH THE LOCAL POLICE DEPARTMENTS SCRIPPS MERCY CHULA VISTA HOSTED TWO "COFFEE WITH A COP" SESSIONS WITH THE CHULA VISTA POLICE DEPARTMENT. DISASTER PREPAREDNESS - COMMUNITY SUPPORT AND OUTREACH EDUCATION SCRIPPS LEADS IN DISASTER PREPAREDNESS, COLLABORATING WITH VARIOUS LEVELS OF GOVERNMENT AND COMMUNITY LEADERS. THESE EFFORTS FOCUS ON PLANNING FOR EMERGENCIES AND ACTIVELY PROMOTE COMMUNITY AWARENESS AND PARTICIPATION IN PREPAREDNESS ACTIVITIES TO HELP CARE FOR DISASTER VICTIMS. HOSPITAL INCIDENT COMMAND SYSTEM (HICS) NATIONAL ADVISORY COMMITTEE SCRIPPS HEALTH IS AN ACTIVE MEMBER IN THE HOSPITAL INCIDENT COMMAND SYSTEM NATIONAL ADVISORY COMMITTEE (HICS). THE TRAINING IS FOCUSED SPECIFICALLY ON HICS, AN INCIDENT MANAGEMENT SYSTEM THAT CAN BE USED BY HOSPITALS TO MANAGE THREATS, PLANNED EVENTS OR EMERGENCIES. SCRIPPS HOSTED A COURSE WHICH WAS OPENED TO THE COMMUNITY AND 39 PEOPLE ATTENDED. SAN DIEGO COUNTY AND STATE OF CALIFORNIA ADVISORY GROUPS SCRIPPS PARTICIPATED IN SAN DIEGO COUNTY AND STATE OF CALIFORNIA ADVISORY GROUPS TO PLAN, IMPLEMENT, AND EVALUATE KEY DISASTER PREPAREDNESS RESPONSE PLANS AND EXERCISES. IN ADDITION, SCRIPPS IS AN ADVISOR TO SAN DIEGO COUNTY FOR FEDERAL AND STATE GRANT DEVELOPMENT AND PLANNING. SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE(SDHDC) SCRIPPS HEALTH ACTIVELY COLLABORATES WITH THE SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE (SDHDC) TO IMPROVE EMERGENCY PREPAREDNESS AND RESPONSE PLANNING. SAN DIEGO COUNTY OPERATIONAL AREA FULL SCALE EXERCISE SCRIPPS PARTICIPATED IN THE SAN DIEGO REGIONAL FULL-SCALE EXERCISE, ENHANCING THE REGION'S RESPONSE TO COMPLEX MASS CASUALTY INCIDENTS. THE EXERCISE SIMULATED A PEDIATRIC SURGE FROM MULTIPLE INCIDENTS ACROSS SAN DIEGO COUNTY, INVOLVING VARIOUS AGENCIES, INCLUDING HOSPITALS. SAN DIEGO COUNTY COALITION SURGE TEST NO NOTICE EXERCISE SCRIPPS PARTICIPATED IN THE SAN DIEGO COUNTY COALITION SURGE TEST NO NOTICE EXERCISE, A DRILL SIMULATING AN ACTIVE SHOOTER SCENARIO INVOLVING APPROXIMATELY 100 PATIENTS, PREDOMINANTLY PEDIATRIC CASES. SAN DIEGO REGIONAL FULL-SCALE EXERCISE SCRIPPS PARTICIPATED IN THE COUNTY WIDE EXERCISE MEDICAL AND HEALTH FULL SCALE EXERCISE. ALL HOSPITALS PARTICIPATED, TESTED AND EVALUATED THE CAPABILITIES OF THE COMMAND CENTER AND THE RESPONSE PLAN FOR PATIENT SURGE AND EVACUATION. SCRIPPS MEDICAL RESPONSE TEAM (SMRT) SCRIPPS HAS A SYSTEM-WIDE DISASTER PREPAREDNESS PROGRAM THAT INCLUDES THE VOLUNTEER SCRIPPS MEDICAL RESPONSE TEAM (SMRT). SMRT IS READY TO DEPLOY WHEN REQUESTED BY THE CALIFORNIA MEDICAL ASSISTANCE TEAM (CAL-MAT) DURING STATE EMERGENCIES LIKE WILDFIRES OR EARTHQUAKES. ALTHOUGH THERE WERE NO DEPLOYMENTS IN 2024, THE TEAM REMAINS PREPARED FOR FUTURE CALLS FOR ASSISTANCE. F4 - ENVIRONMENTAL IMPROVEMENTS F5 - LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 5. F6 - COALITION BUILDING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 6. CHULA VISTA COMMUNITY COLLABORATIVE (CVCC) SCRIPPS TOOK PART IN THE CHULA VISTA COMMUNITY COLLABORATIVE (CVCC), A MONTHLY GATHERING OF OVER 150 LOCAL ORGANIZATIONS FOCUSED ON IMPROVING RESIDENT HEALTH, SAFETY, ECONOMIC RESOURCES, LEADERSHIP EMPOWERMENT, ENVIRONMENTAL QUALITY, AND CULTURAL DIVERSITY IN THE COMMUNITY. STAFF DEDICATED 18 HOURS TO THIS COLLABORATIVE. SOUTH COUNTY ACTION NETWORK (SOCAN) SCRIPPS PARTICIPATED IN THE SOUTH COUNTY ACTION NETWORK (SOCAN), A COLLABORATIVE NETWORK OF INDIVIDUALS AND SERVICE PROVIDERS DEDICATED TO ADVOCATING FOR AND ENHANCING SERVICES FOR OLDER ADULTS AND ADULTS WITH DISABILITIES IN THE SOUTH COUNTY REGION. THERE ARE OVER 75 NETWORK PARTNERS. STAFF DEDICATED 9 HOURS TO THIS COLLABORATIVE. F7 - COMMUNITY HEALTH IMPROVEMENT ADVOCACY - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 7.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	UNCOMPENSATED COST IS DERIVED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD DEBT ADJUSTMENTS, LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 REPRESENTS PATIENT CARE CHARGES WRITTEN OFF TO BAD DEBT WHERE THE PATIENT HAD THE ABILITY TO PAY. WHERE A PATIENT QUALIFIED FOR PARTIAL OR FULL CHARITY CARE, THE UNPAID AMOUNT IS NOT CONSIDERED BAD DEBT. WE BELIEVE THAT BAD DEBT PERTAINING TO PATIENT CARE CHARGES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGARDLESS OF WHETHER WE COLLECT PAYMENT FOR THE SERVICES PERFORMED.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	BAD DEBT WRITE-OFFS REPRESENT THE AMOUNT A PATIENT OR OTHER PAYER CANNOT (OR WILL NOT) PAY OF ITS PORTION OF THE BILL. THE HOSPITAL CONSIDERS BAD DEBT UNRECOVERABLE AND, THEREFORE, IT DIRECTLY DECREASES REVENUE AND IS CONSIDERED A COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	FOOTNOTE FOR BAD DEBT EXPENSE THE ORGANIZATION ADOPTED THE ACCOUNTING STANDARD ADDRESSING THE PRESENTATION OF THE PROVISION FOR BAD DEBTS AS OF THE CURRENT REPORTING PERIOD AND AS SUCH, NET PATIENT SERVICE REVENUES ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE STATEMENTS OF OPERATIONS. THE ORGANIZATION RECORDS ITS PROVISION FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL EXPERIENCE, AS WELL AS COLLECTION TRENDS FOR MAJOR PAYOR TYPES.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	MEDICARE AND MEDICARE HMO: HOSPITALS MEDICARE ALLOWABLE COSTS ARE DETERMINED USING A COST TO CHARGE RATIO. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY AND BAD DEBT ADJUSTMENTS AT COST FOR MEDICARE AND MEDICARE SENIOR PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, SUBSIDIZED HEALTH SERVICES PROVIDED TO MEDICARE PATIENTS AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. AS A NOT-FOR-PROFIT, COMMUNITY BENEFIT 501(C)(3) ORGANIZATION, SCRIPPS HEALTH'S PURPOSE IS TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES SERVED. MEDICARE COVERS A SIGNIFICANT PROPORTION OF THE SAN DIEGO COMMUNITY PATIENT POPULATION, INPATIENT AND OUTPATIENT. THE LEVEL OF QUALITY AND ACCESS TO CARE IS THE SAME, REGARDLESS OF PAYER. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FOR MEDICARE; RATHER, IT IS SUBJECT TO GOVERNMENT REIMBURSEMENT POLICY. THERE IS A WELL-DOCUMENTED MEDICARE REIMBURSEMENT SHORTFALL OF PAYMENT FOR CARE NOT MEETING THE COST OF DELIVERING CARE. THAT SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN THE HOSPITAL'S FINANCIAL STATEMENTS. IT IS REAL AND SUBSTANTIAL. IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS. SCRIPPS MUST ACCEPT THE PATIENTS REGARDLESS OF REIMBURSEMENT RATES FROM MEDICARE AND IF PATIENTS ARE NOT CARED FOR BY SCRIPPS IT IS LIKELY THAT ANOTHER COMMUNITY OR GOVERNMENT AGENCY WOULD HAVE TO COVER THE CARE OF THE PATIENT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	ALL COLLECTION EFFORTS ARE SUSPENDED AS LONG AS THE PATIENT IS MAKING A GOOD FAITH EFFORT TO APPLY FOR A FEDERAL OR STATE PROGRAM OR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. COLLECTION EFFORTS WILL RESUME IF THE PATIENT FAILS TO COMPLY WITH REQUESTS MADE IN CONNECTION WITH THESE PROGRAMS.
Schedule H, Part V, Section B, Line 16a FAP website	A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16a URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16a URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/;
Schedule H, Part V, Section B, Line 16b FAP Application website	A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16b URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16b URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16c URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16c URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/;
Schedule H, Part VI, Line 2 Needs assessment	NEEDS ASSESSMENT AS PART OF THE FEDERAL REPORTING REQUIREMENT FOR PRIVATE, NOT-FOR-PROFIT (TAX EXEMPT) HOSPITALS, SCRIPPS CONDUCTS A CONSOLIDATED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CORRESPONDING JOINT IMPLEMENTATION STRATEGY FOR ITS LICENSED HOSPITAL FACILITIES. THIS COMPREHENSIVE ACCOUNT OF HEALTH NEEDS IN THE COMMUNITY IS DESIGNED FOR HOSPITALS TO PLAN THEIR COMMUNITY BENEFIT PROGRAMS TOGETHER WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY-BASED ORGANIZATIONS, AND CONSUMER GROUPS. TO CARRY OUT THIS REGULATORY REQUIREMENT, SCRIPPS HAS BEEN ACTIVELY INVOLVED IN A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THIS PROCESS BEGAN IN 1995, IN ACCORDANCE WITH THE REQUIREMENTS OF SENATE BILL 697, COMMUNITY BENEFIT LEGISLATION THAT REQUIRES NOT-FOR-PROFIT HOSPITALS IN CALIFORNIA TO FILE A TRIENNIAL CHNA THAT IDENTIFIES COMMUNITY HEALTH NEEDS. FURTHER, SCRIPPS HEALTH 2022 COMMUNITY HEALTH NEEDS ASSESSMENT RESPONDS TO FEDERAL TAX LAW REQUIREMENTS SET FORTH IN INTERNAL REVENUE CODE SECTION 501(R) REQUIRING PRIVATE NOT-FOR-PROFIT (TAX-EXEMPT) HOSPITALS AS DESCRIBED IN CODE SECTION 501(C)3)TO CONDUCT AND MAKE PUBLIC A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY IDENTIFIES, AND DETAILS CURRENT OR PLANNED STRATEGIES INTENDED TO ADDRESS THE NEEDS IDENTIFIED IN THE HOSPITAL'S CHNA. SCRIPPS HEALTH ACTIVELY PARTICIPATES IN THE COLLABORATIVE CHNA PROCESS LED BY THE HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES (HASD&IC). ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE 2022 CHNA COLLABORATIVE PROCESS ALSO INCLUDES HOSPITALS AND HEALTH SYSTEMS WHO ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. THE 2022 CHNA INCLUDES EXTENSIVE QUANTITATIVE ANALYSIS OF SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND IN-PATIENT HOSPITAL DISCHARGE DATA AND OTHER SECONDARY SOURCES. TAKEN TOGETHER, THESE QUALITATIVE AND QUANTITATIVE APPROACHES ALLOWED THE CHNA COMMITTEE TO VIEW COMMUNITY NEEDS FROM MULTIPLE PERSPECTIVES. THE RESULTS OF THE 2022 CHNA WILL BE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. THE 2022 SCRIPPS HEALTH CHNA IS DESIGNED TO PROVIDE A DEEPER UNDERSTANDING OF BARRIERS TO HEALTH IMPROVEMENT IN SAN DIEGO COUNTY. KEEPING PATIENTS AT THE CENTER OF EVERYTHING WE DO, SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION WITH A WIDE RANGE OF PARTNERS AND LIKE-MINDED ORGANIZATIONS. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND COMMUNITY CLINICS, SCRIPPS IS BETTER ABLE TO BUILD UPON EFFORTS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THEREFORE, THE REPORT WILL HELP US BETTER UNDERSTAND OUR COMMUNITY'S HEALTH NEEDS AND INFORM COMMUNITY BENEFIT PLANNING AND THE IMPLEMENTATION STRATEGY FOR SCRIPPS HEALTH. IN ADDITION, THE ASSESSMENT ALLOWS INTERESTED PARTIES AND MEMBERS OF THE COMMUNITY A MECHANISM TO ACCESS THE FULL SPECTRUM OF INFORMATION RELATIVE TO THE DEVELOPMENT OF THE SCRIPPS HEALTH 2022 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. SCRIPPS HEALTH HOPES TO LEVERAGE THE INFORMATION COLLECTED FOR THIS REPORT TO BENEFIT THE COMMUNITY AT-LARGE IN OTHER FUTURE PLANNING INITIATIVES. FOR MORE INFORMATION ABOUT SCRIPPS HEALTH, PLEASE VISIT WWW.SCRIPPSHEALTH.ORG. PURPOSE THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS TO IDENTIFY, UNDERSTAND, AND PRIORITIZE THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS FACING INEQUITIES. THE RESULTS OF THE CHNA ARE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. IN ADDITION, POLICYMAKERS, CIVIC LEADERS, NONPROFIT EXECUTIVES, AND COMMUNITY INVESTORS ARE ENCOURAGED TO USE CHNAS IN THEIR ESSENTIAL WORK. CHNA GOVERNANCE THE HOSPITAL ASSOCIATION OF SAN DIEGO & COUNTIES (HASD&IC) BOARD OF DIRECTORS REPRESENTS ALL MEMBER SECTORS AND PROVIDES POLICY DIRECTION TO ENSURE THE INTERESTS OF MEMBER HOSPITALS AND HEALTH SYSTEMS ARE PRESERVED AND PROMOTED. THE CHNA ADVISORY WORKGROUP INCLUDED REPRESENTATIVES FROM EVERY PARTICIPATING HOSPITAL AND HEALTH SYSTEM AND PROVIDED OVERARCHING GUIDANCE REGARDING THE RESEARCH APPROACH AND COMMUNITY ENGAGEMENT. THE CHNA COMMITTEE WORKED CLOSELY WITH THE CHNA ADVISORY WORKGROUP AND REPORTS TO THE HASD&IC BOARD. METHODOLOGY THERE ARE SOCIAL DRIVERS OF HEALTH AND EQUITY AT ALL LEVELS: INDIVIDUAL, COMMUNITY, AND STRUCTURAL. HISTORICAL AND SYSTEMIC INEQUITIES DISPROPORTIONATELY IMPACT VULNERABLE POPULATIONS, INCLUDING PEOPLE OF COLOR, SOCIALLY DISADVANTAGED GROUPS, AND THOSE LIVING IN POVERTY. THE CHNA COMMITTEE COMPLETED AN EXTENSIVE REVIEW OF NATIONAL BEST PRACTICES AND EVIDENCE-BASED FRAMEWORKS TO DEVELOP A RESEARCH APPROACH TO HEALTH EQUITY. THE HEALTH EQUITY FRAMEWORK DESCRIBES THE CHNA ADVISORY WORKGROUP AND CHNA COMMITTEE'S SHARED VALUES AND COMMITMENT TO UNDERSTANDING THE SOCIAL DRIVERS OF HEALTH AND EQUITY THROUGH OUR COLLECTIVE RESEARCH, ANALYSIS, AND COMMUNITY ENGAGEMENT. RESEARCH METHODS AND APPROACH TO GAIN A DEEP AND MEANINGFUL UNDERSTANDING OF THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS, TWO PRIMARY METHODS WERE EMPLOYED IN THE 2022 CHNA: 1. QUANTITATIVE ANALYSES OF EXISTING PUBLICLY AVAILABLE DATA WERE CONDUCTED TO PROVIDE AN OVERARCHING VIEW OF CRITICAL HEALTH ISSUES ACROSS SAN DIEGO COUNTY. 2. QUALITATIVE INFORMATION WAS GATHERED THROUGH A COMPREHENSIVE COMMUNITY ENGAGEMENT PROCESS TO UNDERSTAND PEOPLE'S LIVED EXPERIENCES AND NEEDS IN THE COMMUNITY. THE CHNA COMMITTEE REVIEWED THE FEEDBACK AND DATA TO PRIORITIZE THE TOP HEALTH NEEDS IN SAN DIEGO COUNTY. THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. THE FOLLOWING DATA WAS USED IN THE PRIORITIZATION PROCESS: QUANTITATIVE DATA: * DATA AND ANALYSIS FROM HEALTH AND HUMAN SERVICES AGENCY, PUBLIC HEALTH SERVICES INCLUDING COMMUNITY HEALTH STATISTICS, HEALTH EQUITY DASHBOARDS, MORBIDITY & MORTALITY DATA * ANALYSIS OF SECONDARY DATA, HEALTH CONDITIONS, AND SOCIAL DETERMINANTS OF HEALTH (SDOH) * COUNTY OF SAN DIEGO LEADING CAUSES OF DEATH 2019 DATA * HOSPITAL DISCHARGE TREND DATA RETRIEVED FROM CALIFORNIA'S DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) LIMITED DATA SETS, 2017-2019 SPEEDTRACK QUALITATIVE DATA: * COMMUNITY GUIDANCE FROM CHNA PLANNING INTERVIEWS * COMMUNITY ENGAGEMENT FINDINGS FROM FOCUS GROUPS * COMMUNITY ENGAGEMENT FINDINGS FROM KEY INFORMANT INTERVIEWS * COMMUNITY ENGAGEMENT FINDINGS FROM INTERVIEWS AND FOCUS GROUPS WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS (CHWS) * 2022 CHNA ONLINE COMMUNITY SURVEY SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH TOP COMMUNITY NEEDS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED: THIS REFERS TO HOW SEVERE THE HEALTH NEED IS (SUCH AS ITS POTENTIAL TO CAUSE DEATH OR DISABILITY) AND ITS DEGREE OF POOR PERFORMANCE AGAINST THE RELEVANT BENCHMARK. THE MAGNITUDE/SCALE OF THE NEED-THE MAGNITUDE REFERS TO THE NUMBER OF PEOPLE AFFECTED BY THE HEALTH NEED. DISPARITIES OR INEQUITIES-THIS REFERS TO DIFFERENCES IN HEALTH OUTCOMES BY SUBGROUPS. SUBGROUPS MAY BE BASED ON GEOGRAPHY, LANGUAGES, ETHNICITY, CULTURE, CITIZENSHIP STATUS, ECONOMIC STATUS, SEXUAL ORIENTATION, AGE, GENDER, OR OTHERS. AND CHANGE OVER TIME-THIS REFERS TO WHETHER THE NEED HAS IMPROVED, STAYED THE SAME, OR WORSENED. OVER THE COURSE OF SEVERAL MEETINGS, THE HASD&IC STAFF AND CHNA COMMITTEE MEMBERS COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. EACH HEALTH CONDITION AND SOCIAL DETERMINANT OF HEALTH FOR WHICH THE COMMITTEE HAD DATA WAS CONSIDERED AND DISCUSSED IN TERMS OF THESE CRITERIA. THOSE COMMUNITY NEEDS THAT MET THE LARGEST NUMBER OF CRITERIA WERE CHOSEN AS TOP PRIORITIES. THE 2022 CHNA INCLUDED EXTENSIVE QUANTITATIVE ANALYSIS OF SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND IN-PATIENT HOSPITAL DISCHARGE DATA AND OTHER SECONDARY SOURCES. TAKEN TOGETHER, THESE QUALITATIVE AND QUANTITATIVE APPROACHES ALLOWED THE CHNA COMMITTEE TO VIEW COMMUNITY NEEDS FROM MULTIPLE PERSPECTIVES. THE RESULTS OF THE 2022 CHNA WILL BE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. QUANTITATIVE DATA WERE USED FOR THREE PRIMARY PURPOSES: 1. DESCRIBE THE SAN DIEGO COUNTY COMMUNITY. 2. PLAN AND DESIGN THE COMMUNITY ENGAGEMENT PROCESS. 3. FACILITATE THE "PRIORITIZATION PROCESS" - IDENTIFYING THE MOST SERIOUS COMMUNITY HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS FACING INEQUITIES.