COMMUNITY HOSPITAL OF SAN BERNARDINO: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: COMMUNITY HOSPITAL OF SAN BERNARDINO (EIN 95-1643373)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-03
IRS object ID: 201301239349300965
Schema version: 2011v1.5
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 H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-03T17:17:20-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

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	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	951643373	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Hospital of San Bernardino	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% DAVE EVANS FINANCE DEPT	InCareOfName
Name Control	COMM	NameControl
Phone	9088876333	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1805 Medical Center Drive	AddressLine1
City	San Bernardino	City
State	CA	State
ZIP Code	92411	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Darryl VandenBosch	Name
Title	VP & CFO	Title
Date Signed	2013-05-03	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	4159635100	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	DARRYL VANDENBOSCH CFO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1805 MEDICAL CNTR DRIVE	AddressLine1
City	SAN BERNARDINO	City
State	CA	State
ZIP Code	92411	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	201056359	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.dignityhealth.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1938	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	Community Hospital of San Bernardino is committed to furthering the healing ministry of Jesus, and to providing high-quality, affordable healthcare to the community we serve.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	9	NbrIndependentVotingMembers
Total Nbr Employees	1654	TotalNbrEmployees
Total Nbr Volunteers	93	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	609137	ContributionsGrantsPriorYear
Contributions Grants Current Year	1038794	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	196791336	ProgramServiceRevenuePriorYear
Program Service Revenue CY	199115964	ProgramServiceRevenueCY
Investment Income Prior Year	56577	InvestmentIncomePriorYear
Investment Income Current Year	23318	InvestmentIncomeCurrentYear
Other Revenue Prior Year	862375	OtherRevenuePriorYear
Other Revenue Current Year	878283	OtherRevenueCurrentYear
Total Revenue Prior Year	198319425	TotalRevenuePriorYear
Total Revenue Current Year	201056359	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	1486148	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1353088	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	122272435	SalariesEtcPriorYear
Salaries Etc Current Year	127298124	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	88510573	OtherExpensePriorYear
Other Expenses Current Year	91239175	OtherExpensesCurrentYear
Total Expenses Prior Year	212269156	TotalExpensesPriorYear
Total Expenses Current Year	219890387	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-13949731	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-18834028	RevenuesLessExpensesCY
Total Assets BOY	63903035	TotalAssetsBOY
Total Assets EOY	78269563	TotalAssetsEOY
Total Liabilities BOY	88099865	TotalLiabilitiesBOY
Total Liabilities EOY	121300421	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	-24196830	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	-43030858	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	COMMUNITY HOSPITAL OF SAN BERNARDINO IS A NON-PROFIT, FULL-SERVICE, ACUTE CARE FACILITY IN BUSINESS TO PROVIDE ACUTE INPATIENT CARE, LONG-TERM CARE AND A WIDE RANGE OF ANCILLARY AND THERAPEUTIC CARE TO THE COMMUNITY WE SERVE. OUR VISION IS TO CREATE AND PROVIDE HEALTH CARE SOLUTIONS, AND MEET THE HEALTH CARE NEEDS OF OUR COMMUNITY.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	200943466	Expense
Grants	1353088	Grants
Revenue	199115964	Revenue
Description	Community Hospital of San Bernardino's mission is to contribute to the health of the community through the provision of quality services delivered in a compassionate and cost effective manner. The hospital is licensed for 442 beds and currently has 360 beds available. The hospital had 90,816 total patient days, 14,455 admissions, and 48,117 emergency room visits. Inpatient services: acute patient care; maternal child care; mental health care; neurological care; and a variety of outpatient care.	Description
Total Program Service Expense	200943466	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
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	false	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	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	true	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	true	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	true	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	true	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	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	12	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1654	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	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	9	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

Field	Value	IRS element (for citing)
Name Person	DAVE EVANS FINANCE DEPT	NamePerson
Telephone Number	9098876333	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1805 MEDICAL CTR DRIVE	AddressLine1
City	SAN BERNARDINO	City
State	CA	State
ZIP Code	92411	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
Steven Barron
Director	1.0	X	0	641553	74017
Dr Alvaro Bolivar
Director/ Ex-officio	1.0	X	213556	0	0
Paulette Brown Ph D
Director	1.0	X	0	0	0
Dr Betty Daniels
Director	1.0	X	0	0	0
Dr Hendrik DeJager
Director	1.0	X	0	0	0
Bruce Ermann MD
Director	1.0	X	0	252801	26422
Richard Gonzalez Esq
Director	1.0	X	0	0	0
Margaret Hill
Director	1.0	X	0	0	0
Dr Bharti Jain
Director/Secretary Nov-Dec2011	28.0	X	0	0	0	X
Albert Karnig PhD
Director	1.0	X	0	0	0
Frank Lyman
Secretary (thru 8/8/11)	1.0	X	0	0	0	X
Peggy Merryman
Director	1.0	X	0	0	0
Dr Vellore Muraligopal
Director	1.0	X	0	0	0
John Nolan Esq
Director	1.0	X	0	0	0
Marvin O'Quinn
Director	1.0	X	0	2991707	441153
Dr Paul Ryan
Director	1.0	X	12000	0	0
Elizabeth Shih
Director	1.0	X	0	1703310	154085
Susan Whitten
Director	1.0	X	0	433014	65434
Marvin Reiter CPA
Chairman	1.0	X	0	0	0	X
June Collison
Hospital President (strt 2/12)	40.0		0	0	0	X
Jack Ivie
COO	40.0		331392	0	21428	X
Diane Nitta
Hospital President (thru 11/28	40.0		782750	0	38808	X
Edward Sorenson
Hospital VP & CFO	40.0		437491	0	28433	X
Darryl VandenBosch
VP/CFO	20.0		0	323805	42744	X
Geraldine C Fike
VP/CNE	40.0		226004	0	24763		X
Kimiko Ford
VP of Ancillary Services	40.0		226318	0	37895		X
Stan Rucker
CSO	40.0		0	269809	27244		X
David J Evans
Controller	40.0		194269	0	35569			X
LAWRENCE LAWLER
Sr Director of Neuro/Behavior	40.0		213806	0	37834			X
Marc Marchetti
VP Business Development	40.0		218065	0	35192			X
Rosilyn Nolan
Dir Home Health	40.0		183732	0	31877			X
Marie R Orpilla
CNIII	40.0		232983	0	34004			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	3272366	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	6615999	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1156902	TotalOtherCompensation
Number Individuals GT100 K	225	NumberIndividualsGT100K
Formers Listed	false	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
AMERICAN VITALCARE INC
PO BOX 502096	ST LOUIS	MO	631502096	Subacute care svc	1577997
SAFEWAY CONSTRUCTION
1474 N MILLER DR	COLTON	CA	923242457	Contractor	1244743
ANGELICA TEXTILE SERVICES
925 S 8TH ST	COLTON	CA	92324	LAUNDRY SERVICES	991364
AXIOM PAIN MANAGEMENT INC
1800 N MEDICAL CENTER DR	SAN BERNARDINO	CA	92411	Medical Services	990083
METROPOLITAN FAMILY MED GROUP
742 W HIGHLAND AVE	SAN BERNARDINO	CA	92405	Medical Services	946565

