2014-05-05T20:12:38-05:00 2013-06-30 135565207 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2012-07-01 237444901 NORTHRIDGE HOSPITAL FOUNDATION NORT 8188858500 18300 Roscoe Boulevard Northridge CA 91328 MICHAEL TAYLOR 2014-04-30 true VALERIE J BALL P00178114 4159635100 2012 2015-11-30 17:44:51Z BRIAN HAMMEL 18300 Roscoe Boulevard Northridge CA 91328 6898019 false X WWW.SUPPORTNORTHRIDGE.ORG X 1974 CA TO ADVANCE THE MISSION, VISION AND VALUES OF DIGNITY HEALTH DBA, NORTHRIDGE HOSPITAL MEDICAL CENTER THROUGH PHILANTHROPIC INITIATIVES AND FINANCIAL SUPPORT OF THE MEDICAL CENTER'S PROGRAMS AND SERVICES. 36 30 0 36 0 0 3948736 4335245 0 0 -101627 533215 -23181 -3612 3823928 4864848 2532745 2031032 0 0 0 0 0 0 190190 959302 980281 3492047 3011313 331881 1853535 12581562 15061249 176858 178913 12404704 14882336 NORTHRIDGE HOSPITAL FOUNDATION'S MISSION IS TO SUPPORT, FINANCIALLY AND OTHERWISE, THE CHARITABLE PURPOSES AND ACTIVITIES OF DIGNITY HEALTH DBA, NORTHRIDGE HOSPITAL MEDICAL CENTER, WHICH PROVIDES HIGH-VALUE AND QUALITY HEALTHCARE SERVICES AND PROGRAMS TO THE RESIDENTS OF THE SAN FERNANDO VALLEY. false false 2421119 2031032 0 THE FOUNDATION IS AN IRC SEC 509(A)(3) SUPPORTING ORGANIZATION TO DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER ("HOSPITAL"). AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE HOSPITAL WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE HOSPITAL. 2421119 true true false false false false false false true false false false true true true false true false false false false false false true true false true false true false false false false false false false false true false false false false true false false false false true X 0 0 0 false false false false false true true false false false false X 36 30 true false false false true true true true true false false false true true true true true false false false CA X RANDY BRADLEY FINANCE DEPT 8188858500 3033 North 3rd Avenue PHOENIX AZ 85301 BRIAN P HAMMEL 40.00 20.00 X X 0 231326 50380 DONALD G GLOISTEIN 2.00 0 X X 0 0 0 MICHAEL S TAYLOR 1.00 40.00 X X 0 293902 50997 PAMELA ALFENITO 1.00 0 X X 0 0 0 PATRICK HAWTHORNE 4.00 0 X X 0 0 0 TONY TORRES 4.00 0 X X 0 0 0 VALERIE KOHLER 1.00 0 X X 0 0 0 ALBERT M LAPIDES 1.00 0 X 0 0 0 ALI ZAMANI 1.00 0 X 0 0 0 BARBARA HAWTHORNE 1.00 0 X 0 0 0 BILL NEWBOLD 1.00 0 X 0 0 0 BRETT DALTON 1.00 0 X 0 0 0 BRYAN SULLIVAN 1.00 0 X 0 0 0 DANA PUMP 1.00 0 X 0 0 0 DARELL F NORRIS 2.00 0 X 0 0 0 DAREN SCHLECTER 1.00 0 X 0 0 0 DAVID PUMP 1.00 0 X 0 0 0 DAVID R FEELEY 1.00 0 X 0 0 0 DIANA WEISS-ALZMAN 1.00 0 X 0 0 0 DOROTHY LAKE 1.00 0 X 0 0 0 ENRIQUE WONG 1.00 0 X 0 0 0 FREDERIC BENNING 1.00 0 X 0 0 0 GRACE LELAND BEHARRY 1.00 40.00 X 0 114805 13931 JEAN KERR 1.00 0 X 0 0 0 JOAN GEISBUSH 4.00 0 X 0 0 0 MARCIA CEVALLOS-HOFFER 1.00 0 X 0 0 0 MARDEE JESSOP 1.00 0 X 0 0 0 MARY GRIM 1.00 40.00 X 0 121448 24285 MAURICE ZEITLIN MD 1.00 20.00 X 0 27000 0 MELANIE COTO 1.00 0 X 0 0 0 MEREDITH S HALE MD 0.01 0 X 0 0 0 ROBERT BOB ALLEN 1.00 0 X 0 0 0 ROBERT BOB CARUSO 1.00 0 X 0 0 0 SALIBA SALO 1.00 40.00 X 0 451088 60442 STEVE FOITLE 1.00 0 X 0 0 0 VANESSA TERZIAN 1.00 0 X 0 0 0 ZOUHEIR ELIAS MD 1.00 0 X 0 0 0 MICHAEL WALL 0.00 40.00 X 0 1880244 61463 0 3119813 261498 12 true true false 0 290943 1206083 517614 2320605 21371 4335245 0 0 0 0 0 0 0 0 0 0 249507 249507 0 0 0 0 0 2076745 1793037 283708 0 283708 283708 212749 290943 232309 -19560 -19560 23773 7825 15948 15948 0 0 0 0 0 0 0 0 0 4864848 0 0 529603 2031032 2031032 0 0 0 0 0 0 0 0 0 0 10000 3334 3333 3333 0 0 0 43082 43082 714740 324891 318757 71092 725 725 98809 42174 15614 41021 52404 52404 0 26400 13200 13200 3360 2080 1280 0 8838 110 110 8618 0 0 0 