2020-11-13T18:25:39-06:00 2019-12-31 346565596 ERNST & YOUNG US LLP 560 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 990 2019-01-01 951914489 ST MARY MEDICAL CENTER STMA 7602422311 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 EUGENE GUTIERREZ CHIEF FINANCIAL OFFICER 7602422311 2020-11-13 1 EVA NITTA P01286320 4158948000 2020-11-10 152.169.64.19 2020-11-13 18:24:49 US P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8C6B038D826617A351DA504230A10C8935A538B8 2019 2021-01-29 14:40:06Z X PROVIDENCE ST MARY MEDICAL CENTER EUGENE GUTIERREZ 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 381827339 0 0928 X PROVIDENCE.ORG/LOCATIONS/ST-MARY-MEDICAL-CENTER X 1953 CA AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 11 10 1918 203 0 0 2807234 3130316 345829033 369732214 10805641 8716150 324006 185908 359765914 381764588 1576400 2667263 0 0 163980014 140695079 0 0 1120629 136433616 175011051 301990030 318373393 57775884 63391195 398944922 498998340 105338859 87207774 293606063 411790566 X AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE. 0 0 307383486 2667263 369168865 SEE SCHEDULE OPROVIDENCEON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (PHS) AND ST. JOSEPH HEALTH SYSTEM (SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT TO FORM PROVIDENCE ST. JOSEPH HEALTH (PROVIDENCE). BY COMING TOGETHER, PROVIDENCE SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST. TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1,085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON.THE FOUNDERS OF BOTH ORGANIZATIONS WERE COURAGEOUS WOMEN AHEAD OF THEIR TIME. THE SISTERS OF PROVIDENCE AND THE SISTERS OF ST. JOSEPH OF ORANGE BROUGHT HEALTH CARE AND OTHER SOCIAL SERVICES TO THE AMERICAN WEST WHEN IT WAS STILL A RUGGED, UNTAMED FRONTIER. NOW, AS WE FACE A DIFFERENT LANDSCAPE A CHANGING HEALTH CARE ENVIRONMENT WE DRAW UPON THEIR PIONEERING AND COMPASSIONATE SPIRIT TO PLAN FOR THE NEXT CENTURY OF HEALTH CARE.PROVIDENCE HEALTH & SERVICESIN 1856, MOTHER JOSEPH AND FOUR SISTERS OF PROVIDENCE ESTABLISHED HOSPITALS, SCHOOLS AND ORPHANAGES ACROSS THE NORTHWEST. OVER THE YEARS, OTHER CATHOLIC SISTERS TRANSFERRED SPONSORSHIP OF THEIR MINISTRIES TO PROVIDENCE, INCLUDING THE LITTLE COMPANY OF MARY, DOMINICANS AND CHARITY OF LEAVENWORTH. RECENTLY, SWEDISH HEALTH SERVICES, KADLEC REGIONAL MEDICAL CENTER AND PACIFIC MEDICAL CENTERS HAVE JOINED PROVIDENCE AS SECULAR PARTNERS WITH A COMMON COMMITMENT TO SERVING ALL MEMBERS OF THE COMMUNITY. ST. JOSEPH HEALTH SYSTEMIN 1912, A SMALL GROUP OF SISTERS OF ST. JOSEPH LANDED ON THE RUGGED SHORES OF EUREKA, CALIFORNIA TO PROVIDE EDUCATION AND HEALTH CARE. THEY LATER ESTABLISHED ROOTS IN ORANGE, CALIFORNIA, AND EXPANDED TO SERVE SOUTHERN CALIFORNIA, NORTHERN CALIFORNIA AND TEXAS. THE HEALTH SYSTEM ESTABLISHED MANY KEY PARTNERSHIPS, INCLUDING A MERGER BETWEEN LUBBOCK METHODIST HOSPITAL SYSTEM AND ST. MARY HOSPITAL TO FORM COVENANT HEALTH IN LUBBOCK, TEXAS. RECENTLY, AN AFFILIATION WAS ESTABLISHED WITH HOAG HEALTH TO INCREASE ACCESS TO SERVICES IN ORANGE COUNTY, CALIFORNIA. REALIZING OUR MISSIONST. MARY MEDICAL CENTER IS PART OF NEWLY FORMED PROVIDENCE ST. JOSEPH HEALTH. ST. MARY MEDICAL CENTER IS AN ACUTE-CARE HOSPITAL FOUNDED IN 1956 IN APPLE VALLEY, CA. IT BECAME A MEMBER OF ST. JOSEPH HEALTH IN 1994. THE FACILITY HAS 212 LICENSED BEDS AND A STAFF OF MORE THAN 1,751 AND PROFESSIONAL RELATIONSHIPS WITH MORE THAN 300 LOCAL PHYSICIANS. MAJOR PROGRAMS AND SERVICES INCLUDE CARDIAC CARE, CRITICAL CARE, DIAGNOSTIC IMAGING, EMERGENCY MEDICINE AND OBSTETRICS.PROGRAM SERVICE ACCOMPLISHMENTS:IDENTIFIED PRIORITIES - ACCESS TO RESOURCESINCREASING ACCESS TO RESOURCES WAS AN IDENTIFIED NEED THAT WAS ADDRESSED THROUGH OUR COMMUNITY CLINICS. THE HOSPITAL'S 2017 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORTS ACCESS CONCERNS BY 41.5% OF RESPONDENTS, AN INCREASE OVER THE 38.4% REPORTED IN THE 2007 CHNA, TEN YEARS PRIOR. THE HOSPITAL'S 2017 CHNA REVEALED THAT THE TOTAL SERVICE AREA SERVED IS SLIGHTLY WORSE IN UNINSURED, 20.3% OF ADULTS, VERSUS 19.3% FOR THE STATE OF CALIFORNIA, AND HAS LOWER RATES OF PRENATAL CARE IN THE FIRST TRIMESTER AS WELL, 79.0% IN OUR TOTAL SERVICE AREA VS. 83.8% FOR THE STATE. ST. MARY COMMUNITY CLINICS RUNS SEVERAL COMMUNITY BENEFIT PROGRAMS:1. BRIDGES FOR FAMILIES RESOURCE CENTER2. BRIGHT FUTURE MOBILE VAN3. HEALTHY BEGINNINGS MIDWIFERY PROGRAMTHE SERVICES PROVIDED THROUGH THE BRIGHT FUTURES MOBILE VAN INCLUDED PHYSICAL EXAMINATIONS, IMMUNIZATIONS, DIABETES SCREENING AND MANAGAGEMENT, CANCER SCREENINGS, AND CHRONIC DISEASE MANAGEMENT, SERVING MOSTLY UNINSURED PEOPLE THAT ARE NOT ELIGIBLE FOR GOVERNMENT PROGRAMS SUCH AS MEDICAID OR ARE NOT ELIGIBLE FOR SUBSIDIES THROUGH OUR INSURANCE EXCHANGE, COVERED CALIFORNIA. THE BRIGHT FUTURES MOBILE VAN HELPED LOW AND MODERATE-INCOME FAMILIES GET HEALTH CARE FOR WOMEN AND CHILDREN AND CONTINUED TO BRING HEALTHCARE SERVICES INTO COMMUNITIES WITH DISPROPORITIONATE UNMET HEALTH NEEDS (DUHN) IN ADELANTO, APPLE VALLEY, HESPERIA LUCERNE VALLEY AND VICTORVILLE. A NEW LOCATION WAS ADDED IN VICTORVILLE - FAMILY LIFE CHURCH. ALL OF THESE ARE LOCATED IN OUR PSA AND SSA. FOR 2019, A TOTAL OF 4,886 ENCOUNTERS ARE REPORTED FOR THE EIGHT (8) LOCATIONS: - ADELANTO CLINIC - SSA- JAMES WOODY CENTER (APPLE VALLEY) - PSA- ST. JOAN OF ARC (VICTORVILLE) PSA- PHOENIX ACADEMY (APPLE VALLEY) PSA- FAMILY LIFE CHURCH (VICTORVILLE) PSA- LUCERNE VALLEY SSA- APPLE VALLEY CLINIC PSA- HESPERIA CLINIC - PSATHE HEALTHY BEGINNINGS MIDWIFERY PROGRAM PROVIDES AN ARRAY OF SERVICES TO A SEGMENT OF THE POPULATION THAT EXPERIENCES DIFFICULTIES IN OBTAINING NEEDED PREGNANCY RELATED SERVICES IN THE CITIES OF ADELANTO, APPLE VALLEY AND HESPERIA. IT OFFERS SAFE PERSONALIZES HEALTHCARE INCORPORATING THE PHYSICAL, SOCIAL AND SPIRITUAL NEEDS OF THE WOMEN. THE MIDWIFERY PROGRAM IS OPEN TO THE UNINSURED AND UNDERINSURED (MEDICAID) PATIENTS. IN TOTAL 7,166 ENCOUNTERS ARE REPORTED FOR 2019. BRIDGES FOR FAMILIES RESOURCE CENTER OFFERS THE NURTURING PARENTING PROGRAM. THIS PROGRAM IS FUNDED BY FIRST 5 SAN BERNARDINO AND THE HOSPITAL, DESIGNED TO HELP PARENTS DEVELOP THE NECESSARY SKILLS TO RAISING HEALTHY CHILDREN AGES 0-5. IN 2018 THE ENCOUNTERS WERE 3,759 AND IN 2019 THERE WERE 5,067, AN INCREASE OF 35% FROM THE PREVIOUS YEAR. ALTHOUGH NOT RUN BY THE COMMUNITY CLINICS, THE MOTHER/BABY ASSESSMENT CENTER LACTATION CLINIC IS A COMMUNITY BENEFIT PROGRAM, OPEN TO ANYONE IN THE COMMUNITY. THIS PROGRAM CONTINUES TO RECEIVE REFERRALS OF PATIENTS FROM LOCAL HOSPITALS. 12,060 ENCOUNTERS ARE REPORTED FOR 2019.ST. JOSEPH HEALTH, ST. MARY WAS AND STILL REMAINS AS THE ONLY PROVIDER IN THE REGION PROVIDING COMPREHENSIVE DIABETES EDUCATION TO THE UNDERINSURED AND UNINSURED. PROVIDING DIABETES PATIENTS WITH PRIMARY CARE, CONSULTATIONS WITH A REGISTERED DIETICIAN, AND PARTICIPATION IN A DIABETES SUPPORT GROUP FOR A TOTAL OF 655 CLINICAL ENCOUNTERS. IN ADDITION, ST. JOSEPH HEALTH, ST. MARY PROVIDED A RESTRICTED $500,000 GRANT TO BORREGO HEALTHCARE FQHC TO PURCHASE A MOBILE DENTAL VAN TO PROVIDE FREE AND REDUCED DENTAL HEALTHCARE SERVICES TO RESIDENTS IN OUR HIGH DESERT REGION. THE DENTAL MOBILE VAN WILL BEGIN TO PROVIDE SERVICES IN 2020. IDENTIFIED NEED - EXPANDING OBESITY PREVENTION PROGRAMSIN THE 2014 CHNA, ADULT OVERWEIGHT AND ADULT OBESITY RATES HAD THE HIGHEST RECORDED PERCENT INCREASE FROM ITS 2007 BASELINE; INCREASING 6.6% TO 37% OVERWEIGHT ADULTS AND A 6.1% INCREASE TO 33% OBESE ADULTS FOR OUR REGION. BOTH THESE FIGURES WERE GREATER THAN ADULT STATE AVERAGES WHICH IN 2014 STOOD AT 36% OVERWEIGHT AND 24% OBESE. FOR THE 2017 CHNA, THE ADULT OBESITY RATES OF 37% IN OUR TOTAL SERVICE AREA WAS HIGHER THAN THAT OF THE STATE, WHICH STOOD AT 26%. TEENS ALSO FARED WORSE OFF AT 38% IN OUR TOTAL SERVICE AREA IN THE OVERWEIGHT OR OBESE CATEGORY, IN COMPARISON TO THE STATE'S 33%. TWO COMMUNITY BENEFIT PROGRAMS DEDICATED EFFORTS TO ADDRESS THE IDENTIFIED NEED IN AN UPSTREAM FASHION:1. COMMUNITIES OF EXCELLENCE - GEARED MOSTLY FOR ADULTS 2. YOUTH WELLNESS PROGRAM - FOCUSED ON SCHOOL AGED CHILDREN IN 2019, ST. JOSEPH HEALTH, ST. MARY HAD THE FOLLOWING ACHIEVEMENTS TO REPORT:- UNHEALTHY DIETS, WHICH ARE HIGH IN CALORIES AND LOW IN NUTRITION, AND THE CONSUMPTION OF SUGARY DRINKS, FEED INTO THE OBESITY PROBLEM. THE COMMUNITIES OF EXCELLENCE PROGRAM PROVIDED NUTRITION HEALTH EDUCATION AT ADELANTO, APPLE VALLEY AND HESPERIA LOGGING IN 373 ENCOUNTERS, COMPARABLE TO 2018 ENCOUNTERS OF 393. THESE FIVE WEEKLY NUTRITION CLASSES TAUGHT ON THE IMPORTANCE OF SODIUM REDUCTION, INCREASED PHYSICAL ACTIVITY, MY PLATE, AND HEALTHY BEVERAGES. - ANOTHER CONTRIBUTOR TO THE OBESITY PROBLEM IS NOT GETTING ENOUGH PHYSICAL ACTIVITY. THE COMMUNITIES OF EXCELLENCE PROGRAM ADDED PHYSICAL ACTIVITY CLASSES IN ADELANTO, APPLE VALLEY, AND HESPERIA. IN TOTAL 769 PEOPLE IN 2019, A 78% INCREASE FROM 2018 (432 PEOPLE) LIVING IN THESE THREE CITIES ENGAGED IN AN EXERCISE CLASS. IN TOTAL THEY LOGGED IN 7,338 A 26% INCREASE FROM 2018 WHICH LOGGED IN 5,833 EXERCISE CLASS ENCOUNTERS, WHICH ARE 1 HOUR IN DURATION. 