GROSSMONT HOSPITAL CORPORATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: GROSSMONT HOSPITAL CORPORATION (EIN 33-0449527)
Tax period: 2011-10-01 to 2012-09-30
Filed: 2013-08-12
IRS object ID: 201312249349302521
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-08-12T16:07:44-05:00	Timestamp
Tax Period End Date	2012-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	346565596	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Ernst & Young US LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	4370 La Jolla Village Dr Suite 500	AddressLine1
City	San Diego	City
State	CA	State
ZIP Code	92122	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	330449527	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Grossmont Hospital Corporation	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	GROS	NameControl
Phone	8584995150	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8695 Spectrum Center Blvd	AddressLine1
City	San Diego	City
State	CA	State
ZIP Code	921231489	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Kari Cornicelli	Name
Title	CFO	Title
Phone	6197404465	Phone
Date Signed	2013-08-12	DateSigned
Authorize Third Party	0	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	8585357200	Phone

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

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Michele Tarbet	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	8695 Spectrum Center Blvd	AddressLine1
City	San Diego	City
State	CA	State
ZIP Code	921231489	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	626385999	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.sharp.com	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1991	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	Grossmont Hospital provides inpatient and outpatient medical services to the community.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	10	NbrIndependentVotingMembers
Total Nbr Employees	3679	TotalNbrEmployees
Total Nbr Volunteers	945	TotalNbrVolunteers
Total Gross UBI	656865	TotalGrossUBI
Net Unrelated Business Txbl Income	205176	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	8212893	ContributionsGrantsPriorYear
Contributions Grants Current Year	19501123	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	536862808	ProgramServiceRevenuePriorYear
Program Service Revenue CY	588093300	ProgramServiceRevenueCY
Investment Income Prior Year	7690658	InvestmentIncomePriorYear
Investment Income Current Year	3981349	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1934973	OtherRevenuePriorYear
Other Revenue Current Year	1924635	OtherRevenueCurrentYear
Total Revenue Prior Year	554701332	TotalRevenuePriorYear
Total Revenue Current Year	613500407	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	830992	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	1088165	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	261462650	SalariesEtcPriorYear
Salaries Etc Current Year	278617440	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	1035456	TotalFundrsngExpCurrentYear
Other Expense Prior Year	260340057	OtherExpensePriorYear
Other Expenses Current Year	274572290	OtherExpensesCurrentYear
Total Expenses Prior Year	522633699	TotalExpensesPriorYear
Total Expenses Current Year	554277895	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	32067633	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	59222512	RevenuesLessExpensesCY
Total Assets BOY	435736190	TotalAssetsBOY
Total Assets EOY	526222992	TotalAssetsEOY
Total Liabilities BOY	108539676	TotalLiabilitiesBOY
Total Liabilities EOY	123937919	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	327196514	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	402285073	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	See Schedule O.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	514334700	Expense
Grants	1088165	Grants
Revenue	588093300	Revenue
Description	Grossmont Hospital provides inpatient and outpatient services to the community. Patient days were 121,214 and outpatient visits were 234,654 for the twelve months ended 9/30/12.See Community Benefits Report on Schedule O.	Description
Total Program Service Expense	514334700	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	0	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	3679	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	10	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

Field	Value	IRS element (for citing)
Telephone Number	8584995150	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	8695 Spectrum Center Blvd	AddressLine1
City	San Diego	City
State	CA	State
ZIP Code	921231489	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
Tom Cantor
Director	2.00	X	0	0	0
Sunita V Cooke
Secretary	1.50	X	0	0	0	X
Jerry Fazio
Director	1.00	X	0	0	0
Dave Grundstrom
Director	2.00	X	0	0	0
Peter Hanson MD
Director	1.00	X	44313	0	0
Tom Karlo
Chairman	2.00	X	0	0	0	X
LeRoy Knutson
Director	2.00	X	0	0	0
Marc Kobernick MD
Director	2.00	X	33625	0	0
Randolph Lenac
Director	3.00	X	0	0	0
Michael Long MD
Director	1.50	X	0	0	0
Deborah McElravy
Director	0.50	X	0	0	0
Michael Murphy
President	6.00	X	0	1322158	90854	X
Shirley Murphy
Director	0.50	X	0	0	0
Jim Parker
Vice Chairman/Treasurer	2.00	X	0	0	0	X
Philip Szold MD
Secretary	2.00	X	0	0	0	X
Michele T Tarbet
CEO - GH	55.00	X	0	546029	39306	X
Ann R Pumpian
Assistant Treasurer	1.00		0	682717	36688	X
Carlisle C Lewis III
Assistant Secretary	9.00		0	588387	47006	X
Kari Cornicelli
CFO - GH	55.00		0	218922	28845	X
Maryann C Cone
COO - GH	55.00		0	307477	38011		X
Anthony M Damico
VP Clinical Services - GH	55.00		0	224980	16099		X
Suzanne K Johnson
VP Hospice	40.00		0	221704	15787		X
Patrick J Craychee
Director of Pharmacy - GH	42.00		208592	0	23914		X
Janet L Hanley
VP Patient Care - GH	50.00		0	199279	26583		X
Vincent J Balesteri
Pharmacist	49.00		235762	0	32698			X
Bruce D Schmidt
Mgr Sharp Central Pharmacy	45.00		200834	0	34758			X
Pauline J Lew
Pharmacist	42.00		187575	0	27645			X
Glicerio M Cid Jr
Advanced Clinician	63.00		191892	0	13450			X
Cornelia S Del Rosario
Clinical Nurse	54.00		189979	0	15973			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1292572	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	4311653	TotalReportableCompFrmRltdOrgs
Total Other Compensation	487617	TotalOtherCompensation
Number Individuals GT100 K	419	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	1	CompensationFromOtherSources
Number Of Contractors GT100 K	0	NumberOfContractorsGT100K
Related Organizations	3954188	RelatedOrganizations
Government Grants	15539034	GovernmentGrants
All Other Contributions	7901	AllOtherContributions
Noncash Contributions	15184429	NoncashContributions
Total Contributions	19501123	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
Medicare/Medicaid	900099	319326058	319326058
Patient Services	900099	258176505	258176505
EHR Incentive	900099	5299392	5299392
Medical Office Lease	531120	3426617	3426617
Reference Lab	621500	656865		656865

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	1207863	TotalRevenueColumn
Related Or Exempt Function Income	1207863	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	588093300	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	3696002	TotalRevenueColumn
Exclusion	$3,696,002	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	12553314	Securities
Other	617625	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	12019365	Securities
Other	866227	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	533949	Securities
Other	-248602	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	285347	TotalRevenueColumn
Exclusion	$285,347	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
Parking	812930	967616	$967,616
Auxiliary	453220	795724	$795,724
Cash Discounts	900099	80866	$80,866

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	80429	TotalRevenueColumn
Exclusion	$80,429	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1924635	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	613500407	TotalRevenueColumn
Related Or Exempt Function Income	587436435	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	656865	UnrelatedBusinessRevenue
Exclusion	$5,905,984	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	1088165	Total
Program Services	1088165	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	2506030	Total
Program Services	1499469	ProgramServices
Management And General	1006561	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	166599	Total
Program Services	166599	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	220939870	Total
Program Services	217053483	ProgramServices
Management And General	3886387	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	10296545	Total
Program Services	10087656	ProgramServices
Management And General	208889	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	28157481	Total
Program Services	27511122	ProgramServices
Management And General	646359	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	16550915	Total
Program Services	16246931	ProgramServices
Management And General	303984	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	20130032	Total
Program Services	18861162	ProgramServices
Management And General	1268870	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	761673	Total
Program Services	56209	ProgramServices
Management And General	705464	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	5526373	Total
Management And General	5526373	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	41682	Total
Management And General	41682	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	122709	Total
Management And General	122709	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	40629769	Total
Program Services	39748131	ProgramServices
Management And General	881638	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	4463042	Total
Program Services	60871	ProgramServices
Management And General	4402171	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	17961725	Total
Program Services	17200256	ProgramServices
Management And General	761469	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	19824234	Total
Program Services	19229507	ProgramServices
Management And General	594727	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	8726000	Total
Program Services	7263294	ProgramServices
Management And General	1462706	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	658276	Total
Program Services	636076	ProgramServices
Management And General	22200	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	517744	Total
Program Services	175019	ProgramServices
Management And General	342725	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1716213	Total
Program Services	906764	ProgramServices
Management And General	809449	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	23182872	Total
Program Services	16250814	ProgramServices
Management And General	6932058	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	3248264	Total
Program Services	2767333	ProgramServices
Management And General	480931	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
UBI Taxes	84801	84801
Medical Supplies	66962779		66962779
Medi-Cal Provider Tax	35366516		35366516
System Allocation	15546126	7331721	8214405

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	9101460	Total
Program Services	6982139	ProgramServices
Management And General	1083865	ManagementAndGeneral
Fundraising	1035456	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	554277895	Total
Program Services	514334700	ProgramServices
Management And General	38907739	ManagementAndGeneral
Fundraising	1035456	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2012191	BOY
EOY	4776870	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	37029263	BOY
EOY	30810103	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	46501940	BOY
EOY	73993762	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	270729	BOY
EOY	136754	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	9387834	BOY
EOY	9728590	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2074650	BOY
EOY	2682956	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	460934354	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	240221054	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	203767889	BOY
EOY	220713300	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	120316315	BOY
EOY	159126454	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1117412	BOY
EOY	1274902	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	13257967	BOY
EOY	22979301	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	435736190	BOY
EOY	526222992	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	37137197	BOY
EOY	51959857	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	7624812	BOY
EOY	7648311	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	15500000	BOY
EOY	16007230	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	48277667	BOY
EOY	48322521	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	108539676	BOY
EOY	123937919	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	316920820	BOY
EOY	389738135	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	9203292	BOY
EOY	11474535	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1072402	BOY
EOY	1072403	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	327196514	BOY
EOY	402285073	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	435736190	BOY
EOY	526222992	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	59222512	ReconcilationRevenueExpenses
Reconcilation Other Changes	15866047	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$41,682	OtherActivitiesAmount
Total Lobbying Expenditures IIB	41682	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Explanation of Lobbying Activities:	Identifier
Return Reference	Part II-B, Line 1:	ReturnReference
Explanation	Grossmont Hospital Corporation (GHC) pays annual dues to the California Hospital Association (CHA), the Healthcare Association of San Diego and Imperial Counties (HASDIC), the California Association of Hospitals and Health Systems (CAHHS), the American Hospital Association (AHA) and the California Hospice and Palliative Care Association (CHAPCA). CHA, HASDIC, CAHHS, AHA, and CHAPCA have determined that a portion of their membership dues are used for lobbying purposes. GHC's FY 2012 portion of annual dues calculated to have been used for lobbying was $41,682.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3277151	BeginningOfYearBalance
Contributions	1000	Contributions
Investment Earnings Or Losses	513052	InvestmentEarningsOrLosses
End Of Year Balance	3791203	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3421590	BeginningOfYearBalance
Contributions	38	Contributions
Investment Earnings Or Losses	-112858	InvestmentEarningsOrLosses
Other Expenditures	31619	OtherExpenditures
End Of Year Balance	3277151	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2331612	BeginningOfYearBalance
Contributions	821647	Contributions
Investment Earnings Or Losses	268716	InvestmentEarningsOrLosses
Other Expenditures	385	OtherExpenditures
End Of Year Balance	3421590	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	2245171	BeginningOfYearBalance
Contributions	75087	Contributions
Investment Earnings Or Losses	11354	InvestmentEarningsOrLosses
End Of Year Balance	2331612	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.55000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.45000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	581843	OtherCostOrOtherBasis
Book Value	581843	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	272313609	OtherCostOrOtherBasis
Depreciation	127720909	Depreciation
Book Value	144592700	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4163810	OtherCostOrOtherBasis
Depreciation	1361026	Depreciation
Book Value	2802784	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	135828323	OtherCostOrOtherBasis
Depreciation	103032037	Depreciation
Book Value	32796286	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	48046769	OtherCostOrOtherBasis
Depreciation	8107082	Depreciation
Book Value	39939687	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	220713300	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescription	AmountAmount
Capital Leases Payable	$66,022
Mark to Market Swap	$843,962
Long Term Pension Liability	$16,426,553
Long Term Workers' Compensation Liability	$399,339
Other Liabilities	$16,987
Intercompany Payable	$2,544,084
Allocated Tax Exempt Bonds	$28,025,574

