2016-05-12T15:21:46-05:00 2015-06-30 GRANT THORNTON LLP 101 CALIFORNIA STREET SUITE 2700 SAN FRANCISCO CA 94111 990 2014-07-01 912154441 Seton Medical Center % JACK SPENCER SETO 6509174528 1900 Sullivan Avenue Daly City CA 94015 Stephen Forney CFO 6509924000 2016-05-09 true BETHANN LONDYNSKY P00847678 4159863900 2014 2016-08-17 19:52:53Z John Ferrelli 1900 Sullivan Avenue Daly City CA 94015 277956734 false 0928 X www.seton.verity.org X 2001 CA Provision of healthcare services. 12 9 1703 132 0 0 43406887 15414004 257036116 257118411 133369 2448619 4075739 2882354 304652111 277863388 352609 2170780 0 0 166230529 165513959 0 0 0 127237508 132438840 293820646 300123579 10831465 -22260191 110787128 131548219 128570947 171212627 -17783819 -39664408 X Provision of healthcare services. false false 218529397 2170780 239272967 Seton Medical Center, an accredited non-profit 357-bed hospital with over 400 physicians, offers the most advanced surgical procedures, treatment, and comprehensive healthcare available. Seton Medical Center offers exemplary medical, surgical, and specialty programs for cardiovascular services, oncology, orthopedics and joint replacement, spine care, and respiratory care, in addition to many specialty services such as diabetes services, urgent care, and care for those without health insurance. Additional information about Seton Medical Center's charitable activities can be found on Schedule O. 17211037 18259018 Seton Medical Center Coastside meets the medical needs of the community of Half Moon Bay, California by offering skilled nursing care to 116 inpatient residents year-round. Key medical services include physical, occupational and speech therapies, radiology/mammography and laboratory, along with full emergency room and other hospital services. 235740434 true true false true false false false false false false true false false true true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 207 0 true 1703 true false false false false false false false false false false X 12 9 false true false false true true true true true false false true true true true true true true true false CA X JACK SPENCER 6505516650 203 REDWOOD SHORES PKWY SUITE 800 Redwood City CA 94065 X Sr Patricia Geoghegan DC Board Chair 1.0 0.0 X X 0 0 0 Colman Ryan MD Vice Chair 1.0 1.0 X X 107563 0 0 Deacon Eugene Smith Secretary/Treasurer 1.0 0.0 X X 0 0 0 Sr Marion Bill DC Board Member 1.0 8.0 X 0 0 0 Sr Linda Ann Cahill DC Board Member 1.0 2.0 X 0 0 0 Sr Michele Randall DC Board Member 1.0 1.0 X 0 0 0 Sr Rachela Silvestri DC Board Member 1.0 1.0 X 0 0 0 Catherine Hamilton MD Board Member 1.0 0.0 X 0 0 0 Michael J Crilly Board Member 1.0 0.0 X 0 0 0 James Rumack MD Board Member 1.0 0.0 X 80640 0 0 Kathy Shapiro MD Board Member 1.0 0.0 X 0 0 0 Robert Issai Board Member 1.0 47.0 X 0 1553079 326419 Michael Pacelli Board Member through Nov. 2014 1.0 0.0 X 0 0 0 Joanne Evelyn Allen President & CEO 40.0 4.0 X 0 756404 131969 Anthony Rispoli Interim CFO through Jan. 2015 40.0 2.0 X 0 0 0 Irwin Shelub Chief Med Offcr thru July 2014 40.0 0.0 X 259294 0 35273 Beverly Fick VP of Patient Care/CNE 40.0 0.0 X 296062 0 29463 Evelyn Nuque Staff Nurse II 40.0 0.0 X 285738 0 24712 Dolly Chan Staff Nurse IV 40.0 0.0 X 270436 0 34313 Anna Wojdyla Lead Echo Technician II 40.0 0.0 X 269106 0 22750 Carol Carmichael Staff Nurse II 40.0 0.0 X 266584 0 24712 Corazon Yabut Staff Nurse IV 40.0 0.0 X 255008 0 24625 2090431 2309483 654236 465 false true false Peninsula Anesthesia Consultants PO Box 39000 SAN FRANCISCO CA 94139 Physician Services 1385556 Healthcare Transformation 70 W Madison CHICAGO IL 60602 Medical Services 1168122 CA Emergency Physicians Medical Gro 2100 Powell Street EMERYVILLE CA 94608 Physician Services 1056431 Shared Imaging 801 Phoenix Lake Avenue STREAMWOOD IL 60107 Medical Services 918425 Action Therapeutics 3b South Linden Ave SOUTH SAN FRANCISCO CA 94080 Medical Services 898769 28 814004 14600000 15414004 NET PATIENT REVENUE 621110 253393179 253393179 MEDICAL OFFICE BUILDING REVENUE 531120 3247226 3247226 OTHER HOSPITAL OPERATING REVENUE 900099 478006 478006 257118411 2541965 2541965 0 0 0 0 0 93346 -93346 -93346 -93346 0 0 0 ELECTRONIC HEALTH RECORDS INCENTIVE REVENUE 900099 1522716 1522716 PHYSICIAN BILLING 541200 413574 413574 PHARMACY 446110 361350 361350 584714 584714 2882354 277863388 257531985 0 4917399 2170780 2170780 0 0 0 527666 527666 0 122764644 88303744 34460900 11100000 7989555 3110445 22381489 16108868 6272621 8740160 6292915 2447245 0 678466 678466 0 0 0 0 32439722 25776299 6663423 0 0 2031746 1828571 203175 9171415 6603419 2567996 0 4267802 3072817 1194985 28603 20594 8009 0 31279 22521 8758 3761613 3761613 0 10334564 9507799 826765 3549864 2305078 1244786 MEDICAL SUPPLIES 32391798 32391798 PROVIDER FEES 21821264 21821264 BAD DEBTS 6844166 6844166 EQUIPMENT RENTAL EXPENSE 2723732 2451359 272373 2362806 1701221 661585 300123579 235740434 64383145 0 0 0 7737751 11936272 0 0 33960295 29855619 0 0 0 0 0 0 2953859 3252827 1641531 321772 264778628 225674897 46888772 39103731 0 0 0 0 0 0 0 0 17604920 47077998 110787128 131548219 9272392 7519403 0 0 0 0 0 15692428 0 0 0 0 0 0 0 0 119298555 148000796 128570947 171212627 X -17783819 -39664408 0 0 0 0 -17783819 -39664408 110787128 131548219 X -22260191 -1396 380998 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 300123579 300123579 1000000 250000 1000000 1000000 1000000 3000000 4500000 780694 0 0 780694 250000 250000 250000 750000 1125000 0 0 0 Explanation of Lobbying Activities Schedule C, Part II-A: Seton Medical Center did not incur any lobbying expenditures or conduct lobbying activities during the tax year ending June 30, 2015. Schedule C is being completed as the organization had an IRC Section 501(h) election in effect during the tax year. 5452823 5452823 146220692 128765569 17455123 91512 91512 108288468 94641301 13647167 4725133 2176515 2548618 39103731 DUE FROM RELATED PARTIES 20878369 OTHER RECEIVABLES 14452456 OTHER RESTRICTED ASSETS 9656048 DUE FROM GOVERNMENT AGENCIES 1760994 DEPOSITS 276095 RENTS RECEIVABLE 54036 47077998 0 DUE TO RELATED ORGANIZATIONS 116073007 OTHER ACCRUED LIABILITIES 18839346 ACCRUED PROVIDER FEES 9424747 PENSION OBLIGATION 1517000 ASSET RETIREMENT OBLIGATION 991545 DUE TO GOVERNMENT AGENCIES 901484 DEPOSITS 253667 148000796 Schedule D, Part X, Line 2 Daughters of Charity Health System and its affiliates do not have a liability for uncertain tax positions under FIN 48 (ASC 740) on their consolidated financial statements for the year ended June 30, 2015. As such, there was no FIN 48 (ASC 740) disclosure in the footnotes to the consolidated financial statements of Daughters of Charity Health System. true true X true X true X true true true false true true 810860 0 810860 0.00280 94351509 63120823 31230686 0.10650 95162369 63120823 32041546 0.10930 21657 805 20852 0.00010 1156 0 1156 0.00010 1199434 749591 449843 0.00150 700 0 700 0.00010 1222947 750396 472551 0.00180 96385316 63871219 32514097 0.11110 20445 0 20445 0.00010 20445 0 20445 0.00010 true 6844166 76737023 110561745 -33824722 X true true 2 1 Seton Medical Center 1900 Sullivan Avenue Daly City CA 94015 www.seton.verity.org 220000026 X X X A 2 Seton Medical Center Coastside 600 Marine Blvd Moss Beach CA 94038 www.setoncoastside.verity.org 220000026 X X X A A false false true X X X X X X X X X 12 true true true true X See Part V, Section C X See Part V, Section C X true 12 true See Part V, Section C false false true X 200. 