307383486 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 X 0 0 1918 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 0 CA X JO ANN ESCASA-HAIGH 9493814000 3345 MICHELSON DRIVE SUITE 100 IRVINE CA 92612 JIM WATSON ESQ SECRETARY 1.00 59.00 X 0 843494 137810 ALAN GARRETT FORMER PRESIDENT/CEO 50.00 2.00 X 0 588476 47377 MARILYN DRONE COO SMMC 50.00 0.00 X 477380 0 43982 TRACEY FERNANDEZ VP FINANCE AND CFO 40.00 0.00 X 444156 0 44463 TARA COWELL FORMER SEC/TREASURER 2.00 52.00 X 0 440453 36845 RIAD ABDELKARIM MD CHIEF MEDICAL OFFICER-STMMC 40.00 0.00 X 394863 0 33576 KIMBERLY DEIMLING CERTIFIED NURSE MIDWIFE - NE 40.00 0.00 X 325738 0 40287 JEAN HOLTMAN FORMER MINISTRY CHRO PSJH 40.00 0.00 X 0 308210 34720 JUDY WAGNER CHIEF MISSION OFFICER (MINISTRY) 40.00 2.00 X 211454 88651 21836 MATTHEW CHANDLER EXEC DIR. ANCILLARY SERVICES 40.00 0.00 X 236617 0 37830 TAMARA BROWN EXECUTIVE DIRECTOR, NURSING 40.00 0.00 X 212961 0 20498 RANDY CASTILLO BOARD OF DIRECTORS/CEO 2.00 0.00 X X 0 193180 38567 OMER AHMED MD BOARD OF DIRECTORS/CHIEF OF STAFF 5.00 0.00 X 0 61890 0 ADOLPH COLLASO BOARD OF DIRECTORS/VICE CHAIR 5.00 0.00 X 0 0 0 PAUL GOSTANIAN BOARD OF DIRECTORS/CHAIR 5.00 0.00 X 0 0 0 CR BURKE BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 MARK YATES BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 REGINA WEATHERSPOON-BELL BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 SISTER JUDITH DUGAN BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 SISTER PAULETTE DETERS BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 SYED RAZA M D BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 ZOHEIR EL-HAJJAOUI MD BOARD OF DIRECTORS 2.00 0.00 X 0 0 0 2303169 2524354 537791 501 1 1 0 ALLIED ANESTHESIA MEDICAL GROUP INC 400 N TUSTIN STE 400 SANTA ANA CA 92705 MEDICAL SERVICES 1859075 HOSPITALIST MEDICINE PHYSICIANS OF CALIF PO BOX 742936 LOS ANGELES CA 90074 MEDICAL SERVICES 1779174 OBHG CALIFORNIA PC 777 LOWNDES HILL RD BLDG 1 GREENVILLE SC 29607 MEDICAL SERVICES 1706843 COR-CARE ASSOCIATES INC 17259 JASMINE STREET SUITE B VICTORVILLE CA 92395 MEDICAL SERVICES 1573850 SYNERGY CT SURGERY PARTNERSHIP 901 SAN BERNARDINO RD SUITE 102 UPLAND CA 91786 MEDICAL SERVICES 1496850 27 127500 1809926 468366 724524 3130316 NET PATIENT REVENUE 622110 366644601 366644601 HOSPITAL FEE 900099 2491208 2491208 CAFETERIA REVENUE 722514 563349 563349 DEBT EXTINGUISHMENTS 900099 24819 24819 CASH PURCHASES & DISCO 900099 402 402 7835 7835 369732214 3744351 3744351 44706 27052 17654 17654 17654 4971799 0 4971799 4971799 4971799 203953 127500 35699 168254 168254 381764588 369168865 0 9465407 X 2667263 2667263 123740481 119949889 3175259 615333 6162676 5981059 149623 31994 1347888 1306955 34289 6644 9444034 9173481 224326 46227 533944 533944 543384 543384 33683350 32725619 843243 114488 18955 387 18568 5492964 5280435 207908 4621 2426235 2415874 7936 2425 195146 124771 59917 10458 27505 22173 4806 526 1561916 1561916 8672697 7452327 1217049 3321 SYSTEM COST ALLOCATION 79464580 76723052 2463402 278126 MEDICAL SUPPLIES 38644002 38571508 68174 4320 HOSPITAL FEE 3212254 3212254 DUES AND SUBSCRIPTIONS 325002 122777 202209 16 209117 91746 115241 2130 318373393 307383486 9869278 1120629 4776520 10533297 2167067 1675057 1051600 1051600 37565148 42099653 676453 667220 3959571 4671266 4377662 56025 289319549 160038181 124240883 129281368 219159098 264958121 0 1041253 0 89467 970920 42874013 398944922 498998340 45754183 24529754 59584676 62678020 105338859 87207774 X 286627343 402542936 6978720 9247630 293606063 411790566 398944922 498998340 X 63391195 25813287 28980021 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 27742 27742 0 PART II-B, LINE 1: OTHER ACTIVITIES THE LOBBYING EXPENDITURES REPORTED REPRESENT THE PORTION OF DUES PAID TO ALLIANCE OF CATHOLIC HEALTH CARE, AMERICAN HOSPITAL ASSOCIATION AND CALIFORNIA HOSPITAL ASSOCIATION FOR LOBBYING SERVICES. 1196864 439605 160042 35500 12045 1748966 1246694 21740 -69070 2500 1196864 1135065 7661 175784 71816 1246694 1027182 12701 151440 56258 1135065 623378 400000 8629 4825 1027182 0.00000 1.00000 0.00000 0 1 1 30153187 30153187 127004184 90076782 36927402 328078 268120 59958 86719982 69693279 17026703 45114118 45114118 129281368 HOSPITAL FEE/PROVIDER TAX RECEIVEABLE 41544382 OTHER ASSETS 1329631 42874013 I/C - TAX-EXEMPT BOND LIABILITIES 47818255 DUE TO AFFILIATES 6911850 OTHER LIABILITIES 3347692 DUE TO THIRD PARTY 1652952 CAPITAL LEASE OBLIGATIONS 1164278 ACCRUED RETIREMENT COMPENSATION 1041253 ANNUITY & TRUST PAYABLE 740086 SECURITY DEPOSIT 1654 62678020 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS USE ENDOWMENT FUNDS WERE DESIGNED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS. GALA 331453 127500 203953 1300 15756 1725 16918 331453 127500 203953 1300 15756 1725 16918 35699 168254 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 0 13605 5362870 0 5362870 0.01680 0 48137 97640243 146647332 0 0.00000 61742 103003113 146647332 5362870 0.01680 11 27404 4154135 957821 3196314 0.01000 1 539 6016 0 6016 0.00000 3 24693 4464249 393581 4070668 0.01280 6 768 2442759 0 2442759 0.00770 21 53404 11067159 1351402 9715757 0.03050 21 115146 114070272 147998734 15078627 0.04730 1 217 2037 0 2037 0.00000 1 0 570 0 570 0.00000 2 217 2607 2607 0.00000 55348289 63005779 -7657490 X 1 1 1 1 ST MARY MEDICAL CENTER 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 WWW.STMARYAPPLEVALLEY.COM 240000207 X X X ST MARY MEDICAL CENTER 1 0 0 1 X X X X X X X X X 19 1 0 0 1 X SEE LINE 10A URL BELOW X 1 19 1 HTTP://WWW.PROVIDENCE.ORG/ABOUT/ANNUAL-REPORT/CHNA-AND-CHIP-REPORTS 0 1 X 200.000000000000 500.000000000000 X X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 SCHEDULE H, PART V, SECTION B, LINE 3E THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WERE BASED ON HEALTH NEEDS IN THE COMMUNITY. A FOUR STEP PROCESS WAS FOLLOWED THAT INCORPORATED THE EXPERIENCE, EXPERTISE, AND PERSPECTIVE OF BOTH INTERNAL AND EXTERNAL COMMUNITY STAKEHOLDERS. THIS PROCESS IDENTIFIED FIFTEEN (15) HEALTH NEEDS, AND THESE WERE SCORED AND RANKED BY COMMUNITY DATA, RESIDENT FOCUS GROUPS, RESIDENT COMMUNITY FORUM AND A NON-PROFIT/STAKEHOLDER FOCUS GROUP RESPONSES. THESE NEEDS WERE PRIORITIZED, AND THE TOP (NUMBER) THREE (3) "IDENTIFIED SIGNIFICANT NEEDS" OF THE COMMUNITY, BASED ON "TOTAL RANK SCORE" THAT WERE SELECTED BY THE COMMUNITY BENEFIT COMMITTEE ARE AS FOLLOWS:1. ACCESS TO RESOURCES2. MENTAL HEALTH AND SUBSTANCE ABUSE3. OBESITYSCHEDULE H, PART V, SECTION B, LINES 4 AND 8:THE FILING ORGANIZATION COMPLETED A CHNA PRIOR TO ITS JUNE 30, 2017 YEAR END. DURING 2017, THE FILING ORGANIZATION CHANGED ITS TAX YEAR END FROM JUNE 30 TO DECEMBER 31 IN 2017. AS A RESULT OF THIS CHANGE, A SHORT PERIOD TAX RETURN WAS FILED FOR THE PERIOD JULY 1, 2017 TO DECEMBER 31, 2017. THE FILING ORGANIZATION ADOPTED A CHNA FOR TAX YEAR 2019 AND WHILE ALL OF THE STEPS WERE COMPLETED PRIOR TO THE FILING OF THIS RETURN, THEY WERE NOT COMPLETED BY DECEMBER 31, 2019. THE COMPLETION OF THE CHNA AFTER DECEMBER 31, 2019 IS NOT AN IRC 501(R) FAILURE PURSUANT TO SECTION 1.501(R)-2(B) OF THE REGULATIONS BECAUSE IT WAS MINOR, INADVERTENT AND DUE TO REASONABLE CAUSE, AND HAS BEEN CORRECTED. IT WAS MINOR BECAUSE IT WAS A SINGLE TIMING ERROR BY A FILING ORGANIZATION OTHERWISE COMPLIANT WITH SECTION 501(R). IT WAS INADVERTENT AND DUE TO REASONABLE CAUSE BECAUSE THE SAME ERROR HAS NOT BEEN MADE PREVIOUSLY AND THE FILING ORGANIZATION HAS AN ESTABLISHED PROCESS FOR COMPLETING CHNAS. THE FILING ORGANIZATION IS AFFILIATED WITH A LARGE HEALTH SYSTEM WHERE THE COMPLETION OF THE CHNA IS COORDINATED ON A SYSTEM-WIDE LEVEL BY A TEAM DEDICATED TO COMMUNITY HEALTH IMPROVEMENT. IT HAS BEEN CORRECTED THROUGH THE COMPLETION OF THE CHNA PRIOR TO FILING THE 2019 FORM 990 AND BY MAKING THE RESULTS OF THE 2019 CHNA WIDELY AVAILABLE. SCHEDULE H, PART V, SECTION B, LINE 5 COMMUNITY INPUTIN CONDUCTING THE CHNA TO IDENTIFY NEEDS, THE HOSPITAL INVITED BOTH LOCAL RESIDENTS AND LEADERS TO THREE (3) RESIDENT FOCUS GROUPS ONE (1) RESIDENT COMMUNITY FORUM AND ONE (1) NON-PROFIT/GOVERNMENT STAKEHOLDER FOCUS GROUP, ALL OF THESE WERE FACILITATED BY THE CONSULTANT, THE OLIN GROUP.THE THREE (3) RESIDENT FOCUS GROUPS WERE CONDUCTED IN THE CITIES OF ADELANTO, APPLE VALLEY AND HESPERIA IN AREAS WHERE HEALTH, PHYSICAL ENVIRONMENT AND SOCIOECONOMIC MATTERS ARE OF GREAT CONCERN. THESE WERE HOSTED AT COMMUNITY-BASED ORGANIZATIONS AND THESE WERE ASKED TO RECRUITPARTICIPANTS. BOTH THE COMMUNITY-BASED ORGANIZATION AND PARTICIPANTS WERE INCENTIVIZED. THESE FOCUS GROUPS WERE FACILITATED BY AN OUTSIDE CONSULTANT, THE OLIN GROUP, IN BOTH ENGLISH AND SPANISH.THE ADELANTO RESIDENT FOCUS GROUP WAS HOSTED BY THE ORGANIZATION, ANOTHER LEVEL FOR WOMEN. ANOTHER LEVEL FOR WOMEN IS A FAITH-BASED NONPROFIT ORGANIZATION DEDICATED TO PROVIDING FINANCIAL, EMOTIONAL, AND EDUCATIONAL SUPPORT SERVICES FOR WOMEN IN THE HIGH DESERT COMMUNITY, PARTICULARLY EXTREMELY LOW-INCOME WOMEN WITH CHILDREN. ANOTHER LEVEL FOR WOMEN RECRUITED FOR AND HOSTED THE ADELANTO RESIDENT FOCUS GROUP AND IT WAS CONDUCTED IN SPANISH.THE HESPERIA RESIDENT FOCUS GROUP WAS HOSTED BY HESPERIA UNIFIED SCHOOL DISTRICT FAMILY RESOURCE CENTER (FRC). THE FRC SERVES FAMILIES IN HESPERIA AND BEYOND WITH SUCH SERVICES AS EDUCATIONAL CLASSES, A LENDING LIBRARY, A TECHNOLOGY CENTER, AND EMERGENCY FOOD AND CLOTHING RESOURCES. THE FRC RECRUITED FOR AND HOSTED THE HESPERIA RESIDENT FOCUS GROUP AND IT WAS CONDUCTED IN ENGLISH.THE APPLE VALLEY RESIDENT FOCUS GROUP WAS HOSTED BY PHOENIX ACADEMY. PART OF THE APPLE VALLEY UNIFIED SCHOOL DISTRICT, PHOENIX ACADEMY SERVES APPROXIMATELY 1,500 KINDERGARTEN THROUGH 8TH GRADE STUDENTS. PHOENIX ACADEMY RECRUITED FOR AND HOSTED THE APPLE VALLEY RESIDENT FOCUS GROUP FOR THE VISTA LOMA AND YUCCA LOMA NEIGHBORHOODS AND IT WAS CONDUCTED IN ENGLISH WITH SPANISH TRANSLATION.THE THREE (3) RESIDENT FOCUS GROUPS FOLLOWED THE SAME PROTOCOL, AND THE SAME LINE OF QUESTIONS. FIRST, THEY SHARED THE HEALTH NEEDS THAT EMERGED FROM GATHERING PUBLICLY AVAILABLE RELIABLE GOVERNMENT SECONDARY DATA, AND ASKED THE RESIDENTS TO COMMENT ON THEM, AND FINALLY TOOK A VOTE TO DOCUMENT THEIR GREATEST CONCERNS.ONE (1) RESIDENT COMMUNITY FORUM WAS CONDUCTED IN THE CITY OF VICTORVILLE, THE OLD TOWN SECTION, AND WAS HOSTED BY TRINITY LUTHERAN CHURCH, PART OF THE EVANGELICAL LUTHERAN CHURCH IN AMERICA, WHICH SERVES THE SPIRITUAL NEEDS OF THE VICTORVILLE AREA AND BEYOND. THE RESIDENT COMMUNITY FORUM WAS BROADLY ADVERTISED, OPEN TO ANYONE IN THE PUBLIC, NO INCENTIVE WAS PROVIDED. THE OUTSIDE CONSULTANT, OLIN GROUP, FACILITATED THE FORUM. WHILE THE RESIDENT FOCUS GROUPS FOLLOWED A SIMILAR PROTOCOL IN WHICH FIVE (5) TO SIX (6) QUESTIONS WERE ASKED OF THE GROUP, THE RESIDENT COMMUNITY FORUM FOLLOWED A DIFFERENT PROCESS. THE OLIN GROUP SHARED THE HEALTH NEEDS THAT HAD EMERGED FROM THE CHNA PROCESS SO FAR, AND ASKED PARTICIPANTS TO COMMENT ON THEM, ADD ANY CONCERNS AND FINALLY TAKE A VOTE ON THEIR GREATEST CONCERNS. THE COMMUNITY RESIDENT FORUM WAS CONDUCTED IN ENGLISH WITH SPANISH TRANSLATION.RESIDENTS WHO PARTICIPATED IN EITHER OF THE THREE (3) FOCUS GROUPS OR THE COMMUNITY FORUM WERE ASKED TO COMPLETE AN ANONYMOUS SURVEY TO CAPTURE DEMOGRAPHIC INFORMATION. IN TOTAL THERE WERE 69 RESPONDENTS, AND BASED ON THE ANSWERS, THESE ARE THE DEMOGRAPHICS TO REPORT:- 89% WERE FEMALE, 11% WERE MALE.