Field	Value	IRS element (for citing)
Total Of Amounts	48322521	TotalOfAmounts
Total Revenue	613500407	TotalRevenue
Total Expenses	554277895	TotalExpenses
Excess Or Deficit For Year	59222512	ExcessOrDeficitForYear
Net Unrealized GL On Investments	12297109	NetUnrealizedGLOnInvestments
Other	$3,568,938	OtherAmount
Total Adjustments	15866047	TotalAdjustments
Excess Or Deficit Per FS	75088559	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	608186815	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	12297109	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	12297109	RevenueNotRptdF990
Revenue Subtotal	595889706	RevenueSubtotal
Investment Expenses Not Included	122709	InvestmentExpensesNotIncluded
Other Revenues Not Included	17487992	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	17610701	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	613500407	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	553305417	TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	553305417	ExpensesSubtotal
Investment Expenses Not Included2	122709	InvestmentExpensesNotIncluded2
Other Expenses Not Included	849769	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	972478	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	554277895	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Description of Intended Use of Endowment Funds:	Part V, Line 4:	Grossmont Hospital Foundation holds 21 board designated and permanent endowments for Grossmont Hospital Corporation that are restricted for a variety of purposes, such as hospice and hospice homes, diabetes, nursing education, cancer treatment, hospital equipment and technology, and more.
Part XI, Line 8 - Other Adjustments:		Change in minimum pension liability 1,946,350. Beneficial Interest in Grossmont Hospital Foundation 1,664,752. Grossmont Imaging LLC (Book/Tax Difference) -42,164. Total to Schedule D, Part XI, Line 8: 3,568,938.
Part XII, Line 4b - Other Adjustments:		Prop G - Donations of Capital/Donations for Capital Purchases 15,539,034. Donations used to Purchase Capital Equipment 981,803. Medical Staff/Auxiliary Revenue 924,991. Grossmont Imaging LLC Book/Tax Difference 42,164.
Part XIII, Line 4b - Other Adjustments:		Medical Staff/Auxiliary Expenses 849,769.
		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.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent350	X	Pcent350
Free Disc Care Medically Indigent	0	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	21309600	TotalCommunityBenefitExpense
Direct Offsetting Revenue	74263	DirectOffsettingRevenue
Net Community Benefit Expense	21235337	NetCommunityBenefitExpense
Percent Of Total Expense	0.03820	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	153373564	TotalCommunityBenefitExpense
Direct Offsetting Revenue	126534445	DirectOffsettingRevenue
Net Community Benefit Expense	26839119	NetCommunityBenefitExpense
Percent Of Total Expense	0.04660	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	28365572	TotalCommunityBenefitExpense
Direct Offsetting Revenue	14686411	DirectOffsettingRevenue
Net Community Benefit Expense	13679161	NetCommunityBenefitExpense
Percent Of Total Expense	0.02460	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	203048736	TotalCommunityBenefitExpense
Direct Offsetting Revenue	141295119	DirectOffsettingRevenue
Net Community Benefit Expense	61753617	NetCommunityBenefitExpense
Percent Of Total Expense	0.10940	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	776925	TotalCommunityBenefitExpense
Net Community Benefit Expense	776925	NetCommunityBenefitExpense
Percent Of Total Expense	0.00140	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	583450	TotalCommunityBenefitExpense
Net Community Benefit Expense	583450	NetCommunityBenefitExpense
Percent Of Total Expense	0.00100	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	66442092	TotalCommunityBenefitExpense
Direct Offsetting Revenue	56437634	DirectOffsettingRevenue
Net Community Benefit Expense	10004458	NetCommunityBenefitExpense
Percent Of Total Expense	0.01800	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1090981	TotalCommunityBenefitExpense
Net Community Benefit Expense	1090981	NetCommunityBenefitExpense
Percent Of Total Expense	0.00200	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	68893448	TotalCommunityBenefitExpense
Direct Offsetting Revenue	56437634	DirectOffsettingRevenue
Net Community Benefit Expense	12455814	NetCommunityBenefitExpense
Percent Of Total Expense	0.02240	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	271942184	TotalCommunityBenefitExpense
Direct Offsetting Revenue	197732753	DirectOffsettingRevenue
Net Community Benefit Expense	74209431	NetCommunityBenefitExpense
Percent Of Total Expense	0.13180	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	43508	TotalCommunityBuildingExpense
Net Community Building Expense	43508	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	24179	TotalCommunityBuildingExpense
Net Community Building Expense	24179	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	67687	TotalCommunityBuildingExpense
Net Community Building Expense	67687	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$11,009,852	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	114640255	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	116949300	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2309045	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 Grossmont Imaging LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	Joint Venture-Diagnostic Imaging	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.50000	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.50000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Grossmont Hospital Corporation	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	5555 Grossmont Center Drive	AddressLine1
City	La Mesa	City
State	CA	State
ZIP Code	91942	ZIPCode

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

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Grossmont Hospital Corporation	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	350.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Medicare Rate	X	MedicareRate
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	9	NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType	Address Line2Address/AddressLine2
Sharp Hospice Care
8881 Fletcher Parkway Suite 336	La Mesa	CA	91942	Hospice
PMB Medical Office Building
8860 Center Drive Suite 100	La Mesa	CA	91942	Outpatient Services
Grossmont Medical Plaza
5525 Grossmont Center Drive Suite	La Mesa	CA	91942	Outpatient Services	LL
Briar Patch
9000 Wakarusa Road	La Mesa	CA	91942	Outpatient Services
Grossmont Imaging LLC
8881 Fletcher Parkway Suite 102	La Mesa	CA	91942	Joint Venture-Diagnostic Imaging
PMB Medical Office Building
8860 Center Drive Suite 200	La Mesa	CA	91942	Outpatient Services-Infusion
LakeView Hospice Home
9472 Loren Drive	La Mesa	CA	91942	Hospice Home
ParkView Hospice Home
5788 Lyden Way	San Diego	CA	92120	Hospice Home
Grossmont Imaging LLC
9640 Mission Gorge Road Suite H	Santee	CA	92071	Joint Venture-Diagnostic Imaging

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
Part I, Line 6a: Grossmont Hospital Corporation's community benefit report is prepared by Sharp HealthCare.
Part I, Line 7: Historical charity care percentages are applied to current revenues to estimate charity on a monthly basis. Actual charity transactions are applied against the estimate and any increase or decrease over estimated amounts is accounted for. Other Cost includes State/County programs included in the S-10 for Medicare Cost Reporting primarily for prison/in custody patient care. RCC were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger with no exclusions, so worksheet C represents direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payer to obtain the fully weighted cost by payer.
Part I, L7 Col(f): Bad debt expense is netted against revenue. As such, $0.00 was backed out of total expenses for column (f) calculation.
Part II: Grossmont Hospital Corporation at times provides a provision for housing for vulnerable patients upon discharge from the hospital.Grossmont Hospital Corporation incurred expenses for disaster preparedness training and capital expenditures.
Part III, Line 4: Bad Debt represents amounts that go unpaid where the patient was determined to have the ability to pay. If an inability to pay is demonstrated, then full or partial Charity is granted and not considered Bad Debt. Bad Debt at Cost should be included as a Community Benefit because, like other shortfall programs, we are required to accept these patients through the Emergency Room or as a referral with "good faith" in collecting.Grossmont Hospital Corporation consolidates into Sharp HealthCare's audited financial statements. The audited financial statements of Sharp HealthCare include a footnote discussing accounts receivable and allowance for doubtful accounts which is included below.* Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, Sharp analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, Sharp analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary. For services associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), Sharp records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.Sharp HealthCare's audited financial statements include a deduction from revenue line on the Combined Statement of Operations titled Provision for Doubtful Accounts. Additionally, the accounts receivable line on the Combined Balance Sheet details the amount of allowance for doubtful accounts that is netted against the receivable balance.
Part III, Line 8: Medicare shortfall should be included as a community benefit because participation in the Medicare program requires all patients be accepted whether through the Emergency Room or as a referral and Grossmont Hospital Corporation must accept the Medicare established rates whether they cover the cost or not. Ratio of Cost to Charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger with no exclusions, representing direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payer to obtain the fully weighted cost by payer.
Part III, Line 9b: It is Sharp's policy to recall/cancel accounts assigned to a collection agency if it is determined, at any time, a patient is eligible for Financial Assistance or Charity care.
Part V, Section B, Line 13g: The hospital has notices posted in the Emergency Department and waiting rooms to notify patients the hospital has a charity care/discounted care policy for financially qualified patients that is available upon request, at the business office, or by calling the phone number provided. Additionally, patients are provided a notice of the hospital policy for charity care and/or partial charity care (discounted care). This notice lists the criteria to qualify for charity care and/or discounted care and informs patients where they may obtain an application.	Grossmont Hospital Corporation
Part VI, Line 2: 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:o Size of the health issueso Seriousness of the health issueo Community resources available to address the health issueo Availability of data/information to evaluate the health issue's outcomeso 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):o Health access and deliveryo Social determinants of healtho A combination of nutrition, weight status, physical activity and fitnesso Injury and violenceo Mental health and mental disorderso Discussion of the above identified issues in community forums held in the six regions of San Diego County in order to:o Allow community stakeholders to identify root causes related to each health issueo Begin the process of understanding each issue from a regional perspectiveo 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:o Health access and deliveryo Social determinants of healtho Combination of nutrition, weight status, physical activity and fitnesso Injury and violenceo Mental health and mental disordersDepending 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 communityIn order to determine the priority needs of the community, the 2010 Community Health Needs Assessment conducted by CHIP was reviewed by each Sharp hospital and used to determine priority needs for their communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing services, in addition to the unique regional, age group and/or health topics.Specifically, Sharp Grossmont Hospital reviewed the needs assessment priorities, specifically focusing on issues relevant to their region and subregional areas with the goal of matching community benefits programs and services to the unique needs of the region with special attention to:* Outreach for flu vaccinations* Health education and screening for seniors* Diabetes education and screening* Cancer education and participation in clinical trials* Stroke education and screening* Heart and vascular disease education and screening* Orthopedic and osteoporosis education and screening* Women's and prenatal health services and education* Prevention of unintentional injuries* Special support services for hospice patients and their loved ones, and the community* Collaboration with local schools to promote interest in health care careers* Support during the transition of care for high-risk, underserved and underfunded patientsIn addition, Sharp Grossmont Hospital:* Incorporates community priorities and community input into its strategic plan and develops service line-specific goals* Estimates an annual budget for community programs and services based on community needs, the prior year's experience and current funding levels* Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided, such as education, screenings and flu shots * Prepares and distributes information on community benefits programs and services through its foundation and community newsletters* Consults with representatives from a variety of departments, to discuss, plan and implement community activities
Part VI, Line 3: Sharp HealthCare's financial assistance policy is in furtherance of its charitable mission. The policy identifies eligibility for, and circumstances under which, financial assistance will be extended to Sharp HealthCare's hospital patients for medically necessary services."Charity Care" is that portion of Sharp HealthCare's charges for medically necessary patient care services provided by a hospital that a patient (either individually or through a third party payer) is unable to pay. Charity Care does not include bad debt, contractual adjustments, or un-reimbursed costs of providing care to patients eligible under government programs for health care services to low-income and medically indigent patients."Financial Assistance," means any reduction of charges for medically necessary services as defined herein that may be made by Sharp HealthCare either for, or on behalf of, a patient who applies to Sharp HealthCare for Financial Assistance and meets Sharp HealthCare's financial eligibility requirements or criteria as described in this policy. For purposes of the policy Financial Assistance includes "charity care" which means a 100% reduction in charges for medically necessary services and "partial charity care" which means a reduction in a portion of charges for such services.All patients should be screened at the time of admission or at registration for ability to pay for services, including whether or not they are candidates for Financial Assistance. Care for patients presenting with a known or possible emergency medical condition or in active labor shall not be delayed in order to assess financial status.In order to both inform patients of the various programs they may be entitled to, and assist them in the application process, Uncompensated Care Specialists provide patient(s) with a Financial Assistance Form. The Uncompensated Care Specialists direct the patient (or their guarantor) to complete a Patient Financial Statement, include specified financial items for both the patient and spouse (if any), direct the patient to return all information within ten days and document in patient's account history notes the substance of any patient discussions and that the Patient Financial Statement was provided.Following internal processing of the Financial Assistance Form, Sharp Uncompensated Care Specialists and/or Private Pay Representatives notify patient of Financial Assistance Application results, document the decision in all approved and denied Financial Assistance Accounts and secure payment arrangements for remaining balance of partial Financial Assistance or denied Financial Assistance accounts. All follow-up and patient interaction is documented in the patient's account history notes.
Part VI, Line 4: The community served by Sharp Grossmont Hospital includes the entire east region of San Diego County, including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. Approximately five percent of the population lives in remote or rural areas of this region. The race/ethnicity breakdown of the community served by Grossmont Hospital is: 55.1% White; 18.7% Hispanic; 7.7% Black; 2.5% Asian/Pacific Islander; and 0.4% Native American. In the County's east region in 2009, 96 percent of children ages 0 to 11, 96.2 percent of children ages 12 to 17 and 86.6 percent of adults ages 18 and older had health insurance, while 97.7 percent of children ages 0 to 11 and 93.7 percent of children ages 12 to 17 had a regular source of medical care - failing to meet the Healthy People (HP) 2020 national targets for health insurance coverage and regular source of medical care. Among uninsured adults ages 18 to 64 years in SDC's east region, 15.7 percent were not currently insured in 2009.
Part VI, Line 5: Grossmont Hospital Corporation has an open medical staff and a community board. Surplus funds generated by hospital operations are re-invested by the organization to fund capital improvements and acquire state of the art medical equipment with the intent of continually improving patient care.
Part VI, Line 6: Sharp HealthCare 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, four skilled nursing facilities, two inpatient rehabilitation programs, 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 also has a Knox-Keene-licensed care service plan, Sharp Health Plan. Serving a population of approximately three million in San Diego County, Sharp is licensed to operate 2,069 beds, has approximately 2,600 Sharp-affiliated physicians and more than 15,000 employees.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. 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 is 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. With 540 licensed beds, Sharp Grossmont Hospital is the largest provider of health care services in San Diego's East County, and operates one of the busiest emergency rooms in San Diego County. Sharp Grossmont Hospital received Magnet Designation for Nursing Excellence by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program is the highest level of honor awarded by the ANCC and is accepted nationally as the gold standard in nursing excellence.
CA	Reports Filed With States	Part VI, Line 7
Sharp HealthCare prepares an annual Community Benefits Report in accordance with the requirements of California Senate Bill (SB) 697, community benefits legislation (According to SB 697, hospitals under the common control of a single corporation or another entity may file a consolidated report with the Calif. Office of Statewide Health Planning and Development (OSHPD)). Sharp HealthCare submits an annual Community Benefits Report to the California OSHPD.The Sharp HealthCare Community Benefits Plan and Report, Fiscal Year 2012 is available online at www.sharp.com/community.No figure is reported on Part III, line 3 (estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's charity care policy) due to all amounts attributable to patients eligible under the charity care policy being reported as charity.The organization incurred additional Medicare shortfall that is not allowed to be reported on Parts I and III, due to the definition of Medicare shortfall as prescribed by the IRS. This additional shortfall arises from the use of the Medicare cost report data which excludes fee based services, non-billable services, and disallowed operating expenses which the organization has determined to be revenues and expenses of the Medicare program and should be included in the total shortfall. A reconciliation of what the organization classifies as Medicare shortfall is as follows:Medicare revenue received reported on Parts I and III - $148,628,171Medicare allowable costs reported on Parts I and III - $158,796,304Shortfall included on Parts I and III - $(10,168,133)Actual Medicare revenue received - $150,617,106Actual Medicare cost - $178,749,231Actual Medicare shortfall - $(28,132,125)Additional Medicare shortfall not on Parts I and III - $(17,963,992)