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - POSTERS ALERTING INDIVIDUALS TO SCRIPPS FINANCIAL ASSISTANCE AND CHARITY CARE PROGRAMS ARE DISPLAYED IN REGISTRATION AREAS IN THE HOSPITALS, INCLUDING THE EMERGENCY DEPARTMENTS, OUTPATIENT SETTINGS, AND MAIN ADMISSION AREAS. - THE FOLLOWING FINANCIAL ASSISTANCE DOCUMENTS INFORMING PATIENTS OF THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE ARE AVAILABLE FOR ALL PATIENTS, BY ASKING A REPRESENTATIVE OR BY OBTAINING A COPY ONLINE AT SCRIPPS.ORG. -PATIENT FINANCIAL ASSISTANCE POLICY, INCLUDING DISCOUNTED PAYMENTS AND CHARITY CARE (FAP) -SCRIPPS PATIENT ACCOUNT MANAGEMENT, BILLING AND COLLECTIONS POLICY, S-FW-LD-5400. -SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY - A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, IS OFFERED TO ALL PATIENTS AT REGISTRATION OR PRIOR TO DISCHARGE AND A COPY IS INCLUDED IN ALL BILLING STATEMENTS. SCRIPPS WILL MAIL A COPY TO THE PATIENT WITHIN 72 HOURS IF NOT RECEIVED AT THE HOSPITAL. - FINANCIAL ASSISTANCE APPLICATION WITH INSTRUCTIONS INFORMS INDIVIDUALS ABOUT CHARITY AND DISCOUNTED CARE. PAPER APPLICATIONS ARE AVAILABLE FREE OF CHARGE IN THE EMERGENCY DEPARTMENT AND MAIN REGISTRATION AREAS. PATIENTS MAY REQUEST A COPY BE SENT TO THEM ELECTRONICALLY. - THE DOCUMENTS LISTED ABOVE, ARE AVAILABLE ONLINE FREE OF CHARGE IN MULTIPLE LANGUAGES INCLUDING THE PRIMARY LANGUAGES OF PATIENT POPULATIONS WITH LIMITED ENGLISH PROFICIENCY (LEP). - SCRIPPS WORKS WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO INFORM THOSE LIKELY TO NEED FINANCIAL HELP. THE SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS TO BE AVAILABLE AT COMMUNITY EVENTS AND IS PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. - SCRIPPS FINANCIAL ASSISTANCE POLICIES AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW. - FACILITY POSTERS ALERT INDIVIDUALS TO FREE CONSUMER ADVOCACY ORGANIZATIONS THAT ARE AVAILABLE FOR ASSISTANCE IN UNDERSTANDING THE BILLING AND PAYMENT PROCESS. - SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS OFFERED ON ADMISSION AND PROVIDED AT DISCHARGE AND WITH EACH BILLING STATEMENT. THIS COMMUNICATION ALSO INFORMS INDIVIDUALS ABOUT: - GOVERNMENT-SPONSORED PROGRAMS THEY MAY QUALIFY FOR. - THE MEDI-CAL HOSPITAL PRESUMPTIVE ELIGIBILITY PROGRAM PROVIDES QUALIFIED INDIVIDUALS IMMEDIATE ACCESS TO TEMPORARY, NO-COST MEDI-CAL, APPLICATIONS ARE AVAILABLE FROM HOSPITAL REGISTRATION STAFF. CURRENT INCOME AND PROGRAM REQUIREMENTS CHANGE FREQUENTLY. TO OBTAIN ASSISTANCE WITH AN APPLICATION FOR MEDI-CAL, PLEASE CALL 1-866-262-9881. - THE CALIFORNIA HEALTH BENEFIT EXCHANGE MAY OFFER AN INSURANCE PLAN WITH THE HELP OF GOVERNMENT SUBSIDIES THAT REDUCE THE COST OF YOUR MONTHLY PREMIUM, DEPENDING ON YOUR INCOME LEVEL. TO LEARN MORE, VISIT COVEREDCA.COM OR CALL 1-800-300-1506. - HOSPITAL BILL COMPLAINT PROGRAM. THE HOSPITAL BILL COMPLAINT PROGRAM IS A STATE PROGRAM, WHICH REVIEWS HOSPITAL DECISIONS ABOUT WHETHER AN INDIVIDUAL QUALIFIES FOR HELP PAYING THEIR HOSPITAL BILL. A PATIENT MAY FILE A COMPLAINT WITH THE HOSPITAL BILL COMPLAINT PROGRAM, HOSPITALBILLPROGRAM.HCAI.CA.GOV - LOCAL CONSUMER ASSISTANCE. FREE CONSUMER ADVOCACY ORGANIZATIONS ASSIST PATIENTS IN UNDERSTANDING THE BILLING AND PAYMENT PROCESS. HEALTH CONSUMER ALLIANCE AT 888-804-3536, HEALTHCONSUMER.ORG FOR MORE INFORMATION.
Schedule H, Part VI, Line 4 Community information	SCRIPPS HEALTH COMMUNITY SERVED SCRIPPS HEALTH COMMUNITY SERVED HOSPITALS AND HEALTH CARE SYSTEMS DEFINE THE COMMUNITY SERVED AS THOSE INDIVIDUALS RESIDING WITHIN ITS SERVICE AREA. A HOSPITAL OR HEALTH CARE SYSTEM SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW INCOME OR UNDERSERVED POPULATIONS. SCRIPPS SERVES THE ENTIRE SAN DIEGO COUNTY REGION WITH SERVICES CONCENTRATED IN NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTHERN REGION OF SAN DIEGO. SCRIPPS PROVIDES SIGNIFICANT VOLUMES OF INPATIENT, EMERGENCY, OUTPATIENT, AND PRIMARY CARE. IN FISCAL YEAR 2024, SCRIPPS PROVIDED 3,168,633 OUTPATIENT VISITS AND 74,942 HOSPITAL DISCHARGES. COMMUNITY OUTREACH EFFORTS ARE FOCUSED IN THOSE AREAS WITH PROXIMITY TO A SCRIPPS FACILITY. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. SCRIPPS MERCY HOSPITAL SAN DIEGO AND SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUSES ARE DESIGNATED BY THE GOVERNMENT AS OF JULY 2024 AS A DISPROPORTIONATE SHARE HOSPITAL, IN REFLECTING THE ECONOMICALLY DISADVANTAGED POPULATION THEY SERVE. BOTH HOSPITAL CAMPUSES PLAY IMPORTANT HEALTH CARE SERVICE ROLES IN THE CENTRAL/SOUTHERN SAN DIEGO COUNTY SERVICE AREA (RANGING FROM INTERSTATE 8 TO THE UNITED STATES-MEXICO BORDER). MORE THAN HALF OF PATIENTS AT SCRIPPS MERCY SAN DIEGO AND CHULA VISTA ARE COVERED BY GOVERNMENT INSURANCE, INCLUDING MEDICARE AND MEDI-CAL.
Schedule H, Part VI, Line 5 Promotion of community health	SCRIPPS PROVIDES A COMPREHENSIVE RANGE OF INPATIENT AND AMBULATORY SERVICES THROUGH OUR SYSTEM OF HOSPITALS AND CLINICS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION WITH A WIDE RANGE OF PARTNERS AND LIKE-MINDED ORGANIZATIONS. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS AND ORGANIZATIONS, GOVERNMENT AGENCIES, BUSINESSES AND COMMUNITY CLINICS, SCRIPPS IS BETTER ABLE TO BUILD UPON EFFORTS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS AND PARTNER WITH A WIDE VARIETY OF ORGANIZATIONS ON COMMUNITY HEALTH IMPROVEMENT PROGRAMS. OUR COLLABORATIONS EXTEND BEYOND OUR LOCAL COMMUNITY TO INCLUDE STATE, NATIONAL, AND GLOBAL EFFORTS IN DISASTER PREPAREDNESS AND RELIEF, EMERGENCY MEDICAL SERVICES, HEALTHCARE ADVOCACY, PHYSICIAN EDUCATION, AND DIRECT PATIENT CARE. IN ALL THAT WE DO, WE ARE COMMITTED TO QUALITY PATIENT OUTCOMES, SERVICE EXCELLENCE, OPERATING EFFICIENCY, CARING FOR THOSE IN NEED TODAY WHILE PLANNING FOR THE HEALTHCARE NEEDS OF FUTURE GENERATIONS. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES HAVE AN OPEN MEDICAL STAFF FOR ALL QUALIFIED PHYSICIANS. THE BOARD OF TRUSTEES HAS AUTHORITY TO APPROVE BYLAWS, RULES AND REGULATIONS FOR THE MEDICAL STAFF OF EACH HOSPITAL, SURGERY CENTER OR SIMILAR FACILITY, AND TO APPOINT, SUSPEND OR REMOVE ANY PHYSICIAN FROM THE MEDICAL STAFF. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES PARTICIPATE IN MEDI-CAL AND MEDICARE CONTRACTS. SCRIPPS SURPLUS FUNDS ARE REINVESTED BACK INTO THE SAN DIEGO COMMUNITY. SURPLUS FUNDS ARE UTILIZED FOR NEW FACILITIES, EQUIPMENT, SEISMIC RETROFITTING, PROFESSIONAL EDUCATION AND HEALTH RESEARCH, ACCESS TO PATIENT CARE AND COMMUNITY BENEFIT PROGRAMS. IRS FORM 990, SCHEDULE H INSTRUCTIONS DEFINE COMMUNITY BENEFIT AS ACTIVITIES OR PROGRAMS THAT RESPOND TO COMMUNITY HEALTH NEEDS AND SEEK TO ACHIEVE ONE OR MORE OF THE FOLLOWING OBJECTIVES: IMPROVING ACCESS TO HEALTH SERVICES, ENABLING LOW-INCOME PERSONS TO AFFORD HEALTH CARE, ENHANCING PUBLIC HEALTH, ADVANCING GENERALIZABLE KNOWLEDGE, EDUCATING HEALTH PROFESSIONALS, AND RELIEVING THE GOVERNMENT BURDEN TO IMPROVE HEALTH. MEDICARE SHORTFALL, BAD DEBT, AND COMMUNITY BUILDING ACTIVITIES ARE REPORTABLE UNDER SCHEDULE H GUIDELINES BUT ARE EXCLUDED FROM THE COMMUNITY BENEFIT TOTALS. HOWEVER, SCRIPPS INCLUDES THESE TOTALS IN OUR OVERALL COMMUNITY BENEFIT CALCULATIONS IN THE ANNUAL COMMUNITY BENEFIT PLAN AND REPORT. FOR MORE INFORMATION SEE HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. THE IRS IDENTIFIES CATEGORIES OF COMMUNITY BENEFIT THAT ARE REPORTABLE ON TAX-EXEMPT HOSPITALS FORM 990, SCHEDULE H: FINANCIAL ASSISTANCE AT COST (ALSO KNOWN AS CHARITY CARE), MEDICAL SHORTFALL, COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS. SCRIPPS ALIGNED ITS 2024 COMMUNITY BENEFIT PLAN AND REPORT WITH THESE CATEGORIES. FOR FULL CATEGORY DEFINITIONS AND ACCOUNTING METHODS SEE IRS SCHEDULE H (FORM 990)(2023) INSTRUCTIONS. COVERING THE PERIOD OF FISCAL YEAR 2024 (OCTOBER 1, 2023, THROUGH SEPTEMBER 30, 2024), SCRIPPS CONTRIBUTED $656,291,701 IN COMMUNITY BENEFIT CONTRIBUTIONS AS DETAILED BELOW BY IRS CATEGORIES. - SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES PROVIDING LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. THE COSTS OF PROVIDING THESE SERVICES ARE NOT FULLY REIMBURSED. DURING FISCAL YEAR 2024, SCRIPPS CONTRIBUTED $587,766,140 IN UNCOMPENSATED HEALTH CARE, INCLUDING $17,768,458 IN CHARITY CARE, $562,399,773 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $7,597,909 IN BAD DEBT. - SCRIPPS INVESTED $10,901,463 IN COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS. THIS INVESTMENT INCLUDES IN-LIEU OF FUNDS WHICH PROVIDES CRITICAL SUPPORT FOR VULNERABLE POPULATIONS, COVERING ESSENTIAL POST-DISCHARGE NEEDS FOR UNFUNDED OR UNDERFUNDED PATIENTS. THESE FUNDS HELP ENSURE ACCESS TO NECESSARY HEALTH CARE SUPPORT SERVICES BEYOND HOSPITAL CARE. - COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS INCLUDE PREVENTION AND WELLNESS PROGRAMS, SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS, HEALTH FAIRS AND OTHER PROGRAMS SUPPORTED BY OPERATIONAL FUNDS, GRANTS, AND IN-KIND DONATIONS AND PHILANTHROPY. CALCULATIONS ARE BASED ON COST, LESS "DIRECT OFFSETTING REVENUE," WHICH INCLUDES ANY REVENUE GENERATED BY THE ACTIVITY OR PROGRAM, SUCH AS PAYMENT OR REIMBURSEMENT FOR SERVICES PROVIDED TO PROGRAM PATIENTS. ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES, "DIRECT OFFSETTING REVENUE" ALSO INCLUDES RESTRICTED GRANTS OR CONTRIBUTIONS THAT THE ORGANIZATION USES TO PROVIDE A COMMUNITY BENEFIT. - EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH HEALTH PROFESSIONAL EDUCATION. DURING FISCAL YEAR 2024, SCRIPPS INVESTED $47,659,269 IN PROFESSIONAL TRAINING PROGRAMS TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES IN SAN DIEGO COUNTY. THIS REFLECTS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES, INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. - SCRIPPS INVESTED $4,991,558 IN HEALTH RESEARCH AND SCRIPPS CLINIC AND CLINICAL RESEARCH SERVICES SUPPORTED MORE THAN 43 PRINCIPAL INVESTIGATORS AND ABOUT 106 ACTIVE CLINICAL RESEARCH PROTOCOLS CROSSING INTERDISCIPLINARY DISEASE CATEGORIES. SCRIPPS HEALTH IS COMMITTED TO PROVIDING THE BEST POSSIBLE PATIENT CARE, AND RESEARCH IS A CRITICAL PART OF THAT MISSION. IN ADDITION TO BRINGING THE LATEST TREATMENTS TO OUR PATIENTS, THE KNOWLEDGE GAINED FROM THESE RESEARCH STUDIES ADVANCES THE QUALITY OF CARE FOR PEOPLE AROUND THE WORLD. SCRIPPS HEALTH PHYSICIANS STUDY NEW MEDICATIONS AND DEVICES, TRACK PATIENT OUTCOMES FOR YEARS OR EVEN DECADES AND GATHER EVIDENCE FOR SOPHISTICATED EDUCATION AND TREATMENT PROGRAMS. THIS INFORMATION IS THEN DISSEMINATED INTO THE SCRIPPS SYSTEM THROUGH GRADUATE AND CONTINUING MEDICAL EDUCATION AND TO THE SCIENTIFIC COMMUNITY THROUGH PEER-REVIEWED PUBLICATIONS. CALCULATIONS ARE BASED ON COST, LESS "DIRECT OFFSETTING REVENUE," WHICH INCLUDES ANY REVENUE GENERATED BY THE ACTIVITY OR PROGRAM, SUCH AS PAYMENT OR REIMBURSEMENT FOR SERVICES PROVIDED TO PROGRAM PATIENTS. ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES, "DIRECT OFFSETTING REVENUE" ALSO INCLUDES RESTRICTED GRANTS OR CONTRIBUTIONS THAT THE ORGANIZATION USES TO PROVIDE A COMMUNITY BENEFIT. * SCRIPPS INVESTED $1,485,542 CASH, GRANTS AND IN-KIND CONTRIBUTIONS MADE BY THE ORGANIZATION TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. * SCRIPPS INVESTED $3,100,477 IN SUBSIDIZED HEALTH SERVICES. THIS FIGURE INCLUDES SCRIPPS INPATIENT BEHAVIORAL HEALTH. SCRIPPS OFFERS INPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL, SAN DIEGO CAMPUS. THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM ACTIVELY SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH OFFERS INPATIENT BEHAVIORAL HEALTH CARE FOR ADULTS ADMITTED THROUGH OUR EMERGENCY DEPARTMENTS OR URGENT CARE CENTERS. OUR OUTPATIENT BEHAVIORAL HEALTH SERVICES ARE AVAILABLE THROUGH PARTNERSHIPS WITH VARIOUS COMMUNITY ORGANIZATIONS.
Schedule H, Part VI, Line 6 Affiliated health care system	AFFILIATED HEALTH CARE SYSTEM FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $4.9 BILLION PRIVATE, TAX EXEMPT, INTEGRATED HEALTH SYSTEM BASED IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS MORE THAN 600,000 PATIENTS ANNUALLY AT ITS FOUR ACUTE-CARE HOSPITALS ON FIVE CAMPUSES, ALONG WITH A ROBUST NETWORK OF 32 OUTPATIENT CENTERS (INCLUDING 12 HEALTH EXPRESS LOCATIONS), PALLIATIVE CARE, CLINICAL RESEARCH, AND ANCILLARY SERVICES TO SERVE OUR SAN DIEGO COMMUNITY AND BEYOND. SCRIPPS IS ALSO ONE OF THE LARGEST EMPLOYERS IN SAN DIEGO, WITH 3,000 AFFILIATED PHYSICIANS AND MORE THAN 17,500 EMPLOYEES, AND IS RECOGNIZED AS ONE OF THE COUNTRY'S BEST COMPANIES TO WORK FOR. SCRIPPS OFFERS PAYER PRODUCTS AND POPULATION HEALTH SERVICES THROUGH SCRIPPS ACCOUNTABLE CARE ORGANIZATION, SCRIPPS HEALTH PLAN, AND CUSTOMIZED NARROW NETWORK PLANS IN COLLABORATION WITH THIRD-PARTY PAYERS. SCRIPPS HEALTH IS A LEADING PROVIDER OF MEDICAL CARE, DEDICATED TO IMPROVING COMMUNITY HEALTH AND ADVANCING MEDICINE IN SAN DIEGO COUNTY. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS, AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH AND IS THE ONLY HEALTH SYSTEM IN THE REGION WITH TWO LEVEL 1 TRAUMA CENTERS. BOTH SCRIPPS MERCY HOSPITAL IN SAN DIEGO AND SCRIPPS MEMORIAL HOSPITAL LA JOLLA HAVE BEEN VERIFIED AS LEVEL 1 TRAUMA CENTERS-THE HIGHEST DESIGNATION AWARDED BY THE AMERICAN COLLEGE OF SURGEONS (ACS), SIGNIFYING THE MOST COMPREHENSIVE LEVEL OF INJURY CARE AVAILABLE. WITH THESE DESIGNATIONS, SCRIPPS HEALTH NOW OPERATES TWO OF THE THREE LEVEL 1 ADULT TRAUMA CENTERS IN SAN DIEGO COUNTY. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONGSTANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. OUR HOSPITALS ARE CONSISTENTLY RANKED AMONG THE NATION'S BEST BY U.S. NEWS & WORLD REPORT AND NUMEROUS OTHER ORGANIZATIONS. SCRIPPS IS FREQUENTLY RECOGNIZED BY FORTUNE MAGAZINE, WORKING MOTHER MAGAZINE, AND THE ADVISORY BOARD AS ONE OF THE BEST PLACES IN THE NATION TO WORK. IMPORTANTLY, SCRIPPS CULTURE IS ONE OF CARING. THE SPIRIT AND CULTURE ESTABLISHED BY TWO PIONEERING FOUNDERS, ELLEN BROWNING SCRIPPS AND MOTHER MARY MICHAEL CUMMINGS, STILL DEFINE WHO WE ARE TODAY. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. EXCELLENCE IN PRIMARY AND SPECIALTY CARE THE SYSTEM IS KNOWN FOR ITS EXPERTISE IN VARIOUS AREAS, INCLUDING CANCER CARE, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT, ORTHOPEDICS, WOMEN'S HEALTH, AND NEUROCOGNITIVE CARE. GENERATIONS OF SAN DIEGANS HAVE RELIED ON SCRIPPS FOR EXCELLENCE IN HEALTH CARE, STARTING WITH PRIMARY CARE DOCTORS WHO ACT AS THE PATIENT'S PERSONAL HEALTH ADVOCATE INCLUDING A FOCUS ON PREVENTIVE CARE AND WELLNESS. FOR PATIENTS' CONVENIENCE, SCRIPPS PHYSICIANS OFFER SEVERAL OPTIONS FOR ONGOING CARE, INCLUDING EXTENDED OFFICE HOURS, TELEMEDICINE OPTIONS, THREE URGENT CARE CENTERS AND HEALTH EXPRESS WALK-IN CLINICS THROUGHOUT THE COUNTY FOR SAME-DAY TREATMENT OF MINOR ILLNESSES AND INJURIES. WITH SOME OF THE MOST ADVANCED TECHNOLOGY AVAILABLE TODAY FOR THE DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC ILLNESSES, SCRIPPS OFFERS PATIENTS A COMPLETE RANGE OF MEDICAL AND SURGICAL SERVICES INCLUDING MANY THAT HAVE BEEN NATIONALLY RECOGNIZED FOR CLINICAL QUALITY AND PATIENT OUTCOMES. GOVERNANCE As a tax-exempt health care system, Scripps takes pride in its service to the community. The Scripps system is governed by a 16-member, volunteer Board of Trustees. This single point of authority for organizational policy ensures a unified approach to serving patients across the region. ORGANIZATIONAL FOUNDATION Scripps provides a comprehensive range of inpatient and ambulatory services through our system of hospitals and clinics. In addition, Scripps participates in many partnerships with government and not-for-profit agencies across our region to improve our community's health. And our partnerships do not stop at our local borders. Our collaborations extend beyond our local community to include state, national, and global efforts in disaster preparedness and relief, emergency medical services, healthcare advocacy, physician education, and direct patient care. In all that we do, we are committed to quality patient outcomes, service excellence, operating efficiency, caring for those in need today while planning for the healthcare needs of future generations.
Schedule H, Part VI, Line 7 State filing of community benefit report	CA