- 62% IDENTIFIED AS HISPANIC/LATINO- 22% AS NON-LATINO WHITE- 12% AS BLACK/AFRICAN AMERICAN- 3% AS NATIVE AMERICAN- 1% AS NATIVE HAWAIIAN OR PACIFIC ISLANDER AND- 3% AS "OTHER" - ARAB/NORTH AFRICAN.OF THE 69 RESPONDENTS, 33% REPORTED AS HAVING A CHRONIC DISEASE.THE MAJORITY OF PEOPLE CAME FROM TWO AGE GROUPS:- 48% FROM THE AGE GROUP 18-44- 39% FROM THE AGE GROUP 45-64THE TOTAL HOUSEHOLD INCOME BEFORE TAXES HAD A MIX OF ANSWERS:- 30% OF THE 69 RESPONDENTS REPORTED LESS THAN $20,000- 28% REPORTED $20,000 - $34,999- 10% REPORTED $35,000 - $49,999- 21% REPORTED $50,000 - $74,999- 3% REPORTED $75,000 - $99,999- 8% REPORTED $100,000 OR MORE.PLEASE NOTE THAT SOME DECLINED TO ANSWER THIS QUESTION, AND THESE WERE NOT INCLUDED IN THE CALCULATION OF PERCENTAGES.THE NON-PROFIT/GOVERNMENT STAKEHOLDER FOCUS GROUP WAS HOSTED BY THE ACADEMY FOR GRASSROOTS ORGANIZATIONS (GO), LOCATED IN VICTORVILLE. ACADEMY GO WORKS TO IMPROVE THE QUALITY OF LIFE IN THE HIGH DESERT REGION BY SUPPORTING AND STRENGTHENING THE SOCIAL SERVICE SECTOR. THEY PROVIDE A VARIETY OF RESOURCES AND NONPROFIT LEARNING OPPORTUNITIES THROUGHOUT THE REGION AND SERVE A NETWORK OF MORE THAN 1,000 NONPROFIT PROFESSIONALS AND VOLUNTEERS. THE NON-PROFIT/GOVERNMENT STAKEHOLDER FOCUS GROUP HAD TWENTY (20) PARTICIPANTS REPRESENTING VARIOUS COMMUNITY ORGANIZATIONS THAT SERVE MINORITY COMMUNITIES, LOW-INCOME, MEDICALLY UNDERSERVED AND GOVERNMENT ENTITIES. THE OUTSIDE CONSULTANT, OLIN GROUP, FACILITATED THE FORUM BY SHARING THE HEALTH NEEDS THAT EMERGED THROUGH RESEARCH OF RELIABLE SECONDARY DATA, AND ASKED THE PARTICIPANTS TO COMMENT ON THEM, AND FINALLY TAKE A VOTE ON THEIR GREATEST CONCERNS. PARTICIPANTS IN THE NON-PROFIT/STAKEHOLDER FOCUS GROUP WERE INVITED BY THE HOSPITAL AND NO INCENTIVE WAS PROVIDED. PARTICIPANTS INCLUDED:- ACADEMY FOR GRASSROOTS ORGANIZATION (GO). THIS IS A NON-PROFIT ENGAGED IN CAPACITY BUILDING OF OTHER NON-PROFITS IN THE HIGH DESERT REGION.- CITY OF HESPERIA, HEALTHY HESPERIA, A CITY LED INITIATIVE FOCUSED ON CREATING HEALTHIER COMMUNITIES.- COMMUNITY ACTION PARTNERS OF SAN BERNARDINO COUNTY- DESERT/MOUNTAIN CHILDREN'S CENTER, A COUNSELING CENTER DESIGNED TO MEET THE THERAPEUTIC NEEDS OF NEWBORNS TO 22 YEARS OF AGE.- DEPARTMENT OF PUBLIC HEALTH, COUNTY OF SAN BERNARDINO.- FAMILY ASSISTANCE PROGRAM, A NON-PROFIT THAT PROVIDES SHELTER FOR HOMELESS YOUTH, VICTIMS OF DOMESTIC VIOLENCE WITH THEIR FAMILIES AND PETS, AND VICTIMS OF SEXUAL TRAFFICKING.- GLOBAL INSTITUTE FOR PUBLIC STRATEGIES, A NON-PROFIT ORGANIZING RESIDENTS TO REVITALIZE OLD TOWN VICTORVILLE (R.O.O.T.).- RESIDENT PARTICIPANT IN THE R.O.O.T. INITIATIVE.- HEALTHY SNOWLINE, AN INITIATIVE ENGAGED IN CREATING HEALTHIER COMMUNITIES IN PHELAN AND PINON HILLS.- INLAND EMPIRE HEALTH PLAN (IEHP), A MEDICAID HEALTH PLAN FOR BOTH THE SAN BERNARDINO AND RIVERSIDE COUNTIES.- INLAND EMPIRE UNITED WAY.- INLAND EMPIRE UNITED WAY DESERT COMMUNITIES REGION.- OFFICE OF FIRST DISTRICT SUPERVISOR LOVINGOOD'S OFFICE.- NATIONAL CORE, A NON-PROFIT HOUSING DEVELOPER.- SAN BERNARDINO COUNTY SUPERINTENDENT OF SCHOOLS, IN APPLE VALLEY.- SAN BERNARDINO COUNTY WORKFORCE DEVELOPMENT DEPARTMENT IN VICTORVILLE.- SHERIFF'S DEPARTMENT - CITY OF ADELANTO- ST. JOHN OF GOD HEALTHCARE SERVICES A SUBSTANCE ABUSE TREATMENT AND REHABILITATION CENTER.- STARS CRISIS WALK-IN CENTER, A 24 HOUR CRISIS INTERVENTION AND STABILIZATION CENTER.- THE VICTOR VALLEY TRANSIT AUTHORITY, A PUBLIC TRANSPORTATION ENTITY. IN ADDITION TO THESE GROUPS, PUBLIC HEALTH OFFICIALS REVIEWED THE FINAL DRAFT OF THE CHNA REPORT WITH SAN BERNARDINO COUNTY PUBLIC HEALTH'S COMMUNITY VITAL SIGNS AND HEALTHY COMMUNITIES PROGRAMS. INFORMATION WAS REQUESTED TO ASSIST IN DEVELOPING A 2015-2020 SAN BERNARDINO COUNTY TRANSFORMATION PLAN FOCUSED IN FOUR (4) AREAS: ECONOMY, EDUCATION, HEALTH AND WELLNESS, AND SAFETY. SCHEDULE H, PART V, SECTION B, LINE 11 THE HOSPITAL IDENTIFIED AND IS FOCUSING ON THE FOLLOWING THREE (3) PRIORITIES:1. ACCESS TO RESOURCES - INCLUDES MOST BARRIERS TO ACCESSING HEALTH CARE SERVICES AND OTHER NECESSARY RESOURCES, SUCH AS TRANSPORTATION, A SHORTAGE OF PROVIDERS, PARTICULARLY SPECIALISTS SUCH AS PEDIATRICIANS, DENTISTS, AND ORTHOPEDISTS, LANGUAGE BARRIERS, AND RESOURCES BEING UNAVAILABLE OUTSIDE OF WORKING HOURS. THIS NEED EMERGED AS A CONSISTENT PRIORITY THROUGHOUT THE CHNA PROCESS. IT WAS A MAJOR DISCUSSION POINT IN EVERY FOCUS GROUP AND RECEIVED SUBSTANTIAL SUPPORT IN THE COMMUNITY FORUM. THE SECONDARY DATA SHOWS THAT THE COUNTY OF SAN BERNARDINO HAS RELATIVELY FEW PHYSICIANS AND DENTIST COMPARED TO THE STATE OF CALIFORNIA AVERAGES. THE ISSUE WAS IDENTIFIED AS A TOP PRIORITY THROUGH THE PRIORITIZATION PROCESS AND WAS ENDORSED BY THE COMMUNITY BENEFIT COMMITTEE. THE COMMITTEE DISCUSSED EXPANDING COMMUNITY BENEFIT PROGRAMS AND CLINIC VISITS TO THE POOR.THIS NEED IS BEING ADDRESSED BY FOUR COMMUNITY BENEFIT PROGRAMS:1. BRIDGES FOR FAMILIES RESOURCE CENTER - OFFERING NURTURING PARENTING PROGRAM TO FAMILIES AND CONNECTING THEM TO OTHER RESOURCES.2. BRIGHT FUTURES MOBILE CLINIC - BRINGING HEALTHCARE INTO COMMUNITIES WITH DISPROPORTIONATE UNMET HEALTH NEEDS (DUHN) IN ADELANTO, APPLE VALLEY, HESPERIA, LUCERNE VALLEY AND VICTORVILLE.3. HEALTHY BEGINNINGS MIDWIFERY PROGRAM - BRINGING TRAINED PRENATAL STAFF TO POPULATIONS THAT EXPERIENCES DIFFICULTIES IN OBTAINING NEEDED PREGNANCY RELATED SERVICES IN THE CITIES OF ADELANTO, APPLE VALLEY AND HESPERIA.4. MOTHER/BABY ASSESSMENT CENTER LACTATION CLINIC - IN PATIENT LACTATION SUPPORT AND FOLLOW-UP CLINIC PROVIDES BREASTFEEDING SUPPORT WITH LACTATION SPECIALISTS TO HELP MAKE BREASTFEEDING MORE COMFORTABLE FOR BOTH MOM AND BABY.5. GRANT TO BORREGO HEALTHCARE - TO SECURE A DENTAL MOBILE VAN TO PROVIDE FREE DENTAL CARE TO HIGH DESERT RESIDENTS.IN SCHEDULE O, PART III, LINE 4A, ARE THE FULL YEAR ACCOMPLISHMENTS REPORTED FOR THIS IDENTIFIED NEED.2. MENTAL HEALTH AND SUBSTANCE ABUSE - COVERS ALL AREAS OF EMOTIONAL, BEHAVIORAL, AND SOCIAL WELL-BEING FOR ALL AGES. INCLUDES ISSUES OF STRESS, DEPRESSION, COPING SKILLS, AS WELL AS MORE SERIOUS HEALTH CONDITIONS SUCH AS MENTAL ILLNESS AND ADVERSE CHILDHOOD EXPERIENCES. THESE WERE COMBINED BY THE COMMUNITY BENEFIT COMMITTEE. COMMITTEE MEMBERS DISCUSSED THAT MENTAL HEALTH WILL BE A PRIORITY FOCUS OF PROVIDENCE ST. JOSEPH HEALTH OVER THE NEXT TEN YEARS. MENTAL HEALTH WAS A FREQUENT THEME IN THE FOCUS GROUPS AND THE FORUM, PARTICULARLY FOCUSING ON THE STRESSES CAUSED BY ECONOMIC INSECURITY, THE CHALLENGES FACED BY CHILDREN AND TEENS, AND THE LACK OF PROVIDERS. THE LACK OF PROVIDERS IS SUPPORTED BY RELIABLE SECONDARY DATA. MENTAL HEALTH WAS THE SECOND HIGHEST PRIORITY THROUGH THE PRIORITIZATION PROCESS; SUBSTANCE ABUSE CAME IN SIXTH, AND WAS ALSO A STRONG THEME ACROSS ALL FOCUS GROUPS.THIS NEED IS BEING ADDRESSED BY THREE COMMUNITY BENEFIT PROGRAMS:1. BRIDGES FOR FAMILIES RESOURCE CENTER - PROVIDES SHORT-TERM COUNSELING FOR INDIVIDUALS, COUPLES OR FAMILY.2. GRANT - FAMILY ASSISTANCE PROGRAM - GRANT TO PROVIDE COUNSELING TO HOMELESS YOUTH. 3. GRANT - ST. JOHN OF GOD - GRANT TO INTEGRATE MENTAL HEALTH SERVICES WITH 90 DAY SUBSTANCE ABUSE TREATMENT AND REHABILITATION PROGRAM.IN SCHEDULE O, PART III, LINE 4A, ARE THE FULL YEAR ACCOMPLISHMENTS REPORTED FOR THIS IDENTIFIED NEED.3. OBESITY - PRIMARILY DEFINED AS THE HEALTH CONDITION IN WHICH INDIVIDUALS ARE SUFFICIENTLY OVERWEIGHT AS TO HAVE DETRIMENTAL EFFECTS ON THEIR OVERALL HEALTH. THIS DOES NOT INCLUDE ISSUES OF EXERCISE OR FOOD CHOICES, WHICH ARE LISTED AS SEPARATE ISSUES. OBESITY WAS FREQUENTLY DISCUSSED IN THE FOCUS GROUPS, PARTICULARLY IN CONJUNCTION WITH ROOT CAUSES SUCH AS NUTRITION AND LACK OF EXERCISE, WITH CHALLENGES WITH WALKABILITY. OBESITY WAS IDENTIFIED AS THE THIRD HIGHEST PRIORITY IN THE PRIORITIZATION PROCESS. THIS NEED IS BEING ADDRESSED BY TWO COMMUNITY BENEFIT PROGRAMS:1. COMMUNITIES OF EXCELLENCE - TARGETING ADULTS BY PROVIDING NUTRITION CLASSES AND FREE OPPORTUNITIES TO DO PHYSICAL ACTIVITY. 2. YOUTH WELLNESS PROGRAM - TARGETING SCHOOL AGED CHILDREN BY TEACHING A WELLNESS CURRICULUM.IN SCHEDULE O, PART III, LINE 4A, ARE THE FULL YEAR ACCOMPLISHMENTS REPORTED FOR THIS IDENTIFIED NEED.NEEDS BEYOND THE HOSPITAL'S SERVICE PROGRAMNO HOSPITAL FACILITY CAN ADDRESS ALL OF THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. OUR MISSION, "AS EXPRESSIONS OF GOD'S HEALING LOVE, WITNESSED THROUGH THE MINISTRY OF JESUS, WE ARE STEADFAST IN SERVING ALL, ESPECIALLY THOSE WHO ARE POOR AND VULNERABLE," IS BEST LIVED BY PARTNERING WITH LIKE-MINDED ORGANIZATIONS THAT COUNT WITH THE CAPACITY AND EXPERTISE TO ADDRESS THE NEEDS OF HIGH DESERT RESIDENTS. WE ARE COMMITTED TO LIVING OUT OUR MISSION THROUGH OUR OWN COMMUNITY BENEFIT PROGRAMS, BY PARTNERING WITH LIKE-MINDED PARTNERS AND BY FUNDING OTHER NON-PROFITS THROUGH OUR CARE FOR THE POOR GRANT FUNDS MANAGED BY ST. JOSEPH HEALTH, ST. MARY.FURTHERMORE, ST. JOSEPH HEALTH, ST. MARY WILL ENDORSE LOCAL NON-PROFIT ORGANIZATION PARTNERS TO APPLY FOR FUNDING THROUGH THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND. ORGANIZATIONS THAT RECEIVE FUNDING PROVIDE SPECIFIC SERVICES AND RESOURCES TO MEET THE IDENTIFIED NEEDS OF UNDERSERVED COMMUNITIES THROUGHOUT ST. JOSEPH HEALTH, ST. MARY'S SERVICE AREAS.THE FOLLOWING COMMUNITY HEALTH NEEDS IDENTIFIED IN THE MINISTRY CHNA WILL NOT BE ADDRESSED AND AN EXPLANATION IS PROVIDED BELOW:DIABETES: SPECIFICALLY FOCUSED ON THE HEALTH CONDITION OF DIABETES, AND AWARENESS AND PREVENTION OF IT. THE COMMUNITY HEALTH NEEDS ASSESSMENT RANKED THE EXPERTISE