Community Benefit Insight - Tax-exempt hospital

View data for this organization below, or select additional hospitals to create a comparison view.

Search tax-exempt hospitals
for comparison purposes.

Dignity Health

185 Berry Street

San Francisco, CA 94107

EIN: 941196203

The hospital that you have selected is part of a multi-facility organization that reports community benefit expenditures in the aggregate and not by individual hospital. The data shown below are for the multi-facility organization. We encourage you to contact the individual hospital directly if you would like community benefit information on the hospital.Learn more

Individual Facility Details: Marian Regional Medical Center, Arroyo Grande

345 S Halcyon Rd
Arroyo Grande, CA 93420

Bed count	67	Medicare provider number	050016	Member of the Council of Teaching Hospitals	NO	Children's hospital	NO

Dignity HealthDisplay data for year:

Community Benefit Spending- 2013
(as % of functional expenses, which all tax-exempt organizations report on Form 990 Schedule H)

13.36%

Spending by Community Benefit Category- 2013
(as % of total functional expenses)

* = CBI denoted preventative categories

Community Benefit Spending Compared to Functional Expenses, 2010-2013

Additional data

Community Benefit Expenditures: 2013

All tax-exempt organizations file a Form 990 with the IRS for every tax year. If the tax-exempt organization operates one or more hospital facilities during the tax year, the organization must attach a Schedule H to Form 990. On Part I of Schedule H, the organization records the expenditures it made during the tax year for various types of community benefits; 9 types are shown on this web tool. By default, this web tool presents community benefit expenditures as a percentage of the organization’s functional expenses, which it reports on Form 990, Part IX, Line 25, Column A. (The more commonly heard term, ‘total operating expenses’, which organizations report to CMS, is generally about 90% of the ‘functional expenses’). The user may change the default to see the dollar expenditures.
Amount spent in the following IRS community benefit categories:

Financial Assistance at cost as % of operating expenses	$ 156,707,092 1.87 %
Medicaid as % of operating expenses	$ 726,804,838 8.67 %
Costs of other means-tested government programs as % of operating expenses	$ 40,195,369 0.48 %
Health professions education as % of operating expenses	$ 63,433,485 0.76 %
Subsidized health services as % of operating expenses	$ 27,718,244 0.33 %
Research as % of operating expenses	$ 23,158,585 0.28 %
Community health improvement services and community benefit operations* as % of operating expenses Note: these two community benefit categories are reported together on the Schedule H, part I, line 7e.	$ 56,152,661 0.67 %
Cash and in-kind contributions for community benefit* as % of operating expenses	$ 25,070,946 0.30 %
Community building* as % of operating expenses	$ 4,919,031 0.06 %

* = CBI denoted preventative categories

Community building activities details:

Did tax-exempt hospital report community building activities?	YES
Number of activities or programs (optional)	110
Physical improvements and housing	4
Economic development	4
Community support	23
Environmental improvements	5
Leadership development and training for community members	12
Coalition building	31
Community health improvement advocacy	26
Workforce development	5
Other	0
Persons served (optional)	8,438
Physical improvements and housing	53
Economic development	49
Community support	2,058
Environmental improvements	4
Leadership development and training for community members	1,135
Coalition building	3,563
Community health improvement advocacy	1,251
Workforce development	325
Other	0
Community building expense as % of operating expenses	$ 4,919,031 0.06 %
Physical improvements and housing as % of community building expenses	$ 864,144 17.57 %
Economic development as % of community building expenses	$ 232,669 4.73 %
Community support as % of community building expenses	$ 1,202,335 24.44 %
Environmental improvements as % of community building expenses	$ 38,451 0.78 %
Leadership development and training for community members as % of community building expenses	$ 269,366 5.48 %
Coalition building as % of community building expenses	$ 111,814 2.27 %
Community health improvement advocacy as % of community building expenses	$ 518,737 10.55 %
Workforce development as % of community building expenses	$ 1,681,515 34.18 %
Other as % of community building expenses	$ 0 0 %
Direct offsetting revenue	$ 1,586,315
Physical improvements and housing	$ 1,195,163
Economic development	$ 0
Community support	$ 331,113
Environmental improvements	$ 1,344
Leadership development and training for community members	$ 16,600
Coalition building	$ 0
Community health improvement advocacy	$ 42,095
Workforce development	$ 0
Other	$ 0

Other Useful Tax-exempt Hospital Information: 2013

In addition to community benefit and community building expenditures, the Schedule H worksheet includes sections on what percentage of bad debt can be attributable to patients eligible for financial assistance, and questions on the tax-exempt hospital's debt collection policy. When searching a specific tax-exempt hospital in this web tool, Section II provides information about bad debt and the financial assistance policy, and whether the state in which the tax-exempt hospital resides has expanded Medicaid coverage under the federal ACA.

Of the tax-exempt hospital’s overall operating expenses, amount reported as bad debt as % of operating expenses	$ 183,198,410 2.19 %
Is the tax-exempt hospital considered a "sole community hospital" under the Medicare program?	NO

Information about the tax-exempt hospital's Financial Assistance Policy and Debt Collection Policy
The Financial Assistance Policy section of Schedule H has changed over the years. The questions listed below reflect the questions on the 2009-2011 Schedule H forms and the answers tax-exempt hospitals provided for those years. The Financial Assistance Policy requirements were changed under the ACA. In the future, as the Community Benefit Insight web site is populated with 2021 data and subsequent years, the web tool will also be updated to reflect the new wording and requirements. In the meantime, if you have any questions about this section, we encourage you to contact your tax-exempt hospital directly.

Does the organization have a written financial assistance (charity care) policy?	YES
Did the tax-exempt hospital rely upon Federal Poverty Guidelines (FPG) to determine when to provide free or discounted care for patients?	YES
Amount of the tax-exempt hospital’s bad debt (at cost) attributed to patients eligible under the organization’s financial assistance (charity care) policy as % of operating expenses	$ 0 0 %

Did the tax-exempt hospital, or an authorized third party, take any of the following collection activities before determining whether the patient was eligible for financial assistance:

Reported to credit agency	Not available
Filed lawsuit	Not available
Placed liens on residence	Not available
Issue body attachments? (an order by the court commanding a sheriff or other official to physically bring before the court a person who is guilty of contempt of court)	Not available

Under the ACA, states have the choice to expand Medicaid eligibility for their residents up to 138% of the federal poverty guidelines. The Medicaid expansion provision of the ACA did not go into effect until January 2014, so data in this web tool will not reflect each state's current Medicaid eligibility threshold. For up to date information, please visit the Terms and Glossary under the Resources tab.
The federal poverty guidelines (FPG) are set by the government and used to determine eligibility for many federal financial assistance programs. Tax-exempt hospitals often use FPG guidelines in their Financial Assistance policies to determine which patients will qualify for free or discounted care.
In addition to the federal requirements, some states have laws stipulating community benefit requirements as a result of tax-exemption. The laws vary from state to state and may require the tax-exempt hospitals to submit community benefit reports. Data on this web tool captures whether or not a state had a mandatory community benefit reporting law as of 2011. For more information, please see Community Benefit State Law Profiles Comparison at The Hilltop Institute.

Community Health Needs Assessment Activities: 2013

The ACA requires all 501(c)(3) tax-exempt hospitals to conduct a Community Health Needs Assessment (CHNA) every three years, starting with the hospital's tax year beginning after March 23, 2012. The 2011 Schedule H included an optional section of questions on the CHNA process. This web tool includes responses for those hospitals voluntary reporting this information. The web tool will be updated to reflect changes in these questions on the 2012 and subsequent Schedule H forms.

Did the tax-exempt hospital report that they had conducted a CHNA?	YES
Did the CHNA define the community served by the tax-exempt hospital?	YES
Did the CHNA consider input from individuals that represent the broad interests of the community served by the tax-exempt hospital?	YES
Did the tax-exempt hospital make the CHNA widely available (i.e. post online)?	YES
Did the tax-exempt hospital adopt an implementation strategy to address the community needs identified by the CHNA?	YES
Did the tax-exempt hospital execute the implementation strategy?	YES
Did the tax-exempt hospital participate in the development of a community-wide plan?	YES

Supplemental Information: 2013

This section presents qualitative information submitted by the hospital, verbatim from the 990H record.

Statement of Program Service Accomplishments
Description of the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.

4A (Expenses $ 7263992175 including grants of $ 187309516) (Revenue $ 8042137336)
Dignity Health is a California nonprofit public benefit corporation headquartered in San Francisco, California. Dignity Health, together with its subsidiary corporations, is one of the largest not-for-profit acute health care delivery systems in the United States as measured by annual revenue. Dignity Health operated 39 hospitals throughout major California markets and in the Phoenix, Arizona and Las Vegas, Nevada metropolitan markets during the year ended June 30, 2014. Dignity health and its subordinate corporations' facilities included approximately 8,500 licensed acute care beds and approximately 700 licensed skilled nursing beds as of June 30, 2014. Dignity health maintains a prominent market share in many of its service areas, and many of its hospitals rank among the finest in the nation. With a significant presence in Greater Sacramento, San Francisco Bay Area, Southern California, Central Coast, Central California, and Northern California, Dignity Health's California operations are well dispersed throughout the state. Dignity Health's hospitals operate emergency rooms that are open to all persons regardless of ability to pay; have governing bodies in which primarily independent persons representative of the community comprise a majority; engage in the training and education of healthcare professionals; and participate in Medicaid, Medicare, Tricare and/or other government-sponsored health care programs. This organization is a public benefit corporation exempt from taxation under Section 501(c)(3) of the internal revenue code.

Facility Information

Schedule H (Form 990) Section C. Supplemental Information for Part V, Section B.

SECTION B, LINE 1 - CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT
St Joseph's Westgate Medical Center THE HOSPITAL BEGAN OPERATING EFFECTIVE 5/12/14. A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS CURRENTLY BEING CONDUCTED IN CONJUNCTION WITH ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER AS THE TWO HOSPITALS SERVE THE SAME SERVICE AREA.