0 LICENSES AND TAXES 326 326 DUES AND SUBSCRIPTIONS 1491 1491 DONOR RECOGNITION 7284 7284 DONOR CULTIVATION 6438 6438 6384 3573 2811 0 3011313 2421119 400004 190190 0 167988 262318 315936 101433 204948 3448 0 0 39750 24132 0 0 0 0 10214609 12951206 0 0 0 0 1638331 1718712 12581562 15061249 82794 114571 42478 12759 0 51586 51583 176858 178913 X 4329193 5403156 7853273 9256942 222238 222238 12404704 14882336 12581562 15061249 X 1853535 543713 80384 X false true X true true true X X X false false false DIGNITY HEALTH (DBA NORTHRIDGE HOSPITAL MEDICAL CENTER) 941196203 3 true true true 3011313 1 3011313 DESCRIPTION OF NON-MONETARY SUPPORT, SCHEDULE A, PART I, LINE 11H, DIGNITY HEALTH (DBA NORTHRIDGE HOSPITAL MEDICAL CENTER): THE FOUNDATION PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS. , RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2883517 1500 269576 5474 3149119 3047215 1747 -164500 945 2883517 2596213 452934 1932 3047215 284622 2069701 247262 5372 2596213 329563 5217 842 51000 284622 0.91300 0.08700 0.00000 false false 0 0 0 0 0 0 BENEFICIAL INTEREST IN CRUT 1715413 INVESTMENT IN CRT AND ANNUITY 3299 1718712 0 OTHER LIABILITIES 48720 CHARITABLE REMAINDER TRUSTS 2863 51583 X Intended uses of endowment funds Schedule D, Part V, Line 4 ENDOWMENT FUNDS ARE USED TO PROVIDE AWARDS FOR OUTSTANDING RESIDENCY NURSES AND DOCTORS. THE INCOME FROM RETURN ON THE INVESTED BOARD DESIGNATED QUASI ENDOWMENT FUNDS ARE USED TO SUPPORT THE CAPITAL AND PROGRAM NEEDS AT THE HOSPITAL. FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 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. STEPPIN OUT 2012 274977 134220 140757 0 4483 26126 80215 41824 0 GOLF 2013 169847 115090 54757 0 1541 368 36961 0 0 2 58868 41633 17235 0 13966 11344 7810 2456 5215 503692 290943 212749 0 19990 37838 124986 44280 5215 232309 -19560 0 0 23773 3000 0 0 4825 false 23773 3000 0 0 4825 7825 15948 CA true false false false 0 1 TONETTE BARCELLONA 18300 ROSCOE BLVD NORTHRIDGE CA 91328 false BRIAN HAMMEL 0 SUPERVISE GAMING ACTIVITIES, RECORDKEEPING X true 21396 Distributions required under state law Schedule G, Part III, Line 17b STATE=CALIFORNIA,MANDATORY DISTRIBUTION AMOUNT=21396; true DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CTR 18300 ROSCOE BLVD NORTHRIDGE CA CA 91328 941196203 501(C)(3) 2031032 0 N/A N/A HOSPITAL SUPPORT 1 0 Procedures for monitoring use of grant funds Schedule I, Part I, Line 2 AS A SEC. 509(A)(3) SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE GRANTEE LISTED IN PART II, ITEM 1 (DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER), WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE BENEFICIARY ORGANIZATION. AS SUCH, THE FOUNDATION DOES NOT MONITOR THE HOSPITAL'S USE OF THE GRANT FUNDS. true true false false false false false false BRIAN P HAMMEL 0 180709 0 45947 0 4670 0 22669 0 27711 0 281706 0 0 MICHAEL S TAYLOR 0 248322 0 43825 0 1755 0 23342 0 27655 0 344899 0 0 MICHAEL WALL 0 188001 0 362213 0 1330030 0 39286 0 22177 0 1941707 0 112333 SALIBA SALO 0 354699 0 86979 0 9410 0 36449 0 23993 0 511530 0 0 Arrangement used to establish the top management official's compensation Schedule J, Part I, Line 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. Severance or change-of-control payment Schedule J, Part I, Line 4a CERTAIN OFFICERS PARTICIPATE IN A DIGNITY HEALTH SEVERANCE PLAN THAT PROVIDES FAIR 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. ONE PAYMENT PURSUANT TO THIS PLAN OCCURRED DURING 2012 TO A FORMER OFFICER; M. WALL, $1,130,444. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXECUTIVE DEFERRED COMPENSATION PLAN, A NONQUALIFIED 457(F) PLAN THAT IS 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. ONE PAYMENT PURSUANT TO THIS PLAN OCCURRED DURING 2012 TO A FORMER OFFICER;M. WALL, $112,332. VESTED AMOUNTS, IF ANY, 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)). PART II, SUPPLEMENTAL DISCLOSURES SCHEDULE J, PART II ALTHOUGH THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, THE SUPPORTED ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO FULFILL THE ORGANIZATION'S 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 BY THE COMPENSATION AND BENEFITS COMMITTEE. 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 J-2 SCHEDULE J, PART II THE SUPPORTED ORGANIZATION DOES NOT COMPENSATE DIRECTORS, DR. MAURICE ZEITLIN, GRACE LELAND BEHARRY, AND MARY GRIM FOR THEIR SERVICES AS BOARD MEMBERS. ALL COMPENSATION AND BENEFITS REPORTED FOR DIRECTORS REPRESENT COMPENSATION AS EITHER AN EMPLOYEE OF THE SUPPORTED ORGANIZATION OR FOR PHYSICIAN SERVICES FOR THE SUPPORTED ORGANIZATION. X 16 RESALE VALUE X 14697 RESALE VALUE X 9 1470 COMPARABLE SALE X GIFT CERT/TICKETS 8 1632 COMPARABLE SALE X FOOD AND WINE 13 1412 COMPARABLE SALE X ELECTRONICS 1 180 COMPARABLE SALE X JEWELRY 2 625 COMPARABLE SALE X SPORTING GOODS 2 300 COMPARABLE SALE X TOYS 4 269 COMPARABLE SALE X 4" AND 6" AZALEAS 1 100 COMPARABLE SALE X 2 PAIRS OF SUNGLASSES 1 160 COMPARABLE SALE X GIFT BASKETS 2 510 COMPARABLE SALE 0 false true false Explanations of reporting method for number of contributions Schedule M, Part I BOOKS AND PUBLICATIONS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. CLOTHING AND HOUSEHOLD GOODS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. COLLECTIBLES: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: GIFT CERT/TICKETS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: FOOD & WINE: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: ELECTRONICS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: JEWELRY: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: SPORTING GOODS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: TOYS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: AZALEAS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. OTHER: THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 4 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 5 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 18 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=GIFT CERT/TICKETS GIFT CERT/TICKETS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. FORM 990, PART V, LINE 2A FORM 990, PART V, LINE 2A THE ORGANIZATION DOES NOT HAVE EMPLOYEES. AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES FOR THE BENEFIT OF THE HOSPITAL AND UTILIZES THE EMPLOYEES OF THAT HOSPITAL. THE PROPORTIONATE SALARIES AND BENEFITS FOR THESE INDIVIDUALS ARE ALLOCATED TO THE FOUNDATION. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED IN THE HOSPITAL ENTITY'S FORM W-3 AND FEDERAL EMPLOYMENT TAX RETURNS. Family/business relationships amongst interested persons Form 990, Part VI, Section A, Line 2 BOARD MEMEBERS DANA PUMP AND DAVID PUMP - FAMILY RELATIONSHIP, BOARD MEMBERS PATRICK HAWTHORNE AND BARBARA HAWTHORNE - FAMILY RELATIONSHIP Classes of members or stockholders Form 990, Part VI, Section A, Line 6 THE ORGANIZATION HAS A SOLE CORPORATE MEMBER, 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 FOUNDATION. 