DIGNITY HEALTH MEDICAL FOUNDATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- DIGNITY HEALTH MEDICAL FOUNDATION (EIN 68-0220314)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-05
- IRS object ID
- 201431259349300743
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-05T15:27:19-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 135565207 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 55 SECOND STREET SUITE 1400 | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680220314 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH MEDICAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DIGN | NameControl |
| Phone | 9163792778 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3400 Data Drive | AddressLine1 |
| City | Rancho Cordova | City |
| State | CA | State |
| ZIP Code | 95670 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TOM LOWRY | Name |
| Title | CFO | Title |
| Date Signed | 2014-04-30 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VALERIE J BALL | Name |
| PTIN | P00178714 | PTIN |
| Phone | 4159635100 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOM LOWRY CFO | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3400 Data Drive | AddressLine1 |
| City | Rancho Cordova | City |
| State | CA | State |
| ZIP Code | 95670 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 469545754 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.DIGNITYHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1990 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | TO ESTABLISH, OPERATE, AND MAINTAIN A MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC TO BENEFIT THE COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 3 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1647 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 107566522 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 88930796 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 359095458 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 379085943 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 109755 | InvestmentIncomePriorYear |
| Investment Income Current Year | 159048 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4740768 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1369967 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 471512503 | TotalRevenuePriorYear |
| Total Revenue Current Year | 469545754 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5775 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 43623 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 116687550 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 132802026 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 323092260 | OtherExpensePriorYear |
| Other Expenses Current Year | 339407585 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 439785585 | TotalExpensesPriorYear |
| Total Expenses Current Year | 472253234 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 31726918 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -2707480 | RevenuesLessExpensesCY |
| Total Assets BOY | 160520045 | TotalAssetsBOY |
| Total Assets EOY | 167238083 | TotalAssetsEOY |
| Total Liabilities BOY | 86866309 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 96057086 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 73653736 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 71180997 | NetAssetsOrFundBalancesEOY |
| Mission Description | DIGNITY HEALTH MEDICAL FOUNDATION'S MISSION IS TO ESTABLISH, OPERATE, AND MAINTAIN A MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC TO PROVIDE COMPASSIONATE, HIGH-QUALITY, AFFORDABLE PATIENT CARE SERVICES AND HEALTH EDUCATION. OUR CLINIC IS COMMITTED TO EXPANDING QUALITY HEALTH CARE ACCESS TO THOSE IN NEED AND CONTRIBUTING TO THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 294390045 | Expense |
| Grants | 43623 | Grants |
| Revenue | 278868642 | Revenue |