SECTION B, LINE 3- COMMUNITY SERVED BY NEEDS ASSESSMENT
St Joseph's Hospital and Medical Center IN JUNE 2012, THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES COMPLETED A COMPREHENSIVE CHNA FOR MARICOPA COUNTY. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. MERCY SAN JUAN MEDICAL CENTER MERCY SAN JUAN MEDICAL CENTER COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 25 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). FIVE FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY GENERAL HOSPITAL MERCY GENERAL HOSPITAL COMPLETED ITS MOST RECENT CHNA IN THE SPRING OF 2013, IN PARTNERSHIP WITH THE NONPROFIT RESEARCH ORGANIZATION VALLEY VISION, REGIONAL HEALTH SYSTEMS, PUBLIC HEALTH EXPERTS, SIERRA HEALTH FOUNDATION, AND CALIFORNIA STATE UNIVERSITY, SACRAMENTO. THE PROCESS ENGAGED MULTIPLE COMMUNITY STAKEHOLDERS OVER A NINE-MONTH PERIOD THAT IN ADDITION TO RESIDENTS, INCLUDED SCHOOL DISTRICT OFFICIALS, PHYSICIANS, LEADERS OF COMMUNITY HEALTH, AND SOCIAL SERVICE ORGANIZATIONS, AND THE 70-MEMBER HEALTHY SACRAMENTO COALITION. THE ASSESSMENT USED A MIXED METHODS RESEARCH APPROACH. PRIMARY QUALITATIVE DATA WAS OBTAINED FROM INTERVIEWS WITH HOSPITAL CLINICAL AND COMMUNITY BENEFIT STAFF MEMBERS AND 37 KEY INFORMANTS (AREA HEALTH AND COMMUNITY EXPERTS). TEN FOCUS GROUPS WERE CONDUCTED WITH AREA RESIDENTS, AND PHONE INTERVIEWS AND WEBSITE ANALYSES WERE CONDUCTED TO ASSESS COMMUNITY HEALTH ASSETS. MERCY MEDICAL CENTER REDDING (MMCR) MMCR CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA) RELATING TO A WIDE ARRAY OF COMMUNITY HEALTH INDICATORS. PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MMCR AND THE PUBLIC HEALTH DEPARTMENT AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. THE SURVEYS WERE EMAILED TO APPROXIMATELY 1,000 EMAILS THROUGH A DISTRIBUTION LIST THAT THE HOSPITAL USES TO DISSEMINATE HEALTH EDUCATION MATERIALS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THERE WERE 168 SURVEYS COMPLETED FOR A RETURN RATE OF APPROXIMATELY 16.8%. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MMCR ADVISORY COUNCIL, COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA, AND SHASTA COUNTY PUBLIC HEALTH. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. CHANDLER REGIONAL MEDICAL CENTER (CRMC) THROUGH THE 2012 NEEDS ASSESSMENT, CRMC AND MERCY GILBERT MEDICAL CENTER CONSULTED WITH ARIZONA STATE UNIVERSITY COMMUNITY HEALTH INFORMATION RESEARCH. THE PRIMARY DATA COLLECTION INCLUDED INTERVIEWS WITH STAFF AND LEADERS OF MORE THAN 20 COMMUNITY SERVICES AGENCIES IN FIVE MUNICIPALITIES, AND TWO FOCUS GROUPS IN COMMUNITY AGENCY LOCATIONS. CRMC PARTNERED WITH ARIZONA STATE UNIVERSITY DOCTORAL STUDENTS AND CHANDLER GILBERT COMMUNITY COLLEGE NURSING STUDENTS TO CONDUCT THE AGENCY INTERVIEWS AND FOCUS GROUPS. GOVERNMENT AGENCY RESOURCES INCLUDED ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM, ARIZONA DEPARTMENT OF HEALTH SERVICES, PUBLIC DATA SOURCES, ARIZONA CANCER REGISTRY, ARIZONA HEALTH STATUS AND VITAL STATISTICS, ARIZONA HEALTH SURVEY, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM, AND US CENSUS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS, RETAINED VALLEY VISION, INC., TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM, HELD IN NOVEMBER 2012. ST. ROSE DOMINICAN HOSPITALS - ROSE DE LIMA, SAN MARTIN AND SIENA THE HEALTHY COMMUNITIES INSTITUTE (HCI) OF BERKELEY, CALIFORNIA, IN PARTNERSHIP WITH ST. ROSE DOMINICAN HOSPITALS, CONDUCTED A CHNA OF CLARK COUNTY, NEVADA IN 2013. BOTH QUANTITATIVE AND QUALITATIVE RESEARCH METHODOLOGIES WERE USED TO ENSURE AN ACCURATE PROFILE OF THE ST. ROSE SERVICE AREAS. PRIMARY AND SECONDARY DATA FROM A VARIETY OF SOURCES INCLUDES: PAPER AND ELECTRONIC SURVEYS; DATA FROM EXISTING LITERATURE AND DATABASES; AND INFORMATION FROM COMMUNITY STAKEHOLDERS. SEVERAL TOOLS WERE CREATED FOR PRIMARY DATA COLLECTION, AND MANY METHODOLOGIES WERE UTILIZED, INCLUDING: 1) 221 INDIVIDUALS COMPLETED A SURVEY RANKING THE TOP HEALTH ISSUES FOR THEIR FAMILY AND THE COMMUNITY. THE SURVEY PROVIDED THE LIST OF 15 HEALTH ISSUES THAT WERE SELECTED AFTER AN ANALYSIS OF HCI AND PREVENTION QUALITY INDICATOR DATA. A CONVENIENCE SAMPLE OF THOSE UTILIZING ST. ROSE COMMUNITY OUTREACH PROGRAMS COMPLETED THE SURVEYS; 2) MORE THAN 50 KEY COMMUNITY STAKEHOLDERS, INCLUDING REPRESENTATIVES OF THE UNIVERSITY OF NEVADA AT LAS VEGAS DEPARTMENT OF PUBLIC HEALTH, WERE INVITED TO COMPLETE A SURVEY RANKING PRIORITY HEALTH NEEDS IDENTIFYING WAYS ST. ROSE CAN ADDRESS THESE HEALTH ISSUES, AND PROVIDING SUGGESTIONS FOR ENHANCED COLLABORATION WITH PARTNER ORGANIZATIONS. NORTHRIDGE HOSPITAL (NHMC) NHMC, IN COLLABORATION WITH THE VALLEY CARE COMMUNITY CONSORTIUM (VCCC), DEVELOPED NHMC'S 2013 CHNA IN COMPLIANCE WITH FEDERAL REQUIREMENTS. VCCC IS THE HEALTH PLANNING COLLABORATIVE FOR THE SAN FERNANDO AND SANTA CLARITA VALLEYS IN LOS ANGELES COUNTY. DATA WERE SUMMARIZED FROM SECONDARY DATA SOURCES TO DESCRIBE 17 HEALTH ISSUES. TABLES OF DISEASES BY ZIP CODE FOCUSING ON THE HOSPITAL'S PRIMARY SERVICE AREA, USING THE 2012 THOMSON REUTERS DATABOOK, WERE COMPARED WITH AVAILABLE COUNTY, STATE AND NATIONAL DATA (CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, LOS ANGELES DEPARTMENT OF PUBLIC HEALTH, THE CENTERS FOR DISEASE CONTROL, AND HEALTHY PEOPLE 2020) AND ANALYZED. BASED ON THIS ANALYSIS, DISCUSSION TOPICS WERE DEVELOPED TO GATHER PRIMARY DATA THROUGH LOCAL FOCUS GROUPS, COMMUNITY FORUMS, PAPER SURVEYS, AN ONLINE SURVEY AND INTERVIEWS WITH KEY INFORMANTS, INCLUDING PUBLIC HEALTH REPRESENTATIVES. THIS COMMUNITY INPUT WAS OBTAINED FROM ACROSS THE HOSPITAL'S COMMUNITY, WITH A FOCUS ON PERSONS AND AREAS IMPACTED BY HEALTH DISPARITIES. DOMINICAN HOSPITAL THE COMMUNITY ASSESSMENT PROJECT I

MERCY MEDICAL CENTER MT. SHASTA
MERCY MEDICAL CENTER MT. SHASTA CONDUCTED THE 2014 CHNA USING COMMUNITY BENEFIT STAFF TO OVERSEE THE PROCESS. MERCY MEDICAL CENTER MT. SHASTA TOOK INTO CONSIDERATION AVAILABLE INTERNAL AND EXTERNAL RESOURCES, AND PARTNERED WITH OUTSIDE INDIVIDUALS AND ORGANIZATIONS AS APPROPRIATE THROUGHOUT THE CHNA PROCESS. THE CHNA PROCESS INCORPORATED DATA FROM A SURVEY AND ALSO SECONDARY DATA RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA). PRIMARY SURVEY DATA WAS COLLECTED BY USING BOTH PAPER SURVEYS AND AN IDENTICAL WEB-BASED SURVEY. THE SURVEY INSTRUMENT WAS DEVELOPED BY MERCY MEDICAL CENTER MT. SHASTA AND THE PUBLIC HEALTH DEPARTMENT, AND IS SIMILAR TO PREVIOUS SURVEYS USED IN THE REGION. THE SURVEYS COLLECTED INFORMATION ABOUT PERCEIVED HEALTH NEEDS FROM COMMUNITY MEMBERS, STAKEHOLDERS AND PROVIDERS. IN ADDITION TO PROVIDING ASSISTANCE WITH THE SURVEY DESIGN, PUBLIC HEALTH AGENCY REPRESENTATIVES DISTRIBUTED THE SURVEYS TO THEIR EMPLOYEES AND CLIENTS. THE HOSPITAL DISTRIBUTED SURVEYS TO ZIP CODES WITHIN THE PRIMARY SERVICE AREA, INCLUDING ZIP CODES WITH DISPROPORTIONATE UNMET HEALTH NEEDS. THE FOLLOWING PARTNERS ASSISTED THE HOSPITAL IN CONDUCTING THE NEEDS ASSESSMENT, INCLUDING THE SURVEY: THE MERCY MEDICAL CENTER MT.SHASTA COMMUNITY ADVISORY COUNCIL COMPRISED OF ACTIVE COMMUNITY MEMBERS REPRESENTING ALL OF THE COMMUNITIES IN OUR PRIMARY SERVICE AREA; SISKIYOU COUNTY RURAL HEALTH CLINICS; AND SISKIYOU COUNTY COMMUNITY RESOURCE CENTERS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF. ST. JOSEPH'S BEHAVIORAL HEALTH CENTER THE HEALTHIER COMMUNITY COALITION, WHICH INCLUDES AREA HOSPITALS, THE COUNTY HEALTH DEPARTMENT, AND COMMUNITY PARTNERS RETAINED VALLEY VISION, INC. TO CONDUCT THE 2012 CHNA. VALLEY VISION ASSEMBLED A TEAM OF EXPERTS FROM MULTIPLE SECTORS TO CONDUCT THE ASSESSMENT, INCLUDING A PUBLIC HEALTH EXPERT AND A GEOGRAPHER, AS WELL AS ADDITIONAL PUBLIC HEALTH PRACTITIONERS AND CONSULTANTS TO COLLECT AND ANALYZE DATA. A COMMUNITY-BASED PARTICIPATORY RESEARCH APPROACH WAS USED TO CONDUCT THE ASSESSMENT, WHICH INCLUDED BOTH PRIMARY AND SECONDARY DATA. PRIMARY DATA COLLECTION INCLUDED INPUT FROM MORE THAN 180 RESIDENTS OF SAN JOAQUIN COUNTY, EXPERT INTERVIEWS WITH 45 KEY INFORMANTS, AND FOCUS GROUP INTERVIEWS WITH 137 COMMUNITY MEMBERS. MEMBERS OF THE COMMUNITY REPRESENTING DIFFERENT DEMOGRAPHIC GROUPS WERE RECRUITED TO PARTICIPATE IN THE FOCUS GROUPS. A STANDARD PROTOCOL WAS USED FOR ALL FOCUS GROUPS TO UNDERSTAND THE LIVED EXPERIENCE OF THESE COMMUNITY MEMBERS AS IT RELATES TO HEALTH DISPARITIES AND CHRONIC DISEASE. IN ALL, EIGHT FOCUS GROUPS WERE CONDUCTED. CONTENT ANALYSIS WAS PERFORMED ON FOCUS GROUP INTERVIEW NOTES AND/OR TRANSCRIPTS TO IDENTIFY KEY THEMES AND SALIENT HEALTH ISSUES AFFECTING COMMUNITY RESIDENTS. FURTHER INPUT WAS GATHERED AT MEETINGS OF THE HEALTHIER COMMUNITY COALITION AND THE ANNUAL COMMUNITY HEALTH FORUM HELD IN NOVEMBER 2012. ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL THE HOSPITAL UTILIZED INFORMATION COMPILED IN A 2012 COUNTYWIDE CHNA BY THE MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH AND THE ARIZONA DEPARTMENT OF HEALTH SERVICES. THIS COLLABORATIVE EFFORT WAS THE CULMINATION OF AN 18-MONTH PROCESS THAT INVOLVED A WIDE VARIETY OF LOCAL PUBLIC HEALTH AGENCIES, HOSPITALS, COMMUNITY HEALTH CENTERS, EDUCATIONAL AND SOCIAL SERVICE AGENCIES, COMMUNITY MEMBERS, HEALTH ADVOCATES, AND OTHER STAKEHOLDERS DOCUMENTED IN THE CHNA REPORT. ASSESSMENTS WERE CONDUCTED USING A VARIETY OF METHODS FROM HEALTH DATA ANALYSIS TO SURVEYS AND FOCUS GROUPS. FOUR-HUNDRED TWENTY-NINE SURVEYS WERE COMPLETED IN FOUR ETHNIC/RACIAL MINORITY COMMUNITIES INCLUDING: HISPANIC/LATINO, ASIAN PACIFIC ISLANDER, AFRICAN AMERICAN, AND NATIVE AMERICAN; 241 SURVEYS WERE CONDUCTED WITH COMMUNITY PARTNERS/HEALTH PROFESSIONALS; AND 303 SURVEYS WERE CONDUCTED WITH MARICOPA COUNTY DEPARTMENT OF PUBLIC HEALTH STAFF.