350. X X X X X X true true X X X X true X X X X X true X false X X X X true X false false Part V, Section B, Lines 2, 3j, 7d, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24: N/A Part V, Section B, Line 5: See disclosure for Part VI, Question 2: Needs Assessment Part V, Section B, Line 6a: Seton Medical Center's ("SMC") Community Health Needs Assessment ("CHNA") was conducted in conjunction with the following hospitals: Sequoia Hospital, Kaiser Permanente (San Mateo Area), Lucile Packard Children's Hospital at Stanford, Mills-Peninsula Health Services, San Mateo Medical Center, and Stanford Hospital & Clinics. Part V, Section B, Line 6b: SMC's CHNA was conducted in conjunction with the following organizations (other than hospitals): San Mateo County Health Department, Health Plan of San Mateo, Hospital Consortium of San Mateo County, Peninsula Health Care District, San Mateo County Human Services Agency, and Silicon Valley Community Foundation. Part V, Section B, Line 7a: The CHNA report can be accessed on the hospital's website at: https://seton.verity.org/aboutus/community-benefit/ Part V, Section B, Line 7b: The CHNA report can be accessed on website's (other than the hospital's own), including: o www.smchealth.org o www.plsinfo.org/healthysmc o www.hospitalcosrt.org Part V, Section B, Line 10a: SMC's most recently adopted implementation strategy can be accessed on the hospital's website at: https://seton.verity.org/aboutus/community-benefit/ Part V, Section B, Line 11: Seton Medical Center ("SMC") and Seton Medical Center Coastside's ("SMCC") Community Benefit Implementation Plan is driven by the Seton Medical Center Executive Team and the Community Advisory Committee. The Seton Medical Center Community Advisory Committee ("CAC") members have been meeting quarterly for nearly 20 years to review community needs and identifying the community benefit plan. CAC members are leaders in the community representing schools, places of worship, community services and businesses, who meet quarterly to discuss the community benefit plan and receive updates on the accomplishments of the CBP goals and objectives. The plan was also presented to the SMC Board for review, discussion and approval. The 2013 implementation plan was developed based on the San Mateo County Community Needs Assessment and a review of the hospital's existing community benefit plan. The CAC reviewed the summary of the 2013 San Mateo Community Needs Assessment and participated in the San Mateo County Healthy Community Collaborative Focus Group health needs prioritization. The Health Needs SMC and SMCC will address include: 1. Obesity 2. Diabetes 3. Cardiovascular disease, heart attack, stroke 4. Cancer 5. Births Obesity, diabetes, cardiovascular disease, heart attack, and stroke are health needs as: the percentage of people who have diabetes is rising; there are a low and declining percentage of people who exhibit healthy behaviors, and the percentage of people who exhibit more than one risk factor cardiovascular disease is increasing (high blood cholesterol, blood pressure, diabetes, smoking, diet, no exercise, alcohol consumption, and family history). To combat these factors, SMC and SMCC have outlined the following strategies: o Promote exercise and "Instant Recess" at health events, local faith based organizations, schools, community centers, Community Day, Streets Alive, and Parks Alive. o Provide low cost cholesterol and diabetes laboratory screenings at SMC and community events. o Provide blood pressure screenings and educational presentations at health fairs o Provide diabetes education (including tips to manage diabetes), diabetes support groups, nutrition information, glucose monitoring information, diabetes meter instructions, and wound care education o Provide nutrition education regarding: the sugar content in food and beverages, reducing salt intake, education for health Filipino and African American cooking, healthy food choices, and an over eaters support group. o Promote development and implementation of work place/school wellness policies Through these actions, SMC and SMCC seek to decrease the percentage of people that exhibit one or more risk factors for cardiovascular disease and increase the percentage of community members which exhibit the four health behaviors: exercise, maintaining a healthy weight, eating 5 fruits and vegetables a day, and not smoking. Success in this area will be measured by benchmarks and outcome indicators outlined in the full implementation strategy. Cancer is a health need as breast, cervical, colorectal, and prostate cancer incidences are all failing benchmarks in San Mateo County. To combat this, SMC and SMCC have outlined the following strategies: o Continue to promote healthy behaviors o Promote early detection screenings internally and at health events o Identify low cost screening opportunities in the community o Identify and establish additional cancer support groups, as needed. Through these actions, SMC and SMCC seek to encourage individuals to adopt healthy lifestyles and increase access to early detection screenings. Success in this area will be measured by benchmarks and outcome indicators outlined in the full implementation strategy. Births is a health need as women of some ethnicities continue to receive inadequate prenatal care. To combat this, SMC turns to the Elizabeth Ann Seton New Life Center, which will provide (with language capacity and culturally sensitivity) all inclusive perinatal services for low income, pregnant women. Additionally, the Elizabeth Ann Seton New Life Center provides quality pre-natal care and delivery, education and appropriate referrals to each mother during the entire pregnancy and 60 days post-partum. Looking forward, SMC seeks to increase outreach to the Pacific Islander population about the importance of pre-natal care and the New Life Center. In doing so, more pregnant women that are Pacific Islander will access pre-natal care. Success in this area will be measured by benchmarks and outcome indicators outlined in the full implementation strategy. SMC's implementation strategy does not target as actionable for