2013-08-07T13:24:35-05:00 2012-09-30 346565596 Ernst & Young US LLP 4370 La Jolla Village Drive Ste 500 San Diego CA 92122 990 2011-10-01 956077327 Sharp HealthCare SHAR 8584995150 8695 Spectrum Center Blvd San Diego CA 921231489 Ann Pumpian 8584995150 2013-08-05 0 8585357200 2011 2016-02-24 21:20:13Z Michael Murphy 8695 Spectrum Center Blvd San Diego CA 921231489 1135638880 0 X www.sharp.com X 1946 CA See Schedule O for Organization's most significant activities. 25 18 10638 0 76180 0 1633253 2179833 1021036470 1024741362 20959429 16871853 34285639 39728264 1077914791 1083521312 171138 194667 0 0 280040348 295638904 0 0 3240909 737601355 797311057 1017812841 1093144628 60101950 -9623316 1514816228 1760015079 1592710498 1809895697 -77894270 -49880618 X See Schedule O. 0 0 427034112 194667 622121023 Sharp HealthCare provides administrative support to its subsidiaries. Its general purpose is to promote healthcare through supporting and/or operating its subsidiaries. 369826790 0 402620338 Sharp HealthCare operates a number of outpatient clinics throughout San Diego County which provide outpatient and urgent care services to the community. Total patient visits were 1,536,181 for the twelve months ended 9/30/2012. See Community Benefit Report on Schedule O 796860902 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 1 0 1 1000 0 1 10638 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 25 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA NC X Staci Dickerson 8584995150 8695 Spectrum Center Blvd San Diego CA 92123 X Deirdre Alpert 4.00 X 0 0 0 Donald C Balfour III MD 8.00 X 565 0 0 James S Brown 2.00 X 0 0 0 Timothy Considine 6.00 X X 0 0 0 VAdm Walter J Davis Jr USN Ret 2.00 X 0 0 0 Barbara DeMichele 2.00 X 0 0 0 Margaret Elizondo MD 2.00 X 0 82376 0 Sergio Flores MD 2.00 X 0 0 0 Richard Freeman 3.00 X X 0 0 0 William Geppert 2.00 X 0 0 0 Peter Hanson MD 2.00 X 0 44313 0 Francisco Hernandez MD 2.00 X 0 33770 0 Robert Kelly 4.00 X X 0 0 0 Henry M Killmar 3.00 X 0 0 0 Errol Korn MD 10.00 X 0 29400 0 Yvonne W Larsen 1.00 X X 0 0 0 Scott McMillin 2.00 X 0 0 0 Richard Mejia Jr 2.00 X 0 0 0 Cary Miller 3.00 X 0 0 0 Lori Moore RN 2.00 X 0 0 0 Michael A Morton 2.00 X 0 0 0 Vincent Mudd 2.00 X 0 0 0 Michael W Murphy 30.00 X X 1322158 0 90854 Regina A Petty 2.00 X 0 0 0 Kenneth Roth MD 10.00 X 0 49800 0 James B SmithIII 4.00 X X 0 0 0 Geoffrey Stiles MD 2.00 X 0 159356 0 Joseph J Strazzeri Esq 2.00 X 0 0 0 Julie Meier Wright 2.00 X 0 0 0 Ann Pumpian 55.00 X 682718 0 36688 Carlisle C Lewis III 36.00 X 588387 0 47006 Daniel Gross 45.00 X 868119 0 48834 Timothy Smith 0.10 X 605945 0 15141 William Spooner 60.00 X 565546 0 15600 Michele Tarbet 0.10 X 546030 0 39306 Donna Mills 45.00 X 474669 0 6249 Mary Henrikson 0.10 X 427064 0 12813 Pablo Velez-Carrillo 0.10 X 392141 0 10053 William Littlejohn 0.10 X 380384 0 29240 Kathleen Lencioni 0.10 X 374473 0 2909 Marcia Hall 0.10 X 365808 0 32721 John Jenrette 50.00 X 538069 0 13484 Nancy Pratt 50.00 X 408783 0 23622 Michael Plopper 0.10 X 403644 0 24832 Alison Fleury 36.00 X 350520 0 32042 Lynne Milgram 50.00 X 347765 0 24384 9642788 399015 505778 1221 0 1 1 Sodexho & Affiliates PO Box 536922 Atlanta GA 303536922 Management/Catering 46478047 Sharp Rees-Stealy Medical Group 4000 Ruffin Road Suite E San Diego CA 92123 Medical Services 35265610 Emergency & Acute Care Medical 440 Stevens Avenue Suite 150 Solana Beach CA 92075 Medical Services 16712388 Rady Childrens Hospital San Diego 3020 Childrens Way MC 5002 San Diego CA 92123 Medical Services 15756285 aLabs Corporation 4650 Overland Ave San Diego CA 92123 Management Services 13578109 448 2179833 2179833 Capitation Revenue 900099 426692550 426692550 Outpatient Care 621110 413821156 413785443 35713 Revenue fm Affiliated 900099 149393911 149393911 Medicare/Medicaid Paym 621110 18229715 18229715 Rental Income 531120 7102985 7102985 9501045 9460578 40467 1024741362 14850131 14850131 -4684 -4684 54021214 122760 51532407 585161 2488807 -462401 2026406 2026406 SCMG Management Fee 561000 39086638 39086638 Medical Records 900099 261190 261190 Parking Lot 812930 114651 114651 265785 265785 39728264 1083521312 1024665182 76180 56600117 194667 194667 5007565 5007565 228356683 92238855 136117828 9097312 3280476 5816836 35853269 15240485 20612784 17324075 7139314 10184761 648019 8302 639717 4185880 4185880 339147 339147 498427 498427 320896725 307468150 13428575 4723402 87745 4635657 18009161 11058297 6950864 42065577 1297385 40768192 27534332 20663905 6870427 975680 387331 588349 20471 20471 5128798 110116 5018682 37153644 9702053 27451591 3229129 2978029 251100 Capitation Paid to Affi 300259241 300259241 Medical Supplies 20769602 20769602 Equipment Repairs/Maint 3640514 2497392 1143122 Fundraising Expenses 3240909 3240909 3992399 1479557 2512842 1093144628 796860902 293042817 3240909 191638 399664 168598686 193351827 12920256 30848489 4200000 4200000 4662674 5606241 28453384 35072633 580603672 334585391 209779361 246018281 537260200 702388592 6406599 6326583 47526274 47337089 494817156 488465680 1514816228 1760015079 122176550 170355749 6068577 3882328 575292910 504503898 889172461 1131153722 1592710498 1809895697 X -123248262 -93078505 41022457 38708730 4331535 4489157 -77894270 -49880618 1514816228 1760015079 X -9623316 37636968 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 33915 1 305232 0 339147 0 Explanation of Lobbying Activities: Part II-B, Line 1: Sharp HealthCare attempts to influence local, state and national legislation related to reimbursement, regulatory requirements, and any other issues that could potentially affect the quality and/or ability to effectively provide healthcare to the San Diego community. 4614953 -62948 455055 86835 4920225 4780027 32761 -115580 82255 4614953 4126569 7529 711976 66047 4780027 4261998 -18528 -50397 66504 4126569 0.01000 0.99000 0.00000 0 1 1 30714222 30714222 119536383 30207114 89329269 54474921 27557913 26917008 342935721 276820364 66115357 32942425 32942425 246018281 Unamortized Financing Costs 2125613 Yield Curve Swap 4123860 Other Long-term Assets 4284950 Basis Swap 1706723 Rec fm Related Org for Alloc Tax Exempt Bond Balance 474504657 Miscellaneous Receivables 1719877 488465680 Intercompany Payables 953799429 Deferred Rent Expense 9273322 Reserve for Malpractice 2300000 LT Pension Liability 16495686 LT Workers Compensation 33994383 Other LT Liabilities 7715767 Mark to Market Swaps 7197715 Capital Leases 61062320 New Market Tax Credit Debt 39315100 1131153722 1083521312 1093144628 -9623316 40282951 -2645983 37636968 28013652 1117676243 40282951 40282951 1077393292 498427 5629593 6128020 1083521312 1092645992 0 1092645992 498427 209 498636 1093144628 Description of Intended Use of Endowment Funds: Part V, Line 4: Sharp HealthCare Foundation holds 8 board designated and permanent endowments for Sharp HealthCare that are restricted for a variety of purposes, such as rehabilitation, nursing education and scholarships, clinical equipment and technology, and more. Part XI, Line 8 - Other Adjustments: Current Year Actuarial Pension Adjustment 2,425,411. Beneficial interest in Sharp HealthCare Foundation -189,185. Book/tax difference on partnership interest - Premier -3,045,148. Book/tax difference on partnership interest - MRI -202,810. Book/tax difference on partnership interest - BMT Program -1,634,251. Total to Schedule D, Part XI, Line 8: -2,645,983. Part XII, Line 4b - Other Adjustments: Foundation contributed capital 747,175. Book/tax difference on partnership interest - Premier 3,045,173. Book/tax difference on partnership interest - MRI 202,994. Book/tax difference on partnership interest - BMT Program 1,634,251. Part XIII, Line 4b - Other Adjustments: Book/tax difference on partnership interest - Premier 25. Book/tax difference on partnership interest - MRI 184. Part X, Line 2: Sharp recognizes tax benefits from any uncertain tax positions only if it is more likely than not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. Sharp records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period that the more likely than not threshold is not met. Sharp recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more likely than not recognition criteria. At September 30, 2012 and 2011, no such assets or liabilities were recorded. Central America and the Caribbean 0 1 Program Services Payments for management of insurance captive services and insurance premium payments to captive. 10771973 Central America and the Caribbean 0 Investments Investments of offshore captive 9191346 0 1 0 0 0 1 19963319 0 19963319 1 0 1 0 0 0 Method Used to Acccount for Expenditures: Schedule F, Part I, Line 3: The accrual method of accounting was used to determine the amounts reported. 1 Silver Crescent Foundation 308 Jamesbury Rd Charleston SC 29492 571039538 501(c)(3) 6000 24th Annual Quest for Excellence conference sponsorship YWCA of San Diego County 1012 C St San Diego CA 92101 951661119 501(c)(3) 10000 In the Company of Women and TWIN Award and Recognition luncheon sponsorship American Heart Association 3640 Fifth Avenue San Diego CA 92103 135613797 501(c)(3) 10000 WS Gala 2012 Sponsorship San Diego Hall of Champions 2131 Pan American Plaza San Diego CA 92101 952856451 501(c)(3) 10000 December Nights Sponsorship Regents of the University of California at Berkeley 133 DOE Library Berkeley CA 94720 946002123 501(c)(3) 116667 Gift to the School of Public Health for Berkeley Forum to Improve California's Health Care Delivery System 5 0 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The Management team evaluates requests for contributions from outside organizations taking into account how they align with the organization's mission. No monitoring is done after grants are made. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 Donald C Balfour III MD 565 0 0 0 0 0 0 0 0 0 565 0 0 0 Michael W Murphy 1084909 0 184453 0 52796 0 75714 0 15140 0 1413012 0 0 0 Geoffrey Stiles MD 0 159356 0 0 0 0 0 0 0 0 0 159356 0 0 Ann Pumpian 562084 0 104134 0 16500 0 21547 0 15141 0 719406 0 0 0 Carlisle C Lewis III 478941 0 92946 0 16500 0 32280 0 14726 0 635393 0 0 0 Daniel Gross 697895 0 130638 0 39586 0 37827 0 11007 0 916953 0 0 0 Timothy Smith 498264 0 91181 0 16500 0 0 0 15141 0 621086 0 0 0 William Spooner 463898 0 85148 0 16500 0 4593 0 11007 0 581146 0 0 0 Michele Tarbet 458783 0 70747 0 16500 0 24166 0 15140 0 585336 0 0 0 Donna Mills 386753 0 71416 0 16500 0 0 0 6249 0 480918 0 0 0 Mary Henrikson 348659 0 62540 0 15865 0 2230 0 10583 0 439877 0 0 0 Pablo Velez-Carrillo 356533 0 35608 0 0 0 3804 0 6249 0 402194 0 0 0 William Littlejohn 298514 0 60165 0 21705 0 14099 0 15141 0 409624 0 0 0 Kathleen Lencioni 299180 0 58793 0 16500 0 2011 0 898 0 377382 0 0 0 Marcia Hall 281525 0 62555 0 21728 0 26484 0 6237 0 398529 0 0 0 John Jenrette 451491 0 70078 0 16500 0 2477 0 11007 0 551553 0 0 0 Nancy Pratt 328244 0 64039 0 16500 0 13265 0 10357 0 432405 0 0 0 Michael Plopper 321102 0 49460 0 33082 0 17662 0 7170 0 428476 0 0 0 Alison Fleury 278771 0 55249 0 16500 0 18480 0 13562 0 382562 0 0 0 Lynne Milgram 281215 0 45743 0 20807 0 17201 0 7183 0 372149 0 0 0 Part I, Line 1a Monthly dues paid to the University Club for Michael Murphy, President/CEO and Daniel Gross, EVP Hospital Operations. University Club membership is provided for business purposes. Part I, Line 4b Sharp HealthCare ("Company") sponsors an Executive Flexible Benefit Plan ("Plan") to provide designated executives with a reasonable level of benefits in return for their continued employment with the Company. The Plan is administered on a Plan Year basis of January 1 to December 31. Changes in Flexible Benefit Options are permitted annually, effective January 1 of the new Plan Year. The provisions of the Plan, which were restated effective as of December 31, 2008, are described below as restated. The Plan is available to the Chief Executive Officer, Executive Vice President of Hospital Operations, and Senior Vice Presidents. The Flexible Benefit Allowance available to each participant each plan year shall equal the sum of the following: - A company provided base allowance equal to 18% of the participant's base salary - A participant deferral up to 6% of the participant's pre-tax base salary for such plan year as elected by the participant - A company match should the participant make an elective deferral for a plan year. The company match begins at 2% for the first 1% elective deferral and increases 0.5% for each additional 1% elective deferral, to a maximum match of 4.5% on a 6% elective deferral. The Plan allows participants to use the Flexible Benefit Allowance to purchase additional long-term disability coverage, long-term care coverage, and flexible survivor coverage/accumulation benefits (life insurance). Participants in the flexible survivor coverage/accumulation benefits plan previously could elect to apply Flexible Benefit Allowance to acquire additional survivor coverage, or toward deposits to the Supplemental Survivor Accumulation Benefit Plan ("SSAB") to fund post-retirement survivor benefits, subject to the ERISA limit provided their policies were issued prior to September 18, 2003. The Company shall automatically continue whatever elective coverage and additional deposit elections that were in place for the SSAB during the 2008 plan year. No elective coverage or additional deposits were available to participants whose policies were issued on or after September 18, 2003. Any Flexible Benefit Allowance that remains after purchasing these additional coverages shall be paid to the participant in cash in equal installments throughout the Plan Year, not less frequently than quarterly. If the participant separates from service during the Plan Year, the participant forfeits any unpaid Allowance. Supplemental Information Part III Compensation was paid to Dr. Donald Balfour through Donald C. Balfour MD Inc., for an honorarium by Sharp HealthCare. He was compensated directly by Donald C. Balfour MD Inc. ABAG Finance Authority for Nonprofit Corporations 943130123 00037CFB1 2003-07-23 29872264 See Part V 0 0 0 ABAG Finance Authority for Nonprofit Corporations 943130123 00037CNR7 2009-02-12 60000000 See Part V 0 0 0 ABAG Finance Authority for Nonprofit Corporations 943130123 00037CPH7 2009-07-22 137265605 See Part V 0 0 0 ABAG Finance Authority for Nonprofit Corporations 943130123 00037CPN4 2009-09-02 99880000 See Part V 0 0 0 30856296 3123763 3106694 246575 27392721 2006 0 0 1 1 60000000 60000000 1 0 1 1 138037297 13138686 112571362 12500000 1 0 1 1 99880000 99880000 1 0 1 1 0 1 1 1 1 1 0.00910 0.00000 0.00910 1 0 1 0 1 1 1 0 1 0 1 1 0.02040 0.00020 0.02060 1 0 0 0 NA 0 0 0 NA 0 0 0 0 1 0 NA 0 0 0 NA 0 0 0 0 0 0 nA 0 0 0 NA 0 0 0 0 1 1 Citibank NA 21.200000000000 0 0 0 NA 0 0 0 Schedule K, Part I, Line A Tax Exempt Bond Issue 2003C The purpose of this bond issuance is to provide funds for the expansion and capital improvements at two hospital entities and to provide for a debt service reserve fund. Schedule K, Part I, Line B Tax Exempt Bond Issue 2009A The purpose of this bond issuance is to refund the Series 2003A&B Auction Rate Securities Schedule K, Part I, Line C Tax Exempt Bond Issue 2009B The purpose of this bond issuance is to provide funds for capital improvements, capacity expansion, and building renovations at four hospital entities, to purchase major equipment, to refund a portion of the 2003B Auction Rate Securities and to provide for a debt service reserve fund. Schedule K, Part I, Line D Tax Exempt Bond Issue 2009CD The purpose of this bond issuance is to refund the Series 2007A&B Statewide Easy Equipment Program (SWEEP) bonds. Schedule K, Part I, Line E Tax Exempt Bond Issue 2010 The purpose of this bond issuance is to finance the acquisition, construction, equipping and improvement of facilitites at four hospital entities. Schedule K, Part I, Line F Tax Exempt Bond Issue 2011A The purpose of this bond issuance is to refund the Series 2001A Revenue bonds and to partially refund the 1998 County of San Diego Certificates of Participation bonds. Schedule K, Part I, Line G Tax Exempt Bond Issue 2012A The purpose of the bond issuance is to refund the 1998 County of San Diego Certificates of Participation bonds. Schedule K, Part II, Line A, Line C & Line E Tax Exempt Bond Issue 2003C, 2009B & 2010A Total proceeds are different than issue price due to investment earnings. Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2003C Stephen Birch HealthCare Center - 2010 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2003C Remaining projects - 2006 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B Stephen Birch HealthCare Center - 2010 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B Sharp Chula Vista Inpatient Capacity Expansion - 2011 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B Chiller piping at Grossmont Hospital - 2011 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B East Tower Renovation at Grossmont Hospital - 2011 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B Sharp Mary Birch Expansion and Remodel - 2012 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2009B Remaining projects - 2011 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2010 Sharp Memorial Central and South Tower Retrofit - project still ongoing Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2010 Sharp Mary Birch Expansion and Remodel - 2012 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2010 Chiller Piping at Grossmont Hospital - 2011 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2010 Sharp Chula Vista Emergency Department Expansion - 2012 Schedule K, Part II, Line 13 Tax Exempt Bond Issue 2010 Sharp Chula Vista Cancer Center - 2012 Schedule K, Part V: Sharp HealthCare has procedures in place to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulation, but these procedures were not written in fiscal 2012 as required to allow a "yes" answer to this question. ABAG Finance Authority for Nonprofit Corporations 943130123 2010-12-16 30000000 See Part V 0 0 0 ABAG Finance Authority for Nonprofit Corporations 943130123 00037GRG7 2011-02-10 78140374 See Part V 0 0 0 ABAG Finance Authority for Nonprofit Corporations 943130123 00037GSJO 2012-01-24 51889934 See Part V 0 0 0 30305092 30305092 0 0 0 1 78140374 3642 78136732 1 0 1 1 51889934 51889934 1 0 1 1 0 0 0 1 1 0.00500 0.00010 0.00510 1 0 1 1 1 1 1 1 0 1 0 1 1 1 0 1 0 NA 0 0 0 NA 0 0 0 0 0 0 NA 0 0 0 NA 0 0 0 0 0 0 NA 0 0 0 NA 0 0 0 Sharp Rees-Stealy Medical Group See Part V 152129365 See Part V 0 Sharp Rees-Stealy Medical Group See Part V 43133934 See Part V 0 Sharp Community Medical Group See Part V 39086638 See Part V 0 Schedule L, Part IV, Line 1 Business Transactions Involving Interested Persons Donald C. Balfour, M.D. is a director on Sharp HealthCare's Board and is the President and Medical Director of Sharp Rees-Stealy Medical Group ("SRSMG"). SRSMG has contracted with Sharp HealthCare ("SHC") to provide professional medical services in clinic facilities owned and operated by SHC for which SRSMG pays SHC a percentage of SRSMG's professional services revenue. SHC's revenues resulting from the SRSMG contract totaled $152,129,365. Schedule L, Part IV, Line 2 Business Transactions Involving Interested Persons Donald C. Balfour, M.D. is a director on Sharp HealthCare's Board and is the President and Medical Director of Sharp Rees-Stealy Medical Group ("SRSMG"). SHC pays SRSMG for certain medical fees and medical related purchased services. These payments from SHC to SRSMG totaled $43,133,934. Schedule L, Part IV, Line 3 Business Transactions Involving Interested Persons Sergio Flores, M.D. was a director on Sharp HealthCare's Board and is an Officer/Director of Sharp Community Medical Group ("SCMG"). SCMG has a management services agreement with Sharp HealthCare ("SHC") whereby SHC manages SCMG's corporate overhead function. SCMG reimburses SHC monthly for the total cost of operations, resulting in a bottom line net zero impact to SHC's financial statements. Payments from SCMG to SHC under the management services agreement totaled $39,086,638. ORGANIZATION'S MOST SIGNIFICANT ACTIVITIES FORM 990, PART I, LINE 1: The organization's primary exempt purpose is to provide administrative support to its tax-exempt subsidiaries. In addition, outpatient services are provided to patients within the greater San Diego area through multispecialty medical group practices. Community members are offered a number of benefit services to assist them in obtaining treatment, and information is provided on topics ranging from disease prevention to improvement of health status. Program Service Statement FORM 990, PART III, LINE 1: To promote health care through supporting and/or operating, directly or through wholly-owned subsidiaries and other appropriate management arrangements, hospitals and other medically-related facilities and activities in the State of California. The specific and primary purposes for which this corporation is formed are to support and be responsive to the needs of its publicly supported, tax-exempt subsidiaries. TAX EXEMPT BOND ISSUE FORM 990, PART IV, LINE 24A: Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, all tax exempt bond balances, including those allocated to other members of the Obligated Group, are reported on the Sharp HealthCare return (EIN 95-6077327). The Sharp HealthCare Obligated Group is comprised of Sharp HealthCare (EIN 95-6077327), Sharp Memorial Hospital (EIN 95-3782169), Grossmont Hospital Corporation (EIN 33-0449527), and Sharp Chula Vista Medical Center (EIN 95-2367304). Form 990, Part VI, Section B, line 11 The final Form 990 is placed on the organization's intranet, prior to the filing date, where it is viewable for comment from all members of the governing body. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the Director of Tax & Accounting, Vice President of Finance, Senior Vice President and Chief Financial Officer, and entity Chief Financial Officer. Additionally, the organization contracts with Ernst & Young, an independent accounting firm, for review of the Form 990. Form 990, Part VI, Section B, line 12c Sharp HealthCare has a written conflict of interest policy which has been reviewed and approved by the Sharp HealthCare governing board. Sharp HealthCare is committed to preventing any Participant of the Corporation from gaining any personal benefit from information received or from any transaction of Sharp. One component of the written conflict of interest policy requires that Board Members, Corporate Officers, Senior Vice Presidents and Chief Executive Officer(s) submit a conflict of interest statement annually to Legal Services/Senior Vice President of Legal Services who will review all statements. In addition, all Vice Presidents and any employees in the Purchasing/Supply Chain, Audit and Compliance, and Case Management/Discharge Planning departments are required to complete an online conflict of interest questionnaire annually that is reviewed by the Conflict Review Committee comprised of employees from Sharp's Legal, Compliance, and Internal Audit departments. In connection with any transaction or arrangement, which may create an actual or possible conflict of interest, the person shall disclose in writing the existence and nature of his/her financial interest and all material facts. Board Members, Corporate Officers, Senior Vice Presidents, and the Chief Executive Officer(s) shall make such disclosures directly to the Chairman of the Board, and to the members of the committee with the board designated powers considering the proposed transaction or arrangement. Upon disclosure of the financial interest and all material facts, the Board Member, Corporate Officer, Senior Vice President or the Chief Executive Officer(s) making such disclosures shall leave the board or the committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In certain instances, such as if someone takes a board seat on a competitor's board of directors or has a role with an organization whereby the information that they may obtain from Sharp would put them in a consistent conflict with their two roles, the conflict could call for the individual's removal from the board. The bylaws for the organization provide for the ability to remove directors in accordance with Section 5222 of the California Corporations Code. This can generally be done on a "for cause" or a "no cause" basis by the action of the member. Form 990, Part VI, Section B, line 15 The Personnel Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (CEO/President, Executive Vice President of Hospital Operations, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Personnel Committee of the Board of Directors by the independent consultant. The Personnel Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Personnel Committee approves the total compensation for the President/Chief Executive Officer and reviews and approves the compensation and compensation salary ranges for the remainder of the executive team. The Personnel Committee presents its decision to the Board of Directors. The Personnel Committee retains minutes of its meetings. The Compensation and Benefits department engages a third party independent consultant to conduct a compensation study covering officers and key employees. The independent third party compares base salaries to similar positions with like institutions. The information is reviewed by the Compensation and Benefits department and is presented to the President/Chief Executive Officer, the Executive Vice President of Hospital Operations and the appropriate Senior Vice President for review and approval. Form 990, Part VI, Section C, line 19 Policies are considered proprietary information, however in Sharp HealthCare's publicly available Code of Conduct, Sharp outlines its Conflict of Interest policies in a user friendly manner. The annual audited financial statements of the consolidated group are published on the dacbond.com website (www.dacbond.com), are attached to the Form 990 filed for each of the Sharp hospitals, and are available upon request. The annual audited financial statements include combining schedules which disclose the financial results (Balance Sheet, Statement of Operations, Statement of Changes in Net Assets) for each entity of the consolidated group. Quarterly financial statements of Sharp's obligated group are published on the dacbond.com website (www.dacbond.com). HOURS DEDICATED TO RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A: Michael Murphy: 6-SMH, 6-GHC, 4-SCVMC, 4-SCHHC, 6-SHP, 4-SHF Carlisle C. Lewis III: 9-SMH, 9-GHC, 3-SCVMC, 3-SCHHC Ann Pumpian: 1-SMH, 1-GHC, 1-SCVMC, 1-SCHHC, 1-SHP Daniel Gross: 10-SMH, 5-SCVMC Alison Fleury: 2-SHP Geoffrey Stiles: 40-SMH Henry Killmar: 1-SHF Kenneth Roth: 2-SHF Joseph Strazzeri: 2-SHF James Brown: 2-SMH Francisco Hernandez: 2-SCVMC Errol Korn: 2-SCVMC Barbara DeMichele: 2-SCHHC Cary Miller: 1-SMH Changes in Net Assets or Fund Balances: Form 990, Part XI, line 5: Net unrealized gains on investments: 40,282,951. Current Year Actuarial Pension Adjustment 2,425,411. Beneficial interest in Sharp HealthCare Foundation -189,185. Book/tax difference on partnership interest - Premier -3,045,148. Book/tax difference on partnership interest - MRI -202,810. Book/tax difference on partnership interest - BMT Program -1,634,251. Total to Form 990, Part XI, Line 5: 37,636,968. Form 5471 Attachment to 2011 Form 990 and Form 5471 Transferee Corporation's Information Statement Filed in Accordance with Reg. Section 1.351-3(b) Transferor Name: SHARP HEALTHCARE Taxable Year End: 9/30/2012 FEIN: 95-6077327 Transferee Name: CONTINUOUS QUALITY INSURANCE SPC (FKA CONTINUOUS QUALITY INSURANCE COMPANY, LTD.) FEIN: N/A Transferee Address: PO BOX 1092, GRAND CAYMAN CAYMAN ISLANDS, BRITISH WEST INDIES This statement is being filed with Sharp HealthCare, the transferee's, Form 5471, Information Return of U.S. Persons, with respect to the transferee, for the taxable year ended 9/30/2012. This statement is filed in accordance with Reg. Section 1.351-3(b) to disclose the details of property transferred to the above controlled corporation. The exchange took place during the year ended 9/30/2012. 1. Property received from the transferor: Contribution of cash. 2. The cost or other basis thereof in the hands of the transferor adjusted to the date of transfer: $ 3,366,086.17 3. Transferee's Corporation Stock: N/A 4. Securities of the transferee corporation: N/A 5. Amount of money paid in the exchange to the transferor: N/A 6. Other property passing to the transferor in the exchange: N/A 7. Each of the transferor's liabilities assumed by the transferee corporation: N/A Attachment to 2011 Form 990 and Form 5471 Transferor Corporation's Information Statement Filed in Accordance with Reg. Section 1.351-3(a) Transferor Name: SHARP HEALTHCARE Taxable Year End: 9/30/2012 FEIN: 95-6077327 Transferee Name: CONTINUOUS QUALITY INSURANCE SPC (FKA CONTINUOUS QUALITY INSURANCE COMPANY, LTD.) FEIN: N/A Transferee Address: PO BOX 1092, GRAND CAYMAN CAYMAN ISLANDS, BRITISH WEST INDIES This statement is being filed with Sharp HealthCare, the transferor's, Form 5471, Information Return of U.S. Persons, with respect to the transferor for the taxable year ended 9/30/2012. This statement is also being filed with Sharp HealthCare, the transferor's, Form 990, Return of Organization Exempt from Income Tax. This statement is filed in accordance with Reg. Section 1.351-3(a) to disclose the details of property transferred to the above controlled corporation. The exchange took place during the tax year ended 9/30/2012. 1. Property transferred to the transferee: Contribution of $3,366,086.17 cash 2. Information with respect to the transferee corporation's stock: (i) The kind of stock and preferences: N/A (ii) The number of shares of each class at the date of the exchange: Before the exchange: N/A After the exchange: N/A (iii) The fair market value per share of each class at the date of the exchange: N/A 3. Securities of the transferee corporation received in the exchange: N/A 4. Amount of money received: N/A 5. Other property received: N/A 6. Liabilities of the transferor assumed by the transferee Corporation: N/A Community Benefits Report Form 990, Part III, Line 4c: FY 2012 Community Benefits Report Section 1 An Overview of Sharp HealthCare Sharp is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals; three specialty hospitals; two affiliated medical groups; 20 medical clinics; five urgent care facilities; three skilled nursing facilities; two inpatient rehabilitation centers; home health, hospice, and home infusion programs; numerous outpatient facilities and programs; and a variety of other community health education programs and related services. Sharp offers a full continuum of care, including: emergency care, home care, hospice care, inpatient care, long-term care, mental health care, outpatient care, primary and specialty care, rehabilitation, and urgent care. Sharp also has a Knox-Keene-licensed care service plan, Sharp Health Plan (SHP). Serving a population of approximately 3 million in San Diego County, as of September 30, 2012, Sharp is licensed to operate 2,069 beds, has approximately 2,600 Sharp-affiliated physicians and nearly 15,500 employees. FOUR ACUTE CARE HOSPITALS: Sharp Chula Vista Medical Center (343 beds) The largest provider of health care services in San Diego's rapidly expanding South Bay, Sharp Chula Vista Medical Center (SCVMC) operates the region's busiest Emergency Department (ED) and is the closest hospital to the busiest international border in the world. Sharp Coronado Hospital and Healthcare Center (181 beds) Sharp Coronado Hospital and Healthcare Center (SCHHC), an acute care hospital, provides services that include sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, hospice and emergency services. Sharp Grossmont Hospital (536 beds) Sharp Grossmont Hospital (SGH) is the largest provider of health care services in San Diego's East County, and has one of the busiest EDs in San Diego County (SDC). Sharp Memorial Hospital (675 beds) A regional tertiary care leader, Sharp Memorial Hospital (SMH) provides specialized care in trauma, oncology, orthopedics, organ transplantation, cardiology and