SCRIPPS HEALTH: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization: SCRIPPS HEALTH (EIN 95-1684089)
Tax period: 2021-10-01 to 2022-09-30
Filed: 2023-08-08
IRS object ID: 202342209349301674
Schema version: 2021v4.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-08-08T20:00:12+00:00	ReturnTs
Tax Period End	2022-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	346565596	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	101 E WASHINGTON ST	AddressLine1Txt
City	PHOENIX	CityNm
State Abbreviation	AZ	StateAbbreviationCd
ZIP	85004	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2021-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	951684089	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SCRIPPS HEALTH	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SCRI	BusinessNameControlTxt
Phone	8586787901	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10140 CAMPUS POINT DRIVE	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92121	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	CHRISTOPHER VAN GORDER	PersonNm
Person Title	CORP SR VP/CFO	PersonTitleTxt
Phone	8586787901	PhoneNum
Signature	2023-08-08	SignatureDt
Discuss With Paid Preparer	false	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	BRETT	PersonFirstNm
Person Last	TANDE	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Steven T Rutti	PreparerPersonNm
PTIN	P00775456	PTIN
Phone	6023223051	PhoneNum
Preparation	2023-07-31	PreparationDt

Field	Value	IRS element (for citing)
Tax	2021	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHRISTOPHER VAN GORDER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10140 CAMPUS POINT DRIVE	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92121	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$4,072,374,959	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.SCRIPPS.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1924	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4.1 billion, private not-for-profit integrated health system in San Diego, Ca. (See Sch O)	ActivityOrMissionDesc
Voting Members Governing Body	20	VotingMembersGoverningBodyCnt
Voting Members Independent	19	VotingMembersIndependentCnt
Total Employee	19571	TotalEmployeeCnt
Total Volunteers	948	TotalVolunteersCnt
Total Gross UBI	$29,325,863	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$2,095,822	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$198,167,041	PYContributionsGrantsAmt
CY Contributions Grants	$55,965,273	CYContributionsGrantsAmt
PY Program Service Revenue	$3,302,028,743	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,710,431,605	CYProgramServiceRevenueAmt
PY Investment Income	$131,452,621	PYInvestmentIncomeAmt
CY Investment Income	$178,704,764	CYInvestmentIncomeAmt
PY Other Revenue	$129,298,395	PYOtherRevenueAmt
CY Other Revenue	$117,250,614	CYOtherRevenueAmt
PY Total Revenue	$3,760,946,800	PYTotalRevenueAmt
CY Total Revenue	$4,062,352,256	CYTotalRevenueAmt
PY Grants And Similar Paid	$840,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$731,000	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$1,552,725,968	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$1,639,300,515	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$7,404,715	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,962,226,886	PYOtherExpensesAmt
CY Other Expenses	$2,191,161,767	CYOtherExpensesAmt
PY Total Expenses	$3,515,792,854	PYTotalExpensesAmt
CY Total Expenses	$3,831,193,282	CYTotalExpensesAmt
PY Revenues Less Expenses	$245,153,946	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$231,158,974	CYRevenuesLessExpensesAmt
Total Assets BOY	$7,649,635,938	TotalAssetsBOYAmt
Total Assets EOY	$7,165,226,432	TotalAssetsEOYAmt
Total Liabilities BOY	$2,365,563,136	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$2,403,384,505	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,284,072,802	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,761,841,927	NetAssetsOrFundBalancesEOYAmt
Mission	SEE SCHEDULE O.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$3,372,263,235	ExpenseAmt
Grant	$731,000	GrantAmt
Revenue	$3,798,688,752	RevenueAmt
Desc	SEE SCHEDULE O.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,589,640	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$1,716,223	RevenueAmt
Desc	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.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$3,373,852,875	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	Yes (true)	ConservationEasementsInd
Collections Of Art	Yes (true)	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (true)	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	Yes (true)	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	651	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	19571	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	Yes (true)	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	20	GoverningBodyVotingMembersCnt
Independent Voting Member	19	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BRETT TANDE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8586786828	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	10140 CAMPUS POINT DRIVE	AddressLine1Txt
City	SAN DIEGO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92121	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (47 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Christopher Van Gorder
President CEO/TRUSTEE	58.0	2.0	Yes (X)	Yes (X)	$2,650,283	$0	$134,600
Kevin T Hamilton
TRUSTEE, VICE CHAIR	13.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Richard C Bigelow
TRUSTEE, CHAIR	13.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Dan Feldman
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Don Goldman
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Elliot A Scott
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Gene H Barduson
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Honorable Irma Gonzalez
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Jan Caldwell
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Jeff Bowman
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
John Boyer PhD
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Judy Churchill PhD
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Katherine A Lauer
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Marty J Levin
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Nicole A Clay
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Richard Vortmann
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Robert Buell Esq
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Shireen Matthews Esq
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Theodore Thomas MD
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
William D Gore
TRUSTEE	13.0	1.0	Yes (X)		$0	$0	$0
Bradley Ellis
Corp VP, Asst Gen Counsel, Secretary	48.0	2.0		Yes (X)	$731,831	$0	$29,492
Brett Tande
Treasurer / SVP / CFO as of 3/2022	54.0	1.0		Yes (X)	$0	$0	$0
Mielle Schwartz
Assistant Secretary	39.0	0		Yes (X)	$76,767	$0	$9,118
Monique Gonzalez
Assistant Secretary	50.0	0		Yes (X)	$92,781	$0	$10,130
Richard Rothberger
Treasurer/Exec VP, CFO - Thru 5/2022	54.0	1.0		Yes (X)	$2,254,735	$0	$27,186
Anil Keswani
Corp Sr VP, Chief Med Officer	50.0	0.0			$1,122,049	$0	$22,381	Yes (X)
Barbara Price
Corp Sr VP, BusServ Line Dev	50.0	0			$1,070,352	$0	$26,605	Yes (X)
Carl Etter
Chief Executive, Sr VP	50.0	0			$1,670,442	$0	$22,781	Yes (X)
Eric Cole
CORP SR VP, HUMAN RESOURCES	50.0	0			$789,456	$0	$8,192	Yes (X)
Ghazala Sharieff
Corp Sr. VP, Acute Care/Clin Excl	50.0	0			$1,283,196	$0	$20,458	Yes (X)
John Engle
Corp Sr. VP, Chief Development	50.0	0			$836,993	$0	$14,811	Yes (X)
June Komar
Corp Exec VP, Strategy Admin	50.0	0			$1,072,954	$0	$82,408	Yes (X)
Lisa RisserThakur
Corp Sr. VP, Ancillary Ops	50.0	0			$673,678	$0	$25,685	Yes (X)
Mary Ellen Doyle
Corp VP, Nursing Ops	50.0	0			$715,025	$0	$23,018	Yes (X)
Richard Neale
Corp Exec VP, Chief Growth Officer	49.0	0			$985,777	$0	$25,190	Yes (X)
Shane Thielman
Corp Sr. VP, CIO	50.0	0			$730,113	$0	$24,619	Yes (X)
Shawn Forrester
Corp VP, Payer Relations	20.0	20.0			$644,282	$0	$16,748	Yes (X)
Thomas Buchholz
Corp Sr. VP, MD Anderson	50.0	0			$1,111,554	$0	$18,502	Yes (X)
Thomas Gammiere
Chief Executive, Sr VP	50.0	0			$1,096,226	$0	$26,586	Yes (X)
Christee Thomas
Corp VP, Rev Cycle/Cnt Bus Ofc	50.0	0			$563,553	$0	$3,765		Yes (X)
Gerald Soderstrom
Corp VP, Audit / Compliance	50.0	0			$605,499	$0	$22,216		Yes (X)
John Poole
Corp VP, System Improvement	50.0	0			$645,400	$0	$18,620		Yes (X)
Richard McKeown
Corp VP, Treasury	50.0	0			$670,842	$0	$23,102		Yes (X)
Tracy Chu
Corp VP, POP Hlth CHF EXEC/ACO	50.0	0			$604,094	$0	$21,747		Yes (X)
James La Belle MD
Corp Sr VP, Chief Med Officer	0.0	0			$386,477	$0	$0			Yes (X)
Richard Sheridan
Former Officer	0.0	0			$332,260	$0	$0			Yes (X)
Shiraz Fagan
FORMER KEY EMPLOYEE	0.0	0			$572,111	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$23,988,733	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$657,959	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	3953	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2Txt
Scripps Clinic Medical Group Inc
10666 N Torrey Pines Rd	La Jolla	CA	92037	Physician Services	$382,619,979
Scripps Coastal Medical Group
501 Washington Ave	San Diego	CA	92103	Physician Services	$70,394,863
Scripps Health Inpatient Providers Med Group
10010 Campus Point Dr	San Diego	CA	92121	Physician Services	$42,371,642
MedImpact Healthcare Systems
10181 Scripps Gateway Ct	San Diego	CA	92131	Pharmaceutical Services	$36,147,535
Emergency Acute Care Med Group
440 Stevens Ave	San Diego	CA	92076	Physician Services	$13,674,861	Ste 100

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	141	CntrctRcvdGreaterThan100KCnt
Fundraising	$757,901	FundraisingAmt
Government Grants	$21,350,418	GovernmentGrantsAmt
All Other Contributions	$33,856,954	AllOtherContributionsAmt
Noncash Contributions	$10,705,193	NoncashContributionsAmt
Total Contributions	$55,965,273	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
HEALTHCARE DELIVERY REV	622110	$3,322,114,216	$3,320,715,182	$1,399,034
PROVIDER FEE REVENUE	622110	$129,377,721	$129,377,721
CAPITATION PREMIUM	622110	$114,485,045	$114,485,045
JOINT VENTURE REVENUE	900099	$23,337,160	$23,337,160
RENTAL INCOME - MOB	531120	$12,721,100	$12,721,100

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$108,396,363	TotalRevenueColumnAmt
Related Or Exempt Func Income	$107,381,813	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,014,550	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,710,431,605	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$93,378,159	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,500	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,447,087	UnrelatedBusinessRevenueAmt
Exclusion	$91,929,572	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$94,843,360	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$9,516,755	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$85,326,605	SecuritiesAmt
Other	$0	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$85,326,605	TotalRevenueColumnAmt
Exclusion	$85,326,605	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$112,223	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$757,901	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$505,948	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$393,725	TotalRevenueColumnAmt
Exclusion	-$393,725	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
MANAGEMENT SERVICES	561110	$52,406,552	$27,349,306	$25,057,246
PHARMACEUTICAL REVENUE	446110	$37,571,291	$37,571,291
ALL OTHER REVENUE	900099	$27,666,496	$25,051,273	$407,946	$2,207,277

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$117,644,339	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,062,352,256	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,797,991,391	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$29,325,863	UnrelatedBusinessRevenueAmt
Exclusion	$179,069,729	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$731,000	TotalAmt
Program Services	$731,000	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$23,287,872	TotalAmt
Management And General	$23,287,872	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$180,808	TotalAmt
Management And General	$180,808	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$1,349,747,592	TotalAmt
Program Services	$1,150,707,416	ProgramServicesAmt
Management And General	$194,567,195	ManagementAndGeneralAmt
Fundraising	$4,472,981	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$49,911,631	TotalAmt
Program Services	$40,898,995	ProgramServicesAmt
Management And General	$8,882,924	ManagementAndGeneralAmt
Fundraising	$129,712	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$115,260,398	TotalAmt
Program Services	$114,837,415	ProgramServicesAmt
Fundraising	$422,983	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$100,912,214	TotalAmt
Program Services	$84,058,656	ProgramServicesAmt
Management And General	$16,600,646	ManagementAndGeneralAmt
Fundraising	$252,912	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$19,673,886	TotalAmt
Program Services	$1,005,280	ProgramServicesAmt
Management And General	$18,667,878	ManagementAndGeneralAmt
Fundraising	$728	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,181,004	TotalAmt
Management And General	$1,167,164	ManagementAndGeneralAmt
Fundraising	$13,840	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$683,524	TotalAmt
Management And General	$683,524	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$6,236,157	TotalAmt
Management And General	$6,236,157	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$868,745,042	TotalAmt
Program Services	$796,069,191	ProgramServicesAmt
Management And General	$71,863,286	ManagementAndGeneralAmt
Fundraising	$812,565	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$3,528,017	TotalAmt
Program Services	$53,567	ProgramServicesAmt
Management And General	$3,474,450	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$75,385,575	TotalAmt
Program Services	$62,081,874	ProgramServicesAmt
Management And General	$12,780,767	ManagementAndGeneralAmt
Fundraising	$522,934	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$65,369,935	TotalAmt
Program Services	$35,519,467	ProgramServicesAmt
Management And General	$29,850,468	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$93,377,861	TotalAmt
Program Services	$83,965,466	ProgramServicesAmt
Management And General	$9,209,483	ManagementAndGeneralAmt
Fundraising	$202,912	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$29,590,606	TotalAmt
Program Services	$25,570,409	ProgramServicesAmt
Management And General	$4,020,197	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$207,958,615	TotalAmt
Program Services	$189,062,223	ProgramServicesAmt
Management And General	$18,896,392	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$13,434,803	TotalAmt
Program Services	$13,408,787	ProgramServicesAmt
Management And General	$26,016	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$657,317,554	$657,317,554
HOSPITAL FEE PROGRAM	$102,629,395	$102,629,395
REPAIRS MAINTENANCE	$38,781,601	$9,240,425	$29,540,465	$711
ALL OTHER EXPENSES	$7,268,192	$6,695,755		$572,437

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,831,193,282	TotalAmt
Program Services	$3,373,852,875	ProgramServicesAmt
Management And General	$449,935,692	ManagementAndGeneralAmt
Fundraising	$7,404,715	FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$656,798,524	BOYAmt
EOY	$627,233,578	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$12,950,578	BOYAmt
EOY	$7,244,369	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$751,613,657	BOYAmt
EOY	$620,769,219	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$21,534,529	BOYAmt
EOY	$22,248,978	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$79,843,600	BOYAmt
EOY	$85,708,077	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$40,345,860	BOYAmt
EOY	$40,453,444	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,745,272,275	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,361,717,238	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,206,924,574	BOYAmt
EOY	$2,383,555,037	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$2,819,854,076	BOYAmt
EOY	$2,162,109,044	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$547,462,000	BOYAmt
EOY	$705,379,000	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$77,238,578	BOYAmt
EOY	$75,901,408	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$45,109,895	BOYAmt
EOY	$45,109,895	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$389,960,067	BOYAmt
EOY	$389,514,383	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,649,635,938	BOYAmt
EOY	$7,165,226,432	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$774,230,142	BOYAmt
EOY	$674,461,229	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,068,134,200	BOYAmt
EOY	$744,871,000	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$120,938,623	BOYAmt
EOY	$109,008,118	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$402,260,171	BOYAmt
EOY	$875,044,158	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,365,563,136	BOYAmt
EOY	$2,403,384,505	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,971,037,007	BOYAmt
EOY	$4,489,437,218	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$313,035,795	BOYAmt
EOY	$272,404,709	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,284,072,802	BOYAmt
EOY	$4,761,841,927	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,649,635,938	BOYAmt
EOY	$7,165,226,432	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$231,158,974	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$754,694,163	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$1,304,314	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	Yes (true)	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$390,782	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$257,150	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$228,091	OtherActivitiesAmt
Total Lobbying Expenditures	$876,023	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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: ACCOUNTABLE CARE ACT (HEALTH REFORM); BUDGET AND FISCAL POLICY IMPACTS; REIMBURSEMENT MATTERS; PROVIDER FEES AND OTHER ASSESSMENTS; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY MATTERS, HEALTH INFORMATION TECHNOLOGY AND THE IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; UNINSURED, COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; SITE-NEUTRAL PRICING, VALUE-BASED PURCHASING; BUNDLED PAYMENTS; ACCOUNTABLE CARE ORGANIZATIONS, MEDICARE, MEDICAID. 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 AND 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 D IRS990ScheduleD

Field	Value	IRS element (for citing)
Historic Structure	Yes (X)	HistoricStructureInd
Total Easements	1	TotalEasementsCnt
Total Acreage	16.0	TotalAcreageCnt
Historic Structure Easements	1	HistoricStructureEasementsCnt
Modified Easements	1	ModifiedEasementsCnt
States Easements Held	1	StatesEasementsHeldCnt
Written Policy Monitoring	Yes (true)	WrittenPolicyMonitoringInd
Staff Hours Spent Enforcement	150.0	StaffHoursSpentEnforcementCnt
Expenses Incurred Enforcement	$6,300	ExpensesIncurredEnforcementAmt
Section170h Rqr Stsfd	Yes (true)	Section170hRqrStsfdInd

Art Public Exhibition Amounts ArtPublicExhibitionAmountsGrp

Field	Value	IRS element (for citing)
Revenues Included	$0	RevenuesIncludedAmt
Assets Included	$742,881	AssetsIncludedAmt

Field	Value	IRS element (for citing)
Collection Used Pub Exhibition	Yes (X)	CollectionUsedPubExhibitionInd
Solicited Assets Sale	false	SolicitedAssetsSaleInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$140,886,000	BeginningYearBalanceAmt
Contributions	$1,207,385	ContributionsAmt
Investment Earnings Or Losses	-$19,713,562	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$3,181,443	OtherExpendituresAmt
Administrative Expenses	$1,324,380	AdministrativeExpensesAmt
End Year Balance	$117,874,000	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$129,880,000	BeginningYearBalanceAmt
Contributions	$540,474	ContributionsAmt
Investment Earnings Or Losses	$15,126,128	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$897,549	GrantsOrScholarshipsAmt
Other Expenditures	$2,574,215	OtherExpendituresAmt
Administrative Expenses	$1,188,838	AdministrativeExpensesAmt
End Year Balance	$140,886,000	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$121,490,000	BeginningYearBalanceAmt
Contributions	-$141,903	ContributionsAmt
Investment Earnings Or Losses	$12,705,109	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$874,375	GrantsOrScholarshipsAmt
Other Expenditures	$2,148,726	OtherExpendituresAmt
Administrative Expenses	$1,150,105	AdministrativeExpensesAmt
End Year Balance	$129,880,000	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$119,389,000	BeginningYearBalanceAmt
Contributions	$956,581	ContributionsAmt
Investment Earnings Or Losses	$4,884,528	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$844,412	GrantsOrScholarshipsAmt
Other Expenditures	$1,820,256	OtherExpendituresAmt
Administrative Expenses	$1,075,441	AdministrativeExpensesAmt
End Year Balance	$121,490,000	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$124,841,000	BeginningYearBalanceAmt
Contributions	$1,966,841	ContributionsAmt
Investment Earnings Or Losses	$6,490,061	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$810,928	GrantsOrScholarshipsAmt
Other Expenditures	$11,995,794	OtherExpendituresAmt
Administrative Expenses	$1,102,180	AdministrativeExpensesAmt
End Year Balance	$119,389,000	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1.0	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.0	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$41,897,333	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$165,165,633	OtherCostOrOtherBasisAmt
Book Value	$207,062,966	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,035,951,980	OtherCostOrOtherBasisAmt
Depreciation	$919,136,656	DepreciationAmt
Book Value	$1,116,815,324	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$119,864,344	OtherCostOrOtherBasisAmt
Depreciation	$88,746,324	DepreciationAmt
Book Value	$31,118,020	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,911,137,977	OtherCostOrOtherBasisAmt
Depreciation	$1,351,963,769	DepreciationAmt
Book Value	$559,174,208	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$471,255,008	OtherCostOrOtherBasisAmt
Depreciation	$1,870,489	DepreciationAmt
Book Value	$469,384,519	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,383,555,037	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
MULTI-STRATEGY FUNDS	$372,954,000	F
PRIVATE EQUITY FUNDS	$284,425,000	F
LIMITED PARTNERSHIP	$48,000,000	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$705,379,000	TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDesc	Book ValueBookValueAmt
RIGHT OF USE - OPERATING	$263,823,275
PROVIDER FEE RECEIVABLE	$85,902,130
DEFERRED INVESTMENTS	$11,860,368
CONTRACT RECEIVABLES	$2,929,943
DEFERRED RENT RECEIVABLE	$1,744,480
ART INVESTMENTS	$742,881
OTHER LONG TERM ASSETS	$22,511,306

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$389,514,383	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (11 entries)

DescDesc	AmtAmt
TAXABLE DEBT	$549,289,141
LEASE LIABILITIES	$235,896,665
SELF-INSURED MALPRACTICE LIABILITY	$47,441,165
SELF-INSURED WORKER'S COMPENSATION	$30,155,000
PROVIDER FEE LIABILITY	$28,617,118
DEFERRED FICA - CARES ACT
ASSET RETIREMENT OBLIGATION	$18,093,996
ANNUITY AND UNITRUSTS	$11,637,365
DEPOSITS AND CONTINGENCIES	$270,112
INTERCOMPANY LIABILITIES	-$46,356,404
DEFERRED RETIREMENT

Field	Value	IRS element (for citing)
Total Liability	$875,044,158	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule D, Part II, Line 9 Conservation easements financial reporting	THE HISTORICAL STRUCTURE THAT IS CONSIDERED TO BE A CONSERVATIVE 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: $16,826,514 CONTRIBUTIONS RECEIVED FOR USE IN THE SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS: $40,748,643 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: $13,831,884
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, 2022 OR 2021. 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 2017 IN MAJOR TAX JURISDICTIONS.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp (3 entries)

RegionRegionTxt	Type Of Activities ConductedTypeOfActivitiesConductedTxt	Specific Services ProvidedSpecificServicesProvidedTxt	Region Total ExpendituresRegionTotalExpendituresAmt
North America (Canada Mexico only)	Program Services	Reconstructive surgery	$47,033
Central America and the Caribbean	Investments		$435,051,459
Europe (Including Iceland and Greenland)	Investments		$74,229,499

Field	Value	IRS element (for citing)
Subtotal Offices	0	SubtotalOfficesCnt
Subtotal Employees	0	SubtotalEmployeesCnt
Continuation Total Office	0	ContinuationTotalOfficeCnt
Continuation Total Employee	0	ContinuationTotalEmployeeCnt
Total Office	0	TotalOfficeCnt
Total Employee	0	TotalEmployeeCnt
Subtotal Spent	$509,327,991	SubtotalSpentAmt
Continuation Spent	$0	ContinuationSpentAmt
Total Spent	$509,327,991	TotalSpentAmt
Transfer To Foreign Corp	Yes (true)	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	Yes (true)	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements	FormAndLineReferenceDesc
Explanation	CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA MEXICO ONLY)-Accrual	ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Spinoff	Event1Nm
Gross Receipts Event1	$391,005	GrossReceiptsEvent1Amt
Charitable Contri Event1	$350,680	CharitableContriEvent1Amt
Gross Revenue Event1	$40,325	GrossRevenueEvent1Amt
Rent Facility Costs Event1	$248,321	RentFacilityCostsEvent1Amt
Other Direct Expenses Event1	$35,620	OtherDirectExpensesEvent1Amt
Event2	SC Golf	Event2Nm
Gross Receipts Event2	$316,819	GrossReceiptsEvent2Amt
Charitable Contri Event2	$246,796	CharitableContriEvent2Amt
Gross Revenue Event2	$70,023	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$1,050	RentFacilityCostsEvent2Amt
Entertainment Event2	$77,812	EntertainmentEvent2Amt
Other Direct Expenses Event2	$33,205	OtherDirectExpensesEvent2Amt
Other Events Total	3	OtherEventsTotalCnt
Gross Receipts Other Events	$162,300	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$160,425	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$1,875	GrossRevenueOtherEventsAmt
Rent Fclty Costs Other Events	$65,461	RentFcltyCostsOtherEventsAmt
Entertainment Other Events	$23,062	EntertainmentOtherEventsAmt
Oth Direct Expnss Other Events	$21,417	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$870,124	GrossReceiptsTotalAmt
Charitable Contributions Tot	$757,901	CharitableContributionsTotAmt
Gross Revenue Total Events	$112,223	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$314,832	RentFcltyCostsTotalEventsAmt
Entertainment Total Events	$100,874	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$90,242	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$505,948	DirectExpenseSummaryEventsAmt
Net Income Summary	-$393,725	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$17,456,417	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$17,456,417	NetCommunityBenefitExpnsAmt
Total Expense	0.0046	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$451,596,524	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$268,483,579	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$183,112,945	NetCommunityBenefitExpnsAmt
Total Expense	0.0478	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$469,052,941	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$268,483,579	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$200,569,362	NetCommunityBenefitExpnsAmt
Total Expense	0.0524	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$9,401,577	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,509,815	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,891,762	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$41,910,209	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,042,914	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,867,295	NetCommunityBenefitExpnsAmt
Total Expense	0.0086	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$16,469,987	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,312,944	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,157,043	NetCommunityBenefitExpnsAmt
Total Expense	0.0008	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$14,606,183	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$11,067,427	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,538,756	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$697,200	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$697,200	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$83,085,156	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$34,933,100	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,152,056	NetCommunityBenefitExpnsAmt
Total Expense	0.0126	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$552,138,097	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$303,416,679	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$248,721,418	NetCommunityBenefitExpnsAmt
Total Expense	0.0649	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,769	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,769	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,614	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$36,614	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$36,119	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$36,119	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$15,194	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$15,194	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$246,825	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$78,273	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$168,552	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$338,521	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$78,273	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$260,248	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$73,482,187	BadDebtExpenseAmt
Reimbursed By Medicare	$451,831,578	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$564,085,748	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$112,254,170	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (4 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct	Physicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
SCRIPPS ENCINITAS SURGERY CENTER
AMBULATORY SURGERY CENTER	0.5538	0.2525
SCRIPPS MEMORIAL XIMED MEDICAL
MEDICAL OFFICE BUILDING	0.153	0.772
SCRIPPS MERCY ASC
AMBULATORY SURGERY CENTER	0.735	0.265
SCRIPPSUSP SURGERY CENTERS
AMBULATORY SURGERY CENTER	0.5	0.39