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	33	NumberOfContractorsGT100K
Related Organizations	744000	RelatedOrganizations
Government Grants	250377	GovernmentGrants
All Other Contributions	44417	AllOtherContributions
Total Contributions	1038794	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
PATIENT REVENUE/CHARITY CARE	900099	86339473	86339473	$0
MEDICARE/MEDICAID PAYMENTS	900099	108955909	108955909	$0
EHR INCENTIVE	900099	3144511	3144511	$0
MEDICAL OFFICE BUILDING	900099	665415	665415	$0
EDUCATION	900099	10656	10656	$0

Field	Value	IRS element (for citing)
Total Program Service Revenue	199115964	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	23318	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$23,318	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

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
CAFETERIA	900099	481089	$481,089
GIFT SHOPS	900099	239164	$239,164
DISCOUNT ON PURCHASES	900099	46253	$46,253

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	111777	TotalRevenueColumn
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$111,777	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	878283	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	201056359	TotalRevenueColumn
Related Or Exempt Function Income	199115964	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$901,601	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1303599	Total
Program Services	1303599	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	49489	Total
Program Services	49489	ProgramServices

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	2583520	Total
Program Services	2484265	ProgramServices
Management And General	99255	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	246000	Total
Program Services	246000	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	95123645	Total
Program Services	90271752	ProgramServices
Management And General	4851893	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	5748095	Total
Program Services	5116998	ProgramServices
Management And General	631097	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	16359774	Total
Program Services	14573133	ProgramServices
Management And General	1786641	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	7237090	Total
Program Services	6448247	ProgramServices
Management And General	788843	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	75896	Total
Management And General	75896	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	81983	Total
Management And General	81983	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	10314	Total
Management And General	10314	ManagementAndGeneral

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	18408591	Total
Program Services	11840068	ProgramServices
Management And General	6568523	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	304158	Total
Program Services	11722	ProgramServices
Management And General	292436	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5677740	Total
Program Services	5485853	ProgramServices
Management And General	191887	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	7665664	Total
Program Services	6839516	ProgramServices
Management And General	826148	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2054402	Total
Program Services	1807874	ProgramServices
Management And General	246528	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	143920	Total
Program Services	114437	ProgramServices
Management And General	29483	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	121082	Total
Program Services	53270	ProgramServices
Management And General	67812	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	3272675	Total
Program Services	3272675	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	3916956	Total
Program Services	3329413	ProgramServices
Management And General	587543	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	3865440	Total
Program Services	3865440	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
MEDI-CAL PROVIDER FEE	13944250	13944250
BAD DEBT	15368332	15368332
MEDICAL SUPPLIES	12990443	12990443
FOOD SUPPLIES	1137714	1137714

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2199615	Total
Program Services	388976	ProgramServices
Management And General	1810639	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	219890387	Total
Program Services	200943466	ProgramServices
Management And General	18946921	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	7625	BOY
EOY	7125	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	2800517	BOY
EOY	261696	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	13480	BOY
EOY	43687	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	21769319	BOY
EOY	23791700	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	195000	BOY
EOY	129841	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	1956785	BOY
EOY	1981374	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1955954	BOY
EOY	2437451	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	8034004	BOY
EOY	24365104	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	104216243	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	78997908	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	27137101	BOY
EOY	25218335	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

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	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	33250	BOY
EOY	33250	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	63903035	BOY
EOY	78269563	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	18918376	BOY
EOY	26095300	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	8409609	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	2000000	BOY
EOY	2000000	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	58771880	BOY
EOY	93205121	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	88099865	BOY
EOY	121300421	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	-24196830	BOY
EOY	-43030858	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	-24196830	BOY
EOY	-43030858	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	63903035	BOY
EOY	78269563	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	-18834028	ReconcilationRevenueExpenses
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

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)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$10,314	OtherActivitiesAmount
Total Lobbying Expenditures IIB	10314	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	PART II-B, LINE 1i	Identifier
Explanation	Lobbying expenditures paid by the Parent organization for annual membership dues where expenses are allocated to the hospital: American Hospital Association $ 1,118 Catholic Health Association $ 1,566 Hospital Association of So. California $ 7,286 National Association of Home Care and Hospice $ 53 California Hospice and Palliative Care Association $ 16 Safety Net Hospitals for Pharmaceutical Access $ 275 ======= TOTAL EXPENDITURES $10,314 =======	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Current Year Minus3 Years		CurrentYearMinus3Years