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

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

2023

Open to Public
Inspection

Name of the organization
SCRIPPS HEALTH

Employer identification number
95-1684089

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(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) California Health Found and Trust (CHFT) 1215 K Street Ste 800 Sacramento,CA95814	95-1684089	501(c)(3)	927,000				CA Hospital Fee Program
(2) ConsR Cent for Health Edu and Advocacy (CCHEA) 1764 San Diego Ave Ste 200 San Diego,CA92110	75-1835298	501(c)(3)	120,000				Program Support
(3) Enlisted Leadership Foundation - The Foundry 2307 Fenton Parkway Ste 107-208 San Diego,CA92018	46-5029314	501(c)(3)	35,000				Program Support
(4) Family Health Center of San Diego Internal Medicine Outpatient Teaching Cl inic Partnership 823 Gateway Center Way San Diego,CA92012	95-2833205	501(c)(3)	309,000				Program Support
(5) San Ysidro Health Center 3350 E Street San Diego,CA92102	22-3746050	501(c)(3)	25,000				Program Support
(6) Family Health Centers of San Diego - Spirit of the Barrio 823 Gateway Center Way San Diego,CA92102	95-2833205	501(c)(3)	7,500				Program Support
(7) The San Diego LGBT Community Center 3909 Centre St San Diego,CA92013	23-7332048	501(c)(3)	10,000				Program Support
(8) Ministry of Jerusalem (Emergency Meals and Water) 100 North Sixth Street Ste 626B Minneapolis,MI55403	20-4092394	501(c)(3)		6,000	FMV	Donated blankets and socks	Program Support
(9) Father Joe's Villages (Scripps Blanket and Sock Drive) 3350 E Street San Diego,CA92102	22-3746050	501(c)(3)		18,000	FMV	Donated water	Program Support
(10) City of Hope 1500 E Duarte Rd Duarte,CA91010	95-3435919	501(c)(3)		50,000	FMV	Donation of Medical Equip	Program Support