Field	Value	IRS element (for citing)
Hospital Facilities	5	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (5 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	Facility Reporting GroupFacilityReportingGroupCd
SCRIPPS MERCY HOSPITAL
1	4077 5TH AVENUE	SAN DIEGO	CA	92103	WWW.SCRIPPS.ORG	090000074	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SCRIPPS MEMORIAL HOSPITAL LA JOLLA
2	9888 GENESEE AVENUE	LA JOLLA	CA	92037	WWW.SCRIPPS.ORG	080000050	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SCRIPPS GREEN HOSPITAL
3	10666 NORTH TORREY PINES RD	SAN DIEGO	CA	92024	WWW.SCRIPPS.ORG	080000139	Yes (X)	Yes (X)	Yes (X)	Yes (X)		A
SCRIPPS MEMORIAL HOSPITAL ENCINITAS
4	354 SANTA FE DRIVE	SAN DIEGO	CA	92103	WWW.SCRIPPS.ORG	080000148	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	A
SELECT SPECIALTY HOSPITAL - SAN DIEGO
5	555 WASHINGTON ST	SAN DIEGO	CA	92103	WWW.SELECTSPECIALTYHOSPITALS.COM	090000404	Yes (X)					B

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	Prior CHNA ImpactPriorCHNAImpactInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Other CriteriaOtherCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP Available On Website URLFAPAvailableOnWebsiteURLTxt	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt	FAP Summary On WebsiteFAPSummaryOnWebsiteInd	FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	Notified FAP Copy Bill DisplayNotifiedFAPCopyBillDisplayInd	Communtity Notified FAPCommuntityNotifiedFAPInd	FAP TranslatedFAPTranslatedInd	Other PublicityOtherPublicityInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Permit No ActionsPermitNoActionsInd	Collection ActivitiesCollectionActivitiesInd	Provided Written NoticeProvidedWrittenNoticeInd	Made Effort Orally NotifyMadeEffortOrallyNotifyInd	Processed FAP ApplicationProcessedFAPApplicationInd	Made Presumptive Elig DetermMadePresumptiveEligDetermInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Prospective Medicare MedicaidProspectiveMedicareMedicaidInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd	FacilityFacilityNum
A
false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	21	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (X)	https://www.scripps.org/about-us/scripps-in-the-community/addressing-community-needs	Yes (X)	Yes (true)	21	Yes (true)	https://www.scripps.org/about-us/scripps-in-the-community/addressing-community-needs	false	Yes (true)	Yes (X)	200.0	400.0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE	Yes (X)	HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE	Yes (X)	HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
B
false	Yes (true)	false																						false	Yes (true)	Yes (X)	200.0	400.0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/	Yes (X)	https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/	Yes (X)	https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false	5

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. 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. HASDIC 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. HASDIC 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 HASDIC 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
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(HASDIC) CONTRACTED WITH THE FOLLOWING RESEARCH PARTNERS ON THE 2022 COMMMUNITY 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. HASDIC 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 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 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 DESCRIBES 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 ABOVE 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 IN THIS REPORT 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 SCRIPPS HEALTH 14 FY2023-2025 IMPLEMENTATION STRATEGY 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 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS CORRESPONDING IMPLEMENTATION STRATGEY. 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 13 Facility A, 1	Facility A, 1 - REPORTING GROUP A. OTHER CRITERIA TO DETEMRINE FINANCIAL ASSISTANCE ELIGIBILITY IF IT IS DETERMINED THAT THE FAMILY INCOME IS ABOVE 400% OF THE FPL, SCRIPPS MAY CONSIDER THE PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON EXTENUATING CIRCUMSTANCES SUCH AS CATASTROPHIC MEDICAL EVENTS OR OTHER SPECIAL SITUATIONS WE WILL NOT CHARGE PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE MORE THAN SCRIPPS'S DISCOUNTED FINANCIAL ASSISTANCE AMOUNT, WHICH REPRESENTS SCRIPPS AGB AS CALCULATED WITH THE PROSPECTIVE METHOD. SCRIPPS USES THE PROSPECTIVE METHOD FOR DETERMINING AGB AND ESTIMATES THE AMOUNT IT WOULD BE PAID BY MEDICARE, INCLUDING AMOUNTS PAYABLE BY A MEDICARE BENEFICIARY. AFTER A DETERMINATION OF ELIGIBILITY, THIS AMOUNT REPRESENTS THE MAXIMUM A QUALIFIED PATIENT WILL BE REQUIRED TO PAY. EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BUT NEED HELP WITH PAYMENTS WILL BE OFFERED A NO-INTEREST PAYMENT PLAN CONSISTENT WITH THEIR NEEDS AND ALL UNFUNDED PATIENTS RECEIVE A MINIMUM OF A 40% DISCOUNT TAKEN AUTOMATICALLY AT BILLING. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS.
Schedule H, Part V, Section B, Line 16 Facility A, 1	Facility A, 1 - REPORTING GROUP A. THE AVAILABILITY OF THE FINANCIAL ASSISTANCE POLICY THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE UPON REQUEST. PAPER COPIES OF OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATIONS, AND A PLAIN LANGUAGE SUMMARY OF THE POLICY IS MADE AVAILABLE UPON REQUEST AND WITHOUT CHARGE AT ALL SCRIPPS PATIENT REGISTRATION AREAS AND BY MAIL. IN ADDITION, THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED AT ALL POINTS OF REGISTRATION AREAS (I.E. EMERGENCY DEPARTMENT, BILLING OFFICE, MAIN ADMISSION AREAS AND ANCILLARY SERVICE LOCATIONS). PLAIN LANGUAGE SUMMARIES ARE STOCKED AS A PATIENT HANDOUT IN BOTH ENGLISH AND SPANISH. FOR INPATIENTS, THE INFORMATION IS INCLUDED IN THE ESSENTIAL HANDBOOK, A COMPREHENSIVE BROCHURE COVERING MANY ASPECTS OF HOSPITALIZATION. UNFUNDED PATIENTS ARE NOT ALWAYS REFERRED TO FINANCIAL COUNSELORS. SOME SITES DO NOT USE FINANCIAL COUNSELORS, BUT THE STAFF MEMBER WHO REGISTERS THE PATIENT CAN DISCUSS FINANCIAL ASSISTANCE AND THE PLAIN LANGUAGE SUMMARY PROVIDES PATIENTS WITH CONTACT INFORMATION FOR FINANCIAL COUNSELORS. SCRIPPS MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES, INCLUDING EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL CARE. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD-PARTY COVERAGE INCLUDING MEDICARE. COMMUNITY OUTREACH AND COMMUNICATION REGARDING SCRIPPS FAP IS ACHIEVED THROUGH THE FOLLOWING METHODS, INCLUDING BUT NOT LIMITED TO: A. POSTERS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE ARE POSTED IN REGISTRATION AREAS IN THE HOSPITAL, I.E. EMERGENCY DEPARTMENT, OUTPATIENT SETTINGS, AND MAIN ADMISSION AREAS. B. PAPER COPIES OF SCRIPPS FAP, FINANCIAL ASSISTANCE APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FAP ("FAP SUMMARY") ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE IN ALL SCRIPPS HOSPITAL EMERGENCY DEPARTMENTS AND ADMISSIONS AREAS. PATIENTS MAY ALTERNATIVELY REQUEST THAT COPIES OF THESE DOCUMENTS BE SENT TO THEM ELECTRONICALLY. C. A WRITTEN NOTICE ABOUT THE AVAILABILITY OF CHARITY CARE AT A SCRIPPS HOSPITAL IS PROVIDED TO EACH PATIENT AT THE TIME OF SERVICE OR WHEN THE PATIENT LEAVES THE FACILITY. IF THE PATIENT IS NOT GIVEN THE NOTICE AT THE HOSPITAL, SCRIPPS WILL MAIL THE NOTICE TO THE PATIENT WITHIN 72 HOURS. D. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, REFERRED TO AS, FAP SUMMARY: i. CONTAINS THE WEBSITE ADDRESS WHERE RESOURCES CAN BE FOUND ONLINE, ii. PROVIDES THE PHYSICAL LOCATION IN THE HOSPITAL WHERE PAPER COPIES MAY BE OBTAINED, iii. IS OFFERED TO ALL PATIENTS AT REGISTRATION OR PRIOR TO DISCHARGE AS PART OF THE AGREEMENT FOR SERVICES AT A SCRIPPS FACILITY. E. SCRIPPS WEB SITE: THE FOLLOWING RESOURCES ARE AVAILABLE ON SCRIPPS WEB SITE TO VIEW, DOWNLOAD AND PRINT FREE OF CHARGE. THEY ARE AVAILABLE IN THE PRIMARY LANGUAGES OF SIGNIFICANT PATIENT POPULATIONS WITH LIMITED ENGLISH PROFICIENCY (LEP): i. PATIENT FINANCIAL ASSISTANCE POLICY, INCLUDING DISCOUNTED PAYMENTS AND CHARITY CARE POLICY (FAP), ii. FINANCIAL ASSISTANCE POLICY SUMMARY (FAP SUMMARY), iii. PATIENT ACCOUNT MANAGEMENT BILLING AND COLLECTIONS POLICY, iv. FINANCIAL ASSISTANCE APPLICATIONS. F. SCRIPPS BILLING STATEMENTS INCLUDE: i. STATEMENT ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, ii. TELEPHONE NUMBER FOR SCRIPPS STAFF THAT PROVIDE ASSISTANCE WITH THE APPLICATION PROCESS, iii. WEBSITE ADDRESS WHERE THE FAP, FAP SUMMARY AND FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND. G. THE FAP SUMMARY WILL BE AVAILABLE AT COMMUNITY EVENTS AND WILL BE PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. SCRIPPS HEALTH WORKED WITH THE CALIFORNIA HOSPITAL ASSOCIATION (CHA) TO INFORM AND NOTIFY MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP AND TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. H. THE FAP AND RELATED INFORMATION WILL ALSO BE PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW.
Schedule H, Part V, Section B, Line 2	SCRIPPS HEALTH ENTERED INTO A JOINT VENTURE RELATIONSHIP WITH UCSD AND SELECT MEDICAL DURING ITS YEAR ENDED SEPTEMBER 30, 2021 TO OPERATE A HOSPITAL CALLED SELECT SPECIALITY HOSPITAL-SAN DIEGO. SCRIPPS AND UCSD WOULD EACH OWN 24.5% OF THE JOINT VENTURE AND SELECT MEDICAL WOULD OWN 51%. SECTION 1.5 OF THE AGREEMENT NOTES THAT THE PURPOSE OF THE COMPANY IS TO OWN, OPERATE, AND MANAGE A LONG TERM ACUTE CARE HOSPITAL AND THAT THE COMPANY AND BUSINESS SHALL AT ALL TIMES BE OPERATED AND MANAGED IN A MANNER THAT FURTHERS THE CHARITABLE AND COMMUNITY-BASED HEALTHCARE PURPOSES, MISSION, VISION AND VALUES OF THE TAX EXEMPT MEMBERS INCLUDING: - PROVIDING ACCESS TO PATIENT CARE SERVICES BASED ON MEDICAL NECESSITY. - PROVIDING CARE TO THOSE COVERED BY MEDICARE, MEDICAID/MEDI-CAL AND OTHER FEDERAL AND STATE GOVERNMENTAL PROGRAMS. - ESTABLISHING A FINANCIAL ASSISTANCE POLICY AND CHARITY CARE POLICY. - COOPERATING WITH THE LLC MEMBERS TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY.
Schedule H, Part V, Section B, Line 13 Facility B, 1	Facility B, 1 - REPORTING GROUP B. OTHER CRITERIA TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY IF IT IS DETERMINED THAT THE FAMILY INCOME IS ABOVE 400% OF THE FPL, SCRIPPS MAY CONSIDER THE PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON EXTENUATING CIRCUMSTANCES SUCH AS CATASTROPHIC MEDICAL EVENTS OR OTHER SPECIAL SITUATIONS WE WILL NOT CHARGE PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE MORE THAN SCRIPPS' DISCOUNTED FINANCIAL ASSISTANCE AMOUNT, WHICH REPRESENTS SCRIPPS AGB AS CALCULATED WITH THE PROSPECTIVE METHOD. EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BUT NEED HELP WITH PAYMENTS WILL BE OFFERED A NO-INTEREST PAYMENT PLAN CONSISTENT WITH THEIR NEEDS AND ALL UNFUNDED PATIENTS RECEIVE A MINIMUM OF A 40% DISCOUNT TAKEN AUTOMATICALLY AT BILLING. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS.
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 ADMISSIONSDEPARTMENT 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.

Field	Value	IRS element (for citing)
Facility	48	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (48 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
SCRIPPS CLINIC - TORREY PINES
10666 N TORREY PINES ROAD	LA JOLLA	CA	92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - RANCHO BERNARDO
15004 INNOVATION DRIVE	SAN DIEGO	CA	92128	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - CARMEL VALLEY
3811 VALLEY CENTER DR	SAN DIEGO	CA	92130	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS MEDICAL LAB
9235 WAPLES ST 150	SAN DIEGO	CA	92121	LABORATORY SERVICES
SCRIPPS CLINIC ANDERSON MEDICAL PAVILION
9898 GENESEE AVE	LA JOLLA	CA	92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
IMAGING HEALTHCARE SPECIALISTS LLC
150 WEST WASHINGTON ST	SAN DIEGO	CA	92103	MEDICAL IMAGING SERVICES
SCRIPPS CLINIC - ENCINITAS
310 SANTA FE DR	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - JEFFERSON
2205 VISTA WAY	OCEANSIDE	CA	92054	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS HOSPITAL MEDICAL SERVICES
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - RANCHO SAN DIEGO
10862 CALLE VERDE	LA MESA	CA	91941	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - ENCINITAS
477 N EL CAMINO REAL A205 B305	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - MISSION VALLEY
7565 MISSION VALLEY RD	SAN DIEGO	CA	92108	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC-LA JOLLA MEMORIAL CAMPUS
9850 GENESEE AVE XIMED BLDG 600	SAN DIEGO	CA	92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC HILLCREST
501 WASHINGTON ST 525 600	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - JEFFERSON
2205 VISTA WAY	OCEANSIDE	CA	92054	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - CARLSBAD
2176 SALK AVE	CARLSBAD	CA	92008	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - OCEANSIDE
4318 MISSION AVE	OCEANSIDE	CA	92057	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SC RADIATION THERAPY CTR - VISTA
916 SYCAMORE AVE 100	VISTA	CA	92082	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - DEL MAR
12395 EL CAMINO REAL 317 112 1	DEL MAR	CA	92130	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
LA JOLLA RADIOLOGY - LA JOLLA
9888 GENESEE AVE	LA JOLLA	CA	92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - ENCINITAS OBGYN
332 SANTA FE DR 115	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - CEDAR
130 CEDAR RD	VISTA	CA	92083	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
MERCY ASC
550 WASHINGTON ST 1ST FL	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS PHARMACY - GREEN
10666 N TORREY PINES RD	LA	CA	92037	MEDICAL PHARMACY
ENCINITAS SURGERY CENTER LLC
320 SANTA FE DR LL1-2	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - EASTLAKE
971 LANE AVENUE	CHULA VISTA	CA	91914	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
LA JOLLA RADIOLOGY - ENCINITAS
354 SANTA FE DR	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - ENCINITAS OP REHAB
1092 EL CAMINO REAL	ENCINITAS	CA	92024	REHABILITATION SERVICES
SCRIPPS CLINIC - MERCY CAMPUS
4020 FIFTH AVE 401	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CARDIO THOR SURG CTR LA JOLLA
9850 GENESEE AVE 560	LA	CA	92037	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - SAN MARCOS
111 CAMPUS WAY STE 301	SAN MARCOS	CA	92078	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - SANTEE
278 TOWN CENTER PKWY 105	SANTEE	CA	92071	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - SAN DIEGO OBGYN
2918 FIFTH AVE 100	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCMC - SOLANA BEACH
380 STEVEN AVE 100	SOLANA BEACH	CA	92075	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - LIBERTY STATION
2445 TRUXTUN RD	SAN DIEGO	CA	92106	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS PHARMACY - ENCINITAS
354 SANTA FE DR	ENCINITAS	CA	92024	MEDICAL PHARMACY
SCRIPPS CLINIC - LA JOLLA OBGYN
9850 GENESEE AVE 170	SAN DIEGO	CA	92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SC RADIATION THERAPY CTR - ENCINITAS
477 N EL CAMINO REAL D100	ENCINITAS	CA	92024	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - HILLCREST SURGERY
4060 FOURTH AVE 330	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - MD ANDERSON CANCER CTR
10670 JOHN JAY HOPKINS DR	LA JOLLA	CA	92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CARDIO THOR SURG CTR-HILLCREST
501 WASHINGTON ST 525	SAN DIEGO	CA	92103	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - CORONADO
1317 A YNES PL	CORONADO	CA	92118	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - EASTLAKE SPECIALTY
971 LANE AVE	CHULA VISTA	CA	91914	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - CEDAR SPECIALTY
130 CEDAR RD	VISTA	CA	92083	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS CLINIC - CHULA VISTA
450 FOURTH AVE	CHULA VISTA	CA	91910	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS HOME HEALTH SERVICES
9619 CHEASPEAKE DR 300	SAN DIEGO	CA	92123	HOME HEALTH SERVICES
SCRIPPS CLINIC - UTC
9333 GENESEE AVE 170	SAN DIEGO	CA	92121	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT
SCRIPPS USP SURGERY CENTERS LLC
15305 DALLAS PKWY STE 1600 LC 28	ADDISON	TX	75001	PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT

Supplemental Information Detail SupplementalInformationDetail (28 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c	SCRIPPS FINANCIAL ASSISTANCE, CHARITY CARE AND DSCOUNT PAYMENTS POLICY ("FAP") DESCRIBES THE PROCESS FOR PATIENTS WHO NEED HELP PAYING FOR THEIR EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL AND AMBULATORY CARE AT SCRIPPS HOSPITALS, (SCRIPPS MEMORIAL HOSPITAL LA JOLLA, SCRIPPS MEMORIAL HOSPITAL ENCINITAS, SCRIPPS GREEN HOSPITAL, SCRIPPS MERCY HOSPITAL, SAN DIEGO AND CHULA VISTA), AND SCRIPPS MEDICAL FOUNDATION. SCRIPPS PROVIDES FINANCIAL ASSISTANCE IN ACCORDANCE WITH ALL STATE AND FEDERAL REGULATIONS. SCRIPPS MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES, INCLUDING EMERGENCY AND OTHER MEDICALLY NECESSARY HOSPITAL CARE AND PROVIDES FULL OR PARTIAL FINANCIAL ASSISTANCE TO QUALIFIED PATIENTS. SCRIPPS FAP IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD PARTY COVERAGE, INCLUDING MEDICARE. THE FAP APPLIES TO ALL SERVICES PROVIDED AT SCRIPPS HEALTH TO INCLUDE PHYSICIAN PROFESSIONAL SERVICES THAT ARE DELIVERED BY SCRIPPS MEDICAL FOUNDATION PHYSICIANS AND SURGEONS. GENERAL CIRCUMSTANCES REQUIRING ASSISTANCE MAY INCLUDE: 1. PATIENTS WITH NO INSURANCE, 2. PATIENTS WHO ARE NOT ELIGIBLE FOR THIRD PARTY ASSISTANCE, 3. PATIENTS WITH 3RD PARTY COVERAGE WHICH DOES NOT COVER/REIMBURSE ALL CHARGES, E.G. MEDICAID, OTHER INDIGENT CARE PROGRAMS. 4. PATIENTS WITH WHO HAVE HIGH MEDICAL COSTS AS DEFINED BY STATE AND FEDERAL LAW, WHO ARE AT OR BELOW 400% OF THE FPL. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME AND EXPENSES. FOR LOW-INCOME, UNINSURED PATIENTS WHO EARN LESS THAN TWICE THE FEDERAL POVERTY LEVEL (FPL), SCRIPPS WILL FULLY FORGIVE THE ENTIRE BILL. FOR THOSE PATIENTS WHO EARN BETWEEN TWO AND FOUR TIMES THE FPL, SCRIPPS WILL FORGIVE A PORTION OF THE BILL. FOR AN INCOME LEVEL BETWEEN 201 AND 400 PERCENT OF FPL, AND FOLLOWING A DETERMINATION OF ELIGIBILITY, THE PATIENT RESPONSIBILITY WILL NOT BE CHARGED MORE THAN THE CALCULATED DISCOUNTED FINANCIAL ASSISTANCE AMOUNT. IF IT IS DETERMINED THAT THE FAMILY INCOME IS ABOVE 400% OF THE FPL, SCRIPPS MAY CONSIDER THE PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON EXTENUATING CIRCUMSTANCES SUCH AS CATASTROPHIC MEDICAL EVENTS OR OTHER SPECIAL SITUATIONS. NET WORTH INFORMATION INCLUDED ON THE PATIENT FINANCIAL ASSESSMENT STATEMENT WILL BE USED TO EVALUATE THESE SPECIAL SITUATIONS. PATIENTS DETERMINED TO BE "HOMELESS AND 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. SCRIPPS DOES NOT CHARGE PATIENTS QUALIFIED FOR FINANCIAL ASSISTANCE MORE THAN SCRIPPS'DISCOUNTED FINANCIAL ASSISTANCE AMOUNT, WHICH REPRESENTS SCRIPPS' AMOUNTS GENERALLY BILLED (AGB) AS CALCULATED WITH THE PROSPECTIVE METHOD. SCRIPPS WILL OFFER EXTENDED PAYMENT PLANS WITHOUT INTEREST TO ALLOW PAYMENT OF THE DISCOUNTED PRICE OVER TIME. THE HOSPITAL AND THE PATIENT SHALL NEGOTIATE THE TERMS OF THE PAYMENT PLAN AND TAKE INTO CONSIDERATION THE PATIENT'S FAMILY INCOME AND ESSENTIAL LIVING EXPENSES. IF AGREEMENT ON TERMS CANNOT BE ACHIEVED, THE FORMULA REQUIRED BY CALIFORNIA LAW WILL BE USED TO CREATE A REASONABLE PAYMENT PLAN. ELIGIBILITY FOR CHARITY CARE OR DISCOUNTED PAYMENT MAY BE DETERMINED AT ANY TIME SCRIPPS IS IN RECEIPT OF DOCUMENTATION OF INCOME OR ASSETS. EVERY REASONABLE EFFORT WILL BE MADE TO MAKE A DETERMINATION OF ELIGIBILITY WITHIN 15 BUSINESS DAYS OF RECEIPT OF ALL REQUESTED DOCUMENTATION. DETAILS OF THE CHARITY CARE OR DISCOUNT WILL BE PROVIDED TO THE PATIENT OR THE PATIENTS REPRESENTATIVE. AN ELIGIBILITY DETERMINATION WILL BE VALID FOR A PERIOD OF SIX MONTHS FROM THE DATE OF DETERMINATION UNLESS THE PATIENT'S CIRCUMSTANCES HAVE CHANGED. AT THE TIME OF THE EVALUATION, SHOULD IT BE DETERMINED THAT THE PATIENT HAS PAID MORE THAN REQUIRED, A REFUND OF THE OVERPAYMENT, WITH INTEREST (10 PERCENT PER YEAR) WILL BE ISSUED PROMPTLY. EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO MAY BENEFIT FROM FINANCIAL ASSISTANCE AS SOON AS POSSIBLE AND PROVIDE COUNSELING AND LANGUAGE INTERPRETATION WHEN NEEDED. PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE BUT NEED HELP WITH PAYMENTS WILL BE OFFERED A NO-INTEREST PAYMENT PLAN CONSISTENT WITH THEIR NEEDS AND ALL UNFUNDED PATIENTS RECEIVE A MINIMUM OF A 50% DISCOUNT TAKEN AUTOMATICALLY AT BILLING. IN ADDITION, SCRIPPS DOES NOT APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A WAY OF COLLECTING UNPAID HOSPITAL BILLS.
Schedule H, Part I, Line 6a SCHEDULE H, PART I, LINE 6A	THE 2022 COMMUNITY BENEFIT REPORT WAS ADOPTED BY THE SCRIPPS BOARD ON MARCH 2022 AND MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT WAS ADOPTED BY THE SCRIPPS BOARD IN SEPTEMBER 2022, TAX YEAR 2021 AND THE CHNA WAS MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY.
Schedule H, Part II DESCRIBE HOW COMM BLDG ACTIVITIES PROMOTE THE HEALTH OF THE COMM (CONT.)	F7 - COMMUNITY HEALTH IMPROVEMENT ADVOCACY - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 7. SCRIPPS HEALTH PUBLIC POLICY AND ADVOCACY THE SCRIPPS HEALTH PUBLIC POLICY ADVOCAY AGENDA IS INTENDED TO ASSIST SCRIPPS IN MEETING WITH POLICYMAKERS AT LOCAL, STATE AND FEDERAL LEVELS. ADVOCACY PRIORITIES ARE DETERMINED BASED ON SCRIPPS STRATEGIC DIRECTION, LONG-TERM FINANCIAL IMPACTS OF THE POLICY IN QUESTION, AND WITH A FOCUS ON SPENDING TIME AND RESOURCES IN AREAS WHERE OUR EFFORTS HAVE THE BEST OPPORTUNITY TO CARRY OUT OUR MISSION OF PROVIDING SUPERIOR HEALTH CARE TO THE INDIVIDUALS AND COMMUNITIES WE SERVE. THE SAN DIEGO LGBT COMMUNITY CENTER SCRIPPS SPONSORED THE SAN DIEGO LESBIAN, GAY, BISEXUAL, AND TRANSGENDER COMMUNITY CENTER INC., (D.B.A., THE CENTER). THE CENTER IS ONE OF THE LARGEST AND MOST VIBRANT LGBT COMMUNITY CENTERS IN THE NATION. FUNCTIONING AS THE SAN DIEGO LGBT COMMUNITY'S ANCHOR ORGANIZATION, THE CENTER IS LED BY A 10-MEMBER BOARD OF DIRECTORS, EMPLOYS MORE THAN 70 PAID STAFF AND UTILIZES MORE THAN 1,200 COMMUNITY VOLUNTEERS TO ACHIEVE ITS TWIN GOALS OF PROMOTING LGBT HEALTH/WELLNESS AND HUMAN RIGHTS. THE CENTER PROVIDES TARGETED PROGRAMS AND SERVICES TO THE FULL DIVERSITY OF THE SAN DIEGO LGBT COMMUNITY, INCLUDING MEN, WOMEN, YOUTH, SENIORS, TRANSGENDER AND NON-BINARY INDIVIDUALS, FAMILIES, LGBT LATINO COMMUNITY MEMBERS AND THEIR FAMILIES, AND THOSE LIVING WITH HIV. LAST YEAR, THE CENTER PROVIDES DIRECT SERVICE VISITS TO SAN DIEGO COMMUNITY MEMBERS, THROUGH ITS EVENTS, ACTIVITIES AND ADVOCACY, AND TOUCHES THE LIVES OF THOUSANDS MORE. F8-WORKFORCE DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 8. YOUNG LEADERS IN HEALTHCARE PROGRAM AN OUTREACH PROGRAM AT SCRIPPS HOSPITAL ENCINITAS, YOUNG LEADERS IN HEALTH CARE TARGETS LOCAL HIGH SCHOOLS' STUDENTS INTERESTED IN EXPLORING HEALTH CARE CAREERS. STUDENTS IN GRADES 9-12 PARTICIPATE IN THE PROGRAM, WHICH PROVIDES A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS CAREER OPPORTUNITIES. THE MISSION OF THE YOUNG LEADERS IN HEALTH CARE IS: - TO PROVIDE A FORUM FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT THE HEALTH CARE SYSTEM AND ITS BREADTH OF CAREER OPPORTUNITIES. - MENTOR STUDENTS IN THE ACT OF LEADERSHIP, GIVING THEM TOOLS TO USE IN THEIR DAILY LIFE CHALLENGES. - PROVIDE A SERVICE PROJECT TO SATISFY HIGH SCHOOL REQUIREMENTS AND MAKE A POSITIVE IMPACT ON THE COMMUNITY. - PROVIDE A VENUE FOR A STUDENT-RUN COMPETITION WHERE EACH SCHOOL PRESENTS A TOPIC IN LINE WITH THE YEAR'S GOAL. THIS COMBINED EXPERIENCE INCLUDES WEEKLY MEETINGS AT LOCAL SCHOOLS FACILITATED BY TEACHERS AND ADVISORS, AS WELL AS MONTHLY MEETINGS AT SCRIPPS HOSPITAL ENCINITAS. THE ADVISORS FOR THE PROGRAM ARE PART OF THE SAN DIEGO ALLIANCE FOR DRUG FREE YOUTH. THE PROGRAM MENTORS' STUDENTS ON LEADERSHIP AND PROVIDES TOOLS FOR DAILY CHALLENGES. EACH YEAR THE STUDENTS WORK TOWARD A FINAL PRESENTATION BASED ON THEIR COMMUNITY SERVICE PROJECTS RELATED TO HEALTH CARE AND WELLNESS. THE 2022 CLASS TOUCHED A VARIETY OF TOPICS FROM MENTAL ILLNESS TO THE OPIOID CRISIS. MORE THAN 170 STUDENTS, COMMUNITY MEMBERS AND HEALTH CARE SPECIALISTS ATTENDED THE YOUNG LEADER IN HEALTH CARE FINAL MEETING, CULMINATING WITH STUDENT PRESENTATIONS ON TYPES OF CANCER AND TREATMENTS. STUDENTS THAT PARTICIPATE IN THE PROGRAM ARE ELIGIBLE TO APPLY TO THE HIGH SCHOOL EXPLORER SUMMER INTERNSHIP PROGRAM. MEETINGS WERE CONDUCTED AS VIRTUAL TEAMS MEETINGS FOR THE 2021-2022 SCHOOL YEAR AND THE VIRTUAL FORMAT ALLOWED TO INCREASE/EXPAND THE HIGH SCHOOLS. OVER 200 STUDENTS ACTIVELY PARTICIPATE MONTHLY. SCRIPPS SCHOOL TO HEALTH CAREERS PATHWAY PROGRAMS SCRIPPS MERCY HOSPITAL CHULA VISTA PROVIDES PROGRAM ACTIVITIES DESIGNED TO PIQUE THE INTEREST OF YOUTH TO PURSUING A CAREER IN HEALTHCARE. ACTIVITIES INCLUDE MENTORING PROGRAMS, HEALTH PROFESSIONALS IN THE CLASSROOM PRESENTATIONS, HOSPITAL TOURS, CAMP SCRIPPS AND SURGERY VIEWINGS. A TOTAL OF 1,137 STUDENTS PARTICIPATED IN THESE PROGRAMS IN FISCAL YEAR 2022. RESIDENCY LED YOUTH PROGRAMS SCRIPPS IS DEDICATED TO BUILDING THE FUTURE PIPELINE OF HEALTH PROFESSIONALS. SCRIPPS IMPLEMENTS A WIDE VARIETY OF YOUTH IN HEALTH CAREER ACTIVITIES. THROUGH SEVERAL INTERNSHIPS AND OTHER EDUCATIONAL PROGRAMS, SCRIPPS COLLABORATES WITH HIGH SCHOOLS TO OFFER STUDENTS OPPORTUNITIES TO EXPLORE A ROLE IN HEALTH CARE AND GAIN FIRST-HAND EXPERIENCE WORKING WITH SCRIPPS HEALTH CARE PROFESSIONALS. FAMILY MEDICINE MEDICAL RESIDENTS HAVE DEVELOPED AN INTERACTIVE CLASSROOM PRESENTATIONS SERIES CALLED "OUR HEALTH". THE PRESENTATIONS FOCUS ON A VARIETY OF PUBLIC HEALTH CONCERNS, MEDICALLY FOCUSED TOPICS AS WELL AS HANDS-ON CLINICAL SKILLS WORKSHOPS AT THE LOCAL HIGH SCHOOLS. THE GOAL IS TO INTRODUCE THE STUDENTS TO HEALTH CAREERS AND THE STUDENTS RECEIVE HEALTH CAREER TOOLS/BROCHURES THAT INCLUDE INFORMATION ON EDUCATION REQUIREMENTS, SCHOLARSHIPS, AND WAYS TO PAY FOR COLLEGE. A TOTAL OF 1,014 STUDENTS PARTCIPATED IN FISCAL YEAR 2022.
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 QUALITIATIVE 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 INDIVIDUAS PARTICPATED 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 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 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 HOSPITALS AND HEALTH SYSTEMS THAT PARTICIPATED IN THE HASDIC 2022 CHNA PROCESS HAVE VARYING REQUIREMENTS FOR NEXT STEPS. PRIVATE, NOT-FOR-PROFIT (TAX EXEMPT) HOSPITALS AND HEALTH SYSTEMS ARE REQUIRED TO DEVELOP HOSPITAL OR HEALTH SYSTEM COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS AND IMPLEMENTATION STRATEGY PLANS TO ADDRESS SELECTED IDENTIFIED HEALTH NEEDS. THE PARTICIPATING HEALTH DISTRICTS AND DISTRICT HEALTH SYSTEMS DO NOT HAVE THE SAME CHNA REQUIREMENTS BUT WORK VERY CLOSELY WITH THEIR PATIENT COMMUNITIES TO ADDRESS HEALTH NEEDS BY PROVIDING PROGRAMS, RESOURCES, AND OPPORTUNITIES FOR COLLABORATION WITH PARTNERS. EVERY PARTICIPATING HOSPITAL AND HEALTH CARE SYSTEM WILL REVIEW THE CHNA DATA AND FINDINGS IN ACCORDANCE WITH THEIR OWN PATIENT COMMUNITIES AND PRINCIPAL FUNCTIONS AND EVALUATE OPPORTUNITIES FOR NEXT STEPS TO ADDRESS THE TOP IDENTIFIED HEALTH NEEDS IN THEIR RESPECTIVE PATIENT COMMUNITIES.
Schedule H, Part VI, Line 2 NEEDS ASSESSMENT (CONTINUATION)	THE CHNA REPORT WILL BE 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. HASDIC 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. THE CHNA COMMITTEE IS IN THE PROCESS OF PLANNING PHASE 2 OF THE 2022 CHNA, WHICH WILL INCLUDE GATHERING COMMUNITY FEEDBACK ON THE 2022 CHNA PROCESS AND STRENGTHENING PARTNERSHIPS AROUND THE IDENTIFIED COMMUNITY NEEDS. SCRIPPS HEALTH IMPLEMENTATION STRATEGY 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. SCRIPPS EVALUATES THE IMPLEMENTATION STRATEGY ANNUALLY BECAUSE A FLEXIBLE APPROACH IS WELL-SUITED TO DEVELOPING A RESPONSE TO THE 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 DESCRIBES 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. SCRIPPS HEALTH HAS A CONSISTENT FOCUS ON THE INITIATIVES, MEASURES OF IMPLEMENTATION AND METRICS USED TO EVALUATE THE EFFECTIVENESS OF THE COMMUNITY NEEDS IDENTIFIED THROUGH THE 2022 CHNA. THE COMPLETE FY23-FY25 IMPLEMENTATION STRATEGY REPORT IS AVAILABLE ONLINE AT SCRIPPS.ORG.
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUATION)	DURING FISCAL YEAR 2022 (OCTOBER 2021 TO SEPTEMBER 2022), SCRIPPS INVESTED $8,588,962 IN COMMUNITY HEALTH SERVICES (DOES NOT INCLUDE SUBSIDIZED HEALTH). THIS FIGURE REFLECTS THE COSTS ASSOCIATED WITH PROVIDING THESE PROGRAMS, SALARIES, MATERIALS, AND SUPPLIES MINUS REVENUE. FOR MORE DETAILED INFORMATION ON THESE AND OTHER PROGRAMS SEE HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. A LACK OF HEALTH INSURANCE IS A PREDICTOR OF MANY HEALTH CONDITIONS, INCLUDING MORE POOR MENTAL HEALTH DAYS, MORE VISITS TO THE ED FOR HEART ATTACKS, A HIGHER PREVALENCE OF ASTHMA, AND OBESITY, MORE LOW BIRTH WEIGHT BABIES, AND HIGHER PREVALENCE OF SMOKING. REDUCED ACCESS TO BASIC HEALTH CARE SERVICES INCREASES ILLNESS, INJURY AND MORTALITY AND IS A MAJOR BURDEN ON HOSPITALS AND HEALTH PROVIDERS, WHO MUST PROVIDE UNCOMPENSATED CARE FOR THE UNINSURED. ACCESS TO HEALTH CARE EMERGED AS A HIGH PRIORITY HEALTH NEED IN BOTH THE SECONDARY DATA ANALYSES AND COMMUNITY ENGAGEMENT DISCUSSIONS IN THE 2022 SCRIPPS COMMUNITY HEALTH NEEDS ASSESSMENT. THROUGH THE COMMUNITY ENGAGEMENT CONDUCTED WE HEARD FROM THE COMMUNITY THAT SEVERAL FACTORS WERE IDENTIFIED AS BEING SIGNIFICANT IN ACCESSING HEALTH CARE IN SAN DIEGO: TRANSPORTATION, LACK OF HEALTHCARE COSTS AND MEDICAL DEBT, THE LACK OF CULTURALLY COMPETENT AND LINGUISTICALLY APPROPRIATE CARE AND LGBTQ+ EXPERIENCE IN HEALTH CARE. IN AN EFFORT TO PROVIDE FOR PEOPLE IN NEED, SCRIPPS SPONSORED A NUMBER OF PROGRAMS AND ACTIVITIES IN FISCAL YEAR 2022. BELOW ARE A FEW EXAMPLES OF ACCESS TO CARE PROGRAMS. MORE DEATILED INFORMATION ON THE BREATH AND SCOPE OF OUR PROGRAMS CAN BE FOUND IN THE 2023 SCRIPPS COMMUNITY BENEFIT PLAN AND REPORT, HTTP://WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE-COMMUNITY. MERCY OUTREACH SURGICAL TEAM PROVIDES LIFE-CHANGING CARE TO CHILDREN IN MEXICO FOR THREE DECADES, THE MERCY OUTREACH SURGICAL TEAM (MOST) HAS BEEN CROSSING BORDERS AND CHANGING LIVES. MOST IS AN INDEPENDENT, NONPROFIT ORGANIZATION FOUNDED IN 1987 AT SCRIPPS MERCY HOSPITAL WHOSE MISSION IS TO PROVIDE FREE SURGERIES AND VISION CARE TO UNDERSERVED CHILDREN IN MEXICO. AFTER THE 9/11 TERRORIST ATTACK, MOST'S MISSIONS HAD TO BE SHIFTED EXCLUSIVELY TO TRIPS IN MEXICO, DUE TO DIFFICULTY GETTING CHILDREN ACROSS THE BORDER FROM MEXICO INTO THE U.S. WORKING IN MEXICO, THE MERCY OUTREACH SURGICAL TEAM PROVIDES RECONSTRUCTIVE SURGERIES FOR CHILDREN SUFFERING FROM BIRTH DEFECTS OR ACCIDENTS. IN SPECIAL CIRCUMSTANCES, SURGERIES ARE ALSO PROVIDED FOR ADULTS. IN MEXICO, MOST VOLUNTEERS TYPICALLY PERFORM HUNDREDS OF SURGERIES PER MISSION-AND MORE THAN 14,000 OVERALL SINCE ITS FOUNDING-FOR ISSUES LIKE CLEFT LIPS, CROSSED EYES, BURN SCARS, HERNIA REPAIRS AND MORE. MOST ALSO ADDED A VISION PROGRAM IN 2004 THAT PROVIDES MORE THAN 100 PAIRS OF EYEGLASSES PER TRIP TO CHILDREN IN NEED. AS THE PAUSE IN TRAVEL FOR MOST CONTINUED INTO 2022, MOST SOUGHT ALTERNATIVE WAYS TO SERVE THOSE IN NEED. SCRIPPS PROVIDED A SPONSORSHIP OF $18,850 TO TWO ROTARY CLUBS IN MEXICO WHICH FUNDED LOCAL SURGEONS TO PERFORM LIFE CHANGING CLEFT LIP AND PALATE SURGERIES TO 27 CHILDREN. THESE ROTARY CLUBS WERE CHARGED WITH DISPERSING THE MONIES AND MAKING SURE THE FUNDS WERE UTILIZED APPROPRIATELY. THE TWO CLINICS WHERE THE SURGERIES WERE PERFORMED WERE CASA AZUL IN MONTEREY, NUEVO LEON, MEXICO AND SONRISA DE LUNA IN TEPIC, NAYARIT, MEXICO. CITY OF REFUGE (CoR) SAN DIEGO RECUPERATIVE CARE UNIT PROGRAM (RCU) RECUPERATIVE CARE (ALSO KNOWN AS MEDICAL RESPITE CARE, A LOWER LEVEL OF MEDICAL CARE PROVIDED WHERE A PATIENT CAN HEAL AND RECOVER FROM AN ILLNESS OR INJURY) PROVIDES PEOPLE WHO ARE EXPERIENCING HOMELESSNESS WITH A SAFE PLACE TO STAY AFTER BEING DISCHARGED FROM THE HOSPITAL TO PREVENT THEM FROM FALLING BACK ONTO THE STREETS WHILE ILL AND RECOVERING. WITHOUT A STABLE PLACE TO STAY, COMMUNITY MEMBERS EXPERIENCING HOMELESSNESS COULD UNDO ANY PROGRESS THEY MADE DURING THEIR HOSPITALIZATION. SCRIPPS HEALTH HAS AN AGREEMENT WITH THE CITY OF REFUGE SAN DIEGO RECUPERATIVE CARE SHELTER (RCS) WHICH PROVIDES A SAFE DISCHARGE FOR CHRONICALLY HOMELESS PATIENTS WITH ONGOING MEDICAL NEEDS. ALL PATIENTS ARE UNFUNDED OR UNDERFUNDED. MOST HAVE SUBSTANCE ABUSE AND/OR MENTAL HEALTH ISSUES. LACK OF FUNDING, MENTAL ILLNESS, AS WELL AS ALCOHOL AND/OR SUBSTANCE ABUSE, MAKES POST-ACUTE PLACEMENT OF THESE HOMELESS PATIENTS DIFFICULT. DURING THE PANDEMIC ALL SAN DIEGO HOMELESS SHELTERS EXPERIENCED COVID-19 OUTBREAKS, MAKING RCS A TRUE PLACE OF REFUGE FOR 37 OF OUR CHRONICALLY HOMELESS PATIENTS. THE RN (REGISTERED NURSE) CASE MANAGEMENT AND SOCIAL WORK DEPARTMENTS ASSIST WITH A NEEDED SUPPLY OF MEDICATION, APPOINTMENTS, DURABLE MEDICAL EQUIPMENT (DME), SETTING UP HOME HEALTH SERVICES IF NEEDED, AND CONNECTS PATIENTS TO PSYCH AS PART OF THE HOSPITAL DISCHARGE PLAN TO THE CITY OF REFUGE. THE CITY OF REFUGE FURTHER SUPPORTS CLIENTS IN MEETING THESE GOALS USING COMMUNITY RESOURCES TO MEET INDIVIDUAL SOCIAL SERVICE NEEDS. SCRIPPS PAYS THE CITY OF REFUGE A DAILY RATE FOR HOUSING AND SERVICES THEY PROVIDE TO THE PATIENTS. THE CITY OF REFUGE PROVIDES A SAFE, SECURE ENVIRONMENT, WITH 24-HOUR SUPERVISION, MEDICATION OVERSIGHT, MEALS, CLOTHING, CASE MANAGEMENT, ASSISTANCE WITH MEDI-CAL, WITH TRANSITION TO MANAGED MEDI-CAL AND DISABILITY APPLICATIONS, REFERRALS TO REHAB AND OTHER PROGRAMS, AND HELP FINDING PERMANENT OR TRANSITIONAL HOUSING USING COUNTY RESOURCES. DME AND OTHER NEEDED SERVICES ARE PROVIDED BY SCRIPPS WHEN FUNDING IS NOT AVAILABLE. ALL PATIENTS ARE CONNECTED TO A MEDICAL HOME, AND PRIMARY CARE IN THE COMMUNITY. PATIENTS WITH PSYCH DISORDERS ARE ESTABLISHED WITH A PSYCHIATRIST IN THE COMMUNITY IF THEY ARE WILLING. PATIENT TRANSPORTATION NEEDS ARE COORDINATED BY THE CITY OF REFUGE, BUT MAY INCLUDE INSURANCE FUNDED TRANSPORT SERVICES, AND OCCASIONALLY SCRIPPS SHUTTLE, OR USE OF TAXI VOUCHER. THE CITY OF REFUGE BEGAN TAKING PATIENTS ROUTINELY IN OCTOBER OF 2019. THIS YEAR 37 PATIENTS SO FAR HAVE MET THE NEED FOR RCS ADMISSION, BUT MANY DID NOT QUALIFY DUE TO BEHAVIOR, UNSTABLE MENTAL ILLNESS, OR UNWILLINGNESS TO ABSTAIN FROM SUBSTANCE ABUSE. AS A GROUP, THE RCS PATIENTS HAD A CUMULATIVE OF 393 HOSPITAL DAYS OF STAY, AN AVERAGE OF 10.6 HOSPITAL DAYS OF STAY, BEFORE GOING TO RCS OCTOBER 2021 TO DATE. THE RCS HAS TAKEN MEDICALLY COMPLEX PATIENTS, INCLUDING THOSE WITH: IV ANTIBIOTICS, WOUND VACS, SKIN GRAFTS, FRACTURES, ABSCESSES, OSTEOMYELITIS, AMPUTATION, DOG BITES, DKA, GI BLEEDS, PANCREATITIS, ESRD ON DIALYSIS, END STAGE LIVER DISEASE, DIABETES, MILD ENCEPHALOPATHY, OSTOMIES, MVA, PEDESTRIAN VERSUS AUTO, PLEURAL EFFUSION, CVA, CANCER (LYMPHOMA, PANCREATIC CANCER), HIV/AIDS, SEPSIS, RESPIRATORY FAILURE, PNEUMONIA, CHF. PATIENTS WERE ASSAULT VICTIMS WITH GUNSHOT AND STAB WOUNDS, FACIAL TRAUMA, AND SURGICAL POST OP PATIENTS AND MANY ARE DIABETIC. PSYCH PROBLEMS ARE COMMON AND OCCASIONALLY THE MAIN ISSUE FOR RCS CLIENTS. OVER 67% OF THIS GROUP WERE EITHER POSITIVE FOR ALCOHOL, DRUGS OR DRUG SCREEN OR HAD A DRUG HISTORY ADDRESSED BY THE PHYSICIAN IN THE H P. THE FOLLOWING ARE OUTCOME METRICS TRACKED BY SCRIPPS FOR THE CITY OF REFUGE PROGRAM. - FOR FY22 TOTAL COST SAVINGS FOR SCRIPPS WERE $1,428,646.00. - OF RECUPERATIVE CARE SHELTER PATIENTS, 10% HAD STANDARD MEDI-CAL INSURANCE, AND 67% MEDI-CAL HMO'S,10% HAD MEDICARE FUNDING, AND 10% WERE TRANSITIONING FROM OUT OF STATE OR OUT OF COUNTY MEDICAID/MEDI-CAL PROGRAMS. ONLY ONE PATIENT LACKED FUNDING. - APPROXIMATELY 8% OF PATIENTS SOUGHT TO SECURE INCOME FROM GOVERNMENT PROGRAMS, SOCIAL SECURITY, AND CA SHORT TERM DISABILITY; 3 TOTAL CLIENTS APPLIED OR RECEIVED INCOME BENEFITS. TWO HAVE APPLIED FOR AND RECEIVED MEDI-CAL HMO'S WHILE AT THE RCS WITH THE ASSISTANCE OF THEIR CASE MANAGEMENT DEPARTMENT. - THERE WERE SEVERAL SUCCESSES, WITH THE RCS MANAGER ASSISTING WITH ONE FAMILY REUNIFICATION OUT OF STATE. FOUR PATIENTS TRANSITIONED TO DRUG REHAB CENTERS, AND SEVERAL INTO ALPHA PROJECT OR FATHER JOE'S SHELTERS, INTERFAITH, AND MENTAL HEALTH TREATMENT PROGRAMS. - THE COMPLEX CARE MANAGER ENSURED 100 PERCENT OF RCS PATIENTS WERE SCHEDULED AND CONNECTED TO A PRIMARY CARE PROVIDER OR HAD ESTABLISHED CARE AT ONE OF THE COMMUNITY CLINICS. - FOLLOWING THEIR STAY IN THE CITY OF REFUGE: 30% OF THE RCS PATIENTS COMPLETED THEIR RECUPERATIVE CARE AND RETURNED TO THEIR PREVIOUS LIVING AND 14% WENT BACK TO THE HOSPITAL AS THEY NEEDED FURTHER TREATMENT. FATHER JOE'S VILLAGES STREET HEALTH INTERVENTION PROJECT SCRIPPS MERCY HOSPITAL SAN DIEGO SERVES A LARGE VOLUME OF SAN DIEGO'S UNSHELTERED HOMELESS POPULATION IN THE EMERGENCY SERVICES DEPARTMENT. BECAUSE OF THE SCARCITY OF SHELTER AND TREATMENT PROGRAM BEDS AVAILABLE FOR THESE PATIENTS, THEY OFTEN LEAVE THE HOSPITAL TO RETURN TO THEIR PREVIOUS OUTSIDE LOCATION. EVEN THOUGH THESE PATIENTS ARE STABLE FOR A SAFE DISCHARGE, THERE ARE MANY WHO COULD BENEFIT FROM A FOLLOW-UP HEALTH CARE AND CARE MANAGEMENT VISIT IN THE COMMUNITY SETTING.
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUATION)	AS THE STREET MEDICINE INSTITUTE EXPLAINS, "THE FUNDAMENTAL APPROACH OF STREET MEDICINE IS TO ENGAGE PEOPLE EXPERIENCING HOMELESSNESS EXACTLY WHERE THEY ARE AND ON THEIR OWN TERMS TO MAXIMALLY REDUCE OR ELIMINATE BARRIERS TO CARE ACCESS AND FOLLOW-THROUGH. VISITING PEOPLE WHERE THEY LIVE - IN ALLEYWAYS, UNDER BRIDGES, OR WITHIN URBAN ENCAMPMENTS - IS A NECESSARY STRATEGY TO FACILITATE TRUST-BUILDING WITH THIS SOCIALLY MARGINALIZED AND HIGHLY VULNERABLE POPULATION. A COLLABORATION HAS BEEN ESTABLISHED BETWEEN FATHER JOE'S VILLAGE STREET HEALTH INTERVENTION PROJECT AND SCRIPPS MERCY HOSPITAL TARGETING UNSHELTERED DISCHARGED PATIENTS WHO COULD BENEFIT FROM A FOLLOW-UP VISIT IN THE COMMUNITY SETTING WHERE THEY RESIDE. THE STREET HEALTH INTERVENTION IS FOR ELIGIBLE, UNSHELTERED PATIENTS PRIOR TO THE EMERGENCY ROOM DISCHARGE. THE INITIATIVE ESTABLISHES A COMMUNITY-SETTING, FOLLOW-UP HEALTH CARE VISIT FROM FATHER JOE'S VILLAGES SENIOR (FJV) MULTIDISCIPLINARY STREET HEALTH TEAM THE FOLLOWING DAY. THIS PROJECT WILL HELP SUPPORT THE NEEDS OF UNSHELTERED PERSONS EXITING THE HOSPITAL BY LINKAGE WITH FJV STREET HEALTH TEAM BECAUSE: - LIMITED AVAILABILITY OF SHELTER BEDS IN THE CITY OF SAN DIEGO - DAILY, THERE IS A SUBSTANTIAL NUMBER OF UNSHELTERED PERSONS DISCHARGED FROM SCRIPPS MERCY HOSPITAL EMERGENCY DEPARTMENT WHO MAY BENEFIT FROM A NURSING FOLLOW UP VISIT - I.E., WOUND CARE AND/OR MEDICATION CHECK OR PRIMARY CARE PHYSICIAN ESTABLISHMENT. - FATHER JOE'S VILLAGES HAS THE CLINICAL STAFF AND EXPERIENCE TO PROVIDE STREET HEALTH OUTREACH TO THE UNSHELTERED IN THE CENTRAL REGION OF SAN DIEGO COUNTY. - FATHER JOE'S VILLAGES STREET HEALTH HAS A RELATIONSHIP WITH PATH OUTREACH TO ASSIST WITH HOUSING AND SOCIAL SERVICE BENEFIT NEEDS. GRADUATE MEDICAL EDUCATION STAFF SUPPORT, ST. LEO'S CLINIC THE GRADUATE MEDICAL EDUCATION (GME) PROGRAM AT SCRIPPS GREEN HOSPITAL AND SCRIPPS CLINIC FOCUSES ON PHYSICIAN TRAINING AND CLINICAL RESEARCH, RESIDENTS AND FELLOWS. GME RESIDENTS AND MANY ATTENDING PHYSICIANS MAINTAIN AN EVENING CLINIC AT ST. LEO'S MISSION COMMUNITY CLINIC IN NORTH COUNTY. TWO RESIDENTS VOLUNTEER EVERY WEDNESDAY TO PROVIDE MEDICAL CARE TO UNINSURED PATIENTS WITH A VARIETY OF CONDITIONS, INCLUDING DIABETES, HIGH BLOOD PRESSURE AND HIGH CHOLESTEROL. THEY ALSO IDENTIFY MANY ACUTE CONDITIONS, INCLUDING VIRAL INFECTIONS, SKIN INFECTIONS, EYE PROBLEMS AND MUSCULOSKELETAL ISSUES, AND EDUCATE PATIENTS ABOUT THEIR HEALTH. PATIENTS MAY GET FLU VACCINATIONS AND SOME BASIC LAB TESTS. IF NEEDED, ST. LEO'S PATIENTS ARE REFERRED TO PROVIDERS WHO PROVIDE CARE AT A REDUCED COST. SCRIPPS SPONSORED AMERICAN RED CROSS BLOOD DRIVES SCRIPPS HEALTH PARTNERED WITH THE AMERICAN RED CROSS IN FISCAL YEAR 2022 TO HOSTED 10 BLOOD DRIVES; 431 SCRIPPS EMPLOYEES DONATED BLOOD THROUGHOUT THE YEAR. SCRIPPS HEALTH COLLECTED 453 PINTS OF BLOOD (FOR EVERY PINT DONATED 3 LIVES ARE SAVED), WHICH SAVED APPROXIMATELY 1,359 LIVES. SCRIPPS PROMOTED THE BLOOD DRIVES THROUGH OUR SYSTEM WIDE COMMUNICATION CHANNELS AND OUR WELLNESS ALL AROUND YOU CAMPAIGN. SCRIPPS HEALTH COMMUNITY BENEFIT (CB) FUND IN FISCAL YEAR 2022, SCRIPPS HEALTH CONTINUED TO DEEPEN ITS COMMITMENT TO PHILANTHROPY WITH ITS COMMUNITY BENEFIT FUND. OVER THE COURSE OF THE YEAR, IT AWARDED $138,500 IN COMMUNITY GRANTS TO PROGRAMS IN SAN DIEGO. THE FUNDED PROJECTS ADDRESS SOME OF SAN DIEGO COUNTY'S HIGH PRIORITY HEALTH NEEDS, SEEKING TO IMPROVE ACCESS TO VITAL HEALTH CARE SERVICES FOR AT RISK POPULATIONS, INCLUDING THE HOMELESS, ECONOMICALLY DISADVANTAGED, MENTALLY ILL AND OTHERS. SINCE THE COMMUNITY BENEFIT FUND BEGAN, SCRIPPS HAS AWARDED $4.4 MILLION TO DATE. PROGRAMS FUNDED DURING FISCAL YEAR 2022 INCLUDED: CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA) THE CONSUMER CENTER PARTNERSHIP IS A MEDICAL LEGAL PARTNERSHIP WITH SCRIPPS MERCY HOSPITAL. THE PROGRAM HELPS TO EDUCATE CONSUMERS ABOUT HEALTH CARE BENEFITS AND CHANGES OCCURRING WITH ELIGIBILITY AND ENROLLMENT IN COVERAGE PROGRAMS. STAFF ASSIST UNINSURED/UNDERINSURED LOW-INCOME SCRIPPS PATIENTS OBTAIN ACCESS TO MEDI-CAL, COUNTY MEDICAL SERVICES (CMS), COVERED CALIFORNIA, AND PRIVATE INSURANCE. FUNDING PROVIDES LOW INCOME, UNINSURED AND BEHAVIORAL HEALTH PATIENTS HELP OBTAIN