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	799341	OtherCostOrOtherBasis
Book Value	799341	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	76579450	OtherCostOrOtherBasis
Depreciation	61465580	Depreciation
Book Value	15113870	BookValue

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovements

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	25878834	OtherCostOrOtherBasis
Depreciation	17351592	Depreciation
Book Value	8527242	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	958618	OtherCostOrOtherBasis
Depreciation	180736	Depreciation
Book Value	777882	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	25218335	TotalOfBookValueLandBuildings
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
DUE TO RELATED PARTIES	$87,052,208
PENSION PAYABLE	$5,223,358
DEFERRED COMPENSATION	$160,628
ASSET RET OBLIG LIABILITY	$768,927

Field	Value	IRS element (for citing)
Total Of Amounts	93205121	TotalOfAmounts

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	500.	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	790	PersonsServed
Total Community Benefit Expense	4857458	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	4857458	NetCommunityBenefitExpense
Percent Of Total Expense	0.02380	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	43522	PersonsServed
Total Community Benefit Expense	131011995	TotalCommunityBenefitExpense
Direct Offsetting Revenue	121193640	DirectOffsettingRevenue
Net Community Benefit Expense	9818355	NetCommunityBenefitExpense
Percent Of Total Expense	0.04800	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Persons Served	620	PersonsServed
Total Community Benefit Expense	3140809	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1176317	DirectOffsettingRevenue
Net Community Benefit Expense	1964492	NetCommunityBenefitExpense
Percent Of Total Expense	0.00960	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	44932	PersonsServed
Total Community Benefit Expense	139010262	TotalCommunityBenefitExpense
Direct Offsetting Revenue	122369957	DirectOffsettingRevenue
Net Community Benefit Expense	16640305	NetCommunityBenefitExpense
Percent Of Total Expense	0.08140	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	19	NumberOfActivitiesOrPrograms
Persons Served	21633	PersonsServed
Total Community Benefit Expense	1931431	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22348	DirectOffsettingRevenue
Net Community Benefit Expense	1909083	NetCommunityBenefitExpense
Percent Of Total Expense	0.00930	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Persons Served	5633	PersonsServed
Total Community Benefit Expense	1636968	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	1636968	NetCommunityBenefitExpense
Percent Of Total Expense	0.00800	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	27266	PersonsServed
Total Community Benefit Expense	3568399	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22348	DirectOffsettingRevenue
Net Community Benefit Expense	3546051	NetCommunityBenefitExpense
Percent Of Total Expense	0.01730	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	26	NumberOfActivitiesOrPrograms
Persons Served	72198	PersonsServed
Total Community Benefit Expense	142578661	TotalCommunityBenefitExpense
Direct Offsetting Revenue	122392305	DirectOffsettingRevenue
Net Community Benefit Expense	20186356	NetCommunityBenefitExpense
Percent Of Total Expense	0.09870	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	3	PersonsServed
Total Community Building Expense	186359	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	286359	NetCommunityBuildingExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServed
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	3	PersonsServed
Total Community Building Expense	186359	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	286359	NetCommunityBuildingExpense
Percent Of Total Expense	0.00090	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$3,424,765	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	21526506	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	23745983	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2219477	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Hospital of San Bernardino	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1805 Medical Center Dr	AddressLine1
City	San Barnardino	City
State	CA	State
ZIP Code	92411	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Community Hospital of San Bernardino	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	500.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Community Convalescent Center	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1676 Medical Center Drive	AddressLine1
City	San Bernardino	City
State	CA	State
ZIP Code	92411	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	SKILLED NURSING	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Schedule H, Part I, Line 7, column (f)	The amount of bad debt expense included on Form 990, Part IX, line 25, column (A) is $15,368,332 and has been subtracted for purposes of calculating the percentages in column (f).
Schedule H, Part I, Line 7	For purposes of calculating the amounts provided in the table, CHSB uses a cost accounting system that combines relative value units (RVU) and cost to charge ratios (CCR) to allocate costs to the patient level. The cost accounting system algorithm allocates total operating expenses to the procedure charge code level based upon an RVU for procedures that have been studied and assigned an RVU, or based upon a CCR for unstudied procedures that do not have an RVU assigned. When a CCR is used, the system calculates that CCR on a departmental specific basis at the hospital where the services were provided. The calculation is similar to the Worksheet 2 of Schedule H, Ratio of Patient Care Cost to Charges, except it is calculated on a departmental specific basis, not in the aggregate. The allocated procedure charge code level costs are then rolled up to the patient level based upon the billed procedure charge codes associated with those services provided to each specific patient. This is done for all patient segments including inpatient, outpatient, emergency department, private insurance, Medicaid, Medicare, uninsured and self pay. The cost accounting system is utilized to determine the unreimbursed cost of Medicaid and other means-tested government programs. The cost of charity care is calculated by applying the CCR derived from the cost accounting system on a per facility basis, to the charges incurred on patients that qualify for charity care at the respective facility. The actual cost is reported for other community benefit activities such as community health improvement services, community benefit operations, health professions education, subsidized health services, research and cash and in-kind donations.