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

GRANTEE SHALL SUBMIT TO SCRIPPS HEALTH, ATTENTION DIRECTOR OF COMMUNITY BENEFIT SERVICES AT 4555 EXECUTIVE DRIVE, SAN DIEGO, CA 92121, THE FOLLOWING: A. A SEMI-ANNUAL SUMMARY PROGRESS REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT IS REQUIRED. REPORTS SHALL INCLUDE, BUT NOT BE LIMITED TO, PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. B. WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT A FINAL PROGRESS REPORT SHALL BE SUBMITTED TO SCRIPPS HEALTH. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHOULD INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT. C. THE GRANTEE SHALL PROVIDE SCRIPPS HEALTH WITH ANY ADDITIONAL INFORMATION OR PROGRESS UPDATES, RELATIVE TO GRANT PROJECT, AS REASONABLY REQUESTED. D. SCRIPPS HEALTH RESERVES THE RIGHT TO AUDIT EXPENDITURES AND SUPPORTING DOCUMENTATION.

Schedule I (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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? ....

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2023

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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Christopher Van Gorder President / CEO	(i) (ii)	2,010,581 ------------- 0	2,113,601 ------------- 0	164,655 ------------- 0	23,100 ------------- 0	30,066 ------------- 0	4,342,003 ------------- 0	0 ------------- 0
2Richard Rothberger Former Officer	(i) (ii)	0 ------------- 0	430,289 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	430,289 ------------- 0	0 ------------- 0
3Shawn Forrester FORMER KEY EMPLOYEE	(i) (ii)	178,048 ------------- 0	164,163 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	342,211 ------------- 0	0 ------------- 0
4Bradley Ellis Corp Sr. VP Chief Legal Officer	(i) (ii)	952,148 ------------- 0	251,136 ------------- 0	14,013 ------------- 0	23,100 ------------- 0	29,890 ------------- 0	1,270,287 ------------- 0	0 ------------- 0
5Brett Tande Treasurer / Exec VP, CFO	(i) (ii)	1,062,752 ------------- 0	187,269 ------------- 0	21,403 ------------- 0	13,200 ------------- 0	42,683 ------------- 0	1,327,307 ------------- 0	0 ------------- 0
6Anil Keswani Corp EVP Chief Med & Ops Officer AMB	(i) (ii)	901,654 ------------- 0	306,200 ------------- 0	54,429 ------------- 0	16,500 ------------- 0	43,084 ------------- 0	1,321,867 ------------- 0	0 ------------- 0
7Richard Neale Corp Exec VP, Chief Growth Officer	(i) (ii)	867,915 ------------- 0	348,980 ------------- 0	52,549 ------------- 0	16,500 ------------- 0	42,481 ------------- 0	1,328,425 ------------- 0	0 ------------- 0
8Thomas Buchholz Corp Sr. VP, MD Anderson	(i) (ii)	1,089,773 ------------- 0	361,242 ------------- 0	15,756 ------------- 0	13,200 ------------- 0	29,708 ------------- 0	1,509,679 ------------- 0	0 ------------- 0
9Thomas Gammiere Chief Executive, Sr VP	(i) (ii)	776,120 ------------- 0	306,173 ------------- 0	31,165 ------------- 0	23,100 ------------- 0	32,475 ------------- 0	1,169,033 ------------- 0	0 ------------- 0
10June Komar Corp Exec VP, Strategy & Admin	(i) (ii)	740,199 ------------- 0	495,738 ------------- 0	17,220 ------------- 0	23,100 ------------- 0	15,070 ------------- 0	1,291,327 ------------- 0	0 ------------- 0
11Barbara Price Corp Sr VP, Bus&Serv Line Dev	(i) (ii)	824,550 ------------- 0	309,881 ------------- 0	41,872 ------------- 0	23,100 ------------- 0	42,503 ------------- 0	1,241,906 ------------- 0	0 ------------- 0
12Carl Etter Chief Executive, Sr VP	(i) (ii)	1,330,331 ------------- 0	360,747 ------------- 0	37,942 ------------- 0	19,800 ------------- 0	32,436 ------------- 0	1,781,256 ------------- 0	0 ------------- 0
13Lisa RisserThakur Corp Sr. VP, Ancillary Ops (part year)	(i) (ii)	583,320 ------------- 0	217,712 ------------- 0	801,567 ------------- 0	0 ------------- 0	14,713 ------------- 0	1,617,312 ------------- 0	748,875 ------------- 0
14Eric Cole Corp Sr. VP, Human Resources	(i) (ii)	736,706 ------------- 0	249,987 ------------- 0	45,931 ------------- 0	13,200 ------------- 0	36,895 ------------- 0	1,082,719 ------------- 0	0 ------------- 0
15John Engle Corp Sr. VP, Chief Development	(i) (ii)	628,291 ------------- 0	237,398 ------------- 0	57,143 ------------- 0	23,100 ------------- 0	32,283 ------------- 0	978,215 ------------- 0	0 ------------- 0
16Ghazala Sharieff Corp EVP Chief Med & Ops Officer Acute	(i) (ii)	1,187,577 ------------- 0	363,364 ------------- 0	58,578 ------------- 0	13,200 ------------- 0	39,797 ------------- 0	1,662,516 ------------- 0	0 ------------- 0
17Shane Thielman Corp SVP CIDO	(i) (ii)	684,559 ------------- 0	249,411 ------------- 0	23,268 ------------- 0	19,800 ------------- 0	42,453 ------------- 0	1,019,491 ------------- 0	0 ------------- 0
18Tracy Chu Corp VP, POP Hlth CHF EXEC/ACO	(i) (ii)	605,231 ------------- 0	173,993 ------------- 0	10,371 ------------- 0	19,800 ------------- 0	14,977 ------------- 0	824,372 ------------- 0	0 ------------- 0
19Gerald Soderstrom Corp SVP Audit/Compliance	(i) (ii)	523,521 ------------- 0	180,266 ------------- 0	18,352 ------------- 0	13,200 ------------- 0	42,899 ------------- 0	778,238 ------------- 0	0 ------------- 0
20John Poole Corp VP, System Improvement	(i) (ii)	611,822 ------------- 0	175,757 ------------- 0	13,139 ------------- 0	13,200 ------------- 0	18,125 ------------- 0	832,043 ------------- 0	0 ------------- 0
21Craig M Uejo Corp VP, Chief Quality Officer	(i) (ii)	527,723 ------------- 0	156,311 ------------- 0	11,556 ------------- 0	13,200 ------------- 0	42,346 ------------- 0	751,136 ------------- 0	0 ------------- 0
22Sherman T Moore Corp VP, Business Development	(i) (ii)	515,529 ------------- 0	135,965 ------------- 0	21,516 ------------- 0	13,200 ------------- 0	42,247 ------------- 0	728,457 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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
Schedule J, Part I, Line 1a Tax indemnification and gross-up payments	CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE TAX GROSS-UP PAYMENTS RELATED TO CERTAIN EXECUTIVE BENEFIT PROGRAMS. THESE AMOUNTS ARE INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2.
Schedule J, Part I, Line 1a Discretionary spending account	CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2.
Schedule J, Part I, Line 1a Housing allowance or residence for personal use	ONE EXECUTIVE REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVED A HOUSING ALLOWANCE FOR LESS THAN ONE YEAR AS PART OF THEIR ONBOARDING COMPENSATION PACKAGE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THE EXECUTIVE'S W-2.
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	SCRIPPS HEALTH INCURS THE MEMBERSHIP COST OF A BUSINESS NETWORKING CLUB IN SAN DIEGO FOR ITS CHIEF EXECUTIVE OFFICER AT AN APPROXIMATE MONTHLY COST OF $200. THE MEMBERSHIP IS USED 100% FOR BUSINESS PURPOSES AND ACCORDINGLY, NO PART OF THIS BENEFIT IS INCLUDED WITHIN THE CHIEF EXECUTIVE OFFICER'S TAXABLE COMPENSATION.
Schedule J, Part I, Line 1a Personal services	CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE REIMBURSEMENT FOR FINANCIAL PLANNING SERVICES AND AN ANNUAL PHYSICAL. THE REIMBURSEMENT IS APPROPRIATELY INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2 WHERE APPLICABLE.
Schedule J, Part I, Line 4a Severance or change-of-control payment	RECEIVE A SEVERANCE PAYMENT OR CHANGE-OF CONTROL PAYMENT THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY IN CALENDAR YEAR 2023: LISA RISSER/THAKUR - $217,266 SHAWN FORRESTER - $178,048
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	SCRIPPS HEALTH EXECUTIVE BENEFITS PROGRAM PROVIDES A 457F PLAN WITH A FLEXIBLE BENEFIT ALLOWANCE THAT CAN BE USED TO PURCHASE ADDITIONAL INSURANCE COVERAGE FOR CERTAIN EXECUTIVE LEVEL EMPLOYEES. ANY REMAINING BENEFIT ALLOWANCE CAN BE DEPOSITED INTO THE SUPPLEMENTAL ACCUMULATION RETIREMENT ACCOUNT (SARA) WITH A FUTURE VESTING DATE. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2023 INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, (B)(III): LISA RISSER/THAKUR - $748,875 EFFECTIVE JANUARY 1, 2021, SCRIPPS HEALTH TRANSITIONED PART OF ITS' EXECUTIVE BENEFITS PROGRAM FROM THE 457F PLAN TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THIS SERP PROVIDES COMPETITIVE SUPPLEMENTAL RETIREMENT BENEFITS TO THE PARTICIPANTS TO ENCOURAGE CONTINUED EMPLOYMENT AND CONTINUED INTEREST IN THE SUCCESS OF THE SYSTEM. THE SYSTEM CREDITS A TARGETED PERCENT PER YEAR OF SERVICE, UP TO A MAXIMUM PERCENT OF THE FINAL AVERAGE SALARY AT AGE 70 FOR 25 YEARS OF SERVICE. THE TARGET BENEFIT IS OFFSET BY (I) BENEFITS UNDER THE FROZEN SARA PLAN, (II) THE SYSTEM-PAID PORTION OF SOCIAL SECURITY RETIREMENT BENEFITS, AND (III) QUALIFIED RETIREMENT PLANS ATTRIBUTABLE TO THE SYSTEM'S CREDITS UNDER THOSE PLANS. ALTHOUGH THE BENEFIT IS TARGETED AT AGE 70, THE SYSTEM MAY ELECT TO CONTINUE CREDITS TOWARD THE BENEFIT SO LONG AS THE PARTICIPANT REMAINS EMPLOYED WITH THE SYSTEM.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
SCRIPPS HEALTH

Employer identification number
95-1684089

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	California Statewide Communities Development Authority	68-0164610	1309116Y1	03-02-2007	49,995,000	SEE PART VI		X		X	X
B	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	02-29-2016	150,000,000	SEE PART VI		X		X		X
C	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	01-31-2017	160,000,000	SEE PART VI		X		X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	11-15-2019	99,360,000	SEE PART VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13032UL48	02-07-2024	918,959,458	SEE PART VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13032UN95	02-07-2024	191,600,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	500,000		124,970,000		13,305,000		4,185,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	49,995,000		150,000,000		160,000,000		99,360,000
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	146,070		0		0		0
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	49,848,390		150,000,000		0		0
11 Other spent proceeds .............	0		0		160,000,000		99,360,000
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2007		2016		2017		2019
	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) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
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 ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
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 Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

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 ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
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 Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Column (e) ISSUE PRICE	BOND ISSUE 1-A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON FORM 8038 AS THE $49,995,000 AMOUNT REPRESENTS THE SCRIPPS HEALTH'S PORTION ON IN A POOL BOND LOAN PROGRAM.
Schedule K, Part III, Line 3b	THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY.
Schedule K, Part IV, Line 6	BOND ISSUE 1-A (2007A): AN AMOUNT IN THE COST OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008.
Schedule K, Part V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION	THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION HAS REVISED ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS.
Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE	BOND ISSUE 1-A (2007A): POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE 1-B (2016A/B): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 1-C (2017A): THE $160,000,000 (2017A) REFUNDED THE 2008B-F BONDS. THE ISSUE DATE FOR THE 2008B-F BONDS WAS 8/14/2008. BOND ISSUE 1-D (2019A): THE 2019A ISSUE REFUNDED THE 2010A ISSUE. BOND ISSUE 1-A & 1-B (2024): EXPENSES INCURRED AT SCRIPPS MEMORIAL HOSPITAL - LA JOLLA, SCRIPPS ENCINITAS HOSPITAL, ENCINITAS, CALIFORNIA AND SCRIPPS CORPORATE HEADQUARTERS IN SAN DIEGO, CALIFORNIA.
Schedule K, Part IV, Line 2c DATE THE REBATE COMPUTATION WAS PERFORMED	BOND ISSUE 1-A (2007A): THE 2007A REBATE COMPUTATION WAS RECENTLY PERFORMED ON MARCH 2, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-B (2016A/C): THE 2016A/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 28, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-C (2017A): THE 2017A REBATE COMPUTATION WAS RECENTLY PERFORMED ON JANUARY 31, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-D (2019A) THE 2019A REBATE COMPUTATION WAS RECENTLY PERFORMED ON NOVEMBER 15, 2023. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD.