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
Boys & Girls Clubs of East County
8820 Tamberly Way	Santee	CA	92071	952088013	501(c)(3)	10200	Sponsorship - East County Children's Ball, It Just Takes One Campaign
California Health Foundation & Trust
1215 K Street Suite 800	Sacramento	CA	95814	941498697	501(c)(3)	938015	Medi-Cal Program

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

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedure for Monitoring Grants in the U.S.:	Identifier
Return Reference	Part I, Line 2:	ReturnReference
Explanation	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.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Peter Hanson MD
44313	0	0	0	0	0	0	0	0	0	44313	0	0	0
Marc Kobernick MD
33625	0	0	0	0	0	0	0	0	0	33625	0	0	0
Michael Murphy
0	1084909	0	184453	0	52796	0	75713	0	15141	0	1413012	0	0
Michele T Tarbet
0	458782	0	70747	0	16500	0	24165	0	15141	0	585335	0	0
Ann R Pumpian
0	562083	0	104134	0	16500	0	21547	0	15141	0	719405	0	0
Carlisle C Lewis III
0	478941	0	92946	0	16500	0	32281	0	14725	0	635393	0	0
Kari Cornicelli
0	191352	0	26949	0	621	0	13243	0	15602	0	247767	0	0
Maryann C Cone
0	245969	0	36167	0	25341	0	24473	0	13538	0	345488	0	0
Anthony M Damico
0	180667	0	26863	0	17450	0	9391	0	6708	0	241079	0	0
Suzanne K Johnson
0	178389	0	27871	0	15444	0	267	0	15520	0	237491	0	0
Patrick J Craychee
177491	0	17814	0	13287	0	8504	0	15410	0	232506	0	0	0
Janet L Hanley
0	174218	0	24219	0	842	0	11076	0	15507	0	225862	0	0
Vincent J Balesteri
218419	0	9974	0	7369	0	26335	0	6363	0	268460	0	0	0
Bruce D Schmidt
186890	0	12738	0	1206	0	19312	0	15446	0	235592	0	0	0
Pauline J Lew
186639	0	724	0	212	0	12389	0	15256	0	215220	0	0	0
Glicerio M Cid Jr
187533	0	474	0	3885	0	7343	0	6107	0	205342	0	0	0
Cornelia S Del Rosario
189218	0	474	0	287	0	9829	0	6144	0	205952	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Part I, Line 1a	Non-management staff were paid superior performance awards which were grossed up so the net payment would be a specified amount based on each staff member's productive hours worked during the year. The net payments per staff member ranged from $100 to $300.
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.
Part III	Compensation was paid to Dr. Peter Hanson through Peter B Hanson MD Inc., for medical director services, by Grossmont Hospital Corporation. He was compensated directly by Peter B Hanson MD Inc.	Supplemental Information
Part III	Compensation was paid to Dr. Marc Kobernick through his professional corporation, for medical director and chief of staff services, by Grossmont Hospital Corporation. He was compensated directly by the professional corporation.	Supplemental Information
Part III	Part I, Line 3: The Compensation Committee of Sharp HealthCare, the parent organization, establishes the compensation of the Chief Executive Officer. The Compensation Committee engages independent compensation consultants and the amount is approved by both the Compensation Committee and Board of Directors.	Supplemental Information

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Cynthia Szold
See Part V	130519	Employment	0
Stephen Hanley
See Part V	36080	Employment	0
Grossmont Imaging LLC
See Part V	510910	See Part V	0

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Identifier	Schedule L, Part IV:	Identifier
Explanation	Cynthia Szold, an employee of Grossmont Hospital Corporation, is married to Philip Szold, a director on the Grossmont Hospital Corporation Board.Stephen Hanley, an employee of Grossmont Hospital Corporation, is the son of Janet Hanley, a key employee of Grossmont Hospital Corporation.Kari Cornicelli, Chief Financial Officer of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation.Michele Tarbet, Chief Executive Officer of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation.Anthony Damico, a key employee of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation.	Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckbox	DescriptionDescription	Number Of ContributionsNumberOfContributions	Noncash Contribs Rptd F990NoncashContribsRptdF990	Method Of Determining RevenuesMethodOfDeterminingRevenues
X	Heart/Vas Center	12	12852544	Cost
X	Central Power Plant	12	998852	Cost
X	East Tower	12	1296746	Cost
X	Equipment, Supplies	6	36287	Cost

Field	Value	IRS element (for citing)
Number Of8283 Received	0	NumberOf8283Received
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	1	ReviewProcessUnusualNCGifts
Third Parties Used	0	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