rehabilitation. THREE SPECIALTY CARE HOSPITALS: Sharp Mary Birch Hospital for Women & Newborns (169 beds) A freestanding women's hospital specializing in obstetrics, gynecology, gynecologic oncology, and neonatal intensive care, Sharp Mary Birch Hospital for Women & Newborns (SMBHWN) delivers more babies than any other private hospital in California. Sharp Mesa Vista Hospital (149 beds) The largest private freestanding psychiatric hospital in California, Sharp Mesa Vista Hospital (SMV) is a premier provider of behavioral health services. Sharp McDonald Center (16 beds) Sharp McDonald Center (SMC) is San Diego County's only licensed chemical dependency recovery hospital. Collectively, the operations of SMH, SMBHWN, SMV and SMC are reported under the nonprofit public benefit corporation of SMH, and are referred to herein as The Sharp Metropolitan Medical Campus (SMMC). The operations of Sharp Rees-Stealy Medical Centers (SRS) are included within the nonprofit public benefit corporation of Sharp, the parent organization. The operations of Sharp Grossmont Hospital (SGH) are reported under the nonprofit public benefit corporation Grossmont Hospital Corporation. Mission Statement It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patient expectations, and are provided in a caring, convenient, cost-effective and accessible manner. Vision Sharp's vision is to become the best health system in the universe. Sharp will attain this position by transforming the health care experience through a culture of caring, quality, service, innovation and excellence. Sharp will be recognized by employees, physicians, patients, volunteers and the community as the best place to work, the best place to practice medicine and the best place to receive care. Sharp will be known as an excellent community citizen, embodying an organization of people working together to do the right thing every day to improve the health and well-being of those it serves. Values * Integrity - Trustworthiness, Respect, Commitment to Organizational Values, and Decision Making * Caring - Service Orientation, Communication, Teamwork and Collaboration, Serving and Developing Others, and Celebration * Innovation - Creativity, Continuous Improvement, Initiating Breakthroughs, and Self-Development * Excellence - Quality, Safety, Operational and Service Excellence, Financial Results, and Accountability Culture: The Sharp Experience For more than 12 years, Sharp has been on a journey to transform the health care experience for patients and their families, physicians and staff. Through a sweeping organization-wide performance and experience improvement initiative called The Sharp Experience, the entire Sharp team has recommitted to purpose, worthwhile work, and creating the kind of health care people want and deserve. This work has added discipline and focus to every part of the organization, helping to make Sharp one of the nation's top-ranked health care systems. Sharp is San Diego's health care leader because it remains focused on the most important element of the health care equation: the people. Through this extraordinary initiative, Sharp is transforming the health care experience in San Diego by striving to be: * The best place to work: Attracting and retaining highly skilled and passionate staff members who are focused on providing quality health care and building a culture of teamwork, recognition, celebration, and professional and personal growth. This commitment to serving patients and supporting one another will make Sharp "the best health system in the universe." * The best place to practice medicine: Creating an environment in which physicians enjoy positive, collaborative relationships with nurses and other caregivers; experience unsurpassed service as valued customers; have access to state-of-the-art equipment and cutting-edge technology; and enjoy the camaraderie of the highest-caliber medical staff at San Diego's health care leader. * The best place to receive care: Providing a new standard of service in the health care industry, much like that of a five-star hotel; employing service-oriented individuals who see it as their privilege to exceed the expectations of every patient - treating them with the utmost care, compassion and respect; and creating healing environments that are pleasant, soothing, safe, immaculate, and easy to access and navigate. Through all of this transformation, Sharp will continue to live its mission to care for all people, with special concern for the underserved and San Diego's diverse population. This is something Sharp has been doing for more than half a century. Pillars of Excellence In support of Sharp's organizational commitment to transform the health care experience, the six Pillars of Excellence serve as a guide for team members, providing a framework and alignment for everything Sharp does. The six pillars listed below are a visible testament to Sharp's commitment to become the best health care system in the universe by achieving excellence in these areas: * Quality - Demonstrate and improve clinical excellence and patient safety to set community standards and exceed patient expectations * Service - Create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence * People - Create a workforce culture that attracts, retains and promotes the best and brightest people, who are committed to Sharp's mission, vision and values * Finance - Achieve financial results to ensure Sharp's ability to provide quality health care services, new technology and investment in the organization * Growth - Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development * Community - Be an exemplary community citizen by making a difference in our community and supporting the stewardship of our environment Awards Sharp recently received the following recognition: Sharp is a recipient of the 2007 Malcolm Baldrige National Quality Award, the nation's highest presidential honor for quality and organizational performance excellence. Sharp is the first health care system in California and eighth in the nation to receive this recognition. Sharp was named the No. 1 "best integrated health-care network" in California and No. 12 nationally by Modern Healthcare magazine in 2012. The rankings are part of the "Top 100 Most Highly Integrated Healthcare Networks (IHN)," an annual survey conducted by health care data analyst IMS. This is the 14th year running that Sharp has placed among the top in the state in the survey. Sharp Rees-Stealy Medical Group, practicing as the Sharp Rees-Stealy Medical Centers, was named "Best Medical Group" by U-T San Diego readers participating in the paper's 2012 "Best of San Diego" Readers Poll. SMH and SGH were ranked second and third "Best Hospitals" while SCVMC, SCHHC and SMBHWN were honored as finalists. SGH and SMH have both received MAGNET Designation for Nursing Excellence by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program is the highest level of honor bestowed by the ANCC and is accepted nationally as the gold standard in nursing excellence. Sharp was named one of the nation's "Most Wired" health care systems in 2012 by Hospitals & Health Networks magazine in the annual Most Wired Survey and Benchmark Study. "Most Wired" hospitals are committed to using technology to enhance quality of care for both patients and staff. In July 2010, SMH was named the "Most Beautiful Hospital in America" by Soliant Health, one of the largest medical staffing companies in the country. With over 10,000 votes from visitors to the Soliant Health website, SMH was voted to the top of the second annual "20 Most Beautiful Hospitals in America" list. In 2012 SMH was designated as a Planetree Patient-Centered Hospital, joining SCHHC as the second hospital in the state to earn the honor. SMH is the largest and most complex hospital in the world to receive designation. SCHHC was originally designated in 2007 and is the only hospital in the state to be re-designated, occurring in 2010. Planetree is a coalition of more than 100 hospitals worldwide that is committed to improving medical care from the patient's perspective. In 2010, Sharp received the Morehead Apex Workplace of Excellence Award. Morehead awards the health care industry's top achiever by objectively identifying the highest performer and acknowledging their contributions to health care. With this singular award, Morehead annually recognizes a client who has reached and sustained the 90th percentile on their employee engagement surveys. Sharp reached the 98th percentile in 2010 and the 99th percentile in 2011. In FY 2012, SCHHC received Energy Star designation from the U.S. Environmental Protection Agency (EPA) for outstanding energy efficiency. Buildings that are awarded the designation use an average of 40 percent less energy than other buildings and release 35 percent less carbon dioxide into the atmosphere. SCVMC is eligible to receive this designation for 2012, and both SCHHC and SCVMC received the designation for the previous three years. Sharp HealthCare was named the Crystal Winner of the 2011 Workplace Excellence Awards from the San Diego Society for Human Resource Management. This designation recognizes Sharp's Human Resources Department as an innovative and valuable asset to overall company performance. Patient Access to Care Programs Uninsured patients with no ability to pay, and insured patients with inadequate coverage receive financial assistance for medically necessary services through Sharp's Financial Assistance Program. Sharp does not refuse any patient requiring emergency medical care. Sharp provides services to help every unfunded patient received in the Emergency Department find coverage options. Patients use a quick, simple online questionnaire through the Foundation for Health Coverage Education to generate personalized coverage options that are filed in their account for future reference and accessibility. The results of the questionnaire allow SHC staff to have an informed discussion about coverage options with the patient, so that the patient becomes part of the solution. Through this program, by June 2012 Sharp provided approximately 32,000 self-pay patients with guidance through the maze of government health coverage programs while maintaining the patient's dignity. The Patient Assistance Team works hard to help patients in need of assistance gain access to free or low-cost medications. Patients are identified through usage reports, or referred through case management, nursing, physicians or even other patients. If eligible, uninsured patients are offered assistance, which can help decrease readmissions due to lack of medication access. The team members research all options available including programs offered by drug manufacturers, grant-based programs offered by foundations, copay assistance, low-cost alternatives, or research where the patient might find their medication at a lower cost. Sharp also continues to offer ClearBalance - a specialized loan program for patients facing high medical bills. Through this collaboration with San Diego-based CSI Financial Services, both insured and uninsured patients have the opportunity to secure small bank loans in order to pay off their medical bills in low monthly payments - as low as $25 per month - and thus prevent unpaid accounts from going to collections. Through this program, Sharp provides a more affordable alternative for patients that struggle with the ability to resolve their hospital bills. In addition, Sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients receive assistance with transportation and placement; connections to community resources; and financial support for medical equipment, medications, and even outpatient dialysis and nursing home stays. Through collaboration with the San Diego Rescue Mission, SCHHC, SGH and SMH discharge their chronically homeless patients to the Rescue Mission's Recuperative Care Unit, where patients not only receive follow-up medical care through Sharp in a safe environment, but through the organization's programs they also receive psychiatric care, substance abuse counseling and guidance to help get them off the street. Since 2011, Sharp's acute care hospitals have partnered with Father Joe's Villages to support Project HOPE (formerly Project SOAR) - a program designed to assist with and expedite social security and disability applications for homeless individuals with urgent health care needs. Through this program, Sharp provides community agencies with the medical information necessary to treat and assist these high-risk individuals. Sharp provides this information at no cost to the agency. As eligible homeless patients are discharged from the hospital, hospital case managers facilitate their transition to Project HOPE workers who then continue the application process on through to completion. The program helps ensure eligible at-risk individuals are able to obtain timely access to the income and medical care benefits that they may not otherwise receive as a result of their homeless status. Sharp also continued to collaborate with the United Way's Project 25 program to provide financial information that will help the program gauge the effectiveness of its interventions to reduce use of emergent and other front line public resources. Project 25 is a partnership between United Way of San Diego County and the City and County of San Diego with a goal to provide permanent housing (via the San Diego Housing Commission) and supportive services (via the County of San Diego) to at least 25 of San Diego County's chronically homeless, who are often the most frequent users of public resources. In addition, in FY 2012 SCVMC continued to provide timely access to primary care health services by establishing medical homes for low-income, medically uninsured and underserved patients in the South Bay that present in the SCVMC ED. The program seeks to: support safety net patients suffering from chronic conditions to better manage their pain, diseases and overall health care with the establishment of a medical home at a community clinic; inform safety net patients about obtaining affordable medications through generic prescription access education; increase patient access and timely referrals to primary care and behavioral health services; increase patient access to follow-up primary care services and establish a medical home at either Chula Vista Family Health Clinic or other community clinics; and offer enhanced access to transportation resources to the Chula Vista Family Health Clinic. It is this ability to schedule timely follow-up appointments for safety net patients that has contributed greatly to the success of this program, and since the program's inception approximately 20 percent of SCVMC's ED patients were referred to the Chula Vista Family Health Clinic. Health Professions Training Internships Students and recent health care graduates are a valuable asset to the community, and Sharp demonstrates a deep investment in these potential and newest members of the health care workforce through internships, financial aid and career pipeline programs. In FY 2012, there were more than 4,000 student interns within the Sharp system, providing more than 517,000 hours in disciplines that included nursing, allied health and professional educational programs. Sharp provides education and training programs for students across the continuum of nursing (e.g., critical care, medical/surgical, behavioral health, women's services and wound care) and allied health professions such as rehabilitation therapies (speech, physical, occupational and recreational therapy), pharmacy, respiratory therapy, dietetics, lab, radiology, social work, psychology, business, health information management, and public health. Students from local community colleges such as Grossmont College (GC), San Diego Mesa College (MC), and Southwestern College (SWC); local and national university campuses such as San Diego State University (SDSU), University of California, San Diego (UCSD), University of San Diego (USD), and Point Loma Nazarene University (PLNU); and vocational schools such as Kaplan College (KC) participate in Sharp's health professions training. Table 1 presents the students and student hours at each of the Sharp entities in FY 2012. Table 1: Sharp HealthCare Internships - FY 2012 Sharp Chula Vista Medical Center Nursing Students - 850 Nursing Group Hours - 62,474 Nursing Precepted Hours - 20,273 Ancillary Students - 120 Ancillary Hours - 24,863 Total Students - 970 Total Hours - 107,610 Sharp Coronado Hospital and Healthcare Center Nursing Students - 346 Nursing Group Hours - 58,011 Nursing Precepted Hours - 3,516 Ancillary Students - 138 Ancillary Hours - 28,360 Total Students - 484 Total Hours - 89,887 Sharp Grossmont Hospital Nursing Students - 693 Nursing Group Hours - 45,648 Nursing Precepted Hours - 16,105 Ancillary Students - 206 Ancillary Hours - 40,829 Total Students - 899 Total Hours - 102,582 Sharp Mary Birch Hospital for Women & Newborns Nursing Students - 173 Nursing Group Hours - 12,195 Nursing Precepted Hours - 3,300 Ancillary Students - 48 Ancillary Hours - 5,289 Total Students - 221 Total Hours - 20,784 Sharp Memorial Hospital Nursing Students - 511 Nursing Group Hours - 35,934 Nursing Precepted Hours - 20,509 Ancillary Students - 314 Ancillary Hours - 58,683 Total Students - 825 Total Hours - 115,126 Sharp Mesa Vista Hospital Nursing Students - 381 Nursing Group Hours - 25,772 Nursing Precepted Hours - 3,856 Ancillary Students - 19 Ancillary Hours - 6,945 Total Students - 400 Total Hours - 36,573 Sharp HealthCare Nursing Students - 168 Nursing Group Hours - 158 Nursing Precepted Hours - 20,164 Ancillary Students - 91 Ancillary Hours - 24,155 Total Students - 259 Total Hours - 44,478 Total Nursing Students - 3,122 Nursing Group Hours - 240,192 Nursing Precepted Hours - 87,723 Ancillary Students - 936 Ancillary Hours - 189,124 Total Students - 4,058 Total Hours - 517,039 College Collaborations In FY 2012, Sharp donated $500,000 to SDSU's College of Health and Human Services in order to establish the Sharp HealthCare Professional Education and Research Institute. The donation allowed for three new scholarships at SDSU, including SDSU's new Doctor of Nursing Practice (DNP) program, which began in fall 2012. Scholarships will also be created for nursing students in the bachelor's and master's programs, as well as a general scholarship for students in SDSU's College of Health and Human Services. The donation will provide a total of six students with scholarships each year, ranging from $1,200 to $2,000. The scholarships are a component of the Sharp HealthCare Professional Education and Research Institute, which includes the already established Sharp HealthCare Human Patient Simulation Center and the Nurses Now program. The new donation brings Sharp's total giving to the university to $2.4 million, making Sharp one of SDSU's largest corporate contributors. Health Sciences High and Middle College Sharp has teamed up as an industry partner with charter school Health Sciences High and Middle College (HSHMC) to provide students broad exposure to careers available in health care. During FY 2012, more than 330 HSHMC students connected to Sharp campuses for a total of more than 52,800 student hours. The collaboration between Sharp and HSHMC prepares high school students to enter health science and medical technology careers in the following five career pathways: Biotechnology Research and Development, Diagnostic Services, Health Informatics, Support Services and Therapeutic Services. During a 16-week period, supervised students rotate through instructional pods in various departments such as nursing, OB-GYN, occupational and physical therapy, behavioral health, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), imaging, rehabilitation, laboratory, pharmacy, engineering, pulmonary, cardiac services, and operations. HSHMC students not only had the opportunity to observe patient care, but also received guidance from Sharp staff on career ladder development and job/education requirements. HSHMC students earn high school diplomas, complete college entrance requirements and have opportunities to earn community college credits, degrees or vocational certificates. With the HSHMC program, Sharp links students with health care professionals through job shadowing and internships to explore real-world applications of their school-based knowledge and skills. The program began in 2007 with HSHMC students on the campuses of SGH and SMH, and expanded to include SMV and SMBHWN in 2009, SCHHC in 2010, and SCVMC in 2011. HSHMC students also devote time to various SRS sites in San Diego. Lectures and Continuing Education Sharp contributes to the academic environment of many colleges and universities in San Diego. In FY 2012, Sharp staff committed more than 500 hours to the academic community by providing lectures, courses and presentations on numerous college/university campuses throughout San Diego. Through the delivery of a variety of guest lectures, including health information technology at San Diego Mesa College, cardiovascular technology at Grossmont College, health information lectures at San Diego Mesa College, pharmacy practice lectures at UCSD, and a variety of health administration lectures to public health graduate students at SDSU, Sharp staff remain active and engaged with San Diego's academic health care community. Sharp's Continuing Medical Education (CME) department assesses, designs, implements and evaluates educational initiatives for Sharp's affiliated physicians, pharmacists and other health care professionals to better serve the health care needs of the San Diego community. In FY 2012 the professionals at Sharp HealthCare CME invested more than 2,100 hours in numerous CME activities open to San Diego health care providers, ranging from conferences on patient safety, cardiology, antimicrobial stewardship, and obesity, to presentations on the hospitalist's experience and hospital overcrowding. Research Innovation is critical to the future of health care, and Sharp HealthCare supports this innovation through its commitment to quality research initiatives that are safe and effective, provide valuable knowledge to the San Diego health care community, and positive impact to patients and community members. Sharp HealthCare Institutional Review Board Sharp HealthCare's Institutional Review Board (IRB) seeks to promote a culture of safety and respect for individuals who choose to participate in research for the greater good of the community. All proposed Sharp research studies with human participants are required to be reviewed by the Sharp HealthCare IRB. The purpose of this review is to protect participant safety and maintain responsible research conduct. In FY 2012, a dedicated IRB committee of 12 individuals - including physicians, psychologists, research nurses and study coordinators - devoted hundreds of hours to the review and analysis of both ongoing and new research studies. The Sharp HealthCare IRB also provides education and guidance for researchers across Sharp as well as in the community. Nurses, pharmacy residents and other members of the health care community receive education on various study-specific requirements regarding the protection of human subjects and HIPAA compliance. Additionally, Sharp HealthCare's Research Department works with the IRB to provide quarterly research meetings (QRM) that are open to physicians, psychologists, research nurses and study coordinators throughout San Diego. These meetings provide education and support to the research community. Recent presentations have covered topics such as the administration of clinical trials, the use of statistical analysis in assessing test bias, the importance of outcomes-based research and the development of effective research questions. Outcomes Research Institute The Outcomes Research Institute (ORI) at Sharp was formed to measure long-term results of care and to promote and develop best practices of health care delivery for members of the professional health care community. With both inpatient and ambulatory locations and a diverse patient population, Sharp is well-positioned to study care processes and outcomes in a real-world setting, reflecting an authentic picture of the health care environment. The ORI collaborates with all Sharp team members interested in optimizing patient care by: facilitating the creation and design of patient-centered outcomes research projects; assisting in database development as well as data collection and analysis; assisting with grant writing and exploring funding mechanisms for research projects; and facilitating IRB application submissions. Among its current and future goals, the ORI aims to ensure patient care produces outcomes consistent with evidence-based medical literature; analyze the relationships between processes and outcomes for treatments, interventions and quality improvement initiatives; establish associations between practice, costs and outcomes for patient care; and develop and disseminate effective approaches to quality care delivery in the health care community. The ORI has completed a number of pilot studies to collect data on optimal sample sizes and variables for expanded research measuring long-term influence of quality interventions on: heart failure readmission; optimal glycemic control in the hospital setting; and inpatient complication rates and length of stay after bowel surgery. Currently the ORI has ten active studies in various phases of development and analysis. The ORI is committed to educational outreach for Sharp HealthCare's clinicians and the health care community at large, and offers numerous educational presentations about outcomes research and health care research methods to nurses, physicians and the broader community throughout the year. ORI staff have also been invited to present lectures on outcomes research and outcomes research designs to the broader health care community and at regional and national conferences. Additionally, the ORI collaborates with San Diego County education and research communities to develop and strengthen those connections. The ORI Student Research Intern Program offers advanced nursing and public health students an opportunity to learn about and become involved in outcomes research. Since its inception in 2011, the program has enrolled nine students (approximately two per semester). The interns learn about outcomes research, and produce presentations that document their research study experience. In addition, the ORI has reached out to the academic community to foster partnership for outcomes research. As a result, the ORI currently is in discussion with researchers at National University (NU), San Diego State University's (SDSU's) Cancer Center Comprehensive Partnership, and the Health Research and Educational Trust to develop common themes as the basis for future research collaborations. Evidence-Based Practice Institute Sharp participates in the Evidence-Based Practice Institute (EBPI), which prepares teams of staff (fellows) and advance practice nurses (mentors) to change and improve nursing practice and patient care. This change occurs through identifying a care problem, developing a plan to solve it, and then incorporating the new knowledge into practice. The EBPI is part of the Consortium of Nursing Excellence, San Diego, which promotes evidence-based practice in the nursing community. The consortium is a partnership between SGH, SMH, SCVMC, Scripps Health, Rady Children's Hospital - San Diego, UCSD Health, and San Diego VA Medical Center, as well as PLNU, SDSU and USD. In FY 2012, the EBPI consisted of a nine-month program culminating with a graduation ceremony in September. The project results of all EBPI fellows are shared at the ceremony. EBPI fellows partner with their mentors and participate in a variety of learning strategies. Mentors facilitate the process of conducting an evidence-based practice change and navigating the hospital system to support the fellow through the process of evidence-based practice. Mentors also assist the fellow in working collaboratively with other key hospital leadership personnel. The San Diego EBPI includes six full-day class sessions that incorporate group activities, as well as self-directed learning programs outside of the classroom, in addition to the structured mentorship provided throughout the program. In FY 2012, approximately 50 fellows graduated from the EBPI program, and completed projects that addressed compelling issues in the health care community, such as: end-of-life care and improving patient pain and symptom management; decreasing hospital-acquired infections through environmental cleaning; and the impact of education and palliative care consults on the moral distress and compassion fatigue of Intensive Care Unit (ICU) nurses. Sharp actively participates in the EBPI through the provision of instructors and mentors, as well as administrative coordination. Volunteer Service Sharp Lends a Hand In FY 2012, Sharp continued its systemwide community service program, Sharp Lends a Hand (SLAH), to further support the San Diego communities it serves. In October, Sharp team members suggested project ideas that focused on improving the health and well-being of San Diego in a broad, positive way; relied on Sharp for volunteer labor only; supported nonprofit initiatives, community activities or other programs that serve the residents of San Diego County; and could be completed by September 30, 2012. Eight projects were selected: Stand Down for Homeless Veterans; San Diego Food Bank; San Diego Coastal Clean-Up; SPORTS for Exceptional Athletes: Basketball and Floor Hockey Tournaments; Helen Woodward Animal Center: Puppy Love 5K Run/Walk; Jewish Family Service of San Diego: Hand Up Youth Food Pantry; Memorial Day headstone cleaning at Fort Rosecrans National Cemetery; and Home of Guiding Hands: Landscape Makeover. In support of these projects, more than 1,600 Sharp employees, family members and friends volunteered nearly 5,500 hours. During eight days in June and July 2012, 522 Sharp employees, family members and friends volunteered at Veterans Village of San Diego, Liberty Station and San Diego High School. The volunteers sorted and organized clothing donations and provided on-site support, medical services and companionship to hundreds of homeless veterans at Stand Down for Homeless Veterans, an annual event sponsored by Veterans Village of San Diego. The San Diego Food Bank feeds people in need throughout San Diego County, and advocates and educates the public about hunger-related issues. During eight days in February, April, June and August, 708 SLAH volunteers inspected and sorted donated food, assembled boxes and cleaned the San Diego Food Bank warehouse. More than 35 SLAH volunteers provided assistance to San Diego County's SPORTS for Exceptional Athletes, a community-wide nonprofit organization that provides sports training and athletic competition for individuals ages 5 through adult with developmental disabilities. During the spring floor hockey and basketball tournaments, Sharp volunteers assisted with timekeeping, score-keeping and cheerleading for the athletes. In May, 60 SLAH volunteers and their family members honored veterans at Fort Rosecrans National Cemetery by cleaning headstones. In September, The SLAH team partnered with I Love a Clean San Diego and San Diego Coastkeeper to put the sparkle back in the San Diego community through the San Diego Coastal Clean-Up. Nearly 150 volunteers of all ages helped keep San Diego's coast a beautiful place to live and play by picking up and removing trash and debris from 16 selected sites in the community. In January, 29 SLAH volunteers provided a landscape makeover at Home of Guiding Hands by installing bark and rock at two different homes. Home of Guiding Hands provides support and services for more than 800 children, adolescents and adults with developmental disabilities in San Diego's East County. During two days in February, 57 SLAH volunteers provided support for the Helen Woodward Animal Center's Puppy Love 5K Run/Walk on Highway 101 in Solana Beach, including setting up exhibit booths, assisting