Schedule K (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
SCRIPPS HEALTH

Employer identification number
95-1684089

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	California Statewide Communities Development Authority	68-0164610	1309116Y1	03-02-2007	49,995,000	SEE PART VI		X		X	X
B	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	02-29-2016	150,000,000	SEE PART VI		X		X		X
C	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	01-31-2017	160,000,000	SEE PART VI		X		X		X
D	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	000000000	11-15-2019	99,360,000	SEE PART VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13032UL48	02-07-2024	918,959,458	SEE PART VI		X		X		X
	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	52-1643828	13032UN95	02-07-2024	191,600,000	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	500,000		124,970,000		13,305,000		4,185,000
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	49,995,000		150,000,000		160,000,000		99,360,000
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	146,070		0		0		0
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	49,848,390		150,000,000		0		0
11 Other spent proceeds .............	0		0		160,000,000		99,360,000
12 Other unspent proceeds .............	0		0		0		0
13 Year of substantial completion .............	2007		2016		2017		2019
	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) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X
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 ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
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 Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X		X		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

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 ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
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 Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Column (e) ISSUE PRICE	BOND ISSUE 1-A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON FORM 8038 AS THE $49,995,000 AMOUNT REPRESENTS THE SCRIPPS HEALTH'S PORTION ON IN A POOL BOND LOAN PROGRAM.
Schedule K, Part III, Line 3b	THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY.
Schedule K, Part IV, Line 6	BOND ISSUE 1-A (2007A): AN AMOUNT IN THE COST OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008.
Schedule K, Part V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION	THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION HAS REVISED ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS.
Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE	BOND ISSUE 1-A (2007A): POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE 1-B (2016A/B): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 1-C (2017A): THE $160,000,000 (2017A) REFUNDED THE 2008B-F BONDS. THE ISSUE DATE FOR THE 2008B-F BONDS WAS 8/14/2008. BOND ISSUE 1-D (2019A): THE 2019A ISSUE REFUNDED THE 2010A ISSUE. BOND ISSUE 1-A & 1-B (2024): EXPENSES INCURRED AT SCRIPPS MEMORIAL HOSPITAL - LA JOLLA, SCRIPPS ENCINITAS HOSPITAL, ENCINITAS, CALIFORNIA AND SCRIPPS CORPORATE HEADQUARTERS IN SAN DIEGO, CALIFORNIA.
Schedule K, Part IV, Line 2c DATE THE REBATE COMPUTATION WAS PERFORMED	BOND ISSUE 1-A (2007A): THE 2007A REBATE COMPUTATION WAS RECENTLY PERFORMED ON MARCH 2, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-B (2016A/C): THE 2016A/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 28, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-C (2017A): THE 2017A REBATE COMPUTATION WAS RECENTLY PERFORMED ON JANUARY 31, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-D (2019A) THE 2019A REBATE COMPUTATION WAS RECENTLY PERFORMED ON NOVEMBER 15, 2023. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD.

Schedule K (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) Chris Van Gorder	Officer	CUMULATIVE DEF COMP (SEE PG 186)		X	10,023,866	14,124,288		No	Yes		Yes
(2) June Komar	Executive	CUMULATIVE DEF COMP (SEE PG 186)		X	2,769,010	3,901,717		No	Yes		Yes
(3) Richard Sheridan	Former Officer	CUMULATIVE DEF COMP (SEE PG 186)		X	4,063,606	5,725,889		No	Yes		Yes

Total ............... $						23,751,894

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) 2023

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	514,376,954	MEDICAL SERVICES		No
(2) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	46,146,546	CONSTRUCTION		No
(3) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	21,882,619	MEDICAL SERVICES		No
(4) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	11,940,161	MEDICAL SERVICES		No
(5) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	9,922,561	CONSTRUCTION		No
(6) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	8,152,997	MEDICAL SERVICES		No
(7) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	5,233,886	MEDICAL SERVICES		No
(8) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	3,409,995	Property Taxes		No
(9) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	2,500,000	MEDICAL SERVICES		No
(10) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	590,287	COMPENSATION		No
(11) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	580,840	COMPENSATION		No
(12) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	536,900	COMPENSATION		No
(13) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	496,805	CONSTRUCTION		No
(14) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	480,500	MEDICAL SERVICES		No
(15) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	411,596	COMPENSATION		No
(16) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	404,306	COMPENSATION		No
(17) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	385,157	CONSTRUCTION		No
(18) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	368,000	MEDICAL SERVICES		No
(19) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	315,577	CONSTRUCTION		No
(20) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	276,887	COMPENSATION		No
(21) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	204,263	MEDICAL SERVICES		No
(22) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	152,961	COMPENSATION		No
(23) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	131,301	COMPENSATION		No
(24) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	130,670	COMPENSATION		No
(25) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	115,517	COMPENSATION		No
(26) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	103,040	MEDICAL SERVICES		No
(27) LINDSEY VAN GORDER	SEE PART V	101,370	SEE PART V		No
(28) DAVID VAN GORDER	SEE PART V	81,928	SEE PART V		No
(29) KATIE WOODHEAD	EMPLOYEE / KEY EMPLOYEE'S DAUGHTER	32,971	SEE PART V		No

Part V

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

Return Reference

Explanation

Schedule L, Part II LOANS TO AND FROM INTERESTED PERSONS

EFFECTIVE JANUARY 1, 2014, SCRIPPS HEALTH FROZE ALL BENEFITS UNDER THE EXISTING SERP PLAN FOR FOUR PLAN PARTICIPANTS. EFFECTIVE APRIL 1, 2014, SCRIPPS HEALTH PROVIDED DEFERRED COMPENSATION ARRANGEMENTS TO THOSE FOUR EXECUTIVES IN THE FORM OF LOANS TO PURCHASE LIFE INSURANCE PRODUCTS TO FUND POST-RETIREMENT INCOME, WITH SUCH DEFERRED COMPENSATION ARRANGEMENTS REFLECTIVE OF THEIR CUMULATIVE SERVICE AT SCRIPPS HEALTH.

Schedule L, Part IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS

LINDSEY VAN GORDER, DAUGHTER-IN-LAW OF BOARD MEMBER AND OFFICER CHRIS VAN GORDER, IS EMPLOYED BY SCRIPPS HEALTH. DAVID VAN GORDER, SON OF BOARD MEMBER AND OFFICER CHRIS VAN GORDER, IS EMPLOYED BY SCRIPPS HEALTH. KATIE WOODHEAD, DAUGHTER OF KEY EMPLOYEE JOHN ENGLE, IS EMPLOYED BY SCRIPPS HEALTH.

Schedule L (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete 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 image

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

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 ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	102	1,334,862	Market value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

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

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

Yes

If "Yes," describe in Part II.

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) (2023)

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
Schedule M, Part I COLUMN (B)	CONTRIBUTIONS REPORTED THE NUMBER OF TRANSACTION, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTRIBUTED, IS BEING REPORTED IN COLUMN B.
Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions	GIFTS OF SECURITIES ARE LIQUIDATED THROUGH LICENSED SECURITIES BROKERS.