Schedule H, Part I, line 7b, column (f)	Beginning in 2009, the State of California established provider fee programs. These programs are funded by quality assurance fees paid by participating hospitals and matching federal funds. Community Hospital of San Bernardino recognized quality assurance fees during the year of $13.9 million which are included in total community benefit expense related to unreimbursed Medicaid (Part I, line 7b, column c), and recognized fee-for-service supplemental payments of $30.4 million during the year reflected under the Medicaid program as direct offsetting revenue (Part I, line 7b, column d). This net reduction in the cost of the Medicaid program is driving the decrease in the overall cost of community benefit expense as a percent of total expenses when compared to prior years. The California Hospital Association created a private program, the California Health Foundation and Trust ("CHFT"), established for several purposes, including aggregating and distributing financial resources to support charitable activities at various hospitals and health systems in California. During the year, Community Hospital of San Bernardino recorded a pledge to a grant fund established by CHFT in the amount $1.3 million. The grant is reported under other benefits (Part I, line 7i, column c), as cash and in-kind contributions to community groups.
Schedule H, Part II - Community Building Activities	CHSB provides financial and in-kind support for community building activities. The following addresses the coalition building activity. Coalition Building: CHSB recognizes the community need for affordable office/work space for non-profit organization who share a mission the advance sustainable action plans that address solutions for documented community needs in the areas of health, environment and social welfare. With the objective of partnering with non-profit organizations to advance these needs, CHSB provides free office space for these agencies to operate.
Schedule H, Part III, Line 4	The amount of the organization's bad debt at cost is determined by applying the CCR (see above) to patient charges that are deemed to be uncollectible. This amount represents the cost of services provided to patients who are unable or refuse to pay their bills and do not qualify for free or discounted care, government sponsored programs or other financial assistance, and are otherwise uninsured. Any portion of a patient bill remaining after applying financial, uninsured or other discounts or payments received on the account that are ultimately determined to be uncollectible are written off to bad debt. As noted in Part I, Line 3, CHSB provides free or discounted care to uninsured or under-insured individuals at or below 500% of the Federal Poverty Level. CHSB also provides patients options for prompt pay discounts, discounts for the medically indigent, and interest-free extended payment plans for patients who have demonstrated good faith and are cooperating in resolving their hospital bills. All accounts for eligible uninsured patients receive an automatic uninsured discount of 25% for patients. The expected patient payment amount on the patient's bill reflects this discount. CHSB makes every effort in determining if a patient qualifies for financial assistance upon admission. CHSB follows Dignity Health's financial assistance policy. The financial assistance policy is communicated to patients upon admission and is available in the languages primarily spoken in the community. It is also posted in various common areas of the hospital and is provided upon billing if eligibility is not previously determined. Eligibility is reevaluated as needed and amounts are classified as charity as soon as eligibility is known. CHSB also utilizes a Payment Assistance Rank Ordering (PARO) scoring system to assist in determining if a patient may qualify for financial assistance even though they have not applied for it. PARO is a methodology that applies consistent screening and application standards to all patients utilizing historical data to develop a predictive model for healthcare financial assistance. In its development, special attention was paid to those socio-economic factors that might adversely affect those patients deserving the most attention. Other criteria are also utilized to ensure that no services that have qualified as financial assistance are reported as bad debt. As such, CHSB does not believe that any amounts included in Part III, Line 2, are attributable to patients eligible under the organization's financial assistance policy. The following is an excerpt from Dignity Health and its subordinate corporations' consolidated annual audited financial statements for the year ended June 30, 2012, related to accounts receivable and allowances for charity and doubtful accounts: Patient accounts receivable and net patient service revenue are reported at the net realizable amount from patients, third-party payors, and others for services rendered. CHSB manages its collection risk by regularly reviewing its accounts and contracts and by providing appropriate allowances. Reserves for charity and uncollectible amounts have been established and are netted against patient accounts receivable in the consolidated balance sheet.
Schedule H, Part III, Line 8	CHSB prepares Medicare cost reports in a manner that comports with Provider Reimbursement Manual (PRM) 15-1, 2150ff and PRM 15-2, 1000ff. As such, the following language per the PRM 15-1 describes the computation of costs per the Medicare Cost Report: Total allowable costs of a provider are apportioned between program beneficiaries and other patients so that the share borne by the program is based upon actual services received by program beneficiaries. The ratio of covered beneficiary charges to total patient charges for the services of each ancillary department is applied to the cost of the department. Added to this amount is the cost of routine services for program beneficiaries, determined on the basis of a separate average cost per diem for all patients for general routine patient care areas. Another factor to be considered is a separate average cost per diem for the intensive care unit, coronary care unit, and other special care inpatient hospital units. Dignity Health believes that the entire Medicare shortfall of $519.9 million, as reported below in Part VI, Line 6, constitutes community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by Dignity Health hospitals in order to continue treating the elderly in our communities. The hospitals provide care regardless of this shortfall and thereby relieve the federal government of the burden of paying the full cost for Medicare beneficiaries. This shortfall includes $2.2 million reported on Part III, Section B, Line 7, primarily for fee for service Medicare patients, as well as the unreimbursed portion of Medicare Managed Care and Medicare Capitated programs for CHSB.