Field	Value	IRS element (for citing)
Identifier	Method for Determining Number of Contributors:	Identifier
Return Reference	Part I, Column (b):	ReturnReference
Explanation	Number of Contributions	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (46 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Program Service Statement	Form 990, Part III, Line 1:	To establish, maintain, conduct, and operate a hospital or hospitals related, associated and complimentary facilities and services, such as, but not limited to, skilled nursing, extended care, outpatient care, home care, and other health care programs, activities, services and facilities. To carry on any educational activities related to rendering care to the sick and injured, or to the promotion of health. To promote and carry on scientific research related to the care of the sick and injured, or to the promotion of health. To participate in any activity designed and carried on to promote the general health of the community. To operate and maintain this corporation and its assets for the benefit of the communities served by Grossmont Healthcare District, a political subdivision of the State of California, organized pursuant to Local Hospital District Law (Division 23 of the California Health & Safety Code), and which is located in San Diego County, California. Generally do anything and everything necessary, expedient or incidental to the foregoing.
	Form 990, Part IV, Line 24a:	Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327). This organization's allocated portion is included in Part X, Line 25.
	Form 990, Part VI, Section A, line 2	Director Dave Grundstrom had business relationships with Director Philip Szold and Director Peter Hanson. Michele Tarbet, Kari Cornicelli, and Anthony Damico were all directors on the governing board of the Grossmont Imaging Joint Venture.
	Form 990, Part VI, Section A, line 6	Sharp HealthCare (FEIN 95-6077327)is the sole member of Grossmont Hospital Corporation.
	Form 990, Part VI, Section A, line 7a	Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members.
	Form 990, Part VI, Section A, line 7b	Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members. Sharp HealthCare also retains the approval rights afforded members for certain significant transactions (e.g. dissolution or sale or transfer of all or substantially all of the assets.)
	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 Accounting & Tax, 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	Grossmont Hospital has a written conflict of interest policy which has been reviewed and approved by the Grossmont Hospital governing board. Grossmont Hospital 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).
	Form 990, Part VII, Section B:	Independent contractors are paid under Sharp HealthCare's tax identification number (95-6077327) and are reported on Sharp HealthCare's tax return.
Hours per week dedicated to related organizations	Form 990, Part VII, Section A:	The following officers and directors dedicated hours to the following organizations which are related to Grossmont Hospital Corporation: Michael Murphy: 30-SHC, 6-SMH, 4-SCVMC, 4-SCHHC, 6-SHP, 4-SHF Carlisle C. Lewis III: 36-SHC, 9-SMH, 3-SCVMC, 3-SCHHC Ann Pumpian: 55-SHC, 1-SMH, 1-SCVMC, 1-SCHHC, 1-SHP Shirley Murphy: 2-GHF Peter Hanson: 2-SHC Michele Tarbet: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Maryann Cone: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Kari Cornicelli: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Suzanne Johnson: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Janet Hanley: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Anthony D'Amico: 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation.
	Form 990, Part X, Line 25:	Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327) and this organization has reported zero on Form 990, Part X, Line 20 and has reported the allocated balance on Line 25.
Changes in Net Assets or Fund Balances:	Form 990, Part XI, line 5:	Net unrealized gains on investments: 12,297,109. Change in minimum pension liability 1,946,350. Beneficial Interest in Grossmont Hospital Foundation 1,664,752. Grossmont Imaging LLC (Book/Tax Difference) -42,164. Total to Form 990, Part XI, Line 5: 15,866,047.
	Form 5471	Form 5471 has been filed on behalf of by Sharp HealthCare (FEIN 95-6077327).
FY 2012 Community Benefits Report	Form 990, Part III, Line 4a:	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.
		Section 4 Sharp Grossmont Hospital * Sharp Grossmont Hospital (SGH) is located at 5555 Grossmont Center Drive in La Mesa, ZIP code 91942. * Sharp HospiceCare is located at 8881 Fletcher Parkway in La Mesa, ZIP code 91942. FY 2012 Community Benefits Program Highlights SGH provided a total of $108,907,011 in community benefits in FY 2012. See Table 1 for a summary of unreimbursed costs based on the categories identified in SB 697. Table 1: Economic Value of Community Benefits Provided Sharp Grossmont Hospital - 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, financial support for on-site workers to process Medi-Cal eligibility forms $27,371,553 Shortfall in Medicare $40,069,351 Shortfall in San Diego County Indigent Medical Services $14,396,722 Shortfall in CHAMPVA/TRICARE $250,215 Charity Care and Bad Debt $24,165,391 Other Benefits for Vulnerable Populations Patient transportation, Project HELP and other assistance for the needy $729,968 Other Benefits for the Broader Community Health education and information, health screenings, health fairs, flu vaccinations, support groups, meeting room space, donations of time to community organizations and cost of fundraising for community events $682,222 Health Research, Education and Training Programs Education and training programs for students, interns and health care professionals $1,241,589 TOTAL $108,907,011 Key highlights: * Unreimbursed Medical Care Services included uncompensated care for patients who were unable to pay for services; the unreimbursed costs of public programs such as Medi-Cal, Medicare, and San Diego County Indigent Medical Services; and financial support for onsite workers to process Medi-Cal eligibility forms. 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 $51.4 million to SGH and an assessment of a quality assurance fee totaling $36.3 million in FY 2012. The net impact of the program totaling $15.1 million reduced the amount of unreimbursed medical care services for the Medi-Cal population at SGH. 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. * Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; comprehensive prenatal clinical and social services to low-income, low-literacy women with Medi-Cal benefits; Project HELP; Project CARE; contribution of time to Stand Down for Homeless Veterans and the San Diego Food Bank; the Sharp Humanitarian Service Program; Meals-on-Wheels Greater San Diego; and other assistance for the needy. * Other Benefits for the Broader Community included health education and information on a variety of topics; support groups; participation in community health fairs and events and health screenings for stroke, blood pressure, glucose, balance/fall prevention, depression, lung function, peripheral artery disease, vascular disease, carotid artery disease, and diseases or disorders of the hands, such as arthritis and tendonitis; flu vaccination clinics for heart disease patients and high-risk adults; and the Breast Cancer Patient Navigator Program. The hospital's Senior Resource Center offered flu vaccinations and specialized education and information. SGH staff collaborated with local schools to promote interest in health care careers. SGH also offered meeting room space at no charge to community groups. In addition, staff at the hospital actively participated in community boards, committees, and civic organizations, such as Aging and Independence Services (AIS), La Mesa Park and Recreation Foundation, East County Chamber of Commerce, Neighborhood Healthcare Community Clinics, Santee Chamber of Commerce, Salvation Army Kroc Center Board, Meals-on-Wheels Greater San Diego Advisory Board, San Diego Nutrition Council, San Diego County Social Services Advisory Board, YMCA, San Diego Caregiver Coalition and the East County Senior Service Providers. See Appendix A for a listing of Sharp community involvement. 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 of health care professionals; student and intern supervision; time devoted to health-related research projects that were generalizable and 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). Definition of Community The community served by SGH includes the entire east region of San Diego County (SDC), including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. Approximately five percent of the population lives in remote or rural areas of this region. Description of Community Health In the County's east region in 2009, 96 percent of children ages 0 to 11, 96.2 percent of children ages 12 to 17 and 86.6 percent of adults ages 18 and older had health insurance - failing to meet the Healthy People (HP) 2020 national targets for health insurance coverage. See Table 2 for a summary of key indicators of access to care, and Table 3 for data regarding eligibility for Medi-Cal Healthy Families. Table 2: Health Care Access in San Diego County's East Region, 2009 Description/Rate Health Insurance Coverage Children 0 to 11 Years Rate - 96.0% Year 2020 Target - 100% Children 12 to 17 Years Rate - 96.2% Year 2020 Target - 100% Adults 18 + Years Rate - 86.6% Year 2020 Target - 100% Regular Source of Medical Care
		Children 0 to 11 Years Rate - 97.7% Year 2020 Target - 100% Children 12 to 17 Years Rate - 93.7% Year 2020 Target - 100% Adults 18 + Years Rate - 89.7% Year 2020 Target - 89.4% Not Currently Insured Adults 18 to 64 Years Rate - 15.7% Source: 2009 CHIS Table 3: Medi-Cal (Medicaid)/Healthy Families Eligibility, Among Uninsured in San Diego County (Adults Ages 18 to 64 years) 2009 Description/Rate Medi-Cal Eligible - 8.3% Healthy Families Eligible - 0.8% Not Eligible - 90.9% Source: 2009 CHIS Heart disease and cancer were the top two leading causes of death in the County's east region. See Table 4 for a summary of leading causes of death in the east region. Table 4: Leading Causes of Death in San Diego County's East Region 2010 Cause of Death Number of Deaths Percent of Total Deaths Malignant neoplasms 883 25.2% Diseases of heart 818 23.4 Chronic lower respiratory diseases 196 5.6 Alzheimer's disease 186 5.3 Cerebrovascular diseases 179 5.1 Accidents (unintentional injuries) 170 4.9 Diabetes mellitus 132 3.8 Essential (primary) hypertension and hypertensive renal disease 83 2.4 Intentional self-harm (suicide) 61 1.7 Chronic liver disease and cirrhosis 58 1.7 Influenza and pneumonia 47 1.3 Parkinson's disease 34 1.0 Nephritis, nephritic syndrome and nephrosis 27 0.8 Viral hepatitis 26 0.7 Septicemia 24 0.7 All other causes 577 16.5 Total Deaths 3,501 100.0% Source: County of San Diego, HHSA, Public Health Services, Community Epidemiology Branch Community Benefits Planning Process In addition to the steps outlined in Section 3 regarding community benefits planning, SGH: Incorporates community priorities and community input into its strategic plan and develops service line-specific goals * Estimates an annual budget for community programs and services based on community needs, the prior year's experience and current funding levels * Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided such as education, screenings and flu vaccinations * Prepares and distributes information on community benefits programs and services through its foundation and community newsletters * Consults with representatives from a variety of departments to discuss, plan and implement community activities Priority Community Needs Addressed in Community Benefits Report SGH's Community Benefits Report addresses the following identified community needs: * Outreach for flu vaccinations * Health education and screening for seniors * Diabetes education and screening * Cancer education and participation in clinical trials * Stroke education and screening * Heart and vascular disease education and screening * Orthopedic and osteoporosis education and screening * Women's and prenatal health services and education * Prevention of unintentional injuries * Special support services for hospice patients, their loved ones and the community * Collaboration with local schools to promote interest in health care careers * Support during the transition of care for high-risk, underserved and underfunded patients For each priority community need identified above, subsequent pages include a summary of the rationale and importance of the need, measurable objective(s), FY 2012 Report of Activities conducted in support of the objective(s), and FY 2013 Plan of Activities.
		Identified Community Need: Outreach for Flu Vaccinations Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified keeping immunizations current as the seventh most important health-related behavior overall in the 2010 CHNA. * Findings presented in the 2010 CHNA revealed that uninsured individuals are less likely to get recommended care for disease prevention and management. Large differences were observed between individuals with private insurance and those with no insurance for measures related to: cancer screening; diabetes management; dental care; counseling about diet and exercise; and flu vaccination. * Pneumonia and influenza ranked as the ninth leading cause of death in SDC. * In 2010, there were 47 deaths due to pneumonia and influenza in the County's east region. The region's age-adjusted death rate due to pneumonia and influenza was 9.1 per 100,000 population. * In SDC, an estimated 72 percent of seniors 65 years and older were vaccinated for influenza in 2007, failing to meet the HP 2020 target of at least 90 percent of adults 65 years and older vaccinated annually for influenza. * The CDC recommends annual vaccination against influenza for the following: people aged 50 years and older; adults and children with a chronic health condition; children aged 6 months up to their 19th birthday; pregnant women; people who live in nursing homes and other long-term care facilities; and people who live with or care for those at high risk for complications from flu, including health care workers, household contacts of persons at high risk for complications from the flu, and household contacts and caregivers of children younger than 5 years of age. * Flu clinics offered in community settings at no or low cost improve access for those who may experience transportation, cost or other barriers. Measurable Objectives * In collaboration with community partners, offer seasonal flu vaccination clinics at convenient locations for seniors and high-risk adults in the community * Provide information at the seasonal flu clinics about other Senior Resource Center programs and other health education materials FY 2012 Report of Activities SGH's Senior Resource Center coordinated notification of availability and provision of seasonal flu vaccines in selected community settings through activity reminders, collaborative outreach conducted by the flu clinic site and newspaper notices. The SGH Senior Resource Center provided more than 875 seasonal flu vaccinations at 16 community sites to high-risk adults with limited access to health care resources, including seniors with limited resources for transportation and those with chronic illnesses. Sites included senior centers, community centers, churches, senior housing complexes, food banks and hospital departments. At these community sites, SGH provided activity calendars for the Senior Resource Center detailing upcoming community events, including blood pressure clinics, community senior programs and Project CARE. At the food banks, the SGH Senior Resource Center provided vaccines not only to seniors, but also to high-risk community members, many of whom were either uninsured or underinsured, or had limited access to transportation. FY 2013 Plan The SGH Senior Resource Center will conduct the following: * Provide seasonal flu vaccinations at 16 community sites for seniors with limited mobility and access to transportation, as well as high-risk adults, including low-income, minority and refugee populations * Coordinate the notification of seniors regarding the availability of seasonal flu vaccines and the provision of seasonal flu vaccines to high-risk individuals in select community settings * Direct seniors and other chronically ill adults to available seasonal flu clinics, including physicians' offices, pharmacies and public health centers * Work with community agencies to ensure seasonal flu immunizations are offered at sites convenient to seniors and chronically ill adults * Continue to provide seasonal flu immunizations at food bank sites across SDC * Publicize flu clinics through media and community partners Identified Community Need: Health Education and Screening for Seniors Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified heart disease and stroke, cancer, diabetes, arthritis, overweight and obesity, and chronic respiratory disease as the top six health issues facing seniors age 65 years and older in the 2010 CHNA. * In 2010, the leading causes of death among senior adults age 65 years and older in SDC were heart disease; cancer; Alzheimer's disease; stroke; chronic lower respiratory diseases; diabetes; influenza and pneumonia; unintentional injuries; hypertension and hypertensive renal disease; chronic liver disease and cirrhosis; and Parkinson's disease. * In 2007, there were 83,906 visits by seniors aged 65 years and older that were treated and discharged from a SDC Emergency Department (ED) (23,883 per 100,000), or one out of every four senior residents of SDC. The rate of ED discharge increased with age and was higher among females than males. Black and Hispanic seniors had the highest rates of ED discharge, and rates were highest among residents of the County's central and east regions. * In 2009, rates of hospitalization among senior adults age 65 years and older in SDC were higher than the general population due to: coronary heart disease, stroke, diabetes, chronic lower respiratory diseases, non-fatal unintentional injuries (including falls), arthritis and dorsopathy (diseases of the spine). * In 2008, the top causes of ED utilization among persons age 65 years and older were falls, arthritis, chronic lower respiratory diseases, diabetes and stroke. * Older adults utilize more ambulatory care, hospital services, nursing home services and home health services than young people. * Seniors in SDC use the 911 system at higher rates than any other age group. In 2007, 58,060 calls were made to 911 for seniors aged 65 years and older in need of pre-hospital (ambulance) care in SDC, at a rate of 16,526 per 100,000 population, or one out of every six seniors. The rate increased with age to one out of three seniors aged 85 years and older, and was higher for females than for males. * There are an estimated 4 million family caregivers in California today, according to the California Caregiver Resource Center (CRC). Whether aging Californians live in their own homes, with a relative, in an assisted-living residential facility or in a nursing home, one of the keys to their care is family caregiving - defined as those family members and informal care providers who assist with the care of disabled elderly relatives. Reaching out to families and community members who care for older adults helps to maintain the health of older adults as well as their caregivers. * Project CARE is a cooperative safety net designed to ensure the well-being and independence of older persons and persons with disabilities in the community. Through its component services, Project CARE helps people live independently in their homes. The County's east region autonomously administers a local Project CARE site, located at SGH's Senior Resource Center, to meet the unique needs of the community's seniors.