HEALTH CARE BENEFITS, SSI AND RELATED SERVICES, WHILE REDUCING UNCOMPENSATED CARE EXPENSES AT MERCY. THIS MEDICAL LEGAL PARTNERSHIP PLACES CONSUMER CENTER PLACES STAFF ONSITE AT SCRIPPS MERCY HOSPITAL WITHIN THE BEHAVIORAL HEALTH UNIT (BHU) AND PROVIDES ACCESSIBLE LEGAL ASSISTANCE, IN ADDITION TO RECEIVING DIRECT REFERRALS FROM OTHER SCRIPPS FACILITIES. DUE TO THE SAFETY CONCERNS DURING THE PUBLIC HEALTH EMERGENCY, THE CONSUMER CENTER STAFF PROVIDED HIGH QUALITY SERVICES TO PATIENTS BASED ON DIRECT REFERRALS FROM SCRIPPS BHU AND PATIENT REPRESENTATIVE SERVICES STAFF AT MERCY AND OTHER SCRIPPS FACILITIES. THE PROJECT PROVIDES ADVOCACY SERVICES FOR TIME INTENSIVE GOVERNMENT BENEFIT CASES AND THE CONSUMER CENTER STRESSES THE IMPORTANCE OF ACCESSING COMMUNITY-BASED SERVICES FOR ROUTINE HEALTH CARE INSTEAD OF USING THE ED'S AND HOSPITAL DEPARTMENTS AS WELL AS THE IMPORTANCE OF ESTABLISHING MEDICAL HOMES. ERIC PAREDES SAVE A LIFE FOUNDATION EACH YEAR, 7,000 TEENS LOSE THEIR LIVES DUE TO SUDDEN CARDIAC ARREST (SCA). SCA IS NOT A HEART ATTACK, IT IS CAUSED BY AN ABNORMALITY IN THE HEART'S ELECTRICAL SYSTEM THAT CAN EASILY BE DETECTED WITH A SIMPLE ELECTROCARDIOGRAM (EKG). UNFORTUNATELY, HEART SCREENINGS ARE NOT PART OF A REGULAR, WELL-CHILD EXAM OR PRE-PARTICIPATION SPORTS PHYSICAL. THE FIRST SYMPTOM OF SCA COULD BE DEATH. SAN DIEGO ALONE LOSES THREE TO FIVE TEENS FROM SCA ANNUALLY. SCRIPPS FUNDING ASSISTS WITH SCREENING FOR YOUTH ATHLETES COUNTYWIDE. CATHOLIC CHARITIES FUNDING WAS NOT PROVIDED IN FISCAL YEAR 2022, BUT THE PARTNERSHIP CONTINUED. CATHOLIC CHARITIES PROVIDES SEVERAL SHELTER BED OPTIONS FOR MEN AND WOMEN EXPERIENCING HOMELESSNESS. BECAUSE OF THE LONG-STANDING PARTNERSHIP BETWEEN SCRIPPS HEALTH AND CATHOLIC CHARITIES, CATHOLIC CHARITIES MAKES EVERY EFFORT TO ACCOMMODATE THE NEEDS OF SMH PATIENTS, IF A BED IS AVAILABLE AND THE REFERRAL IS APPROPRIATE. ONCE A BED IS SECURED, SHELTER RESIDENTS ARE ASSISTED THROUGH CASE MANAGEMENT TO OBTAINING OTHER HEALTH AND SOCIAL SUPPORTS NEEDED TO STABILIZE AND IMPROVE THEIR CURRENT LIFE SITUATION. THE MOBILE HEALTH AND RESOURCE FAIR RACIAL/ETHNIC MINORITY WOMEN CONTINUE TO EXPERIENCE DELAYED DIAGNOSIS OF BREAST CANCER, CARDIOVASCULAR DISEASE, AND DEMENTIA, AND AFRICAN AMERICAN WOMEN ARE ALSO MORE LIKELY TO BE DIAGNOSED WITH MORE AGGRESSIVE BREAST CANCERS AND TO DIE FROM BREAST CANCER AT AN EARLIER AGE. REGULAR SCREENING IS KEY TO PREVENT DELAYED DIAGNOSIS, BUT MARGINALIZED POPULATIONS SUCH AS AFRICAN AMERICAN AND UNDERSERVED HISPANIC WOMEN ARE LESS LIKELY TO GET MAMMOGRAMS AND OTHER PREVENTIVE HEALTH MEASURES. A SYSTEMATIC REVIEW FOUND THAT ONE OF THE MOST EFFECTIVE METHODOLOGIES FOR DISEASE PREVENTION IN UNDERSERVED POPULATIONS IS TO REACH OUT DIRECTLY INTO THE COMMUNITY RATHER THAN REQUIRE INDIVIDUALS TO COME TO A HEALTHCARE CENTER. THE MOBILE HEALTH AND RESOURCE FAIR HAS CONSISTENTLY SERVED HUNDREDS OF DIVERSE COMMUNITY MEMBERS EACH MONTH, MANY OF WHOM CONTINUE TO RETURN FOR SERVICES. LED BY A RETIRED PHYSICIAN AND A BREAST CANCER SURVIVOR/ADVOCATE/CEO OF COMMUNITY-BASED ORGANIZATION MANY SHADES OF PINK. THESE VOLUNTEERS HOPE TO EXPAND AND UPGRADE THEIR SERVICES (E.G., ADDING CHOLESTEROL SCREENING, ADDING ADDITIONAL DEMENTIA SCREENINGS AND MENTAL HEALTH RESOURCES). SCRIPPS FUNDING ALLOWS TO PROVIDE MORE REGULAR CARDIOVASCULAR HEALTH AND NEUROCOGNITIVE SCREENINGS, AS WELL AS RESOURCES AND REFERRALS FOR BREAST CANCER SCREENING TO THESE UNDERSERVED AND OFTEN HIGH-RISK POPULATIONS. THE OBJECTIVE OF THIS PROGRAM IS TO HELP PREVENT DELAYED DIAGNOSES OF BREAST CANCER, CARDIOVASCULAR DISEASE, AND DEMENTIA AND PROMOTE HEALTH MAINTENANCE. THE FUNDING ALSO SUPPORTS THE HIRING OF DEDICATED COMMUNITY-BASED PATIENT NAVIGATORS TO HELP CONNECT COMMUNITY MEMBERS WITH THE APPROPRIATE HEALTH CARE RESOURCES, ESPECIALLY THROUGH THE BREAST AND CERVICAL CANCER PREVENTION AND TREATMENT ACT THAT CAN CONNECT PATIENTS TO MEDI-CAL AND FOLLOW-UP CARE AT SCRIPPS HEALTH. IN CONJUNCTION TO ENHANCED SCREENING SERVICES, SCRIPPS CONDUCTS RESEARCH TO BETTER UNDERSTAND BARRIERS UNIQUE TO THE UNDERSERVED IN SOUTHEAST SAN DIEGO AND TO BETTER MEET THEIR HEALTH CARE NEEDS IN TERMS OF PREVENTIVE AND MAINTENANCE OF HEALTH CARE. THE RESEARCH FINDINGS WILL HELP THE TEAM TO OPTIMIZE THE DELIVERY OF SERVICES AND MAXIMIZE THEIR COMMUNITY REACH.
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUATION)	SCRIPPS HEALTH CAL FRESH SCREENINGS AS HEALTH CARE DELIVERY SYSTEMS MOVE TOWARDS A POPULATION HEALTH PARADIGM THAT INCENTIVIZES KEEPING PATIENTS HEALTHY, HOSPITALS AND CLINICS ARE RECOGNIZING THE SIGNIFICANCE OF ADDRESSING SOCIAL DETERMINANTS OF HEALTH, SUCH AS FOOD INSECURITY (FI). HOSPITALS HAVE BEEN MORE PROACTIVE IN INTERVENING AT SOME LEVEL OF CARE TO AID THE INDIVIDUALS SUFFERING FROM FI AND THEIR ABILITY TO GAIN CONTROL OVER THEIR HEALTH. THE PUBLIC RESOURCE SPECIALIST (PRS) TEAM SCREENS ALL UNINSURED PATIENTS WHO HAVE RECEIVED SERVICES AT ANY OF THE FIVE SCRIPPS HOSPITAL FACILITIES. SCRIPPS HEALTH BEGAN SCREENING FOR CAL FRESH IN JUNE 2017 THROUGH THE SUPPORT OF THE PRS TEAM. THE TEAM HAS BEEN SUCCESSFUL IN HAVING AN IMPORTANT CONVERSATION ABOUT FOOD INSECURITY WITH PATIENTS AND IN FISCAL YEAR 2022, THE PRS TEAM SUCCESSFULLY SCREENED 5,080 FOOD INSECURE PATIENTS. OUT OF THOSE SCREENINGS, PRS SUBMITTED 3,854 MEDI-CAL APPLICATIONS TO THE COUNTY, 674 CAL FRESH APPLICATIONS AND 382 EXPEDITED CAL FRESH APPLICATION. SCRIPPS MERCY WIC PROGRAM THE SPECIAL SUPPLEMENT NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC) WAS ESTABLISHED AS A PERMANENT PROGRAM IN 1974 TO SAFEGUARD THE HEALTH OF LOW-INCOME WOMEN, INFANTS, AND CHILDREN UP TO AGE 5 WHO ARE AT NUTRITIONAL RISK. SCRIPPS MERCY HOSPITAL IS ONE OF FIVE REGIONAL ORGANIZATIONS THAT ADMINISTER THE STATE FUNDED WIC PROGRAM. THE PROGRAM SERVES SIX LOCATIONS CONVENIENTLY SITUATED NEAR COMMUNITY CLINICS AND/OR HOSPITALS IN THE CENTRAL SAN DIEGO AREA. WIC TARGETS LOW INCOME PREGNANT AND POSTPARTUM WOMEN, INFANTS, AND CHILDREN (AGES 0 TO 5 YEARS). SCRIPPS MERCY WIC SERVES ON AVERAGE 6,200 WOMEN AND CHILDREN ANNUALLY, 44 PERCENT IN THE CITY HEIGHTS COMMUNITY. IN CITY HEIGHTS CLIENTS ARE 91 PERCENT HISPANIC AND INCLUDE PREGNANT AND POSTPARTUM WOMEN (24%), INFANTS (20%) AND CHILDREN (56%). IN FISCAL YEAR 2022, THE PROGRAM PROVIDED NUTRITION SERVICES, COUNSELING AND FOOD VOUCHERS FOR 72,926 WOMEN AND CHILDREN IN SOUTH AND CENTRAL SAN DIEGO. THE SCRIPPS MERCY WIC PROGRAM PLAYS A KEY ROLE IN MATERNITY CARE BY REACHING LOW-INCOME WOMEN TO PROMOTE PRENATAL CARE, GOOD NUTRITION AND BREASTFEEDING DURING PREGNANCY AND OFFER LACTATION SUPPORT (ONE ON ONE AND GROUP), AS WELL AS BREAST PUMPS, PADS, AND OTHER SUPPLIES DURING THE POSTPARTUM PERIOD. IDENTIFYING THE SOCIAL DETERMINANTS OF HEALTH FOR PATIENTS POST DISCHARGE SCRIPPS MERCY HOSPITAL CHULA VISTA WELL BEING CENTER STAFF MEET WITH PATIENTS AT THE BEDSIDE OR FOLLOW UP WITH PATIENTS THROUGH PHONE CALLS AND HOME VISITS TO DETERMINE THE PATIENT'S NEEDS. PATIENTS ARE SCREENED FOR BARRIERS USING A SOCIAL DETERMINANTS OF HEALTH (SDOH) SCREENING TOOL TO HELP IDENTIFY THE PATIENT'S SPECIFIC NEEDS. ADDRESSING SDOH IS VITAL FOR IMPROVING HEALTH AND REDUCING LONGSTANDING HEALTH DISPARITIES. ONCE THE PATIENT'S NEEDS AND ROOT CAUSES OF HOSPITALIZATION ARE IDENTIFIED, STAFF ASSIST THE PATIENT IN SCHEDULING FOLLOW UP DOCTOR'S APPOINTMENT(S) AND ACCESSING COMMUNITY RESOURCES/SUPPORTIVE SERVICES. THROUGH COLLABORATION WITH VARIOUS AGENCIES, STAFF CAN EFFECTIVELY LINK PATIENTS TO TRANSITIONAL CARE AND SUPPORTIVE SERVICES. FULL ACCESS AND COORDINATED TRANSPORTATION (FACT) INC. IN 2019, SCRIPPS ENTERED A PARTNERSHIP WITH A LOCAL NONPROFIT- FACILITATING ACCESS TO COORDINATED TRANSPORTATION (FACT) INC., FOR ON-DEMAND RIDES FOR PATIENTS. SCRIPPS STAFF RELIES ON FACT TO ARRANGE FOR PATIENTS TO GET TO APPOINTMENTS AND FOR DISCHARGED PATIENTS TO RETURN HOME OR GET TO OTHER FACILITIES. THIS COLLABORATIVE SERVICE HAS QUICKLY PROVED TO BE A RELIABLE, CONVENIENT, AND COST-EFFECTIVE SOLUTION TO ONE OF THE DIFFICULT AND EXPENSIVE CHALLENGES IN ACCESSING MEDICAL CARE TRANSPORTATION. THE PROGRAM STREAMLINES A VARIETY OF MEDICAL TRANSPORTATION OPTIONS THROUGH A SINGLE POINT OF CONTACT AT FACT. FACT PROVIDED RIDES FOR PATIENTS INCLUDING THOSE WHO NEED SPECIALIZED VEHICLES OR PERSONAL ASSISTANCE TO COMPLETE THE TRIP. SCRIPPS STAFF USE A SINGLE TELEPHONE NUMBER TO CONTACT STAFF AT FACT, WHO THEN HANDLE THE SELECTION OF THE APPROPRIATE VEHICLE, EQUIPMENT, AND PERSONNEL, AND DISPATCH THE RIDE. THE PROGRAM PROVIDES SAVINGS IN PROCESSING TIME, COST OF TRANSPORTATION AND IT OFFERS THE RIDER A MORE RELIABLE AND CONVENIENT TRANSPORTATION SERVICE. THE INITIAL PILOT PROJECT WAS PARTLY FUNDED BY A COMMUNITY ENHANCEMENT GRANT AWARDED TO FACT BY THE COUNTY OF SAN DIEGO. SCRIPPS REALIZED A BENEFIT USING FACT TRANSPORT AS A COST SAVINGS; RATHER THAN USING TAXI VOUCHERS, AS WELL AS TRIPS THAT COULD TAKE SCRIPPS STAFF A GREAT DEAL OF TIME TO FIND A VENDOR TO DO AS OTHER VENDORS MAY NOT BE ABLE TO DO TRIPS TO THE BORDER OR IMPERIAL COUNTY AS READILY. FACT IS A CLEARINGHOUSE OF SORTS WITH MULTIPLE VENDORS AND THEREFORE SAVES THE STAFF TIME IN FINDING THE APPROPRIATE TRANSPORT AT THE RIGHT TIME. TRANSPORTATION IS AVAILABLE 7 DAYS A WEEK FOR SCRIPPS DISCHARGED PATIENTS TO ANY LOCATION WITHIN SAN DIEGO AND BEYOND. MOST RIDES BEGIN AND END AT THE CURBSIDE, HOWEVER DOOR THROUGH DOOR RIDES, WHEELCHAIR ACCESSIBLE RIDES AND GURNEY RIDES ARE AVAILABLE ON DEMAND. FACT HAS PROVIDED 2,003 RIDES THROUGH JUNE 2022 FOR SCRIPPS PATIENTS THROUGHOUT SAN DIEGO AND AS FAR AWAY AS IMPERIAL COUNTY. THE FOLLOWING ARE THE DIFFERENT TRANSPORTATION MODALITIES THAT FACT-SD PROVIDES: - AMBULATORY - THE RIDER CAN WALK ALONE TO AND FROM THE VEHICLE - CURB-TO-CURB - THE RIDER WILL BE PICKED UP AND DROPPED OFF AT THE CURB OF THE FACILITY/RESIDENCE - DOOR-TO-DOOR - THE RIDER REQUIRES THE DRIVER TO WALK THEM FROM THE DOOR OF THE FACILITY/RESIDENCE TO THE VEHICLE AND FROM THE VEHICLE TO THE DOOR OF THE FACILITY/RESIDENCE - DOOR-THROUGH-DOOR - THE RIDER REQUIRES THE DRIVER TO COME INSIDE THE FACILITY AND TRANSPORT THEM TO THE VEHICLE, THE DRIVER WILL DROP THEM OFF AT THE DOOR OF THE FACILITY OR RESIDENCE - ACCESSIBLE VEHICLES AND MOBILITY DEVICES - WALKER, CANE, FOLDING WHEELCHAIR, WHEELCHAIR, SCOOTER, AND VEHICLES EQUIPPED WITH RAMP OR LIFT - GURNEY TRANSPORTATION SCRIPPS MOBILIZATION TO FIGHT THE COVID-19 PANDEMIC SINCE THE PANDEMIC BEGAN, SCRIPPS HAS BEEN IN OVERDRIVE - FINDING NEW WAYS TO CONNECT WITH PATIENTS, CARING FOR THOSE WHO BECOME ILL AND ADMINISTERING LIFESAVING VACCINES TO THE PEOPLE OF SAN DIEGO. ACROSS THE SCRIPPS HEALTH SYSTEM, DOCTORS, NURSES, CAREGIVERS AND SUPPORT STAFF CONTINUED TO WORK TOGETHER IN FISCAL YEAR 2022 TO FIGHT THE COVID-19 PANDEMIC. SCRIPPS CONTINUED WITH THE IMPLEMENTATION OF COMMAND CENTERS, COVID-19 NURSE LINE, TESTING AND SURGE TENTS AS TESTING CABANAS AND COMMUNITY SUPPORT IN THE EARLY PART OF 2022. IN ADDITION, AWARENESS AND EDUCATION FOR THE COMMUNITY IN VACCINE SAFETY AND AVAILABILITY INCLUDING PRODUCTION, EDUCATIONAL MATERIAL, COORDINATION OF MEDIA RESPONSE AND TELEPHONE HOTLINES FOR ANSWERING QUESTIONS CONTINUED. SCRIPPS POST-COVID CONTINUING CARE. SCRIPPS HEALTH DEVELOPED THE POST-COVID CONTINUING CARE PROGRAM TO ADDRESS THE LINGERING COMPLICATIONS ENDURED BY MANY PATIENTS PREVIOUSLY INFECTED WITH THE COVID-19 VIRUS. SOME PATIENTS EXPERIENCE ONGOING SYMPTOMS SUCH AS SHORTNESS OF BREATH, CONTINUED LOSS OF TASTE OR SMELL, DIZZINESS OR HEADACHES, FATIGUE, AND FOG. THE PROGRAM IS DESIGNED FOR SCRIPPS PATIENTS RECOVERING FROM A HOSPITAL STAY, AS WELL AS THOSE WHO DID NOT REQUIRE HOSPITALIZATIONS BUT ARE RECOVERING FROM COVID. THE GOAL OF THE PROGRAM IS TO HELP PATIENTS ON THE ROAD TO RECOVERY AND ENSURE THAT POST-COVID PATIENTS GET PROPER, COMPASSIONATE MEDICAL TREATMENT CUSTOMIZED TO THEIR NEEDS. FOR MORE INFORMATION ON THIS PROGRAM VISIT, RECOVERY PROGRAM - COVID-19 - SCRIPPS HEALTH. THE PROGRAM HAS ENROLLED 3,200 PATIENTS AS OF AUGUST 2022. THE FOCUS OF THE PROGRAM IN 2022 EVOLVED TO SCREENING COVID-19 POSITIVE PATIENTS AND COORDINATING THE MONOCLONAL TREATMENTS IF PATIENTS MET THE CRITERIA. IN ADDITION, THE COVID CARE COMPANION TEAM BEGAN WORKING WITH THE AMBULATORY PROVIDERS TO GET IMMUNOSUPPRESSED PATIENTS TO PRE-EXPOSURE PROPHYLAXIS TREATMENT.
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUATION)	SCRIPPS EMPLOYEE FOOD SHARING PROGRAM SCRIPPS EMPLOYEES HAVE COME TOGETHER SEVERAL TIMES DURING THE COVID-19 PANDEMIC TO HELP HUNDREDS OF COLLEAGUES' FAMILIES WHO HAVE EXPERIENCED FOOD INSECURITY. WHILE MANY OF THESE COLLEAGUES HAVE BEEN ABLE TO CONTINUE WORKING, THE UNEXPECTED UNEMPLOYMENT OR REDUCTION IN WORK HOURS FOR FAMILY MEMBERS HAS IMPACTED THEIR ABILITY TO CONSISTENTLY PROVIDE THREE DAILY MEALS FOR THEMSELVES AND THEIR CHILDREN. AS A RESULT OF THESE MUTUAL CONCERNS THE SCRIPPS EMPLOYEE FOOD SHARING PROGRAM WAS ESTABLISHED TO ASSIST SCRIPPS FAMILIES EXPERIENCING FOOD INSECURITY AS THE COVID-19 CRISIS CONTINUED. A FOOD DISTRIBUTION EVENT WAS HELD ON DECEMBER 18, 2021. THE SCRIPPS EMPLOYEE FOOD SHARING PROGRAM SUCCESSFULLY DISTRIBUTED FOOD TO 391 FAMILY MEMBERS. FOOD DISTRIBUTED: 6,500 POUNDS OF GROCERIES AND EACH STAFF MEMBER RECEIVED MILK, EGGS, BREAD, FRUIT, VEGETABLES, A BOX OF NON-PERISHABLE FOOD. THE MAJORITY OF THE FOOD WAS DISTRIBUTED ON DECEMBER 18 BUT AT LEAST 25 ADDITIONAL PACKAGES OF FOOD WAS DISTRIBUTED THE FOLLOWING WEEK. MANY DEPARTMENTS WORKED COLLABORATIVELY TO MAKE THIS INITIATIVE A SUCCESS SUCH AS HUMAN RESOURCES, FOOD AND NUTRITION SERVICES, AND SECURITY AND FACILITIES TO NAME A FEW. THE SCRIPPS LEADERSHIP ACADEMY ALUMNI ALSO VOLUNTEERED TO HELP PACKAGE AND DISTRIBUTE THE FOOD. MUCH APPRECIATION TO THE EMPLOYEES, PHYSICIANS AND VENDORS WHO DONATED TO THE PROGRAM AS THEIR GENEROSITY HELPED TO MAKE A DIFFERENCE FOR MANY DURING A DIFFICULT TIME. DONATIONS FOR UKRAINE RESPONSE IN RESPONSE TO EMPLOYEE AND PHYSICIAN REQUESTS FOR UKRAINE SUPPORT, SCRIPPS PARTNERED WITH MEDSHARE, A GLOBAL ORGANIZATION PROVIDING REQUESTED AND NEEDED MEDICAL SUPPLIES TO UKRAINE. SCRIPPS FIRST LEARNED OF MEDSHARE WHEN THE SCRIPPS MEDICAL RESPONSE TEAM WAS ASSISTING IN HAITI AFTER THE COUNTRY'S EARTHQUAKE. MEDSHARE IS ACTIVELY COLLECTING CASH DONATIONS AND OTHER SUPPORT FOR THEIR EFFORTS AND HAD MORE THAN 7 SHIPMENTS SCHEDULED OVER SEVERAL WEEKS, RANGING IN SIZE AND SCOPE FROM TWO PALLETS OF WOUND CARE DRESSINGS TO A FULL 40-FOOT OCEAN CONTAINER OF ASSORTED MEDICAL SUPPLIES, BIOMEDICAL EQUIPMENT AND SURGICAL TOOLS. MEDSHARE ALSO PARTNERS WITH AN ARRAY OF OTHER INTERNATIONAL RELIEF ORGANIZATIONS TO ENSURE AID IS HANDLED APPROPRIATELY AND REACHES THE MOST CRITICAL COMMUNITIES. SCRIPPS STAFF AND PHYSICIANS RALLIED TO THE WORTHY CAUSE WITH THEIR OWN CASH CONTRIBUTIONS IN THE AMOUNT OF $10,710. (MADE THROUGH PAYROLL DEDUCTION), AND SCRIPPS HEALTH TOOK THE LEAD WITH ITS OWN LEAD GIFT OF $10,000. STAFF WERE ALSO ABLE TO MAKE DONATIONS DIRECTLY THROUGH THE MEDSHARE WEBSITE. SOCK AND BLANKET DRIVE THE SOCK AND BLANKET DRIVE WAS HELD AS PART OF SCRIPPS SPIRIT WEEK. DONATIONS ACROSS THE SCRIPPS SYSTEM WERE COLLECTED AND GIVEN TO FATHER JOE'S VILLAGES TO BENEFIT THE HOMELESS IN THE COMMUNITY. CONTRIBUTIONS WERE MADE BY JUST ABOUT EVERY SITE THROUGHOUT THE SYSTEM. FATHER JOE'S WILL INCLUDE THE DONATED ITEMS IN HYGIENE KITS FOR THE HOMELESS AND DISTRIBUTE THEM AT SHELTERS AND DAY CENTERS AND DURING WEATHER EVENTS. IN ALL THERE WERE 3,312 PAIRS OF SOCKS DONATED, ESTIMATED BY SUPPLY CHAIN AT A VALUE OF $5,862. THERE WERE ALSO 204 BLANKETS GIVEN AT AN ESTIMATED VALUE OF $5,712.
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
Schedule H, Part V Reporting Group A	REPORTING GROUP A INCLUDES THE FOLLOWING HOSPITAL FACILITIES: 1 SCRIPPS MERCY HOSPITAL 2 SCRIPPS MEMORIAL HOSPITAL LA JOLLA 3 SCRIPPS GREEN HOSPITAL 4 SCRIPPS MEMORIAL HOSPITAL ENCINITAS
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 2022 WAS $3,157,043. THIS 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. BEHAVIORAL HEALTH INPATIENT PROGRAMS INDIVIDUALS SUFFERING FROM ACUTE PSYCHIATRIC DISORDERS ARE SOMETIMES UNABLE TO LIVE INDEPENDENTLY OR MAY EVEN POSE A DANGER TO THEMSELVES OR OTHERS. IN SUCH CASES, HOSPITALIZATION MAY BE THE MOST APPROPRIATE ALTERNATIVE. THE BEHAVIORAL HEALTH INPATIENT PROGRAM AT SCRIPPS MERCY HOSPITAL HELPS PATIENTS AND THEIR LOVED ONE'S WORK THROUGH SHORT-TERM CRISES, MANAGE MENTAL ILLNESS AND RESUME THEIR DAILY LIVES. TEAM OF SPECIALISTS INCLUDE PSYCHIATRISTS, PSYCHOLOGISTS, MARRIAGE AND FAMILY THERAPISTS, NURSES, SOCIAL WORKERS, ACTIVITY THERAPISTS, OCCUPATIONAL THERAPISTS, CHAPLAINS AND PHARMACISTS. TREATMENT GOALS INCLUDE RESOLVING ISSUES THAT LED TO HOSPITALIZATION, REDUCING THE RISK OF DANGEROUS BEHAVIOR, ALLEVIATING THE SYMPTOMS THAT LED TO HOSPITALIZATION AND INCREASING COPING SKILLS TO LIVE MORE EFFECTIVELY IN THE COMMUNITY. WHEN THESE GOALS ARE MET, OUR DEDICATED STAFF DEVELOP A DISCHARGE PLAN CLOSELY INTEGRATED WITH COMMUNITY SERVICES TO ENCOURAGE ONGOING CARE AND HELP PATIENTS RETURN TO THEIR FAMILIES AND COMMUNITIES. IN FY22, AS PART OF A SUCCESSFUL JOINT COMMISSION VISIT THE BEHAVIORAL HEALTH INPATIENT UNIT RECEIVED NEW LIGATURE RESISTANT FURNITURE AS PART OF AN OVERALL INITIATIVE TO REDUCE SUICIDE RISK. BEHAVIORAL HEALTH OUTPATIENT SERVICES SCRIPPS BEHAVIORAL HEALTH ENTERED INTO AN AGREEMENT IN MAY 2016 TO TRANSITION THE BEHAVIORAL HEALTH OUTPATIENT DAY PROGRAM TO THE FAMILY HEALTH CENTERS OF SAN DIEGO TO EXPAND OUTPATIENT BEHAVIORAL HEALTH OFFERINGS TO THE MEDI-CAL POPULATION. COLLABORATION WITH HOSPITAL PARTNERS SUCH AS NAMI (NATIONAL ALLIANCE OF MENTAL ILLNESS), THE FAMILY HEALTH CENTERS OF SAN DIEGO, THE MCALISTER INSTITUTE AND HAZELDEN BETTY FORD HIGHLIGHT SCRIPPS COMMITMENT TO THE COMMUNITY WE SERVE. SCRIPPS HAS ALSO RECEIVED GRANT MONEY AS PART OF THE BEHAVIORAL HEALTH PILOT PROJECT TO EMBED SUBSTANCE USE COUNSELORS IN THE EMERGENCY DEPARTMENT TO FACILITATE LINKAGE TO MEDICATION ASSISTED OUTPATIENT PROGRAMS. BEHAVIORAL HEALTH CHALLENGES - LIKE MANY BEHAVIORAL HEALTH PROGRAMS ACROSS THE COUNTRY, FUNDING IS DIFFICULT, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE COST TO PROVIDE CARE. - IN FISCAL YEAR 2022, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM EXPERIENCED A $7.8 MILLION LOSS IN TOTAL OPERATIONS WITH $4.3 MILLION OF THIS LOSS BEING CAPTURED IN MEDI-CAL/CMS AND CHARITY CARE. - IN FISCAL YEAR 2022, 1 PERCENT OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	SCRIPPS UNCOMPENSATED CARE METHODOLOGY FISCAL YEAR 2022 SCRIPPS CONTINUES TO CONTRIBUTE RESOURCES TO PROVIDE LOW AND NO-COST HEALTH CARE SERVICES TO POPULATIONS IN NEED. DURING FISCAL YEAR 2022, SCRIPPS CONTRIBUTED $643,952,528 IN UNCOMPENSATED HEALTH CARE, $17456,417 IN CHARITY CARE, $619,090,066 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $7,406,044 IN BAD DEBT. SCHEDULE H METHODOLOGY - SCHEDULE H REQUIRES THE UNCOMPENSATED CARE TO BE DIVIDED INTO FOUR CATEGORIES: CHARITY CARE, UNDER-REIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS, BAD DEBT, AND UNDER-REIMBURSED MEDICARE. 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. 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.
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 F2 - ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP SPONSORED BY THE OFFICE OF THE PRESIDENT, DONATES TIME ON NOT-FOR PROFIT BOARDS REPRESENTING SCRIPPS HEALTH, INCLUDING THE FOLLOWING ORGANIZATIONS AND BOARDS: SAN DIEGO REGIONAL CHAMBER OF COMMERCE (CHAMBER BOARD, CHAMBER CEO ROUNDTABLE AND POLICY COMMITTEE ASSIGNMENTS; SAN DIEGO COUNTY TAXPAYERS ASSOCIATION (SDCTA BOARD, EXECUTIVE COMMITTEE AND HEALTH COMMITTEE WORK ASSIGNMENTS); SAN DIEGO REGIONAL ECONOMIC DEVELOPMENT CORPORATION (EDC BOARD AND POLICY COMMITTEE ASSIGNMENTS); AND THE DOWNTOWN SAN DIEGO PARTNERSHIP (DSDP BOARD AND WORKING COMMITTEE ASSIGNMENTS). NORTH SAN DIEGO BUSINESS CHAMBER HEALTH COMMITTEE MEETING THE CHAMBER STRIVES TO DELIVER UP-TO-DATE, HEALTH-RELATED INFORMATION GO ENHANCE THE QUALITY OF LIFE TO THE BUSINESS COMMUNITY. THE HEALTH COMMITTEE SERVES AS A FRONT LINE TO EDUCATE SAN DIEGO NORTH BUSINESS ABOUT HEALTH CARE ISSUES SPECIFIC TO THE REGION THAT IMPACT BOTTOM LINES AND WORKFORCE PRODUCTIVITY. THE SCRIPPS DIRECTOR OF COMMUNITY BENEFIT ATTENDS THESE MEETINGS. F3 - COMMUNITY SUPPORT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 3. DISASTER PREPAREDNESS - COMMUNITY SUPPORT AND OUTREACH EDUCATION HAVING THE ABILITY TO PROVIDE EMERGENCY SERVICES TO THOSE INJURED IN A LOCAL DISASTER WHILE CONTINUING TO CARE FOR HOSPITALIZED PATIENTS IS A CRITICAL COMMUNITY NEED. SCRIPPS HEALTH MAXIMIZES AWARENESS AND ENCOURAGES PARTICIPATION IN DISASTER PREPAREDNESS ACTIVITIES TO AFFECT CHANGE AT THE COMMUNITY LEVEL. SCRIPPS PARTICIPATES 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. HOSPITAL INCIDENT COMMAND SYSTEM (HICS) NATIONAL ADVISORY COMMITTEE SCRIPPS HEALTH IS AN ACTIVE MEMBER IN THE HOSPITAL INCIDENT COMMAND SYSTEM NATIONAL ADVISORY COMMITTEE. SAN DIEGO COUNTY HEALTHCARE DISASTER COALITION SCRIPPS PARTNERED WITH THE SAN DIEGO HEALTHCARE DISASTER COALITION FOR SURGE CAPACITY PLANNING TO INSURE EMERGENCY DEPARTMENT AND URGENT CARE READINESS IN THE EVENT OF A SURGE OF COVID/FLU PATIENTS. SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE SCRIPPS HEALTH PARTICIPATES IN THE SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE AT VARIOUS LEVELS TO INCLUDE BUDGET, PEIDATRIC SURGE, DECONTAMINATION, BURN SURGE AND REGIONALIZATION COMMITTEE'S. THE WORKGROUPS PROVIDE LEADERSHIP, REPRESENATION AND FUNDING THROUGH THE APPLICATION OF GRANTS, COOPERATIVE AGREEMENTS TO STATE, TERRITORIES AND ELIGIBLE MUNICIPALITIES TO IMPROVE SURGE CAPACITY, HEALTH EQUITY AND ENHANCED COMMUNITY AND HOSPITAL PREPAREDNESS FOR PUBLIC HEALTH. SAN DIEGO COUNTY OPERATIONAL AREA FULL SCALE EXERCISE FULL SCALE EXERCISE PLANNED FOR EIGHT HOURS, SPANNING ONE HALF MILE OFF OF OCEAN BEACH AND INTO MISSION BAY. THE EXRERISE CONSISTED OF A PEDIATRIC SURGE FROM MULTIPLE SIMULTAINOUS INCIDENTS THROUGHOUT THE COUNTY OF SAN DIEGO SURGING THE ENTIRE SYSTEM ALL AT ONCE. EXERCISE PLAY IS LIMITED TO THE RESCUE, TRANSPORT AND TREATMENT OF A SIMULATED BUS CRASH AND AN SUSPECTED TERRIORIST INCIDENT AT A CHILD DEVELOPMENT CENTER LOCATED IN SAN DIEGO COUNTY. THE ASSESMENT OF THE EXERCISE WAS A CORRDINATED RESPONSE FOR FEDERAL, STATE AND LOCAL AGENCIES TO INCLUDE BUT NOT LIMITED TO FEDERAL AGENCIES, MILITARY, STATE AND LOCAL POLICE, FIRE AGENCIES. ALL SAN DIEGO OUNTY HOSPITALS PARTICIPATED IN THE DRILL. SAN DIEGO COUNTY COALITION SURGE TEST NO NOTICE EXERCISE THE SURGE DRILL IS POSTPPONED TO NEXT YEAR DUE TO THE CURRENT PEDIATRIC SURGE AT CHILDREN'S HOSPITAL. THE DRILL IS CURRENTLY BEING PLANNED AND WILL BE A SYSTEM WIDE PEDIATRIC SURGE DRILL. SAN DIEGO COUNTY MEDICAL AND HEALTH FULL SCALE EXERCISE IN JULY, SCRIPPS PARTICIPATED IN THE COUNTY WIDE EXERCISE. ALL HOSPITALS PARTICIPATED, TESTED AND EVALUATED THE CAPABILITIES OF THE COMMAND CENTER AND THE RESPONSE PLAN FOR PATIENT SURGE AND EVACUATION. THIS INCLUDE MOC PARTICIPATION TO INCLUDE USE OF WEB-EOC. THIS WAS A COUNTY WIDE DRILL THAT INCLUDE ALL FACILITIES TO INCLUDE HOSPITALS, LONG TERM CARE AND TRANSPORT CAPABILITIES FOR THE COUNTY AND ITS PARTNERS. SAN DIEGO REGIONAL FULL-SCALE EXERCISE SCRIPPS HEALTH PARTICIPATES IN THE SAN DIEGO HEALTHCARE ADVISORRY COMMITTEE REGIONAL FULL-SCALE EXERCISE. THE EXERCISE WAS CONDUCTED IN JULY 2022 CONSISTING OF A MAJOR EARTHQUAKE THAT DAMAGED THE CURRENT INFASTRUCTURE TO INCLUDE MAJOR HIGHWAYS LOCATED THROUGHOUT THE SAN DIEGO AREA. THE EARTHQUAKE IMPACTED FACILITIES VITAL INFASTRUCTURE TO INCLUDE POWER AND WATER. HOSPITALS, CLINICS AND LONGTERM CARE FACILITIES PARTICIPATED ALONG WITH THE COUNTY OF SAN DIEGO. SCRIPPS HOSPITAL COMMAND CENTERS WERE UTILIZED AT EVERY HOSPITAL AND COMMUNICATIONS WERE TESTED TO INCLUDE RADIO, HAM RADIOS, CELL PHONES, TEAMS AND WEB-EOC CAPABILITIES. HOSPITALS WERE ALSO TESTED ON SURGE CAPABILITIES DURING THE DRILL. 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. ENLISTED LEADERSHIP FOUNDATION - THE FOUNDRY ENLISTED LEADERSHIP FOUNDATION IS A SAN DIEGO BASED NON-PROFIT GROUP 501(C)3 DEDICATED TO LEADERSHIP DEVELOPMENT OF NAVY SECOND CLASS, FIRST CLASS, AND CHIEF PETTY OFFICERS. THIS ORGANIZATION WAS FORMED BY A TEAM OF ACTIVE DUTY AND RETIRED COMMAND / MASTER CHIEF PETTY OFFICERS TO DEVELOP CURRENT AND FUTURE LEADERS THROUGH A PHILOSOPHY OF SHARING AND MENTORING BASED ON COMBINED GENERATIONS OF GROWTH AND GROOMING. THE FOUNDRY HELD THREE CLASSES IN 2022 FOR A TTOAL OF 348 STUDENTS AND SENIOR ELISTED MENTORS. THE LEADING PETTY OFFICE ACADEMY HELD THREE WORKSHOPS WITH A TOTAL OF 136 STUDENTS, PRIMARLY THE NAVY. THE CHIEF PETTY OFFICER PRODE DAY WAS HELD AT THE SILVER STRAND BEACH AND HAD 2,500 PEOPLE IN ATTENDANCE. THE $35,000 SCRIPPS SUPPORT ENABLED THE FOUNDRY TO ACCOMPLISH THESE PROGRAMS AND KEEP STUDENTS COST LOWER. SAN DIEGO SHERRIFF'S SEARCH RESCUE ACADEMY - EMERGENCY REPONSE MODULE THE AMERICAN RED CROSS EMERGENCY MEDICAL RESPONSE COURSE PROVIDES THE PARTICIPANT WITH THE KNOWLEDGE AND SKILLS NECESSARY TO WORK AS AN EMERGENCY MEDICAL RESPONDER (EMR). THE CLASS INSTRUCTED BY CHRIS VAN GORDER, SCRIPPS PRESIDENT AND CEO. F6 - COALITION BUILDING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 6 INJURY PREVENTION AND COUNTY'S HEALTH AND SAFTEY COALITION GROUPS AND TASK FORCES SCRIPPS HEALTH INJURY PREVENTION COMMUNITY OUTREACH PARTICIPATES IN A VARIETY OF HEALTH AND SAFETY COALITION GROUPS AND TASK FORCES FOR THE COUNTY'S HEALTH AND HUMAN SERVICES AGENCY. THESE INCLUDE WORKGROUPS THAT FOCUS ON BEHAVIORAL HEALTH, ECONOMIC DEVELOPMENT, FOOD INSECURITY, HOMELESSNESS, AGING AND INDEPENDENCE SERVICES, FALL PREVENTION TASK FORCE, GUN VIOLENCE REDUCTION ADVISORY WORK GROUP, GANG VIOLENCE, DOMESTIC VIOLENCE, HIGHWAY SAFETY, CALIFORNIA TEEN SAFE DRIVING COALITION, SUICIDE PREVENTION COUNCIL, METH STRIKE FORCE, AND THE SAN DIEGO ALCOHOL POLICY PANEL. STAFF HOURS TO BE CAPTURED IN FY23.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	METHODOLOGY FOR CALCULATING BAD DEBT 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 ADJUSTMNTS 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 BENFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGRDLESS 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	COLLECTION POLICY THE PURPOSE OF THIS POLICY IS TO PROVIDE INFORMATION WITH RESPECT TO THE CHARGING, BILLING AND COLLECTION OF PATIENT DEBT PURSUANT TO THE CALIFORNIA HEALTH AND SAFETY CODE, THE FEDERAL PATIENT PROTECTION, AND AFFORDABILITY CARE ACT, AND THE POLICIES AND PRACTICES OF SCRIPPS HOSPITALS, (SCRIPPS MEMORIAL HOSPITAL LA JOLLA, SCRIPPS MEMORIAL HOSPITAL ENCINITAS, SCRIPPS GREEN HOSPITAL, SCRIPPS MERCY HOSPITAL, SAN DIEGO AND CHULA VISTA), AND SCRIPPS MEDICAL FOUNDATION. ALL PATIENT FINANCIAL RESOURCES ARE EXPLORED PRIOR TO USING A COLLECTION AGENCY OR OTHER MEANS TO COLLECT ON ACCOUNTS. THE ORGANIZATION ALSO SCREENS PATIENTS WHO CANNOT AFFORD TO PAY CO-INSURANCE AND DEDUCTIBLES TO SEE WHETHER THEY QUALIFY FOR FINANCIAL ASSISTANCE. IF THE PATIENT DOES NOT QUALIFY, OR IF THERE IS A LACK OF INFORMATION AVAILABLE TO MAKE A DETERMINATION AND NO CONTACT IS ESTABLISHED WITH THE PATIENT, THEN THE ORGANIZATION MAY USE A COLLECTION AGENCY OR INTERNAL STAFF TO COLLECT THE ACCOUNT. WHEN A COLLECTION AGENCY OR THE ORGANIZATION STAFF DETERMINES THAT A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ORGANIZATION WRITES THE ACCOUNT OFF IN WHOLE OR PART AS CHARITY. SHOULD A PATIENT MAKE A PAYMENT ON AN ACCOUNT THAT HAS BEEN WRITTEN OFF TO BAD-DEBT EXPENSE, BAD-DEBT EXPENSE IS REDUCED TO THE EXTENT OF THE PAYMENT. ACCOUNTS BEING EVALUATED FOR FINANCIAL ASSISTANCE WILL NOT BE TURNED OVER TO A COLLECTION AGENCY UNTIL THE CONCLUSION OF THE FINANCIAL ASSISTANCE EVALUATION OR THE PATIENT FAILS TO COOPERATE IN PURSUING HIS OR HER REQUEST FOR ASSISTANCE.