Schedule H, Part III, Line 9b	At time of patient billing, CHSB provides to all Patients information concerning services and charges provided. Information provided includes, patient financial assistance information, uninsured patient discount information, information regarding eligibility Assistance for Government sponsored healthcare and Payment Assistance. CHSB ensures that patient accounts are processed fairly and consistently. CHSB's collection policy contains provisions that prohibit the collection of amounts due from patients who the organization knows qualify for financial assistance. Accounts with incorrect or incomplete demographic information are assigned to a collection agency if CHSB or the billing company retained by CHSB is unable to obtain an updated address through skip tracing or other means. For patients who have an application pending for either government-sponsored financial assistance or for assistance under CHSB's Patient Payment Assistance Policy, or where the patient is attempting in good faith to settle an outstanding bill with the facility via payment plans, CHSB will not knowingly send that patient's bill to an outside collection agency. Legal action will not be pursued to collect debts from patients who have qualified for charity or are cooperating in good faith to resolve their debt. CHSB does not impose wage garnishments or liens on primary residences. On self-pay accounts that do not meet the criteria noted above, the initial determination of assignment to a collection agency will vary depending on the nature of the account with the final decision being at the discretion of each hospital patient financial assistance department. Upon assignment of such a patient account to a collection agency, CHSB requires the agency to comply with the Fair Debt Collection Practices Act.
Schedule H, Part V, Section B, Line 13g	All language regarding the policy is communicated to patients via the methods outlined below. 1. Signage in all admitting areas; 2. At the point of registration, all patients receive brochures explaining the facilitys financial assistance program and the availability of government sponsored programs; 3. All initial statements to uninsured patients includes verbiage informing patients of the facilitys financial assistance program and a copy of the financial assistance application. A telephone number is provided for patients to request further information about the program and assistance is available in languages other than English; 4. Information about the facilitys financial assistance program, access to the application, and contact information is available on the facilitys webpage.
Schedule H, Part V, Section B, Line 19d	Patients who are applying for discounts under the discount provision of Hospital Fair Pricing Act California Health and Safety Code 127400 whose household income is at or below 350% of the FPL are eligible to receive services at the highest average rate the hospital would receive for providing services from Medicare, Medicaid, or any other government-sponsored health program of health benefit in which the hospital participates, whichever is greater.
Schedule H, Part VI, Line 2 - Needs Assessment	The passing of California's Community Benefit Law (SB 697) created a process and major tool for CHSB to determine its community benefit plan, which outlines how the hospital will give back to the community in the form of health care and other community services to address unmet community health needs. In the spring of 2008 a Community Needs Assessment (CNA) was carried out in partnership with St. Bernardine Medical Center. It incorporates components of primary data collection and secondary data analysis that focus on the health and social needs of the CHSB Service Area. Additionally, eight focus groups were conducted with residents of communities in the CHSB primary service area. Five of the groups were conducted in English and three in Spanish. Through the participation in this needs assessment and benefits planning process CHSB remains committed to participating in community processes that update and refresh the ongoing quest to understand and to respond to the community's priorities for health and quality of life improvements. The CNA continues to be a focal point and an essential tool in developing the strategic direction of CHSB, along with participatory and solution focused processes which have taken inventory of community assets and resources in our community by the Latino Health Collaborative, the African American Health Institute, and the Loma Linda School of Public Health.
Schedule H, Part VI, Line 3 - Patient Education of Eligibility for	Communication of the Financial Assistance Program to Patients and the Public: Information about Dignity Health's Financial Assistance Program and a contact number are made available to patients and the public. Patients are informed of the facility's financial assistance program via signage in all admitting areas and in various common areas of the hospital. Financial assistance program information notices are posted in the Emergency and Admitting Departments and at other public places as the hospital may elect. Such information is provided in the primary languages spoken in the communities the hospital serves. The signage includes notification that all uninsured patients with annual incomes less than $250,000 receive an uninsured discount of 25% for services provided and that further discounts may be provided upon the completion and submission of a financial assistance application. Payment assistance information, government program resource information, tools to assist patients in finding health coverage, answers to frequently asked billing questions, and other such information can also be found on Dignity Health's website at www.dignityhealth.org. At the point of registration, all patients receive brochures explaining the facility's financial assistance program and the availability of government sponsored programs. Uninsured patients receive copies of the financial assistance and Medicaid applications in addition to the brochure upon admission to the facility. It is Dignity Health's policy that at the time of patient billing, CHSB provides to all uninsured patients the same billing information concerning services and charges provided to all other patients who receive care at CHSB. If financial assistance eligibility is not determined prior to billing, initial billing statements to uninsured patients include a request to the patient to provide any insurance information that was valid for the dates of service billed, a statement informing patients without insurance coverage they may be eligible for a government sponsored program or facility funded financial assistance, instructions on how to apply for a government program or financial assistance and the provision of such applications. Additionally, contract terms with collection vendors working on behalf of Dignity Health includes language requiring all initial statements to uninsured patients include verbiage informing patients of the facility's financial assistance program and a copy of the financial assistance application. Also, any member of CHSB facility staff or medical staff may make referrals of patients for financial assistance. The patient or a family member, a close friend or an associate of the patient may also make a request for financial assistance.	Assistance