IN ADDRESSING THIS HEALTH OUTCOME IN 4TH PLACE. ALTHOUGH NOT RANKED IN THE TOP THREE NEEDS, A COMMUNITY BENEFIT PROGRAM, "ST. JOSEPH HEALTH, ST. MARY'S DIABETES PROGRAM," RUN BY OUR COMMUNITY CLINICS, ADDRESSES THIS NEED. "ST. JOSEPH HEALTH, ST. MARY'S DIABETES PROGRAM" REMAINS THE ONLY AMERICAN DIABETES ASSOCIATION CERTIFIED PROGRAM IN THE HOSPITAL'S TOTAL SERVICE AREA. THE PROGRAM EXPANDS NUTRITIONAL AND CERTIFIED DIABETES TRAINED STAFF FROM HOSPITAL-BASED DIABETES AND CHILD OBESITY PROGRAMS. PROGRAM STAFF CONTINUE PARTICIPATING IN A SJH REGIONAL DIABETES WORKGROUP SHARING BEST PRACTICES. A REFERRAL RELATIONSHIP HAS BEEN ESTABLISHED FROM PHYSICIANS OF ST. MARY HIGH DESERT MEDICAL GROUP. THE TARGETING OF DIABETES EDUCATION IN NEIGHBORHOODS WITH POOR AND UNINSURED PERSONS AND POPULATIONS HAS INCREASED THROUGH INTRODUCTION TO RESIDENTS OF "COMMUNITIES OF EXCELLENCE," ANOTHER COMMUNITY BENEFIT PROGRAM, WITH A FOCUS ON NUTRITION AND PHYSICAL ACTIVITY. EFFORTS TO DISCUSS DIABETES SCREENING DURING FOOD PANTRY GIVEAWAYS STARTED. IN ADDITION, THE HOSPITAL'S DIABETES PROGRAM IS STARTING TO IMPLEMENT A CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) CURRICULUM, "DIABETES PREVENTION PROGRAM," THROUGHOUT THE HIGH DESERT.FOOD AND NUTRITION: CONCERNS ABOUT HEALTHY EATING HABITS, NUTRITION KNOWLEDGE, AND CHALLENGES OF COST AND AVAILABILITY OF HEALTHY OPTIONS. THIS NEED IS ADDRESSED BY LIKE-MINDED PARTNERS. AN INTEGRATED APPROACH TO ADDRESS ISSUES OF BEING A FOOD DESERT ARE BEING TACKLED THROUGH A REGIONAL APPROACH - THE COMMUNITY ACTION PARTNERSHIP - HIGH DESERT FOOD COLLABORATIVE. NON-PROFITS OUTSIDE OUR REGION ARE BEING APPROACHED, AS WAS THE CASE WITH LOS ANGELES BASED FOOD FORWARD. THIS NON-PROFIT WAS RECRUITED TO PROVIDE DONATIONS OF FRESH FRUITS AND VEGETABLES TO LOCAL FOOD PANTRIES OPERATED IN ADELANTO, APPLE VALLEY, PHELAN AND VICTORVILLE. THE MAJORITY OF FOOD PANTRIES ARE OPERATED BY CHURCHES: BROKEN HEARTS MINISTRY, THE LORD'S TABLE, ANOTHER LEVEL FOR WOMEN, VICTOR VALLEY RESCUE MISSION. OTHER NON-PROFITS WORKING AROUND THIS NEED ARE THE HIGH DESERT OUTREACH CENTER, SQUASH4FRIENDS, AND SCHOOLS THAT ARE HOSTING SUMMER MEAL PROGRAMS. COMMUNITY ACTION PARTNERSHIP RECEIVED A PLANNING GRANT FROM THE ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND, TO BEGIN DEVELOPING A TIMELINE FOR OPENING A LOCAL HIGH DESERT OFFICE THAT WOULD INCLUDE A SMALL FOOD BANK. IN 2019 COMMUNITY ACTION PARTNERSHIP SECURED A SPACE INSIDE THE IEHP RESOURCE CENTER (IEHP IS THE COUNTY RUN MEDICAID HEALTH PLAN) IN THE CITY OF VICTORVILLE WHERE THEY ARE DOING FOOD DISTRIBUTION, WEATHERIZATION, RENTAL AND UTILITY ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 11 (CONT'D) SUBSTANCE ABUSE: PERTAINS TO THE MISUSE OF ALL DRUGS, INCLUDING ALCOHOL, MARIJUANA, OPIATES, PRESCRIPTION MEDICATION, AND OTHER LEGAL OR ILLEGAL SUBSTANCES. IT DOES NOT ENCOMPASS CIGARETTE SMOKING, WHICH WAS CONSIDERED SEPARATELY AND NOT IDENTIFIED AS A SIGNIFICANT HEALTH NEED. THIS ISSUE IS TIED VERY CLOSELY TO MENTAL HEALTH (WHICH WAS IDENTIFIED AS A PRIORITY) AND WILL BE ADDRESSED. OUR HOSPITAL'S LACK OF EXPERTISE IN THIS MATTER HAS PLACED US IN CONTACT WITH OTHER LIKE-MINDED NON-PROFIT PARTNERS. WE GAVE, AND FORESEE CONTINUING GIVING, CARE FOR THE POOR RESTRICTED FUNDS, TO PROVIDE COUNSELING FOR PARTICIPANTS OF ST. JOHN OF GOD'S HEALTHCARE SERVICES' 90-DAY DRUG AND ALCOHOL CENTER. PRIOR TO THIS GRANT, THE COUNSELING SERVICE WAS NOT OFFERED, AND NOW PARTICIPANTS ON THIS SUBSTANCE ABUSE PROGRAM CAN EXPLORE THE UNDERLYING REASONS BEHIND THEIR SUBSTANCE ABUSE, ADDRESS THAT TRAUMA, AND CAN DEVISE A PLAN TO COPE WITHOUT THE USE OF DRUGS AND LIQUOR.LACK OF EXERCISE: IN ADDITION TO THE BEHAVIOR ITSELF, IT ALSO INCLUDES ISSUES AROUND ACCESS TO PLACES TO EXERCISE AND PEOPLE NOT HAVING ENOUGH TIME TO EXERCISE. THIS ISSUE IS TIED VERY CLOSELY TO OBESITY (WHICH WAS IDENTIFIED AS A PRIORITY) AND WILL BE ADDRESSED BY "COMMUNITIES OF EXCELLENCE, AND WITH THE ADELANTO UNITIY CENTER, TOWN OF APPLE VALLEY PARKS AND RECREATION DEPARTMENT, HESPERIA PARKS AND RECREATION AND THE VICTORVILLE ARKS AND RECREATION DEPARTMENT. ALL OF THESE LIKE-MINDED PARTNERS HOST FREE WEEKLY PHYSICAL ACTIVITY CLASSES. ALSO, THROUGH THE HEALTHY CITIES INITIATIVES IN ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE, WE CONSTANTLY ADVOCATE CITY LEADERS TO CREATE BIKE PATHWAYS, MORE PARKS AND SAFETY MEASURES SO THAT MORE FAMILIES CAN ENJOY THE PARKS AND THEIR SURROUNDING NEIGHBORHOODS.ECONOMIC INSECURITY: IDENTIFIED AS A ROOT CAUSE OF OTHER HEALTH ISSUES, THIS ISSUE COVERS THE EFFECTS OF POVERTY AND ECONOMIC CONCERNS AS WELL AS DIFFICULTIES AROUND FINDING JOBS THAT PAY LIVABLE SALARIES. ST. JOSEPH HEALTH, ST. MARY WILL COLLABORATE WITH LOCAL CITY ECONOMIC DEVELOPMENT DEPARTMENTS, AND THE WORKFORCE DEVELOPMENT FORCE THAT ADDRESS THE AFOREMENTIONED COMMUNITY NEEDS. IN ADDITION, ST. JOSEPH HEALTH, ST. MARY IS PART OF THE ST. JOSEPH HEALTH SYSTEM AND AS SUCH WE FOLLOW CATHOLIC SOCIAL TEACHINGS WHICH DICTATE THAT IN REGARDS TO JOBS AND SALARIES, "THE ECONOMY MUST SERVE PEOPLE NOT THE OTHER WAY AROUND. WORK IS MORE THAN A WAY TO MAKE A LIVING; IT IS A FORM OF CONTINUING PARTICIPATION IN GOD'S CREATION. IF THE DIGNITY OF WORK IS TO BE PROTECTED, THEN THE BASIC RIGHTS OF WORKERS MUST BE RESPECTED THE RIGHT TO PRODUCTIVE WORK, TO DECENT AND FAIR WAGES, TO THE ORGANIZATION AND JOINING OF UNIONS, TO PRIVATE PROPERTY AND TO ECONOMIC INITIATIVE".EDUCATION: INCLUDES BOTH FORMAL EDUCATION GOALS AND ATTAINMENT, INCLUDING JOB TRAINING, AND COMMUNITY-BASED EDUCATION AROUND ISSUES SUCH AS EXERCISE, NUTRITION, HEALTH ACCESS, AND FINANCES. HEALTH EDUCATION IS TIED VERY CLOSELY TO OBESITY (WHICH WAS IDENTIFIED AS A PRIORITY) AND WILL BE ADDRESSED BY "COMMUNITIES OF EXCELLENCE", A COMMUNITY BENEFIT PROGRAM, WHICH TEACHES NUTRITION EDUCATION CLASSES IN ADELANTO, APPLE VALLEY, HESPERIA, PINON HILLS AND VICTORVILLE. IN ADDITION, OUR FACILITY HAS FORMAL UNDERSTANDINGS WITH SEVERAL UNIVERSITIES AND COLLEGES AND PROVIDED NURSING STUDENTS WITH, "HEALTH PROFESSIONS EDUCATION", A COMMUNITY BENEFIT THAT RESULTED IN A DEGREE, CERTIFICATE, OR TRAINING NECESSARY TO BE LICENSED TO PRACTICE AS A HEALTH PROFESSIONAL, AS REQUIRED BY STATE LAW, OR CONTINUING EDUCATION NECESSARY TO RETAIN STATE LICENSE OR CERTIFICATION BY A BOARD IN THE HEALTH PROFESSION'S SPECIALTY. IN ADDITION, ST. JOSEPH HEALTH, ST. MARY IS ASSISTING IN CREATING A PIPELINE FOR LOCAL FUTURE MENTAL HEALTH PROFESSIONALS. THE HOSPITAL IS PARTICIPATING IN THE "MENTAL HEALTH CAREER DEVELOPMENT PROGRAM". THIS PROGRAM IS RUN BY DESERT MOUNTAIN CHILDREN'S CENTER, A BEHAVIORAL HEALTH PROGRAM OFFERING SERVICES TO CHILDREN AND YOUTH, BIRTH TO 22 YEARS OF AGE, CURRENTLY PROVIDING BEHAVIORAL HEALTH SERVICES IN OVER 200 SCHOOLS. IN SEPTEMBER OF 2019 IT CONNECTED OVER 100 HIGH DESERT HEALTHCARE STUDENTS TO FURTHER EXPLORE MENTAL HEALTH CAREERS, AND TO SPEAK WITH LOCAL BUSINESSES THAT HIRE THESE PROFESSIONALS, SUCH AS KAISER.WALKABILITY: THE LACK OF WALKABLE AREAS AND STREETS, INCLUDING THE LACK OF SIDEWALKS, CROSSWALKS, STREET LIGHTS, AS WELL AS THE LONG DISTANCES NECESSARY TO GO PLACES AND THE PREVALENCE OF HIGH-SPEED BUSY STREETS. THIS ISSUE IS TIED VERY CLOSELY TO OBESITY (WHICH WAS IDENTIFIED AS A PRIORITY) AND WILL BE ADDRESSED THROUGH ST. JOSEPH HEALTH, ST. MARY'S "COMMUNITIES OF EXCELLENCE" WORK. IN NOVEMBER OF 2017 CITY LEADERS OF ADELANTO, APPLE VALLEY, HESPERIA, PINON HILLS AND VICTORVILLE RECEIVED A "REPORT CARD" ON THE STATE OF WALKABILITY IN LOW INCOME NEIGHBORHOODS, AS WELL AS THE ACCESS OF FRESH PRODUCE FOR RESIDENTS LIVING IN THESE NEIGHBORHOODS. WE WILL TRAIN RESIDENTS TO ADVOCATE FOR SAFER STREETS THROUGH THEIR ELECTED OFFICIALS, BY VOICING THEIR CONCERNS IN CITY PLANNING AND CITY COUNCIL MEETINGS.HOMELESSNESS: PRIMARILY FOCUSED ON THE CONDITION OF HOMELESSNESS, INCLUDING HELPING HOMELESS INDIVIDUALS, PREVENTION OF HOMELESSNESS, AND MITIGATING ITS IMPACT ON COMMUNITIES. ACCORDING TO THE 2019 SAN BERNARDINO COUNTY HOMELESS COUNT AND SURVEY, THE CITY OF VICTORVILLE (PART OF OUR PRIMARY SERVICE AREA (PSA) HAS THE SECOND HIGHEST HOMELESS POPULATION IN THE COUNTY OF SAN BERNARDINO. THE FIRST DISTRICT SUPERVISOR'S OFFICE HAS FOCUSED ON RAPID RE-HOUSING, AND THE CITY OF VICTORVILLE'S SHERIFF'S OFFICE HAS THE HOMELESS OUTREACH PROACTIVE ENFORCEMENT (H.O.P.E.) PROGRAM AIMED AT ADDRESSING NEEDS OF THE HOMELESS POPULATION. IN 2019, THE CITY OF VICTORVILLE CREATED A "HOMELESS SOLUTIONS TASK FORCE", A COMMITTEE MADE UP OF CITIZENS REPRESENTING VARIOUS STAKEHOLDERS THAT MEETS MONTHLY. ST. JOSEPH HEALTH, ST. MARY, IS ONE OF TWELVE COMMITTEE MEMBERS, REPRESENTING THE HEALTHCARE SECTOR. CURRENTLY, THE COMMITTEE IS ENGAGED IN CREATING A SAFE AND WELCOMING ONE STOP HUB FOR HOMELESS INDIVIDUALS AND FAMILIES TO CONNECT TO NEEDED RESOURCES AND OBTAIN HOUSING. RECOGNIZING THAT "HOUSING IS HEALTH" THE CITY OF VICTORVILLE IS ALSO LOOKING AT AFFORDABLE HOUSING, AS A MEANS TO PREVENT HOMELESSNESS FROM OCCURRING IN THE FIRST PLACE. IT IS SPEAKING WITH DEVELOPERS, LIKE JAMBOREE HOUSING, TO SEE IF CREATING AFFORDABLE HOUSING IS A POSSIBILITY WITHIN THE CITY. IN ADDITION, WE HAVE THE FOLLOWING PARTNERS: HOMELESS SERVICES SHELTER, VICTOR VALLEY RESCUE MISSION AND ST. JOHN OF GOD PROVIDING HOUSING TO HOMELESS INDIVIDUALS AND FAMILIES. THERE ARE ALSO TWO DOMESTIC VIOLENCE SHELTERS, FAMILY ASSISTANCE PROGRAM AND A BETTER WAY.INSURANCE AND COST OF CARE: ENCOMPASSES BOTH THOSE WHO DO NOT HAVE HEALTH INSURANCE, BUT ALSO THOSE FOR WHOM THE COST OF SERVICES IS A BARRIER EVEN THOUGH THEY HAVE INSURANCE. ST. JOSEPH HEALTH, ST. MARY OFFERS PRIMARY CARE SERVICES THROUGH THE "BRIGHT FUTURES MOBILE VAN", A COMMUNITY BENEFIT PROGRAM, FOR THOSE THAT ARE UNINSURED IN THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA, LUCERNE VALLEY AND VICTORVILLE. WE ALSO PARTNER WITH COVERED CALIFORNIA IN INSURANCE ENROLLMENT CAMPAIGNS AND CONTINUE ADVOCATING AND SUPPORTING FEDERALLY QUALIFIED HEALTH