SECTION B, LINE 4- OTHER HOSPITAL FACILITIES INCLUDED IN NEEDS ASSSESSMENT
ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER BANNER HEALTH, SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL MERCY SAN JUAN MEDICAL CENTER MERCY HOSPITAL OF FOLSOM, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER MERCY GENERAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER MERCY GILBERT MEDICAL CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON ST. JOSEPH'S BEHAVIORAL HEALTH, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ST. ROSE DOMINICAN HOSPITAL - SIENA CAMPUS ST. ROSE DOMINICAN HOSPITAL SAN MARTIN AND ST. ROSE DOMINICAN HOSPITAL DE LIMA NORTHRIDGE HOSPITAL MEDICAL CENTER ADVANCE HEALTH MEDICAL CENTER, DEL CARMEN MEDICAL CENTER, GLENDALE ADVENTIST MEDICAL CENTER, HENRY MAYO NEWHALL MEMORIAL HOSPITAL, HOLLYWOOD COMMUNITY HOSPITAL OF VAN NUYS, KAISER PERMANENTE WOODLAND HILLS, KAISER PERMANENTE PANORAMA CITY, MISSION COMMUNITY HOSPITAL, PROVIDENCE HEALTH CENTER, SHERMAN OAKS HOSPITAL, AND VALLEY PRESBYTERIAN HOSPITAL DOMINICAN HOSPITAL SUTTER MATERNITY AND SURGERY CENTER, WATSONVILLE COMMUNITY HOSPITAL MARIAN REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND FRENCH HOSPITAL MEDICAL CENTER CALIFORNIA HOSPITAL MEDICAL CENTER GOOD SAMARITAN HOSPITAL AND ST. VINCENT MEDICAL CENTER ST. BERNARDINE MEDICAL CENTER COMMUNITY HOSPITAL SAN BERNARDINO MERCY HOSPITAL BAKERSFIELD DELANO REGIONAL MEDICAL CENTER, BAKERSFIELD MEMORIAL HOSPITAL, KAISER PERMANENTE AND SAN JOAQUIN COMMUNITY HOSPITAL MERCY GILBERT MEDICAL CENTER CHANDLER REGIONAL MEDICAL CENTER METHODIST HOSPITAL OF SACRAMENTO MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER SEQUOIA HOSPITAL STANFORD HOSPITAL & CLINICS, SETON MEDICAL CENTER, MILLS-PENINSULA HEALTH SERVICES, SAN MATEO MEDICAL CENTER, LUCILE PACKARD CHILDREN'S HOSPITAL AT STANFORD, KAISER PERMANENTE SAN MATEO AREA ST. JOHN'S REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. MARY MEDICAL CENTER - LONG BEACH LONG BEACH MEMORIAL, MILLER'S CHILDREN'S HOSPITAL, COMMUNITY HOSPITAL OF LONG BEACH, AND LONG BEACH DEPARTMENT OF HEALTH AND HUMAN SERVICES IN COLLABORATION WITH KAISER PERMANENTE ST. MARY'S MEDICAL CENTER CALIFORNIA PACIFIC MEDICAL CENTER, CHINESE HOSPITAL, KAISER PERMANENTE HOSPITAL, SAINT FRANCIS MEMORIAL HOSPITAL, UCSF MEDICAL CENTER MERCY HOSPITAL OF FOLSOM MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, WOODLAND MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER GLENDALE ADVENTIST MEDICAL CENTER AND USC VERDUGO HILLS HOSPITAL ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL DE LIMA WOODLAND MEMORIAL HOSPITAL MERCY HOSPITAL OF FOLSOM, MERCY SAN JUAN MEDICAL CENTER, MERCY GENERAL HOSPITAL, METHODIST HOSPITAL OF SACRAMENTO, SIERRA NEVADA MEMORIAL HOSPITAL, UC DAVIS MEDICAL CENTER, KAISER PERMANENTE, SUTTER MEDICAL CENTER ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS ST. ROSE DOMINICAN HOSPITAL SIENA AND ST. ROSE DOMINICAN HOSPITAL SAN MARTIN FRENCH HOSPITAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL AND MARIAN REGIONAL MEDICAL CENTER ST. JOHN'S PLEASANT VALLEY HOSPITAL ST. JOHN'S REGIONAL MEDICAL CENTER ARROYO GRANDE COMMUNITY HOSPITAL FRENCH HOSPITAL MEDICAL CENTER AND MARIAN REGIONAL MEDICAL CENTER SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S BEHAVIORAL HEALTH CENTER ST. JOSEPH'S MEDICAL CENTER OF STOCKTON, DAMERON HOSPITAL, SUTTER-TRACY HOSPITAL, KAISER STOCKTON AND LODI HEALTH ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER, BANNER HEALTH, CHANDLER REGIONAL MEDICAL CENTER, MERCY GILBERT MEDICAL CENTER, AND SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL

SECTION B, LINE 5A- AVAILABILITY OF NEEDS ASSESSMENT
INDIVIDUAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPLEMENTATION PLAN SUMMARIES MAY BE ACCESSED AT HTTP://WWW.DIGNITYHEALTH.ORG/CM/CONTENT/PAGES/COMMUNITY-BENEFIT.ASP INDIVIDUAL WEB SITES FOR EACH FACILITY ARE PROVIDED BELOW. ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER http://www.dignityhealth.org/stjosephs/about-us/community-benefit/communit y-benefit-resources MERCY SAN JUAN MEDICAL CENTER http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY GENERAL HOSPITAL http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community MERCY MEDICAL CENTER REDDING http://redding.mercy.org/Who_We_Are/Serving_the_Community/index.htm CHANDLER REGIONAL HOSPITAL http://www.dignityhealth.org/chandlerregional/about-us/community-benefit-a nd-outreach ST. JOSEPH'S MEDICAL CENTER OF STOCKTON http://www.stjosephscares.org/Who_We_Are/Serving_the_Community/index.htm ST. ROSE DOMINICAN HOSPITALS - SIENA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment NORTHRIDGE HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/northridgehospital/who-we-are/serving-the-com munity DOMINICAN HOSPITAL http://www.dominicanhospital.org/Who_We_Are/Serving_the_Community/index.ht m MARIAN REGIONAL MEDICAL CENTER http://www.marianmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm CALIFORNIA HOSPITAL MEDICAL CENTER http://www.dignityhealth.org/californiahospital/who-we-are/community-benef its ST. BERNARDINE MEDICAL CENTER http://www.dignityhealth.org/stbernardinemedical/who-we-are/serving-the-co mmunity MERCY HOSPITAL BAKERSFIELD http://www.mercybakersfield.org/Who_We_Are/Serving_the_Community/index.htm MERCY GILBERT MEDICAL CENTER http://www.dignityhealth.org/mercygilbert/about-us/community-benefit-outre ach METHODIST HOSPITAL OF SACRAMENTO http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community SEQUOIA HOSPITAL http://www.sequoiahospital.org/Who_We_Are/Serving_the_Community/index.htm MERCY MEDICAL CENTER MERCED http://www.mercymercedcares.org/Who_We_Are/Serving_the_Community/index.htm ST. JOHN'S REGIONAL MEDICAL CENTER http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. MARY MEDICAL CENTER - Long Beach http://www.dignityhealth.org/stmarymedical/community-benefits ST. MARY'S MEDICAL CENTER http://www.stmarysmedicalcenter.org/Who_We_Are/Serving_the_Community/index .htm MERCY HOSPITAL OF FOLSOM http://www.dignityhealth.org/sacramento/about-us/community-benefit/serving -the-community GLENDALE MEMORIAL HOSPITAL & HEALTH CENTER http://www.dignityhealth.org/glendalememorial/who-we-are/serving-the-commu nity/community-health-needs-assessment-and-plan ST. ROSE DOMINICAN HOSPITAL - SAN MARTIN CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment WOODLAND MEMORIAL HOSPITAL http://www.dignityhealth.org/woodland/Community-Benefit ST. ROSE DOMINICAN HOSPITAL - ROSE DE LIMA CAMPUS http://www.dignityhealth.org/las-vegas/about-us/community-health-needs-ass essment FRENCH HOSPITAL MEDICAL CENTER http://www.frenchmedicalcenter.org/Who_We_Are/Serving_the_Community/index. htm ST. JOHN'S PLEASANT VALLEY HOSPITAL http://www.stjohnshealth.org/Who_We_Are/Serving_the_Community/index.htm ST. ELIZABETH COMMUNITY HOSPITAL http://redbluff.mercy.org/Who_We_Are/Serving_the_Community/DEVCV120839 ARROYO GRANDE COMMUNITY HOSPITAL http://www.arroyograndehospital.org/Who_We_Are/Serving_the_Community/index .htm MERCY MEDICAL CENTER MT. SHASTA http://www.mercymtshasta.org/Who_We_Are/Serving_the_Community/index.htm SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL HTTP://WWW.OASISHOSPITAL.COM/ ST. JOSEPH'S BEHAVIORAL HEALTH CENTER http://www.stjosephscanhelp.org/Who_We_Are/Serving_the_Community/index.htm ARIZONA ORTHOPEDIC SPECIALTY HOSPITAL HTTP://AZOSH.COM/

SECTION B, LINE 5B - OTHER WEBSITES
MERCY HOSPITAL SAN JUAN HTTP://WWW.HEALTHYLIVINGMAP.COM MERCY GENERAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S MEDICAL CENTER OF STOCKTON WWW.HEALTHIERSANJOAQUIN.ORG. DOMINICAN HOSPITAL HTTP://WWW.APPLIEDSURVEYRESEARCH.ORG/PROJECTS_DATABASE/QUALITY-OF-LIFE/SAN TA-CRUZ-COUNTY-COMMUNITY-ASSESSMENT-PROJECT-CAP.HTML MERCY HOSPITAL BAKERSFIELD HTTP://WWW.HEALTHYKERN.ORG/ METHODIST HOSPITAL OF SACRAMENTO HTTP://WWW.HEALTHYLIVINGMAP.COM SEQUOIA HOSPITAL WWW.HOSPITALCONSORT.ORG HTTP://WWW.PLSINFO.ORG/HEALTHYSMC/PDF/2013_EXECUTIVE_SUMMARY_FINAL.PDF ST. MARY'S MEDICAL CENTER HTTP://WWW.SFHIP.ORG/ MERCY HOSPITAL FOLSOM HTTP://WWW.HEALTHYLIVINGMAP.COM WOODLAND MEMORIAL HOSPITAL HTTP://WWW.HEALTHYLIVINGMAP.COM ST. JOSEPH'S BEHAVIORAL HEALTH CENTER WWW.HEALTHIERSANJOAQUIN.ORG.