Schedule H, Part V, Section B, Line 16a FAP website	A - SCRIPPS MERCY HOSPITAL: Line 16a URL: HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE; 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 MERCY HOSPITAL: Line 16b URL: HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE; 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 MERCY HOSPITAL: Line 16c URL: HTTPS://WWW.SCRIPPS.ORG/PATIENTS-AND-VISITORS__FINANCIAL-ASSISTANCE; 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 (HASDIC). 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 (HASDIC) 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 HASDIC 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 HASDIC 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 SCRIPPS ACTIVELY SCREENS, MONITORS AND IDENTIFIES PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE, PROVIDES COUNSELING, INFORMATION AND LANGUAGE INTERPRETATION AND MAKES EVERY REASONABLE EFFORT TO ASSIST PATIENTS IN MEETING FINANCIAL OBLIGATIONS. WHEN NECESSARY, SCRIPPS ALSO HELPS PATIENTS UNDERSTAND AND PARTICIPATE IN FINANCIAL ASSISTANCE OPTIONS. THIS INCLUDES BILLING STATEMENTS THAT ALERT PATIENTS TO THE AVAILABILITY OF ASSISTANCE AS WELL AS LIMITS ON ACCOUNT COLLECTION ACTIVITIES. (SCRIPPS DOES NOT, FOR EXAMPLE, APPLY WAGE GARNISHMENT OR LIENS ON PRIMARY RESIDENCES AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS.) ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON AN EVALUATION OF INCOME AND EXPENSE INFORMATION. FOR LOW-INCOME, UNINSURED PATIENTS EARNING LESS THAN 200 PERCENT OF THE FEDERAL POVERTY GUIDELINES (FPG), SCRIPPS FULLY FORGIVES THE ENTIRE BILL. FOR INDIVIDUALS WHO EARN BETWEEN 201-400 PERCENT OF THE FPG, FINANCIAL ASSISTANCE IS BASED ON A SCHEDULE WITH SHARE-OF-COST DISCOUNTS. SCRIPPS POSTS A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY ON THE SCRIPPS WEBSITE AND FINANCIAL ASSISTANCE CONTACT INFORMATION IN ADMISSIONS AREAS, EMERGENCY ROOMS, AND OTHER AREAS OF THE ORGANIZATION'S FACILITIES WHERE ELIGIBLE PATIENTS ARE LIKELY TO BE PRESENT. THE FINANCIAL ASSISTANCE POLICY SETS FORTH SCRIPPS POLICIES REGARDING DISCOUNT PAYMENTS AND 100 PERCENT FINANCIAL ASSISTANCE FOR QUALIFIED PATIENTS AND IS IN WRITTEN FORM TO DIRECT AND GUIDE STAFF, AND EFFECTIVELY COMMUNICATE HOW OUR COMMITMENT WILL BE APPLIED CONSISTENTLY TO ALL PATIENTS. THE POLICY INITIALLY ESTABLISHED IN 2001 WAS REVISED TO BE CONSISTENT WITH STATE AND FEDERAL LEGISLATION. THE PRACTICES ESTABLISHED IN THE POLICY REFLECT SCRIPPS' CONTINUING COMMITMENT TO ASSISTING LOW-INCOME UNINSURED PATIENTS WITH DISCOUNTED HOSPITAL CHARGES, CHARITY CARE, BILLING AND DEBT COLLECTION PRACTICES. POLICY HIGHLIGHTS INCLUDE: - SCRIPPS HEALTH WILL RESPECT THE DIGNITY OF EACH PATIENT, ACT ETHICALLY IN ALL PATIENT FINANCIAL MATTERS AND COMMUNICATE EFFECTIVELY TO ASSIST PATIENTS IN RESOLVING THEIR FINANCIAL OBLIGATIONS. EVERY REASONABLE EFFORT IS MADE TO ASSIST PATIENTS IN MEETING THEIR FINANCIAL OBLIGATION TO PAY FOR HOSPITAL SERVICES. SCRIPPS FINANCIAL ASSISTANCE IS DESIGNED TO SUPPORT PATIENTS WITH DEMONSTRATED FINANCIAL NEED AND IS NOT INTENDED TO SUPPLEMENT OR CIRCUMVENT THIRD PARTY COVERAGE INCLUDING MEDICARE. - PATIENT COMMUNICATION AND COMMUNITY OUTREACH AND COMMUNICATION REGARDING SCRIPPS FINANCIAL ASSISTANCE IS ACHIEVED THROUGH THE FOLLOWING MEASURES, TO INCLUDE BUT NOT LIMITED TO: 1. POSTERS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED IN REGISTRATION AREAS IN THE HOSPITAL (I.E. EMERGENCY DEPARTMENT AND MAIN ADMISSION AREAS.) PAPER COPIES OF SCRIPPS FAP, FINANCIAL ASSISTANCE APPLICATION AND A PLAIN LANGUAGE SUMMARY OF THE FAP ("FAP SUMMARY") ARE AVAILABLE UPON REQUEST AND WITHOUT CHARGE IN ALL SCRIPPS HOSPITAL EMERGENCY DEPARTMENTS AND ADMISSIONS AREAS. PATIENTS MAY ALTERNATIVELY REQUEST THAT COPIES OF THESE DOCUMENTS BE SENT TO THEM ELECTRONICALLY. 2. THE FAP, FAP SUMMARY, AND FINANCIAL ASSISTANCE APPLICATIONS ARE POSTED ON THE SCRIPPS WEBSITE TO VIEW, DOWNLOAD AND PRINT FREE OF CHARGE. THE FAP SUMMARY WILL CONTAIN THE WEBSITE ADDRESS WHERE THESE DOCUMENTS CAN BE FOUND ONLINE, IN ADDITION TO THE PHYSICAL LOCATION IN THE HOSPITAL WHERE PAPER COPIES MAY BE OBTAINED. 3. THE FAP SUMMARY IS OFFERED TO ALL PATIENTS AT REGISTRATION OR PRIOR TO DISCHARGE AS PART OF THE AGREEMENT FOR SERVICES AT A SCRIPPS FACILITY. 4. ALL BILLING STATEMENTS INCLUDE A STATEMENT ON THE AVAILABILITY OF FINANCIAL ASSISTANCE, INCLUDING A TELEPHONE NUMBER FOR SCRIPPS HOSPITAL STAFF THAT PROVIDE ASSISTANCE WITH THE APPLICATION PROCESS AND THE WEBSITE ADDRESS WHERE THE FAP, FAP SUMMARY AND FINANCIAL ASSISTANCE APPLICATION CAN BE FOUND. 5. THE FAP, FAP SUMMARY AND FINANCIAL ASSISTANCE APPLICATION ARE AVAILABLE IN THE PRIMARY LANGUAGES OF SIGNIFICANT PATIENT POPULATIONS WITH LIMITED ENGLISH PROFICIENCY (LEP). 6. THE FAP SUMMARY WILL BE AVAILABLE AT COMMUNITY EVENTS AND WILL BE PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. SCRIPPS HEALTH WORKED WITH THE CALIFORNIA HOSPITAL ASSOCIATION (CHA) TO INFORM AND NOTIFY MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL ABOUT THE FAP AND TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. 7. THE FAP AND RELATED INFORMATION WILL ALSO BE PROVIDED TO THE OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AS REQUIRED BY LAW. - SELF-PAY PATIENTS ARE PROVIDED WITH COUNSELING AND WRITTEN INFORMATION REGARDING FINANCIAL ASSISTANCE. THE PATIENT FINANCIAL ASSESSMENT STATEMENT IS AVAILABLE AND WILL BE PROVIDED TO PATIENTS WHO EXPRESS AN INTEREST IN, OR WHO HAVE BEEN IDENTIFIED AS, NEEDING FINANCIAL ASSISTANCE WHEN POSSIBLE. WRITTEN MATERIALS WILL BE AVAILABLE IN ENGLISH AND SPANISH. LANGUAGE INTERPRETIVE SERVICES ARE PROVIDED WHENEVER NECESSARY TO FACILITATE THE PATIENT'S UNDERSTANDING AND PARTICIPATION IN OPTIONS FOR FINANCIAL ASSISTANCE. - PATIENT ACCOUNTS THAT MAY BENEFIT FROM FINANCIAL ASSISTANCE ARE ACTIVELY SCREENED, MONITORED AND IDENTIFIED AS SOON AS POSSIBLE. PATIENTS ARE SCREENED FOR THE ABILITY TO PAY AND/OR TO DETERMINE ELIGIBILITY FORPAYMENT PROGRAMS INCLUDING THOSE OFFERED DIRECTLY THROUGH SCRIPPS HEALTH. OUR PERSONNEL WILL MAKE ALL REASONABLE EFFORTS TO OBTAIN INFORMATION FROM PATIENTS ABOUT WHETHER PRIVATE OR PUBLIC HEALTH INSURANCE MAY FULLY OR PARTIALLY COVER THE CHARGES FOR CARE. SCRIPPS WILL PROVIDE ASSISTANCE IN ASSESSING THE PATIENT'S ELIGIBILITY FOR MEDI-CAL, COUNTY MEDICAL SERVICES (CMS) OR ANY OTHER-THIRD PARTY COVERAGE AS PART OF THE APPLICATION PROCESS FOR FINANCIAL ASSISTANCE. EVALUATION FOR FINANCIAL ASSISTANCE ELIGIBILITY IS BASED ON THE EVALUATION OF INCOME AND EXPENSE INFORMATION PROVIDED BY THE PATIENT. - SCRIPPS HEALTH WILL WORK TO ASSIST ANY PATIENT UNABLE TO PAY FOR SERVICES, WHO COOPERATIVELY PROVIDES INFORMATION ABOUT HIS/HER ABILITY TO PAY. FAILURE BY THE PATIENT TO COOPERATE MAY RESULT IN THE INABILITY OF THE HOSPITAL TO PROVIDE FINANCIAL ASSISTANCE DETERMINATION. - FINANCIAL ASSISTANCE APPLIES TO INDIVIDUALS WHOSE FAMILY INCOME LEVEL IS 400 PERCENT OF THE FEDERAL POVERTY GUIDELINES OR BELOW. DETERMINATION IS MADE ON AN ALL-OR PARTIAL BASIS USING THE APPROVED DISCOUNT SCHEDULE. IF THE HOSPITAL IS UNABLE TO OBTAIN ADEQUATE INFORMATION AFTER DILIGENT EFFORTS REGARDING ABILITY TO PAY FOR ANY PATIENT TREATED IN THE EMERGENCY DEPARTMENT, THE PATIENT MAY BE GRANTED 100 PERCENT FINANCIAL ASSISTANCE ONLY AFTER APPROPRIATE BILLING AND/OR OTHER ATTEMPTS TO COLLECT INFORMATION HAVE BEEN MADE.
Schedule H, Part VI, Line 4 Community information	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 AND GROWING VOLUMES OF EMERGENCY, OUTPATIENT, AND PRIMARY CARE. IN FISCAL YEAR 2022, SCRIPPS PROVIDED 2,871,687 OUTPATIENT VISITS AND 69,817 HOSPITAL DISCHARGES. 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. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. THE HEALTH CARE SAFETY NET IN SAN DIEGO COUNTY IS HIGHLY DEPENDENT UPON HOSPITALS AND COMMUNITY HEALTH CLINICS TO CARE FOR UNINSURED AND MEDICALLY UNDERSERVED COMMUNITIES. FINDING MORE EFFECTIVE WAYS TO COORDINATE AND ENHANCE THE SAFETY NET IS A CRITICAL POLICY CHALLENGE. WHILE PUBLIC SUBSIDIES HELP FINANCE SERVICES FOR SAN DIEGO COUNTY'S UNDERINSURED POPULATIONS, THESE SUBSIDIES DO NOT COVER THE FULL COST OF CARE. COMBINED WITH MEDI-CAL AND MEDICARE FUNDING SHORTFALLS, SCRIPPS AND OTHER LOCAL HOSPITALS ABSORB THE COST OF CARING FOR UNINSURED/UNDERINSURED PATIENTS IN THEIR OPERATING BUDGETS. THIS PLACES A SIGNIFICANT FINANCIAL BURDEN ON HOSPITALS AND PHYSICIANS. SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 65 PERCENT OF THE CHARITY CARE WITHIN THE SCRIPPS SYSTEM. SCRIPPS MERCY'S SERVICE AREA HAS A MORE ECONOMICALLY DISADVANTAGED POPULATION COMPARED TO THE COUNTY, WITH THE LOWEST NUMBERS OF INSURED ADULTS IN THE COUNTY AND A MUCH HIGHER PERCENTAGE OF ETHNIC MINORITIES, PRIMARILY HISPANIC AND ASIAN. SCRIPPS MERCY HOSPITAL SAN DIEGO AND SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUSES ARE DESIGNATED BY THE GOVERNMENT AS A DISPROPORTIONATE SHARE HOSPITAL, IN REFLECTION OF THE DIVERSITY OF THE 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 SCRIPPS MERCY SAN DIEGO AND CHULA VISTA PATIENTS ARE GOVERNMENT INSURED MEDICARE AND MEDI-CAL. DEMOGRAPHIC PROFILE OF SAN DIEGO COUNTY (SDC) LOW-INCOME, UNINSURED INDIVIDUALS HAVE BEEN FOUND TO BE MOST AT RISK FOR POOR HEALTH STATUS. DATA FROM THE AMERICAN COMMUNITY SURVEY SHOW HOW THESE INDICATORS IMPACT THE SAN DIEGO COMMUNITY. EVALUATING THESE RISK FACTORS IS IMPORTANT FOR IDENTIFYING COMMUNITIES WITH THE MOST SIGNIFICANT HEALTH NEEDS AND HEALTH DISPARITIES. POVERTY CREATES BARRIERS TO ACCESSING SERVICES THAT PROMOTE WELL-BEING INCLUDING HEALTH SERVICES, HEALTHY FOOD, HOUSING, CHILDCARE, TRANSPORTATION, AND OTHER NECESSITIES THAT CONTRIBUTE TO IMPROVED HEALTH STATUS. CURRENT POPULATION DEMOGRAPHICS AND CHANGES IN DEMOGRAPHIC COMPOSITION OVER TIME PLAY A DEFINING ROLE IN THE TYPES OF HEALTH AND SOCIAL SERVICES NEEDED BY COMMUNITIES. POPULATION SIZE CHANGE IN POPULATION, RACE AND ETHNICITY, AND AGE DISTRIBUTION OF A POPULATION ARE ALL IMPORTANT FACTORS IN UNDERSTANDING COMMUNITIES AND THEIR RESIDENTS. IDENTIFYING HIGH-NEED AREAS A CRITICAL COMPONENT OF UNDERSTANDING COMMUNITY HEALTH IS TO IDENTIFY GEOGRAPHIC AREAS OF INEQUITIES. THE CHNA COMMITTEE UTILIZED TWO METRICS TO DETERMINE WHICH AREAS OF SAN DIEGO COUNTY LIKELY EXPERIENCE THE GREATEST HEALTH DISPARITIES: (1) THE HEALTHY PEOPLE INDEX (HPI) WHICH ANALYZES HEALTH OPPORTUNITIES BY CENSUS TRACT; AND (2) THE DIGNITY HEALTH/TRUVEN HEALTH COMMUNITY NEED INDEX (CNI), WHICH MEASURES BARRIERS TO SOCIO-ECONOMIC SECURITY BY ZIP CODE. DATA FROM THESE TWO SOURCES PROVIDED KEY INFORMATION ABOUT RESOURCES AND DISPARITIES IN DIFFERENT REGIONS OF SAN DIEGO COUNTY AND GUIDED THE SELECTION PROCESS FOR THE COMMUNITY ENGAGEMENT. CITIES WITH HIGH NEED INDEX SCORES (4.2-5.0) BY SAN DIEGO COUNTY HHSA - CENTRAL SAN DIEGO - 92102, 92015, 92113, 92115 - NORTH CENTRAL SAN DIEGO - 92111 - EAST SAN DIEGO - 91905,91917,92020,92021,91934,91963,91980 - NORTH COASTAL SAN DIEGO - 92083 - NORTH INLAND SAN DIEGO - 92025, 2069 - SOUTH SAN DIEGO -91910, 91911, 91932, 91950, 92154, 92173 ADDITIONAL INFORMATION ON SOCIOECONOMIC FACTORS, ACCESS TO CARE, HEALTH BEHAVIORS, AND THE PHYSICAL ENVIRONMENT CAN BE FOUND IN THE SCRIPPS HEALTH 2022 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. FURTHER BREAKDOWNS IN SAN DIEGO COUNTY DEMOGRAPHICS ARE DISPLAYED BELOW. SAN DIEGO IS THE SECOND MOST POPULOUS COUNTY IN CALIFORNIA AND FIFTH MOST POPULOUS IN THE UNITED STATES. SAN DIEGO HAS : - OVER 3.3 MILLION RESIDENTS - MAJORITY MINORITY POPULATION -- ASIAN - 11.6% -- BLACK - 4.7% -- HISPANIC/LATINO - 33.7% -- NATIVE AMERICAN/ALASKA NATIVE - 0.4% -- PACIFIC ISLANDER/NATIVE HAWAIIAN - 0.4% -- SOME OTHER RACE - 0.2% -- MULTIPLE RACES - 3.4% - BUSIEST LAND BORDER CROSSING IN THE WORLD - 1 OF EVERY 13 PEOPLE WHO ENTER THE US COME THROUGH SAN YSIDRO - 70 MILES OF COASTLINE - 16 NAVAL AND MILITARY INSTALLATIONS - 18 FEDERALLY QUALIFIED RECOGNIZED INDIAN RESERVATIONS - A TOTAL OF 4,526 SQUARE MILES, LARGER THAN RHODE ISLAND AND DELAWARE COMBINED - SAN DIEGO COUNTY AGE GROUPS -- 6.3% AGES 0-4; 14% AGES 5-14; 29.8% AGES 25-44; 24.3% AGES 45-64 AND 13.7% AGES 65+ - SOCIOECONOMIC -- LIVING IN POVERTY (LESS-THAN 100% FEDERAL POVERTY LEVEL) - 11.6% -- CHILDREN IN POVERTY - 14.7% -- UNEMPLOYMENT - 3.1% - HEALTH INSURANCE -- 92.2% HAD HEALTH INSURANCE IN 2019 AND 7.8% HAD NO HEALTH INSURANCE.
Schedule H, Part VI, Line 5 Promotion of community health	PROMOTION OF COMMUNITY HEALTH SCRIPPS PROVIDES A COMPREHENSIVE RANGE OF INPATIENT AND AMBULATORY SERVICES THROUGH OUR SYSTEM OF HOSPITALS AND CLINICS. IN ADDITION, SCRIPPS PARTICIPATES IN DOZENS OF 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 PARTICIPATION AT THE STATE, NATIONAL AND INTERNATIONAL LEVELS INCLUDE WORK WITH GOVERNMENT AND PRIVATE DISASTER PREPAREDNESS AND RELIEF AGENCIES, THE STATE COMMISSION ON EMERGENCY MEDICAL SERVICES, NATIONAL HEALTH ADVOCACY ORGANIZATIONS, AS WELL AS INTERNATIONAL PARTNERSHIPS FOR PHYSICIAN EDUCATION AND TRAINING, AND DIRECT PATIENT CARE. IN ALL THAT WE DO, WE ARE COMMITTED TO QUALITY PATIENT OUTCOMES, SERVICE EXCELLENCE, OPERATING EFFICIENCY, CARING FOR THOSE WHO NEED US TODAY AND PLANNING FOR THOSE WHO MAY NEED US IN THE FUTURE. 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. EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH CLINICAL RESEARCH AND MEDICAL EDUCATION PROGRAMS. DURING FY22 OCTOBER 2021 TO SEPTEMBER 2022), SCRIPPS INVESTED $36,406,050 IN PROFESSIONAL TRAINING PROGRAMS AND HEALTH RESEARCH TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES FOR SAN DIEGO COUNTY. FOR MORE DETAILED INFORMATION ON THESE AND OTHER PROGRAMS SEE HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. QUALITY HEALTH CARE DEPENDS ON 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 WOULD BE GREATLY DIMINISHED. MEDICAL RESEARCH ALSO PLAYS AN IMPORTANT ROLE IN IMPROVING THE COMMUNITY'S OVERALL HEALTH THROUGH THE DEVELOPMENT OF NEW AND INNOVATIVE TREATMENT OPTIONS. PROFESSIONAL EDUCATION AND HEALTH RESEARCH REFLECTS CLINICAL RESEARCH, AS WELL AS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. RESEARCH TAKES PLACE PRIMARILY AT SCRIPPS CLINICAL RESEARCH SERVICES AND SCRIPPS WHITTIER DIABETES INSTITUTE. CALCULATIONS ARE BASED ON TOTAL PROGRAM EXPENSES LESS APPLICABLE 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. ONE EXAMPLE OF OUR PROFESSIONAL EDUCATION GRADUATE MEDICAL EDUCATION IS THE SCRIPPS RESIDENT CLINIC AT FAMILY HEALTH CENTER OF SAN DIEGO (FHCSD). THE COLLABORATIVE RELATIONSHIP BETWEEN SCRIPPS MERCY HOSPITAL AND FHCSD HAS BEEN WELL ESTABLISHED WITH MANY TREMENDOUSLY PRODUCTIVE SHARED ENDEAVORS. THE TWO ORGANIZATIONS HAVE JOINTLY APPROACHED OPPORTUNITIES AND CHALLENGES IN THE COMMUNITY THAT FACE THE MEDICALLY UNDERSERVED. SOME OF THESE PROJECTS INCLUDE A FAMILY MEDICINE RESIDENCY PROGRAM, A PEDIATRIC RESIDENCY TRAINING PROGRAM AT FHCSD NORTH PARK FAMILY HEALTH CENTER, A SUCCESSFUL COLLABORATIVE PRENATAL CARE AND DELIVERY PROGRAM, EMERGENCY ROOM REFERRALS OF MEDICALLY UNDERSERVED PATIENTS WITHOUT A PRIMARY CARE PROVIDER/MEDICAL HOME AND A COORDINATED OUTPATIENT BEHAVIORAL HEALTH PROGRAM FOR PATIENTS DISCHARGED FROM SMH'S INPATIENT BEHAVIORAL HEALTH FACILITY. SCRIPPS MERCY HOSPITAL TRANSITIONED THE INTERNAL MEDICINE AMBULATORY TEACHING PROGRAM FROM SCRIPPS MERCY HOSPITAL TO FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD) HILLCREST FAMILY HEALTH CENTER. THE SCRIPPS RESIDENT CLINIC HAS BEEN SUCCESSFULLY INCORPORATED INTO THE OPERATIONS OF THE HILLCREST FAMILY HEALTH CENTER. THE GME AFFILIATION WITH FHCSD HAS PROVEN TO BE A SIGNIFICANT OPPORTUNITY FOR THE CONTINUITY OF CARE PATIENTS TO HAVE ACCESS TO MUCH MORE COMPREHENSIVE INTERDISCIPLINARY CARE INCLUDING DENTAL, BEHAVIORAL HEALTH OUTPATIENT SERVICES AND A VARIETY OF SOCIAL CARE SUPPORT INTERVENTIONS. IT HAS ALSO BEEN AN OPPORTUNITY FOR OUR RESIDENTS TO LEARN MORE ABOUT FUNCTIONING IN AN INTERDISCIPLINARY SETTING AND COLLABORATING WITH OTHER HEALTHCARE PROVIDERS. ADDITIONAL TRAINING OPPORTUNITIES HAVE RESULTED WITH THIS AFFILIATION IN SPECIALTY CARE CLINICS, SUCH AS HIV AND HBV CLINICS TO NAME A FEW. AS WELL, THE AFFILIATION WITH FHCSD HAS IMPROVED THE PATIENT'S TRANSITION OF CARE FROM THE HOSPITAL'S INPATIENT SETTING TO OUTPATIENT / FOLLOW-UP CARE WITH THE SUPPORT OF FHCSD CARE COORDINATION PROCESSES. THE AGREEMENT TO CO-LOCATE THE GME PROGRAM WITH FAMILY HEALTH CENTERS OF SAN DIEGO (FHCSD) IS AN EXPANSION OF THE ONGOING, COLLABORATIVE RELATIONSHIP WITH THIS FEDERALLY QUALIFIED HEALTH CENTER. SCRIPPS AND FHCSD ALREADY WORK TOGETHER IN A NUMBER OF AREAS THAT BENEFIT THE MEDICALLY UNDERSERVED, INCLUDING A PEDIATRIC RESIDENCY TRAINING PROGRAM, A COLLABORATIVE PRENATAL CARE AND DELIVERY PROGRAM, A COORDINATED BEHAVIORAL HEALTH PROGRAM, AND A TRANSITIONS OF CARE (TOC) PROGRAM. THE TOC PROGRAMS HAS TWO (2) SUCCESSFUL STRATEGIES:(1) SMH SD AND CV STAFF HAVE THE CAPABILITY OF LOGGING ONTO THE FHCSD APPOINTMENT SYSTEM WITH PATIENTS IN THE HOSPITAL SETTING TO SCHEDULE MEDICAL AND BEHAVIORAL HEALTH FOLLOW UP VISITS POST-DISCHARGE, AND (2) FHCSD SOCIAL WORK STAFF ARE HOUSED AT BOTH THE SAN DIEGO AND CHULA VISTA CAMPUS MEET PATIENTS IN THE EMERGENCY DEPARTMENT OR INPATIENT SETTING TO ASSIST THEM WITH VARIOUS POST-DISCHARGE NEEDS. IN ADDITION, SINCE 2013, SCRIPPS MERCY MEDICAL EDUCATION HAS SUPPORTED THE TEACHING HEALTH CENTERS FAMILY MEDICINE RESIDENCY AT FAMILY HEALTH CENTERS, WITH ALL INPATIENT TEACHING EXCEPT FOR PEDIATRICS OCCURRING AT SCRIPPS MERCY HOSPITAL SAN DIEGO. UNDERSERVED MEDICINE CURRICULUM THE INTERNAL MEDICINE FACULTY ARE CURRENTLY DEVELOPING A NEW OPTIONAL ROTATION GEARED TOWARD LEARNING ABOUT MODALITIES TO SERVE VULNERABLE POPULATIONS. THIS ONE OR TWO-WEEK ROTATION EXPERIENCE WILL INCLUDE TRAINING WITH VARIOUS COMMUNITY-BASED LOCATIONS THAT SERVE MEDICALLY UNDERSERVED POPULATIONS ALONG WITH INDEPENDENT LITERATURE STUDY RELATED TO CARING FOR THESE POPULATIONS. DURING THE INDEPENDENT STUDY PART OF THE CURRICULUM THE RESIDENTS WILL LEARN ABOUT DISPARITIES (INTRODUCTION AND DEFINITIONS), CLINICAL CARE OF LGBTQ PATIENTS AND SYSTEM BASED PRACTICE. THE CURRICULUM SITES MAY CHANGE YEAR TO YEAR BASED ON RESIDENT INTERESTS AND SITE AVAILABILITY. THE GOALS AND OBJECTIVES OF THE CURRICULUM ARE TO GAIN A DEEPER UNDERSTANDING OF THE RESOURCES AVAILABLE WITHIN THE SAN DIEGO COMMUNITY THAT PROVIDE CARE FOR THE UNDERSERVED PATIENTS IN VARIOUS SETTINGS, TO LEARN MORE ABOUT THE DISPARITIES THAT CURRENTLY EXIST WITHIN THE HEALTHCARE SYSTEM AND TO REFLECT ON WAYS THE CURRENT SYSTEM CAN BE IMPROVED, TO PARTICIPATE IN THE EDUCATION AND HEALTHCARE OF UNDERSERVED PATIENTS. SOME OF THE ROTATIONS IN THE CURRICULUM INCLUDE THE FOLLOWING: - ASYLUM SEEKERS CLINIC - RURAL HEALTH EXPERIENCE - PACE (PROGRAM OF ALL-INCLUSIVE CARE OF THE ELDERLY) - FATHER JOE'S VILLAGE HEALTH CENTER - RIDE ALONG WITH THE FATHER JOE'S VILLAGE STREET HEALTH TEAM TO IDENTIFY UNSHELTERED PERSONS LIVING OUT IN THE COMMUNITY WHO ARE IN NEED OF MEDICAL CARE. - SAN DIEGO AMERICAN INDIAN HEALTH CENTER - TREATING THE NATIVE AMERICAN AND INDIGENOUS POPULATIONS - HOMELESS OUTREACH TEAM - FAMILY HEALTH CENTER - THE RESIDENT WILL JOIN THE HOMELESS OUTREACH TEAM THAT TRAVELS TO CHULA VISTA - MEDICATION ASSISTED TREATMENT THROUGH FAMILY HEALTH CENTER - SAN DIEGO RESCUE MISSION - PARTICIPATION IN THE EDUCATION OF RESIDENTS AND JOIN THE HOMELESS OUTREACH TEAM. - SALVATION ARMY - LEARN WHAT PROGRAMS ARE BEING OFFERED THROUGH THE SALVATION ARMY THAT ADDRESS HEALTH DISPARITIES AND OBSERVE A GRADUATION CEREMONY. - SAN YSIDRO HEALTH CLINIC: BORDER HEALTH - LA MAESTRA COMMUNITY HEALTH CENTER - ASSISTING PROVIDERS AT LA MAESTRA COMMUNITY HEALTH CENTER IN CITY HEIGHT, SERVING A WIDELY DIVERSE REFUGEE AND IMMIGRANT POPULATIONS
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 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 16,000 EMPLOYEES. SCRIPPS CARES FOR PEOPLE THROUGHOUT THE SAN DIEGO REGION WITH FOUR ACUTE CARE HOSPITALS ON FIVE CAMPUSES, 31 OUTPATIENT CLINICS, AND 15 SCRIPPS HEALTHEXPRESS SITES. SCRIPPS ALSO OFFERS PAYER PRODUCTS AND POPULATION HEALTH SERVICES THROUGH SCRIPPS ACCOUNTABLE CARE ORGANIZATION, SCRIPPS HEALTH PLAN, ANDCUSTOMIZED 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. THE SYSTEM IS RECOGNIZED FOR EXPERTISE IN WOMEN'S HEALTH, CANCER CARE, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT, AND NEUROCOGNITIVE CARE INCLUDING DEMENTIA AND THERAPY-INDUCED COGNITIVE SEQUELA. SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, AND DIGITAL HEALTH CARE. 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. AS A TAX-EXEMPT HEALTH CARE SYSTEM, SCRIPPS TAKES PRIDE IN ITS SERVICE TO THE COMMUNITY. THE SCRIPPS SYSTEM IS GOVERNED BY A 20-MEMBER, VOLUNTEER BOARD OF TRUSTEES. THIS SINGLE POINT OF AUTHORITY FOR ORGANIZATIONAL POLICY ENSURES A UNIFIED APPROACH TO SERVING PATIENTS ACROSS THE REGION. SCRIPPS PROVIDES A COMPREHENSIVE RANGE OF INPATIENT AND AMBULATORY SERVICES THROUGH OUR SYSTEM OF HOSPITALS AND CLINICS. IN ADDITION, SCRIPPS PARTICIPATES IN DOZENS OF 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 PARTICIPATION AT THE STATE, NATIONAL AND INTERNATIONAL LEVELS INCLUDE WORK WITH GOVERNMENT AND PRIVATE DISASTER PREPAREDNESS AND RELIEF AGENCIES, THE STATE COMMISSION ON EMERGENCY MEDICAL SERVICES, NATIONAL HEALTH ADVOCACY ORGANIZATIONS, AS WELL AS INTERNATIONAL PARTNERSHIPS FOR PHYSICIAN EDUCATION AND TRAINING, AND DIRECT PATIENT CARE. IN ALL THAT WE DO, WE ARE COMMITTED TO QUALITY PATIENT OUTCOMES, SERVICE EXCELLENCE, OPERATING EFFICIENCY, CARING FOR THOSE WHO NEED US TODAY AND PLANNING FOR THOSE WHO MAY NEED US IN THE FUTURE.
Schedule H, Part VI, Line 7 State filing of community benefit report	CA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
American Heart Association - Heart walk
9404 Genesee Ave Ste 240	La Jolla	CA	92037	135613797	501(C)(3)	$10,000	Program support
Consumer Ctr of Legal Aid Soc of SD
1215 K St Ste 800	San Diego	CA	92110	951869806	501(C)(3)	$120,000	Program Support
Enlisted Leadership Fdn - The Foundry
2307 Fenton Parkway	San Diego	CA	92018	465029314	501(C)(3)	$35,000	Program Support
Eric Paredes Save a Life Fdn
2514 Jamacha Rd Ste 502	El Cajon	CA	92109	800636157	501(C)(3)	$8,500	Program Support
FAMILY HEALTH CENTERS OF SAN DIEGO
823 Gateway Ctr Way	San Diego	CA	92102	952833205	501(C)(3)	$316,500	Program Support
The San Diego LGBT Community Center
3909 Centre St	San Diego	CA	92013	237332048	501(C)(3)	$10,000	Program Support
MedShare - Donation for UA Response
3240 Clifton Springs Rd	Decatur	GA	30034	582433968	501(C)(3)	$10,000	Program Support
California Health Fdn and Trust (CHFT)
1215 K Street Ste 800	Sacramento	CA	95814	951684089	501(C)(3)	$221,000	CA Hospital Fee Program