intervention by SMC all of the health priority needs that were identified during the assessment because of limited resources and the availability of other providers in the community with more capacity/expertise to address those needs. SMC provides referrals to programs offered in the community addressing these identified needs and will continue to collaborate with the community services and resources that address these top community health needs. (1) Asthma & Respiratory: was not identified as one of the top five priorities by CAC due to a lack of resources to expand services. SMC provides asthma and respiratory direct service programs that address these health needs and refers to community resources. (2) Substance Abuse: SMC does not have the resources to provide direct services for substance abuse treatment/prevention. SMC provides referrals to community partners/programs addressing substance abuse, including: Alcoholic, Alanon, Alateen Recovery; Asian American Recovery Services; Catholic Charities; El Centro de Libertad; Pyramid Alternatives; StarVISTA; Sitike Counseling Center, Women's Recovery Association. (3) Poor Oral Health: SMC does not have the resources to provide a dental program. Referrals are made to community based programs, including Sonrisas and the County Health Department. (4) Violence: SMC does not have the resources to provide direct services. SMC partners with community programs that provide counseling and address violence, including: Community Overcoming Relationship Abuse (CORA); ALICE; Freedom House; Rape Trauma Services; Fatherhood Collaborative and Cleo Eulau Center; Police Activities League; and Bay Area Legal Aide. (5) Infectious Diseases: SMC has an infection control program within the hospital and educates the community about hand hygiene during the flu season. SMC refers people seeking TB screenings to the County Health Department. (6) STDs, including HIV-AIDS: SMC does not have the resources to provide a STD program. SMC refers to community programs and services, including: County Health Clinic, Clinic by the Bay; Daly City Youth Health Center. Health Center. Part I, Line 3c: N/A Part I, Line 6a: Seton Medical Center ("SMC") prepares an annual Community Benefit Report. The report includes both the SMC location and the Seton Medical Center Coastside ("SMCC") location. The Community Benefit Plan ("CBP") is driven by the commitment to the SMC mission by the SMC Executive Team and the CAC. Committee members consist of leaders in the communities representing schools, places of worship, community services and businesses. These committee members meet semi-annually to discuss our community benefit plan and receive updates on the accomplishments of the CBP goals and objectives. Semi-annual reports are presented to the SMC/SMCC Board of Directors, Finance and Audit Committee, and Daughters of Charity Health System ("DCHS") corporate offices. An annual update is prepared and presented to the SMC/SMCC Board of Directors for approval. The annual update is made available to medical center leadership, key stakeholders, DCHS, and the community. The annual update is presented to the California Office of Statewide Planning and Development, in accordance with SB697. Part I, Line 7, Column (f): Form 990, Part IX, line 25, Column A for SMC/SMCC reflects a bad debt expense of $6,844,166 which is not included in the line 7 calculation. Part I, Line 7: SMC/SMCC utilizes a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges. Part II: N/A Part III, Line 2: Bad debt expense is estimated by utilizing historical data and expected net collections of self-pay patients. In making this estimate, Management also considers business and general economic conditions in its service area. Part III, line 3: N/A Part III, Line 4: SMC/SMCC is included in the DCHS Consolidated Audited Financial Statements. The financial statements for FY 2015 do not contain a separate footnote on bad debts. Part III, Line 8: As a not-for-profit hospital it is our mission to improve the health status of all people within our community and provide healthcare to all patients regardless of their ability to pay or their insurance status. SMC and SMCC accepts Medicare which results in shortfalls in the costs for caring for patients utilizing this program. We utilize a cost accounting system that determines costs for providing medical services based on the organizations relationship of costs to charges. The entire shortfall shown on Part III, Line 7 should be reflected as a community benefit. Part III, Line 9b: SMC/SMCC follows the Collection Practices as outlined in DCHS Charity Care and Financial Discount and Financial Assistance operating policies. For patients who qualify for charity care and financial discount, SMC/SMCC provides the patient with a written notice prior to commencing collection activities. The notice states that nonprofit counseling services may be available in the area and provides information concerning state and federal law requirements for debt collectors. SMC/SMCC does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed or there are not significant income sources. SMC/SMCC does not assign patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SMC/SMCC does not report adverse information to a consumer credit agency or commence civil action for nonpayment of a patient debt prior to 150 days after the initial billing of the patient. SMC/SMCC does not use wage garnishments or liens on real property as a means of collecting unpaid hospital bills for eligible patients. SMC/SMCC expects its external collection agencies to not pursue legal action against an eligible patient without prior approval from SMC/SMCC. SMC/SMCC expects its external collection agencies to follow Fair Debt and Collection Practices, Assembly Bill AB774 and act in a manner that treats individuals with dignity, respect and compassion. In addition, for patients who qualify for financial assistance, SMC/SMCC does not pursue legal action for non-payment of bills against any household where the primary wage earner(s) is unemployed, uninsured or there are not significant income sources or assets. SMC/SMCC does not assign eligible patients meeting an agreed upon monthly payment plan to a collection agency and does not report the patient to credit bureaus. SMC/SMCC does not use liens on real property as a means of collecting unpaid hospital bills for eligible patients. Part VI, Question 2: In an effort to identify the most critical health care needs in SMC/SMCC's service area, a Community Needs Assessment is conducted every three years. The annual SMC/SMCC Community Benefit Plan ("CBP") is developed through: (1) analysis of San Mateo County health indicators, and (2) review of the accomplishments of CBP goals. SMC and SMCC Community Advisory Committee ("CAC") members meet