SECTION B, LINE 7 - NEEDS NOT ADDRESSED IN NEEDS ASSESSMENT
"ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER WITHIN THE SCOPE OF THE HOSPITAL'S SERVICES, THE PRIORITY NEEDS NOT BEING ADDRESSED ARE THOSE OF CHILDREN'S HEALTH FROM 1 TO 15 YEARS OF AGE. THESE HEALTH ISSUES ARE BEING ADDRESSED IN VARIOUS WAYS BY SEVERAL OTHER HEALTH PROVIDERS IN THE COMMUNITY. IN 2012 THE HOSPITAL JOINED PHOENIX CHILDREN'S HOSPITAL IN HELPING TO ADDRESS THESE NEEDS. MERCY SAN JUAN MEDICAL CENTER THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED BY ANOTHER HOSPITAL IN THE AREA. MERCY GENERAL HOSPITAL THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESSED AT ANOTHER HOSPITAL IN THE AREA. MERCY MEDICAL CENTER REDDING WHILE THE HEALTH NEEDS AND RISKS OF DOMESTIC VIOLENCE AND CHILD ABUSE/NEGLECT WERE ALSO IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT, THE HOSPITAL HAS LIMITED RESOURCES AND ABILITY TO EFFECT SUSTAINABLE CHANGE. MERCY MEDICAL CENTER REDDING WILL SUPPORT LOCAL NON-PROFIT ORGANIZATIONS THAT ADDRESS THOSE NEEDS THROUGH DONATIONS, SPONSORSHIPS, AND THE COMMUNITY GRANTS PROGRAM, AS APPROPRIATE. CHANDLER REGIONAL MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY CHANDLER REGIONAL MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY CRMC INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. ST. JOSEPH'S MEDICAL CENTER OF STOCKTON IDENTIFIED HEALTH NEEDS NOT BEING ADDRESSED DIRECTLY BY THE HOSPITAL INCLUDE: LACK OF OR LIMITED ACCESS TO DENTAL CARE, LIMITED OR NO NUTRITION LITERACY/ACCESS TO HEALTHY, NUTRITIOUS FOODS, FOOD SECURITY, LIMITED TRANSPORTATION OPTIONS, AND A LACK OF SAFE AND AFFORDABLE PLACES TO BE ACTIVE. ALTHOUGH NOT SPECIFICALLY ADDRESSED IN THE IMPLEMENTATION PLAN, THESE NEEDS WILL RECEIVE SECONDARY SUPPORT BY THE HOSPITAL, AS ABLE. THIS MAY INCLUDE SUPPORTING PARTNERS BETTER SUITED TO ADDRESS THESE NEEDS THROUGH THE GRANTS PROGRAM. ST. ROSE HOSPITAL SIENA CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITION, LACK OF SOCIAL SUPPORT, AND OBESITY. ST. ROSE DOMINICAN HOSPITALS' PROGRAMS MAY TOUCH UPON ASPECTS OF THESE HEALTH ISSUES, ALTHOUGH NOT AS A PRIMARY FOCUS, THROUGH EXISTING PROGRAMS OR PARTNERSHIPS WITH OTHERS IN THE COMMUNITY. NORTHRIDGE HOSPITAL MEDICAL CENTER ONE OF THE NEEDS IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT NOT BEING ADDRESSED BY NORTHRIDGE HOSPITAL MEDICAL CENTER IS ACCESS TO AFFORDABLE DENTAL HEALTH SERVICES. THE HOSPITAL DOES NOT HAVE THE RESOURCES TO ADDRESS THIS HEALTH ISSUE, BUT THE HOSPITAL DOES MAKE REFERRALS TO APPROPRIATE CARE PROVIDERS. DOMINICAN HOSPITAL DOMINICAN HOSPITAL WILL NOT FOCUS ON ISSUES RELATED TO CATEGORIES THAT INCLUDE SELECT WOMEN'S SERVICES, SUBSTANCE ABUSE AND CHEMICAL DEPENDENCY ISSUES, ORAL/DENTAL CARE,AND END OF LIFE ISSUES. THESE ISSUES ARE EITHER BEYOND THE SCOPE OF HOSPITAL RESOURCES OR ARE ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MARIAN REGIONAL MEDICAL CENTER ORAL HEALTH, CULTURAL AWARENESS AND TRANSPORTATION ARE THREE AREAS IDENTIFIED IN THE NEEDS ASSESSMENT THAT WILL NOT BE DIRECTLY ADDRESSED BY THE HOSPITAL. THE HOSPITAL OFFERS SPACE WITHIN THE FACILITY AND SUPPORT SERVICES FOR SOME ORAL HEALTH NEEDS, BUT THE HEALTH ISSUE IS BEING ADDRESSED BY OTHERS IN THE COMMUNITY. THOUGH THE HOSPITAL DOES NOT HAVE A SPECIFIC FOCUS ON CULTURAL AWARENESS OR TRANSPORTATION, BOTH WILL BE GIVEN CONSIDERATION AS THE OTHER HEALTH PRIORITIES ARE ADDRESSED. CALIFORNIA HOSPITAL MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA NOT BEING ADDRESSED BY CALIFORNIA HOSPITAL MEDICAL CENTER INCLUDE ALZHEIMER'S DISEASE (LOW INCIDENCE RATE), ALLERGIES (OTHER FACILITIES ASSIST ADOLESCENTS), CANCER (ASSIST INDIVIDUALS TO FIND A MEDICAL HOME FOR PREVENTIVE SERVICES), HIV/AIDS (ADDRESSED BY OTHER RESOURCES IN THE COMMUNITY), AND SEXUALLY TRANSMITTED DISEASES (LA COUNTY DEPT OF PUBLIC HEALTH AND LOCAL PUBLIC HEALTH CLINICS ARE ADDRESSING THIS ISSUE). ST. BERNARDINE MEDICAL CENTER NEEDS IDENTIFIED IN THE CHNA WITH UNFAVORABLE COMPARISONS TO THE GOALS ESTABLISHED BY HEALTHY PEOPLE 2020 THAT ARE NOT ADDRESSED IN THE ESTABLISHED HEALTH PRIORITIES INCLUDE: HIV/AIDS, CANCER SCREENINGS AND PREVENTION PRACTICES (SENIOR PNEUMONIA SHOT, COLORECTAL CANCER SCREENING, PAP SMEAR, AND MAMMOGRAM). WHILE RECOGNIZING THAT THESE ARE VALID HEALTH CONCERNS, WITH LIMITED RESOURCES THE COMMITTEE PRIORITIZED HEALTH ISSUES THAT IMPACT HOSPITAL ADMISSIONS, RECOGNIZING THAT THERE ARE EXISTING COMMUNITY RESOURCES IN PLACE THAT HAVE THE COMPETENCIES AND CAPACITY TO ADDRESS THESE OTHER ISSUES. MERCY HOSPITAL BAKERSFIELD LOW BIRTHWEIGHT AND INFANT MORTALITY ARE NOT BEING ADDRESSED BY THE HOSPITAL. THESE ISSUES ARE BEING ADDRESSED BY OTHER ENTITIES AND ORGANIZATIONS IN THE COMMUNITY. MERCY GILBERT MEDICAL CENTER TO ADDRESS NEEDS NOT SPECIFICALLY MET BY MERCY GILBERT MEDICAL CENTER, STRONG AND EFFECTIVE PARTNERSHIPS ENSURE THE COMMUNITY HAS ACCESS TO CARE, REGARDLESS OF THE NEED. SERVICES NOT PROVIDED BY THE HOSPITAL ARE MET BY OTHER HEALTH CARE FACILITIES OR PARTNERS IN THE SERVICE AREA. SERVICES NOT PROVIDED BY MERCY GILBERT MEDICAL CENTER INCLUDE OUTPATIENT CANCER TREATMENT SERVICES, BEHAVIORAL HEALTH, BURN TREATMENT, AND IN-PATIENT PEDIATRICS. METHODIST HOSPITAL OF SACRAMENTO THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. SEQUOIA HOSPITAL SEQUOIA HOSPITAL WILL NOT BE DIRECTLY FOCUSING ON MENTAL HEALTH, ORAL HEALTH, VIOLENCE OR STDS/HIV-AIDS ISSUES BECAUSE THEY ARE BEYOND THE SCOPE OF THE HOSPITAL FACILITY AND ARE BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY MEDICAL CENTER MERCED MERCY MEDICAL CENTER MERCED HAS PROGRAMS AND HEALTH SERVICES TO ADDRESS ALL OF THE TOP ELEVEN IDENTIFIED HEALTH PRIORITIES, EXCEPT FOR THE FOLLOWING FOUR: FAMILY PLANNING, ORAL HEALTH, INJURY AND VIOLENCE PREVENTION, AND VISION. SERVICES ARE BEING PROVIDED IN THE COMMUNITY BY OTHER ENTITIES OR THE HOSPITAL DOES NOT HAVE EXPERTISE IN THESE AREAS. ST. JOHN'S REGIONAL MEDICAL CENTER THE HOSPITAL HAS LIMITED ABILITY TO ADDRESS THE DIFFERENCES IN PROSPERITY/POVERTY AT A PUBLIC POLICY LEVEL, DUE TO A LACK OF A MEANINGFUL AVENUE TO APPROACH THIS ISSUE. NONETHELESS, THE HOSPITAL DOES HAVE REPRESENTATION ON THE GOLD COAST BOARD AND A MONTHLY NETWORKING MEETING IN AN ATTEMPT TO BUILD COHESION AT A HUMAN SERVICES PROVIDER LEVEL. THE CHNA NEED REGARDING ""CONTINUING ENVIRONMENTAL DEGRADATION"" IS NOT ADDRESSED DUE TO A LACK OF STAFF AND FUNDING; HOWEVER ST. JOHN'S HOSPITAL HAS AN EFFECTIVE IN-HOUSE ECOLOGY PROGRAM WHICH IS INTENDED TO REDUCE THE FACILITY'S OWN ECOLOGICAL FOOTPRINT. ST. MARY MEDICAL CENTER THE HOSPITAL IS NOT DIRECTLY ADDRESSING THE FOLLOWING PRIORITIES: ARTHRITIS, EXERCISE CLASSES, DRUG AND ALCOHOL PROGRAMS, BEFORE AND AFTER SCHOOL PROGRAMS, COUNSELING AND ASSISTED LIVING. THESE ARE EITHER BEYOND THE EXPERTISE OF THE HOSPITAL OR ARE BEING ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS. ST. MARY'S MEDICAL CENTER THE IDENTIFIED NEED TO ""ENSURE SAFE AND HEALTHY LIVING ENVIRONMENTS"" IS BEYOND THE SCOPE OF THE HOSPITAL'S SERVICES AND RESOURCES, AND IT IS ALREADY BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. MERCY HOSPITAL FOLSOM THE HOSPITAL DOES NOT HAVE THE EXPERTISE TO ADDRESS DENTAL CARE; OTHER FACILITIES IN THE AREA ARE ALREADY PROVIDING DENTAL CARE. THE HOSPITAL DOES NOT AT THIS TIME HAVE RESOURCES TO ADDRESS THE NEED FOR HEALTHY FOODS. THIS NEED IS ADDRESS BY ANOTHER FACILITY IN THE AREA. GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER WILL NOT BE ADDRESSING DISABILITY AND ORAL HEALTH DUE TO LIMITED RESOURCES. FURTHERMORE, GLENDALE HEALTHY KIDS WORKS WITH CHILDREN IN THE COMMUNITY TO PROVIDE ORAL HEALTH EDUCATION AND SERVICES FOR CHILDREN. ST. ROSE HOSPITAL SAN MARTIN CAMPUS HEALTH NEEDS NOT BEING ADDRESSED INCLUDE: TOBACCO USAGE, BABIES WITH LOW BIRTHWEIGHT, CERVICAL CANCER SCREENING AND PREVENTION, COLORECTAL CANCER SCREENING AND PREVENTION, COPD MANAGEMENT, FLU AND PNEUMONIA IMMUNIZATIONS, HEALTHY ENVIRONMENTS INCLUDING ACCESS TO FITNESS AND NUTRITIO"

SECTION B, LINE 11 - ELIGIBILITY FOR PROVIDING DISCOUNTED CARE CRITERIA
DIGNITY HEALTH OPERATES TWO FOR-PROFIT HOSPITALS THROUGH JOINT VENTURE ARRANGEMENTS. THESE HOSPITALS ARE SPECIALTY HOSPITALS THAT PRIMARILY PROVIDE ELECTIVE SURGERY TO PATIENTS. SOUTHWEST ORTHOPEDIC AND SPINE HOSPITAL PROVIDES A 35% DISCOUNT TO ALL SELF-PAY PATIENTS.