| Description | DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES INCLUDE FAMILY, PEDIATRIC, AND GERIATRIC MEDICINE AS WELL AS A VARIETY OF SPECIALTIES. AMONG THE SPECIALTY HEALTHCARE SERVICES WE PROVIDE TO OUR PATIENTS ARE MENTAL HEALTH SERVICES, PAIN MANAGEMENT, REHABILITATION AND OCCUPATIONAL SERVICES, OPHTHALMOLOGY, CARDIOLOGY, DIAGNOSTIC IMAGING, OUTPATIENT SURGERY, NEUROLOGY, ORTHOPEDICS, PODIATRY, AND OBSTETRICS AND GYNECOLOGY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 92492952 | Expense |
| Grants | 0 | Grants |
| Revenue | 95150192 | Revenue |
| Description | DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES INCLUDES MEDICAL SERVICES FOR THE COMMUNITY. OUR CLINICS ARE LOCATED IN THE SACRAMENTO REGION [SACRAMENTO, EL DORADO HILLS, ELK GROVE, AND ROCKLIN], WOODLAND, SIERRA NEVADA, STOCKTON, SANTA CRUZ, SAN FRANCISCO, VENTURA, BAKERSFIELD AND SEQUOIA. THE EXPENSES AND REVENUE ABOVE ARE THE DOLLARS FOR MEDICARE AND MEDICAID. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4925601 | Expense |
| Grants | 0 | Grants |
| Revenue | 5067109 | Revenue |
| Description | DIGNITY HEALTH MEDICAL FOUNDATION OUTPATIENT SERVICES ALSO INCLUDE SUPPORT FOR OUR COMMUNITIES BY ACTIVELY PARTICIPATING WITH AND/OR IN THE COMMUNITY WITH THE FOLLOWING TYPES OF ACTIVITIES: CHARITY CARE, FLU CLINIC, CASH DONATIONS, CANCER SCREENINGS, HEALTH FAIRS, PRICE PHARMACY WHERE THE AVERAGE UNINSURED PARTICIPATING PATIENT HAS A COST SAVINGS OF $1,500 PER YEAR, TRAINING UP AND COMING PHYSICIANS, AND TELEHEALTH WHICH IS WORKING WITH THE HOSPITAL TO ENSURE TIMELY DIAGNOSIS TO PATIENTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 391808598 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | true | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 761 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1647 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 3 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAREN GRIMMER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9163792747 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3400 DATA DRIVE RANCHO | AddressLine1 |
| City | CORDOVA | City |
| State | CA | State |
| ZIP Code | 95670 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY SCOTT CARSWELL | ||||||||||
| SECRETARY | 2.00 | 40.00 | X | X | 0 | 441500 | 75058 | |||
| JAG GILL SC D | ||||||||||
| BOARD MEMBER/CEO (THRU 12/20/12) | 40.00 | 0.00 | X | X | 0 | 600866 | 74721 | |||
| JOSEPH JASSER MD | ||||||||||
| CEO (started 6/20/13) | 40.00 | 0.00 | X | X | 0 | 0 | 0 | |||
| KARL SILBERSTEIN | ||||||||||
| CHAIRMAN | 2.00 | 40.00 | X | X | 0 | 705073 | 93649 | |||
| BRUCE SWARTZ | ||||||||||
| BOARD MEMBER | 2.00 | 40.00 | X | 0 | 528088 | 47983 | ||||
| ELIZABETH SHIH | ||||||||||
| BOARD MEMBER | 2.00 | 41.00 | X | 0 | 1264972 | 212726 | ||||
| GARY GREENSWEIG DO | ||||||||||
| BOARD MEMBER | 2.00 | 0 | X | 0 | 0 | 0 | ||||
| HAROLD RAY MD | ||||||||||
| BOARD MEMBER | 5.00 | 0.00 | X | 0 | 2638 | 0 | ||||
| KARL ULRICH MD | ||||||||||
| BOARD MEMBER | 2.00 | 40.00 | X | 0 | 250498 | 17965 | ||||
| MARVIN O'QUINN | ||||||||||
| BOARD MEMBER | 1.00 | 41.00 | X | 0 | 1250572 | 304328 | ||||
| NANETTE MICKIEWICZ MD | ||||||||||
| BOARD MEMBER | 2.00 | 44.30 | X | 0 | 419960 | 74232 | ||||
| THOMAS LOWRY | ||||||||||
| CFO | 40.00 | 0 | X | 361041 | 0 | 30460 | ||||
| EDWARD KELLY | ||||||||||
| EXEC DIR GRTR BAY AREA | 40.00 | 0 | 269130 | 0 | 37885 | X | ||||
| KEVIN VAZIRI | ||||||||||
| SERVICE AREA LEADER - WOODLAND | 20.00 | 22.00 | 0 | 483550 | 70518 | X | ||||
| SIGRID OWYANG | ||||||||||
| VP CLINIC OPERATIONS | 40.00 | 0 | 282647 | 0 | 47026 | X | ||||
| JOHN MICHEELS | ||||||||||
| OPERATIONS MANAGER | 40.00 | 0 | 142485 | 0 | 34334 | X | ||||
| MARJORIE D GORTHY | ||||||||||
| EXECUTIVE DIRECTOR, MIC | 40.00 | 0 | 213758 | 0 | 29605 | X | ||||
| MICHAEL D MATUSKA | ||||||||||
| MANAGER/LEAD RADIATION THERAPIST | 40.00 | 0 | 124581 | 0 | 30053 | X | ||||
| MICHAEL FAGAN | ||||||||||
| DIRECTOR CLINICAL OPERATIONS | 40.00 | 0 | 182961 | 0 | 38549 | X | ||||