semi-annually to receive updates on the accomplishments on the CBP goals and participate in discussions concerning community health. Annual CBP reports are presented to the SMC Board and Finance and Audit Committee for review, discussion and approval. Analysis of State, County and local health indicators are conducted through the review of the Fiscal Year 2013 (tax year 2012) Community Health Needs Assessment: Health and Quality of Life in San Mateo County, a group of San Mateo County organizations interested in the community's health, worked together to conduct the FY 2013 Community Needs Assessment of San Mateo County as follow-up to assessments conducted in 1995, 1998, 2001, 2004, 2008 and 2011. A copy of the complete Community Needs Assessment, is available on the Internet on the County Website or Peninsula Library System website at http://plsinfo.org/healthysmc. The FY2013 Community Health Needs Assessment: Health & Quality of Life in San Mateo County is designed to serve as a tool for guiding policy and planning efforts, and to formulate strategies to improve the quality of life. For participating hospitals, the information in this assessment will serve to assist in developing Community Benefit Plans pursuant to Legislative Bill 697. The goals of the Community Collaborative are twofold: 1. To produce a functional, comprehensive, triennial community needs assessment that can be used for strategic planning of community programs throughout the County and as a guideline for policy and advocacy efforts; and 2. To promote collaborative efforts in the community to develop projects to improve the health of our communities based on the data, community input, and group consensus. Healthy Community Collaborative Members: o Sequoia Hospital o San Mateo County Health Department o Health Plan of San Mateo o Hospital Consortium of San Mateo County o Kaiser Permanente, San Mateo Area o Lucile Packard Children's Hospital at Stanford o Mills-Peninsula Health Services o Peninsula Health Care District o San Mateo County Health Department o San Mateo County Human Services Agency o San Mateo Medical Center o Seton Medical Center o Silicon Valley Community Foundation o Stanford Hospital & Clinics The FY2013 Community Health Needs Assessment: Health & Quality of Life in San Mateo County highlights that in many areas San Mateo County residents are healthier than in many other places. However, the data also demonstrates that preventable diseases are on the rise and so we must do more to prevent these diseases from occurring in the first place. It also shows that health is not distributed evenly across the population and there are many communities that still do not experience good health and a high quality of life. The following health needs were generated from the primary and secondary data as well as input from focus group participants. Seton Medical Center's Prioritized Community Needs are: 1) Obesity 2) Diabetes 3) Cardiovascular disease, heart attack, stroke 4) Cancer 5) Births Health Needs: 1) Obesity 2) Diabetes 3) Cardiovascular disease, heart attack, stroke Need: The percentage of people who have diabetes is rising. There are a low and declining percentage of people who exhibit healthy behaviors. The percentage of people who exhibit more than one risk factor for cardiovascular disease is increasing (high blood cholesterol, blood pressure, diabetes, smoking, diet, no exercise, alcohol consumption, and family history). Action: o Promoting exercise and "Instant Recess" at health events, local faith based organizations, schools, community centers, Community Day, Streets Alive, and Parks Alive. Supporting exercise weekly community shopping center walking program Walkabout/TalkAbout. Heart Healthy Exercise Program and Cardiac Rehabilitation. o Low costs cholesterol and diabetes laboratory screenings at Seton and at community events. o Blood pressure screening at health fairs and educational presentations. o Diabetes education, managing your diabetes, support group, nutrition information, glucose monitoring, diabetes meter instruction, and wound care education. o Nutrition education: Sugar content in food and beverages, reducing salt intake, healthy Filipino and African American cooking, healthy food choice, and Over Eaters support group. o Advocacy: Promote development and implementation of work place/school wellness policies. Community Advisory Committee Members presenting Community Needs Assessment and Community Benefit Implementation Plan to City Mayors and City Mangers, businesses in service area. Outcome: An increase of the percentage of community members will exhibit the four healthy behaviors: exercise, maintaining healthy weight, eating 5 fruits and vegetables, not smoking. Decrease in the percentage people that exhibit more than one risk factor for cardiovascular disease. Measurement: o Number of presentations made to chamber of commerce and city government officials o More business and employers will promote healthy living o Providing health education and screenings at 12 community events. 4) Cancer: Need: Breast, Cervical, Colorectal and prostate cancer incidence are all failing benchmarks. Action: o Promote healthy behaviors. o Promoting early detection screenings internally and at health events. o Identify low cost screening opportunities in community. o Identify and establish additional cancer support group as needed. Outcome: People will adopt health lifestyles and access early detection screenings. Measurement: o Prostate Cancer support group meeting consistently o Number of people attending Prostate Cancer Support Group o Number of low cost screening opportunities in community 5) Births: Need: Women of some ethnicities continue to receive inadequate prenatal care. Action: o Elizabeth Ann Seton New Life Center will provide with language capacity and cultural sensitivity all inclusive perinatal services for low income, pregnant women. Provide quality pre-natal care and delivery, education and appropriate referrals to each mother during the entire pregnancy and 60 days post-partum. Increase outreach to the Pacific Islander population about the importance of pre-natal care and the New Life Center. Outcome: More pregnant women that are Pacific Islanders will access pre-natal care. Measurement: number of pregnant women that are Pacific Islanders that received pre-natal care Part VI, Question 3: Patients who present at SMC/SMCC's Emergency Department and SMC/SMCC's Admitting Department are provided with a financial assistance packet that consists of an informational flyer on various programs for which they may be eligible. The flyer is in English and Spanish. The packet includes a Medi-Cal application, as well as a Charity Care application. In addition, there are signs posted in English and Spanish in the Patient Financial