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 THE HOSPITAL'S ACCOUNTING DEPARTMENT HAS WORKED CLOSELY WITH DIGNITY HEALTH AND AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. IT PRESENTED THE FINAL DRAFT OF THE FORM 990 TO THE CHAIR OF THE FINANCE AND INVESTMENT COMMITTEE EXCLUDING COMPENSATION SCHEDULES AND SCHEDULE B. COMPENSATION INFORMATION WERE REVIEWED BY CFO FOR THE FINAL DRAFT. IN ADDITION TO CONSULTING WITH THE CFO, THE FINANCE COMMITTEE CHAIR MET WITH THE FOUNDATION CEO AND ITS STAFF. DIGNITY HEALTH ALSO MET WITH THE ACCOUNTING FIRM HIRED TO REVIEW THE FORM 990. DUE TO TIMING, THE FINAL FORM 990 WILL BE REVIEWED BY THE FINANCE AND INVESTMENT COMMITTEE AND WILL REPORT BACK TO THE BOARD REGARDING ITS OVERSIGHT OF THE FORM 990, AGAIN EXCLUDING COMPENSATION SCHEDULES AND SCHEDULE B, SUBSEQUENT TO FILING WITH THE INTERNAL REVENUE SERVICE. Conflict of interest policy Form 990, Part VI, Section B, Line 12c THE FOUNDATION 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 15 FORM 990, PART VI, LINE 15 THE FOUNDATION PRESIDENT IS COMPENSATED BY DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL AND MEDICAL CENTER. FOR 2012 COMPENSATION, DIGNITY HEALTH'S HUMAN RESOURCES DEPARTMENT CONDUCTED AN ANNUAL REVIEW AND ANALYSIS TO PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGE OF THE FOUNDATION PRESIDENT. 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 ADMINISTRATIVE SERVICES - TOTAL EXPENSE: 666440, PROGRAM SERVICE EXPENSE: 321071, MANAGEMENT AND GENERAL EXPENSES: 280901, FUNDRAISING EXPENSES: 64468; PROFESSIONAL SERVICES - TOTAL EXPENSE: 18337, PROGRAM SERVICE EXPENSE: 3820, MANAGEMENT AND GENERAL EXPENSES: 7893, FUNDRAISING EXPENSES: 6624; OTHER PURCHASED SERVICES - TOTAL EXPENSE: 29963, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 29963, FUNDRAISING EXPENSES: ; Other changes in net assets or fund balances Form 990 , Part XI, Line 9 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS - 80384; FORM 990, PART XII, LINE 3B FORM 990, PART XII, LINE 3B THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN DIGNITY HEALTH'S CONSOLIDATED OMB CIRCULAR A-133 AUDITED SCHEDULE OF FEDERAL EXPENDITURES. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=FOOD AND WINE FOOD & WINE: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=ELECTRONICS ELECTRONICS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=JEWELRY JEWELRY: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=SPORTING GOODS SPORTING GOODS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=TOYS TOYS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=4" AND 6" AZALEAS AZALEAS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=2 PAIRS OF SUNGLASSES THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=GIFT BASKETS THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 4 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 5 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line 18 THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=GIFT CERT/TICKETS GIFT CERT/TICKETS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=FOOD AND WINE FOOD & WINE: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=ELECTRONICS ELECTRONICS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=JEWELRY JEWELRY: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=SPORTING GOODS SPORTING GOODS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=TOYS TOYS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=4" AND 6" AZALEAS AZALEAS: THE FOUNDATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=2 PAIRS OF SUNGLASSES THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. Number of contributions or items contributed. Schedule M, part I, column (b), Line other=GIFT BASKETS THE FOUNDATION IS REPORTING BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CTR 18300 ROSCOE BOULEVARD NORTHRIDGE CA 91328 HOSPITAL CA 501(C)(3) 3 NA false CHARITABLE REMAINDER TRUST (1) INVESTMENTS CA NHF TRUST false true true false false false false false false false false true false false false false false false false