Schedule M (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

Return Reference	Explanation
Form 990, Part I, Line 1 FORM 990, PART III, LINE 1 (CONTINUED)	FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $4.3 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 3,000 AFFILIATED PHYSICIANS AND 17,500 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, GENOMIC MEDICINE, WIRELESS HEALTH AND GRADUATE MEDICAL EDUCATION. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONG STANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. TODAY, THE HEALTH SYSTEM EXTENDS FROM CHULA VISTA TO OCEANSIDE, WITH 26 PRIMARY AND SPECIALTY CARE OUTPATIENT CENTERS. A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS WAS NAMED BY TRUVEN IN 2013 AS ONE OF THE TOP 15 LARGE HEALTH SYSTEMS IN THE NATION FOR PROVIDING HIGH-QUALITY, SAFE AND EFFICIENT PATIENT CARE. ON THE FOREFRONT OF GENOMIC MEDICINE AND WIRELESS HEALTH TECHNOLOGY, THE ORGANIZATION IS DEDICATED TO IMPROVING COMMUNITY HEALTH WHILE ADVANCING MEDICINE THROUGH CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. SCRIPPS HAS ALSO EARNED A NATIONAL REPUTATION AS A PREMIER EMPLOYER, NAMED BY FORTUNE MAGAZINE AS ONE OF AMERICA'S "100 BEST COMPANIES TO WORK FOR" EVERY YEAR SINCE 2008. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS	See Scripps Health Annual Community Benefit Plan and Report at Scripps Community Benefits - San Diego - Scripps Health. Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4.9 billion private, tax exempt integrated health system based in San Diego, California. Scripps treats more than 600,000 patients annually through the dedication of more than 3,000 affiliated physicians and more than 17,500 employees. Scripps cares for people throughout the San Diego region with four acute care hospitals on five campuses, 32 outpatient clinics, and 12 Scripps HealthExpress sites. Scripps also offers payer products and population health services through Scripps Accountable Care Organization, Scripps Health Plan, and customized narrow network plans in collaboration with third-party payers. Scripps Health is a leading provider of medical care, improving community health and advancing medicine in San Diego County. Scripps is a recognized leader in the prevention, diagnosis and treatment of disease, and is at the forefront of clinical research and the only health system in the region with two level 1 trauma centers. With three highly respected graduate medical education programs, Scripps is a longstanding member of the Association of American Medical Colleges. Our hospitals are consistently ranked among the nation's best by U.S. News & World Report and numerous other organizations. Scripps is frequently recognized by Fortune magazine, Working Mother magazine, and the Advisory Board as one of the best places in the nation to work. Importantly, Scripps culture is one of caring. The spirit and culture established by two pioneering founders, Ellen Browning Scripps and Mother Mary Michael Cummings, still define who we are today. More information can be found at www.scripps.org. Excellence in Primary and Specialty Care The system is known for its expertise in various areas, including cancer care, cardiovascular disease prevention and treatment, orthopedics, women's health, and neurocognitive care. Generations of San Diegans have relied on Scripps for excellence in health care, starting with primary care doctors who act as the patient's personal health advocate including a focus on preventive care and wellness. For patients' convenience, Scripps physicians offer several options for ongoing care, including extended office hours, telemedicine options, three urgent care centers and HealthExpress walk-in clinics throughout the county for same-day treatment of minor illnesses and injuries. With some of the most advanced technology available today for the diagnosis and treatment of acute and chronic illnesses, Scripps offers patients a complete range of medical and surgical services including many that have been nationally recognized for clinical quality and patient outcomes. Organizational Foundation Scripps provides a comprehensive range of inpatient and ambulatory services through our system of hospitals and clinics. In addition, Scripps participates in many partnerships with government and not-for-profit agencies across our region to improve our community's health. And our partnerships do not stop at our local borders. Our collaborations extend beyond our local community to include state, national, and global efforts in disaster preparedness and relief, emergency medical services, healthcare advocacy, physician education, and direct patient care. In all that we do, we are committed to quality patient outcomes, service excellence, operating efficiency, caring for those in need today while planning for the healthcare needs of future generations. Scripps Health Community Served Hospitals and health systems define the community served as individuals residing within the service area, encompassing all residents in a specified geographic vicinity surrounding the hospital, without exclusion based on income or underserved status. Given the diverse range of hospitals in the region, the service area is designated as the entire County of San Diego for both Scripps and the Community Health Needs Assessment . The San Diego County Health and Human Service Agency (HHSA) organizes its planning areas into six geographic regions: Central, East, North Central, North Coastal, North Inland, and South. Scripps serves the entire San Diego County region with services concentrated in North Coastal, North Central, Central and Southern region of San Diego. Scripps provides significant volumes of inpatient, emergency, outpatient, specialty and primary care. In Fiscal Year 2024, Scripps provided a total of 3,168,633 outpatient visits and facilitated 74,942 hospital discharges. Community outreach efforts are focused in those areas with proximity to a Scripps facility. The hospital's patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. Scripps Health Community Health Needs Assessment Scripps Health bases its community benefit planning on its triennial community health needs assessment (CHNA). The CHNA aims to identify, understand, and prioritize the health-related needs of San Diego County residents facing inequities. The results of the 2022 CHNA are used to inform and adapt hospital programs and strategies better to meet the health needs of San Diego County residents. The following prioritized needs are addressed in the FY24 Community Benefit Plan and Report: - Access to Care (Community Outreach) and financial support for uninsured and underinsured community members. Increase and support access to health care services for the underserved through direct programs and partnerships with community-based organizations. - Aging Care and Support - health education, fall prevention support, social support and screening activities for seniors and others with aging concerns. - Behavioral Health - strengthen the continuum of integrated primary and mental health services for patients discharged from various hospital settings (medical and behavioral health inpatient and emergency care) through a variety of timely patient engagement strategies including the expansion of community-based behavioral health services adjacent to the hospital. - Children and Youth Wellbeing - education and training for community health care professionals and collaboration with local schools to promote interest and provide career pathways in health care. - Chronic Health Conditions - education, prevention and wellness programs, screening and support programs for chronic health conditions and various other health needs including, but not limited to, cardiovascular disease, stroke, cancer, diabetes, and obesity. - Community Safety - community education to decrease preventable deaths and injuries. - Economic Stability - improve outcomes for high-risk underfunded patients and community members through facilitated referrals and connection to other services in the community. - Scripps addresses many of the identified social determinants of health (SDOH) within the health conditions identified in the 2022 CHNA such as, community and social support, food insecurity, transportation, education, and homelessness. Select Specialty Hospital - San Diego Select Specialty Hospital San Diego is a 110-bed, free-standing critical illness recovery hospital (licensed by Medicare as a Long-Term Acute Care Hospital LTACH) which specializes in treating patients recovering from catastrophic critical illness. This unique level of acute hospital care focuses on pulmonary/ventilator liberation, and the treatment of medically complex, wound care, renal disorders, infectious disease, cardiac conditions, brain injury and other neurologic conditions. Select Specialty Hospital San Diego is part of Select Medical, one of the largest providers of post-acute recovery and rehabilitation in the United States. The Scripps Health Board and Select Hospital Management Committee approved an amended 2022 CHNA and a FY23-FY25 Implementation Strategy in December 2023 and January 2024, respectively. As Select Hospital is a calendar year-end taxpayer, their financial results will be incorporated in Scripps Health's IRS Form 990 based on the calendar year ended within Scripps Health's tax reporting year. (e.g., Select Hospital CY23 results of $4,438,138 community benefit contributions are included in Scripps Health's FY24 tax return).
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	Scripps Health 2025 Community Benefit Plan and Report The Scripps Community Benefit Plan and Report was developed in response to Senate Bill 697. Passed in 1994, the bill requires California's not-for-profit hospitals to annually describe and document the full range of community benefits they provide. The report incorporates not only documentation of community benefits, but also a more detailed explanation of the specific community benefit activities provided by our five acute-care hospital campuses, wellness centers and ambulatory care clinics. Scripps Health strives to improve community health through collaboration with a wide range of partners and like-minded organizations. Working with other health systems, community groups, government agencies, businesses and community clinics, Scripps is better able to build upon efforts to achieve broad community health goals and partner with a wide variety of organizations on community health improvement programs. The documented activities in this report reflect our commitments to improving the health of both our patients and the diverse communities of San Diego. As a longstanding member of these communities and as a not-for-profit community resource, our goal and responsibility are to assist all who seek care, particularly those who are vulnerable and lack support. This responsibility is an intrinsic part of our mission. Through our continued actions and community partnerships, we strive to enhance the quality of life across the entire community. Community Benefit Services are programs and services designed to improve health in communities. IRS Form 990, Schedule H instructions define community benefit as activities or programs that respond to community health needs and seek to achieve one or more of the following objectives: improving access to health services, enabling low-income persons to afford health care, enhancing public health, advancing generalizable knowledge, educating health professionals, and relieving the government burden to improve health. The 2025 Community Benefit Plan and Report covers the period of Fiscal Year 2024 (October 1, 2023, through September 30, 2024). During this fiscal year, Scripps devoted $656,291,701 to community benefit programs and services. Community outreach efforts are focused in those areas with proximity to a Scripps facility. Scripps hosts, sponsors, and participates in many community-building events throughout the year. Our programs emphasize community-based prevention efforts and use effective approaches to reach residents at the highest risk for health problems. Scripps aligns its 2025 Community Benefit Plan and Report with the IRS established categories as detailed below. Community Health Improvement Services and Community Benefit Operations During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $10,901,463 in community health improvement services and community benefit operations. This investment includes In-Lieu of Funds which provides critical support for vulnerable populations, covering essential post-discharge needs for unfunded or underfunded patients. These funds help ensure access to necessary health care support services beyond hospital care. Community Health Improvement Services and Community Benefit Operations include prevention and wellness programs, screenings, health education, support groups, health fairs and other programs supported by operational funds, grants, and in-kind donations and philanthropy. Calculations are based on cost, less "direct offsetting revenue," which includes any revenue generated by the activity or program, such as payment or reimbursement for services provided to program patients. According to the Schedule H 990 IRS guidelines, "direct offsetting revenue" also includes restricted grants or contributions that the organization uses to provide a community benefit. The following is a snapshot of Scripps community health improvement services provided in FY24. For more detailed information, see Scripps Health Annual Community Benefit Plan and Report at Scripps Community Benefits - San Diego - Scripps Health. These costs are included in the IRS Form 990 Schedule H Part I-line 7e, and 7i. - Recuperative Care Partnerships: This initiative offered safe discharges for chronically homeless patients with ongoing medical needs. - Father Joe's Village Street Health Project Collaboration: A joint effort with Scripps Mercy Hospital aimed at reaching unsheltered discharged patients for follow-up visits within their communities. - In FY 2024, Scripps Mercy San Diego Internal Medicine Faculty and Residents administered flu vaccines to 35 shelter residents from local programs, including the Salvation Army and San Diego Rescue Mission. This was the first year the residency program participated in the State General Fund Flu Vaccine Program, receiving vaccines at no cost for vulnerable populations. - Support for Community Clinics: Sponsorships, grants and clinical partnerships were provided to community clinics to enhance healthcare access and services. - Residents at Scripps Green participated in five unique community service projects this year, addressing social barriers to health through group-led initiatives as part of the Internal Medicine curriculum. - Scripps established a Graduate Medical Education Diversity, Equity, Inclusion, and Belonging Committee and curriculum, aimed at fostering a more diverse healthcare workforce. This initiative ensures that residents and fellows are educated in an environment that reflects and respects diversity." - American Red Cross Blood Drives: A partnership facilitated blood donation drives. - Medical Legal Partnership with Consumer Center for Health Education and Advocacy: This partnership educated consumers on healthcare benefits, eligibility, and coverage program changes. - Mobile Health and Resource Fair in Southeast San Diego: Scripps partnered with this resource fair at the YMCA to address healthcare needs, offering cardiovascular health and neurocognitive screenings, resources, and breast cancer screening referrals to underserved populations. - Services for Seniors: Programs included fall prevention, wellness education, and the Advanced Care Clinic for adults with multiple chronic diseases. - Behavioral Health Partnership with Family Health Centers of San Diego (FHCSD): This collaboration aimed to strengthen integrated primary and mental health services for Medi-Cal patients receiving care at Scripps Mercy Hospital. - In 2024, the Teaching Health Center Psychiatric Residency Program aims to address the psychiatrist shortage and enhances behavioral health services in the San Diego community, balancing psychotherapeutic techniques with psychopharmacology in its training. In collaboration with FHCSD Health Center Psychiatric Residency Program, Scripps Mercy Hospital has committed to host 6- PGY-1 Residents within the Hospital's Medical Service Floors for training in co-occurring medical and behavioral health conditions among patients during Academic Year 2024-2025. - Supportive Mental Health Services: These services were offered at local-based clinics. - Substance Use Disorder Service (SUDS): SUDS nurses assisted patients at risk for or experiencing detox from addictive substances within the Scripps Health system. - Cancer Programs and Support Services: These services included counseling, support groups, complementary therapies, and educational workshops. - Heart Health and Cardiovascular Disease Prevention: Activities and programs targeted heart health, stroke, and cardiovascular disease prevention and treatment. - Addressing Cardiovascular Disease and Sudden Cardiac Arrest (SCA) in Teens: A partnership with the Eric Paredes Save A Life Foundation focused on screening SCA in teenagers. - Diabetes Care Management Programs: Scripps provided comprehensive and culturally sensitive care to high-risk, underserved communities through Project Dulce, using a specialized team to counsel diabetes patients. - Health Education and Community Engagement: Scripps delivered various classes, prevention lectures, support groups, and participated in health fairs and events to address community needs. - Food Insecurity Support: Assistance included Cal-Fresh screening, Scripps Mercy WIC program, and identifying social determinants of health. - Transportation Services: Scripps partnered with Facilitating Access to Coordinated Transportation (FACT) Inc. to offer on-demand rides for patients traveling to medical appointments. - Engagement in Community Initiatives: Scripps executive leadership and staff actively participated in various community organizations, committees, and coalitions to enhance community health.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	Uncompensated Care Scripps contributes significant resources providing low and no cost health care for our patients in need. The costs of providing these services are not fully reimbursed. Uncompensated health care includes the sum of expenses associated with Charity Care, Medi-Cal and Other Means-Tested Government Programs, Medicare Shortfall and Bad Debt. Medicare Shortfall, Bad Debt and Community Building Activities are reportable under IRS guidelines but are not reportable in the community benefit totals. However, Scripps includes these totals in our overall community benefit calculations. During Fiscal Year 2024, Scripps contributed $587,766,140 in uncompensated health care, including $17,768,458 in charity care, $562,399,773 in Medi-Cal and Medicare shortfall, and $7,597,909 in bad debt. Charity care is included in the Internal Revenue Service (IRS) Form 990 Schedule H Part I Line 7a and Medi-Cal costs are included in Line 7b. This represents unreimbursed community benefit costs after the impact of the Medi-Cal Hospital Fee Program. The State of California enacted legislation for a provider fee program to fund certain Medi-Cal coverage expansions ("Provider Fee Program"). The Provider Fee Program charges hospitals a quality assurance fee that is used to obtain federal matching funds for Medi-Cal with the proceeds redistributed as supplemental payments to California hospitals that treat Medi-Cal patients. In December 2023, CMS approved the January 1, 2023, through December 31, 2024, Provider Fee Program VIII. The Organization's policy is to recognize program revenues and expenses on the accrual basis once the Federal waiver has been approved. Federal and state payments received from these programs are included as provider fee revenue in total patient service revenue, and fees paid or payable to the state and California Health Foundation and Trust are included in provider fee expense in operating expenses. Uncompensated health care costs are included in the IRS Form 990 Schedule H Part I-line 7a-7c. Scripps Mercy Hospital (including San Diego and Chula Vista campuses) provides 64% percent of the charity care within the Scripps system. The service area of Scripps Mercy Hospital reflects a higher proportion of economically disadvantaged individuals compared to the county average, with notably lower rates of insured adults and a significantly higher percentage of ethnic minorities, particularly Hispanic and Asian populations. Both hospital campuses play crucial roles in delivering healthcare services to the Central/Southern San Diego County area, ranging from Interstate 8 to the United States-Mexico border. Over half of the patients served by Scripps Mercy San Diego and Chula Vista are covered by government insurance programs, including Medicare and Medi-Cal. Health Professional Education Quality health care is highly dependent upon health education systems and medical research programs. Without the ability to train and inspire a new generation of health care providers, or to offer continuing education to existing health care professionals, the quality of health care will be diminished. Health Professional Education includes educational programs for physicians, interns and residents, medical students, nurses and nursing students, pastoral care trainees and other health professionals. This education is necessary to retain a state licenses or certification by boards in the individual's health profession specialty. Each year, Scripps allocates resources to advance health care services through health professional education. During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $47,659,269 in professional training programs to enhance service delivery and treatment practices in San Diego County. This figure reflects the costs associated with professional education for non-Scripps employees, including graduate medical education, nursing resource development and other health care professional education. These costs are included in the IRS Form 990 Schedule H Part I Lines 7f. The following is a snapshot of Scripps professional education services provided in FY24. Graduate Medical Education A key component of Scripps Mission is to advance the education of physicians and health care professionals and sponsor graduate medical education. By investing in these areas, we help secure quality care for our community. Scripps has been training future physicians longer than any other institution in San Diego. For more than 70 years physicians in Scripps graduate medical education programs have helped care for underserved populations throughout the region. Scripps offers a comprehensive range of graduate medical education programs at Scripps Mercy Hospital San Diego, Scripps Mercy Hospital Chula Vista, and Scripps Green Hospital. These programs are renowned for their commitment to excellence and feature a hands-on curriculum that places a strong emphasis on patient-centered care. They encompass a wide array of medical specialties, such as internal medicine, family medicine, podiatry, trauma, pharmacy, palliative care, emergency and surgical critical care, as well as research-focused programs. Scripps Graduate Medical Education programs serve our community in two equally important ways: providing much-needed medical care to the diverse patient population of San Diego County; and developing the talent and skills of new leaders in medicine, who together with Scripps will continue to break new ground in innovative, compassionate medical care. In Fiscal Year 2024, Scripps enrolled a total of 165 medical residents, 49 fellows across the Scripps health system, underscoring our commitment to medical education and community healthcare. Graduate Medical Education (GME). Scripps has a pharmacy residency program at Scripps Mercy Hospital and Scripps Memorial Hospital La Jolla which trains residents with Doctor of Pharmacy degrees. Additional Professional Education and Training Programs - Scripps Conference Services and CME: Provides evidence-based, up-to-date, and clinically relevant CME courses. - Scripps Mercy EMS: Offers hospital-based clinical internships and continuing education. Collaborates with local and regional institutions. Training for First Responders, EMTs, Paramedics, Law Enforcement, Military, Mobile Intensive Care Nurses, and Resident Physicians. - Scripps Mercy Hospital Trauma Services: Part of a six-hospital trauma system. Level 1 trauma center offering physician education and trauma research. Offers graduate medical education in trauma and critical care. Partners with Naval Medical Center San Diego and other healthcare providers. Provides training for various residency programs. - Scripps Memorial Hospital La Jolla Trauma Program: Part of a six-hospital trauma system. Level 1 trauma center offering physician medical education and trauma physician training and conducts trauma research. Provides hands-on training for residents and fellows. - Trauma Research Graduate Student Internship: For students in public health, epidemiology, trauma, and related fields. Involves constructing study samples, data analysis, and manuscript writing. Runs concurrently with the Clinical Research Fellowship. - Scripps Whittier Diabetes Institute: Offers education programs led by experts to enhance diabetes management knowledge. Targets healthcare professionals, community partners, clinical providers, and peer educators. - UCSD/Scripps Health Hospice and Palliative Medicine Fellowship: Prepares doctors for hospice and palliative care. Designed for physicians seeking a subspecialty. Provides training for diverse care settings.