Schedule H, Part VI, Line 4 - Community Information	Community Hospital of San Bernardino is located in an area that has struggled economically for years, and has only seen the quality of life plummet with the recent national economic downturn. Eighty percent (80%) of discharges come from thirteen (13) zip codes concentrated in the following cities: Bloomington, Colton, Fontana, Highland, Rialto and San Bernardino. The Inland Empire has been severely impacted by the recession. Within the service area, unemployment had risen to 16.2% in 2010. The data indicate that within the CHSB Service Area, poverty increased markedly for the population at or below 200% of the Federal Poverty Level. Many of the neighborhoods served by CHSB have close to half of the residents living at or below 200% of the Federal Poverty Level. In San Bernardino 92410, over two-thirds of the population is at this level of poverty (67.7%), followed closely by San Bernardino 92411 (63.3%) and San Bernardino 92408 (61.1%). In San Bernardino 92401, 83% of individuals live at or below the 200% poverty level. Contributing to the dismal earning potential of its residents, the community has a low education rate. Of the population age 25 and over, 32.1% have less than a high school diploma, more than double the state rate of 14.9%. Furthermore, for 26.9% of area adults, high school graduation was their highest level of educational attainment. Only 12.7% of the population holds a Bachelor's Degree or greater. Confirming the difficult economics of the region, in July 2012 the City of San Bernardino filed for Chapter 9 bankruptcy protection. This action will exacerbate the ability of non-profits to aid the most vulnerable in our community. The following reflects demographics for the primary service area: " Population: 660,751 " Diversity: Hispanic (66.4%), Caucasian (16.5%), African American (10.5%), Asian & Pacific Islander (4.6%), all others (2.1%) " Average Income: $57,112 " Uninsured: 27.27% " Unemployment: 8.3% " No High School Diploma: 32.1% " Renters: 36% " CNI Score: 4.8 " MediCal Patients: 25.41% " Other Area Hospitals: 5 In addition to Community Hospital of San Bernardino and St. Bernardine Medical Center, other hospitals serving the area include: Arrowhead Regional Medical Center, Kaiser Permanente-Fontana, Loma Linda University Medical Center and Redlands Community Hospital. The Community Need Index (CNI) is a tool developed by Dignity Health to measure community need in a specific geography through analyzing the degree to which a community has the following health care access barriers: 1) Income Barriers, 2) Educational Barriers, 3) Cultural Barriers, 4) Insurance Barriers and 5) Housing Barriers. Communities with scores of "5" are more than twice as likely to need inpatient care for preventable conditions as communities with a score of "1". The median CNI score of the hospital's service area is 4.8 with six (6) of the zip code communities scoring a "5". Many of the neighborhoods served have been federally designated as a Medically Underserved Area (MUA). Portions of the following zip codes served by the hospital fall in a MUA: 92401, 92404, 92405, 92335 and 92336. When reviewing Community Grant proposals, special attention is paid to organizations serving these areas.
Schedule H, Part VI, Line 5 - Promotion of Community Health	A majority of the CHSB's governing body is comprised of persons who reside in the primary service area and who are neither employees, family members nor contractors of the Hospital. The Hospital extends medical staff privileges to all qualified physicians in the community. CHSB recognizes the importance of community health and promotes community health beyond the walls of the hospital through a variety of methods: community education classes on a variety of topics are offered free of charge throughout the year to community members; referrals to appropriate social agencies are made to those seeking assistance; free flu shots; collaboration with a variety of non-profit agencies sharing a mission of health, environment and social welfare; active membership on St. Bernardine Medical Center's Community Benefit Initiative Committee (CBIC) where input from key community stakeholders is critical in reviewing the needs of the community and assist in establishing health priorities and goals. CHSB reinvests all its operating and investment income in hospital improvements, technology enhancements, community health programs, and employee benefits. This active reinvestment makes it possible for us to deliver on our mission, including ensuring that everyone has access to health care.
Schedule H, Part VI, Line 6 - Affiliated Health Care System	CHSB is affiliated with Dignity Health. Affiliates of Dignity Health also promote the health of additional communities in Bakersfield, San Bernardino, San Francisco, San Andreas, and Grass Valley/Nevada City, California. These affiliates follow practices similar to those noted above in determining the unmet healthcare needs of their communities. The summary of Total unsponsored community benefit expense for Dignity Health and its subordinate corporations for the year ended June 30, 2012, is as follows: Persons Net Comm % of Served Benefit Exp excl Bad Debt Benefits for the Poor: Traditional Charity Care 108,530 188,380,000 2.0% Unpaid Costs of Medicaid/Medi-Cal 1,060,508 571,491,000 6.0% Other Means-tested Programs 280,517 66,067,000 0.7% Community Services: Community Health Services 525,831 53,467,000 0.6% Health Professions Education 86 27,000 0.0% Subsidized Health Services 193,751 28,297,000 0.3% Donations 155,219 33,140,000 0.3% Community Building Activities 12,811 1,623,000 0.0% Community Benefit Operations 3,884 8,911,000 0.1% Total Community Services for the poor 891,582 125,465,000 1.3% Total Benefits for the Poor 2,341,137 951,403,000 10.0% Benefits for the Broader Community: Community Services: Community Health Services 585,949 17,034,000 0.2% Health Professions Education 68,974 69,132,000 0.7% Subsidized Health Services 9,430 2,210,000 0.0% Research 26,281 30,049,000 0.3% Donations 165,149 7,584,000 0.1% Community Building Activities 38,641 3,138,000 0.0% Community Benefit Operations 87 1,446,000 0.0% Total Benefits for the Broader Community 894,511 130,593,000 1.3% Total Community Benefits 3,235,648 1,081,996,000 11.3% Unpaid Costs of Medicare 1,116,214 519,981,000 5.4% Total Community Benefits including Cost of Medicare 4,351,862 1,601,977,000 16.7%
STATE FILING OF COMMUNITY BENEFIT REPORT	CA,	990 SCHEDULE H, PART VI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable (2 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
California Health Foundation and Trust
1215 K Street Ste 800	Sacramento	CA	95814	941498697	501(c)(3)	1278110	0	N/A	N/A	Service for the Poor healthcare
Catholic Charities
1450 N D Street	San Bernardino	CA	92405	953516461	501(c)(3)	25489	0	N/A	N/A	Religious Community