		Measurable Objectives * Host a variety of senior health education and screening programs * Produce activity calendars four times a year * Act as lead agency for East County Project CARE FY 2012 Report of Activities In FY 2012, the SGH Senior Resource Center provided more than 50 free health education programs to nearly 1,400 community members. In addition, the SGH Senior Resource Center provided 14 health screening events, serving more than 630 members of the senior community. Health education topics included hearing, stroke, arthritis, the power of touch, cardiovascular disease, osteoporosis, fitness, diabetes, senior services, patient-provider communication, Project CARE, Vials of Life, Advance Directives for Health Care, financial issues, memory loss, back health, caregiver resources, end-of-life issues, Medicare, depression, chronic pain management, sleep disorders and maintaining a healthy voice. Educational programs were offered at the hospital campus, the Grossmont Healthcare District Conference Center and in various communities in East County. The hospital offered free monthly blood pressure screenings at community sites, along with four balance/fall prevention screenings, and five hand screenings (arthritis, tendonitis, etc.). The hospital also offered health screenings for depression, lung function, diabetes, carotid artery disease and stroke. From these screenings, 65 attendees were referred to physicians for follow-up. The SGH Senior Resource Center also provided a series of physician lectures in FY 2012, covering topics such as arthritis, stroke, chronic pain management and hearing loss. In total, more than 175 community members attended these lectures. Calendars highlighting SGH's Senior Resource Center activities were mailed four times a year to more than 7,650 households. The SGH Senior Resource Center distributed nearly 140 Advance Directives for Health Care, and more than 3,200 Vials of Life, which provide important medical information to emergency personnel for seniors and disabled people living in their homes. Project CARE is a community program that includes the County of San Diego's Aging and Independence Services (AIS), Jewish Family Services, SDG&E, local senior centers, sheriff and police, and many others. Through this program, the SGH Senior Resource Center provided daily Are You OK? phone calls to approximately 40 East County seniors who live alone each day. Are You OK? program participants select regularly scheduled times to receive computerized phone calls at their home. In the event that staff members do not connect with participants through these phone calls, the participants' friends or neighbors are contacted to ensure the participants' safety. In FY 2012, a total of 10,414 phone calls were placed to seniors or disabled individuals, and 122 follow-up phone calls were placed to their friends or neighbors. In collaboration with the San Diego Caregiver Coalition, the SGH Senior Resource Center provided Caregiver Conferences at the La Mesa Community Center, Point Loma Community Presbyterian Church, and College Avenue Baptist Church for nearly 400 family caregivers, and provided education on emotional issues, physical aspects of care giving and community resources. The SGH Senior Resource Center also coordinated an end-of-life conference with Sharp HospiceCare entitled Aging, Planning and Communicating. The conference provided information on how to plan future health care needs and understand available resources to more than 100 community members. The conference also featured experts in the field of aging and health care to assist seniors to more effectively navigate their golden years. The Senior Resource Center also participated in health fairs in El Cajon, Rancho San Diego, Lakeside, Santee, La Mesa, the College Area, and San Diego. In addition, the SGH Senior Resource Center participated in the Sharp HospiceCare Resource and Education Expo at the College Avenue Baptist Church, serving 250 community members. The SGH Senior Resource Center provided blood pressure screenings at the event, as well as educational resources on senior and caregiver services. Through a presence at these community venues, the SGH Senior Resource Center provided education and resources to a total of nearly 1,375 community members. In FY 2012, the Senior Resource Center maintained active relationships with organizations serving seniors, enhancing networking among East County professionals and providing quality programming for seniors. These organizations included AIS (Project CARE and the San Diego Caregiver Coalition), East County Senior Service Providers, Meals-on-Wheels Greater San Diego, and the Caregiver Education Committee. FY 2013 Plan SGH's Senior Resource Center will do the following: * Provide resources at the Senior Resource Center to address relevant concerns of seniors, including health information and community resources through educational programs, monthly blood pressure clinics, and four to eight types of health screenings annually * Utilize Sharp experts and community partners to provide approximately 30 seminars per year that focus on issues of concern to seniors * Participate in six community health fairs and special events targeting seniors * Collaborate with Rancho San Diego YMCA, AIS and East County Action Network on a healthy living for seniors conference * Coordinate two conferences - one dedicated to family caregiver issues in collaboration with San Diego Caregiver Coalition and one focused on chronic care management in collaboration with Sharp HospiceCare * Maintain daily contact through phone calls with individuals (many are home bound) in rural and suburban settings who are at risk for injury or illness, and continue supporting Project CARE services for the East County community * Produce and distribute quarterly calendars highlighting events of interest to seniors and family caregivers * Provide 2,000 Vials of Life to seniors * In collaboration with Sharp HospiceCare, present an Advanced Directives and Health Care Decisions program to inform seniors about advance directives and other necessary documents available to communicate their end-of-life wishes Identified Community Need: Diabetes Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified diabetes as the most important health outcome overall (when considering a total of seven health outcomes) in the 2010 CHNA. * In 2010, there were 132 deaths due to diabetes in SDC's east region. The region's age-adjusted death rate due to diabetes was 26.6 per 100,000 population, the highest of all regions and higher than the SDC age-adjusted rate of 19.1 deaths per 100,000 population. (Note: Diabetes is also a contributing cause of death.) * In 2009, there were 822 hospitalizations due to diabetes in the County's east region. The rate of hospitalizations for diabetes was 174.6 per 100,000 population. The hospitalization rate in the region was higher than the County average of 127.0 diabetes hospitalizations per 100,000 population. * In 2009, there were 709 diabetes-related ED visits in the County's east region. The rate of visits was 150.6 per 100,000 population. The diabetes-related ED visit rate in the region was higher than the County average of 133.0 per 100,000 population. * 4.5 percent of adults in the County's east region participating in the 2009 CHIS indicated that they were ever diagnosed with diabetes. The rate was one of the lowest among SDC's regions and lower than the County rate of 7.8 percent of adults. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's HHSA, the most common risk factors associated with Type II diabetes include overweight and obesity, physical inactivity, smoking, hypertension and abnormal cholesterol. (Note: Two out of three Americans are now overweight or obese.)
		Measurable Objective * Provide diabetes education and screening in the east region of SDC FY 2012 Report of Activities The SGH Diabetes Education Program is recognized by the American Diabetes Association (ADA) and meets national standards for excellence and quality in diabetes education. In FY 2012, the SGH Diabetes Education Program conducted two community educational lectures and five blood glucose screening events at hospital and off-site locations, reaching approximately 380 community members. The SGH Diabetes Education team screened nearly 250 community members during these events. As a result of the screenings, 44 individuals were identified with elevated blood glucose levels and provided with follow-up resources. Screening events were located throughout San Diego's East County, including the Grossmont Healthcare District Library, the Sharp Senior Resource Center at SGH, Mt. Miguel Covenant Village, the 13th Annual Senior Health Fair at the Santee Trolley Square, and the Grossmont Center Health Fair. SGH's Diabetes Education Program conducted community lectures on diabetes at libraries, community centers, educational institutions, national conferences and other hospitals. Screenings and educational events were developed with input from the Diabetes Behavioral Institute. The SGH Diabetes Education Program also continued to support the ADA's Step Out: Walk to Stop Diabetes held in October at Mission Bay through fundraising and team participation. In addition, the SRS Diabetes Education Program conducted a screening event at the student health fair at Cuyamaca College, providing education to and screening more than 50 community members. As a result of these screenings, four individuals were identified with elevated blood glucose levels and received follow-up resources. SGH's Diabetes Education Program conducted educational seminars for health care professionals on the management of diabetes in hospitalized patients and outpatients as well as other topics, including prevention of diabetic heart disease, diabetes and renal failure. In addition, the SGH Diabetes Education team delivered a talk on nutrition to a dialysis support group in El Centro, providing education and resources to approximately 16 community members in the group. In FY 2012, the SGH Diabetes Education Program continued to provide targeted outreach to the newly immigrated Iraqi Chaldean population in San Diego. The program facilitated translation, as well as provided materials and resources to better understand the cultural needs of this newly immigrated population. The resources provided included an information binder on topics, such as: How to Live Healthy With Diabetes; What You Need to Know About Diabetes; All About Blood Glucose for People With Type II Diabetes; All About Carbohydrate Counting; Getting the Very Best Care for Your Diabetes; All About Insulin Resistance; and All About Physical Activity With Diabetes. Handouts were provided in Arabic as well as Somali, Tagalog, Vietnamese and Spanish for additional populations. Education was also provided to staff members regarding the different cultural needs of these communities. FY 2013 Plan The SGH Diabetes Education Program will do the following: * Coordinate and implement blood glucose screenings at community and hospital sites in the County's east region * Conduct educational lectures at various community venues * Continue to support ADA's Step Out: Walk to Stop Diabetes * Continue to collaborate with the Diabetes Behavioral Institute to host community lectures that will assist diabetes patients and their loved ones * Conduct educational symposiums for health care professionals * Continue to provide resources for culturally competent diabetes education and/or outreach to newly immigrated populations * Keep current on resources to give to the community for support of diabetes treatment and prevention * Foster relationships with community clinics to provide education and resources to community members * Develop partnerships with YMCAs in East County to provide screenings, education, and resources to community members Identified Community Need: Cancer Education and Participation in Clinical Trials Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified cancer as the fourth most important health outcome overall (when considering a total of seven health outcomes). * In 2010, cancer was the leading cause of death in the County's east region, responsible for 25.2 percent of deaths. * In 2010, there were 883 deaths due to cancer (all sites) in the County's east region. The region's age-adjusted death rate due to cancer was 180.4 deaths per 100,000 population, higher than the SDC age-adjusted rate of 149.5 deaths per 100,000 population, and higher than the HP 2020 target of 160.6 deaths per 100,000. * In 2007, 23 percent of all cancer deaths in the County's east region were due to lung cancer, 10 percent to colorectal cancer, 7 percent to female breast cancer, 6 percent to prostate cancer, and less than 1 percent to cervical cancer. * Research for the 2010 CHNA recognized the importance of various types of preventative health screenings, including cancer, in preventing disease. * Findings presented in the 2010 CHNA revealed that uninsured individuals are less likely to get recommended care for disease prevention and management. Large differences were observed between individuals with private insurance and those with no insurance for measures related to: cancer screening; diabetes management; dental care; counseling about diet and exercise; and flu vaccination. * According to a 2012 report from the California Cancer Registry, breast cancer is the most common cancer among women in California, with an estimated 292,400 existing cases (42 percent of all cancers). * According to the 2009 Susan G. Komen for the Cure San Diego Affiliate Community Profile Report, San Diego had the highest incidence rate for breast cancer (163.95 per 100,000) compared to the neighboring counties of Imperial, Los Angeles, Orange and Riverside. San Diego's incidence rate for breast cancer is also above that of the State (151.82 per 100,000). * Cancer survivors face many physical, psychological, social, spiritual and financial issues at diagnosis, during treatment and for the remainder of their lives. According to findings presented in the 2007 CHNA, cancer survivors identified several significant burdens, including poorer health, spending more days in bed, increased need for help with activities of daily living and decreased likelihood of employment. * Behavioral and social risk factors associated with cancer deaths include overweight/obesity, poor nutrition, lack of physical activity, and lack of appropriate medical care often due to health disparities, according to research for the 2010 CHNA. * According to the Susan G. Komen for the Cure San Diego Affiliate Community Profile Report, the most common barriers to receiving effective breast health care included lack of awareness and knowledge, financial barriers, cultural barriers and emotional factors. The most common challenges in the current breast health care system included cost of care, quality of providers, lack of communication, and education and language barriers. Increased advocacy, education, funding and partnerships were among the suggestions for improving programs, services and the breast health care system overall. * Breast Cancer Patient Navigator Programs address barriers to quality standard care by providing individualized assistance to patients, cancer survivors and their families.
		Measurable Objectives * Provide cancer education and support services to the community * Participate in cancer clinical trials, including screening and enrolling patients FY 2012 Report of Activities Note: The SGH Cancer Center is accredited by the National Accreditation Program for Breast Centers (NAPBC). The NAPBC grants accreditation to only those centers that voluntarily commit to providing the best possible care to patients with diseases of the breast. The SGH Cancer Center is also accredited by the American College of Surgeons Commission on Cancer Program (CoC). CoC accreditation standards promote comprehensive cancer services, including consultation among surgeons, medical and radiation oncologists, diagnostic radiologists, pathologists, and other cancer specialists, resulting in improved patient care. As part of its journey in comprehensive cancer care, the SGH Cancer Center recently added nutritional and genetic counseling to its services. In FY 2012, SGH Cancer Center participated in a variety of community cancer educational events. These events served more than 800 community members, and included the East County Senior Service Provider Health Event; the It's How We Live Festival; the East County Senior Health Fair at Santee Trolley Station; Learn and Live Events for Breast, Colon and Prostate Cancer; the Summer Healthcare Saturday event at Grossmont Center; Sharp HospiceCare Resource and Education Expo; Sharp's Speaking of Women's Health Conference; the CMF Women's Association Poker Run for Cancer and the Brighton Power of Pink 2012 Making Strides charity event held in Parkway Plaza. SGH Cancer Center staff also supported the American Cancer Society (ACS) Making Strides Against Breast Cancer Walk and the Susan G. Komen Race for the Cure(r) in Balboa Park. At the Race for the Cure event, the SGH Cancer Center also provided educational materials on breast cancer at the resource booth. In addition, SGH Cancer Center staff served as health and science project judges for 40 junior high and high school student projects at the San Diego Science Fair held in Balboa Park. Throughout FY 2012, SGH provided educational sessions to community members whose lives are impacted by cancer through its Learn and Live Events for Breast, Colon and Prostate Cancer. In October, the Live and Learn Breast Cancer seminar provided nearly 50 women in the community with education and resources on topics such as preventative measures, detection and diagnosis, radiation therapy and breast reconstruction. The seminar included physician speakers and also featured a breast cancer survivor who shared her story with seminar attendees. SGH also provided three Live and Learn Prostate Cancer educational seminars to approximately 65 community members during FY 2012. The sessions covered critical issues around prostate cancer, including treatment options with radiation. The SGH Cancer Center continued to offer support programs for cancer patients in FY 2012, including biweekly breast cancer support group meetings. These meetings were held at no cost to participants, with an average attendance of 12 to 15 community members. In addition, the Look Good...Feel Better program - offered through the ACS - provided five classes throughout FY 2012 to approximately 35 women in the community. The program boosts women's self-confidence by teaching them how to cope with skin changes and hair loss using cosmetic and skin care products, wigs, scarves and other accessories. In FY 2012, SGH continued its Breast Health Navigator Program, where an RN certified in breast health personally assists breast cancer patients in their navigation of the health care system. The Breast Health Navigator offers support, guidance, financial assistance referrals, and connection to community resources. Through collaboration with community clinics - including Family Health Centers, Neighborhood Healthcare, and La Maestra Family Clinics - the Breast Health Navigator refers unfunded or underfunded women to local community clinics for a covered mammogram diagnostic work-up or immediate Medi-Cal insurance should their biopsy prove positive and require treatment. The Breast Health Navigator also plays an active role in community education, providing presentations and educational resources about breast cancer, mammography guidelines, and early detection, at no charge to the San Diego