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	Nursing, Allied Health and Clinical Student Preceptorships Scripps commitment to ongoing learning and health care excellence extends beyond our organization. Our student programs help promote health care careers to a new generation, shape the future workforce and develop future leaders in our community. Interacting with health care professionals in the field expands education outside the classroom. Scripps employees play a significant role as preceptors by investing their time to create a valuable experience for the community. In Fiscal Year 2024, Scripps hosted 1,651 students within our system and provided 250,885 development hours spanning nursing and allied health settings. Scripps Clinic Medical Group and Scripps Coastal Medical Group are dedicated to offering meaningful clinical experiences for Nurse Practitioner and Physician Assistant students. In Fiscal Year 2024, Scripps Clinic Medical Group hosted 153 preceptorship rotations for nurse practitioners and physician assistants, totaling 19,030 hours of completed training. Similarly, Scripps Coastal Medical Group provided 31 preceptorship rotations, accounting for 6,716 hours of practical learning. These experiences empower students to apply their theoretical knowledge and critical thinking in a genuine healthcare environment. School Collaborations and Affiliations Scripps collaborates extensively with local educational institutions, offering students valuable exposure to healthcare roles alongside Scripps professionals. This includes affiliations with over 110 schools and programs, both clinical and nonclinical. An affiliation agreement committee evaluates new partnerships to meet community and workforce needs, ensuring a systemic approach to student placements. Student Pipeline Programs Scripps is dedicated to nurturing future healthcare professionals through a variety of youth-oriented initiatives, focusing on school-to-health career activities like mentoring, camps, job shadowing, health education classes, health chats, support groups, and health fairs. - Scripps School to Health Career Pathway Program: Engaged over 1,600 youths in mentoring programs, health professional presentations, surgery viewings, work-study programs, and Scripps Camp. - Internships and Educational Programs: Scripps collaborates with high schools and colleges to offer students opportunities to explore healthcare roles and gain hands-on experience. Nurses and staff play key roles, interacting with students daily. - Family Practice Medical Residents: Medical Residents deliver interactive classroom presentations on public health concerns, medically focused topics, and conduct hands-on clinical skills workshops at local high schools, enriching students' understanding of healthcare careers and medical practices. Health Research Scripps Health is committed to providing the best possible patient care, and research is a critical part of that mission. In addition to bringing the latest treatments to our patients, the knowledge gained from these research studies advances the quality of care for people around the world. Scripps Health physicians' study new medications and devices, track patient outcomes for years or even decades and gather evidence for sophisticated education and treatment programs. This information is then disseminated into the Scripps system through graduate and continuing medical education and to the scientific community through peer-reviewed publications. Scripps Health Research. During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $4, 991, 558 in health research as it is a critical part of our mission to provide the best care to patients, with many promising new treatments beginning in clinical trials. Internally funded research and research funded by tax-exempt, or government entities are eligible for reporting. Calculations are based on cost, less "direct offsetting revenue," which includes any revenue generated by the activity or program, such as payment or reimbursement for services provided to program patients. These costs are included in the IRS Form 990 Schedule H Part I 7h. Cash, Grants and In-Kind Contributions Scripps provided $1,485,542 in cash, grants and in-kind contributions to community groups and nonprofit organizations. These costs are included in the IRS Form 990 Schedule H Part I Lines 7 i. Below is a snapshot of Scripps sponsorships in FY24: - American Heart Association Go Red for Women Luncheon: Sponsored to unite women nationwide in combating heart disease and stroke, addressing local community needs. - Mental Health Association of San Diego - Meeting of the Minds: The Scripps Mercy Trauma Department played an active role in the planning, organization, and implementation of the conference. - The San Diego LGBT Community Center: Scripps sponsored the San Diego LGBT Community Center, which is one of the nation's largest and most active LGBT community centers. Their mission encompasses promoting LGBT health and human rights, providing a range of programs and services to the diverse San Diego LGBT community, including individuals of various demographics and those living with HIV. - Family Health Center of San Diego - Spirit of the Barrio: Scripps sponsored the event, which is hosted by Family Health Centers of San Diego, the event raises awareness for healthcare in underserved communities. - Family Health Center of San Diego Partnership: Enhanced healthcare services for the underserved at the Internal Medicine Outpatient Clinic through a long-term agreement. - La Maestra Casino Night: Donated to support the La Maestra Community Health Center's annual fundraiser. - San Ysidro Health Center: Sponsored a fundraising "Emerald Ball" to commemorate 55 years of providing high-quality health care for all and the social services for underserved populations. -Turkey Giveaway and Health Resource Fair: Scripps sponsored this event hosted by Assemblymember Dr. Akilah Weber's office. The event aimed to distribute 1,000 turkeys, along with produce and sides purchased from the San Diego Food Bank and Feeding San Diego, to provide complete Thanksgiving meals to the community. - Eric Paredes Save A Life Foundation: Partnered to prevent sudden cardiac arrest in middle and high schoolers in San Diego, providing grants and volunteers for screenings. - California Health Foundation and Trust: Supported charitable activities in hospitals across California. - Consumer Center for Health Education and Advocacy (CCHEA): Funded assistance for low-income uninsured Mercy patients in obtaining healthcare benefits, reducing uncompensated care expenses. - Emergency Meals and Water: Donated 750 cases of water valued at $18,000 to the Ministry of Jerusalem. - Scripps Pay it Forward Sock Drive: Collected 3,823 pairs of socks valued at $5,862 for Father Joe's Villages during Spirit Week to distribute to the homeless. Employees dedicated 80 hours of working time to this effort. - Scripps Health donated medical equipment to the City of Hope. - Greater La Jolla Meals on Wheels: Provided office space to support meal deliveries to seniors and disabled individuals in La Jolla. - Scripps La Jolla Emergency Department donated car seats to patients who have been in an automobile accident and their child's car seat has been rendered unsafe to use. - Scripps donated 31 boxes of books to the San Diego Public Library. - Scripps donated ophthalmology equipment to La Maestra Clinic.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	Subsidized Health Services Subsidized health services are those clinical services provided despite a financial loss to the organization, after removing losses associated with bad debt, financial assistance, Medi-Cal, and Other Means-Tested Government Programs, to meet an identified community need. Scripps Inpatient Behavioral is categorized as subsidized health. The total expense for subsidized health services for Scripps Fiscal Year 2024 was $3,100,477. Subsidized health only includes Scripps Inpatient Behavioral Health. Scripps offers inpatient adult behavioral health services at the Scripps Mercy Hospital, San Diego campus. The Scripps Mercy behavioral health program also actively supports community programs to reduce the stigma of mental illness and help affected individuals live and work in the community. These costs are included in the IRS Form 990 Schedule H Part I Lines 7g. Scripps Health offers inpatient behavioral health care for adults admitted through our emergency departments or urgent care centers. Our outpatient behavioral health services are available through partnerships with various community organizations. Like many behavioral health programs nationwide, funding remains a challenge, as payment rates have not kept pace with the actual cost of care. In Fiscal Year 2024, the Scripps Mercy Behavioral Health Program reported a total operational loss of $8.3 million, with $5 million attributed to Medi-Cal, or other means tested government programs and charity care. Notably, 1.1% of patients in the inpatient unit were uninsured, underscoring the financial pressures faced by these programs. - Scripps Mercy Inpatient Behavioral Health Scripps Mercy Hospital offers a 36-bed Psychiatric Adult Inpatient Unit for individuals suffering from acute psychiatric disorders who cannot live independently or pose a danger to themselves or others. This program helps patients, and their loved ones work through short-term crises, manage mental illness, and resume daily lives. - Outpatient Behavioral Health Services Partnership with Family Health Centers of San Diego (FHCSD): Established in 2016, this collaboration aims to enhance mental health care for Medi-Cal patients at Scripps Mercy Hospital. It integrates primary and mental health care, placing social workers and SUD counselors in emergency departments to connect patients with resources. FHCSD offers outpatient therapy near the hospital, while patients from Scripps Mercy Chula Vista and Mercy San Diego are referred for help with behavioral health issues such as addiction, loss, and anxiety, and other mental health issues. Community Building Activities Community Building Activities support community assets by offering the expertise and resources of the hospital organization. These activities may address the root causes of health problems or the determinants of health, such as education, homelessness, poverty, and the environment. In FY24, Scripps invested $387,252 in community building activities. The following are the community building activities that Scripps participated in. Physical Improvements / Housing - Leadership Retreat Volunteer Service Day: Leaders participated in community service projects for homeless service providers, including Casa de Misericordia, Father Joe's Village, and others. Economic Development - Community Boards: Scripps engaged in boards like the San Diego Downtown Partnership and Hillcrest Business Association to advocate for health and safety. Community Support - SOHL Conference: Sponsored the San Diego Organization of Healthcare Leaders annual event. - LGBT Pride Parade & Fundraisers: Sponsored the Pride Parade and events supporting LGBTQ+ leadership and advocacy. - Chicano Federation: Sponsored events supporting family, housing, and educational programs. - "Coffee with a Cop": Held dialogue sessions with the San Diego Police Department. - Advisory Board & Coalition Meetings: Participated in local boards, with over 700 members, addressing community needs. Disaster Preparedness - Community Outreach & Education: Led efforts in disaster preparedness and community readiness. - Scripps Medical Response Team (SMRT): A volunteer team prepared for state emergency deployments. - Emergency Drills: Participated in county-wide and state disaster response exercises. Coalition Building - Chula Vista Collaborative & SOCAN: Engaged with community groups focused on health, safety, and support for older adults and people with disabilities. Workforce Development - Mana De San Diego (MANASD): Sponsored the Latina empowerment organization. - North County African American Women's Association (NCAAWA): Supported education and career development for African American women and girls. - High School Programs: Hosted students for healthcare career exposure through internships and educational events. Advancing Health Equity The mission of Scripps Health is to provide superior health care services in a caring environment and to make a positive difference in the health of individuals throughout our diverse communities. That mission has been our driving force for the past 100 years and will always be at the heart of everything we do. Today, disparities exist in health care for people throughout the nation. Scripps is committed to reducing health care disparities by evaluating and addressing variations in clinical outcomes as part of our ongoing commitment to high quality care for our patients and community. The following are some of the FY24 highlights for health equity accomplishments. These efforts reflect Scripps commitment to advancing health equity through improved data collection, enhanced patient care, and community outreach. 1. Health Equity Data Improvements: - Exceeded targets for race, ethnicity, and language (REaL) data collection, achieving 110% of the goal. - Surpassed targets for sexual orientation and gender identity (SOGI) data collection, reaching 33% and 36.5%, respectively. - Implemented a system-wide ethnic background data collection process, increasing data capture by over 40%. 2. Social Determinants of Health (SDOH) Screening: - Rolled out SDOH screening across five hospitals, assessing food security, housing instability, and other key domains for patients 18+. - Established processes for responding to positive screens and connected patients with community resources post-discharge. 3. Interpreter Services & Compliance: - Improved utilization and documentation compliance of qualified interpreter use for our patients with preferred language other than English. - Streamlined processes and created detailed instructions for accessing remote and telehealth interpreter services, collaborated with Center For Learning colleagues to enhance education on Interpreter Services for new staff, and revised Epic documentation screens while publishing an updated Interpreter Services Tip Sheet. - Added the CyraCom application to bedside patient iPads initially at Scripps Mercy campuses and later expanded to all hospital campuses and conducted an annual regulatory review and enhancement of Scripps policy. CyraCom provides language interpretation and translation services. These services help organizations communicate with non-English-speaking individuals, ensuring compliance with language access laws and improving accessibility for diverse populations. - To enhance accountability and regulatory compliance, Scripps implemented a Power BI Inpatient Interpreter Services Dashboard and published two articles in internal communications to promote the use of qualified interpretation resources. This dashboard enables Scripps to ensure that interpretive services are provided and documented for those who need them, supporting adherence to regulatory standards. Additionally, it allows to identify areas performing well, enabling to learn best practices, and pinpoint areas needing improvement, allowing to tailor countermeasures effectively. 4. Heart Failure Management & Readmission Targets and Discharge Planning: - Met CMS targets for heart failure readmissions across all five Scripps hospitals. - Launched the Enhanced Discharge Planning Pilot for unhoused heart failure patients, providing tailored dietary education, follow-up appointment scheduling, transportation vouchers, and post-discharge phone calls by a pharmacist. - Partnered with the Scripps Well Being Center - Scripps Mercy Hospital, Chula Vista for post-discharge follow-ups, reducing heart failure readmission rates at Mercy SD and CV campuses. Collaborated with Mama's Kitchen to improve health outcomes and reduce readmissions for congestive heart failure patients, with 72 patients enrolled in FY24 and 123 total number of patients since the beginning of the study. 5. Breast Cancer Screening & Outreach: - Improved breast cancer screening rates among Spanish-speaking populations with targeted campaigns. - Conducted 28 outreach interviews to identify barriers to screening, with findings presented in a medical poster.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	6. Community Health Partnerships & Outreach: - Mobile Health Initiative: Provided education and services to over 790 individuals, focusing on breast cancer prevention, early detection, and cardiovascular health. The health fair supports underserved communities, promotes preventive care, and helps identify effective ways to meet their healthcare needs. - Cognitive Health Screenings: Conducted screenings for over 150 community members at the monthly mobile health fair using a validated tool to assess cognitive decline in underinsured minorities. - Healthy Living Program: Engaged 690 participants in a heart disease prevention program. Led by Scripps staff and Promotoras, the program successfully met its goals and will expand in the next fiscal year. - Breast Cancer Awareness: Delivered educational sessions to 80 individuals in low-income, underserved communities across San Diego. - Scripps Well-Being Center: Served over 10,241 multicultural participants through support groups, classes, outreach, education, and other community health prevention programs. 7. Health Disparities Research and Interventions: - Funded eight research projects focused on health disparities, totaling $72,200 in grants. - Organized the second Annual Research Symposium, with 85+ attendees presenting health equity-focused research. 8. AB 1204 Hospital Equity Reporting: - In FY24, Scripps Health proactively set up the necessary infrastructure to comply with AB 1204, the Medical Equity Disclosure Act, which mandates the collection and reporting of healthcare disparities data. Ongoing Health Equity Programs and Services As Scripps undertakes the work of identifying and reducing disparities in clinical outcomes and ensuring our compliance with government directives regarding health equity, it is important to recognize that Scripps has been engaged in a broad range of programs and initiatives that address health disparities for the vulnerable population for many years. Evidence-based interventions are underway to address these core challenges. Below are some examples, with further details on these programs in the 2025 Scripps Community Benefit Plan and Report. - Aging Care and Support: Provide, proactive, medical, and social services to adults living with multiple chronic diseases. Partner with local senior centers, churches, and senior housing and conduct senior health chats that are designed to provide health education to the older adult community. - Behavioral Health: Establish initiatives to create a more robust behavioral health care system with emphasis on vocational training, reducing opioid use and substance abuse. - Cancer: Offer wig banks to support individuals undergoing cancer treatment and/or experiencing hair loss, transportation for appointments, lodging, Survivor's Day events, breast health outreach and education and more. - Cardiovascular Disease: Address cardiovascular disease through sudden cardiac arrest (SCA) screenings, virtual cardiac rehabilitation, cardiometabolic health education, and improving food insecurities. - Diabetes: Advocate for diabetes prevention, research and education through in-person and virtual programs and events for the various communities and patients impacted by the diabetes epidemic. - Maternal Child Health and High-Risk Pregnancy: Provide perinatology services, health education and awareness and other key programs to support the health of mothers, infants and families. - Professional Education: Support physician training and clinical research, residents and fellows through various residency programs and curriculum dedicated to uplifting health equity, reducing bias, and caring for the underserved. - Health Research: Identify how to measure health equity through the work of the Scripps Collaborative for Health Equity, related research grants, the Health Equity Information Center and more. - Youth Career Pathways/Pipeline Programs: Promote health care as a rewarding career to students via internship programs, outreach programs, scholars' programs and more. - Community Outreach: Help the homeless, food insecure, and un-insured/under-insured low-income patients through programs specifically designed to supplement their overall health care and living needs.
Form 990, Part VI, Line 16a JOINT VENTURES	SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT & COMPLIANCE COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT IS REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST. ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR PRESIDENT/CEO ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS +8.0% GEOGRAPHIC DIFFERENTIAL AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. THE BOARD SELECTS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 06, 2023, JANUARY 24, 2024, AND MARCH 24, 2024. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS +8.0% GEOGRAPHIC DIFFERENTIAL AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. THE BOARD SELECTS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 06, 2023, JANUARY 24, 2024, AND MARCH 24, 2024. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES.
Form 990, Part VI, Line 19 Required documents available to the public	FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST.
Form 990, Part VIII, Line 2f Other Program Service Revenue	OTHER REVENUE - Total Revenue: 17668016, Related or Exempt Function Revenue: 17015924, Unrelated Business Revenue: 652092, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	PHYS FEES-PROVIDER SVS AGRMENT - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 4845493, Fundraising Expenses: 0; OTHER PURCHASED SVS - NON MED - Total Expense: 94840871, Program Service Expense: 54119026, Management and General Expenses: 40458468, Fundraising Expenses: 263377; PHYSICIAN FEES - Total Expense: 88166272, Program Service Expense: 87537125, Management and General Expenses: 629147, Fundraising Expenses: 0; PURCHASED MEDICAL SERVICES - Total Expense: 30604161, Program Service Expense: 30604161, Management and General Expenses: 0, Fundraising Expenses: 0; ALL OTHER FEES FOR SERVICES - Total Expense: 44217091, Program Service Expense: 30785525, Management and General Expenses: 13264676, Fundraising Expenses: 166890;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CHANGE IN VALUE OF DEFERRED GIFTS - 205990; JOINT VENTURE DISTRIBUTION - 1305372; OTHER CHANGES IN NET ASSETS - -51; ROUNDING - 19347; Other - -43841820;