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	Provision of food	TypeOfGrant
Number Of Recipients	4262	NumberOfRecipients
Amount Of Non Cash Assistance	49489	AmountOfNonCashAssistance
Method Of Valuation	cost	MethodOfValuation
Description Of Non Cash Assistance	food/meal	DescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Part I, Line 2	Identifier
Explanation	The hospital is a 501(c)(3) organization that uses a software package to document grant funding, to monitor and report program outcomes and to formulate criteria for grant selections.	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 (18 entries)

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
Steven Barron
0	396189	0	226846	0	18518	0	36512	0	37505	0	715570	0	0
Dr Alvaro Bolivar
213556	0	0	0	0	0	0	0	0	0	213556	0	0	0
Bruce Ermann MD
0	235518	0	14539	0	2744	0	14509	0	11913	0	279223	0	0
Marvin O'Quinn
0	869909	0	1817959	0	303839	0	390406	0	50747	0	3432860	0	0
Elizabeth Shih
0	623398	0	788373	0	291539	0	104121	0	49964	0	1857395	0	253744
Susan Whitten
0	260577	0	160603	0	11834	0	32162	0	33272	0	498448	0	0
Jack Ivie
272167	0	50271	0	8954	0	18676	0	2752	0	352820	0	0	0
Diane Nitta
202496	0	213905	0	366349	0	32566	0	6242	0	821558	0	0	0
Edward Sorenson
168162	0	0	0	269329	0	19437	0	8996	0	465924	0	0	0
Darryl VandenBosch
0	263242	0	48524	0	12039	0	25465	0	17275	0	366545	0	0
Geraldine C Fike
184454	0	33699	0	7851	0	12435	0	12328	0	250767	0	0	0
Kimiko Ford
188369	0	36256	0	1693	0	20465	0	17430	0	264213	0	0	0
Stan Rucker
0	216187	0	40384	0	13238	0	14886	0	12358	0	297053	0	0
David J Evans
173277	0	12997	0	7995	0	18347	0	17222	0	229838	0	0	0
LAWRENCE LAWLER
179905	0	33556	0	345	0	20596	0	17238	0	251640	0	0	0
Marc Marchetti
179865	0	33842	0	4358	0	18025	0	17167	0	253257	0	0	0
Rosilyn Nolan
162829	0	12393	0	8510	0	14679	0	17198	0	215609	0	0	0
Marie R Orpilla
229180	0	1326	0	2477	0	16893	0	17111	0	266987	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

IdentifierIdentifier	ExplanationExplanation
Sch J-1	Alvaro Bolivar's compensation is for Chief of Staff Services provided to the organization. Dr. Bharti Jain's and Dr. Paul Ryan's compensation is for medical Services provided to the organization.
Schedule J, Part I, Line 3	Although the organization employs personnel, 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 President's compensation. See Schedule O disclosure for Form 990, Part VI, Section B, Line 15a for additional information.
Schedule J, PART I, LINE 4a	The organization's certain officers, key employees and its highest compensated employees participate in a severance plan established by its supported organization. The plan provides market-standard compensation, ranging from payments of 1 month 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 two officers occurred during 2011; D Nitta, $322,193 and E. Sorenson, $187,808.
Schedule J, PART I, LINE 4b	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 under this formula 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 officers and key employees 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. No payments were made under this plan during 2011. Certain listed persons participate in the Dignity Health 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. No payments were made to any listed persons during 2011 pursuant to this plan. 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 additional compensation to eligible employees, commensurate with their contributions to the success of Dignity Health, in a form that would provide incentives and rewards for meritorious performance and encourage the recipients' continuance as employees of Dignity Health. Grants of options could be made to any employee who was eligible for the Company's Key Employee Retention Program. No payments were made under this plan during 2011. 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. Vested amounts are reported as deferred compensation in the year vesting occurs (column C) and are reflected again as reportable compensation in the year paid (column B(iii)). Payments made during 2011 pursuant to this plan include $253,744 to E. Shih.
PART II - SUPPLEMENTAL DISCLOSURES	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 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.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	521598225	IssuerEIN
CUSIP Number	13033FTN0	CUSIPNumber
Date Issued	2004-05-19	DateIssued
Issue Price	150000000	IssuePrice
Description Of Purpose	NEW MONEY TO FUND VARIOUS PROJECTS	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer
Pool Financing	true	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Amount Retired	0	AmountRetired
Amount Bond Defeased	0	AmountBondDefeased
Total Proceeds	2004025	TotalProceeds
Amount In Reserve Fund	0	AmountInReserveFund
Capitalized Interest	0	CapitalizedInterest
Refunding Escrow	0	RefundingEscrow
Issuance Costs From Proceeds	0	IssuanceCostsFromProceeds
Credit Enhancement	0	CreditEnhancement
Working Capital Expenditures	0	WorkingCapitalExpenditures
Capital Expenditures	2004025	CapitalExpenditures
Other Spent Proceeds	0	OtherSpentProceeds
Amount Unspent	0	AmountUnspent
Year Of Subst Completion	2005	YearOfSubstCompletion
Current Refunding	false	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	false	OwningBondFinancedProperty
Any Lease Arrangements	true	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	true	MngmentCntrctBondFinancdPrprty
Engage Bond Counsel Contracts	true	EngageBondCounselContracts
Any Research Agreements	true	AnyResearchAgreements
Engage Bond Counsel Research	true	EngageBondCounselResearch
Prcntge Prvt Business Use By Others	0.00000	PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI	0.00000	PercentageOfPrvtBusinessReUBI
Total Private Business Use	0.00000	TotalPrivateBusinessUse
Post Issuance Compliance Procdrs	true	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	false	Form8038TFiled
Variable Rate Issue	true	VariableRateIssue
Hedge Identified In Books And Recds	false	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1

Field	Value	IRS element (for citing)
Gross Proceeds Invested	true	GrossProceedsInvested
Exception To Rebate	false	ExceptionToRebate