SECTION B, LINE 14G - OTHER WAYS HOSPITAL PUBLICIZED FINANCIAL ASSISTANCE
ADDITIONAL MEASURES TAKEN TO PUBLICIZE DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS, A COPY OF THE CHARITY CARE APPLICATION, A TELEPHONE NUMBER FOR PATIENTS TO REQUEST FURTHER INFORMATION ABOUT THE PROGRAM, AVAILABLITY OF INFORMATION IN LANGUAGES OTHER THAN ENGLISH, CONTACT INFORMATION FOR FINANCIAL COUNSELORS OR OTHER REPRESENTATIVES WHO CAN PROVIDE INFORMATION, AND THE FACILITY'S WEBPAGE ADDRESS WHERE ADDITIONAL INFORMATION AND APPLICATIONS CAN BE ACCESSED.

SECTION B, LINE 20D - MEANS USED TO DETERMINE AMOUNTS BILLED
FOR ALL HOSPITALS THAT MARKED BOX 20D PATIENTS WHO ARE APPLYING FOR DISCOUNTS UNDER THE DISCOUNT PROVISION POLICY WHOSE HOUSEHOLD INCOME IS AT OR BELOW 350% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES FROM MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT SPONSORED HEALTH PROGRAM OR HEALTH BENEFIT IN WHICH THE HOSPITAL PARTICIPATES. PATIENTS WHOSE INCOME IS ABOVE 350% BUT NOT MORE THAN 500% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT 135% OF THE HIGHEST AVERAGE PAYMENT RATE THE HOSPITAL WOULD RECEIVE FOR PROVIDING SERVICES TO PATIENTS COVERED BY MEDICARE, MEDICAID, OR ANY OTHER GOVERNMENT-SPONSORED HEALTH ROGRAM OF HEALTH BENEFITS IN WHICH THE HOSPITAL PARTICIPATES.

Supplemental Information

Schedule H (Form 990) Part VI

PART I, LINES 6A & 6B - COMMUNITY BENEFIT
EACH TAX-EXEMPT HOSPITAL FACILITY LISTED IN SCHEDULE H, PART V, PREPARES A SEPARATE COMMUNITY BENEFIT REPORT. CALIFORNIA HOSPITALS SUBMIT THEIR REPORTS TO THE OFFICE OF STATEWIDE HEALTH PLANNING DEPARTMENT AND NEVADA HOSPITALS SUBMIT THEIR REPORTS TO THE NEVADA DEPARTMENT OF HEALTH AND HUMAN SERVICES. DIGNITY HEALTH INCLUDES A CONSOLIDATED COMMUNITY BENEFIT REPORT IN ITS ANNUAL AUDITED FINANCIAL STATEMENTS FOR ITS HOSPITALS AND THE HOSPITALS OF RELATED ORGANIZATIONS THAT ARE CONSOLIDATED FOR FINANCIAL REPORTING PURPOSES(SEE PART VI, LINE 6). DIGNITY HEALTH'S FINANCIAL STATEMENTS ARE POSTED ON DIGNITY HEALTH'S EXTERNAL WEB SITE. SUMMARIES OF THE INDIVIDUAL HOSPITALS' REPORTS ARE POSTED ONLINE AND FULL REPORTS ARE AVAILABLE BY REQUEST.

Part I, Line 7 - FINANCIAL ASSISTANCE & CERTAIN OTHER COMMUNITY BENEFITS
"A COSTING METHODOLOGY IS USED TO CALCULATE FINANCIAL ASSISTANCE FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE. DIGNITY HEALTH USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO PATIENTS. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL HOSPITAL WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE CALCULATION ON WORKSHEET 2 OF THE INSTRUCTIONS FOR FORM 990, SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN AGGREGATED FOR EACH PATIENT BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH SERVICES PROVIDED TO EACH PATIENT. THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF PAYMENT ASSISTANCE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR PAYMENT ASSISTANCE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH AND CASH AND IN-KIND DONATIONS. PART I, LINE 7B - MEDICAID INCLUDED IN COMMUNITY BENEFIT EXPENSE FOR MEDICAID, COLUMN (C) IS $156.6 MILLION OF QUALITY ASSURANCE FEES ASSESSED TO DIGNITY HEALTH IN ACCORDANCE WITH THE CALIFORNIA PROVIDER FEE PROGRAMS. INCLUDED IN DIRECT OFFSETTING REVENUE FOR MEDICAID, COLUMN (D), IS $242.4 MILLION IN SUPPLEMENTAL PAYMENTS RECEIVED UNDER THESE PROGRAMS. PART I, LINE 7, COLUMN (F) - BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), WHICH IS NON-PATIENT RELATED BAD DEBT EXPENSE, IS $3,197,895 AND HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN COLUMN (F). PART I, LINE 7G - SUBSIDIZED HEALTH SERVICES INCLUDED IN SUBSIDIZED HELATH SERVICES IS $3.7 MILLION OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION. PART I, LINE 7I INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $6.6 MILLION IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST (""CHFT""). CHFT WAS ESTABLISHED FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA."