| TRACY KUGEL | ||||||||||
| MANAGER OF MARKETING AND BUSINESS DEVELOPMENT | 40.00 | 0 | 161618 | 0 | 29497 | X | ||||
| GARY SPAUGH | ||||||||||
| Former Officer | 0.00 | 40.00 | 0 | 742499 | 56624 | X | ||||
| WILLIAM J HUNT | ||||||||||
| Former Officer | 0.00 | 0.00 | 0 | 2393948 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1738222 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 9084164 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1305214 | TotalOtherCompensation |
| Number Individuals GT100 K | 562 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| DESCOR BUILDERS | |||||
| 3164 GOLD CAMP DR SUITE 250 | RANCHO CORDOVA | CA | 95670 | GENERAL CONTRACTOR | 7819136 |
| CASE ANESTHESIA | |||||
| 3315 WATT AVE | SACRAMENTO | CA | 95821 | ANESTHESIOLOGISTS | 1423526 |
| HARBISON MAHONY HIGGINS BUILDER | |||||
| 15 BUSINESS PARK WAY SUITE 101 | SACRAMENTO | CA | 95828 | GENERAL CONTRACTOR | 1019895 |
| ALLSCRIPTS LLC | |||||
| 24630 NETWORK PL | CHICAGO | IL | 606731246 | IT HEALTHCARE SERVICES | 850381 |
| SACRAMENTO MIDTOWN ENDOSCOPY CENTER | |||||
| 3941 J ST SUITE 460 | SACRAMENTO | CA | 95819 | MEDICAL SERVICES | 774315 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 37 | NumberOfContractorsGT100K |
| Related Organizations | 73355601 | RelatedOrganizations |
| Government Grants | 4028795 | GovernmentGrants |
| All Other Contributions | 11546400 | AllOtherContributions |
| Total Contributions | 88930796 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT NET OF CHARITY AND BAD DEBT | 900099 | 246740450 | 246740450 |
| MEDICARE / MEDICAID PAYMENTS | 900099 | 113721437 | 113721437 |
| PHYSICIAN PROFESSIONAL FEES REV | 900099 | 5188914 | 5188914 |
| HOSPITALIST PROGRAMS | 900099 | 5051871 | 5051871 |
| MEANINGFUL USE INCENTIVES (EHR) | 900099 | 4699157 | 4699157 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3684114 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3684114 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 379085943 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 159048 | TotalRevenueColumn |
| Exclusion | $159,048 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MANAGEMENT FEES | 541610 | 557685 | $557,685 |
| EAP | 541610 | 327315 | $327,315 |
| ADMINISTRATIVE SERVICES REV | 900099 | 167910 | $167,910 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 317057 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $317,057 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1369967 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 469545754 | TotalRevenueColumn |
| Related Or Exempt Function Income | 379085943 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,529,015 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43623 | Total |
| Program Services | 43623 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1024825 | Total |
| Program Services | 740898 | ProgramServices |
| Management And General | 283927 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97666831 | Total |
| Program Services | 70608325 | ProgramServices |
| Management And General | 27058506 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2624278 | Total |
| Program Services | 1889308 | ProgramServices |
| Management And General | 734970 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24340567 | Total |
| Program Services | 17519760 | ProgramServices |
| Management And General | 6820807 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7145525 | Total |
| Program Services | 5165864 | ProgramServices |
| Management And General | 1979661 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1672674 | Total |
| Program Services | 145506 | ProgramServices |
| Management And General | 1527168 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126329 | Total |
| Management And General | 126329 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 202817228 | Total |
| Program Services | 192150912 | ProgramServices |