Services department and at every point of registration stating that SMC/SMCC has financial assistance and charitable programs available for qualified low income, uninsured patients who may not have the ability to meet the financial obligation of their hospital services and a contact number to call. After discharge, the back of the monthly patient bills includes this same statement. Part VI, Question 4: Seton Medical Center is a major tertiary care center; serving northern and central San Mateo County and the most southern part of San Francisco County. Seton Coastside in Moss Beach provides the only 24-hour physician-staffed standby emergency department on the coast between Daly City and Santa Cruz. Seton Coastside also provides a skilled nursing unit, an acute-care unit, radiology, laboratory, and rehabilitative services. Seton Coastside's service area constitutes a large geographic area that extends 45 miles from Montara south to the Santa Cruz County line. San Mateo County is clearly one of California's richly ethnically diverse counties. The Asian/Pacific Islander population and Hispanic/Latino population are primarily clustered in Northern San Mateo County and along the Coast. In Daly City, a primary service area of Seton, 52% of the residents are foreign born residents and 68.1% of persons over the age of five speak a language other than English at home. South San Francisco, the second largest service area of Seton has 42.9% foreign born and 60.3% of persons over the age of five speak a language other than English at home. While other age groups will decrease in terms of percent of county population (0-19 years, 20-39 years, 40-59 years) from 2010 to 2050, those 60 years and older will increase from 18.9 percent to 30.9 percent. Asian/Pacific Islander and Hispanic seniors will comprise the largest proportion of seniors in San Mateo County in 2050. At the other end of the age spectrum, the ethnic makeup of children under the age of 15 years is projected to be Hispanic, Asian/Pacific Islander, White, Black and multi-race in 2050. In 2010, median earnings for San Mateo County residents aged 25 years and older was $47,060. Real per capita income in San Mateo County in 2010 was $68,582, and the average weekly wages in 2010 were $1,450, down 13% from 2000. According to the American Community Survey (U.S. Census Bureau), from 2006-2010, the percentage of SMC individuals below poverty level was 7 percent with 9.1 percent of children under the age of 18 below the poverty level. According to the Family Economic Self- Sufficiency Standard, a more realistic measure of poverty in SMC takes local conditions like cost of living into consideration; a single parent with two children must earn approximately $78,000 annually to meet the family's basic needs, the equivalent of nearly five, full-time minimum wage jobs. According to the Elder Index, 36 percent of seniors struggle to cover basic expenses and, if their annual income exceeds federal poverty guidelines ($10,830), they may be ineligible for public assistance programs. Part VI, Question 5: Our promotion of community health includes ongoing health education about healthy habits. SMC/SMCC participated in over 12 annual community events and focuses on small venues to further this health education effort. Nurses and physicians volunteering at these events talk individually with community members about blood pressure management, nutrition and healthy habits. SMC/SMCC physicians, nurses and medical staff routinely volunteer their time to make presentations on healthy heart practices, stroke awareness and nutrition at schools, community centers and places of worship. Within the hospital, health related support groups are provided. To address the uninsured, SMC/SMCC continues to support free urgent care to the uninsured at two RotaCare Clinics. Monday night RotaCare Clinic is located at Seton Medical Center in Daly City and Wednesday night RotaCare Clinic is located in Half Moon Bay. The Clinics provide medical care, certain medications, laboratory and diagnostics, x-rays, immunizations, referrals to Seton Ophthalmologist services, social needs referrals within the community, health education and health care referrals. The medical care is provided primarily by volunteer physicians, physician assistants, nurse practitioners, and nurses. The partnership with Daly City ACCESS serves as the catalyst to promote community outreach with cultural sensitivity and language capacity at health fairs. Representatives of family service agencies and healthcare facilities work together to provide language interpretation, as needed at the health fairs. The St. Elizabeth Ann Seton New Life Center established at Seton Medical Center in 2003, provides all-inclusive peri-natal services for low-income, pregnant women in our community. In order to achieve its goal of decreasing the incidence of pre-term and low birth-weight babies of mothers in the program, the New Life Center provides quality prenatal care and delivery, education and appropriate referrals to each mother for entire pregnancy and 60 days post-partum, and expedites enrollment of pregnant women into the Medi-Cal program. The Center offers physician services and health education, as well as nutritional, social and support services, all in one location. Seton Medical Center supports the New Life Center by providing comprehensive birthing facilities for new mothers. There is a direct correlation between the economic distressed clients and the increase of the variety of challenges they face, e.g. potential homelessness, drug use, domestic violence, poor access to food and clothing, lack of transportation, noninvolvement of the fathers of the babies, joblessness, and low education. This year there has been a significant increase in the percentage of clients that complete the program along with an increase of clinic visits. Community Building Activities Collaboration with the community enables SMC/SMCC to successfully reach the annual CBP goals and objectives. Participating on various committees throughout the county is another avenue to learn about community needs, which services are provided and to avoid duplication of the services. Partners include local schools and school districts, businesses, community service clubs, churches, foundations and State, County and City elected officials and agencies. Additionally, community volunteers, Seton Medical Staff and Seton Associates routinely donate time and resources. Chamber of Commerce Boards: SMC/SMCC has consistently shown support with the following chamber of commerce boards, Daly City - Colma, Brisbane, Half Moon Bay, Pacifica, and South San Francisco. SMC/SMCC is also members of the Chairman's Circle on the following chambers: Daly City - Colma, Brisbane, Half Moon Bay and Pacifica. Many of the