Field	Value	IRS element (for citing)
Fed Tax Requirements Compliance	X	FedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	BOND A, CUSIP 13033FTN0	Identifier
Return Reference	0	ReturnReference
Explanation	THE DIFFERENCE BETWEEN THE ISSUE PRICE IN PART 1(E) AND PART II LINE 3 IS DUE TO INVESTMENT EARNINGS. COMMUNITY HOSPITAL OF SAN BERNARDINO (CHSB) AS A SEPARATE ENTITY RECEIVED $2 MILLION OF THE $150 MILLION CHFFA 2004JK POOL BONDS. PART III, LINE 3A ALTHOUGH THERE ARE MANAGEMENT OR SERVICE CONTRACTS THAT MAY GENERATE PRIVATE USE, CHSB HAS POLICIES AND PROCEDURES IN PLACE THAT REQUIRE SUCH CONTRACT BE IN COMPLIANCE WITH REVENUE PROCEDURE 97-13. PART III, LINE 3B ALTHOUGH THERE ARE RESEARCH AGREEMENTS WHICH MAY RESULT IN PRIVATE USE, CHSB HAS POLICIES AND PROCEDURES IN PLACE THAT REQUIRE SUCH CONTRACT BE IN COMPLIANCE WITH REVENUE PROCEDURE 2007-47. PART IV LINE 1 ARBITRAGE CALCULATIONS WERE PERFORMED BY ARBITRAGE CONSULTANT AND THERE WAS NO REBATABLE ARBITRAGE LIABILITY SO NO FORM 8038-T FILED.	Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

Field	Value	IRS element (for citing)
Name Person	Alvara Bolivar MD	NamePerson
Purpose Of Loan	physician loan	PurposeOfLoan
Loan From Organization	X	LoanFromOrganization
Original Principal	$195,000	OriginalPrincipalAmount
Balance Due	129841	BalanceDue
Default	false	Default
Approved By Board	true	ApprovedByBoard
Written Agreement	true	WrittenAgreement

Field	Value	IRS element (for citing)
Total Balance Due	129841	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	BHARTI JAIN MD INC	NamePerson

Field	Value	IRS element (for citing)
Relationship	BM, B JAIN IS SOLE OWNER	Relationship
Amount Of Transaction	246000	AmountOfTransaction
Description Of Transaction	MEDICAL SERVICES	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI through PART XII	FORM 990, PART VI, SECTION A, LINE 6 The sole corporate member is Dignity Health, a 501(c)(3) exempt organization. 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. FORM 990, PART VI, SECTION A, LINE 7b Reserved rights of the corporate member include: Adoption of Mission & Philosophy statements, Amendment or restatement of the Articles of Incorporation and Bylaws; Dissolution of the corporation, acquire another corporation, or create a subsidiary; Merging or consolidating 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 & dismissals; Selection or removal of independent auditors; Transactions outside the ordinary course of business. FORM 990, PART VI, SECTION B, LINE 11a The organization's CFO and Controller worked closely with the parent organization and an independent accounting firm engaged to review the return. The Board of Directors has delegated the review of the Form 990 to the Finance Committee. Management presented the draft of the Form 990 to the Finance Committee. 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 has been reviewed by the Compensation and Benefits Committee of the Dignity Health Board of Directors. Subsequent to its review, the Finance and Investment Committee reported back to the Board regarding its review and provided a draft to the Board of Directors, again excluding compensation for certain directors. FORM 990, PART VI, SECTION B, LINE 12C The Organization has adopted Dignity Health's Conflicts of Interest Policy. The Organization's Board is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to these policies, an annual conflict of interest disclosure statement, aimed at determining any family and business relationships and transactions, or other transactions that may pose a potential conflict, is distributed to all covered persons (e.g., board members, officers and executive leadership, key employees and all management personnel whose responsibilities include business decisions which may give rise to conflicts of interest). Covered persons are also required to disclose real or potential conflicts at the time such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to submit an updated disclosure statement and to sign a statement affirming that he/she: (1) has received a copy of the policy applicable to their 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 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 must be approved by a majority of disinterested persons, based on certain criteria; 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. FORM 990, PART VI, SECTION B, LINE 15A Although the organization employs personnel, the President's compensation is set by a related organization, Dignity Health. For 2011, 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 President. Appropriate comparability data for similar jobs in peer companies (both taxable and tax-exempt) WAS obtained from independent third-party survey sources. FORM 990, PART VI, SECTION B, LINE 15B For 2011 compensation, the organization's human resources department conducted an annual review and analysis to provide benchmarking data for the total compensation and benefits package of key employees. The compensation for these individuals was based on the qualification and experience of the candidates. Compensation is also reviewed annually as part of the merit increase process. 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. 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.
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Steven Barron TITLE:Director HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Bruce Ermann MD TITLE:Director HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Dr Bharti Jain TITLE:Director/Secretary Nov-Dec2011 HOURS:28	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Marvin O'Quinn TITLE:Director HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Elizabeth Shih TITLE:Director HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Susan Whitten TITLE:Director HOURS:40	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:Darryl VandenBosch TITLE:VP/CFO HOURS:20	FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
Community Hospital Foundation
1805 Medical Center Drive	San Bernardino	CA	92411	953051931	Fund raising	CA	501(c)(3)	11; Type I	CHSB	true
DIGNITY HEALTH
185 Berry Street	San Francisco	CA	94107	941196203	Hospital	CA	501(C)(3)	3	NA	false

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
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	false	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	true	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

Field	Value	IRS element (for citing)
Business Name Line1	COMMUNITY HOSP OF SAN BERNARDINO FOUNDATION	BusinessNameLine1

Field	Value	IRS element (for citing)
Transaction Type	c	TransactionType
Amount Involved	744000	AmountInvolved
Method Of Amt Determination	SEE Part VI	MethodOfAmtDetermination

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	Schedule R, Part V, line 2 column (c)	Identifier
Explanation	Line 1c CHSB is supported by one foundation. As a supporting organization, the Foundation operates for the benefit of, to raise funds for, or to carry out the purposes of CHSB. As a result, payments are made directly to CHSB from the Foundation or directly to the Foundation from CHSB.	Explanation