Field	Value	IRS element (for citing)
Total501c3 Org	8	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	FormAndLineReferenceDesc
Explanation	GRANTEE SHALL SUBMIT TO SCRIPPS HEALTH, ATTENTION DIRECTOR OF COMMUNITY BENEFIT SERVICES AT 10140 CAMPUS POINT COURT, CPA 320, 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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Discretionary Spending Acct	Yes (X)	DiscretionarySpendingAcctInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Personal Services	Yes (X)	PersonalServicesInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (25 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Christopher Van Gorder
President CEO/TRUSTEE	$1,594,968	$0	$887,589	$0	$167,726	$0	$127,180	$0	$7,421	$0	$2,784,883	$0	$32,000	$0
Richard Sheridan
Former Officer	$0	$0	$0	$0	$332,260	$0	$0	$0	$0	$0	$332,260	$0	$0	$0
Bradley Ellis
Corp VP, Asst Gen Counsel, Secretary	$533,431	$0	$146,052	$0	$52,348	$0	$20,300	$0	$9,192	$0	$761,323	$0	$40,155	$0
Richard Rothberger
Treasurer/Exec VP, CFO - Thru 5/2022	$922,961	$0	$442,631	$0	$889,143	$0	$17,400	$0	$9,786	$0	$2,281,921	$0	$802,243	$0
Shiraz Fagan
FORMER KEY EMPLOYEE	$0	$0	$0	$0	$572,111	$0	$0	$0	$0	$0	$572,111	$0	$0	$0
James La Belle MD
Corp Sr VP, Chief Med Officer	$0	$0	$0	$0	$386,477	$0	$0	$0	$0	$0	$386,477	$0	$0	$0
Thomas Buchholz
Corp Sr. VP, MD Anderson	$755,204	$0	$343,098	$0	$13,252	$0	$11,600	$0	$6,902	$0	$1,130,056	$0	$0	$0
Eric Cole
CORP SR VP, HUMAN RESOURCES	$507,173	$0	$201,812	$0	$80,470	$0	$0	$0	$8,192	$0	$797,649	$0	$60,768	$0
Mary Ellen Doyle
Corp VP, Nursing Ops	$425,253	$0	$159,873	$0	$129,899	$0	$14,500	$0	$8,518	$0	$738,043	$0	$108,054	$0
John Engle
Corp Sr. VP, Chief Development	$502,232	$0	$216,721	$0	$118,041	$0	$6,169	$0	$8,642	$0	$851,804	$0	$66,238	$0
Carl Etter
Chief Executive, Sr VP	$732,339	$0	$315,281	$0	$622,822	$0	$17,400	$0	$5,381	$0	$1,693,224	$0	$559,812	$0
Shawn Forrester
Corp VP, Payer Relations	$459,424	$0	$174,153	$0	$10,705	$0	$11,600	$0	$5,148	$0	$661,030	$0	$0	$0
Thomas Gammiere
Chief Executive, Sr VP	$672,538	$0	$290,132	$0	$133,557	$0	$20,300	$0	$6,286	$0	$1,122,812	$0	$105,339	$0
Anil Keswani
Corp Sr VP, Chief Med Officer	$648,157	$0	$265,096	$0	$208,797	$0	$11,600	$0	$10,781	$0	$1,144,430	$0	$188,358	$0
June Komar
Corp Exec VP, Strategy Admin	$676,690	$0	$340,004	$0	$56,260	$0	$77,923	$0	$4,485	$0	$1,155,362	$0	$13,600	$0
Richard Neale
Corp Exec VP, Chief Growth Officer	$571,635	$0	$291,578	$0	$122,564	$0	$14,500	$0	$10,690	$0	$1,010,967	$0	$75,283	$0
Barbara Price
Corp Sr VP, BusServ Line Dev	$663,801	$0	$274,937	$0	$131,615	$0	$17,400	$0	$9,205	$0	$1,096,957	$0	$119,100	$0
Lisa RisserThakur
Corp Sr. VP, Ancillary Ops	$460,746	$0	$200,333	$0	$12,600	$0	$20,300	$0	$5,385	$0	$699,363	$0	$0	$0
Ghazala Sharieff
Corp Sr. VP, Acute Care/Clin Excl	$753,484	$0	$265,437	$0	$264,275	$0	$11,600	$0	$8,858	$0	$1,303,653	$0	$217,422	$0
Shane Thielman
Corp Sr. VP, CIO	$499,996	$0	$207,686	$0	$22,431	$0	$14,500	$0	$10,119	$0	$754,732	$0	$0	$0
Tracy Chu
Corp VP, POP Hlth CHF EXEC/ACO	$434,178	$0	$147,351	$0	$22,565	$0	$17,400	$0	$4,347	$0	$625,841	$0	$12,379	$0
Richard McKeown
Corp VP, Treasury	$397,272	$0	$150,004	$0	$123,566	$0	$14,500	$0	$8,602	$0	$693,944	$0	$108,917	$0
John Poole
Corp VP, System Improvement	$460,243	$0	$173,501	$0	$11,657	$0	$11,600	$0	$7,020	$0	$664,020	$0	$0	$0
Gerald Soderstrom
Corp VP, Audit / Compliance	$395,281	$0	$146,446	$0	$63,772	$0	$11,600	$0	$10,616	$0	$627,715	$0	$46,968	$0
Christee Thomas
Corp VP, Rev Cycle/Cnt Bus Ofc	$302,702	$0	$145,263	$0	$115,588	$0	$0	$0	$3,765	$0	$567,317	$0	$85,429	$0