safety nets for families and community members have been cut back due to the economy. Some of the services are in collaboration with each other and event sharing staff to keep programs operating at a minimum. Part VI, Question 6: The Daughters of Charity Health System ("DCHS") is a regional health care system of hospitals and medical centers ("Local Health Ministries") spanning the California coast from the San Francisco Bay Area to Los Angeles. In the spirit of our founders, St. Vincent de Paul, St. Louise de Marillac and St. Elizabeth Ann Seton, the Daughters of Charity Health System is committed to serving the sick and the poor. With Jesus Christ as our model, we advance and strengthen the healing mission of the Catholic Church by providing comprehensive, excellent health care that is compassionate and attentive to the whole person: body, mind and spirit. We promote healthy families, responsible stewardship of the environment, and a just society through values-based relationships and community based collaboration. Every day in DCHS Local Health Ministries, dedicated associates, physicians and volunteers provide quality, compassionate care. These thousands of people are the hands and hearts of the Daughters of Charity, reaching out to provide comfort and holistic healing - body, mind and spirit - to the people of California, just as the first Daughters did more than 150 years ago. As a member of the Daughters of Charity Health System, SMC/SMCC continues to uphold its mission of providing quality medical services to the most vulnerable populations, the sick, the poor, the elderly, and children. SMC/SMCC is committed to the fulfillment of the mission of its founding sisters through the delivery of charitable services and care to the community. Part VI, Question 7: SMC/SMCC annually updates its Community Benefits Report and SMC/SMCC files a copy of its Community Benefits Report on an annual basis with the State of California. true DCHS Medical Foundation 400 Race Street San Jose CA 95126 413691852 501(c)(3) 2170780 Program Support 1 0 Grant to DCHS Medical Foundation Schedule I, Parts I & II: Seton Medical Center is part of a related group of tax exempt organizations, which includes DCHS Medical Foundation. Grants are made to support this related tax exempt organization's exempt purpose. false true false false false false false false false Robert Issai Board Member 0 937792 0 0 0 615287 0 303132 0 23287 0 1879498 0 0 Joanne Evelyn Allen President & CEO 0 468170 0 0 0 288234 0 91531 0 40438 0 888373 0 0 Irwin Shelub Chief Med Offcr thru July 2014 226564 0 0 0 32730 0 12349 0 22924 0 294567 0 0 0 Beverly Fick VP of Patient Care/CNE 280004 0 0 0 16058 0 8733 0 20730 0 325525 0 0 0 Evelyn Nuque Staff Nurse II 282681 0 0 0 3057 0 4550 0 20162 0 310450 0 0 0 Dolly Chan Staff Nurse IV 266416 0 0 0 4020 0 4550 0 29763 0 304749 0 0 0 Anna Wojdyla Lead Echo Technician II 268454 0 0 0 652 0 22750 0 0 0 291856 0 0 0 Carol Carmichael Staff Nurse II 263463 0 0 0 3121 0 4550 0 20162 0 291296 0 0 0 Corazon Yabut Staff Nurse IV 255008 0 0 0 0 0 4463 0 20162 0 279633 0 0 0 Methods Used to Establish Compensation for CEO by a Related Organization Schedule J, Part I, Line 3: The President & CEO is an employee of Daughters of Charity Healthy System ("DCHS"). DCHS uses one or more of the following methods to establish top management officials' compensation: independent compensation consultant, compensation survey or study, approval by the Board or Compensation Committee, Form 990 of other organizations, and written employment contracts. Severance Arrangements Schedule J, Part I, Line 4a: Some of the listed individuals may have a severance provision as part of their employment arrangement. The severance provision ranges from 6 months to 2 years. Nonqualified Retirement Plan Schedule J, Part I, Line 4b: The following individuals participated in a supplemental nonqualified retirement plan, which is included in compensation reported on Schedule J, Part II, Column (c): Robert Issai $104,257 Joanne Evelyn Allen $ 31,589 Beverly Fick $ 933 Explanation of Other Reportable Compensation Schedule J, Part II: Certain individuals listed on Schedule J, Part II received a retention payment during the 2014 calendar year, which is reported as "Other Reportable Compensation" on Schedule J, Part II, Column (b)(iii). The payments were made to retain employees whose continuity of employment was essential during the transaction period of solicitation of proposals for the sale of the Daughters of Charity Health System, which includes this filing organization. These payments were approved in advance by the Board of Directors of Daughters of Charity Health System. A CA Statewide Communities Development Authority 680164610 13080SCV4 2014-07-30 110000000 Working Capital false false true B CA Statewide Communities Development Authority 680164610 13080SCX0 2014-08-27 15000000 Working Capital false false true A 0 0 13937000 0 0 0 253400 0 13683600 0 0 0 false false true true B 0 0 1900500 0 0 0 0 0 1900500 0 0 0 false false true false A false false false false 0.00000 0.00000 0.00000 false false false true B false false false false 0.00000 0.00000 0.00000 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true Schedule K, Part I, Column (e) The issue price for the bond dated 7/30/2014 is $110,000,000 (as declared on the filed Form 8038); Seton Medical Center benefited from $13,937,000 of these funds. The issue price for the bond dated 8/27/2014 is $15,000,000 (as declared on the filed Form 8038); Seton Medical Center Form 990, Part III, Line 4a: The Daughters of Charity Health System ("DCHS") is a regional health care system of hospitals and medical centers ("Local Health Ministries") spanning the California coast from the San Francisco Bay Area to Los Angeles. In the spirit of our founders, St. Vincent de Paul, St. Louise de Marillac and St. Elizabeth Ann Seton, the Daughters of Charity Health System is committed to serving the sick and the poor. With Jesus Christ as our model, we advance and strengthen the healing mission of the Catholic Church by providing comprehensive, excellent health care that is compassionate and attentive to the whole person: body, mind and spirit. We promote healthy families, responsible stewardship of the environment, and a just society through values-based relationships and community based collaboration. Every day in DCHS Local Health Ministries, dedicated associates, physicians and volunteers provide quality, compassionate care. These thousands of people are the hands and hearts of the Daughters of Charity, reaching out to provide comfort and holistic healing - body, mind and spirit - to the people of California, just as the first Daughters did more than 150 years ago. As a member of the Daughters of Charity Health System, Seton Medical