CLINICS (FQHC) EXPANSION. THREE FQHC OPERATORS SUPPORT THE REGION: BORREGO HEALTH (BARSTOW AND ADELANTO) MISSION CITY (BARSTOW AND VICTORVILLE) AND SAN BERNARDINO COUNTY PUBLIC HEALTH (ADELANTO AND HESPERIA). WE ALSO PROVIDED A GRANT TO BORREGO HEALTH FQHC A GRANT TO PURCHASE A DENTAL MOBILE VAN TO PROVIDE FREE DENTAL CARE TO HIGH DESERT RESIDENTS. HOUSING CONCERNS: INCLUDES AFFORDABILITY, AVAILABILITY, OVERCROWDING, AND QUALITY OF HOUSING. ST. JOSEPH HEALTH, ST. MARY RECOGNIZES THAT OTHER ORGANIZATIONS HAVE A GREATER EXPERTISE IN THIS MATTER. LOW-INCOME HOUSING STABILIZATION PROGRAMS OF ADELANTO, APPLE VALLEY, HESPERIA AND VICTORVILLE AS WELL AS THE HOUSING AUTHORITY OF SAN BERNARDINO COUNTY AND TRANSITIONAL ASSISTANCE DEPARTMENT, AND HOUSING PARTNERS, INC., ALL ADDRESS THIS ISSUE.POLLUTION AND AIR QUALITY: INCLUDES INDUSTRIAL POLLUTION BUT ALSO VERMIN, TRASH, AND DUST DUE TO DRYNESS AND A LACK OF PAVED ROADS. THIS ISSUE WAS SECOND TO LOWEST PRIORITY ISSUE IDENTIFIED THROUGH THE 2017 COMMUNITY HEALTH NEEDS ASSESSMENT. ORGANIZATIONS WORKING ON THIS NEED ARE THE MOJAVE AIR QUALITY MANAGEMENT DISTRICT, SAN BERNARDINO COUNTY DEPARTMENT OF ENVIRONMENTAL HEALTH AND THE COMMUNITY ACTION PARTNERSHIP THROUGH THEIR LEAD PAINT ABATEMENT OF RESIDENTIAL HOUSING. SCHEDULE H, PART V, SECTION B, LINE 11 (CONT'D) CRIME AND SAFETY: ENCOMPASSES THE INCIDENCE OF CRIME AND VIOLENCE AS WELL AS THE FEAR OF IT, WHICH PREVENTS PEOPLE FROM USING OPEN SPACE OR ENJOYING THEIR COMMUNITY, NEGATIVELY IMPACTING WALKABILITY. THIS ISSUE RANKED AS THE LOWEST PRIORITY. BY WORKING WITH LOCAL LAW ENFORCEMENT OFFICES, SCHOOL DISTRICTS, AND ELECTED OFFICIALS, OUR HOPE IS THAT CRIME WILL GO DOWN AND THE IMAGE OF THE HIGH DESERT REGION WILL IMPROVE, ATTRACTING NEW EMPLOYERS TO THIS REGION. ONE PROJECT FUNDED BY ST. JOSEPH HEALTH COMMUNITY PARTNERSHIP FUND, RESIDENTS OF OLD TOWN VICTORVILLE (R.O.O.T.) IS A GRASSROOTS EFFORTS RUN BY VICTORVILLE RESIDENTS TO ADDRESS SAFETY ISSUES THAT IMPACT THE HEALTH OF THEIR NEIGHBORHOOD. OLD TOWN VICTORVILLE IS PARTICULAR IN THAT THE MAJORITY OF THE HOMELESS POPULATION (VICTORVILLE HAS THE SECOND HIGHEST HOMELESS POPULATION IN THE ENTIRE SAN BERNARDINO COUNTY) IS CONCENTRATED IN THAT SECTION. THE HIGH DESERT HAS MANY JAILS AND PRISONS, AND MOST RELEASE THEIR PRISONER POPULATION IN OLD TOWN VICTORVILLE. R.O.O.T. BEGAN ADVOCATING FOR ENVIRONMENTAL CHANGES, LIKE BRIGHTER STREET LIGHTS AND NEW LIGHTS IN ALLEYS, WHICH HAS HAPPENED, AND RESIDENTS ARE REPORTING THAT THEY FEEL CRIME HAS LOWERED. IN ADDITION, ST. JOSEPH HEALTH, ST. MARY WILL COLLABORATE, WHEN FEASIBLE, WITH ORGANIZATIONS THAT ADDRESS AFOREMENTIONED COMMUNITY NEEDS, TO COORDINATE CARE AND REFERRAL TO ADDRESS THESE UNMET NEEDS. SCHEDULE H, PART V, SECTION B, LINE 13H THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDER-INSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 16A FAP WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE SCHEDULE H, PART V, SECTION B, LINE 16B FAP APPLICATION WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/CA/ORANGE-COUNTY-AND-HIGH-DESERT/FINANCIAL-ASSISTANCE#TABCONTENT-1-PANE-2 SCHEDULE H, PART V, SECTION B, LINE 16C FAP PLAIN LANGUAGE SUMMARY WEBSITE:HTTPS://WWW.PROVIDENCE.ORG/OBP/PLAIN-LANGUAGE-SUMMARY 5 1 - OUTPATIENT SURGERY PAVILLION 18122 US HIGHWAY 18 APPLE VALLEY CA 92307 AMBULATORY SURGERY CENTER 2 - WOUND CARE CENTER 16077 KAMANA ROAD APPLE VALLEY CA 92307 WOUND CARE 3 - HEALTHY BEGINNINGS CLINIC 18977 S OUTER HWY 18 A APPLE VALLEY CA 92307 CLINIC 4 - ADELANTO CLINIC 11424 CHAMBERLAIN WAY STE 89 ADELANTO CA 92301 CLINIC 5 - HESPERIA CLINIC 17091 MAIN STREET STE100 HESPERIA CA 92345 CLINIC PART I, LINE 3C: IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE, FPG IS A KEY FACTOR. THE ORGANIZATION ALSO CONSIDERED CERTAIN ASSETS OF A PATIENT. IN ADDITION, A PATIENT'S SPECIAL CIRCUMSTANCES WERE ALSO CONSIDERED WHEN DETERMINING ELIGIBILITY, INCLUDING BUT NOT LIMITED TO, DISABILITY AND HOMELESSNESS. PART I, LINE 6A: ST. JOSEPH HEALTH, ST. MARY PREPARES AN ANNUAL REPORT AND IT IS PUBLICLY AVAILABLE ATHTTPS://WWW.PROVIDENCE.ORG/LOCATIONS/ST-MARY-MEDICAL-CENTER/ABOUT-US/COMMUNITY-BENEFIT PART I, LINE 7: THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSED ALL PATIENT SEGMENTS. PART I, LINE 7G: NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS WERE INCLUDED. PART II, COMMUNITY BUILDING ACTIVITIES: PROMOTING THE HEALTH OF HIGH DESERT COMMUNITIES IS OF DEEP IMPORTANCE TO ST. MARY MEDICAL CENTER. THIS EXTENDS FROM OUR VISION OF "HEALTH FOR A BETTER WORLD", THROUGH THE CREATION OF HEALTHY COMMUNITIES.ONE OF THE COMMUNITY BUILDING ACTIVITIES THAT CREATED HEALTHIER COMMUNITIES WAS THE MENDED HEARTS PROGRAM. THIS PROGRAM SAW OUR CARDIAC NURSES TEACH HEART PATIENTS HOW TO SHARE THEIR EXPERIENCES AND TALK TO OTHER HOSPITAL BOUND HEART PATIENTS ABOUT WHAT THEY MAY FACE IN THE NEAR FUTURE, ADDRESSING LIFESTYLE CHANGES, DEPRESSION, RECOVERY, AND TREATMENT. IN TOTAL, TEN (10) MEETINGS WERE CONDUCTED WITH 217 IN ATTENDANCE. THE COMMUNITY BENEFIT FOR THIS PROGRAM FOR CALENDAR YEAR 2019 WAS $2,037.THE HOSPITAL ALSO ENGAGED IN ADVOCACY THAT PROMOTED MENTAL HEALTH, WHICH WAS ONE OF THREE IDENTIFIED NEEDS WE PROMISED TO ADDRESS FOR CY2018-2020.THIS ADVOCACY INCLUDED WORKING WITH AND SUPPORTING NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) WERE WE HOSTED AND PROVIDED FOOD FOR A MENTAL HEALTH DINNER. THE COMMUNITY BENEFIT INVESTED TOTALED TO $570. PART III, LINE 2: THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND TRENDS TO ESTIMATE THE APPROPRIATE BAD DEBT EXPENSE. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED PRIOR TO CALCULATING BAD DEBT EXPENSE. PART III, LINE 3: THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USED AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT WERE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS WERE NOT PURSUED ON THESE ACCOUNTS ONCE THEY WERE RECLASSIFIED BECAUSE RECLASSIFIED ACCOUNTS WERE GRANTED 100 PERCENT FINANCIAL ASSISTANCE (FREE CARE). AFTER THE RECLASSIFICATION, THERE WAS NO REMAINING AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER OUR FINANCIAL ASSISTANCE POLICY. PART III, LINE 4: FINANCIAL STATEMENT BAD DEBT EXPENSE FOOTNOTE THE HEALTH SYSTEM PROVIDED FOR AN ALLOWANCE AGAINST PATIENT ACCOUNTS RECEIVABLE FOR AMOUNTS THAT COULD BECOME UNCOLLECTIBLE. THE HEALTH SYSTEM ESTIMATED THIS ALLOWANCE BASED ON THE AGING OF ACCOUNTS RECEIVABLE, HISTORICAL COLLECTION EXPERIENCE BY PAYOR, AND OTHER RELEVANT FACTORS. THERE ARE VARIOUS FACTORS THAT CAN IMPACT THE COLLECTION TRENDS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF COPAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE COVERAGE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS USED BY THE HEALTH SYSTEM. THE HEALTH SYSTEM RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICES ON THE BASIS OF PAST EXPERIENCE, WHICH HAS HISTORICALLY INDICATED THAT MANY PATIENTS ARE UNRESPONSIVE OR ARE OTHERWISE UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: COMMUNITY BENEFITSTHE ORGANIZATION DOES NOT REPORT MEDICARE REVENUES AND EXPENSES AS COMMUNITY BENEFIT. PART III, LINE 9B: PATIENT ACCOUNTS WERE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MADE A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMED AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIED FOR FINANCIAL ASSISTANCE. ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR FREE CARE WERE WRITTEN OFF AND COLLECTION EFFORTS WERE NOT PURSUED. THE ORGANIZATION'S COLLECTION POLICY ALSO APPLIED TO ACCOUNTS FOR PATIENTS WHO QUALIFIED FOR DISCOUNTED CARE. PART VI, LINE 2: NEEDS ASSESSMENTOUR COMMUNITY BENEFIT PLAN IS ALIGNED WITH ST. MARY MEDICAL CENTER'S STRATEGIC PLAN.1. DEVELOPING A NETWORK OF CARE - COMMUNITY CLINICS, WHICH INCLUDES THE "BRIGHT FUTURES MOBILE VAN" IS EXPANDING CLINIC SERVICE DAYS AND GOING TO OTHER CITIES LIKE LUCERNE VALLEY, LOCATED IN OUR SECONDARY SERVICE AREA (SSA). HIGH DESERT ST. MARY MEDICAL GROUP, AN AFFILIATE OF THE HOSPITAL, IS ALSO POISED TO INCREASE THE NETWORK OF CARE IN THE HIGH DESERT REGION THROUGH PRIMARY CARE AND CHRONIC DISEASE MANAGEMENT CLINICAL SERVICES OF ONGOING PATIENTS.2. POPULATION HEALTH - FAITH-BASED ORGANIZATIONS FROM ALL DENOMINATIONS ARE APPROACHED ON CREATING AND CONTINUING A HEALTH MINISTRY, ADDRESSING BOTH SPIRITUAL AND HEALTHCARE NEEDS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHE ORGANIZATION POSTED NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES WERE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES WERE ALSO POSTED AT LOCATIONS WHERE A PATIENT COULD PAY THEIR BILL. NOTICES INCLUDED CONTACT INFORMATION ON HOW A PATIENT COULD OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES WERE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT WERE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATED LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS WERE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND WERE OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY HAVE BEEN ELIGIBLE. PART VI, LINE 4: COMMUNITY INFORMATIONST. MARY MEDICAL CENTER PROVIDES THE VICTOR VALLEY AND BARSTOW COMMUNITIES WITH ACCESS TO ADVANCED CARE. THE FACILITY IS THE ONLY ST. JOSEPH HEALTH HOSPITAL OPERATING IN SAN BERNARDINO COUNTY AND THE ONLY NON-PROFIT HOSPITAL IN THE HIGH DESERT REGION. THE HOSPITAL'S SERVICE AREA EXTENDS FROM HIGHWAY 58 AND THE 15 FREEWAY IN THE NORTH, HIGHWAY 395 AND THE 15 FREEWAY IN THE SOUTH, UNINCORPORATED COMMUNITIES INCLUDING LUCERNE VALLEY IN THE EAST AND UNINCORPORATED COMMUNITIES OF EL MIRAGE IN THE WEST. OUR HOSPITAL TOTAL SERVICE AREA (TSA), THE COMMUNITY SERVED BY THE HOSPITAL IN BOTH THE PRIMARY SERVICE AREA (PSA) AND THE SECONDARY SERVICE AREA (SSA) [TSA = PSA+SSA] INCLUDES THE CITIES OF ADELANTO, APPLE VALLEY, BARSTOW, HESPERIA, ORO GRANDE AND VICTORVILLE AND SEVERAL SMALLER UNINCORPORATED COMMUNITIES INCLUDING HELENDALE, LUCERNE VALLEY, OAK HILLS, PHELAN, SNOWLINE COMMUNITIES AND WRIGHTWOOD. TOTAL