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 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 $173. 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 A REIMBURSEMENT FOR FINANCIAL PLANNING SERVICES. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2.
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 2021: SHIRAZ FAGAN - $572,111 JAMES LA BELLE, MD - $386,477 RICHARD SHERIDAN - $332,260
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	SCRIPPS HEALTH SUPPLEMENTAL RETIREMENT PLAN (SERP) PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN KEY EMPLOYEES. THIS PLAN HAS BEEN CLOSED TO NEW PARTICIPANTS SINCE 2001. EFFECTIVE JANUARY 1, 2014, SCRIPPS HEALTH FROZE ALL BENEFITS UNDER THIS SERP PLAN FOR THE PARTICIPANTS AND, EFFECTIVE DECEMBER 31, 2017, SCRIPPS HEALTH TERMINATED THE PLAN AND DISTRIBUTED TO EACH PARTICIPANT AN AMOUNT EQUAL TO THE INCOME TAX WITHHOLDING AND FICA TAXES DUE ON THE VESTED BENEFITS. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM THE PLAN IN CALENDAR YEAR 2021 INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, (B)(III). CHRISTOPHER VAN GORDER $32,000 ANIL KESWANI $117,846 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 2021 INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, (B)(III): RICHARD ROTHBERGER - $ 478,837 CARL ETTER - $141,658 GHAZALA SHARIEFF - $34,653 ANIL KESWANI - $70,512 THOMAS GAMMIERE - $105,339 BARBARA PRICE - $119,100 RICHARD NEALE - $75,283 JOHN ENGLE - $66,238 ERIC COLE - $60,768 BRADLEY ELLIS - $40,155 MARY ELLEN DOYLE - $43,158 RICHARD MCKEOWN - $52,279 GERALD SODERSTROM - $46,968 TRACY CHU - $12,379 CHRISTEE THOMAS - $85,429 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 K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
California Statewide Communities Development Authority
A	680164610	1309116Y1	2007-03-02	$49,995,000	SEE PART IV	false	false	Yes (true)
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
B	521643828	13033LFL6	2010-02-04	$100,000,000	SEE PART IV	false	false	false
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
C	521643828	13033LVZ7	2012-02-01	$288,143,095	SEE PART IV	false	false	false
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
D	521643828	000000000	2016-02-29	$150,000,000	SEE PART IV	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$49,995,000	$0	$0	$0	$146,070	$0	$0	$49,848,390	$0	$0	2007	Yes (true)	false	Yes (true)	Yes (true)
B	$0	$0	$100,002,530	$0	$0	$0	$0	$0	$0	$100,002,530	$0	$0	2011	false	false	Yes (true)	Yes (true)
C	$2,200,000	$0	$288,160,329	$0	$0	$0	$0	$0	$0	$288,160,329	$0	$0	2013	false	false	Yes (true)	Yes (true)
D	$93,075,000	$0	$150,000,000	$0	$0	$0	$0	$0	$0	$150,000,000	$0	$0	2016	false	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	false	false	Yes (true)
B	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	false	false	Yes (true)
C	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	false	false	Yes (true)
D	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd
A	Yes (true)	Yes (true)	false	false	Yes (true)	Yes (true)
B	false	Yes (true)	false	false	false	Yes (true)	false	false	Yes (true)
C	false	Yes (true)	false	false	false	Yes (true)	false	false	Yes (true)
D	false	false	false	false	false	Yes (true)	false	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)
D	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 II, Line 3 TOAL PROCEEDS OF ISSUE	BOND ISSUE 1-B (2010B/C): THE AMOUNT SHOWN IN PART II, LINE 3 CONSISTS OF THE ISSUE PRICE OF THE BONDS $100,000,000 PLUS PROJECT FUND INVESTMENT EARNINGS OF $2,530. BOND ISSUE 1-C (2012A-C): THE AMOUNT SHOWN IN PART II, LINE 3 CONSISTS OF THE ISSUE PRICE OF THE BONDS $288,143,095 PLUS INVESTMENT EARNINGS OF $17,234.
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 (2010B C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 1-C (2012A-C): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 1-D (2016A/B): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 2-A (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 2-B (2019A): THE 2019A ISSUE REFUNDED THE 2010A ISSUE.
Schedule K, Part IV, Line 3	BOND ISSUE 1-C (2012A-C): THE 2012A ISSUE TOTALING $188,143,094 IS A FIXED RATE ISSUE WHEREAS THE 2010BC TOTALING $100,000,000 IS A VARIABLE RATE ISSUE.
Schedule K, Part IV, Line 2c DATE THE REBATE COMPUTATION WAS PERFORMED	BOND ISSUE 1-B (2010B/C): THE 2010B/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 4, 2020. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-C (2012A-C): THE 2012A-C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 1, 2017. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-D (2016A/B): THE 2016A/B REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 28, 2018. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 2-A (2017) THE 2017 REBATE COMPUTATION WAS RECENTLY PERFORMED ON JANUARY 31, 2021. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
A	521643828	000000000	2017-01-31	$160,000,000	SEE PART IV	false	false	false
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY
B	521643828	000000000	2019-11-15	$99,360,000	SEE PART IV	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$0	$0	$160,000,000	$0	$0	$0	$0	$0	$0	$0	$160,000,000	$0	2017	Yes (true)	false	Yes (true)	Yes (true)
B	$3,360,000	$0	$99,360,000	$0	$0	$0	$0	$0	$0	$0	$99,360,000	$0	2019	Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.0	0.0	0.0	false	false	Yes (true)
B	false	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.0	0.0	0.0	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	false	false	false	Yes (true)	false	false	false	false	Yes (true)
B	false	Yes (true)	false	false	false	false	false	false	Yes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
Chris Van Gorder
Officer	CUMULATIVE DEF COMP (SEE PG 186)	Yes (X)	$10,023,866	$13,230,564	false	Yes (true)	Yes (true)
June Komar
Executive	CUMULATIVE DEF COMP (SEE PG 186)	Yes (X)	$2,769,010	$3,654,834	false	Yes (true)	Yes (true)
Richard Sheridan
Former Officer	CUMULATIVE DEF COMP (SEE PG 186)	Yes (X)	$4,063,606	$5,363,580	false	Yes (true)	Yes (true)