Center continues to uphold its mission of providing quality medical services to the most vulnerable populations, the sick, the poor, the elderly, and children. Seton Medical Center is committed to the fulfillment of the mission of its founding sisters through the delivery of charitable services and care to the community. During fiscal year ended June 30, 2015, Seton Medical Center provided total quantifiable community benefits of $206.9 million. After offsetting direct revenue, Seton Medical Center provided unsponsored community benefits of $66.4 million, at cost. Total unsponsored community benefits of $66.4 million, at cost consisted of quantifiable unsponsored benefits for the poor at a cost of $32.5 million, quantifiable unsponsored benefits to the broader community at a cost of $0.1 million, and quantifiable unsponsored benefits to beneficiaries of the medicare program at a cost of $33.8 million. Form 990, Part IV, Line 12b, and Part XII, Line 2b and 2c: The financial statements of the organization are consolidated by the Daughters of Charity Health System and include each of the affiliated Local Health Ministries, their related fundraising Foundations and other related organizations (as listed on Form 990 Schedule R) in accordance with GAAP and audited by an independent public accounting firm. The Daughters of Charity Health System's Board and Audit Committee of the Board have responsibility for oversight of the audit of the consolidated financial statements and selection of the independent public accounting firm. Form 990, Part VI, Line 3 and Part VII, Section A and Line 5: The management duties of Interim Chief Financial Officer (until January 2015) were delegated to Anthony Rispoli, a consultant with Healthcare Transformation LLC, an unrelated organization that works exclusively with a number of hospitals providing consulting services and temporary executive staffing, during tax year ended June 30, 2015. Form 990, Part VI, Line 6: Seton Medical Center has one member, Daughters of Charity Health System, a California nonprofit religious corporation. Form 990, Part VI, Line 7a: The Member's Board of Directors may appoint the organization's directors and officers. Form 990, Part VI, Line 7b: The sole member has broad powers including the power to amend the Bylaws and Articles of Incorporation, and approve, interpret and change any statement of mission, philosophy, role or purpose of Seton Medical Center. The member has the right to approve any merger, dissolution, consolidation or reorganization of Seton Medical Center. In addition, the member has the right to approve capital and operating budgets, approve debt incurred or guaranteed, approve the disposition of the assets, and establish policy concerning quality of care, finance and resources. Finally, the member has such other powers and rights as provided by the California Nonprofit Corporation Law. Form 990, Part VI, Line 11b: Grant Thornton LLP and the System's finance staff work together to gather the required tax information necessary to complete the tax returns. The initial draft return is reviewed by Grant Thornton and the System's finance staff. After the return is discussed and reviewed, recommended changes are reflected on the return and a draft tax return is prepared. Prior to filing with the internal revenue service, the final version of the Form 990 is distributed to the organization's board of directors. Form 990, Part VI, Line 12c: Daughters of Charity Health System ("DCHS") has a Conflict of Interest Policy that covers DCHS and all of its affiliates. The policy provides for a systematic and ongoing method of requiring individuals who have decision making responsibility to disclose and address potential and actual conflicts of interest. Covered individuals are required to complete an annual statement disclosing any conflicts of interest and have a duty to update the disclosure for any potential conflicts of interest that arise during the year. The Presidents/CEOs of the health ministries report the conflict of interest findings and resolutions to their respective Board of Directors. This policy is reviewed annually for compliance by the DCHS's Corporate Responsibility Officer. Form 990, Part VI, Line 15a and 15b: The Daughters of Charity Health System ("DCHS") compensation programs cover DCHS and all of its affiliated Local Health Ministries. The CEO of each Local Health Ministry is employed by DCHS. The DCHS compensation programs are designed to recruit, retain, and motivate qualified executives. The programs are designed for positions that have a significant impact on the high-level strategic and policy direction of DCHS and its affiliated Local Health Ministries. All of the Local Health Ministry CEOs are paid directly by DCHS and covered by the DCHS compensation programs. Market data analyses are made of comparable organizations within the industry and within the region. Total compensation is established for all executive positions to target similar total compensation of comparable organization market compensation. Base pay is established for all executive positions to target the median range of comparable organization market compensation. DCHS utilizes a benefits committee to review compensation and benefits. The DCHS Board of Directors reviews and approves compensation recommended by the benefits committee, and documents its conclusion that the proposed compensation is reasonable. In evaluating and finalizing its determination of base pay and total compensation for comparable positions at comparable organizations in comparable markets, DCHS utilizes available market data analyses including the DCHS benefits committee, independent compensation consultant, Form 990 of other organizations, written employment contracts, compensation survey or study, recommendation of the benefits committee and approval by the DCHS Board of Directors. Form 990, Part VI, Line 19: Seton Medical Center makes its Form 990 available upon request. Form 990, Part XI, Line 9: The other changes in net assets or fund balance consist of the following: Change in Funded Status of Pension Plan $ 626,000 Change in Fair Value of Pension Retirement Plan $(245,002) FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:20619347 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL FEES TOTAL FEES:7192214 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT LABOR TOTAL FEES:4103804 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING & MANAGEMENT TOTAL FEES:277671 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:246686 SEE PART VII See Part VII See Part VII false true true true true false false false false false false false true true true true true false false Seton Medical Center Foundation c 783349 Cost Seton Medical Center Foundation o 198345 Cost Seton Medical Center