SERVICE AREA (TSA):THE COMMUNITY PROFILE OF THE TOTAL SERVICE AREA (TSA) OF ST. JOSEPH HEALTH, ST. MARY IS A COMBINED POPULATION OF APPROXIMATELY 372,642 PEOPLE, AN INCREASE OF 13% FROM THE PRIOR 2014 CHNA ASSESSMENT. SOCIOECONOMIC INDICATORS ARE WORSE OFF IN THE TSA IN COMPARISON TO COUNTY AND STATE AVERAGES. THE MEDIAN HOUSEHOLD INCOME OF THE TSA IS APPROXIMATELY $50,500, WHICH IS LOWER THAN THE COUNTY OF SAN BERNARDINO'S MEDIAN OF $55,726 AND THE STATE MEDIAN OF $62,554 . POVERTY, AS MEASURED BY THE FEDERAL POVERTY LEVEL (FPL), AN ECONOMIC MEASURE TO CHECK IF INDIVIDUALS OR FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS SUCH AS MEDI-CAL, CAL-FRESH (FOOD STAMPS), ETC. IS ALSO HIGHER IN THE TSA IN COMPARISON TO COUNTY AND STATE PERCENTAGES. HOUSEHOLDS LIVING BELOW 200% FPL IN THE TSA IS TEN (10) PERCENT POINTS HIGHER THAN CALIFORNIA TSA STANDS AT 40.9% AND CALIFORNIA AT 29.8%. HOUSEHOLDS LIVING BELOW 100% FPL IS ALSO HIGHER IN THE TSA, 19.4% IN COMPARISON TO THE STATE WHICH IS 12.3%. WHEN LOOKING AT HEALTH OUTCOMES THE TSA HAS HIGHER RATES OF ASTHMA THAN CALIFORNIA AND MUCH HIGHER RATES OF DIABETES (13.1%) COMPARED TO THE COUNTY (11.2%) AND STATE (8.8%). IN REGARDS TO RACE AND ETHNICITY MAKE-UP OF THE TSA, ALMOST HALF ARE LATINO (47.5%). IN COMPARISON TO SAN BERNARDINO COUNTY, THERE ARE MORE AFRICAN AMERICANS AND FEWER ASIAN/PACIFIC ISLANDERS. THE HOSPITAL'S TSA CURRENTLY SERVES RESIDENTS OF THREE (3) OF SAN BERNARDINO COUNTY'S FIVE (5) SUPERVISORY DISTRICTS. THE REGION IS 90% DESERT AND THE LARGEST NEAREST METROPOLITAN AREA, THE CITY OF SAN BERNARDINO, IS 40 MILES AWAY.PRIMARY SERVICE AREA (PSA):THE PRIMARY SERVICE AREA (PSA), THE GEOGRAPHIC AREA FROM WHICH THE MAJORITY OF THE HOSPITAL'S PATIENTS ORIGINATE, INCLUDES APPLE VALLEY, HESPERIA AND VICTORVILLE. SOCIOECONOMIC INDICATORS SHOW IT IS WORSE OFF THAN THE STATE OF CALIFORNIA. 39.5% OF HOUSEHOLDS LIVE BELOW 200% FPL, CLOSE TO TEN (10) PERCENT POINTS HIGHER THAN CALIFORNIA WHICH STANDS AT 29.8%. HOUSEHOLDS LIVING BELOW 100% FPL IS 18.3% ALSO HIGHER THAN THE STATE (12.3%).SECONDARY SERVICE AREA (SSA):THE SECONDARY SERVICE AREA (SSA), WHERE AN ADDITIONAL POPULATION OF THE HOSPITAL'S INPATIENTS RESIDES, INCLUDES THE ENTIRETY OF ADELANTO, HELENDALE, LUCERNE VALLEY AND ORO GRANDE. THE SSA HAS MORE CHILDREN (30.2%) THAN THE STATE (23.6%). WHEN LOOKING AT SOCIOECONOMIC INDICATORS, MORE THAN HALF (51.3%) OF HOUSEHOLDS LIVE BELOW 200% FPL; THAT IS MORE THAN TWENTY (20) PERCENT POINTS HIGHER THAN THAT OF THE STATE, 29.8%. CLOSE TO THREE QUARTERS, 73.3% OF RENTERS PAY MORE THAN 30% OF HOUSEHOLD INCOME FOR RENT IT IS 57.2% IN THE STATE OF CALIFORNIA.HEALTH OUTCOMES ARE ALSO WORSE OFF FOR THE SSA. MORE THAN ONE QUARTER OF ADULTS REPORT THEIR HEALTH AS "FAIR OR "POOR," WHICH IS HIGHER THAN EITHER THE COUNTY OR THE STATE.OTHER HOSPITALS IN THE TSA:TWO OTHER HOSPITALS ARE LOCATED IN THE PSA DESERT VALLEY HOSPITAL AND VICTOR VALLEY GLOBAL MEDICAL CENTER. THERE ARE NO HOSPITALS IN THE SSA.HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AND MEDICALLY UNDERSERVED AREAS (MUA) & MEDICALLY UNDERSERVED POPULATIONS (MUP) AREAS WITHIN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS ARE LISTED AS MEDICALLY UNDERSERVED AREAS INCLUDING THE COMMUNITY OF BARSTOW AND ADELANTO. ADDITIONALLY, THE REGION IS LISTED AS A MEDICAL HEALTH PROFESSIONAL SHORTAGE AREA FOR MENTAL HEALTH. WITH SOME EXCEPTIONS, THESE HEALTH AND SOCIAL CONDITIONS ARE LARGELY HOMOGENOUS ACROSS SAN BERNARDINO COUNTY. FOR THIS REASON NONPROFIT HOSPITALS IN SAN BERNARDINO ARE REPORTING SIMILAR INCREASES IN CHRONIC DISEASE AND SOCIAL DISPARITIES. IN RESPONSE A COUNTY-WIDE HEALTH IMPROVEMENT PLAN HAS BEEN DEVELOPED WHICH THE HOSPITAL IS ACTIVE IN. THIS PLAN PRIORITIZES IMPROVING (1) EDUCATION, (INCREASING GRADUATION RATES) (2) THE ECONOMY (REDUCING POVERTY) (3) SAFETY (IMPROVING SCHOOL AND COMMUNITY SAFETY) AND (4) HEALTH & WELLNESS (REDUCING OBESITY).THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION DESIGNATE MEDICALLY UNDERSERVED AREAS (MUAS) AND HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AS AREAS WITH A SHORTAGE OF PRIMARY MEDICAL CARE, DENTAL CARE, OR MENTAL HEALTH PROVIDERS. THEY ARE DESIGNATED ACCORDING TO GEOGRAPHY (I.E., SERVICE AREA), DEMOGRAPHICS (I.E., LOW-INCOME POPULATION), OR INSTITUTIONS (I.E., COMPREHENSIVE HEALTH CENTERS). THE AREA WEST OF THE HOSPITAL INCLUDING PORTIONS OF VICTORVILLE AND ADELANTO ARE DESIGNED AS MUAS AND HPSA POPULATIONS. THE TSA OF ST. JOSEPH HEALTH, ST. MARY IS LOCATED IN A HPSA WITH LARGE PORTIONS OF THE SERVICE AREA NEEDING INCREASED ACCESS TO PRIMARY CARE AND MENTAL HEALTH. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHST. MARY MEDICAL CENTER PROVIDES VITAL COMMUNITY HEALTH SERVICES AND ADDRESSES THE NEEDS OF THE UNINSURED AND UNDERINSURED THROUGH ITS FINANCIAL ASSISTANCE PROGRAM PROVIDING FREE AND DISCOUNTED CARE. ST. MARY MEDICAL CENTER IS COMMITTED TO PROMOTING THE HEALTH AND QUALITY OF LIFE IN ITS SURROUNDING COMMUNITY. THIS IS DEMONSTRATED THROUGH THE FOLLOWING MECHANISMS:1) A COMMUNITY BENEFIT COMMITTEE THAT HAS COMMUNITY REPRESENTATION AND IS A SUBCOMMITTEE OF THE BOARD OF TRUSTEES2) OPEN MEDICAL STAFF3) ROBUST COMMUNITY BENEFIT PROGRAMS THAT ADDRESS COMMUNITY HEALTH NEEDS. PLEASE SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS.LOCAL COMMUNITY BENEFIT COMMITTEE:THE ROLE OF THE ST. JOSEPH HEALTH, ST. MARY COMMUNITY BENEFIT (CB) COMMITTEE IS TO SUPPORT THE BOARD OF TRUSTEES IN OVERSEEING COMMUNITY BENEFIT EFFORTS. THE CB COMMITTEE ACTS IN ACCORDANCE WITH A BOARD APPROVED CHARTER. THE CB COMMITTEE IS CHARGED WITH DEVELOPING POLICIES AND PROGRAMS THAT ADDRESS "IDENTIFIED SIGNIFICANT NEEDS" IN THE SERVICE AREA PARTICULARLY FOR UNDERSERVED POPULATIONS, OVERSEEING DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN/IMPLEMENTATION STRATEGY REPORTS AND PROVIDING DIRECTION OF COMMUNITY BENEFIT ACTIVITIES. THE CB COMMITTEE HAS A MINIMUM OF EIGHT (8) MEMBERS INCLUDING THREE (3) MEMBERS OF THE BOARD OF TRUSTEES. CURRENT MEMBERSHIP INCLUDES FOUR (4) MEMBERS OF THE BOARD OF TRUSTEES AND FIVE (5) COMMUNITY MEMBERS. A MAJORITY OF MEMBERS HAVE KNOWLEDGE AND EXPERIENCE WITH THE POPULATIONS MOST LIKELY TO HAVE DISPROPORTIONATE UNMET HEALTH NEEDS. THE CB COMMITTEE GENERALLY MEETS QUARTERLY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMON JULY 1, 2016, PROVIDENCE HEALTH & SERVICES (LEGACY PHS) AND ST. JOSEPH HEALTH SYSTEM (LEGACY SJHS) ENTERED INTO A BUSINESS COMBINATION AGREEMENT. BY COMING TOGETHER, PROVIDENCE ST. JOSEPH HEALTH SEEKS TO BETTER SERVE ITS COMMUNITIES THROUGH GREATER PATIENT AFFORDABILITY, OUTSTANDING CLINICAL CARE, IMPROVEMENTS TO THE PATIENT EXPERIENCE AND INTRODUCTION OF NEW SERVICES WHERE THEY ARE NEEDED MOST.TOGETHER, OUR CAREGIVERS SERVE IN 51 HOSPITALS, 1085 CLINICS ACROSS ALASKA, CALIFORNIA, MONTANA, NEW MEXICO, OREGON, TEXAS AND WASHINGTON. PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 ST JOSEPH HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 330143024 501(C)(3) 1708900 OPERATIONAL SUPPORT 1 0 PART I, LINE 2: DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS IN THE APPLICATION FOR SUPPORT, A DETAILED EXPLANATION OF THE KIND OF SERVICES PROVIDED TO THE COMMUNITY ALONG WITH SPECIFIC FINANCIAL DATA IS REQUESTED. IF THE APPLICATION FOR SUPPORT IS APPROVED, A LETTER IS SENT INDICATING THE AMOUNT OF THE SUPPORT ALONG WITH A REQUEST FOR DOCUMENTATION OF HOW THE FUNDS WERE USED, ALONG WITH A REPORT OF THE NUMBER OF CHILDREN/FAMILIES SERVED OVER THE YEAR. GRANTS MADE TO AFFILIATED FOUNDATIONS ARE MONITORED ON A MONTHLY BASIS AS THE FINANCIAL STATEMENTS OF THESE ORGANIZATIONS ARE READILY AVAILABLE. OTHER GRANTS ARE MADE THAT COMPLY WITH THE MISSION AND FURTHER THE TAX-EXEMPT PURPOSE OF THE ORGANIZATION. 1 1 0 0 0 0 0 1 0 JIM WATSON ESQ SECRETARY 0 467350 0 370314 0 5830 0 103753 0 34057 0 981304 0 0 ALAN GARRETT FORMER PRESIDENT/CEO 0 77775 0 501590 0 9111 0 44798 0 2579 0 635853 0 0 MARILYN DRONE COO SMMC 386022 0 82705 0 8653 0 19600 0 24382 0 521362 0 0 0 TRACEY FERNANDEZ VP FINANCE AND CFO 347720 0 91504 0 4932 0 13796 0 30667 0 488619 0 0 0 TARA COWELL FORMER SEC/TREASURER 0 124703 0 148637 0 167113 0 35239 0 1606 0 477298 0 0 RIAD ABDELKARIM MD CHIEF MEDICAL OFFICER-STMMC 295272 0 95468 0 4123 0 10927 0 22649 0 428439 0 0 0 KIMBERLY DEIMLING CERTIFIED NURSE MIDWIFE - NE 293490 0 26400 0 5848 0 24139 0 16148 0 366025 0 0 0 JEAN HOLTMAN FORMER MINISTRY CHRO PSJH 0 201453 0 98801 0 7956 0 10036 0 24684 0 342930 0 0 JUDY WAGNER CHIEF MISSION OFFICER (MINISTRY) 153942 87641 55463 0 2049 1010 6245 3547 8179 3865 225878 96063 0 0 MATTHEW CHANDLER EXEC DIR. ANCILLARY SERVICES 217057 0 17407 0 2153 0 8737 0 29093 0 274447 0 0 0 TAMARA BROWN EXECUTIVE DIRECTOR, NURSING 194601 0 15106 0 3254 0 16723 0 3775 0 233459 0 0 0 RANDY CASTILLO BOARD OF DIRECTORS/CEO 0 169981 0 0 0 23199 0 25961 0 12606 0 231747 0 0 PART I, LINE 1A PROVIDENCE EXPENSE REIMBURSEMENT PROCEDURES INCLUDE THE FOLLOWING POLICIES: FIRST CLASS TRAVEL OR CHARTER TRAVEL AIR TRAVEL IS GENERALLY REIMBURSABLE AT THE LEAST EXPENSIVE AIRFARE WHICH PERMITS DEPARTURES AND ARRIVALS AT REASONABLE TIMES AND REASONABLE DISTANCE TRAVELED. EMPLOYEES ARE ENCOURAGED TO PLAN IN ADVANCE TO GET AVAILABLE DISCOUNTS. AIRLINE FREQUENT FLYER UPGRADES WILL NEVER BE REIMBURSED. IN LIMITED SITUATIONS FIRST CLASS TICKETS AND CHARTER MAY BE REIMBURSED WHEN APPROVED BY A SENIOR LEVEL SUPERVISOR. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS RELOCATION PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO RELOCATION EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THE RELOCATION EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THE RELOCATION BENEFITS, SO THAT A PORTION OF THE REIMBURSEMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. TAX INDEMNIFICATIONS OR GROSS-UP PAYMENTS - FINANCIAL/RETIREMENT PLANNING PROVIDENCE FOLLOWS THE FEDERAL AND STATE TAXATION LAWS RELATED TO FINANCIAL AND RETIREMENT PLANNING EXPENSES PAID TO THE EMPLOYEE OR TO A THIRD PARTY ON THE EMPLOYEE'S BEHALF. THEY ARE CONSIDERED TAXABLE WAGES AND ARE REPORTED AS SUCH. BASED ON THE WAY PROVIDENCE HAS CHOSEN TO PAY THESE OTHER EXPENSES, PROVIDENCE REPORTS REIMBURSEMENTS AND PAYMENTS TO VENDORS AS INCOME AND THESE EXPENSE PAYMENTS ARE REFLECTED ON THE EXECUTIVE'S FORM W-2. PROVIDENCE PROVIDES A GROSS-UP FOR THIS BENEFIT, SO THAT A PORTION OF THE PAYMENT DOES NOT HAVE TO BE USED TO PAY TAXES, AND THIS TAX GROSS-UP IS ALSO REPORTED AS TAXABLE INCOME. THE AMOUNTS REPORTED FOR THESE GROSS-UP PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990. PERSONAL SERVICES PROVIDENCE OFFERS FINANCIAL PLANNING SERVICES AS AN OPTIONAL BENEFIT TO EMPLOYEES AT VICE PRESIDENT LEVEL AND ABOVE. THE AMOUNTS REPORTED FOR THE FINANCIAL PLANNING SERVICES ARE INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COLUMN B (III) - OTHER REPORTABLE COMPENSATION ON THE FORM 990 FOR THE EMPLOYEES WHO PARTICIPATE. PART I, LINE 3 DESCRIPTION OF PROCESS TO REVIEW COMPENSATION PAID TO TOP MANAGEMENT OFFICIAL THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER/TOP MANAGEMENT OFFICIAL IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS USED BY PROVIDENCE. PART I, LINES 4A-B THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS IN 2019 TARA COWELL - $165,422 ENTITIES WITHIN THE PROVIDENCE SYSTEM SPONSOR NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS FOR CERTAIN EXECUTIVES. THE PLANS PROVIDE FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND, DEPENDING ON THE PLAN, ARE SUBJECT TO EITHER A THREE YEAR, AGE 59 1/2 OR A FIVE YEAR, AGE 65 VESTING SCHEDULE. UNTIL THE EXECUTIVE PROVIDES THESE SUBSTANTIAL FUTURE SERVICES, THESE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE AT RISK, AND WILL BE FORFEITED IF THE EXECUTIVE LEAVES THE ORGANIZATION BEFORE REACHING HER OR HIS VESTING DATE. THE SUPPLEMENTAL RETIREMENT CONTRIBUTIONS ARE INCLUDED IN COLUMN (C) AS A NONTAXABLE BENEFIT IN THE YEAR THE CONTRIBUTION IS CREDITED TO THE EXECUTIVE'S ACCOUNT, AND ARE INCLUDED AGAIN ON THE FORM 990 IN COLUMN (B)(III) IF AND WHEN THE AMOUNT BECOMES VESTED IN A FUTURE YEAR, AS THE FORM 990 REQUIRES. NO INDIVIDUALS RECEIVED A PAYOUT DURING THE CURRENT YEAR. PART I, LINE 7 NON-FIXED PAYMENTS THE PROVIDENCE EXECUTIVE COMPENSATION COMMITTEE (OF THE BOARD) HAS APPROVED AN EXECUTIVE COMPENSATION PHILOSOPHY THAT CLOSELY TIES AN EXECUTIVE'S COMPENSATION TO PERFORMANCE - BOTH THE PERFORMANCE OF THE ORGANIZATION AND THE PERFORMANCE OF THE EXECUTIVE. THERE IS NO GUARANTEE THAT THIS PART OF A LEADER'S COMPENSATION WILL BE PAID - IF THE PERFORMANCE OF THE ORGANIZATION OR OF THE INDIVIDUAL DOES NOT MEET THE PERFORMANCE STANDARDS FOR PAYMENT, NO PERFORMANCE-BASED PAYMENT IS MADE. THIS APPROACH IS REFLECTED IN PROVIDENCE'S LEADERSHIP ANNUAL INCENTIVE PLAN, WHICH IS A PERFORMANCE-BASED ANNUAL INCENTIVE PLAN THAT AFFORDS PARTICIPATING EXECUTIVES THE OPPORTUNITY TO EARN "AT RISK" COMPENSATION THROUGH PERFORMANCE AGAINST VERY CHALLENGING GOALS. PAYOUTS WILL BE AWARDED BASED ON GOALS RELATED TO STRATEGIC OBJECTIVES, FISCAL STEWARDSHIP AND QUALITY OF CARE - THESE GOALS ARE SET BEFORE THE YEAR BEGINS AND ARE VERY CHALLENGING. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS AND APPROVES EACH YEAR'S PERFORMANCE GOALS TO MAKE SURE THEY ARE SUFFICIENTLY CHALLENGING, AND TO MAKE SURE THE GOALS ARE DESIGNED TO HELP PROVIDENCE MEET ITS MISSION AND STRATEGIC PURPOSES. EACH YEAR THE PSJH BOARD EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE INCENTIVE PERFORMANCE AND MUST CERTIFY THE ACHIEVEMENT OF PERFORMANCE GOALS BEFORE ANY AWARDS ARE PAID OUT. WHEN REVIEWING AND APPROVING TOTAL COMPENSATION FOR EXECUTIVES, THE EXECUTIVE COMPENSATION COMMITTEE INCLUDES INCENTIVE AWARDS, TO MAKE SURE THAT COMPENSATION IS REASONABLE AND WELL-SUPPORTED BY MARKET DATA. THE COMMITTEE CONSISTS ONLY OF DIRECTORS WHO ARE FREE OF CONFLICTS OF INTEREST, AND THE COMMITTEE RELIES ON MARKET SURVEY DATA GATHERED BY AN INDEPENDENT CONSULTANT. THE COMMITTEE CONDUCTS THIS REVIEW AND APPROVAL PROCESS IN A MANNER THAT IS IN ACCORDANCE WITH IRS REQUIREMENTS FOR COMPENSATION OF TAX-EXEMPT ORGANIZATION LEADERS, AND IN ACCORDANCE WITH THE BEST GOVERNANCE PRACTICES IN THE INDUSTRY. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) - SECOND YEAR OF THE YOUTH WELLNESS PROGRAM, OPERATED AT LOW-INCOME SCHOOLS. FIFTH GRADE STUDENTS WERE TARGETED AS DATA DEMONSTRATES THAT PHYSICAL ACTIVITY DECLINES WHILE VIDEO GAME AND SCREEN TIME INCREASES AT AGES 10 TO 11. THE EIGHT (8) SCHOOLS WERE FROM THE ADELANTO, APPLE VALLEY, HESPERIA, SNOWLINE AND VICTORVILLE SCHOOL DISTRICTS. IN TOTAL, 28 CLASSROOMS WITH A TOTAL OF 850 STUDENTS AND 8,689 ENCOUNTERS WERE TAUGHT THE CURRICULUM "7 DIMENSIONS OF WELLNESS," WHICH INCLUDED LESSON PLANS IN ACADEMIC, EMOTIONAL, ENVIRONMENTAL, OCCUPATIONAL PHYSICAL, SOCIAL AND SPIRITUAL WELL-BEING." IDENTIFIED NEED - BUILDING A MENTAL HEALTH COLLABORATIVE ACCORDING TO OUR 2014 CHNA, THE LOW SELF-RATED MENTAL HEALTH IN THE HIGH DESERT WAS RECORDED AT 18.4%; NATIONALLY IT STOOD AT 11.7%. FOR OUR MOST CURRENT 2017 CHNA, THE LACK OF MENTAL HEALTH RESOURCES WAS A FREQUENT THEME IN THE FOCUS GROUPS AND FORUM, PARTICULARLY THE LACK OF PROVIDERS. IN 2019, ST. JOSEPH HEALTH, ST. MARY ACHIEVED THE FOLLOWING: THE BRIDGES FAMILY RESOURCE CENTER PROVIDED 1,102 SHORT TERM COUNSELING VISITS FOR INDIVIDUAL, COUPLES AND FAMILY. A LIKE MINDED PARTNER, AND RECIPIENT OF A CARE FOR THE POOR MENTAL HEALTH GRANT, NON-PROFIT FAMILY ASSISTANCE PROGRAM PROVIDED 768 ENCOUNTERS TO 96 AT RISK YOUTH, SOME HOMELESS. A $1,500,000 RESTRICTED MENTAL HEALTH GRANT WAS GIVEN TO THE NON-PROFIT, ST. JOHN OF GOD, TO EXPANDS ITS SUBSTANCE RECOVERY PROGRAM. IN ADDITION, THIS PROGRAM PROVIDES MARRIAGE FAMILY THERAPIST (MFT) INTERNS WITH THE OPPORTUNITY TO COMPLETE THEIR CLINICAL HOURS NECESSARY FOR THE BOARD OF BEHAVIORAL SCIENCES IN ORDER TO BECOME A MENTAL HEALTHCARE PROFESSIONAL IN THE FUTURE. BY WORKING WITH INTERNS, THIS PROGRAM SERVED ON TWO LEVELS; ASSISTING SUBSTANCE USE PARTICIPANTS WITH MENTAL HEALTH SERVICES, AND INCREASING THE NUMBER OF MENTAL HEALTH PROFESSIONALS IN OUR REGION. IN ADDITION, ST. JOSEPH HEALTH, ST. MARY FOUNDATION WAS AWARDED A BE WELL GRANT TO ADDRESS CHILDREN'S MENTAL HEALTH ISSUES. ONE APPROACH IS TO PARTNER WITH LOCAL SCHOOL DISTRICTS TO EDUCATE ON ADVERSE CHILDHOOD EXPERIENCES (ACES), AND SUICIDE PREVENTION, IDENTIFY THESE IN A STUDENT, AND OFFERING RESOURCES AND SOLUTIONS TO HELP WHEN THESE MANIFEST. HESPERIA UNIFIED SCHOOL DISTRICT (HUSD), A K-12 SCHOOL DISTRICT, ALLOWED AN OUTSIDE MENTAL HEALTH PROFESSIONAL, DR. RON POWELL, WHO IS COMPENSATED THROUGH THE FOUNDATION, TO TRAIN LOCAL EDUCATORS ON ACES AND HOW TO ADDRESS THEM IN NEW WAYS RATHER THAN THE COMMON DISCIPLINE ACTION OF SUSPENSION. DR. RON POWELL HAS BEEN INSTRUMENTAL IN THE DEVELOPMENT OF SEVERAL EXEMPLARY PROGRAMS FOR AT-RISK YOUTH AND IS HIGHLY REGARDED BECAUSE OF HIS ADVOCACY AND EXPERTISE ON THE ISSUE. ANOTHER OUTSIDE CONSULTANT, LIFE SKILLS AWARENESS (LSA), WAS ALSO HIRED TO NAVIGATE ON CHILDREN COMING TO THE HOSPITAL'S EMERGENCY ROOM DISPLAYING MENTAL HEALTH ISSUES. THE THERAPISTS AT LSA UTILIZE A SYSTEMATIC AND HOLISTIC APPROACH TO THERAPY SERVICES. THEY STRIVE TO IDENTIFY PROBLEMS AND PROVIDE INTERVENTIONS THAT IMPLEMENT CHANGE AND SUPPORT THROUGHOUT THE THERAPY PROCESS AND BEYOND. EARLY INTERVENTION, FAMILY INCLUSION, AND UTILIZATION OF COMMUNITY RESOURCES ARE ESSENTIAL TO LSA'S TREATMENT APPROACH. FORM 990, PART V, LINE 1A ST. JOSEPH HEALTH SYSTEM PAYS ALL VENDORS FOR ST. MARY MEDICAL CENTER FROM ITS SHARED SERVICES. ST. JOSEPH HEALTH SYSTEM ISSUES FORM 1099-MISC UNDER ITS TAX ID NUMBER AND COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. FORM 990, PART V, LINE 15 INDIVIDUALS LISTED AS OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION THAT ARE PAID BY A RELATED ORGANIZATION ARE COMMON LAW EMPLOYEES OF THE RELATED ORGANIZATION. IT IS THE INTENTION OF PROVIDENCE AND THE FILING ORGANIZATION TO MAKE INFORMATION ACCESSIBLE AND TRANSPARENT, REPORTING THOSE EMPLOYEES OF A RELATED ORGANIZATION WHO HAVE OFFICER AND KEY EMPLOYEE RESPONSIBILITIES TO THE FILING ORGANIZATION. THE RELATED ORGANIZATION COMMON LAW EMPLOYEES ARE INCLUDED IN THE RELATED ORGANIZATIONS SECTION 4960 TAX ANALYSIS AND REPORTING. FORM 990, PART VI, SECTION A, LINE 6 CLASSES OF MEMBERS OR STOCKHOLDERS ST. JOSEPH HEALTH SYSTEM AND COVENANT HEALTH NETWORK, INC. ARE THE SOLE CORPORATE MEMBERS OF ST. MARY MEDICAL CENTER. FORM 990, PART VI, SECTION A, LINE 7A CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ST. MARY MEDICAL CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. MARY MEDICAL CENTER BOARD. ALL TRUSTEE NOMINATIONS THAT COME FROM THE ST. MARY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER AND ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. THE TRUSTEES ARE THEN APPROVED AND ELECTED BY THE COVENANT HEALTH NETOWRK, INC, BOARD. FORM 990, PART VI, SECTION A, LINE 7B CLASSES OF PERSONS, DECISIONS REQUIRING APPROVAL & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, EXEMPT PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBER, ST. JOSEPH HEALTH SYSTEM, RESERVES THE RIGHT TO APPROVE THE PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW FORM 990 THE FORM 990 WAS PREPARED BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION INCLUDING THE FINANCE TEAM, HUMAN RESOURCES, PAYROLL, COMPLIANCE AND THE GENERAL COUNSEL'S OFFICE. THE ORGANIZATION ENGAGED AN OUTSIDE ACCOUNTING FIRM TO PREPARE THE RETURN. THE RETURN HAS BEEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A FULL COPY OF THE FORM 990 WAS PROVIDED TO ALL BOARD MEMBERS PRIOR TO FILING WITH THE IRS. THE AUDIT COMMITTEE OF THE PARENT ORGANIZATION IS PROVIDED AN ANNUAL UPDATE ON THE TAX REPORTING PROCESS AND KEY DISCLOSURES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST PROVIDENCE TAKES THE ISSUE OF CONFLICTS OF INTEREST, AND INDEPENDENT UNCONFLICTED DECISION-MAKING, VERY