Part II - COMMUNITY BUILDING ACTIVITIES
"DIGNITY HEALTH'S EFFORTS TO PROMOTE THE HEALTH OF THE COMMUNITIES SERVED GO BEYOND PROVIDING HEALTH SERVICES. DIGNITY HEALTH'S ACTIVITIES SUPPORT COMMUNITIES BY OFFERING THE EXPERTISE AND SERVICES OF THE ORGANIZATION. DIGNITY HEALTH TAKES A PROACTIVE APPROACH TO ADDRESSING THE SOCIAL AND ECONOMIC BARRIERS TO GOOD HEALTH, AND SUPPORTS THE WORLD HEALTH ORGANIZATION DEFINITION OF HEALTH AS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY. THROUGH THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM, LOW INTEREST LOANS AND LINES OF CREDIT ARE PROVIDED TO NON-PROFITS THAT ARE ADDRESSING SOCIAL DETERMINANTS OF HEALTH, INCLUDING AFFORDABLE HOUSING AND SOCIAL SERVICES VITAL TO A COMMUNITY'S HEALTH. THE DIGNITY HEALTH COMMUNITY INVESTMENT PROGRAM HAS PROVIDED LOANS TOTALING $143 MILLION SINCE ITS INCEPTION IN 1990. THE INVESTMENT IMPACTS HAVE INCLUDED: HOUSING - NEARLY 500 RENTALS AND HOMES HAVE BEEN CONSTRUCTED OR IMPROVED IN CALIFORNIA, AND 180 UNITS OF AFFORDABLE SENIOR RENTAL AND ASSISTED LIVING UNITS HAVE BEEN DEVELOPED IN NEVADA; COMMUNITY DEVELOPMENT - ACCESS TO SHELTERS SERVING HOMELESS INDIVIDUALS DISCHARGED FROM HOSPITAL EMERGENCY ROOMS HAVE BEEN PROVIDED IN CENTRAL LOS ANGELES AND PHOENIX; COMMUNITY CLINICS - EXPANSION OF TWO HEALTH CENTERS IN SANTA CRUZ HAS BEEN PROVIDED AS WELL AS FINANCING ASSISTANCE OF AN INNOVATIVE TRANSIT ORIENTED DEVELOPMENT PROJECT IN THE WATTS DISTRICT OF SOUTH LOS ANGELES, REFURBISHING A 140-UNIT RENTAL COMPLEX THAT WILL HAVE A NEW FEDERALLY QUALIFIED HEALTH CLINIC ON THE PREMISES; FRESH FOODS - THE FRESHWORKS FUND INVESTED OVER $31 MILLION IN 11 HEALTHY FOOD PROJECTS AND CREATED NEARLY 400 NEW JOBS; MICROLENDING - FINANCED 55 SMALL BUSINESSES IN ARIZONA, NEVADA AND CALIFORNIA; AND INTERMEDIARIES - LOANS WILL LEVERAGE $25 MILLION FOR THE CONSTRUCTION OF AFFORDABLE HOUSING AND COMMUNITY FACILITIES (PRIMARY HEALTH CLINICS) FOR THE ELDERLY AND DISABLED. OFTEN THE LARGEST EMPLOYERS IN THEIR COMMUNITIES, DIGNITY HEALTH HOSPITALS PARTICIPATE IN ECONOMIC DEVELOPMENT COUNCILS AND LOCAL CHAMBERS OF COMMERCE. GRANTS ARE OFFERED TO COMMUNITY ORGANIZATIONS FOR THE PURPOSE OF ECONOMIC DEVELOPMENT OR TO HELP ENSURE A CONTINUUM OF CARE FOR THE COMMUNITY. YOUTH PROGRAMS FOCUS ON ACTIVITIES TO DETER DELINQUENCY, DEVELOP LEADERSHIP SKILLS, ENHANCE LITERACY AND ACADEMIC SUCCESS, IMPROVE HEALTH, CULTIVATE COMMUNITY RESPONSIBILITY, PROVIDE EDUCATION WITH CULTURAL ENRICHMENT, AND OFFER CAREER EXPLORATION OPPORTUNITIES. DIGNITY HEALTH HOSPITALS OPEN THEIR DOORS TO COMMUNITY GROUPS AND ALSO SERVE AS MEMBERS OF COMMUNITY COALITIONS THAT FOCUS ON THE WELL-BEING OF THEIR RESPECTIVE COMMUNITIES. DIGNITY HEALTH ADVOCACY REPRESENTATIVES ARE TIRELESS AS THEY STRIVE TO IMPROVE ACCESS TO HEALTHCARE, PROMOTE THE HEALTH OF THE PUBLIC, AND ADVOCATE FOR SOCIAL JUSTICE AND HUMAN RIGHTS. IN MEDICALLY UNDERSERVED AREAS, EFFORTS TO RECRUIT PHYSICIANS AND OTHER HEALTH PROFESSIONALS ARE ONGOING, AS ARE THE PARTNERSHIPS WITH COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORK-FORCE SHORTAGE. MANY DIGNITY HEALTH HOSPITALS OFFER HEALTH CAREER MENTORING PROJECTS AND PROVIDE SCHOOL-BASED AND COMMUNITY PROGRAMS THAT DRIVE ENTRY INTO HEALTH CAREERS AND NURSING PRACTICE. COMMUNITY BUILDING - PHYSICAL IMPROVEMENTS AND HOUSING EXAMPLES OF PHYSICAL IMPROVEMENTS AND HOUSING INCLUDE SUBSIDIZING LOW INCOME HOUSING UNITS IN SANTA CRUZ AND PARTNERING WITH ""REBUILDING TOGETHER"" TO RESTORE HOMES OF LOW INCOME INDIVIDUALS IN THE LAS VEGAS VALLEY. COMMUNITY BUILDING - ECONOMIC DEVELOPMENT ACTIVITIES INCLUDE THE INVOLVEMENT OF THE LEADERSHIP STAFF OF SEVERAL DIGNITY HEALTH FACILITIES PARTICIPATE IN CHAMBERS OF COMMERCE AND VARIOUS CIVIC ORGANIZATIONS AIMED AT ENSURING THE ECONOMIC DEVELOPMENT, GROWTH AND STABILITY OF THEIR LOCAL COMMUNITIES. COMMUNITY BUILDING - COMMUNITY SUPPORT DIGNITY HEALTH FACILITIES LEAD AND/OR COLLABORATE WITH OTHER COMMUNITY-BASED ORGANIZATIONS IN SUPPORT OF THE SUCCESS OF CHILDREN, YOUTH AND FAMILIES, WHICH ENGAGE AND STRENGTHEN THE COMMUNITIES SERVED. COMMUNITY BUILDING - ENVIRONMENTAL IMPROVEMENTS DIGNITY HEATH IS ENGAGED IN ONGOING EFFORTS TO REDUCE COMMUNITY ENVIRONMENTAL HAZARDS IN THE AIR, WATER AND GROUND, AS WELL AS THE SAFE REMOVAL OF OTHER TOXIC WASTE PRODUCTS. THE COMMITMENT OF DIGNITY HEALTH TO IMPROVE AND SUSTAIN THE ENVIRONMENT IS CODIFIED BY POLICIES, INCLUDING A PURCHASING POLICY WHICH PURSUES MULTIPLE ENVIRONMENTAL GOALS TO REDUCE WASTE AT ITS SOURCE AND TO REDUCE THE AMOUNT OF VIRGIN MATERIALS PURCHASED. DIGNITY HEALTH ATTEMPTS TO PURCHASE GOODS WITH RECYCLED CONTENT AND ONCE PURCHASES REACH THE END OF THEIR INITIAL USE, DIGNITY HEALTH FOCUSES ON REUSE WITHIN THE HOSPITAL, TRANSFER TO OTHER USERS (SUCH AS COMMUNITY ORGANIZATIONS), RECYCLING, AND FINALLY, PROPER WASTE DISPOSAL. DIGNITY HEALTH HAS TRANSITIONED TO PRODUCTS THAT ARE FREE OF POLYVINYL CHLORIDE (PVC) AND DI(2-ETHYLHEXYL) PHTHALATE (DEHP) AND HAS ELIMINATED THE USE OF MERCURY. COMMUNITY BUILDING - LEADERSHIP DEVELOPMENT / TRAINING FOR COMMUNITY MEMBERS DIGNITY HEALTH HOSPITALS ARE COMMITTED TO BUILDING HEALTHIER COMMUNITIES THROUGH LEADERSHIP DEVELOPMENT, PARTICULARLY OF ADOLESCENT, TEEN AND YOUNG ADULT LEADERSHIP, AND CAREER DEVELOPMENT. COMMUNITY BUILDING - COALITION BUILDING THE DIGNITY HEALTH MISSION STATEMENT SPECIFICALLY CALLS UPON US ""TO PARTNER WITH OTHERS IN THE COMMUNITY TO IMPROVE THE QUALITY OF LIFE."" IN THIS REGARD, DIGNITY HEALTH FACILITIES PROVIDE REPRESENTATION ON COMMUNITY COALITIONS AND COLLABORATIVE PARTNERSHIPS TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY, AND HOST AND/OR PARTICIPATE IN COMMUNITY COALITION MEETINGS AND SPECIFIC PROJECTS AND INITIATIVES. COMMUNITY BUILDING - ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENT STAFF AT DIGNITY HEALTH HOSPITALS ADVOCATE ON BEHALF OF THE POOR AND DISENFRANCHISED, PARTICULARLY FOR IMPROVED ACCESS TO HEALTH CARE SERVICES AS WELL AS FOR ENVIRONMENTAL IMPROVEMENTS. DIGNITY HEALTH ALSO ADVOCATES FOR SOCIAL JUSTICE AND HUMAN RIGHTS THROUGH DUES AND GIFTS TO ORGANIZATIONS THAT SUPPORT SOCIAL JUSTICE, AND BY ADVOCATING FOR SOCIAL JUSTICE, ENVIRONMENTAL RESPONSIBILITY AND HUMAN RIGHTS THROUGH INVESTMENTS AS A SHAREHOLDER. COMMUNITY BUILDING - WORKFORCE DEVELOPMENT DIGNITY HEALTH IS COMMITTED TO THE DEVELOPMENT OF THE HEALTH CARE WORKFORCE, AND ACTIVELY ENGAGES IN THE RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS IN MEDICALLY UNDERSERVED AREAS. DIGNITY HEALTH SUPPORTS THE TRAINING AND RECRUITMENT OF UNDERREPRESENTED MINORITIES AND PARTICIPATES IN COMMUNITY WORKFORCE BOARDS AND PARTNERSHIPS. SEVERAL DIGNITY HEALTH FACILITIES, AS WELL AS THE ORGANIZATION ITSELF, HAVE PARTNERED WITH LOCAL COMMUNITY COLLEGES AND UNIVERSITIES TO ADDRESS THE HEALTH CARE WORKFORCE SHORTAGE AND ACTIVELY ENGAGE IN HEALTH CAREER MENTORING PROGRAMS."

Part III - BAD DEBT, MEDICARE, & COLLECTION PRACTICES
SECTION A, LINE 2 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE BAD DEBT EXPENSE THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER PAYMENT ASSISTANCE, AND ARE OTHERWISE UNINSURED. DIGNITY HEALTH PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 200%, 201%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. DIGNITY HEALTH ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS, DISCOUNTS FOR THE MEDICALLY INDIGENT, AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 25% FOR PATIENTS SEEN AT CALIFORNIA AND ARIZONA FACILITIES, AND 30% FOR PATIENTS SEEN AT NEVADA FACILITIES. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE. SECTION A, LINE 3 - BAD DEBT EXPENSE - METHODOLOGY USED TO ESTIMATE AMOUNT AS COMMUNITY BENEFIT DIGNITY HEALTH MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR PAYMENT ASSISTANCE UPON ADMISSION. DIGNITY HEALTH'S PAYMENT ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, URGENT CARE CENTERS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF A PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE. SECTION A, LINE 4 - BAD DEBT EXPENSE - FINANCIAL STATEMENT FOOTNOTE THE FOLLOWING ARE EXCERPTS FROM DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS' CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2014, RELATED TO ACCOUNTS RECEIVABLE AND ALLOWANCES FOR CHARITY AND DOUBTFUL ACCOUNTS: PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. DIGNITY HEALTH REGULARLY REVIEWS ACCOUNTS AND CONTRACTS AND PROVIDES APPROPRIATE CONTRACTUAL ALLOWANCES AND RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS THAT ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEETS. BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS, A SIGNIFICANT PORTION OF DIGNITY HEALTH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, DIGNITY HEALTH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBT RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. SECTION B, LINE 8 - COMMUNITY BENEFIT AND METHODOLOGY FOR DETERMINING MEDICARE COSTS DIGNITY HEALTH HOSPITALS PREPARE MEDICARE COST REPORTS IN A MANNER THAT COMPORTS WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT: TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. IN HOSPITALS, ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS. DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS BELIEVE THAT THE ENTIRE MEDICARE SHORTFALL OF $674.0 MILLION, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY DIGNITY HEALTH HOSPITALS IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $358.3 MILLION REPORTED ON PART III, SECTION B, LINE 7, FOR FEE FOR SERVICE MEDICARE PATIENTS, THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS. SECTION C, LINE 9B - COLLECTION PRACTICES FOR PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE DIGNITY HEALTH ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. DIGNITY HEALTH'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHO THE ORGANIZATION KNOWS QUALIFY FOR PAYMENT ASSISTANCE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE DIGNITY HEALTH FACILITY OR BILLING COMPANY RETAINED BY DIGNITY HEALTH IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED PAYMENT ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY HEALTH'S PATIENT PAYMENT ASSISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, DIGNITY HEALTH WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT. DIGNITY HEALTH DOES NOT IMPOSE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES. ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF EACH HOSPITAL PATIENT PAYMENT ASSISTANCE DEPARTMENT. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNT TO A COLLECTION AGENCY, DIGNITY HEALTH REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.

PART VI, LINE 2 - NEEDS ASSESSMENT IN ADDITION TO CHNAS REPORTED IN PART
V, SECTION B IN ADDITION TO CONDUCTING CHNAS, DIGNITY HEALTH CONTINUOUSLY ASSESSES THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES BY WORKING COLLABORATIVELY WITH LOCAL FEDERALLY QUALIFIED HEALTH CENTERS, OTHER NON-PROFIT CLINICS, PUBLIC HEALTH DEPARTMENTS, AND OTHER HEALTH, SOCIAL SERVICE AND COMMUNITY DEVELOPMENT ORGANIZATIONS. DIGNITY HEALTH GAINS AND MAINTAINS KNOWLEDGE OF HEALTH NEEDS IN PART THROUGH REFERRAL RELATIONSHIPS, SERVICE PLANNING ACTIVITIES, AND LOCAL ADVOCACY CONDUCTED IN CONJUNCTION WITH THESE COMMUNITY PARTNERS. DIGNITY HEALTH ALSO USES HEALTH CARE UTILIZATION DATA TO ASSESS THE DEMAND FOR CARE FOR PERSONS PRESENTING WITH AMBULATORY CARE SENSITIVE CONDITIONS THAT EVIDENCE SUGGESTS COULD HAVE BEEN AVOIDED, AT LEAST IN PART, THROUGH MORE PROACTIVE OR MORE ROBUST PRIMARY OUTPATIENT CARE. HOSPITALS, COMMUNITY LEADERS, AND POLICY MAKERS USE SUCH DATA TO IDENTIFY COMMUNITY NEED LEVELS, TARGET RESOURCES, AND TRACK THE IMPACT OF PROGRAMMATIC AND POLICY INTERVENTIONS. DIGNITY HEALTH, IN PARTNERSHIP WITH TRUVEN HEALTH (FORMERLY SOLUCIENT), DEVELOPED A COMMUNITY NEED INDEX (CNI) WHICH PROVIDES AN AGGREGATE SCORE OF THE SOCIOECONOMIC BARRIERS THAT PUT RESIDENTS AT GREATER RISK OF NEEDING HEALTH SERVICES. THE CNI AGGREGATES FIVE SOCIOECONOMIC INDICATORS KNOWN TO CONTRIBUTE TO HEALTH DISPARITY. THESE INCLUDE INCOME, CULTURE/LANGUAGE, EDUCATION, HOUSING STATUS, AND INSURANCE COVERAGE. THE INDEX BASED ON THESE DATA IS CALCULATED ANNUALLY FOR EVERY ZIP CODE IN THE UNITED STATES. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATION FOR MANAGABLE CONDITIONS AS COMMUNITIES WITH THE LOWEST CNI SCORES. THE CNI PROVIDES COMPELLING EVIDENCE FOR ADDRESSING SOCIOECONOMIC BARRIERS WHEN CONSIDERING HEALTH POLICY AND LOCAL HEALTH PLANNING. THE TOOL HIGHLIGHTS HEALTH CARE DISPARITIES AND ENABLES HEALTH CARE PROVIDERS, POLICYMAKERS, AND OTHERS TO TARGET RESOURCES WHERE THEY ARE MOST NEEDED. ADDITIONAL INFORMATION ABOUT THE CNI IS ACCESSIBLE ON DIGNITY HEALTH'S WEBSITE: http://www.dignityhealth.org/cm/content/pages/community-investments.asp