| Management And General | 10666316 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1515735 | Total |
| Program Services | 511830 | ProgramServices |
| Management And General | 1003905 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13255570 | Total |
| Program Services | 10539200 | ProgramServices |
| Management And General | 2716370 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11153551 | Total |
| Program Services | 8703835 | ProgramServices |
| Management And General | 2449716 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18994876 | Total |
| Program Services | 8142494 | ProgramServices |
| Management And General | 10852382 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1064147 | Total |
| Program Services | 532889 | ProgramServices |
| Management And General | 531258 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 211630 | Total |
| Program Services | 114725 | ProgramServices |
| Management And General | 96905 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2884233 | Total |
| Management And General | 2884233 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12698188 | Total |
| Program Services | 6299955 | ProgramServices |
| Management And General | 6398233 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5874875 | Total |
| Program Services | 3648133 | ProgramServices |
| Management And General | 2226742 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL PROVIDER OUT OF NETWORK | 46666803 | 46666803 | |
| MEDICAL SUPPLIES | 17967113 | 17734535 | 232578 |
| RECRUITING | 1050452 | 425126 | 625326 |
| LICENSES & TAXES | 264594 | 118402 | 146192 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1189587 | Total |
| Program Services | 106475 | ProgramServices |
| Management And General | 1083112 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 472253234 | Total |
| Program Services | 391808598 | ProgramServices |
| Management And General | 80444636 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10334 | BOY |
| EOY | 11666 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19061578 | BOY |
| EOY | 30587643 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24564455 | BOY |
| EOY | 25382637 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 940483 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10451069 | BOY |
| EOY | 5453293 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 154694548 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 52048008 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 105660152 | BOY |
| EOY | 102646540 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30588 | BOY |
| EOY | 265331 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 607869 | BOY |
| EOY | 607869 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134000 | BOY |
| EOY | 1342621 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160520045 | BOY |
| EOY | 167238083 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33247187 | BOY |
| EOY | 44020829 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 667905 | BOY |
| EOY | 583217 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52951217 | BOY |
| EOY | 51453040 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 86866309 | BOY |
| EOY | 96057086 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73623148 | BOY |
| EOY | 70915666 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30588 | BOY |
| EOY | 265331 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 73653736 | BOY |
| EOY | 71180997 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160520045 | BOY |
| EOY | 167238083 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -2707480 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 234742 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941196203 | EIN |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | true | SupportedOrganizationNotified |
| Organized In US | true | OrganizedInUS |
| Amount | $459,555,047 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 459555047 | SumOfAmounts |