Foundation q 66604 Cost Schedule R, Part II: THE FOLLOWING ORGANIZATIONS LISTED BELOW ARE RELATED TO THE FILING ORGANIZATION: DAUGHTERS OF CHARITY MINISTRY SERVICES CORPORATION 26000 ALTAMONT ROAD LOS ALTOS HILLS, CA 94022-4317 EIN: 77-0482943 COL (B): PRIMARY ACTIVITY - MANAGERIAL AND CONSULTING SERVICES IN THE AREAS OF FINANCE, ADMINISTRATION AND FACILITIES TO THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL PROVINCE OF THE WEST MINISTRIES. COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 1 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL PROVINCE OF THE WEST COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO DAUGHTERS OF CHARITY HEALTH SYSTEM 203 REDWOOD SHORES PARKWAY, SUITE 800 REDWOOD CITY, CA 94065 EIN: 91-2145484 COL (B): PRIMARY ACTIVITY - HEALTH SYSTEM LEADERSHIP AND SUPPORT TO HEALTH MINISTRIES. COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11B COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY MINISTRY SERVICES CORPORATION COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO CARITAS BUSINESS SERVICES 203 REDWOOD SHORES PARKWAY, SUITE 800 REDWOOD CITY, CA 94065 EIN: 51-0659139 COL (B): PRIMARY ACTIVITY - PROMOTE AND SUPPORT THE ACTIVITIES OF THE DAUGHTERS OF CHARITY HEALTH SYSTEM AND ITS LOCAL HEALTH MINISTRIES BY PERFORMING ACCOUNTING, BUDGETING AND PATIENT FINANCIAL SERVICES ON A CENTRALIZED BASIS, ALL OF WHICH MUST BE PROVIDED INTERNALLY BY EACH HOSPITAL FOR ITS EXEMPT OPERATIONS IF NOT PROVIDED BY CARITAS BUSINESS SERVICES. COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO HOTEL DIEU, INC. 26000 ALTAMONT ROAD LOS ALTOS HILLS, CA 94022-4317 EIN: 95-475156 COL (B): PRIMARY ACTIVITY - LOW-INCOME RESIDENCE FOR FRAGILE SENIOR CITIZENS COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 9 C COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY MINISTRY SERVICES CORPORATION COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO O'CONNOR HOSPITAL 2105 FOREST AVENUE SAN JOSE, CA 95128 EIN: 91-2154436 COL (B): PRIMARY ACTIVITY - HOSPITAL COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO O'CONNOR HOSPITAL FOUNDATION 2105 FOREST AVENUE SAN JOSE, CA 95128 EIN: 77-0006295 COL (B): PRIMARY ACTIVITY - FUNDRAISING COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - O'CONNOR HOSPITAL COL (G): SECTION 512(b)(13) CONTROLLED ENTITY - NO ROBERT F. KENNEDY MEDICAL CENTER 203 REDWOOD SHORES PARKWAY, SUITE 800 REDWOOD CITY, CA 94065 EIN: 91-2154440 COL (B): PRIMARY ACTIVITY - HOSPITAL - INACTIVE COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ROBERT F. KENNEDY MEDICAL CENTER FOUNDATION 203 REDWOOD SHORES PARKWAY, SUITE 800 REDWOOD CITY, CA 94065 EIN: 95-3745227 COL (B): PRIMARY ACTIVITY - FUNDRAISING - INACTIVE COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - ROBERT F. KENNEDY MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. FRANCIS MEDICAL CENTER 3630 EAST IMPERIAL HIGHWAY LYNWOOD, CA 90262-2636 EIN: 91-2154439 COL (B): PRIMARY ACTIVITY - HOSPITAL COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. FRANCIS MEDICAL CENTER OF LYNWOOD FOUNDATION 3630 EAST IMPERIAL HIGHWAY, SUITE 400 LYNWOOD, CA 90262-2636 EIN: 95-3190773 COL (B): PRIMARY ACTIVITY - FUNDRAISING COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - ST. FRANCIS MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO SAINT LOUISE REGIONAL HOSPITAL 9400 NO NAME UNO GILROY, CA 95020 EIN: 91-2154437 COL (B): PRIMARY ACTIVITY - HOSPITAL COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO SAINT LOUISE REGIONAL HOSPITAL FOUNDATION 9400 NO NAME UNO GILROY, CA 95020 EIN: 56-2384735 COL (B): PRIMARY ACTIVITY - FUNDRAISING COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - SAINT LOUISE REGIONAL HOSPITAL COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. VINCENT MEDICAL CENTER 2131 WEST THIRD STREET LOS ANGELES, CA 90057 EIN: 91-2154438 COL (B): PRIMARY ACTIVITY - HOSPITAL COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. VINCENT DE PAUL ETHICS CORPORATION 3630 EAST IMPERIAL HIGHWAY LYNWOOD, CA 90262 EIN: 95-4426405 COL (B): PRIMARY ACTIVITY - SUPPORTS DCHS MINISTRIES COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - ST. FRANCIS MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. VINCENT DIALYSIS CENTER 2131 WEST THIRD STREET LOS ANGELES, CA 90057 EIN: 95-3749293 COL (B): PRIMARY ACTIVITY - HOSPITAL COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 3 COL (F): DIRECT CONTROLLING ENTITY NAME - ST. VINCENT MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. VINCENT FOUNDATION 2200 WEST THIRD STREET, SUITE 200 LOS ANGELES, CA 90057 EIN: 95-3922511 COL (B): PRIMARY ACTIVITY - FUNDRAISING COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - ST. VINCENT MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO ST. VINCENT SENIOR CENTER NUTRITION PROGRAM, INC. 2131 WEST THIRD STREET LOS ANGELES, CA 90057 EIN: 95-3696693 COL (B): PRIMARY ACTIVITY - NUTRITION PROGRAM COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 9 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY MINISTRY SERVICES CORPORATION COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO SETON MEDICAL CENTER FOUNDATION 1900 SULLIVAN AVENUE DALY CITY, CA 94015 EIN: 94-2824033 COL (B): PRIMARY ACTIVITY - FUNDRAISING COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 11A COL (F): DIRECT CONTROLLING ENTITY NAME - SETON MEDICAL CENTER COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO DCHS MEDICAL FOUNDATION 400 RACE STREET SAN JOSE, CA 95126 EIN: 41-3691852 COL (B): PRIMARY ACTIVITY - MEDICAL FOUNDATION COL (C): LEGAL DOMICILE - CA COL (D): EXEMPT CODE SECTION - 501(C)(3) COL (E): PUBLIC CHARITY STATUS - 9 COL (F): DIRECT CONTROLLING ENTITY NAME - DAUGHTERS OF CHARITY HEALTH SYSTEM COL (G): SECTION 512(B)(13) CONTROLLED ENTITY - NO Schedule R, Part III: O'Connor Health Center 1, A California Limited Partnership 1960 The Alameda, Suite 20 San Jose, CA 95126 EIN: 77-0419045 Col (B): Primary Activity - Development and Rental Col (C): Legal Domicile - CA Col (D): Direct Controlling Entity Name - N/A Col (E): Predominant Income - N/A Col (F): Share of Total Income - N/A Col (G): Share of End-of-Year Assets - N/A Col (H): Disproportionate Allocations - No Col (I): Code V - UBI Amount in Box 20 of Schedule K-1 (Form 1065) - N/A Col (J): General or Managing Partner - No Col (K): Percentage of Ownership - N/A Schedule R, Part IV: Marillac Insurance Company, LTD. C/O AON Insurance Managers (Cayman), LTD. P.O. Box 69, Grand Cayman KY1-1102 EIN: 98-0417930 Col (B): Primary Activity - Insurance Col (C): Legal Domicile - CJ Col (D): Direct Controlling Entity Name - N/A Col (E): Type of Entity - C Corporation Col (F): Share of Total Income - N/A Col (G): Share of End-of-Year Assets - N/A Col (H): Percentage Ownership - N/A Col (I): Section 512(b)(13) Controlled Entity: No