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

SCRIPPS HEALTH

Employer identification number

95-1684089

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) SCRIPPS CLINIC BILLING LLC 4555 Executive Dr SAN DIEGO,CA92121 87-0797749	HLTHCR ADMIN	CA	654,975,747	0	SCRIPPS HLTH
(2) SCRIPPS MERCY BILLING LLC 4555 Executive Dr SAN DIEGO,CA92121 87-0737748	HLTHCR ADMIN	CA	96,030,712	0	SCRIPPS HLTH
(3) IMAGING HEALTHCARE SPECIALISTS LLC 4555 Executive Dr SAN DIEGO,CA92121 20-3872122	MED IMAGING	CA	63,064,686	51,780,451	IHS HOLDING
(4) SCRIPPS HOSPITAL MEDICAL BILLING SERVICES LLC 4555 Executive Dr SAN DIEGO,CA92121 61-1677183	HLTHCR ADMIN	CA	14,185,565	0	SCRIPPS HLTH
(5) SCRIPPS CARDIO&THORACTIC SURGERY BILLING 4555 Executive Dr SAN DIEGO,CA92121 27-0620996	HLTHCR ADMIN	CA	3,565,701	0	SCRIPPS HLTH
(6) MAXWELL H & MURIEL GLUCK CHILD CARE CTR 4555 Executive Dr SAN DIEGO,CA92121 83-1953045	CHILDCARE	CA	2,291,164	1,557,061	SCRIPPS HLTH
(7) SCRIPPS ACCOUNTABLE CARE ORGANIZATION 4555 Executive Dr SAN DIEGO,CA92121 36-4837442	HLTHCR ADMIN	CA	1,147,000	5,333,999	SCRIPPS HLTH
(8) SCRIPPS ASC MANAGEMENT LLC 4555 Executive Dr SAN DIEGO,CA92121 83-1187975	HLTHCR ADMIN	CA	0	0	SCRIPPS HLTH
(9) IHS HOLDING COMPANY LLC 4555 Executive Dr SAN DIEGO,CA92121 47-3437677	HLTHCR ADMIN	CA	0	35,779,242	SCRIPPS HLTH
(10) SCRIPPS BEHAVIORAL HEALTH LLC 4555 Executive Dr SAN DIEGO,CA92121 83-4326624	HLTHCR ADMIN	CA	0	0	SCRIPPS HLTH
(11) SCRIPPS HOME HEALTH & HOSPICE VENTURE 4555 Executive Dr SAN DIEGO,CA92121 84-1894278	HOME HEALTH/HOSPICE	CA	993,933	0	SCRIPPS HLTH

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)HORIZON HOSPICE 4555 Executive Dr SAN DIEGO,CA92121 33-0220777	Dissolved December 2023	CA	501(c)(3)	10	SCRIPPS HEALTH	Yes
(2)MERCY HOSPITAL FOUNDATION SAN DIEGO 4555 Executive Dr SAN DIEGO,CA92121 94-2958094	Dissolved August 2024	CA	501(c)(3)	Type I	SCRIPPS HEALTH	Yes
(3)SCRIPPS HEALTH PLAN SERVICES INC 10790 Rancho Bernardo Rd SAN DIEGO,CA92127 33-0782099	HLTHCARE SVCS	CA	501(c)(3)	Type I	SCRIPPS HEALTH	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) SCRIPPS ENCINITAS SURGERY CTR 15305 DALLAS PKWY STE 1600 LB 28 ADDISON,TX75001 20-5942958	AMBUL SURGERY CTR	CA	SCRIPPS HEALTH	Related	5,170,731	2,668,928		No			No	55.38 %
(2) SCRIPPSUSP SURGERY CTR 15305 DALLAS PKWY STE 1600 LB 28 ADDISON,TX75001 20-5942911	AMBUL SURGERY CTR	CA	NA	Related	405,557	1,015,110		No			No	50 %
(3) SCRIPPS MERCY AMBUL SURG CTR 4555 Executive Dr SAN DIEGO,CA92121 45-0503246	AMBUL SURGERY CTR	CA	SCRIPPS HEALTH	Related	10,427,078	4,906,103		No		Yes		82.5 %
(4) SCRIPPS MEMORIAL XIMED MED CTR 9850 GENESEE AVE STE 900 LA JOLLA,CA92037 33-0475481	REAL ESTATE	CA	SCRIPPS HEALTH	Related	801,441	3,923,442		No		Yes		15.3 %
(5) Vibra Hospital of San Diego LLC 4714 Gettysburg Road Mechanicsburg,PA10755 26-1466122	LT ACUTE CARE	PA	SCRIPPS HEALTH	Related	-2,440,427	10,971,667		No			No	24.5 %

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?
(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	Yes	No
(1) CHARITABLE LEAD TRUST (1) 4555 Executive Dr SAN DIEGO,CA92121	HOSPITAL SUPPORT	CA	NA	Trust				Yes
(2) CHARITABLE REMAINDER TRUST (26) 4555 Executive Dr SAN DIEGO,CA92121	HOSPITAL SUPPORT	CA	NA	Trust				Yes

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

Yes

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

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

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Scripps Health Plan Services (SHPS)	M	71,925,487	Accrual
(2) Scripps Health Plan Services (SHPS)	Q	26,239,938	Accrual
(3) Scripps Encinitas Surgery Center	A	320,297	Accrual
(4) Scripps Mercy Ambulatory Surgery Center	A	322,024	Accrual
(5) Scripps Health Plan Services (SHPS)	J	135,415	Accrual
(6) Scripps Health Plan Services (SHPS)	L	359,690,370	Accrual
(7) Scripps Health Plan Services (SHPS)	N	258,817	Accrual

Schedule R (Form 990) 2023

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

1	Briefly describe the organization’s mission or most significant activities: Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4.9 billion, private not-for-profit integrated health system in San Diego, Ca. (see Sch O)
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	20,408
6	Total number of volunteers (estimate if necessary) .............	6	1,522
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	30,574,038
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	3,892,225

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	75,146,449	43,068,436
9	Program service revenue (Part VIII, line 2g) .........	3,851,530,919	4,574,697,762
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	86,554,526	123,981,850
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	126,977,440	127,717,495
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	4,140,209,334	4,869,465,543
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	535,437	1,507,500
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,841,634,102	2,010,509,221
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 8,756,658
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	2,247,895,981	2,513,892,493
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	4,090,065,520	4,525,909,214
19	Revenue less expenses. Subtract line 18 from line 12.......	50,143,814	343,556,329
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	7,496,795,108	9,124,382,316
21	Total liabilities (Part X, line 26).............	2,391,449,190	3,089,779,778
22	Net assets or fund balances. Subtract line 21 from line 20.....	5,105,345,918	6,034,602,538

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 4,048,891,514 including grants of $ 1,507,500 ) (Revenue $ 4,669,120,872 )
	SEE SCHEDULE O.

4b	(Code: ) (Expenses $ 1,576,284 including grants of $ 0 ) (Revenue $ 2,592,060 )
	The Maxwell H. and Muriel Gluck Child Care center provides child care and pre-school education for the benefit of individuals in the community of San Diego, including employees and patients of the nonprofit 501(C)(3) entities of Scripps Health and Scripps Research Institute. Special emphasis is placed on a variety of learning and play activities in the musical and visual arts field.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses4,050,467,798

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	26,824,199	0	1,068,348

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	437,369
d	Related organizations		1d
e	Government grants (contributions)		1e	11,118,091

f	All other contributions, gifts, grants, and similar amounts not included above		1f	31,512,976

g	Noncash contributions included in lines 1a - 1f:$		1g	1,334,862

h Total. Add lines 1a-1f.......		43,068,436

		Business Code
2a	HEALTHCARE DELIVERY REV	622110	4,145,604,542	4,144,143,452	1,461,090
b	PROVIDER FEE REVENUE	622110	297,816,293	297,816,293
c	CAPITATION PREMIUM	622110	71,146,644	71,146,644
d	JOINT VENTURE REVENUE	900099	30,220,542	30,220,542
e	RENTAL INCOME - MOB	531120	12,241,725	12,241,725
f	All other program service revenue.		17,668,016	17,015,924	652,092	0
g	Total. Add lines 2a–2f .....		4,574,697,762

3 Investment income (including dividends, interest, and othersimilar amounts) ......			93,151,157			93,151,157
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	839,382,317
b	Less: cost or other basis and sales expenses	7b	808,551,624
c	Gain or (loss)	7c	30,830,693	0
d	Net gain or (loss).........			30,830,693			30,830,693
8a	Gross income from fundraising events (not including $ 437,369of contributions reported on line 1c). See Part IV, line 18 ....
			8a	1,302,887
b	Less: direct expenses ...		8b	1,154,185
c	Net income or (loss) from fundraising events..			148,702			148,702
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	MANAGEMENT SERVICES		561110	58,113,441	29,842,298	28,271,143
b	ALL OTHER REVENUE		900099	43,484,175	41,201,695	189,713	2,092,767
c	PHARMACEUTICAL REVENUE		446110	25,971,177	25,971,177
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			127,568,793
12	Total revenue. See instructions.....			4,869,465,543	4,669,599,750	30,574,038	126,223,319

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	1,507,500	1,507,500
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	20,921,162		20,921,162
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	216,270		216,270
7	Other salaries and wages........	1,676,018,448	1,444,664,381	226,004,838	5,349,229
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	59,596,504	50,423,221	8,992,605	180,678
9	Other employee benefits .......	132,887,992	132,414,459		473,533
10	Payroll taxes ...........	120,868,845	103,994,242	16,575,324	299,279
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	11,746,342	4,742,426	6,999,283	4,633
c	Accounting ...........	1,304,245		1,289,052	15,193
d	Lobbying ...........	502,081		502,081
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	6,008,502		6,008,502
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	935,551,921	875,923,870	59,197,784	430,267
12	Advertising and promotion ....	1,951,240		1,950,614	626
13	Office expenses .......	89,492,761	75,868,140	12,785,944	838,677
14	Information technology ......	68,922,416	35,835,540	33,086,876
15	Royalties ..
16	Occupancy ...........	112,632,098	95,808,115	16,744,792	79,191
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	40,457,026	35,231,253	5,225,773
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	175,766,845	156,551,591	19,215,254
23	Insurance ...	16,248,983	16,229,518	19,465
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	784,995,757	784,994,722		1,035
b	HOSPITAL FEE PROGRAM	213,400,447	213,400,447
c	REPAIRS & MAINTENANCE	44,187,945	13,220,625	30,949,139	18,181
d	ALL OTHER EXPENSES	10,723,884	9,657,748		1,066,136
e	All other expenses	0	0	0	0
25	Total functional expenses. Add lines 1 through 24e	4,525,909,214	4,050,467,798	466,684,758	8,756,658
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			328,877,965	2	664,366,806
3	Pledges and grants receivable, net ......			7,714,518	3	6,731,561
4	Accounts receivable, net .............			626,510,398	4	680,894,472
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 .......
				22,987,129	5	23,751,894
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			76,645,463	8	72,129,893
9	Prepaid expenses and deferred charges ......			53,130,912	9	50,374,375
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,478,754,162
b	Less: accumulated depreciation	10b	1,718,003,224	2,613,087,085	10c	2,760,750,938
11	Investments—publicly traded securities .			2,558,568,903	11	3,349,918,598
12	Investments—other securities. See Part IV, line 11 .....			720,177,000	12	854,913,000
13	Investments—program-related. See Part IV, line 11 ..			74,349,869	13	75,271,371
14	Intangible assets ...............			45,109,895	14	45,109,895
15	Other assets. See Part IV, line 11 ...........			369,635,971	15	540,169,513
16	Total assets. Add lines 1 through 15 (must equal line 33)...			7,496,795,108	16	9,124,382,316

17	Accounts payable and accrued expenses .....	592,625,617	17	730,059,359
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	711,154,000	20	1,416,000,000
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 .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	187,426,010	23	7,378,392
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	900,243,563	25	936,342,027
26	Total liabilities. Add lines 17 through 25..	2,391,449,190	26	3,089,779,778

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	4,851,868,923	27	5,778,276,035
28	Net assets with donor restrictions ...........	253,476,995	28	256,326,503
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	5,105,345,918	32	6,034,602,538
33	Total liabilities and net assets/fund balances ........	7,496,795,108	33	9,124,382,316

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No