SERIOUSLY. PROVIDENCE HAS A COMPREHENSIVE CONFLICT OF INTEREST POLICY AND INTEREST DISCLOSURE POLICY, AND CAREFULLY AND THOROUGHLY ADMINISTERS THESE POLICIES. BOARD MEMBERS, SPONSORS, SENIOR LEADERS AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST IN ACCORDANCE WITH THE PROVIDENCE CONFLICT OF INTEREST POLICY, AND SO THAT THE INDIVIDUAL SATISFIES HIS OR HER FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES ARE MADE ANNUALLY, AS WELL AS ANY TIME AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. PROVIDENCE CHIEF LEGAL OFFICER AND/OR THE PROVIDENCE CHIEF RISK OFFICER, REVIEW ALL DISCLOSURES. WHERE APPROPRIATE, THE CEO AND/OR THE BOARD CHAIR WILL REVIEW CONFLICT OF INTEREST SITUATIONS THAT INVOLVE SENIOR LEADERSHIP OR A BOARD MEMBER OTHER THAN THE CHAIR. PROVIDENCE CHIEF LEGAL OFFICER AND/OR CHIEF RISK OFFICER REVIEW MATTERS WHERE CONFLICT IS DIFFICULT OR CANNOT BE READILY RESOLVED AND PRESENT RECOMMENDATIONS TO THE APPROPRIATE BOARD COMMITTEE OR THE CEO, FOR DISCUSSION AND RESOLUTION. WHEN APPROPRIATE, THE INDIVIDUAL WITH THE REAL/POTENTIAL CONFLICT THAT IS BEING REVIEWED MAY PARTICIPATE IN THE DISCUSSION BUT IS EXCUSED FROM THE MEETING, AND FROM ANY FINAL DISCUSSION AND VOTE, WHEN A DECISION IS BEING MADE ON WHETHER A CONFLICT EXISTS, OR WHEN THE ACTION GIVING RISE TO THE CONFLICT OF INTEREST IS DECIDED. WHERE APPROPRIATE, THE CHIEF RISK OFFICER OR CHIEF LEGAL OFFICER WILL PROVIDE PLAN TO MANAGE CONFLICTS AND AVOID PARTICIPATION BY THE CONFLICTED INDIVIDUAL IN THE MATTER GIVING RISE TO THE CONFLICT OF INTEREST. AUDITING AND MONITORING OF THIS PROCESS IS DONE REGULARLY. ALL DOCUMENTATION OF CONFLICT OF INTEREST DISCLOSURES IS RETAINED IN ACCORDANCE WITH ORGANIZATION RETENTION POLICY. FORM 990, PART VI, SECTION B, LINE 15B PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. IT IS PROVIDENCE'S INTENTION TO MAKE FINANCIAL INFORMATION ACCESSIBLE AND TRANSPARENT. ALTHOUGH THE FILING OF FORM 990 PROVIDES INSIGHT INTO HOW PROVIDENCE ACHIEVES ITS MISSION, DELIVERS ITS PROGRAMS AND STEWARDS ITS FINANCES, DECIPHERING THE INFORMATION DIRECTLY FROM FORM 990 CAN BE CHALLENGING. THE FOLLOWING PARAGRAPHS PROVIDE FURTHER INFORMATION ABOUT THE PROCESS WE USE TO DETERMINE COMPENSATION FOR TOP MANAGEMENT, OFFICERS AND KEY EMPLOYEES. PROVIDENCE HAS A SINGLE FIDUCIARY BOARD, WITH RESPONSIBILITY FOR FINANCIAL OVERSIGHT ASSOCIATED WITH FULFILLMENT OF THE PROVIDENCE MISSION, DEVELOPING SYSTEM POLICIES, PROTECTING THE ASSETS ENTRUSTED TO THE ORGANIZATION AND OVERSEEING THE STRATEGIC AND OPERATIONAL AFFAIRS OF PROVIDENCE'S LEGAL ENTITIES. PROVIDENCE ALSO MAINTAINS A NETWORK OF COMMUNITY ENTITY BOARDS WITH RESPONSIBILITY FOR QUALITY OF CARE OVERSIGHT, COMMUNITY RELATIONS, ADVOCACY AND COMMUNITY NEEDS ASSESSMENTS. PROVIDENCE HAS A CONSISTENT COMPENSATION PHILOSOPHY FOR ALL OF ITS SENIOR EXECUTIVES, INCLUDING ALL OFFICERS. SALARIES FOR SENIOR EXECUTIVES ARE REVIEWED AT LEAST ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE, WHICH IS A COMMITTEE OF THE PROVIDENCE BOARD CONSISTING ONLY OF OUTSIDE, INDEPENDENT DIRECTORS. THE COMMITTEE MAKES SURE, AT EACH OF ITS MEETINGS, THAT NO MEMBER OF THE COMMITTEE HAS A CONFLICT OF INTEREST AS TO ANY EXECUTIVE WHOSE COMPENSATION IS REVIEWED BY THE COMMITTEE. THE EXECUTIVE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT CONSULTANT EACH YEAR TO REVIEW SALARIES OF THOSE IN THE MOST SIGNIFICANT LEADERSHIP ROLES IN THE ORGANIZATION. PART OF THE CONSULTANT'S ROLE IS TO REVIEW AN EXTENSIVE ARRAY OF COMPENSATION SURVEYS OF LARGE, NOT-FOR-PROFIT HEALTH CARE SYSTEMS IN THE UNITED STATES. PROVIDENCE IS ONE OF THE LARGER HEALTH SYSTEMS IN THE COUNTRY, AND AS SUCH, THE BOARD BENCHMARKS EXECUTIVE COMPENSATION AGAINST OTHER LARGE, NOT-FOR-PROFIT HEALTH SYSTEMS THAT ARE SUBSTANTIALLY SIMILAR TO PROVIDENCE IN SIZE AND COMPLEXITY (SUCH AS HAVING A SIMILAR AMOUNT OF ANNUAL NET REVENUE). ADDITIONALLY, BECAUSE PROVIDENCE OFTEN LOOKS TO GENERAL INDUSTRY FOR LEADERS IN CERTAIN FUNCTIONAL AREAS, PROVIDENCE ALSO TAKES INTO CONSIDERATION GENERAL INDUSTRY MARKET DATA IN THESE SPECIAL SITUATIONS. BASE SALARIES FOR PROVIDENCE EXECUTIVES ARE GENERALLY TARGETED TO THE "MEDIAN" LEVEL OF THE MARKET DATA (WHERE HALF THE SALARIES IN THE DATA ARE LOWER AND HALF THE SALARIES IN THE DATA ARE HIGHER), AS IDENTIFIED BY THE INDEPENDENT CONSULTANT AND REVIEWED WITH THE EXECUTIVE COMPENSATION COMMITTEE. THE PRESIDENT/CEO UTILIZES THE MARKET INFORMATION PROVIDED BY THE CONSULTANT ALONG WITH FORMAL PERFORMANCE EVALUATIONS, TO DETERMINE SALARY RECOMMENDATIONS FOR OTHER SENIOR EXECUTIVES. THIS PROCESS INCLUDES A RIGOROUS ANALYSIS OF THOSE RECOMMENDATIONS WITH THE EXECUTIVE COMPENSATION COMMITTEE AS A PART OF THE REVIEW AND APPROVAL PROCESS. TOTAL COMPENSATION IS TIED CLOSELY TO PERFORMANCE OF THE ORGANIZATION AND THE INDIVIDUAL. PERFORMANCE INCENTIVES ALLOW EXECUTIVES TO EARN ADDITIONAL COMPENSATION IF THEY HELP LEAD PROVIDENCE IN ACHIEVING SPECIFIC ORGANIZATIONAL GOALS FOR FURTHERING PROVIDENCE'S OPERATING COMMITMENTS AND STRATEGIC OBJECTIVES. THE BOARD OF DIRECTORS CONDUCTS A THOROUGH REVIEW PROCESS TO ENSURE PERFORMANCE INCENTIVES ARE ALIGNED WITH APPROPRIATE MARKET PRACTICES. THE BOARD'S PROCESS FOR SETTING, REVIEWING AND APPROVING EXECUTIVE COMPENSATION FULLY COMPLIES WITH IRS STANDARDS (TO ASSURE THAT ALL COMPENSATION IS CONSIDERED REASONABLE) AND REFLECTS BEST GOVERNANCE PRACTICES IN THE INDUSTRY. THE PROCESS WAS LAST COMPLETED IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. THE PROVIDENCE COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, CONSOLIDATED AUDITED FINANCIAL STATEMENTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE PROVIDENCE INTERNET SITE. FORM 990, PART IX, LINE 11G AGENCY & CONTRACT LABOR: PROGRAM SERVICE EXPENSES 7,729,141. MANAGEMENT AND GENERAL EXPENSES 153,798. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,882,939. BILLING & COLLECTIONS: PROGRAM SERVICE EXPENSES 1,971,096. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,971,096. GENERAL CONSULTING FEES: PROGRAM SERVICE EXPENSES 7,794,133. MANAGEMENT AND GENERAL EXPENSES 613,289. FUNDRAISING EXPENSES 114,488. TOTAL EXPENSES 8,521,910. MEDICAL DIRECTOR & MED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 11,584,609. MANAGEMENT AND GENERAL EXPENSES 14,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,598,809. OTHER PATIENT SERVICES: PROGRAM SERVICE EXPENSES 2,537,874. MANAGEMENT AND GENERAL EXPENSES 48,556. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,586,430. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 1,108,766. MANAGEMENT AND GENERAL EXPENSES 13,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,122,166. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS BETWEEN RELATED TAX-EXEMPT ORGANIZATIONS 28,465,082. OTHER 514,939. COVENANT ACO 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 611573313 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH NETWORK INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 461259908 HEALTHCARE CA 501(C)(3) 12,III SJHS 1 COVENANT HEALTH PARTNERS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 463516417 HEALTHCARE TX 501(C)(3) 12,I CHS 1 COVENANT HEALTH SYSTEM 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS 1 COVENANT HEALTH SYSTEM FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752897026 HEALTHCARE TX 501(C)(3) 7 CHS 1 COVENANT HOSPITAL HOBBS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 844273963 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 822913146 HEALTHCARE TX 501(C)(3) 3 CHS 1 COVENANT MEDICAL GROUP 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752743883 HEALTHCARE TX 501(C)(3) 3 CHS 1 E WA & MT UNEMPLOYMENT COMPENSATION INSURANCE TRUST 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911082119 UNEMPLOYMENT WA 501(C)(3) 12,I PHS WA 1 EVERETT TRANSITIONAL CARE SERVICES PO BOX 5128 EVERETT WA 982065128 943264605 TRANS. CARE WA 501(C)(3) 10 N/A 0 FACEY MEDICAL FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954322584 SUPPORT CA 501(C)(3) 7 PHS SOCAL 1 GAMELIN WASHINGTON ASSOCIATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 201910170 SUPPORT WA 501(C)(3) 7 PHS WA 1 GLOBAL TO LOCAL HEALTH INITIATIVE 2800 SOUTH 192ND ST 104 SEATAC WA 98188 273133200 HEALTHCARE WA 501(C)(3) 7 SHS 1 GRACE CLINIC OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 203856995 HEALTHCARE TX 501(C)(3) 3 CHS 1 HMTS INC 1 HOAG DRIVE NEWPORT BEACH CA 92658 453583707 HEALTHCARE CA 501(C)(3) 12,I HMHP 1 HOAG CHARITY SPORTS 2081 BUSINESS CENTER DR STE 195 NEWPORT BEACH CA 92663 452982422 SUPPORT CA 501(C)(3) 7 HHF 1 HOAG CLINIC 1 HOAG DRIVE BOX 6100 NEWPORT BEACH CA 92658 330676831 HEALTHCARE CA 501(C)(3) 10 HMHP 1 HOAG HOSPITAL FOUNDATION 330 PLACENTIA AVE NEWPORT BEACH CA 92663 953222343 FUNDRAISING CA 501(C)(3) 7 HMHP 1 HOAG MEMORIAL HOSPITAL PRESBYTERIAN 1 HOAG ROAD BOX 6100 NEWPORT BEACH CA 92663 951643327 HEALTHCARE CA 501(C)(3) 3 CHN 1 HOSPICE OF LUBBOCK 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 752133781 HEALTHCARE TX 501(C)(3) 10 CHS 1 INLAND NORTHWEST HEALTH SERVICES 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 911307555 HEALTHCARE WA 501(C)(3) 3 PHS WA 1 INSTITUTE FOR MENTAL HEALTH & WELLNESS 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 814260130 HEALTHCARE WA 501(C)(3) 7 PHS SJHS 1 INSTITUTE FOR SYSTEMS BIOLOGY 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 912003593 HEALTHCARE WA 501(C)(3) 7 WHC 1 JOHN WAYNE CANCER INSTITUTE 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 954291515 HEALTHCARE CA 501(C)(3) 4 PSJHC 1 KADLEC AUXILIARY INC 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 916033089 SUPPORT WA 501(C)(3) 12,III KRMC 1 KADLEC FOUNDATION 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 237005501 SUPPORT WA 501(C)(3) 7 KRMC 1 KADLEC REGIONAL MEDICAL CENTER 1801 LIND AVE SW ATTN TAX DEPT RENTON WA 98057 910655392 HEALTHCARE WA 501(C)(3) 3 WHC 1 LITTLE COMPANY OF MARY 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