community. During pre-lecture educational booths during the Live and Learn Event for Breast Cancer, the Navigator provided breast lump models, demonstrated breast self-exam techniques and answered questions regarding breast health among community attendees. In addition, the Breast Health Navigator facilitated access to care for approximately 180 breast cancer patients in need - many with late-stage cancer diagnoses - through the provision of referrals to various community and national organizations for gas money and gas card assistance. In FY 2012, SGH Cancer Center screened approximately 120 patients for participation in cancer clinical trials. As a result, seven new patients were enrolled in cancer research studies, while 59 patients continued to receive follow up care through the studies. In addition, the SGH Cancer Center trained eight X-ray students from Pima Medical Institute who observed and participated in clinical rotations in radiology. FY 2013 Plan SGH Cancer Center will do the following: * Provide biweekly breast cancer support groups to participants at no charge * Provide free six- to eight-week CLIMB (Children's Lives Include Moments of Bravery) course * Provide six Look Good...Feel Better classes * Continue to provide education and resources to the community with the Breast Health Navigator; also provide ongoing personalized education and information, support and guidance to breast cancer patients and their loved ones as they move through the continuum of care * Screen and enroll oncology patients in clinical trials for research studies * Provide educational lectures to the community on leading forms of cancer and radiation oncology treatment options * Provide educational information on cancers and available treatments through community physician lectures and participation in health fairs and events with demonstrations on breast self-exams Identified Community Need: Stroke Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * San Diego Community Health Improvement Partners (CHIP) members identified heart disease and stroke as the second most important health outcomes overall (when considering a total of seven health outcomes). * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's Health and Human Services Agency (HHSA), in 2007, stroke was the third leading cause of death in SDC. * In 2010, there were 179 deaths due to cerebrovascular diseases in SDC's east region. The region's age-adjusted death rate due to cerebrovascular diseases was 35.7 deaths per 100,000 population. The region's age-adjusted death rate was the second highest of all regions and higher than the SDC age-adjusted rate of 33.7 deaths per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, if no changes are made in risk behavior, based on current disease rates, it is projected that the total number of deaths from heart disease and stroke will both increase by 38 percent by the year 2020. * In 2009, there were 1,289 hospitalizations due to stroke in SDC's east region. The rate of hospitalizations for stroke was 273.7 per 100,000 population. The stroke hospitalization rate in the east region was the highest among SDC's regions and higher than the County average of 211.4 stroke hospitalizations per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, in 2007, nearly 63 percent of hospitalizations were due to heart disease and stroke. If no changes are made in risk behavior, based on current rates, the total number of hospitalizations is projected to increase by 31 percent for stroke by the year 2020. * In 2009, there were 236 stroke-related ED visits in the County's east region. The rate of visits was 50.1 per 100,000 population. The stroke-related ED visit rate in the east region was the highest among SDC's regions and higher than the County average of 41.0 stroke ED visits per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, the most common risk factors associated with stroke include physical inactivity, obesity, hypertension, cigarette smoking, high cholesterol and diabetes.
		* Although the east suburban area has the same percentage of seniors age 65 and over as the county of San Diego (11 percent), a higher percentage (15.2 percent) of the east rural area population are seniors. Measurable Objective * Provide stroke education and screening services for the community, with an emphasis on seniors FY 2012 Report of Activities Note: SGH is recognized with advanced certification by The Joint Commission as a Primary Stroke Center. The program is nationally recognized for its outreach, education and thorough screening procedures, as well as documentation of its success rate. Sharp Grossmont Hospital is a recipient of the American Heart Association's Get With the Guidelines (GWTG) Gold Plus Achievement Awards for Stroke. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with stroke patients. SGH's Stroke Center conducted stroke screening and educational events to educate the public on stroke risk factors, warning signs and appropriate interventions, including arrival at hospitals within early onset of symptoms. In FY 2012, the hospital conducted eight community screenings/educational events in East SDC, serving more than 250 attendees from the community. The events were held at the Sharp Grossmont Senior Resource Center; Summer Healthcare Saturday at Grossmont Center; Spring Valley Health Fair; Country Fair in Campo; American Association of Retired Persons (AARP) Live Well San Diego at the Ronald Reagan Community Center in El Cajon; Lemon Grove Library Health Fair; East County Senior Health Fair at Santee Trolley Center; and the Good Samaritan Retirement Center in Rancho San Diego. SGH's Stroke Center also provided stroke screenings and educational materials at St. Michael's Catholic Church in Paradise Hills, reaching more than 60 community members during the event. In addition to offering stroke screenings at these events, SGH provided education and advised behavior modification, including smoking cessation, weight reduction and stress reduction for community members with health risk factors identified during the stroke screenings. In addition, in May SGH's Stroke Center presented a Meet the Physician lecture entitled Stroke Is a Brain Attack organized through the Senior Resource Center. In May, Sharp's systemwide stroke program participated in the Strike Out Stroke Night at the Padres event, held at Petco Park. The event was a collaboration with the San Diego Stroke Consortium and the County of San Diego. Sharp participated along with Scripps Health, Palomar Health, Tri City Medical Center, Alvarado Hospital, Kaiser Foundation Hospital San Diego, University of California, San Diego (UCSD) Health and the San Diego Padres to promote an evening of stroke awareness and survivor celebration. More than 900 community members attended the event, and more than 40 screenings were provided to attendees. Additionally, stroke education was provided throughout the evening to the entire stadium of 19,000 community members via the prominently displayed JumboTron. In FY 2012, the SGH Outpatient Rehabilitation Department offered a stroke support group for stroke survivors and their family members at no charge to participants. In addition, SGH actively participated in the quarterly San Diego County Stroke Consortium, a collaborative effort to improve SDC stroke care and discuss issues impacting stroke care in SDC. In November 2011, SGH provided expert speakers on stroke and interventional radiology procedures to approximately 200 attendees at the Vascular Symposium designed for local physicians and health care workers. Speakers also presented related topics to approximately 130 attendees at the Cardiac Nursing Symposium held in March 2012. Additionally, SGH collaborated with SDC to provide data for the County's stroke registry. FY 2013 Plan SGH Stroke Center will do the following: * Participate in stroke screening and education events in the east region of SDC * Provide education for individuals with identified risk factors * Offer a stroke support group, in conjunction with the hospital's Outpatient Rehabilitation Department * Participate with other SDC hospitals in the Stroke Consortium * Continue to provide data to the SDC stroke registry * Continue to collaborate with the state of California to develop a stroke egistry * Provide at least one physician speaking event around stroke care and prevention * Participate in SGH Heart and Vascular Conference for community physicians and nurses * Provide stroke education and screenings for Sharp's Women's Health Conference Identified Community Need: Heart and Vascular Disease Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified heart disease and stroke as the second most important health outcomes overall (when considering a total of seven health outcomes). * Vascular disease affects approximately 12 percent of the population in the U.S., but most people do not have symptoms. Among persons over age 55 years, 10 to 25 percent are affected. Those with vascular disease have a six-fold higher death rate due to cardiovascular disease than those without vascular disease. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report from the County's HHSA, in 2007 heart disease was the second leading cause of death in SDC. * In 2010, there were 818 deaths due to heart disease in SDC's east region. The region's age-adjusted death rate due to diseases of the heart was 164.1 per 100,000 population. The region's age-adjusted death rate was the second highest of all regions, higher than the SDC age-adjusted rate of 146.6 deaths per 100,000 population, and higher than the Healthy People (HP) 2020 target of 100.8 deaths per 100,000. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, if no changes are made in risk behavior, based on current disease rates, it is projected that by the year 2020, the total number of deaths from heart disease and stroke will both increase by 38 percent. * In 2009, there were 1,988 hospitalizations due to coronary heart disease in the County's east region. The rate of hospitalizations for coronary heart disease was 422.2 per 100,000 population. The hospitalization rate in the east region was the highest of all regions and higher than the County average of 318.0 coronary heart disease hospitalizations per 100,000 population. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, in 2007, almost 63 percent of hospitalizations were due to heart disease and stroke. If no changes are made in risk behavior, based on current rates, it is projected that by the year 2020 the total number of hospitalizations is projected to increase by 28 percent for heart disease. * In 2009, there were 159 coronary heart disease-related ED visits in SDC's east region. The rate of visits was 33.8 per 100,000 population. The coronary heart disease-related ED visit rate in the east region was the highest of all regions and higher than the County average of 24.6 per 100,000 population. * In 2009, 5.2 percent of adults in the County's east region participating in the 2009 CHIS indicated that they were ever diagnosed with heart disease, lower than the County statistic of 6.4 percent. * The 2010 CHNA recognized smoking cessation, increasing physical activity, achieving healthy weight status and improving nutrition as health-related behaviors that are important components in long-term health. * According to the 3-4-50 Chronic Disease in San Diego County 2010 report, the most common risk factors associated with heart disease include physical inactivity, obesity, hypertension, cigarette smoking, high cholesterol and diabetes.
		Measurable Objectives * Provide heart and vascular education and screening services for the community, with an emphasis on adults, women and seniors * Participate in programs to improve the care and outcomes of individuals with heart and vascular disease FY 2012 Report of Activities SGH is recognized as a Blue Distinction Center for Cardiac Care(r) by Blue Cross/Blue Shield (BCBS) for demonstrated expertise in delivering quality cardiac health care. SGH is also a recipient of the American Heart Association's GWTG Gold Performance Achievement Award for heart failure care. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with congestive heart failure patients. In February, SGH provided a multicultural cardiopulmonary resuscitation (CPR) and automated external defibrillator training to approximately 25 community members. Held at Chula Vista Municipal Golf Course, the training focused on CPR techniques for the lay rescuer, including friends and family members. In March, SGH also provided a congestive heart failure (CHF) class covering topics such as exercise, nutrition, treatment plans and symptoms. In addition, SGH's Cardiac Rehabilitation Department served approximately 350 individuals through cardiac education classes. These classes, offered twice per month, were open to community members and provided education and resources on heart disease and its risk factors. Throughout FY 2012, SGH provided education and resources on cardiac health at various community events, including Celebrando, December Nights, and Speaking of Women's Health. Approximately 1,500 community members attended these events, and the SGH Cardiac Training Department offered education on critical issues of cardiac health, including prevention, evaluation, and treatment. SGH also provided cardiovascular disease preventative screenings throughout FY 2012, serving approximately 145 community members. Additionally, SGH continued to provide meeting space for the La Mesa chapter of Mended Hearts - a cardiac support group for community members. In addition, SGH's Cardiac Rehabilitation Program participated in the Summer Healthcare Saturday Health Fair at Grossmont Center, as well as the Santee Senior Health Fair, serving approximately 120 community members through these events. In October, the SGH Cardiac Rehabilitation Department also conducted a flu vaccination clinic for heart disease patients, seniors and high-risk adults. Throughout the year, SGH provided expert speakers on heart disease and heart failure for various professional events, including SGH's Cardiac Symposium and SGH's Vascular Symposium. SGH also participated in several programs to improve the care and outcomes of individuals with heart and vascular disease. To assist in improving care for acutely ill patients in the County, SGH provided data on STEMI (ST elevation myocardial infarction or acute heart attack) to San Diego County Emergency Medical Services (EMS). New in FY 2012, SGH collaborated with Scripps Health on a research study to examine the character of circulating endothelial cells in acute myocardial infarction, and the potential for these cells to serve as markers to determine a heart attack more quickly and efficiently. SGH's Cardiac Department is committed to supporting future health care leaders through active participation in student training and internship programs. The Sharp Grossmont Cardiac Catheterization Lab hosted a Grossmont College cardiovascular technologist student three days per week, eight hours per day for eight months, for a total of more than 750 hours. The Cath lab RN and staff also worked with a nursing student every Tuesday during the school year. The Noninvasive Cardiology Department also hosted students in echocardiography, electrocardiography and vascular laboratory two days per week during the school year. FY 2013 Plan SGH will do the following: * Provide free bimonthly cardiac education classes by the Cardiac Rehabilitation Department * Provide free CHF education classes * Provide cardiac and/or vascular risk factor education and/or screening through participation in one to two community events, such as health fairs and lectures * Provide weekly preventive heart and vascular screenings * In collaboration with SGH Stroke Center, provide carotid artery screenings for community members Identified Community Need: Orthopedic / Osteoporosis Education and Screening Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * According to the CDC, arthritis is the nation's most common cause of disability. An estimated 50 million U.S. adults (about one in five) report doctor-diagnosed arthritis. As the U.S. population ages, these numbers are expected to increase sharply to 67 million by 2030, and more than one-third of these adults will have limited activity as a result. In addition, a recent study indicated that some form of arthritis or other rheumatic condition affects one in every 250 children (CDC, 2011). * According to the NIH (2006), osteoporosis is responsible for more than 1.5 million fractures each year, including 250,000 wrist fractures, 300,000 hip fractures, 700,000 vertebral fractures, and 300,000 fractures at other sites. * According to an HP 2010 Progress Review released in 2006, osteoporosis is responsible for more than $14 billion in health care costs annually. * According to data presented in the 2007 CHNA, in the U.S., the age-adjusted prevalence of doctor-diagnosed arthritis is estimated to be 21.3 percent among adults ages 18 and over. * According to HP 2020, approximately 80 percent of Americans experience low back pain (LBP) in their lifetime. Each year, it is estimated that 15 to 20 percent of the population develops protracted back pain, 2 to 8 percent have chronic back pain (pain that lasts more than 3 months), 3 to 4 percent of the population is temporarily disabled due to back pain, and 1 percent of the working-age population is disabled completely and permanently due to LBP. * In addition, research for HP 2020 reveals that Americans spend $50 billion each year for LBP, which is the third most common reason to undergo a surgical procedure and the fifth most frequent cause of hospitalization (2009). * In the County's east region from 2007 to 2009, the number of arthritis-related hospitalizations increased from 1,654 to 1,726, while the rate of arthritis-related hospitalizations increased from 359.9 to 366.5 per 100,000 population. The region's 2009 arthritis-related hospitalization rate of 366.5 per 100,000 population was higher than all other SDC regions and higher than the age-adjusted County average of 289.3 arthritis hospitalizations per 100,000 population.