Field	Value	IRS element (for citing)
Total Balance Due	$22,248,978	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (17 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$50,896,066	MEDICAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$19,110,953	CONSTRUCTION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$10,119,606	MEDICAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$4,596,893	CONSTRUCTION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$3,076,078	CONSTRUCTION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$2,751,665	MEDICAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$1,327,380	MEDICAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$836,666	FINANCIAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$427,902	EMPLOYEE SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$313,443	COMPENSATION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$246,699	COMPENSATION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$213,939	CONSTRUCTION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$202,015	MEDICAL SERVICES	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$132,000	COMPENSATION	false
SUBSTANTIAL CONTRIBUTOR
SUBSTANTIAL CONTRIBUTOR	$124,453	MEDICAL SERVICES	false
LINDSEY VAN GORDER
SEE PART V	$94,883	SEE PART V	false
DAVID VAN GORDER
SEE PART V	$76,244	SEE PART V	false

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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 M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	58	ContributionCnt
Noncash Contributions Rpt F990	$4,099,193	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Market value	MethodOfDeterminingRevenuesTxt

Real Estate Residential RealEstateResidentialGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$6,600,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Market value	MethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	Remodel Services	Desc
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$6,000	NoncashContributionsRptF990Amt
Method Of Determining Revenues	Market value	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	Yes (true)	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule M, Part I COLUMN (B)	CONTRIBUTIONS REPORTED THE NUMBER OF TRANSACTION, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTIRBUTED, 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. Gifts of real estate are liquidated through licensed real estate brokers.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 $4.1 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 16,000 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 full Scripps Health Annual Community Benefit Plan and Report at https://www.scripps.org/about-us/scripps-in-the-community. Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4 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 16,000 employees. Scripps cares for people throughout the San Diego region with four acute care hospitals on five campuses, 31 outpatient clinics, and 15 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. The system is recognized for expertise in women's health, cancer care, cardiovascular disease prevention and treatment, and neurocognitive care including dementia and therapy-induced cognitive sequela. Scripps is also at the forefront of clinical research, and digital health care. With three highly respected graduate medical education programs, Scripps is a longstanding member of the Association of American Medical Colleges. Scripps 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. Scripps provides a comprehensive range of inpatient and ambulatory services through the system of hospitals and clinics. In addition, Scripps participates in dozens of 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. Scripps participation at the state, national and international levels include work with government and private disaster preparedness and relief agencies, the State Commission on Emergency Medical Services, national health advocacy organizations, as well as international partnerships for physician education and training, and direct patient care. In all that we do, Scripps is committed to quality patient outcomes, service excellence, operating efficiency, caring for those who need us today and planning for those who may need us in the future. As a tax-exempt health care system, Scripps takes pride in its service to the community. The Scripps system is governed by a 17-member, volunteer Board of Trustees. This single point of authority for organizational policy ensures a unified approach to serving patients across the region. 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 and growing volumes of emergency, outpatient, and primary care. In Fiscal Year 2022, Scripps provided 2,871,687 outpatient visits and 69,817 hospital discharges. The hospital's patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. 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 community benefit programs are commitments Scripps makes to improve the health of both patients and the diverse San Diego communities. As a longstanding member of these communities, Scripps' goal and responsibility is to assist all who come to us for care, and to reach out especially to those who find themselves vulnerable and without support. Through our continued actions and community partnerships, we strive to raise the quality of life in the community as a whole. The report covers the period of Fiscal Year 2022 (October 1, 2021, through September 30, 2022). During this fiscal year, Scripps devoted $692,364,831 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 innovative approaches to reach residents at greatest risk for health problems. The report details programs and services that provide community benefits beyond standard practices of care into three main categories listed below: - Uncompensated Care (includes charity care, bad debt, and Medi-Cal and Medicare shortfalls) - Community Health Services - Professional Education and Health Research Uncompensated Care Scripps contributes significant resources providing low and no-cost health care for our patients in need. During Fiscal Year 2022, Scripps contributed $643,952,528 in uncompensated health care, including $17,456,417 in charity care, $619,090,066 in Medi-Cal and Medicare shortfall, and $7,406,044 in bad debt. This represents unreimbursed community benefit costs after the impact of the Medi-Cal Hospital Fee Program. Scripps received $26.7 million in net operating income from the provider fee. The State of California enacted legislation for a provider fee program to fund certain Medi-Cal coverage expansions. 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 February 2020, the Centers for Medicare Medicaid Services ("CMS") approved the July 1, 2019, through December 31, 2021, provider fee program. In September 2022, CMS approved the January 1, 2022, through December 31, 2022, provider fee program. The Organization's policy is to recognize program revenues and expenses on the accrual basis once the Federal waiver has been approved. Accordingly, all related supplemental payments have been recognized as revenue and related quality assurance fees have been recognized as expense as of September 30, 2022, and 2021. 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 ("CHFT") 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.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	The health care safety net in San Diego County is highly dependent upon hospitals and community health clinics to care for uninsured and medically underserved communities. Medi-Cal provides health insurance coverage for 1,000,000 in San Diego County in 2022 (almost 1 out of 3 people in San Diego County are Medi-Cal beneficiaries). San Diego County has the 2nd largest Medi-Cal population in California. Five percent of enrollees with the highest-cost needs account for over half of Medi-Cal spending. Finding more effective ways to coordinate and enhance the safety net is a critical policy challenge. While public subsidies help finance services for San Diego County's underinsured populations, these subsidies do not cover the full cost of care. Combined with Medi-Cal and Medicare funding shortfalls, Scripps and other local hospitals absorb the cost of caring for uninsured/underinsured patients in their operating budgets. This places a significant financial burden on hospitals and physicians. Scripps Mercy Hospital (including San Diego and Chula Vista campuses) provides 65 percent of the charity care within the Scripps system. Scripps Mercy's service area has a more economically disadvantaged population compared to the county, with the lowest numbers of insured adults in the county and a much higher percentage of ethnic minorities, primarily Hispanic and Asian. Scripps Mercy Hospital San Diego and Scripps Mercy Hospital Chula Vista campuses are designated by the government 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 Scripps Mercy San Diego and Chula Vista patients are government insured Medicare and Medi-Cal. Community Health Services During Fiscal Year 2022 (October 2021 to September 2022), Scripps invested $8,588,962 in community health services (does not include subsidized health). Subsidized Health Services included our inpatient behavioral health unit with a net community benefit of $3,157,043 (subsidized costs are included in the IRS Form 990 Schedule H Part I-line 7g). These figures reflects the costs associated with providing these programs, salaries, materials, and supplies minus revenue. Community Health Services 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. 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 grassroots movements, 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 documentation and activities described in the report are commitments we make to improve the health of both our patients and the diverse San Diego communities. As a longstanding member of these communities, and as a not-for-profit community resource, our goal and responsibility are to aid all who come to us for care, and to reach out especially to those who find themselves vulnerable and without support. This responsibility is an intrinsic part of our mission. Through our continued actions and community partnerships, we strive to raise the quality of life in the whole community. 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 CHNA are used to inform and adapt hospital programs and strategies better to meet the health needs of San Diego County residents. The following needs are addressed in the FY22 Community Benefit Plan and Report: - Access to Care 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 other services in the community. In addition, Scripps addresses many of the social determinants of health within the health conditions identified in the CHNA such as, community and social support, food insecurity, transportation, education, and homelessness.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	The following is a snapshot of Scripps Community Benefits provided in FY22. For more detailed information, see Scripps Health Annual Community Benefit Plan and Report at https://www.scripps.org/about-us/scripps-in-the-community. Community Benefit programs included recuperative care partnerships to provide a safe discharge for chronically homeless patients with ongoing medical needs; a collaboration between Father Joe's Village Street Health Intervention Project and Scripps Mercy Hospital targeting unsheltered discharged patients who could benefit from a follow-up visit in the community setting where they reside; financial and other support to community clinics to assist in providing and improving access to health services partnership with St Leo's Mission Community Clinic in which Scripps medical residents provided medical care to uninsured individuals; partnership with the American Red Cross to host blood drives; partnership with the Consumer Center for Health Education and Advocacy on a medical legal partnership to educate consumers about health care benefits and changes occurring with eligibility and enrollment in coverage programs; involvement in a mobile health and resource fair in Southeast San Diego to better meet the health care needs and provide more regular cardiovascular health and neurocognitive screenings, as well as resources and referrals for breast cancer screening to these underserved and often high-risk populations; services and support to seniors such as fall prevention and wellness education and the Advanced Care Clinic which provided intensive, proactive, medical, and social services to adults living with multiple chronic diseases; behavioral health partnership with Family Health Centers of San Diego (FHCSD) to create a more robust behavioral health care system for Medi-Cal patients that receive care at Scripps Mercy Hospital with the goal to 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; supportive mental health services at local based clinics and substance use disorder service (SUDS) nurses helping patients throughout the Scripps Health system who have been admitted to the hospital and are at risk for detox or who are actively experiencing detox from addictive substances; a variety of cancer programs and support services such as counseling, support groups, complementary therapies, and educational workshops; a variety of heart health, stroke, and cardiovascular disease prevention and treatment activities; addressed cardiovascular disease and Sudden Cardiac Arrest (SCA) in teens through our partnership with the Eric Paredes Save A Life Foundation; provided comprehensive, culturally sensitive diabetes care management programs to provide care for people in high-risk, underserved communities through Project Dulce, which uses nurses, dieticians and specially trained educators known as "Promotoras" to counsel diabetes patients while educating them to support others with diabetes within their own cultural groups; community members participated in a variety of classes, prevention lectures and support groups; held at the Scripps Chula Vista Well Being Center; provided bicycle/e-bike safety education and a car seat program to patients who have been in an automobile accident and their child's car seat has been rendered unsafe to use; assistance with food insecurity such as screening for Cal-Fresh, Scripps Mercy WIC program, identifying social determinants of health for patients post discharge and Scripps employee food sharing program; transportation partnership with Facilitating Access to Coordinated Transportation (FACT) Inc., for on-demand rides for patients to and from medical appointments. Health education and information provided on-site, virtually and in partnership with community-based organizations participation in community health fairs and events addressing the unique needs of the community Scripps executive leadership and staff also actively participated in numerous community organizations, committees, and coalitions to improve the health of the community. These costs are included in the IRS Form 990 Schedule H Part I-line 7e, and 7i. Professional Education and Health Research 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. Medical research also plays a vital role in improving the community's overall health by developing new and innovative treatments. Each year, Scripps allocates resources to advance health care services through clinical research, medical education, and health professional education. During Fiscal Year 2022 (October 2021 to September 2022), Scripps invested $36,406,050 in professional training programs and clinical research to enhance service delivery and treatment practices in San Diego County. This figure reflects the costs associated with clinical research, as well as professional education for non-Scripps employees, including graduate medical education, nursing resource development and other health care professional education. Research takes place primarily at Scripps Clinical Research Services, Scripps Whittier Diabetes Institute, Scripps Genomic Medicine, and Scripps Translational Science Institute. 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-line 7f and 7h. 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 has a comprehensive range of graduate medical education programs at Scripps Mercy Hospital, Scripps Family Practice Residency Program and Scripps Green Hospital. Scripps graduate medical education programs are well-known for excellence, provide a hands-on curriculum that focuses on patient-centered care and offer residencies in a variety of practices, including internal medicine, family medicine, podiatry, pharmacy, and palliative care. In Fiscal Year 2022, Scripps enrolled a total of 163 medical residents and 50 fellows throughout the Scripps health system. In addition, Scripps has a pharmacy residency program which trains residents with Doctor of Pharmacy degrees. 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 2022, Scripps hosted 1,287 students within our system and provided 225,232 development hours spanning nursing and allied health settings.
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED)	Scripps collaborates with local high schools, colleges, and universities to help students explore health care roles and gain firsthand experience as they work with Scripps professionals. Scripps is affiliated with more than 110 schools and programs, including clinical and nonclinical partnerships. Local schools include, but are not limited to, Point Loma Nazarene University (PLNU), University of California San Diego (UCSD), California State University San Marcos (CSUSM), San Diego State University (SDSU), University of San Diego (USD), Mesa College, San Diego City College, Grossmont College, Palomar College, and Mira Costa College. Scripps considers new partnerships, based on community and workforce needs, and maintains an affiliation agreement committee to review all requests and provide a systemwide approach to securing new students placements. This interdisciplinary committee represents education and department leadership across the Scripps system ensuring a proactive approach to building a career pipeline for top talent. To ensure students from health care professions programs have access to appropriate educational experiences at Scripps and foster a smooth, efficient process for student placement requests receipt and management, Scripps is a member of the San Diego Nursing and Allied Health Service Education Consortium and American Databank's Complio online compliance tracking system. Scripps is dedicated to building the future pipeline of health professionals. Scripps implements a wide variety of youth in health careers activities. A primary focus is to implement school-to-health career activities, including mentoring, camps, job shadowing, health education classes, health chats, support groups, health fairs and others. Scripps School to Health Career Pathway Program implemented a wide variety of youth-into-health-professions activities for 2,151 youth including mentoring programs, health professionals' classroom presentations, surgery viewing, work-study, and Scripps Camp. Through several internships and other educational programs, Scripps collaborates with high schools and colleges to offer students opportunities to explore a role in health care and gain first-hand experience working with Scripps health care professionals. Nurses and other clinical and non-clinical employees play important roles in these educational experiences, as the students are interacting with them daily through the programs. Due to COVID-19 and in-person restrictions all youth activities (mentoring, classroom presentations, hospital tours, surgery viewings) were transitioned to virtual platforms for distance learning for Fiscal Year 2022. Family Practice Medical Residents provide interactive classroom presentations on a variety of public health concerns, medically focused topics as well as hands-on clinical skills workshops mentoring at the local high schools. Advancing Health Equity Across the nation, there is increasing understanding that disparities exist in the health care and health status among patient populations, and in the outcomes of medical care. Providers of inpatient and ambulatory care have the unique capability and opportunity to contribute to reducing health disparities through a focus on reducing the variation in the outcomes of the clinical care services we provide, as part of our commitment to high quality care. To advance this work, Scripps has established a health equity council structure, composed of an acute care council, an ambulatory council, and a system workgroup which serves as the integration and oversight point for health equity efforts across the Scripps system. The work of the councils and the system work group is supported through Scripps health equity information center and operations data teams across the organization. Health Equity Definition To guide the work of the Council and health equity efforts across the Scripps system, Scripps has adopted the following health equity definition: At Scripps, health equity is addressing disparities in clinical quality, outcomes, and experience regardless of patients' diverse backgrounds. Diverse backgrounds include, yet are not limited to, race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status and age, among other factors. Reducing Variation in Care Outcomes Scripps has the unique capability and opportunity to reduce health disparities through reducing the variation in the outcomes of the clinical care services we provide. Scripps Health Equity Focus As the foundation for the efforts of our acute, ambulatory and system health equity work, Scripps focus for 2023 and 2024 is meeting the health equity requirements established at the federal and State levels of government and regulatory bodies: - Implement the role of our two Chief Medical Officers to lead activities to reduce health care disparities for patients - Assess the patient's health-related social needs and provides information about community resources and support services - Identify health care disparities in our patient population by stratifying quality and safety data using the sociodemographic characteristics of our patients - Develop a written action plan that describes how we will address at least one of the health care disparities identified in our patient population and act when we do not achieve or sustain the goal(s) in our action plan to reduce health care disparities Report on: -- Activities related to the collection equity-focused data and social determinants of health information -- Activities related to the analysis of health equity data to identify gaps -- Participation in quality improvement activities focused on reducing disparities -- Activities related to incorporating equity goals into our strategic plan -- Engagement of senior leadership in equity strategic planning and performance - Inform key stakeholders, including leaders, licensed practitioners, and staff, about our progress to reduce identified health care disparities, at least annually - Prepare an equity report that includes analysis of health status and access to care disparities for patients on the basis of age, sex, race, ethnicity, language, disability status, sexual orientation, gender identify and payer -- Includes a plan to reduce disparities including specific time frame and measurable objectives -- Is posted annually to Scripps' website - Collect and report to the California Department of Health Care Access and Information our hospital discharge abstract and emergency and ambulatory surgery data -- Billing Z codes (Z55-Z65) if a social determinant of health condition is captured in the medical record -- Patient's full address is reported, including ZIP code - Yes/No indicator is included to flag if the patient is experiencing homelessness 2022 Inventory of Health Equity Activities 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 many years. The inventory of this work in 2022 is contained in https://www.scripps.org/about-us/scripps-in-the-community.
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 +4.0% 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 +4.0% GEROGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +4.0% 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 +4.0% 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 +4.0% 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 08, 2021, JANUARY 26, 2022, AND MARCH 30, 2022. 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 +4.0% 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 +4.0% GEROGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +4.0% 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 +4.0% 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 +4.0% 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 08, 2021, JANUARY 26, 2022, AND MARCH 30, 2022. 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: XXX-XX-XXXX, Related or Exempt Function Revenue: XXX-XX-XXXX, Unrelated Business Revenue: 1014550, 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: 5339817, Fundraising Expenses: 0; OTHER PURCHASED SVS - NON MED - Total Expense: 87534827, Program Service Expense: 33726995, Management and General Expenses: 53586507, Fundraising Expenses: 221325; PHYSICIAN FEES - Total Expense: 79751560, Program Service Expense: 78554113, Management and General Expenses: 1197447, Fundraising Expenses: 0; PURCHASED MEDICAL SERVICES - Total Expense: 28891870, Program Service Expense: 28891870, Management and General Expenses: 0, Fundraising Expenses: 0; ALL OTHER FEES FOR SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: 94713002, Management and General Expenses: 11739515, Fundraising Expenses: 591240;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	CHANGE IN VALUE OF DEFERRED GIFTS - 934769; JOINT VENTURE DISTRIBUTION - 532036; OTHER CHANGES IN NET ASSETS - -92364; ROUNDING - -70127;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SCRIPPS CLINIC BILLING LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	870797749	HLTHCR ADMIN	CA	$535,995,947	$0	SCRIPPS HLTH
SCRIPPS MERCY BILLING LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	870737748	HLTHCR ADMIN	CA	$73,332,204	$0	SCRIPPS HLTH
IMAGING HEALTHCARE SPECIALISTS LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	203872122	MED IMAGING	CA	$57,776,666	$48,018,058	IHS HOLDING
SCRIPPS HOSPITAL BILLING SERVICES LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	611677183	HLTHCR ADMIN	CA	$8,896,356	$0	SCRIPPS HLTH
SCRIPPS CARDIOTHORACTIC SURGERY BILLING
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	270620996	HLTHCR ADMIN	CA	$5,577,977	$0	SCRIPPS HLTH
MAXWELL H MURIEL GLUCK CHILD CARE CTR
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	831953045	CHILDCARE	CA	$1,955,062	$1,415,631	SCRIPPS HLTH
SCRIPPS ACCOUNTABLE CARE ORGANIZATION
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	364837442	HLTHCR ADMIN	CA	$1,144,263	$737,208	SCRIPPS HLTH
SCRIPPS ASC MANAGEMENT LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	831187975	HLTHCR ADMIN	CA	$0	$0	SCRIPPS HLTH
IHS HOLDING COMPANY LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	473437677	HLTHCR ADMIN	CA	$0	$35,779,242	SCRIPPS HLTH
SCRIPPS BEHAVIORIAL HEALTH LLC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	834326624	HLTHCR ADMIN	CA	$0	$0	SCRIPPS HLTH
SCRIPPS HOME HEALTH HOSPICE VENTURE
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	841894278	HOME HEALTH/HOSPICE	CA	$45,601	$0	SCRIPPS HLTH

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
HORIZON HOSPICE
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	330220777	INACTIVE	CA	501(c)(3)	10	SCRIPPS HEALTH	Yes (true)
MERCY HOSPITAL FOUNDATION
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	942958094	FUNDRAISING	CA	501(c)(3)	Type I	SCRIPPS HEALTH	Yes (true)
SCRIPPS HEALTH PLAN SERVICES INC
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	330782099	HLTHCARE SVCS	CA	501(c)(3)	Type I	SCRIPPS HEALTH	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
SCRIPPS ENCINITAS SURGERY CTR
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75001	205942958	AMBUL SURGERY CTR	CA	SCRIPPS HEALTH	Related	$4,200,612	$1,849,435	false	$0	false	0.7475
SCRIPPSUSP SURGERY CTR
15305 DALLAS PKWY STE 1600 LB 28	ADDISON	TX	75001	205942911	AMBUL SURGERY CTR	CA	NA	Related	$258,422	$1,658,171	false	$0	false	0.5
SCRIPPS MERCY AMBUL SURG CTR
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	450503246	AMBUL SURGERY CTR	CA	SCRIPPS HEALTH	Related	$5,571,060	$3,621,141	false	$0	Yes (true)	0.735
SCRIPPS MEMORIAL XIMED MED CTR
9850 GENESEE AVE STE 900	LA JOLLA	CA	92037	330475481	REAL ESTATE	CA	SCRIPPS HEALTH	Related	$1,340,775	$3,679,639	false	$0	Yes (true)	0.153

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
CHARITABLE LEAD TRUST (1)
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	HOSPITAL SUPPORT	CA	NA	Trust	false
CHARITABLE REMAINDER TRUST (33)
10140 CAMPUS POINT DRIVE	SAN DIEGO	CA	92121	HOSPITAL SUPPORT	CA	NA	Trust	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (true)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Scripps Health Plan Services (SHPS)
M	$126,606,924	Accrual
Scripps Health Plan Services (SHPS)
Q	$38,385,601	Accrual
Scripps Encinitas Surgery Center
A	$410,061	Accrual
Scripps Mercy Ambulatory Surgery Center
A	$279,321	Accrual
Scripps Health Plan Services (SHPS
J	$163,306	Accrual
Scripps Health Plan Services (SHPS)
L	$388,133,847	Accrual