| General Explanation | DESCRIPTION OF NON-MONETARY SUPPORT, SCHEDULE A, PART I, LINE 11H, DIGNITY HEALTH: DIGNITY HEALTH MEDICAL FOUNDATION PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS. , | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | 1625 | PoliticalExpenditures |
| Volunteer Hours | 0 | VolunteerHours |
| Amt Of4955 Tax | 163 | AmtOf4955Tax |
| Amt Of4955 Tax On Managers | 0 | AmtOf4955TaxOnManagers |
| Form4720 Filed4955 Tax | true | Form4720Filed4955Tax |
| Correction Made | true | CorrectionMade |
Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of political campaign activities | Schedule C, Part I-A, Line 1 | DURING THE YEAR, DIGNITY HEALTH MEDICAL FOUNDATION PAID MEMBERSHIP DUES TO CA ASSOCIATION OF PHYSICIAN GROUPS ("ASSOCIATION"). THE INVOICES PROVIDED FOR VOLUNTARY CONTRIBUTIONS TO THE ASSOCIATION'S POLITICAL ACTION COMMITTEE (PAC). THE CHECK REQUESTS FOR ANNUAL DUES INADVERTENTLY INCLUDED AN AMOUNT FOR VOLUNTARY CONTRIBUTIONS TO THE PAC. |
| Steps taken to correct political campaign activities | Schedule C, Part I-B, Line 4b | DIGNITY HEALTH MEDICAL FOUNDATION HAS POLICIES AND PROCEDURES IN PLACE TO AVOID SUCH TRANSACTIONS, AND ONCE THE ORGANIZATION BECAME AWARE OF THIS SITUATION, IMMEDIATE ACTION WAS TAKEN TO OBTAIN A REFUND FROM THE ASSOCIATION FOR THE AMOUNTS DESIGNATED FOR THE PAC. A COPY OF THE REFUND CHECK, DATED 4/02/13 EVIDENCING THAT $1,624.98 HAS BEEN RECOVERED AND HAS BEEN ATTACHED TO FORM 4720. THIS REPRESENTS THE FULL AMOUNT OF INADVERTENT PAYMENT MADE RELATED TO VOLUNTARY CONTRIBUTIONS TO THE ASSOCIATION'S PAC. |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4422099 | OtherCostOrOtherBasis |
| Book Value | 4422099 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 52296225 | OtherCostOrOtherBasis |
| Depreciation | 9740577 | Depreciation |
| Book Value | 42555648 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 39349062 | OtherCostOrOtherBasis |
| Depreciation | 12830624 | Depreciation |
| Book Value | 26518438 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 55782185 | OtherCostOrOtherBasis |
| Depreciation | 29476807 | Depreciation |
| Book Value | 26305378 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2844977 | OtherCostOrOtherBasis |
| Book Value | 2844977 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 102646540 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| PHYSICIANS CONTINGENCY | $1,004,524 |
| DUE TO RELATED ORGANIZATIONS | $47,710,620 |
| LONG-TERM PENSION PAYABLE | $2,574,109 |
| DEFERRED COMPENSATION | $163,787 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 51453040 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) footnote | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|---|---|
| DOMINICAN HOSPITAL FOUNDATION | ||||||||||
| 1555 SOQUEL DRIVE | SANTA CRUZ | CA | 950661705 | 942450442 | 501(C)(3) | 17500 | 0 | NONE | 0 | PREVENTIVE CARE |
| UNITED WAY OF SANTA CRUZ COUNTY | ||||||||||
| 4450 CAPITOLA RD | CAPITALO | CA | 95010 | 941422471 | 501(C)(3) | 10000 | 0 | NONE | 0 | SOCIAL HEALTH |
| HEALTH IMPROVEMENT PARTNERSHIP OF SANTA CRUZ COUNTY | ||||||||||
| 1600 GREEN HILLS ROAD SUITE 101 | SCOTTS VALLEY | CA | 95066 | 010826156 | 501(C)(3) | 5000 | 0 | NONE | 0 | PREVENTIVE CARE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedures for monitoring use of grant funds | Identifier |
| Return Reference | Schedule I, Part I, Line 2 | ReturnReference |
| Explanation | GRANTS ARE PROVIDED BY DIGNITY HEALTH MEDICAL FOUNDATION TO NOT-FOR-PROFIT ORGANIZATIONS THAT FURTHER DIGNITY HEALTH MEDICAL FOUNDATION'S EXEMPT PURPOSE. ALL ORGANIZATIONS THAT ARE PROVIDED GRANTS ARE REQUIRED TO BE A SECTION 501(C)(3) ORGANIZATION. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (19 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY SCOTT CARSWELL | ||||||||||||||
| SECRETARY | 0 | 350298 | 0 | 87314 | 0 | 3889 | 0 | 35766 | 0 | 39292 | 0 | 516559 | 0 | 0 |
| BRUCE SWARTZ | ||||||||||||||