with registration and working as route/road marshals. The Helen Woodward Animal Center is a San Diego-based nonprofit organization committed to saving the lives of animals by providing humane care, animal adoption and other programs and resources for individuals who care for animals. In May, 40 SLAH volunteers offered their assistance to the Jewish Family Service of San Diego's Hand Up Youth Food Pantry, a program dedicated to alleviating hunger by delivering food to thousands of community members in need. SLAH volunteers helped set up food shopping areas, assisted parents with shopping and carrying their groceries, and entertained children with arts and crafts. Jewish Family Service is one of San Diego's premier human care service organizations. Each year, the organization serves more than 35,000 people throughout SDC and the Coachella Valley, providing more than 50 programs and services to address human and family needs. Sharp Humanitarian Service Program In FY 2012, the Sharp Humanitarian Service Program funded 28 Sharp employees, enabling them to participate in service programs that provide health care or other supportive services to underserved or adversely affected populations. Sharp employees devoted their time and expertise to a variety of humanitarian organizations, including Facing Futures, an organization that provides free medical care to children suffering from facial abnormalities as a result of birth defects or trauma. Over a period of two weeks, a team of Sharp physicians, nurses and support staff provided free maxillofacial surgeries for approximately 100 children in Vietnam. In addition, Sharp staff partnered with the Children of the Nations (COTN) organization to provide basic medical care to more than 180 children between four and eighteen years of age, in Lira, Uganda. A team of physicians, students and therapists also provided education on wound care, hydration, nutrition and safety procedures, including CPR and the Heimlich maneuver, to both staff and children in the village. Sharp staff also participated in the Helping Older People Equally (HOPE) organization's Elderly Week in Belize, providing physical therapy screenings and assessments, as well as education and exercise programs to approximately 100 elderly community members. Additionally, in FY 2012 Sharp staff helped organize a week-long medical mission trip to the northwest mountains of Guatemala. A team of 75 individuals including Sharp-affiliated physicians, nurses, technical staff, therapists, chaplains and many others participated in this effort in partnership with the Ioamai Medical Ministries and Helps International. During a span of seven days, the team set up a temporary hospital at a local military base and treated more than 1,000 patients, performing approximately 140 surgeries, including hernia, cleft-lip, cleft palette, and gynecological procedures. In some cases, members of the impoverished mountain community traveled many hours to receive care at the hospital. Sharp also donated numerous supplies and equipment to this life-changing experience for both patients and participants. In addition, Sharp staff collaborated with the 2012 Pacific Partnership medical mission that serves individuals in Indonesia, Cambodia, Vietnam and the Philippines over a span of three months. Specifically, Sharp staff participated in the Pacific Partnership two-week medical mission trip to Cambodia alongside the San Diego-based U.S. Naval hospital ship, Mercy. Medical personnel from all branches of the U.S. military participated, as well as personnel from other countries, such as Australia, New Zealand and the Netherlands. The team implemented four medical sites throughout Cambodia, providing medical, dental and ophthalmic care to approximately 12,700 patients and performing more than 200 surgeries. In addition, team members taught and shared U.S. medical practices with Cambodian medical students. In FY 2012, Sharp staff spent a week supporting the God's Child Project, working with college students to provide various services to impoverished communities in Antigua, Guatemala, including building a one-room house with a cement foundation for a family of seven; serving dinner at a homeless shelter; caring for malnourished children; and gathering and distributing vegetables to community members. Sharp staff also participated in the work of Amor Ministries in Tijuana, Mexico, a nonprofit organization that has served the people of Mexico for more than 32 years and has helped build more than 16,000 homes. Over the course of four days, the team constructed a home for one poverty-stricken family. In addition, Sharp staff worked with Family Friends Community Connection (FFCC), a San Diego-based nonprofit organization, to lend vital assistance to victims of the earthquakes that devastated Haiti in January 2010. A team of 17 individuals, including Sharp staff, assisted in the construction of an orphanage dormitory, installed water filtration systems, distributed food packages and held a soccer tournament for children from four local orphanages. Community Walks For the past 17 years, Sharp has proudly supported the American Heart Association (AHA) annual Heart Walk. In September 2012, more than 1,000 walkers represented Sharp at the San Diego Heart Walk held in Balboa Park. Sharp was the No. 1 Heart Walk team in San Diego and the AHA Western Region Affiliates, raising nearly $190,000 for the American Heart Association. Sharp Volunteers Sharp volunteers are a critical component of Sharp's dedication to the San Diego community. Sharp provides a multitude of volunteer opportunities throughout San Diego County for individuals to serve the community, meet new people and assist programs ranging from pediatrics to Senior Resource Centers. Volunteers devote their time and compassion to patients as well as to the general public, and are an essential element to many of Sharp's programs, events and initiatives. Sharp volunteers spend their time within hospitals, in the community, and in support of the Sharp HealthCare Foundation, Grossmont Hospital Foundation, and Coronado Hospital Foundation. Sharp employees also donate time to Sharp as volunteers for the Sharp organization. In FY 2012, more than 3,600 individuals volunteered for various programs across the Sharp system, contributing more than 242,000 hours of their time in service to Sharp and its initiatives. This includes more than 950 auxiliary members and thousands more individual volunteers from the San Diego community. More than 9,000 of these hours were provided externally to the community through activities such as delivering meals to homebound seniors and assisting with health fairs and events. Table 2 details the number of individual volunteers and the hours provided in service to each of Sharp's entities, specifically for patient and community support. Volunteers also spent additional hours supporting Sharp's three foundations for events such as Grossmont Hospital Foundation's annual Golf Tournament; galas held for SCHHC and SGH; and other events in support of Sharp entities and services. Table 2: Sharp Individual Volunteers and Volunteer Hours - FY 2012 Sharp Chula Vista Medical Center Number of Individual Volunteers - 325 Volunteer of Hours - 5,396 Sharp Coronado Hospital and Healthcare Center Number of Individual Volunteers - 134 Volunteer of Hours - 6,234 Sharp Grossmont Hospital Number of Individual Volunteers - 945 Volunteer of Hours - 128,415 Sharp Metropolitan Medical Campus Number of Individual Volunteers - 2,091 Volunteer of Hours - 95,659 TOTAL Number of Individual Volunteers - 3,495 Volunteer of Hours - 235,704 Sharp employees also volunteer their time for the Cabrillo Credit Union Sharp Division Board, the Sharp and Children's MRI Board, the UCSD Medical Center/Sharp Bone Marrow Transplant Program Board, Grossmont Imaging LLC Board, and the SCVMC - SDI Imaging Center. In addition, volunteers on Sharp's auxiliary boards and the various Sharp entity Boards volunteer their time to provide program oversight, administration and decision-making regarding financial resources. In FY 2012, 128 community members contributed their time to Sharp's boards. Other Sharp Volunteer Efforts In FY 2012, Sharp staff volunteered their time and passion to a number of unique initiatives, underscoring Sharp's commitment to the health and welfare of San Diegans. Below are just a few examples of how Sharp employees gave of themselves to the San Diego community. SGH's Engineering Department participated in a number of initiatives in FY 2012, including the continuation of their "This Bud's for You" program. The program brought comfort to unsuspecting patients and their loved ones with the delivery of hand-picked flowers from the medical campus's abundant gardens. The SGH landscape team grew, cut, bundled and delivered colorful bouquets each week, bringing an element of natural beauty to patients and visitors of both the hospital and the SGH Hospice Houses. The team also regularly offered single-stem roses in a small bud vase to passers-by. In its second year, the "This Bud's for You" program has become a natural part of the landscape team's day, an act that is simply part of what they do to enhance the experience of visitors to the hospital. SGH also continued to provide the "Shirt Off Our Backs" program during the 2011 holiday season, and brought clothing, shoes, blankets and household items directly to San Diego's homeless population. The SGH landscape team and Engineering Department, the SGH Auxiliary and local businesses collaborated to implement the program, and SGH's Waste Management team provided ancillary support with loaner recycle bins to use for collection. Hundreds of pounds of clothing, shoes, towels, blankets, toiletries and other items that could be put to use immediately were collected, washed, folded, boxed/bagged and prepared before delivery to the San Diego population in need, and this year three pickup trucks were required to deliver the collected items. The efforts provided food and comfort to all who expressed need - ranging from small children to adults of all sizes. New in FY 2012, the SGH Engineering Department began the "Feed the Cubs...Our Future Engineers" program, and provided students enrolled in the hospital's high school mentorship program with lunch, snacks and frozen meals through a department-wide fundraising effort. Through the program, the department ensured that the students ate both breakfast and lunch during their time at the hospital. At SMMC, the Arts for Healing program was established to improve the spiritual and emotional health of patients that face significant medical challenges. The program provides services at SMH, SMH Outpatient Pavilion (OPP), SMBHWN, SMV and SMC. Since the inception of the program in 2007, more than 18,000 patients and their families, guests and staff have benefitted from the time and talent provided by Arts for Healing staff and volunteers. Trained volunteers are the primary providers of the program, which is coordinated by a chaplain of the Spiritual Care program. The Arts for Healing program utilizes the power of art and music to enhance the healing process for patients challenged by significant illness, chronic pain and long-term hospitalization. At SMH, oftentimes these are stroke patients, cancer patients or patients facing life with newly acquired disabilities following catastrophic events. Throughout FY 2012, Arts for Healing also provided art therapy for patients and community members at the Pavilion cancer support group on Saturday mornings. At SMBHWN, the program is provided to high-risk mothers who are in the hospital from one to four months, awaiting childbirth and experiencing stress and loneliness over the separation from their families. Participants paint and create cards and seasonal craft projects. In addition, Arts for Healing provided art activities for children at Saturday With Santa, a community event hosted by the SMH auxiliary for children to have their picture taken with Santa. This and other Arts for Healing events have benefited hundreds of community members through the healing power of art. In addition, Sharp sponsored the TEDxSanDiego and TEDxYouth events held in November 2011, providing support in advance of the event, including show direction, technical direction, experience design and registration. TEDxSanDiego and TEDxYouth are events for members of the San Diego community and beyond, and are designed to bring together innovators, explorers, teachers and learners in an environment that encourages collaboration, conversation and interaction. TED is a nonprofit organization devoted to "Ideas Worth Spreading," and has grown over the past 25 years to support an array of world-changing ideas with multiple initiatives. TEDxSanDiego and TEDxYouth are not-for-profit events organized entirely by local, unpaid volunteers. Sharp team members volunteered their time on-site at each event, delivering The Sharp Experience as way finders, ushers, stage managers, speaker shadows and in other roles. All Ways Green Initiative As San Diego's largest private employer, Sharp recognizes that the health of its patients, employees and the community is directly tied to the health of their environment. Sharp promotes a culture of environmental responsibility by providing education and outreach to employees to improve their health and the health of those they serve. Sharp's systemwide All Ways Green(tm) Committee is charged with evaluating opportunities and recognizing best practices to (1) increase energy efficiency, (2) improve water conservation, (3) minimize waste, (4) investigate and promote cleaner means of transportation, and (5) reduce the amount of harmful chemicals released to the environment, as well as the promotion of other initiatives to lower Sharp's carbon footprint and be a positive environmental influence. Sharp's Environmental Policy serves to affirm its commitment to improving the health of the environment and therefore the communities it serves. Sharp created its All Ways Green(tm) logo to brand its environmental activities and communicate sustainable activities throughout Sharp and the SDC community. Established Green Teams at each entity are charged with developing new programs that educate Sharp employees to conserve natural resources and reduce, reuse and recycle. Sharp has partnered with organizations in the community and its vendors to develop new programs and initiatives to help achieve its environmental goals. According to the EPA, inpatient hospital facilities are the second-most energy-intensive industry after food service and sales, with energy utilization rates 2.7 times greater than that of office buildings on a square-foot basis. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and must provide service during power outages, natural disasters and other emergencies. Given this reality, Sharp has embarked on several green initiatives to enhance energy efficiency including: retro-commissioning of heating, ventilation and air conditioning (HVAC) systems; occupancy sensor installation; energy audits; energy-efficient motor and pump replacements; equipment modernization; and development of a Sharp HealthCare Energy Guideline to help manage energy utilization practices throughout the system. Other projects completed in 2012 include lighting retrofits, pipe insulations and infrastructure control initiatives, which are expected to generate annual energy savings in excess of $200,000. All Sharp entities participate in the EPA's Energy Star (ES) database and monitor their ES scores on a monthly basis. ES is an international standard for energy efficiency created by the EPA. Buildings that are designated by ES must earn a 75 or higher on the EPA's energy performance scale, indicating that the building performs better than at least 75 percent of similar buildings nationwide. According to the EPA, buildings that qualify for the ES typically use 35 percent or less energy than buildings of similar size and function. In 2007, SCHHC first earned EPA's ES certification and also earned the ES designation for 2010, 2011 and 2012. SCVMC is eligible to receive the EPA ES designation again in 2012, and earned this recognition for the three previous years. The ES designation is the result of Sharp's commitment to superior energy performance and responsible use of natural resources. In addition, Sharp's new SRS Downtown medical office building is the first Leadership in Energy and Environmental Design (LEED) gold-certified medical office building in San Diego. In an effort to conserve water, Sharp has researched and implemented infrastructure changes to ensure Sharp's facilities are optimally operated while monitoring and measuring water consumption. Such changes include installation of motion-sensing faucets, drip irrigation systems, mist eliminators, water-saving devices and equipment, water monitoring and control systems, water practice and utilization evaluations, reduced landscape watering times, hardscaping and redesigning areas with drought-resistant plants. The EPA and Hospitals for a Healthy Environment report that each patient generates approximately 15 pounds of waste each day, while U.S. medical centers generate approximately 2 million tons of waste each year. Sharp has implemented a systemwide single-stream recycling program to divert waste from the landfills. Other waste reduction efforts include: reprocessing of surgical instruments; use of reusable sharps and pharmaceutical waste containers; sterile processing equipment to eliminate blue-wrapped instrument trays; use of recyclable paper for printing brochures, newsletters and other marketing materials; electronic patient bills and paperless payroll; recycling of exam table paper; encouragement of reduced paper use at meetings through electronic correspondence; and use of one-at-a-time paper napkin and plastic cutlery dispensers. Office Depot, Sharp's primary office supply vendor, has initiated a new program called GreenerOffice(tm) Delivery Service aimed at making client deliveries more environmentally friendly. Sharp was an early adopter of this program whereby Office Depot replaced its small and mid-sized cardboard boxes with paper bags that are composed of 40 percent post-consumer recycled material. The paper bags are protected during shipping by reusable plastic totes, which are returned to Office Depot for reuse. Nationally, GreenerOffice Delivery Service will result in 3,130 tons less wood (equivalent to 21,691 fewer trees) and a reduction in energy use, CO2 emissions, wastewater and solid waste. Furthering carbon footprint reduction efforts, Office Depot and Sharp have arranged for 30 percent recycled copy paper to be used at all Sharp entities. Additionally, in July 2012 SCHHC and SGH began a one-year Integrated Waste Management Program pilot with an outside vendor, which aims to increase Sharp's waste diversion rate through employee education of appropriate waste stream disposal and increased recycling activities. In support of electronic waste recycling, Sharp hosted two community electronic recycling events at their corporate office location in April and September 2012. During these events, Sharp partnered with the Drug Enforcement Agency's (DEA) National Prescription Drug Take Back Day to provide a safe, convenient and responsible means of drug disposal while educating the general public about the potential for abuse of their medications. The four-hour long community waste collection events welcomed employees and community members, and collected nearly 500 pounds of pharmaceuticals and 12 bins (approximately 6,600 pounds) of electronic waste. In addition, Sharp employees were encouraged to recycle personal eyeglasses and sunglasses through the Lion's Club Recycle Sight program, which distributes recycled glasses to people in need both locally and globally. On average, Sharp employees donate more than 400 pairs of glasses through the program each year. In April 2012, Sharp held its third-annual systemwide Earth Week event, including Green Fairs at each of the Sharp entities. During the fairs, employees learned how they can contribute to recycling, waste minimization, healthy eating practices and other sustainability efforts. Many of Sharp's key vendor partners participated in the Green Fairs to help raise awareness and education regarding green initiatives and how they involve Sharp HealthCare. In addition, on November 15, 2011, Sharp recognized America Recycles Day through a systemwide electronic announcement that highlighted Sharp's recycling efforts and accomplishments, and provided staff with tips and reminders for proper recycling at work. The impact of Sharp's waste reduction programs has been significant. In FY 2012, Sharp facilities diverted over 7.4 million pounds of paper, cardboard, glass, aluminum, metals, polystyrene, batteries and electronic waste from local landfills. SCHHC and SMMC diverted 36,729 pounds of waste through utilization of reusable sharps and pharmaceutical waste containers in FY 2012. Sharp recycled/reclaimed 186,910 pounds of hazardous and universal waste (e.g., batteries, solvents and fluorescent light bulbs) and diverted 33,317 pounds of waste through surgical device reprocessing. Table 3 presents the quantity of waste diversion at Sharp shown as pounds (lbs.) diverted. Table 3: Sharp HealthCare Waste Diversion - FY 2012 Sharp Chula Vista Medical Center Recycled Waste Per Year (lbs.) - 578,191 Total Waste Per Year (lbs.) - 2,445,809 Percent Recycled - 23.6% Sharp Coronado Hospital and Healthcare Center Recycled Waste Per Year (lbs.) - 228,541 Total Waste Per Year (lbs.) - 1,310,172 Percent Recycled - 17.4% Sharp Grossmont Hospital Recycled Waste Per Year (lbs.) - 1,759,342 Total Waste Per Year (lbs.) - 4,982,960 Percent Recycled - 35.3% Sharp Metropolitan Medical Campus Recycled Waste Per Year (lbs.) - 2,237,629 Total Waste Per Year (lbs.) - 6,789,857 Percent Recycled - 32.9% Total Sharp HealthCare Recycled Waste Per Year (lbs.) - 7,481,158 Total Waste Per Year (lbs.) - 20,295,500 Percent Recycled - 37% Sharp implements sustainable food practices throughout the system including: removal of Styrofoam from cafeterias; use of green-label kitchen soaps and cleansers; electronic cafe menus; recycling of all cardboard, cans and grease from cafes; and partnering with vendors who are committed to reducing product packaging. Other sustainable food practices include organic markets at each of Sharp's hospitals and corporate office; purchasing of hormone-free milk; and increased purchasing of locally grown fruits and vegetables, approaching 65 percent at some entities. Both SMH and SCHHC have also created the first County-approved organic gardens with produce to be used at employee cafes. In FY 2012, SMH and SMBHWN partnered with the City of San Diego to plan and implement a Food Waste Composting Program, making Sharp the first San Diego health care organization to join the city's initiative. Through this program, food waste is picked up weekly by EDCO, a solid waste vendor, for transport to the Miramar Greenery, a 74-acre facility located at the Miramar Landfill in Kearny Mesa. The composted rich soil is sold to commercial landscapers and non-city residents, and provided at no charge to city residents at volumes of up to two cubic yards. From April to September 2012, approximately 76 tons were diverted from the landfill and composted at the Miramar Greenery. SMH and SMBHWN hosted a free Community Composting Workshop to share their food waste composting experiences and encourage other organizations to begin composting. Sharp plans to continue its partnership with the City of San Diego to expand the Food Waste Composting Program to other Sharp entities. Ride sharing, public transit programs and other transportation efforts contribute to the reduction of Sharp's transportation emissions. Sharp's Commuter Solution Sub-Committee is responsible for developing new programs and education campaigns aimed at reducing the number of cars on the road. Sharp ensures carpool parking spaces and designated bike racks and motorcycle spaces are available at each employee parking lot. In addition, Sharp offers discounted monthly bus passes for purchase by employees. In partnership with the San Diego Association of Governments (SANDAG), a vanpool and carpool match-up program has been created to help employees find convenient ride share partners. In FY 2012, Sharp was selected as a participant in SANDAG's iCommute Carpool Incentive Pilot program to incentivize employees to carpool. Employees who committed to carpooling a minimum of 13 trips per month were offered a $50 gas card for a maximum of three months. More than 150 employees participated in this pilot program. Sharp monitors ride sharing by its employee population and the reduction of its carbon footprint through SANDAG's iCommute website. Education and marketing campaigns are held throughout the year to educate employees on the benefits of ride sharing. In FY 2012, Sharp employees saved more than 1,383,000 miles and reduced more than 791,000 pounds of carbon dioxide by carpooling, vanpooling, telecommuting and the use of public transportation. In FY 2012, the Sharp system participated in the SANDAG iCommute Corporate Challenge, achieving second place in the Mega employee category. In addition, Sharp uses centralized patient scheduling to improve patient vanpools, and has replaced higher fuel-consuming cargo vans with economy Ford transit vehicles, saving approximately five miles per gallon. As part of the nationwide Electric Vehicle Project, Sharp has installed electric vehicle chargers (EVC) at its corporate office location and Metropolitan campus, and is in the process of expanding EVC installation across the system. Sharp is the first health care system in San Diego to offer the EVCs, supporting the creation of a national infrastructure required for the promotion of EVCs to reduce carbon emissions and dependence on foreign oil. In FY 2012, Sharp presented to professionals at the California Higher Education Sustainability Conference (CHESC) at University of California, Davis, highlighting its waste minimization efforts, including its Food Waste Composting Program. Sharp's waste minimization initiatives have also been recognized by several publications including San Diego Business Journal, North County Times and BioCycle, a national magazine about composting, renewable energy and sustainability. Table 4 highlights the All Ways Green(tm) efforts at Sharp entities. Going forward, Sharp remains committed to the All Ways Green(tm) initiative and will continue to investigate opportunities to reduce its carbon footprint. Green purchasing methods will be explored to reduce waste volume and toxicity with less packaging, fewer toxic materials and more recyclable packaging prior to entering the Sharp system. Sharp's All Ways Green(tm) Committee continues to work with system employees, physicians and corporate partners to develop new and creative ways to reduce Sharp's impact on the environment and meet their goal of being an outstanding community citizen through environmental responsibility. Table 4: All Ways Green Initiatives by Sharp Entity - FY 2012 SMH/SMBHWN *Energy Efficiency - Electric vehicle chargers - Energy audits - Energy-efficient chillers/motors - Energy Star participation - HVAC projects - Lighting retrofits - Occupancy sensors - Pipe insulations *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Electronic cafe menus - Food waste composting - Single-serve paper napkin and plastic cutlery dispensers - Reusable sharp waste containers - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Drought tolerant rooftop garden - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Organic farmer's market - Organic gardens - Recycling education - Ride share promotion SMV/SMC *Energy Efficiency - Energy audits - Energy Star participation - HVAC projects - Lighting retrofits - Motor and pump replacements *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Single-stream recycling - Styrofoam elimination - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Organic farmer's market - Recycling education - Ride share promotion SGH *Energy Efficiency - Energy audits - Energy Star participation - HVAC projects - Lighting retrofits - Retro-commissioning *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Electronic cafe menus - Single-serve paper napkin and plastic cutlery dispensers - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Organic farmer's market - Recycling education - Ride share promotion SCVMC *Energy Efficiency - Energy audits - Energy-efficient chillers/motors - Energy Star participation and award eligible - HVAC projects - Lighting retrofits *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Compactor renovation - Electronic cafe menus - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Organic farmer's market - Recycling education - Ride share promotion SCHHC *Energy Efficiency - Elevator/chiller modernizations - Energy audits - Energy-efficient chillers/motors - Energy Star Award HVAC projects - Lighting retrofits *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Reusable sharp containers - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Organic farmer's market - Organic gardens - Recycling education - Ride share promotion SRS *Energy Efficiency - Energy audits - Energy Star participation - Lighting retrofits *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Low-flow systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Recycling of exam paper - Single-stream recycling - Styrofoam elimination *Education and Outreach - Contractor education - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Recycling education - Ride share promotion SHP *Energy Efficiency - Energy audits - HVAC projects - Lighting retrofits - Occupancy sensors *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Single-stream recycling - Spring cleaning events *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Recycling education - Ride share promotion Sharp System Services *Energy Efficiency - Electric vehicle chargers - Energy audits - Energy efficient chillers/motors - Energy Star participation - HVAC projects - Lighting retrofits - Occupancy sensors - Thermostat control software *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Electronic patient bills and paperless payroll - Electronic and pharmaceutical waste recycling events - Green Grocer's market - Single-serve paper napkin and plastic cutlery dispensers - Single-stream recycling *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No Smoking Policy - Recycling education - Ride share promotion Emergency and Disaster Preparedness Sharp contributes to the health and safety of the San Diego community through essential emergency and disaster planning activities and services. Throughout FY 2012, Sharp provided education to community members, staff and other health care professionals on emergency and disaster preparedness. In June, Sharp provided a lecture entitled, Lessons Learned from the San Diego County Power Outage, to 125 community health care and emergency preparedness professionals at the Los Angeles County Statewide Medical Exercise Planning Conference. In addition, Sharp's disaster preparedness team offered several disaster education courses to first responders, health care providers and community members across SDC. The Hospital-Based First Receiver Awareness Course and First Receiver Operations Course were offered as a two-part series to educate and prepare hospital staff for a decontamination event. Course topics included decontamination principles and best practices, basic hazards, utilization of appropriate Personal Protective Equipment (PPE), response concepts, containment, decontamination and recovery. A standardized federal emergency management training for hospital management entitled, NIMS (National Incident Management System)/ ICS (Incident Command System)/ HICS (Hospital Incident Command System), was also offered by Sharp's disaster team, as well as a START (Simple Triage and Rapid Treatment) Triage/ Jump START Triage class to train emergency responders at all levels to triage a large volume of trauma