PART VI, LINE 3 - PATIENT EDUCATION ON ELIGIBILITY FOR FINANCIAL
ASSISTANCE COMMUNICATION OF THE FINANCIAL ASSISTANCE PROGRAM TO PATIENTS AND THE PUBLIC FOR DIGNITY HEALTH'S WHOLLY OWNED HOSPITALS: INFORMATION ABOUT DIGNITY HEALTH'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE DIGNITY HEALTH FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES DIGNITY HEALTH'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS WITH ANNUAL INCOMES LESS THAN $250,000 RECEIVE AN UNINSURED DISCOUNT OF 25% FOR SERVICES PROVIDED IN A CALIFORNIA OR ARIZONA FACILITY, AND 30% FOR SERVICES PROVIDED IN A NEVADA FACILITY, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON DIGNITY HEALTH'S WEBSITE AT WWW.DIGNITYHEALTH.ORG. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. UNINSURED PATIENTS RECEIVE COPIES OF THE FINANCIAL ASSISTANCE AND MEDICAID APPLICATIONS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY. IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF DIGNITY HEALTH REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE DIGNITY HEALTH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.

PART VI, LINE 4 - COMMUNITY INFORMATION
DIGNITY HEALTH DELIVERS CARE TO DIVERSE COMMUNITIES ACROSS ARIZONA, CALIFORNIA AND NEVADA. FOLLOWING IS A SUMMARY OF THE COMMUNITIES SERVED BY DIGNITY HEALTH, INCLUDING THE DEMOGRAPHICS OF EACH COMMUNITY. DIGNITY HEALTH HOSPITALS DEFINE THE COMMUNITY AS THE GEOGRAPHIC AREA SERVED BY THE HOSPITAL, CONSIDERED ITS PRIMARY SERVICE AREA. THIS IS BASED ON A PERCENTAGE OF HOSPITAL DISCHARGES. SECONDARY SERVICE AREAS INCLUDE NEIGHBORING AREAS AND POPULATIONS BEYOND THE PRIMARY SERVICES AREA THAT HAVE UNMET HEALTH NEEDS. ARROYO GRANDE COMMUNITY HOSPITAL SERVES THE SOUTHERN PART OF SAN LUIS OBISPO COUNTY INCLUDING THE CITIES OF ARROYO GRANDE, GROVER BEACH, OCEANO, PISMO BEACH AND SHELL BEACH AND THE NORTHERN PART OF THE CITY OF NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 105,216 DIVERSITY: CAUCASIAN 69.6%, HISPANIC 23.4%, ASIAN OR PACIFIC ISLANDER (ASIAN/PI) 3.2%, AFRICAN AMERICAN 0.7%, OTHER 3.1% AVERAGE HOUSEHOLD INCOME: $74,766 UNINSURED: 15.3% UNEMPLOYMENT: 8.1% NO HS DIPLOMA: 11.8% RENTERS: 37.1% CNI SCORE: 3.4 MEDICAID PATIENTS: 11.0% OTHER AREA HOSPITALS: 2 CALIFORNIA HOSPITAL MEDICAL CENTER. WHILE THE HOSPITAL IS LOCATED IN SERVICE PLANNING AREA (SPA) 4 OF METRO LOS ANGELES, ITS SERVICE AREA ALSO INCLUDES PARTS OF SPA 6 (SOUTH) AND SPA 8 (SOUTH BAY). CALIFORNIA HOSPITAL MEDICAL CENTER IS LOCATED IN A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND SERVES A MEDICALLY UNDERSERVED POPULATION. POPULATION: 1,571,248 DIVERSITY: CAUCASIAN 5.8%, HISPANIC 65%, ASIAN/PI 7.9%, AFRICAN AMERICAN 19.6%, OTHER 1.7% AVERAGE INCOME: $47,328 UNINSURED: 30.5% UNEMPLOYMENT: 10.9% NO HS DIPLOMA: 40.6% RENTERS: 74.0% CNI SCORE: 5 MEDICAID PATIENTS: 35.0% OTHER AREA HOSPITALS: 6 CHANDLER REGIONAL MEDICAL CENTER'S COMMUNITY IS THIRTY-SIX ZIP CODES IN MARICOPA AND PINAL COUNTIES, ARIZONA. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION IN SEVERAL ZIP CODES OF THE SERVICE AREA. POPULATION: 605,394 DIVERSITY: CAUCASIAN 55.7%, HISPANIC 25%, ASIAN/PI 7.3%, AFRICAN AMERICAN 5.5%, OTHER 6.5% AVERAGE INCOME: $79,192 UNINSURED: 6% UNEMPLOYMENT: 5.6% NO HS DIPLOMA: 9.5% RENTERS: 26% CNI: 3.0 MEDICAID: ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM: AHCCCS: 18% OTHER AREA HOSPITALS: 2 IN THE PRIMARY SERVICE AREA, 12 IN THE SECONDARY SERVICE AREA DOMINICAN HOSPITAL. THE PRIMARY SERVICE AREA IS SANTA CRUZ COUNTY WHICH COVERS 441 SQUARE MILES, AND IS A RELATIVELY ISOLATED COMMUNITY. THE TWO MAJOR CITIES ARE SANTA CRUZ, LOCATED ON THE NORTHERN SIDE OF THE MONTEREY BAY, AND WATSONVILLE, SITUATED IN THE SOUTHERN PART OF THE COUNTY. OTHER INCORPORATED AREAS IN THE COUNTY INCLUDE THE CITIES OF SCOTTS VALLEY AND CAPITOLA. APPROXIMATELY 51% OF THE POPULATION LIVES IN THE UNINCORPORATED PARTS OF THE COUNTY, INCLUDING THE TOWNS OF APTOS, DAVENPORT, FREEDOM, SOQUEL, FELTON, BEN LOMOND AND BOULDER CREEK, AND DISTRICTS SUCH AS THE SAN LORENZO VALLEY, LIVE OAK AND PAJARO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 63,440 (CITY OF SANTA CRUZ); 52,508 (CITY OF WATSONVILLE) (JAN 2014) DIVERSITY: CAUCASIAN 58.3%, HISPANIC 33.0%, ASIA/PI 4.4%, AFRICAN AMERICAN 0.8%, TWO OR MORE RACES 3.4%, OTHER 0.1% AVERAGE INCOME: $82,904 UNINSURED: OVERALL 16.2% UNEMPLOYMENT: 9.5% NO HS DIPLOMA: 13% RENTERS: 43% CNI SCORE: 3.5 MEDICAID PATIENTS: 14.7% OTHER AREA HOSPITALS: 2 FRENCH HOSPITAL MEDICAL CENTER IS LOCATED IN CENTRAL SAN LUIS OBISPO COUNTY. ITS PRIMARY SERVICE AREA ENCOMPASSES SAN LUIS OBISPO, ATASCADERO, MORRO BAY, LOS OSOS AND PASO ROBLES, WITH A SECONDARY SERVICE AREA IDENTIFIED AS PISMO BEACH, ARROYO GRANDE, OCEANO, GROVER BEACH AND AVILA BEACH. THE SERVICE AREA OF FRENCH HOSPITAL MEDICAL CENTER HAS BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND AS A MEDICALLY UNDERSERVED POPULATION. POPULATION: 242,493 DIVERSITY: CAUCASIAN 70.5%, HISPANIC 21%, ASIAN 3.4%, AFRICAN AMERICAN 2%, AMERICAN INDIAN/ALASKA NATIVE 0.5%, TWO OR MORE RACES 2.4%, OTHER 0.2% AVERAGE INCOME: $74,235 UNINSURED: 16.1% UNEMPLOYMENT: 5% NO HS DIPLOMA: 11.3% RENTERS: 35.8% CNI SCORE: 3.6 MEDICAID PATIENTS: 11.6% OTHER AREA HOSPITALS: 3 GLENDALE MEMORIAL HOSPITAL AND HEALTH CENTER'S SERVICE AREA INCLUDES BURBANK, GLENDALE, LA CRESCENTA, LOS ANGELES, NORTH HOLLYWOOD, PANORAMA CITY, SUNLAND, SUN VALLEY, AND TUJUNGA. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 1,436,704 DIVERSITY: CAUCASIAN 28.7%, HISPANIC 50.9%, ASIAN/PI 13.0%, AFRICAN AMERICAN 5.3%, AMERICAN INDIAN/ALASKAN NATIVE 0.2%, TWO OR MORE RACES 1.7%, OTHER 0.2% AVERAGE INCOME: $63,363 UNINSURED: 23.3% NO HIGH SCHOOL DIPLOMA: 28.8% RENTERS: 61.7% CNI SCORE: 4.8 MEDICAID PATIENTS: 26.9% OTHER HOSPITALS SERVING THE AREA: 2 MARIAN REGIONAL MEDICAL CENTER IS LOCATED IN NORTHERN SANTA BARBARA COUNTY WITH THE SANTA MARIA VALLEY AS THE LARGEST REGION IN ITS SERVICE AREA. THE LARGEST COMMUNITIES IN MARIAN'S PRIMARY SERVICE AREA INCLUDE THE CITY OF SANTA MARIA AND GUADALUPE WITH THE SECONDARY SERVICE AREA BEING NIPOMO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 138,189 DIVERSITY: CAUCASIAN 29.8%, HISPANIC 62.4%, ASIAN/PI 4.4%, AFRICAN AMERICAN 1.2%, OTHER 2.2% AVERAGE INCOME: $68,848 UNINSURED: 15.4% UNEMPLOYMENT: 8% NO HS DIPLOMA: 28.8% RENTERS: 38.6% CNI SCORE: 4.5 MEDICAID PATIENTS: 16.7% OTHER AREA HOSPITALS: 0 MERCY GENERAL HOSPITAL, A TERTIARY CARE FACILITY, SERVES RESIDENTS FROM A BROAD GEOGRAPHIC AREA. THE HOSPITAL'S PRIMARY SERVICE AREA LIES IN THE CENTRAL DOWNTOWN AREA OF SACRAMENTO, AND INCLUDES 40 ZIP CODES. POPULATION: 1,521,777 DIVERSITY: CAUCASIAN 47.26%, HISPANIC 22.90%, AFRICAN AMERICAN 9.20%, ASIAN/PI 15.18%, AMERICAN INDIAN/ALASKA NATIVE .56%, OTHER 4.9% MEDIAN HOUSEHOLD INCOME: $51,214 UNINSURED: 14.1% UNEMPLOYMENT: 10.6% NO HIGH SCHOOL DIPLOMA: 15% RENTERS: 39.3% CNI SCORE: 4.0 MEDICAID PATIENTS: 20.3% OTHER AREA HOSPITALS: 7 MERCY GILBERT MEDICAL CENTER'S COMMUNITY INCLUDES THE URBAN AND SUBURBAN AREAS OF MARICOPA COUNTY, INCLUDING CHANDLER, GILBERT, PHOENIX, TEMPE, AND MESA. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 917,973 DIVERSITY: CAUCASIAN 62.9% HISPANIC 23.1%, ASIAN/PI 5.1%, AFRICAN AMERICAN 4.2%, OTHER 4.7% AVERAGE INCOME: $75,835 UNINSURED: 11.9% UNEMPLOYMENT: 5.9% NO HS DIPLOMA: 3.7% RENTERS: 15% CNI SCORE: 2.7 MEDICAID PATIENTS: 95,357 OTHER AREA HOSPITALS: 3 PRIMARY SERVICE AREA, 12 SECONDARY SERVICE AREA MERCY HOSPITAL BAKERSFIELD SERVES ALL OF KERN COUNTY, INCLUDING BAKERSFIELD (THE COUNTY SEAT) AND OUTLYING RURAL COMMUNITIES SUCH AS LOST HILLS, TAFT, AND WASCO. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA AND A MEDICALLY UNDERSERVED POPULATION. POPULATION: 610,579 DIVERSITY: CAUCASIAN 33.9%, HISPANIC 52.3%, ASIAN/PI 5.1%, AFRICAN AMERICAN 6.0%, OTHER 2.7% AVERAGE HOUSEHOLD INCOME: $61,877 UNINSURED: 22.3% UNEMPLOYMENT: 10.4% NO HS DIPLOMA: 28.4% RENTERS: 37.7% CNI SCORE: 4.8 MEDICAID PATIENTS: 20.9% OTHER AREA HOSPITALS: 9 MERCY HOSPITAL OF FOLSOM'S PRIMARY SERVICE AREA ENCOMPASSES BOTH SUBURBAN AND RURAL AREAS OF SACRAMENTO COUNTY AND EXTENDS INTO EL DORADO COUNTY. WITHIN ITS PRIMARY SERVICE AREA, THE HOSPITAL SERVES MAJOR COMMUNITIES, INCLUDING FOLSOM, RANCHO CORDOVA, SLOUGHHOUSE, EL DORADO HILLS, RESCUE, SHINGLE SPRINGS, PLACERVILLE, ORANGEVALE, CITRUS HEIGHTS, CARMICHAEL, FAIR OAKS, AND OTHER SURROUNDING NEIGHBORHOODS. THE HOSPITAL SERVES A FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREA. POPULATION: 395,398 DIVERSITY: CAUCASIAN 70.1%, HISPANIC 13.7%, AFRICAN AMERICAN 3.8%, ASIAN 7.8%, AMERICAN INDIAN/ALASKA NATIVE 0.6%, OTHER 4.0% MEDIAN INCOME: $70,532 UNINSURED: 9.36% UNEMPLOYMENT: 6.2% NO HIGH SCHOOL DIPLOMA: 7.9% RENTERS: 29.6% CNI SCORE: 3.0 MEDICAID PATIENTS: 12.1% OTHER AREA HOSPITALS: 1 MERCY MEDICAL CENTER MERCED'S PRIMARY SERVICE AREA IS COMPRISED OF THE COMMUNITIES OF MERCED, ATWATER, WINTON AND LIVINGSTON. MERCED IS A MEDICALLY UNDERSERVED AREA. POPULATION: MERCED COUNTY 255,793 (PROVIDED BY THE 2010 US CENSUS) HOSPITAL SERVICE AREA 155,207 DIVERSITY: CAUCASIAN 31.1%, HISPANIC 52.3%, ASIAN/PI 9.4%, AFRICAN AMERICAN 4.6%, AMERICAN INDIAN/ALASKA NATIVE 0.5%, OTHER 2.1% AVERAGE INCOME: $42,267 UNEMPLOYMENT: SEPTEMBER 2012, 14.5% UNINSURED: 29.82% NO HS DIPLOMA: 30.6% CNI SCORE: 4.8 MEDICAID PATIENTS: 30% OTHER AREA HOSPITALS: 2 MERCY MEDICAL CENTER MT. SHASTA SERVES AN AREA COMPRISED MOSTLY OF ZIP CODES IN SOUTHERN SISKIYOU COUNTY. PORTIONS OF SISKIYOU COUNTY ARE FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS. THE FOLLOWING DATA REPRESENTS THE PRIMARY SERVICE AREA. POPULATION: 17,168 DIVERSITY: CAUCASIAN 80.2% , HISPANIC 10.2%, ASIAN/PI 2.5%, AFRICAN AMERICAN 2.5%, AMERICAN INDIAN/ALASKA NATIVE 1.2%, TWO OR MORE RACES 3.3%, OTHER 0.1% MEDIAN INCOME: $41,742 UNINSURED: 19.3% UNEMPLOYMENT: 13.0% NO HS DIPLOMA: 8.1% RENTERS: 27.8% CNI MEDIAN SCORE: 3.8 M

PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH
USE OF SURPLUS FUNDS - AS A NOT-FOR-PROFIT ORGANIZATION DEDICATED TO IMPROVING THE QUALITY OF LIFE, DIGNITY HEALTH REINVESTS ALL OF ITS SURPLUS FUNDS FROM ITS OPERATING AND INVESTMENT ACTIVITIES TO IMPROVE THE QUALITY OF PATIENT CARE, EXPAND AND REPLACE EXISTING FACILITIES AND EQUIPMENT, INVEST IN TECHNOLOGICAL ADVANCEMENTS, SUPPORT COMMUNITY HEALTH PROGRAMS, AND ADVANCE MEDICAL TRAINING, EDUCATION, AND RESEARCH. THIS ACTIVE REINVESTMENT OF FUNDS MAKES IT POSSIBLE FOR DIGNITY HEALTH TO DELIVER ON ITS MISSION, INCLUDING ENSURING THAT EVERYONE IN THE COMMUNITIES SERVED HAS ACCESS TO HEALTHCARE. OPEN MEDICAL STAFF - MEDICAL STAFF PRIVILEGES ARE OPEN TO PHYSICIANS WHOSE EXPERIENCE AND TRAINING ARE VERIFIED THROUGH A CREDENTIALING PROCESS. THE PROCESS GATHERS AND VERIFIES CREDENTIALS, ALLOWS THE MEDICAL STAFF TO EVALUATE AN APPLICANT'S QUALIFICATIONS, PREVIOUS EXPERIENCE, AND COMPETENCE, AND TO ULTIMATELY MAKE A DECISION TO GRANT OR DENY MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES. CREDENTIALS VERIFICATION IS THE DETERMINATION OF WHETHER A PRACTITIONER'S CREDENTIALS ARE AUTHENTIC AND VALID. THE ROLE OF THE BOARD - THE DIGNITY HEALTH BOARD OF DIRECTORS ESTABLISHES KEY MEASURES OF SYSTEM-WIDE COMMUNITY BENEFIT PERFORMANCE AND RECEIVES REGULAR REPORTS ON PROGRESS TOWARD ESTABLISHED GOALS. DIGNITY HEALTH HOSPITAL COMMUNITY BOARDS AND SUBSIDIARY BOARDS (COMMUNITY BOARDS), WHICH ARE RATIFIED BY THE DIGNITY HEALTH BOARD, ARE RESPONSIBLE FOR ENSURING THE HOSPITALS DEVELOP PROGRAMS TO ADDRESS THE DISPROPORTIONATE UNMET HEALTH-RELATED NEEDS OF THE COMMUNITIES THE HOSPITALS SERVE. IN ADDITION, COMMUNITY BOARDS ENSURE THE DEVELOPMENT OF COMMUNITY BENEFIT INITIATIVES TO PROMOTE THE BROADER HEALTH OF THE COMMUNITY. IN FULFILLING THESE RESPONSIBILITIES, THE COMMUNITY BOARD MAY DESIGNATE A COMMUNITY HEALTH COMMITTEE OF THE BOARD TO INCLUDE AT LEAST TWO BOARD MEMBERS, WITH A MAJORITY REPRESENTATION FROM A RANGE OF COMMUNITY STAKEHOLDERS WHO HAVE KNOWLEDGE OF THE COMMUNITY. THE COMMUNITY BOARD, OR BOARD COMMITTEE, PARTICIPATES IN THE PROCESS OF ESTABLISHING PROGRAM PRIORITIES BASED ON COMMUNITY NEEDS ASSESSMENTS AND DEVELOPING THE HOSPITAL'S COMMUNITY BENEFIT PLAN AND MONITORING PROGRESS TOWARD IDENTIFIED GOALS. IF APPLICABLE, MEMBERS OF THE COMMITTEE ENSURE THAT THE COMMUNITY BOARD IS REGULARLY BRIEFED ON ACTIVITIES AND DEVELOPMENTS AND THAT THE COMMITTEE HAS INFORMATION FROM THE COMMUNITY BOARD AND MANAGEMENT NEEDED TO MAKE INFORMED DECISIONS. THE COMMUNITY BOARD IS ALSO RESPONSIBLE FOR REVIEW AND APPROVAL OF THE ANNUAL HOSPITAL COMMUNITY BENEFIT PLAN AND REPORT. DIGNITY HEALTH PROVIDES HOSPITAL SERVICES AND CARRIES OUT ITS MISSION AT THE HOSPITAL FACILITIES LISTED IN PART V, SECTION A. FOR DETAILED INFORMATION ON THE SERVICES AND COMMUNITY BENEFITS PROVIDED AT THESE FACILITIES, AS WELL AS COPIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN SUMMARIES FOR EACH FACILITY, PLEASE VISIT THE DIGNITY HEALTH WEBSITE AT http://www.dignityhealth.org/cm/content/pages/community-health.asp INDIVIDUAL FACILITY COMMUNITY BENEFIT REPORTS AND PLANS ARE ALSO ACCESSIBLE AT http://www.dignityhealth.org/cm/content/pages/community-benefit.asp

PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM
AFFILIATES OF DIGNITY HEALTH ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, AND GRASS VALLEY/NEVADA CITY, CALIFORNIA. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE FOR DIGNITY HEALTH AND ITS SUBORDINATE CORPORATIONS FOR THE YEAR ENDED JUNE 30, 2014, IS AS FOLLOWS. Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 118,274 175,717,000 1.7% Unpaid Costs of Medicaid/Medi-Cal 1,182,999 864,074,000 8.3% Other Means-tested Programs 269,323 51,389,000 0.5% Community Services: Community Health Services 434,278 39,122,000 0.4% Health Professions Education 54 24,000 0.0% Subsidized Health Services 108,604 27,467,000 0.3% Donations 128,428 19,579,000 0.2% Community Building Activities 4,623 1,508,000 0.0% Community Benefit Operations 2,886 6,793,000 0.1% Total Community Services for the poor 678,873 94,493,000 1.0% Total Benefits for the Poor 2,249,469 1,185,673,000 11.5% Benefits for the Broader Community: Community Services: Community Health Services 297,849 13,162,000 0.1% Health Professions Education 37,567 63,515,000 0.6% Subsidized Health Services 3,990 771,000 0.0% Research 408 23,158,000 0.2% Donations 31,034 9,080,000 0.1% Community Building Activities 7,068 3,716,000 0.0% Community Benefit Operations 21 1,110,000 0.0% Total Benefits for the Broader Community 377,937 114,512,000 1.1% Total Community Benefits 2,627,406 1,300,185,000 12.6% Unpaid Costs of Medicare 1,032,864 674,324,000 6.5% Total Community Benefits including Cost of Medicare 3,660,270 1,974,509,000 19.1%