		* In the County's east region from 2007 to 2009, the number of arthritis-related ED discharges increased from 2,003 to 2,241, while the rate of arthritis-related ED discharges increased from 435.9 to 475.9 per 100,000 population. The region's 2009 arthritis-related ED discharge rate of 475.9 per 100,000 population was higher than the age-adjusted County average of 403.7 per 100,000 population. * In the County's east region in 2009, females had a higher ED discharge rate for arthritis-related diagnosis than males (514.0 and 435.9 per 100,000 population, respectively). Blacks had a higher ED discharge rate for arthritis-related diagnosis than persons of other racial or ethnic groups, and persons ages 65 and over had higher ED discharge rates for arthritis-related diagnosis than younger persons. Measurable Objective * Provide education on orthopedics and osteoporosis to the community, with an emphasis on seniors FY 2012 Report of Activities Note: SGH is certified by The Joint Commission in Disease-Specific Care for its Total Knee and Total Hip Replacement Programs. The programs are nationally recognized for their outreach, education and utilization of evidence-based practices, as well as documentation of its performance measures and success rates. In FY 2012, SGH offered quarterly educational sessions on hip and knee problems to more than 230 community members. Topics included management of arthritis and hip/knee repair and treatment. Sessions were held at the Grossmont Healthcare District Conference Center, the John A. Davis Family YMCA in La Mesa and the Rancho Family YMCA in Rancho San Diego. Attendance ranged from 70 to more than 85 individuals at each event. In addition, SGH provided two seminars for treatment of shoulder pain, reaching more than 180 community members and providing education on arthritis, torn rotator cuff, bursitis, frozen shoulder, as well as treatment options. In collaboration with the SGH Senior Resource Center, SGH offered three Fight Fractures with Fitness classes, where a physical therapist provided education on osteoporosis and the prevention benefits of a simple exercise program to more than 130 members of the senior community. Additionally, Sharp offered specialized education on osteoporosis prevention and treatment to the community during the Speaking of Women's Health Conference held at the Sheraton San Diego Hotel and Marina in November. The event served approximately 200 community members, and attendees received education regarding osteoporosis, calcium/vitamin D requirements, and exercise for osteoporosis treatment and prevention. FY 2013 Plan SGH will do the following: * Continue to offer orthopedic, arthritis, joint health and osteoporosis educational presentations to the community * Continue partnership with East County YMCAs to provide education on hip/knee treatment and low-impact exercises for joints * Provide education and resources to the Sharp Women's Health Conference Identified Community Need: Women's and Prenatal Health Services and Education Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * CHIP members identified maternal, infant and child health/family planning as the fifth most important health outcome overall (when considering a total of seven health outcomes) in the 2010 CHNA. * According to a 2006 report by the CDC, progress in the United States to improve pregnancy outcomes - including low birth weight, premature birth, and infant mortality - has slowed, in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat and help women modify behaviors, health conditions and risk factors that contribute to adverse maternal and infant outcomes. * Between 2005 and 2009, mothers in SDC beginning their prenatal care during their first trimester decreased from 87.2 percent to 82.0 percent, a 5.2 percent decrease. * According to HP 2020, the risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception and interconception care. Healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential. * Women who deliver prematurely, experience repeated miscarriages, or develop gestational diabetes are at increased risk of complications with subsequent pregnancies, according to the CDC (2006). * According to the CDC, only 30 percent of women ages 18 years and older engage in regular leisure-time physical activity (CDC, 2008). * Nationally, 35 percent of women ages 20 and older are obese, and 30 percent of these women have hypertension (CDC, 2003 to 2006). * Data from the 2005 CHIS indicate that only 38.6 percent of SDC women ages 18 to 65 consume the recommended five or more servings of fruits and vegetables daily. * According to the 2007 CHIS, only 18.1 percent of adult women (aged 18 to 65 years) in SDC indicated that they engage in moderate physical activity. * In the County's east region, only 13.8 percent of adult women (aged 18 to 65 years) indicated that they engage in vigorous physical activity. The rate of self-reported vigorous physical activity was lower than all SDC regions and lower than the county average of 20.1 percent (CHIS, 2007). Measurable Objectives * Conduct outreach and education activities for women on a variety of health topics as well as prenatal care and parenting skills * Collaborate with community organizations to help raise awareness of women's health issues and services, as well as to provide low-income and underserved women in the San Diego community with critical prenatal services * Participate in professional associations related to women's services and prenatal health and disseminate research * Demonstrate best practices in breastfeeding and maternity care, and provide education and support to new mothers on the importance of breastfeeding FY 2012 Report of Activities In FY 2012, SGH offered four wellness and prevention-related community classes that addressed women's health topics. These classes - led by physicians and topic-experts - reached approximately 185 women. The range of topics for these classes included information on heart health, the health benefits of adequate sleep and the ever-popular cooking demonstrations. This latter class focused on healthy cooking methods for cancer-fighting super foods, and provided recipes, nutritional tips and suggestions for healthy cooking to approximately 85 members of the community. One particular seminar entitled The Doctor Is In: Get Answers to Your Women's Top Health Questions, featured a physician and nurse practitioner who provided education to nearly 30 women in the community on various topics, including heart attack symptoms for women, breast cancer risk, urinary tract infections, Kegel exercises, menopause treatment and critical health screenings for women. In addition, attendees had the opportunity to have their personal health questions answered by health care professionals. During FY 2012, SGH also offered three educational seminars to the community on gynecologic robotic procedures, and provided education and resources on treatment options to nearly 75 women through these sessions.
		Throughout FY 2012, SGH provided free breastfeeding support groups to the community twice a week. Facilitated by RN lactation consultants, each session provided education and support to approximately 25 mothers in the community. SGH also offered weekly postpartum depression support groups for women and families struggling with the challenges and adaptations of having a newborn. SGH participated in and partnered with a number of community organizations and advisory boards for maternal and child health in FY 2012, including the local Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) chapter, Women, Infants, and Children (WIC), California Teratogen Information Service (CTIS), Partnership for Smoke-Free Families, San Diego County Breastfeeding Coalition Advisory Board, the Beacon Council's Patient Safety Collaborative, Association of California Nurse Leaders (ACNL), the regional Perinatal Care Network (PCN), Perinatal Safety Collaborative, and the Public Health Nurse Advisory Board. In FY 2012, SGH provided a poster presentation at the annual AWHONN convention on its successful implementation of the 39 Weeks Is Fine initiative - a program to reduce elective deliveries less than 39 weeks throughout the state of California. SGH also delivered a presentation on this initiative to nurse leaders in the community, sharing the best practices and efforts that resulted in the reduction of the elective delivery rate at SGH by 66 percent. The program also reduced null C-section rates at SGH by nine percent and reduced primary C-section rates from 18 to 15 percent. Over the past fiscal year, SGH implemented critical process improvements to improve breastfeeding rates among new mothers, and continued to explore and participate in opportunities to share these best practices with the broader health care community. Initiatives included facilitating skin-to-skin contact with the newborn immediately after delivery, and implementing early intervention strategies for women identified as having difficulty with breastfeeding. Additionally, SGH is currently seeking Baby-Friendly USA Designation by September 2014 through the implementation of evidence-based maternity care practices. Established by the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO) in 1991, the Baby-Friendly Hospital Initiative (BFHI) recognizes and encourages hospitals and birthing centers that offer high-quality breastfeeding care. The BFHI has been implemented in more than 170 countries, resulting in the designation of more than 20,000 birthing facilities. The requirements for a Baby-Friendly USA Designation include but are not limited to: training health care staff to properly implement a breastfeeding policy; providing education to pregnant women on the benefits of breastfeeding; demonstrating how to breastfeed and maintain lactation to new mothers; encouraging breastfeeding on demand; allowing mothers and infants to remain together 24 hours a day; and establishing breastfeeding support groups and referring mothers to these resources following discharge from the hospital or clinic. Throughout FY 2012, SGH incorporated the requirements of a Baby-Friendly hospital along with other process improvements in order to improve exclusive breastfeeding at discharge. As a result of these comprehensive efforts, SGH Women's Health Center was successful in raising the exclusive breastfeeding rate at discharge from 49 percent in 2011 to 67 percent in 2012. SGH also incorporated quality initiatives to promote the exclusive use of breast milk for Neonatal Intensive Care Unit (NICU) infants by incorporating a pumping log for mothers, documenting exclusive breast milk volumes daily and incorporated early intervention strategies to promote the establishment of breast milk in the first couple of weeks. These strategies promote the nutritional health of high risk infants and prevent inflammatory disease processes that can cause serious bacterial infection in the intestine of sick premature infants and can result in death of intestinal tissue and even progression to blood poisoning or septicemia. In addition, SGH revamped all of the breastfeeding educational resources provided at the community clinics and the childbirth education classes to reflect best practices in breastfeeding for mothers and their families. SGH's Women's Health Center's Prenatal Clinic midwives continued to provide in-kind help at Neighborhood Health Centers in El Cajon and Lakeside, and Family Health Centers of San Diego (FHCSD) throughout FY 2012. The SGH Prenatal Clinic participated in the California Department of Public Health (CDPH) Comprehensive Perinatal Services Program (CPSP) to offer comprehensive prenatal clinical and social services to low-income, low-literacy women with Medi-Cal benefits. Services provided included health education, nutritional guidance and psychological/social issue support, as well as translation services for non-English speaking women. As part of this effort, and in order to reduce the number of women that reach gestational diabetic criteria, women were offered nutrition classes, and those with nutrition issues were referred to an SGH registered dietician or the SGH Diabetes Program as appropriate. At-risk women with elevated BMIs received education and glucometers to measure their sugars and help prevent the development of gestational diabetes. Women with a current diabetes diagnosis were referred to the SGH Diabetes Program. Free education on gestational diabetes was also provided to pregnant members of the community. The SGH Women's Health Center's Prenatal Clinic also provided educational resources tailored specifically to the increasing Chaldean population. In addition, the SGH Women's Health Center continued its partnership with Vista Hill ParentCare to assist drug-addicted patients with psychological and social issues during pregnancy. These approaches have been shown to reduce both low birth weight rates and health care costs in women and infants. The SGH Women's Health Center also provided women with referrals to a variety of community resources including but not limited to CTIS, WIC and the SDC Public Health Nurse. FY 2013 Plan SGH will do the following: * Provide wellness and prevention classes that focus on lifestyle tips to enhance overall health * Provide cooking demonstrations and wellness classes on nutrition and maintaining a healthy lifestyle * Provide videos on various nutrition topics through the SGH website and social media * Provide education on cardiovascular health and wellness as part of the first Women's Heart Health Expo * Partner with Curves La Mesa to provide education on fitness and weight management * Provide free breastfeeding and postpartum support groups * Provide parenting education classes * Participate in community events such as the Sharp Women's Health Conference * Provide medical services to low-income patients through the prenatal clinic * Share evidence-based practices regarding improvements in elective deliveries less than 39 weeks as well as breastfeeding rates at discharge through presentations at national conferences and research publications Identified Community Need: Prevention of Unintentional Injuries Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated.
		Rationale * CHIP members identified injury and violence as the fourth most important health-related behaviors overall (when considering a total of seven health-related behaviors) in the 2010 CHNA. * Injury, including both intentional and unintentional, is the number one killer and disabler of persons aged 1 to 44 in California. * Unintentional injuries - motor vehicle accidents, falls, firearms, fire/burns, drowning, poisoning (including drugs and alcohol, gas, cleaners and caustic substances) and injuries at work - are one of the leading causes of death for SDC residents of all ages, regardless of gender, race or region. * In 2010, unintentional injury was the leading cause of death for persons ages 1 to 4 years and 15 to 34 years, and the sixth leading cause of death overall in SDC. * Between 2006 and 2010, 4,723 San Diegans died as a result of unintentional injuries. * In 2010, there were 170 deaths due to unintentional injury in the County's east region. The region's age-adjusted death rate due to unintentional injuries was 34.7 deaths per 100,000 population, the highest of all regions and higher than the SDC age-adjusted rate of 29.2 deaths per 100,000 population. * In 2009, there were 4,129 hospitalizations related to unintentional injury in the County's east region. The rate of hospitalizations was 876.8 per 100,000 population, the highest of all regions and higher than the County average of 663.9 per 100,000 population. * In 2009, there were 25,245 ED visits related to unintentional injury in the County's east region. The rate of visits was 5,361.0 per 100,000 population, the highest of all regions and higher than the County average of 4,691.2 per 100,000 population. * According to HP 2020, most events resulting in injury, disability or death are predictable and preventable. There are many risk factors for unintentional injury and violence, including individual behaviors and choices, such as alcohol use or risk-taking; the physical environment both at home and in the community; access to health services and systems created for injury-related care; and the social environment, including individual social experiences (social norms, education, victimization history), social relationships (parental monitoring and supervision of youth, peer group associations, family interactions), the community environment (cohesion in schools, neighborhoods and communities) and societal-level factors (cultural beliefs, attitudes, incentives and disincentives, laws and regulations). Measurable Objective * To offer an injury and violence prevention program for children, adolescents, and young adults throughout SDC FY 2012 Report of Activities In FY 2012, ThinkFirst/Sharp on Survival participated in 61 programs that served more than 4,000 elementary, middle and high school students in East County. The programs consisted of one- to two-hour classes on the modes of injury, disability awareness, and the anatomy and physiology of the brain and spinal cord. They also heard personal testimonies from individuals, known as Voices for Injury Prevention (VIPs), with traumatic brain or spinal cord injuries. In addition, ThinkFirst/Sharp on Survival offered schools multiple opportunities for learning with the provision of a variety of lesson plans, including information on physical rehabilitation, careers in health care, and disability awareness panels to meet the needs of specific class curricula. ThinkFirst/Sharp on Survival also spoke to at-risk youth about the consequences of reckless driving, violence, and poor decision making. ThinkFirst/Sharp on Survival participated in a variety of community events throughout FY 2012, including presentations for youth and their parents, health- and safety-related fairs, and community groups. These community-based events and presentations served more than 1,000 participants. Think First/Sharp on Survival participated in the annual Kids Care Fest event sponsored by the Grossmont Healthcare District in La Mesa, providing helmet-fitting information and education on booster and car seats to approximately 500 community members. In addition, children were given the opportunity to win a booster seat by coloring and drawing their version of what a "cool" booster seat looked like. Artwork submissions were mailed into the ThinkFirst office and a winner was picked in November 2012. In October 2011, ThinkFirst/Sharp on Survival also provided proper helmet-fitting information and booster seat education at the El Cajon Fire Department Safety Fair and Open House, serving 500 people. With the partnership and financial support of the Health and Science Pipeline Initiative (HASPI), dozens of schools throughout San Diego County had the opportunity to provide ThinkFirst/Sharp On Survival speakers to their students. These students, who all have an interest in pursuing careers in health care, were provided with classroom presentations and the opportunity to participate in a half-day tour of the Sharp Memorial Rehabilitation Center. In 2012, a dozen high school seniors from Granite Hills toured the rehabilitation center and received an in-depth look at occupational, physical, speech, recreation therapy and nursing careers. Students also rotated through several "stations" run by VIP speakers to practice their wheelchair mobility, lower body dressing and driving skills using the driving simulator. Additionally, students conducted small group patient therapy activities to test memory, organization and a variety of executive cognitive skills. In addition, more than 200 college students enrolled in San Diego State University's (SDSU's) Disability in Society course and received injury prevention education, learning about brain injury, spinal cord injury and disability awareness. In FY 2012, ThinkFirst/Sharp on Survival implemented a booster seat project funded by the Grossmont Healthcare District. The project developed in response to the new California law - implemented in January 2012 - that changed the requirements for booster seats from age six or 60 pounds to age eight or a height of four feet nine inches. The project is modeled after a larger, successful booster seat project implemented by ThinkFirst San Diego, in partnership with the ThinkFirst National Office, and funded by the National Health and Transportation Safety Administration (NHTSA) in 2004. This program not only provided education to parents on specifics of the law and consequences of misuse, but also offered education to alter children's misconceptions that booster seats are for "babies." After two years, the program successfully increased booster seat use in six schools by an average of 19 percent. The ThinkFirst/Sharp on Survival booster seat project will model the best practices from the previous program, and will provide more than 1,500 students with assembly and classroom education, 65 students with a free booster seat, and approximately 1,000 parents and caregivers with information on the new law and the importance of booster seats. The program is scheduled to run through January of 2013. FY 2013 Plan ThinkFirst/Sharp on Survival will do the following: * With funding support from grants, provide educational programming and presentations for local schools and organizations * Increase community awareness of the program through attendance and participation at community events and health fairs using grant funding * Continue to evolve program curricula to meet the needs of health career pathway classes as part of the HASPI partnership * Continue to address the needs of elementary school children and their parents by providing booster seat education with funding support from grants * Continue to provide college students with injury prevention education through SDSU's Disability in Society course * Explore further opportunities to provide education to health care professionals and college students interested in health care careers Identified Community Need: Special Support Services for Hospice Patients and Their Loved Ones and the Community Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated.