| BOARD MEMBER | 0 | 459168 | 0 | 57500 | 0 | 11420 | 0 | 27751 | 0 | 20232 | 0 | 576071 | 0 | 0 |
| EDWARD KELLY | ||||||||||||||
| EXEC DIR GRTR BAY AREA | 209214 | 0 | 58892 | 0 | 1024 | 0 | 20051 | 0 | 17834 | 0 | 307015 | 0 | 0 | 0 |
| ELIZABETH SHIH | ||||||||||||||
| BOARD MEMBER | 0 | 686873 | 0 | 424564 | 0 | 153535 | 0 | 153244 | 0 | 59482 | 0 | 1477698 | 0 | 90833 |
| GARY SPAUGH | ||||||||||||||
| FORMER OFFICER | 0 | 227157 | 0 | 91963 | 0 | 423379 | 0 | 24174 | 0 | 32450 | 0 | 799123 | 0 | 365748 |
| JAG GILL SC D | ||||||||||||||
| BOARD MEMBER/CEO (THRU 12/20/12) | 0 | 307358 | 0 | 202362 | 0 | 91146 | 0 | 40556 | 0 | 34165 | 0 | 675587 | 0 | 0 |
| JOHN MICHEELS | ||||||||||||||
| OPERATIONS MANAGER | 122567 | 0 | 18344 | 0 | 1573 | 0 | 13417 | 0 | 20918 | 0 | 176819 | 0 | 0 | 0 |
| KARL SILBERSTEIN | ||||||||||||||
| CHAIRMAN | 0 | 547595 | 0 | 138095 | 0 | 19383 | 0 | 51538 | 0 | 42111 | 0 | 798722 | 0 | 0 |
| KARL ULRICH MD | ||||||||||||||
| BOARD MEMBER | 0 | 121113 | 0 | 52000 | 0 | 77385 | 0 | 11082 | 0 | 6883 | 0 | 268463 | 0 | 0 |
| KEVIN VAZIRI | ||||||||||||||
| SERVICE AREA LEADER - WOODLAND | 0 | 313960 | 0 | 160002 | 0 | 9588 | 0 | 37895 | 0 | 32624 | 0 | 554068 | 0 | 0 |
| MARJORIE D GORTHY | ||||||||||||||
| EXECUTIVE DIRECTOR, MIC | 174994 | 0 | 37776 | 0 | 988 | 0 | 14479 | 0 | 15126 | 0 | 243362 | 0 | 0 | 0 |
| MARVIN O'QUINN | ||||||||||||||
| BOARD MEMBER | 0 | 866580 | 0 | 369474 | 0 | 14518 | 0 | 239502 | 0 | 64826 | 0 | 1554900 | 0 | 0 |
| MICHAEL D MATUSKA | ||||||||||||||
| MANAGER/LEAD RADIATION THERAPIST | 117235 | 0 | 7022 | 0 | 324 | 0 | 9319 | 0 | 20734 | 0 | 154634 | 0 | 0 | 0 |
| MICHAEL FAGAN | ||||||||||||||
| DIRECTOR CLINICAL OPERATIONS | 130441 | 0 | 31747 | 0 | 20774 | 0 | 13059 | 0 | 25490 | 0 | 221511 | 0 | 0 | 0 |
| NANETTE MICKIEWICZ MD | ||||||||||||||
| BOARD MEMBER | 0 | 341548 | 0 | 67816 | 0 | 10596 | 0 | 34699 | 0 | 39534 | 0 | 494192 | 0 | 0 |
| SIGRID OWYANG | ||||||||||||||
| VP CLINIC OPERATIONS | 218665 | 0 | 62909 | 0 | 1074 | 0 | 25572 | 0 | 21454 | 0 | 329673 | 0 | 0 | 0 |
| THOMAS LOWRY | ||||||||||||||
| CFO | 299998 | 0 | 59773 | 0 | 1270 | 0 | 23025 | 0 | 7434 | 0 | 391501 | 0 | 0 | 0 |
| TRACY KUGEL | ||||||||||||||
| MANAGER OF MARKETING AND BUSINESS DEVELOPMENT | 147821 | 0 | 13455 | 0 | 342 | 0 | 15172 | 0 | 14325 | 0 | 191115 | 0 | 0 | 0 |
| WILLIAM J HUNT | ||||||||||||||
| FORMER OFFICER | 0 | 2393948 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2393948 | 0 | 1192140 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Arrangement used to establish the top management official's compensation | Schedule J, Part I, Line 3 | DIGNITY HEALTH MEDICAL FOUNDATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH THAT USED A COMPENSATION COMMITTEE, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH DIGNITY HEALTH MEDICAL FOUNDATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION. |
| Severance or change-of-control payment | Schedule J, Part I, Line 4a | CERTAIN LISTED PERSONS PARTICIPATE IN DIGNITY HEALTH'S SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 6 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT FOR ONE HIGEST COMPENSATED EMPLOYEE AND ONE FORMER OFFICER OCCURRED DURING 2012; M. FAGAN, $13,542 AND W. HUNT, $1,201,809. |
| Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b | CERTAIN LISTED PERSONS PARTICIPATE IN DIGNITY HEALTH'S EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT FOR TWO FORMER OFFICERS OCCURRED DURING 2012; G. SPAUGH, $20,899; AND W. HUNT, $602,380. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN ONE OF TWO NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. NO BENEFIT WILL VEST UNDER THIS 457(F) PLAN BEFORE THE ATTAINMENT OF AGE 62 OR THE COMPLETION OF 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN BOARD MEMBERS WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENT FOR TWO FORMER OFFICERS OCCURRED DURING 2012; G. SPAUGH, $79,386; AND W. HUNT, $589,760. CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP), WHICH WAS FROZEN IN MAY 2002. THE KEYSOP PROGRAM WAS ESTABLISHED IN 2001 WITH THE PURPOSE OF PROVIDING INCOME DEFERRAL OPPORTUNITIES TO EMPLOYEES ELIGIBLE FOR THE COMPANY'S KEY EMPLOYEE RETENTION PROGRAM. NO PAYMENTS WERE MADE UNDER THIS PLAN DURING 2012. ONE HIGHEST PAID EMPLOYEE PARTICIPATED IN A SUPPLEMENTAL RETIREMENT AGREEMENT WHICH WAS ENTERED INTO DURING THE ACQUISITION OF A HOSPITAL AND GUARANTEED THAT THE EXECUTIVE WOULD BE PAID, UPON RETIREMENT, AN AMOUNT AT LEAST EQUAL TO THE BENEFITS THAT WOULD HAVE BEEN PAID UNDER THAT HOSPITAL'S DEFERRED COMPENSATION PLAN UNDER ITS PRIOR OWNERSHIP. A PAYMENT OF $265,463 WAS MADE PURSUANT TO THIS PLAN FOR G. SPAUGH DURING 2012. CERTAIN OFFICERS AND KEY EMPLOYEES PARTICIPATE IN THE DIGNITY HEALTH SUPPLEMENTAL EXECUTIVE RETENTION/RETIREMENT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN WHICH IN 2002 WAS OFFERED TO MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM BY THE DIGNITY HEALTH BOARD OF DIRECTORS AND WOULD BE PAID ONLY IF THE EXECUTIVES STAYED WITH THE ORGANIZATION FOR A SPECIFIED NUMBER OF YEARS AS THE PRIMARY PURPOSE OF THIS PLAN IS TO PROVIDE FOR THE RETENTION AND RETIREMENT OF THE PARTICIPANTS. THE EXECUTIVE MANAGEMENT TEAM WAS RECRUITED FROM STABLE CAREERS IN ORGANIZATIONS FROM ACROSS THE COUNTRY AND FROM VARIOUS INDUSTRIES TO ENGINEER AND LEAD A FINANCIAL AND OPERATIONAL TURNAROUND AFTER THE ORGANIZATION HAD LOST NEARLY $1 BILLION IN NET OPERATING PERFORMANCE. THE CALCULATION FOR THE PAYMENTS TO EACH EXECUTIVE IS BASED ON THE VALUE OF A FINAL AVERAGE PAY ANNUITY BENEFIT BASED ON RETIREMENT AGE AND SERVICE YEARS TO THE ORGANIZATION. DISTRIBUTION OCCURS EACH JULY 1 IF THE PLAN FORMULA WARRANTS A PAYMENT. PAYMENTS MADE DURING 2012 PURSUANT TO THIS PLAN INCLUDE $90,833 TO E. SHIH. VESTED AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR VESTING OCCURS (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS W-2 REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)). |
| SCHEDULE J, PART II | SCHEDULE J, PART II | PART II - SUPPLEMENTAL DISCLOSURE THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE THE ORGANIZATION TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES THE ORGANIZATION SERVES, PROMOTING EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND THE ORGANIZATION'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE AND REVENUE. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE SOLE CORPORATE MEMBER IS DIGNITY HEALTH, A 501(C)(3) EXEMPT ORGANIZATION. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | DIGNITY HEALTH, AS THE SOLE CORPORATE MEMBER, RATIFIES THE SELECTION OF MEMBERS AND THE DIGNITY HEALTH BOARD APPROVES NEW BOARD MEMBERS OF THE ORGANIZATION. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | THERE IS A TWO LEVEL REVIEW FOR THE DIGNITY HEALTH MEDICAL FOUNDATION FORM 990; FIRST THE ACCOUNTING MANAGER WORKED CLOSELY WITH THE PARENT ORGANIZATION AND AN INDEPENDENT ACCOUNTING FIRM IT ENGAGED TO REVIEW THE FORM 990, THE FINAL REVIEW WAS DONE BY THE CEO AND SENIOR VICE PRESIDENT OF FINANCIAL OPERATIONS. THE DRAFT WAS COMPLETE EXCEPT IT EXCLUDED COMPENSATION INFORMATION FOR DIRECTORS WHO ARE ALSO KEY EXECUTIVES OF DIGNITY HEALTH, THE FILING ORGANIZATION'S SOLE MEMBER. COMPENSATION BY DIGNITY HEALTH TO THOSE DIRECTORS WAS REVIEWED BY THE COMPENSATION AND BENEFITS COMMITTEE OF THE DIGNITY HEALTH BOARD OF DIRECTORS. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | THE ORGANIZATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. UNDER SUCH POLICIES, THE EVP/GENERAL COUNSEL IS RESPONSIBLE FOR COLLECTING, REVIEWING AND VALIDATING ANNUAL DISCLOSURES OF ALL COVERED PERSONS (I.E., BOARD AND BOARD COMMITTEE MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE DIRECTOR LEVEL AND ABOVE, AND ANY OTHER PERSONNEL AT HIS OR HER DISCRETION). THE ORGANIZATION'S BOARD IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS ARISING FROM BUSINESS, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERIORS AND TO RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON, AND ANNUALLY THEREAFTER. EACH COVERED PERSON IS REQUIRED TO CERTIFY AT LEAST ANNUALLY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE POLICY APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE STATEMENT AS REQUIRED BY THE POLICY. THE PRESIDENT/CEO AND EVP/GENERAL COUNSEL PREPARE ANNUAL REPORTS OF REPORTED CONFLICTS OF INTEREST WHICH ARE PROVIDED TO THE BOARD OF DIRECTORS, COMMITTEE CHAIRS, AND KEY LEADERS OF THE ORGANIZATION TO ENABLE RESPONSIBLE INDIVIDUALS TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED, AFTER WHICH HE/SHE SHALL LEAVE THE MEETING; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (4) IF WARRANTED, ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, AND COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION IS APPROVED BY A MAJORITY OF DISINTERESTED PERSONS, AND CONSISTENT WITH ANY REQUIREMENTS OF BYLAWS OR POLICIES ; AND (6) ANY CONFLICTING ISSUES ARISING DURING THE COURSE OF A BOARD MEETING WHICH CANNOT BE RESOLVED MAY BE REFERRED TO AN INDEPENDENT COMMITTEE OF THE BOARD OF DIRECTORS. THERE ARE ALSO CONFLICTS OF INTEREST PROVISIONS UNDER THE STANDARDS OF CONDUCT APPLICABLE TO ALL EMPLOYEES, AND WHICH ARE ADMINISTERED BY THE CHIEF COMPLIANCE OFFICER WHO HAS REPORTING RESPONSIBILITY TO THE AUDIT & COMPLIANCE COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 15A | FORM 990, PART VI, LINE 15A | ALTHOUGH THE ORGANIZATION EMPLOYS PERSONNEL, THE TOP MANAGEMENT OFFICIAL IS COMPENSATED BY DIGNITY HEALTH. FOR 2012, DIGNITY HEALTH'S COMPENSATION AND BENEFITS DEPARTMENT CONDUCTED AN ANNUAL REVIEW AND ANALYSIS TO PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGE OF THE TOP MANAGEMENT OFFICIAL. APPROPRIATE COMPARABILITY DATA FOR SIMILAR JOBS IN PEER COMPANIES (BOTH TAXABLE AND TAX-EXEMPT) IS OBTAINED FROM INDEPENDENT THIRD-PARTY SURVEY SOURCES. |
| FORM 990, PART VI, LINE 15B | FORM 990, PART VI, LINE 15B | DIGNITY HEALTH MEDICAL FOUNDATION COMPENSATION AND BENEFITS DEPARTMENT CONDUCTS ANNUAL REVIEWS AND ANALYSIS THAT ALLOWS A RANGE FOR COMPENSATION FOR EACH KEY EMPLOYEE FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGE. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE ON ITS WEBSITE AND UPON REQUEST. |
| Other Expenses | Form 990, Part IX, Line 11g | PHYSICIAN MEDICAL FEES - TOTAL EXPENSE: XXX-XX-XXXX, PROGRAM SERVICE EXPENSE: XXX-XX-XXXX, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; PROFESSIONAL FEES - TOTAL EXPENSE: 4942990, PROGRAM SERVICE EXPENSE: 1445742, MANAGEMENT AND GENERAL EXPENSES: 3497248, FUNDRAISING EXPENSES: ; OVERHEAD ALLOCATION CORPORATE - TOTAL EXPENSE: 3984989, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 3984989, FUNDRAISING EXPENSES: ; MAINTENANCE CONTRACT AND REPAIRS - TOTAL EXPENSE: 3907849, PROGRAM SERVICE EXPENSE: 3210073, MANAGEMENT AND GENERAL EXPENSES: 697777, FUNDRAISING EXPENSES: ; OTHER EXPENSES - TOTAL EXPENSE: 6826290, PROGRAM SERVICE EXPENSE: 4339988, MANAGEMENT AND GENERAL EXPENSES: 2486302, FUNDRAISING EXPENSES: ; |
| Other changes in net assets or fund balances | Form 990 , Part XI, Line 9 | INTEREST IN UNCONSOLIDATED FOUNDATION - 234742; |
| FORM 990, PART XII, LINE 3 | FORM 990, PART XII, LINE 3A | THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN DIGNITY HEALTH'S CONSOLIDATED OMB CIRCULAR A-133 AUDITED SCHEDULE OF FEDERAL EXPENDITURES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIGNITY HEALTH | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 185 BERRY STREET | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94107 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | HOSPITAL | PrimaryActivities |
| Legal Domicile State | CA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | false | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | true | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
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