victims within a short period of time. In FY 2013, Sharp's disaster team will lead a Pediatric/Burn Surge course for hospital staff, health care providers and other emergency responders, and will provide training to effectively manage specific patient populations during a surge or abnormal event. In FY 2012, Sharp's disaster leadership donated their time to state and local organizations and committees including the Southern California Earthquake Alliance, the County of San Diego Emergency Medical Care Committee and the County of San Diego Healthcare Disaster Council, a group of representatives from SDC hospitals, other health care delivery agencies, county officials, fire agencies, law enforcement, American Red Cross and others who meet monthly to share best practices for emergency preparedness. In addition, Sharp's disaster leadership served on the Statewide Medical Health Exercise work group that designed training materials, including an exercise guidebook and other resources, for the 2012 California Statewide Medical Health Training and Exercise Program through the California Department of Public Health (CDPH) and the Emergency Medical Services Authority (EMSA). The program is designed to guide local emergency planners in developing, planning and conducting emergency responses. Sharp supports safety efforts of the state and the city of San Diego through maintenance and storage of a county decontamination trailer at Sharp Grossmont Hospital, to be used in response to a mass decontamination event. Sharp has also arranged for the prospective storage of 24 state hospital ventilators at three Sharp hospitals. In addition, Sharp is exploring opportunities to join EMSA Mobile Field Hospital (MFH) program to provide maintenance and storage for a state MFH. The MFH is designed to increase disaster preparedness by rapidly responding to emergencies such as earthquakes, fires and floods that impact hospital surge needs. Within 72 hours of an emergency, the MFH can provide up to 600 acute care hospital beds for patient treatment and transport anywhere in the state. Additionally, all Sharp hospitals are prepared for an emergency with backup water supplies that last up to 96 hours in the event the system's normal water supply is interrupted. As part of its participation in the U.S. Department of Health & Human Services Public Health Emergency Hospital Preparedness Program (HPP) grant, Sharp created the Sharp HealthCare HPP Disaster Preparedness Partnership (the Partnership). The Partnership includes SCVMC, SCHHC, SGH, SMH, SRS Urgent Care Centers and Clinics, San Diego's Ronald McDonald House, Rady Children's Hospital, Scripps Mercy Hospital, Scripps Chula Vista Medical Center, Kaiser Hospital, Alvarado Hospital, Paradise Valley Hospital, the Council of Community Clinics, Naval Air Station North Island/Naval Medical Services, San Diego County Sheriffs, MCAS Miramar Fire Department and Fresenius Medical Centers. The Partnership seeks to continually identify and develop relationships with health care entities, nonprofit organizations, law enforcement, military installations and other organizations that serve SDC and are located near partner health care facilities. Through networking, planning, and the sharing of resources, trainings and information, the partners will be better prepared for a collaborative response to an emergency or disaster affecting SDC. In FY 2013, Sharp will educate the San Diego community on effective disaster preparedness and response with its Household Disaster Preparedness Expo. At the expo, local disaster vendors and emergency personnel will provide community members with disaster preparedness education and emergency demonstrations. In addition, Sharp plans to collaborate with other SDC hospitals to create regional decontamination teams of health care personnel trained to respond to a community decontamination event. Internally, Sharp plans to develop employee disaster teams who will be trained to provide leadership, order and safety during an emergency or disaster. Section 2 Executive Summary This Executive Summary provides an overview of community benefits planning at Sharp, a listing of community needs addressed in this Community Benefits Report, and a summary of community benefits programs and services provided by Sharp in Fiscal Year (FY) 2012 (October 1, 2011, through September 30, 2012). In addition, the summary reports the economic value of community benefits provided by Sharp, according to the framework specifically identified in SB 697, for the following: * Sharp Chula Vista Medical Center * Sharp Coronado Hospital and Healthcare Center * Sharp Grossmont Hospital * Sharp Mary Birch Hospital for Women & Newborns * Sharp Memorial Hospital * Sharp Mesa Vista Hospital and Sharp McDonald Center * Sharp Health Plan Community Benefits Planning at Sharp HealthCare Sharp bases its community benefits planning on the triennial community health needs assessment (CHNA) conducted by San Diego Community Health Improvement Partners (CHIP) combined with the expertise in programs and services of each Sharp hospital. Listing of Community Needs Addressed in This Community Benefits Report The following community needs are addressed by one or more Sharp hospitals in this Community Benefits Report: * Access to care for individuals without a medical provider, and support for high-risk, underserved and underfunded patients * Focused education and screening programs on health conditions such as heart and vascular disease, stroke, cancer, diabetes, preterm delivery, unintentional injuries and behavioral health * Health education and screening activities for seniors * Outreach for flu vaccinations * Special support services for hospice patients and their loved ones, and for the community * Support of community nonprofit health organizations * Education and training of health care professionals * Collaboration with local schools to promote interest in health care careers * Welfare of seniors and disabled people * Cancer education, patient navigator services, and participation in clinical trials * Women's and prenatal health services and education * Meeting the needs of new mothers and their loved ones * Mental health and substance abuse education for the community Highlights of Community Benefits Provided by Sharp in FY 2012 The following are examples of community benefits programs and services provided by Sharp hospitals and entities in FY 2012. * Unreimbursed Medical Care Services included uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as Medi-Cal, Medicare, San Diego County Indigent Medical Services, Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and TRICARE - the regionally managed health care program for active-duty and retired members of the uniformed services, their loved ones and survivors; and unreimbursed costs of workers' compensation programs. This also included financial support for on-site workers to process Medi-Cal eligibility forms. * Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; financial and other support to community clinics to assist in providing health services, and improving access to health services; Project HELP; Project CARE; contribution of time to Stand Down for Homeless Veterans and the San Diego Food Bank; financial and other support to the Sharp Humanitarian Service Program; and other assistance for the needy. * Other Benefits for the Broader Community included health education and information, and participation in community health fairs and events addressing the unique needs of the community, plus providing flu vaccinations and health screenings. Sharp collaborated with local schools to promote interest in health care careers; made Sharp facilities available for use by community groups at no charge; and executive leadership and staff actively participated in numerous community organizations, committees and coalitions to improve the health of the community. See Appendix A for a listing of Sharp's involvement in community organizations. In addition, the category included costs associated with planning and operating community benefit programs, such as community health needs assessments and administration. * Health Research, Education and Training Programs included education and training programs for medical, nursing and other health care professionals, as well as student/intern supervision; time devoted to generalizable, health-related research projects that were made available to the broader health care community; and financial support of the Sharp HealthCare Professional Education and Research Institute at San Diego State University (SDSU). Economic Value of Community Benefits Provided in FY 2012 In FY 2012, Sharp provided a total of $305,335,556 in community benefits programs and services that were unreimbursed. Table 1 displays a summary of unreimbursed costs based on the categories specifically identified in SB 697. In FY 2012, the State of California and the Centers for Medicare and Medicaid Services approved a Medi-Cal Hospital Fee Program for the time period of January 2011 through December 2013. This resulted in an increased reimbursement of $153.4 million and an assessment of a quality assurance fee totaling $101.1 million in FY 2012. The net impact of the program totaling $52.3 million reduced the amount of unreimbursed medical care service for the Medi-Cal population. This reimbursement helped offset prior years' unreimbursed medical care services, however the additional funds recorded in FY 2012 understate the true unreimbursed medical care services performed for the past fiscal year. Table 1: Total Economic Value of Community Benefits Provided Sharp HealthCare Overall - FY 2012 Senate Bill 697 Category Programs and Services Included in Senate Bill 697 Category Estimated FY 2012 Unreimbursed Costs *Medical Care Services Shortfall in Medi-Cal $59,465,473 Shortfall in Medicare $132,907,288 Shortfall in San Diego County Indigent Medical Services $33,285,408 Shortfall in CHAMPVA/TRICARE $3,460,691 Shortfall in Workers' Compensation $31,286 Charity Care and Bad Debt $65,682,992 *Other Benefits for Vulnerable Populations Patient transportation and other assistance for the needy $2,490,485 *Other Benefits for the Broader Community Health education and information, support groups, health fairs, meeting room space, donations of time to community organizations and cost of fundraising for community events $2,143,857 *Health Research, Education and Training Programs Education and training programs for students, interns and health care professionals $5,868,076 TOTAL $305,335,556 Table 2 shows a listing of these unreimbursed costs provided by each Sharp entity. Table 2: Total Economic Value of Community Benefits Provided Sharp HealthCare Entities - FY 2012 Estimated FY 2012 Unreimbursed Costs *Sharp Chula Vista Medical Center $50,452,708 *Sharp Coronado Hospital and Healthcare Center $10,281,860 *Sharp Grossmont Hospital $108,907,011 *Sharp Mary Birch Hospital for Women & Newborns $6,074,797 *Sharp Memorial Hospital $119,435,933 *Sharp Mesa Vista Hospital and Sharp McDonald Center $10,041,903 *Sharp Health Plan $141,344 *ALL ENTITIES $305,335,556 Table 3 includes a summary of unreimbursed costs for each Sharp entity based on the categories specifically identified in SB 697. Sharp leads the community in unreimbursed medical care services among San Diego County's SB 697 hospitals and health care systems. Table 3: FY 2012 Detailed Economic Value of Community Benefits at Sharp HealthCare Entities Based on Senate Bill 697 Categories Sharp Chula Vista Medical Center *Medical Care Services - $48,647,016 *Other Benefits for Vulnerable Populations - $467,891 *Other Benefits for the Broader Community - $319,937 *Health Research, Education and Training Programs - $1,017,864 *Estimated FY 2012 Unreimbursed Costs - $50,452,708 Sharp Coronado Hospital and Healthcare Center *Medical Care Services - $9,934,485 *Other Benefits for Vulnerable Populations - $27,932 *Other Benefits for the Broader Community - $140,309 *Health Research, Education and Training Programs - $179,134 *Estimated FY 2012 Unreimbursed Costs - $10,281,860 Sharp Grossmont Hospital *Medical Care Services - $106,253,232 *Other Benefits for Vulnerable Populations - $729,968 *Other Benefits for the Broader Community - $682,222 *Health Research, Education and Training Programs - $1,241,589 *Estimated FY 2012 Unreimbursed Costs - $108,907,011 Sharp Mary Birch Hospital for Women & Newborns *Medical Care Services - $5,468,616 *Other Benefits for Vulnerable Populations - $48,031 *Other Benefits for the Broader Community - $133,424 *Health Research, Education and Training Programs - $424,726 *Estimated FY 2012 Unreimbursed Costs - $6,074,797 Sharp Memorial Hospital *Medical Care Services - $116,592,880 *Other Benefits for Vulnerable Populations - $742,724 *Other Benefits for the Broader Community - $562,766 *Health Research, Education and Training Programs - $1,537,563 *Estimated FY 2012 Unreimbursed Costs - $119,435,933 Sharp Mesa Vista Hospital and Sharp McDonald Center *Medical Care Services - $7,936,909 *Other Benefits for Vulnerable Populations - $464,187 *Other Benefits for the Broader Community - $174,013 *Health Research, Education and Training Programs - $1,466,794 *Estimated FY 2012 Unreimbursed Costs - $10,041,903 Sharp Health Plan *Other Benefits for Vulnerable Populations - $9,752 *Other Benefits for the Broader Community - $131,186 *Health Research, Education and Training Programs - $406 *Estimated FY 2012 Unreimbursed Costs - $141,344 ALL ENTITIES *Medical Care Services - $294,833,138 *Other Benefits for Vulnerable Populations - $2,490,485 *Other Benefits for the Broader Community - $2,143,857 *Health Research, Education and Training Programs - $5,868,076 *Estimated FY 2012 Unreimbursed Costs - $305,335,556 Section 3 Community Benefits Planning Process For the past 16 years, Sharp has based its community benefits planning on findings from the triennial Community Health Needs Assessment (CHNA) conducted by San Diego Community Health Improvement Partners (CHIP), as well as the combination of expertise in programs and services of each Sharp hospital and knowledge of the populations and communities served by those hospitals. Methodology to Conduct the 2010 Community Health Needs Assessment Since 1995, Sharp has participated in a countywide collaborative - including a broad range of hospitals, health care organizations, and community agencies - to conduct a triennial CHNA. The 2010 CHNA is publicly available at: http://www.sdchip.org/initiatives/charting-the-course-vi.aspx. In 2010, the CHIP Needs Assessment Advisory Council, under the direction of the CHIP Steering Committee, determined a methodology and approach to the sixth edition of the triennial needs assessment, which included a community priority-setting process composed of the following steps: * Review of the 38 Healthy People 2020 focus areas by the Needs Assessment Advisory Council, comprised of more than 30 community stakeholders. Seventeen health issues emerged as a result of the combining and streamlining of these areas by the Council. * Division of the 17 health issues into the following three categories: Overarching Issues, Health-Related Behaviors and Health Outcomes. Health issue briefs were developed to provide detailed information on each of the 17 identified health issues. * Invitation to community leaders throughout San Diego County (72 out of 379 invitees participated) to prioritize each health issue with information from the health issue briefs and based on the following criteria: - Size of the health issues - Seriousness of the health issue - Community resources available to address the health issue - Availability of data/information to evaluate the health issue's outcomes - Each of the health issues were scored separately within the three categories noted above (Overarching Issues, Health-Related Behaviors and Health Outcomes) * Utilization of the Spectrum of Prevention Framework to determine which issues prioritized by the community were most impacted by prevention activities (as opposed to treatment): - Health access and delivery - Social determinants of health - A combination of nutrition, weight status, physical activity and fitness - Injury and violence - Mental health and mental disorders * Discussion of the above identified issues in community forums held in the six regions of San Diego County in order to: - Allow community stakeholders to identify root causes related to each health issue - Begin the process of understanding each issue from a regional perspective - Foster community relationships and promote the voice(s) of San Diego's various regional and subregional communities in the needs assessment process * In-depth analysis of each of the five health issues selected for the 2010 CHNA, identified as: - Health access and delivery - Social determinants of health - Combination of nutrition, weight status, physical activity and fitness - Injury and violence - Mental health and mental disorders Depending on the level of available data, these analyses included an overview of the health issue and its importance; seriousness of the health issue in terms of economic costs, use of resources and/or loss of functional status; incidence data as well as prevalence of morbidity and mortality on the populations most impacted by the health issue; and the local impact of the health issue. In addition to a review of the results from the priority-setting process, the 2010 CHNA utilized information from the following: * Analysis of health-related statistics gathered and analyzed by the County of San Diego Health and Human Services Agency (HHSA), supplemented by data from the California Health Interview Survey (CHIS), California Office of Statewide Health Planning and Development (OSHPD), the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System and census data from the San Diego Association of Governments (SANDAG). * Review of health-related scientific literature * Review of the results from facilitated discussions of six community regional forums held with a cross-section of stakeholders from the San Diego County community Determination of Priority Community Needs: Sharp HealthCare Each Sharp hospital reviewed the 2010 CHNA and used it to determine priority needs for their hospital's communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing programs and services, in addition to the needs of the unique, ever-changing demographics and/or health topics that comprise the entity's service area and region. For example, the specialty hospitals - SMBHWN, SMV, and SMC - reviewed the needs assessment priorities, specifically focusing on issues relevant to women and infants, behavioral health, and substance abuse, respectively. Sharp's general acute-care hospitals reviewed the needs assessment with a focus on the region and/or subregional areas, with the goal of matching community benefit programs and services to the unique needs of the region. Steps Completed to Prepare an Annual Community Benefits Report On an annual basis, each Sharp hospital performs the following steps in preparation of its Community Benefits Report: * Establishes and/or reviews hospital-specific measurable objectives * Verifies the need for an ongoing focus on identified community needs and/or adds new identified community needs * Reports on activities conducted in the prior fiscal year - FY 2012 Report of Activities * Develops a plan for the upcoming fiscal year, including specific steps to be undertaken - FY 2013 Plan * Reports and categorizes the economic value of community benefits provided in FY 2012, according to the framework specifically identified in SB 697 * Reviews and approves a Community Benefits Plan * Distributes the Community Benefits Plan and Report to members of the Sharp Board of Directors and Sharp hospital boards of directors, highlighting activities provided in the prior fiscal year as well as specific action steps to be undertaken in the upcoming fiscal year Ongoing Commitment to Collaboration In support of its ongoing commitment to working with others on addressing community health priorities to improve the health status of San Diego County residents, Sharp executive leadership, operational experts and other staff are actively engaged in the national American Hospital Association, statewide California Hospital Association, Hospital Association of San Diego and Imperial Counties, and other local collaboratives such as the CHIP Access to Health Literacy Initiative and the CHIP Behavioral Health Work Team. Appendix A Sharp HealthCare Involvement in Community Organizations The list below shows the involvement of Sharp executive leadership and other staff in community organizations and coalitions in Fiscal Year 2012. Community organizations are listed alphabetically. * 2-1-1 San Diego Board * Access to Independence * Adult Protective Services * Aging and Independence Services (AIS) * Alzheimer's Association * American Association of Critical Care Nurses, San Diego Chapter * American Cancer Society (ACS) * American College of Cardiology * American College of Healthcare Executives (ACHE) * American Diabetes Association (ADA) * American Health Information Management Association * American Heart Association * American Hospital Association * American Lung Association (ALA) * American Liver Foundation * American Parkinson Disease Association, Inc. * American Psychiatric Nurses Association * American Red Cross of San Diego * Arthritis Foundation (AF) * Association for Ambulatory Behavioral Health Care (National) * Association for Ambulatory Behavioral Health Care of Southern California * Association for Clinical Pastoral Education * Association of California Nurse Leaders (ACNL) * Association of Practical and Professional Ethics (APPE) * Association of Rehabilitation Nurses * Association of Women's Health and Obstetric Neonatal Nurses (AWHONN) * Azusa Pacific University * Bankers Hill Park West Community Development Corporation * Bayside Community Center * Boys and Girls Club of San Diego * Bonita Business and Professional Organization * California Association of Health Plans * California Association of Hospitals and Health Systems * California Association of Physician Groups * California Behavioral Health Board * California College, San Diego * California Council for Excellence * California Department for Public Health * California Dietetic Association, Executive Board * California HealthCare Foundation * California Health Information Association * California Hospice and Palliative Care Association * California Library Association * California Nursing Student Association * California State Bar, Health Subcommittee * California State University - San Marcos * California Teratogen Information Service * California Women Lead * Caring Hearts Medical Clinic * Chelsea's Light Foundation * Community Health Improvement Partners (CHIP) Behavioral Health Work Team * CHIP Board * CHIP Health Literacy Task Force * CHIP Suicide Prevention Work Team * CHIP Independent Living Facilities (ILF) Work Team * Chula Vista Chamber of Commerce * Chula Vista Community Collaborative * Chula Vista Family Health Center * Chula Vista Rotary * City of Chula Vista Wellness Program * Community Emergency Response Team (CERT) * Consortium for Nursing Excellence, San Diego * Coronado Chapter of Rotary International * Coronado Christmas Parade * Coronado Fire Department * Creative Arts Consortium * Council of Women's and Infants' Specialty Hospitals (CWISH) * Cycle EastLake * Diabetes Behavioral Institute * Disabled Services Advisory Board * Downtown San Diego Partnership * East County Senior Service Providers * El Cajon Community Collaborative Council * El Cajon Fire Department * El Cajon Rotary * Emergency Nurses Association, San Diego Chapter * Employee Assistance Professionals Association * EMSTA College * Facing Futures * Family Health Centers of San Diego (FHCSD) * Gardner Group * George Stevens Senior Center * Girl Scouts San Diego Imperial Council, Inc. * Grossmont College * Grossmont Healthcare District * Grossmont Union High School District * Health Care Communicators Board * Helen Woodward Animal Center * Helix Charter High School * Helping Older People Equally (HOPE) * Home of Guiding Hands * Hospital Association of San Diego and Imperial Counties (HASDIC) * HASDIC Community Health Needs Assessment Advisory Group * Health Sciences High and Middle College (HSHMC) Board * I Love a Clean San Diego * International Association of Eating Disorders Professionals (IAEDP) * International Lactation Consultants Association (ILCA) * Jewish Family Services of San Diego * John Brockington Foundation * Kaplan College Advisory Board * Kiwanis Club of Chula Vista * Komen Latina Advisory Council * Komen Race for the Cure Committee * La Maestra Family Clinics * La Mesa Lion's Club * La Mesa Park and Recreation Foundation Board * Las Hermanas * LEAD, San Diego, Inc. * Leukemia & Lymphoma Society * Liberty Charter High School * Mama's Kitchen * March of Dimes * Meals-on-Wheels Greater San Diego * Medical Library Group of Southern California and Arizona * Mended Hearts * Mental Health America Board * Mental Health Coalition * Miracle Babies * Mountain Health and Community Services, Inc. Advisory Board * MRI Joint Venture Board * National Alliance on Mental Illness (NAMI) * National Association of Neonatal Nurses (NANN) * National Association of Hispanic Nurses (NAHN), San Diego Chapter * National Association of Psychiatric Healthcare Systems * National Council on Alcoholism and Drug Dependence (NCADD) * National Hospice and Palliative Care Association * National Initiative for Children's Healthcare Quality * National Kidney Foundation * National Perinatal Information Center * National University * Neighborhood Healthcare Community Clinic Board of Directors * NurseWeek * Orchard Apartments * Pacific Arts Movement (Pac-Arts, formerly the San Diego Asian Film Foundation) * Parents for Addiction, Treatment and Healing (PATH) * Partnership for Philanthropic Planning of San Diego (formerly San Diego Planned Giving Roundtable) * Partnership for Smoke-Free Families * Peninsula Shepherd Senior Center * Perinatal Safety Collaborative * Perinatal Social Work Cluster * Planetree Board of Directors * Professional Oncology Network * Project CARE Council * Public Health Nurse Advisory Board * Recovery Innovations of California (RICA) * Regional Home Care Council * Regional Perinatal System * Residential Care Council * Safety Net Connect * San Diego Community Action Network (SanDi-Can) * San Diegans for Healthcare Coverage * San Diego Healthcare Disaster Council * San Diego Association for Diabetes Educators * San Diego Association of Directors of Volunteer Services * San Diego Association for Healthcare Recruitment * San Diego Black Nurses Association * San Diego Blood Bank * San Diego Brain Injury Foundation * San Diego Caregiver Coalition * San Diego City College * San Diego City Parks and Recreation * San Diego Committee on Employment of People with Disabilities * San Diego Council on Suicide Prevention * San Diego County Perinatal Care Network * San Diego County Taxpayers Association * San Diego Diabetes Coalition * San Diego Dietetic Association Board * San Diego East County Chamber of Commerce Board * San Diego Emergency Medical Care Committee * San Diego Eye Bank Nurses Advisory Board * San Diego Food Bank * San Diego Foundation * San Diego Health Information Association * San Diego Healthcare Disaster Council * San Diego Imperial Council of Hospital Volunteers * San Diego Interreligious Committee * San Diego Lesbian, Gay, Bisexual, and Transgender Community Center, Inc. (The Center) * San Diego Mental Health Coalition * San Diego Mesa College * San Diego North Chamber of Commerce * San Diego Nutrition Council * San Diego Organization of Healthcare Leaders (SOHL), a local ACHE Chapter * San Diego Patient Safety Consortium * San Diego Regional Energy Office * San Diego Regional Homecare Council * San Diego Rescue Mission * San Diego Restorative Justice Mediation Program * San Diego Stroke Consortium * San Diego Urban League * San Diego Regional Chamber of Commerce * San Diego Science Alliance * San Ysidro High School * San Ysidro Middle School * Santee Chamber of Commerce * Schizophrenics in Transition * San Diego State University (SDSU) * Senior Community Centers of San Diego * Sigma Theta Tau International Honor Society of Nursing * Society of Trauma Nurses * South Bay Community Services * South County Economic Development Council * Southern California Association of Neonatal Nurses * St. Vincent de Paul Village * Susan G. Komen Breast Cancer Foundation * Sustainable San Diego * Sweetwater Union High School District (SUHSD) * The Meeting Place * Third Avenue Charitable Organization (TACO) * Trauma Center Association of America * United Way of San Diego County * University of California, San Diego (UCSD) * University of San Diego (USD) * VA San Diego Healthcare System * Veterans Home of Chula Vista * Veterans Village of San Diego * Vista Hill ParentCare * Women, Infants and Children (WIC) * YMCA * YWCA Becky's House * YWCA Board of Directors * YWCA Executive Committee * YWCA In the Company of Women Event Sharp Memorial Hospital (SMH) 8695 Spectrum Center Blvd San Diego CA 921231489 953782169 Hospital CA 501(c)3 3 Sharp HealthCare 1 Grossmont Hospital Corporation (SGH) 8695 Spectrum Center Blvd San Diego CA 921231489 330449527 Hospital CA 501(c)3 3 Sharp HealthCare 1 Sharp Chula Vista Medical Center (SCVMC) 8695 Spectrum Center Blvd San Diego CA 921231489 952367304 Hospital CA 501(c)3 3 Sharp HealthCare 1 Sharp Coronado and Healthcare Center (SCHHC) 8695 Spectrum Center Blvd San Diego CA 921231489 950651579 Hospital CA 501(c)3 3 Sharp HealthCare 1 Sharp Health Plan (SHP) 8695 Spectrum Center Blvd San Diego CA 921231489 330519730 Health Plan CA 501(c)4 N/A Sharp HealthCare 1 Sharp HealthCare Foundation 8695 Spectrum Center Blvd San Diego CA 921231489 953492461 Healthcare Foundation CA 501(c)3 7 Sharp HealthCare 1 Grossmont Hospital Foundation 8695 Spectrum Center Blvd San Diego CA 921231489 330124488 Hospital Foundation CA 501(c)3 7 Grossmont Hospital Corporation 1 SharpCare 8695 Spectrum Center Blvd San Diego CA 921231489 611637133 Dissolved Healthcare Organization CA 501(c)3 3 SharpCare 0 Sharp and Children's MRI Center LLC 7901 Frost Street San Diego CA 92123 330520955 Imaging CA Sharp HealthCare Related 1245578 1903124 0 1 0.33330 Sharp HealthCare ACO LLC 8695 Spectrum Center Blvd San Diego CA 92123 452724833 Accountable Care Organization CA Sharp HealthCare Related 0 0 0.56500 Continuous Quality Insurance SPC PO Box 1092 Grand Cayman CJ Captive Insurance Company CJ Sharp HealthCare C 60182 16975348 1.00000 0 1 1 1 0 0 0 0 1 1 1 1 1 1 1 1 1 1 Sharp Memorial Hospital J 276914 Accrual Accounting Sharp Memorial Hospital K 96874 Accrual Accounting Sharp Memorial Hospital L 8670579 Accrual Accounting Sharp Memorial Hospital O 224879 Accrual Accounting Sharp Memorial Hospital P 786402741 Accrual Accounting Sharp Memorial Hospital Q 2577656 Accrual Accounting Sharp Memorial Hospital R 178158388 Accrual Accounting Grossmont Hospital Corporation J 2512989 Accrual Accounting Grossmont Hospital Corporation L 4352115 Accrual Accounting Grossmont Hospital Corporation O 200634 Accrual Accounting Grossmont Hospital Corporation P 590052202 Accrual Accounting Grossmont Hospital Corporation Q 1859695 Accrual Accounting Sharp Chula Vista Medical Center L 327875 Accrual Accounting Sharp Chula Vista Medical Center P 276645327 Accrual Accounting Sharp Chula Vista Medical Center Q 177706 Accrual Accounting Sharp Chula Vista Medical Center R 10826112 Accrual Accounting Sharp Coronado and Healthcare Center P 74730915 Accrual Accounting Sharp Coronado and Healthcare Center Q 240580 Accrual Accounting Sharp Coronado and Healthcare Center R 6534176 Accrual Accounting Sharp Health Plan L 113764185 Accrual Accounting Sharp Health Plan P 5070582 Accrual Accounting Sharp Health Plan Q 85612 Accrual Accounting Sharp HealthCare Foundation L 3240909 Accrual Accounting Sharp HealthCare Foundation C 1775249 Accrual Accounting Grossmont Hospital Foundation C 404584 Accrual Accounting Continuous Quality Insurance SPC Q 3366086 Accrual Accounting