		Rationale * As patients and their loved ones deal with death and dying, many experience intense grief over the loss of life, yet have the opportunity to experience a profound transformation. A hospice model - combining medical, spiritual, emotional and other support services - can offer many patients and their families assistance, information and strategies related to bereavement, grief and healing. * A 2004 Journal of the American Medical Association (JAMA) study titled, "Quality of End-of-Life Care and Last Place of Care," examined 1,578 family members of people who died in the year 2000 of non-traumatic causes. Families were asked about the quality of patients' experiences at the last place where they spent more than 48 hours. Significant findings of the study include more than one-third of those cared for by nursing homes, hospitals and home health agencies reported either insufficient or problematic emotional support for the patient and/or family, compared to one-fifth of those in hospice (Source: JAMA January 7, 2004). * As presented in the 2010 CHNA, the Agency for Healthcare Research and Quality has identified coping with the end of life as a component of its National Health Care Quality Report, a conceptual framework for measuring the performance improvement of the U.S. health system in its provision of high-quality care. * A study by the National Hospice and Palliative Care Organization (NHPCO) suggests that hospice may have a positive impact on patients' longevity. The study found that for certain well-defined terminally ill populations, patients who choose hospice care live an average of 29 days longer than similar patients who do not choose hospice, allowing patients and their families extra time for resolution and closure at the end of life (Conner, et al., 2007). * According to a 2011 article in the American Family Physician Journal (AFPJ), in the next few decades, the demand for family caregivers is expected to rise by 85 percent. Furthermore, family caregiving has been affected in several important ways over the past five years: caregivers and care recipients are older and have higher levels of disability than in years past; the duration, intensity and burden of care has increased; the financial cost associated with informal caregiving has risen; and the use of paid formal care has declined significantly. * According to a 2010 article in JAMA, when compared with nursing homes or home health nursing services, bereaved family members report fewer unmet needs for pain and emotional support when the last place of care was hospice. In addition, lower spousal mortality at 18 months was found among bereaved wives of decedents who used hospice care versus those who did not. Measurable Objectives * Provide education, resources, counseling and support to community members with life-limiting illness and their loved ones * Offer education and outreach to the San Diego community concerning hospice and palliative care services within the care continuum * Deliver professional education to community physicians and other health care professionals through innovative care model development * Collaborate with community, state and national organizations to develop and implement appropriate services for the needs of the aging population FY 2012 Report of Activities In FY 2012, Sharp HealthCare was awarded the American Hospital Association's (AHA) Circle of Life Award for Transitions, a home-based palliative care program provided by Sharp HospiceCare and built on four pillars of care: in-home skilled care, evidence-based prognostication, caregiver support and advance care planning. This prestigious national recognition is awarded by the AHA to three health care agencies annually, and honors innovative programs in palliative and end-of-life care. Sharp HospiceCare provides hospice and palliative care within the Sharp HealthCare care continuum. In FY 2012, key services included community and professional education, advance care planning, involvement in community organizations, volunteer and student training, the Memory Bear Program and bereavement counseling and support. Throughout the year, Sharp HospiceCare offered a variety of bereavement service options in Spanish and English, including professional bereavement counseling for individuals, families and groups, as well as education, support groups and monthly newsletter mailings. In FY 2012, Sharp HospiceCare devoted more than 1,650 hours to home, office and phone contacts made to patients and their loved ones, providing them with pre-bereavement and bereavement counseling services by professionals with specific training in grief and loss. In FY 2012, 15 bereavement support groups, including two Spanish-speaking groups, were provided free of charge and served 215 participants. The various groups were facilitated by skilled mental health care professionals who specialize in the needs of the bereaved. A unique event entitled Healing Through the Holidays served nearly 130 adults at five locations with presentations on coping with grief during the holiday season, spirituality during the holidays and a family's grief journey through the holidays. In further support of bereavement counseling, 1,400 people received 13 monthly issues of the bereavement support newsletters, Healing Through Grief (for adults) and Journey to My Heart (for children under 12 years). In addition, Sharp HospiceCare bereavement counselors provided referrals to needed community services including ongoing mental health services, financial assistance, child protective services, drug and alcohol counseling, parent education courses and anger management. In an effort to support bereavement needs throughout the Sharp system, Sharp HospiceCare led a workgroup comprised of an interdisciplinary team from each Sharp entity. As a result of their efforts, a bereavement booklet was developed, When You Lose a Loved One, in English and Spanish, to assist families who have lost a loved one unexpectedly. The booklet is provided to families served throughout Sharp, and functions as a resource and support tool during their time of need. To date, more than 1,000 booklets have been distributed. In FY 2012, Sharp HospiceCare provided community education and outreach to more than 2,500 people at an assortment of educational events, expos, community forums and health fairs at various sites throughout SDC, including service clubs, senior centers, retirement communities, home health agencies, community centers, churches, libraries, colleges and universities. Advance Care Planning (ACP) is a component of the Transitions program that has also been developed into a free community outreach program. Sharp HospiceCare's ACP consultants are available to meet with community members in groups or individually to discuss goals of care and health care preferences, identify an appropriate health care agent and complete an advance directive. In FY 2012, the ACP team provided 17 presentations to more than 400 community members throughout SDC. In addition, the Sharp HospiceCare integrative therapies team provided a monthly stress management class called The Power of Touch, which taught relaxation techniques to nearly 150 family caregivers and their loved ones. In October 2011, Sharp HospiceCare collaborated with Sharp Coronado Hospital and Healthcare Center (SCHHC) to host an event entitled the Aging: Planning and Coping Conference at the SCHHC Sandermann Education Center. During the free conference, more than 30 community members received educational presentations from Sharp physicians and end-of-life professionals, including Health Care Planning: The Importance of Making Your Wishes Known; A Quick Glance at Medicare; Coping with Stress: Understanding Psychological Challenges of Aging; and Geriatric Frailty Syndrome: Understanding the Physiology of the Aging Process. In addition, in April 2012 Sharp HospiceCare and the SGH Senior Resource Center coordinated an end-of-life conference at the La Mesa Community Center entitled Aging: Planning and Communicating. More than 100 community members attended the conference to learn about future health care planning and communicating their wishes to loved ones. The free conference provided community resources from health and senior service agencies, as well as presentations from Sharp HospiceCare leadership and community health experts.
		The Sharp HospiceCare leadership team provided education to physicians, case managers, nurses and other health care professionals at local and national conferences, including the California Hospice and Palliative Care Association (CHAPCA) Conference, the NHPCO Leadership Conference and the American Hospital Association Committee on Performance Improvement. Presentations included Avoiding Avoidable Care, Understanding Geriatric Frailty, Developing a Concurrent Palliative Care Program in an Accountable Care Organization (ACO) Model, Transforming Late Stage Disease Management, Advance Care Planning and Evidence-Based Nursing Home Care. In November 2011, Sharp HospiceCare hosted its sixth annual conference for San Diego end-of-life professionals entitled Caring for End-of-Life Patients in the Age of Health Care Reform. The conference featured a nationally renowned expert in hospice and palliative care and provided more than 200 members of the professional health care community with an in-depth perspective on how caregiver core values influence care and treatment at the end of life. In addition, the conference provided attendees the opportunity to examine health care reform guidelines for hospice and palliative care. In June 2012, approximately 250 community health care professionals attended the Sharp HospiceCare Resource & Education Expo at College Avenue Baptist Church. The expo featured resource exhibits by more than 40 community health agencies supporting end-of-life care, as well as several presentations from community speakers. Presentations included Navigating the Cancer Journey, Donation - Facts vs. Myths, Personal Safety for the Healthcare Provider and Physician Orders for Life-Sustaining Treatment Paradigm (POLST) for Special Populations. In addition, Sharp HealthCare provided presentations entitled Managing Your Personal Power, Injury Prevention, Nursing Skills and Competency, and Delivering on Our Brand Promise, while Sharp HospiceCare leadership provided the expo's keynote address. Sharp HospiceCare also collaborated with a variety of local networking groups and community-oriented agencies to provide caregiver classes, end-of-life programs, advance care planning seminars and web presentations for consumers and health care professionals. Educational presentations in FY 2012 included introduction to Hospice, Bioethics, Hospice and Palliative Care, Hospice and Dementia, Transitions and Oncology and Advance Care Planning. Sharp HospiceCare continues to maintain active relationships and leadership roles with national organizations including NHPCO and CHAPCA, and local organizations including the Hospice and Palliative Nurses Association San Diego Chapter (HPNA), San Diego County Council on Aging (SDCCOA), San Diego Regional Home Care Council (RHCC) and San Diego County Coalition for Improving End of Life Care. Sharp HospiceCare provided extensive training for more than 70 new volunteers in FY 2012. Volunteers underwent a rigorous 32-hour training program to confirm their understanding of and commitment to hospice care. In FY 2012, more than 190 new and returning Sharp HospiceCare volunteers served as part of the hospice interdisciplinary team. Volunteers devoted more than 14,200 hours to the Sharp HospiceCare team, including more than 6,300 hours of direct patient care and nearly 7,900 hours of clerical and administrative support. Sharp HospiceCare also coordinated a volunteer-run wig donation program for community members who suffer from hair loss. During FY 2012, Sharp HospiceCare and its volunteers met with 37 individuals and provided approximately 75 wigs. Sharp HospiceCare supported its volunteers by providing a monthly volunteer support group and recognized their valuable contribution during National Volunteer Month and National Hospice Month. The Memory Bear Program, a component of the Volunteer Program, provides a unique keepsake for family members by making teddy bears from garments of the loved one who has passed on. For surviving family members, these bears become permanent reminders of their loved ones. In FY 2012, Sharp HospiceCare volunteers, who handcraft all bears, devoted more than 5,600 hours to craft nearly 950 bears for more than 280 families. The Sharp HospiceCare Teen Volunteer Program trained 18 teenagers (14 to 18 years old) during FY 2012. The teen program specializes in helping to create family videos; however, teens are also assigned special projects in the office or patient assignments at Sharp HospiceCare's LakeView and ParkView homes. Sharp HospiceCare also hosted a student volunteer from San Diego Metropolitan Regional & Technical High School during FY 2012. The student spent time in both Sharp HospiceCare's administrative office and a Sharp HospiceCare home, and experienced hospice care through case conferences, interdisciplinary team (IDT) meetings and a variety of other tasks. In addition, Sharp HospiceCare's LakeView and ParkView homes served as training sites for approximately 30 SDSU nursing students during the 2011 fall semester. Each student spent an eight-hour day shadowing and learning from the highly skilled and compassionate nursing staff at each of the homes. In FY 2012, Sharp HospiceCare staff provided a lecture on hospice care services and the importance of advance care planning to 20 SDSU nursing students, and a lecture entitled Providing Home Health Services at a Hospice Facility to 15 Certified Nursing Assistant (CNA) students from Grossmont College. In addition, Sharp HospiceCare provided training and supervision to 15 premedical students through the Pre-Professional Program at SDSU. FY 2013 Plan Sharp HospiceCare will do the following: * Continue to provide professional education on hospice-related topics to community members, students and other health care professionals * Provide community education and resource services * Conduct outreach activities to community groups, health care facilities, colleges and universities * Continue to provide training opportunities for nursing students and interns * Provide an end-of-life learning environment in community-based hospice homes * Offer individual and family bereavement counseling and support groups * Provide 13 mailings of bereavement support newsletters * Provide volunteer training programs for at least 75 adults and teens * Offer a Memory Bear program to serve 250 families Identified Community Need: Collaboration With Local Schools to Promote Interest in Health Care Careers Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * The demand for registered nurses and other health care personnel in the United States will continue to rise with the growing health care needs of the 78 million baby boomers that began to retire in 2010. The DHHS estimates that by 2020, there will be a need for 2.8 million nurses, 1 million more than the projected supply. In 2008, the U.S. Department of Labor (DOL) ranked RN as the occupation with the highest demand rate. * According to the 2010 Healthcare Shortage Areas Atlas from the County of San Diego HHSA, SDC is one of 27 counties in California listed as a Registered Nurse Shortage Area. * The DOL reports that allied health professions represent about 60 percent of the American health care work force and projects severe shortages of many allied health care professionals (DOL, 2010). * According to the San Diego Workforce Partnership 2011 report titled Healthcare Workforce Development in SDC: Recommendations for Changing Times, health care occupations that will be in highest demand in the next three to five years include physical therapists, medical assistants, occupational therapists, registered nurses, medical record and health information technicians, radiologic technologists and technicians, pharmacists, and medical and clinical laboratory technologists. * According to the San Diego Workforce Partnership, despite the growing demand for health care workers, employers express an "experience gap" among recent graduates as a challenge to filling open positions. While new graduates often possess the requisite academic knowledge to be hired, they lack necessary real world experience. * The San Diego Workforce Partnership recommends programs that provide volunteer experiences to high school and post-secondary students, as on-the-job training could provide real world experience for workers. Programs that target underrepresented groups and disadvantaged students could help increase the number of culturally competent health care workers. Measurable Objective * In collaboration with local schools, colleges and universities, offer opportunities for students to explore a vast array of health care professions FY 2012 Report of Activities
		In collaboration with Grossmont Union High School District (GUHSD), SGH participated in the Health-careers Exploration Summer Institute (HESI), providing 12 students with opportunities for classroom instruction, job shadowing observations and limited hands-on experiences in hospital departments. At the conclusion of the program, students presented their experiences as case studies to family members, educators and hospital staff. Those completing the program received high school credits equal to two summer school sessions. In FY 2012, HESI students spent approximately 1,344 hours on the SGH campus. SGH also continued its participation in the Health Sciences High and Middle College (HSHMC) program in FY 2012, providing early professional development for 142 students from a broad array of backgrounds in grades nine through 12. Students spent a total of approximately 42,000 hours with an estimated 50 health professionals in 33 different departments and nursing areas, and were in direct contact with health care professionals throughout the hospital. During each semester, students were supervised in different levels of the HSHMC program as they rotated through instructional pods in areas such as nursing, obstetrics, occupational and physical therapy, behavioral health, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), imaging, engineering, rehabilitation, laboratory, pharmacy, pulmonary, cardiac services and food services. In May 2012, the HSHMC program graduated its second full class of students. Level I of the HSHMC program is the entry level for all students and is conducted over a 16-week period. For FY 2012, 51 ninth-graders shadow primarily in non-nursing areas of the hospital, including physical therapy, food services, laboratory, cardiac services, imaging, physician offices, pulmonary, pharmacy and radiation therapy. In FY 2012, ninth-graders spent a greater length of time within each department in order to more fully experience different clinical areas of the hospital, and in total devoted 6,853 hours to the program. Level II of the HSHMC program offers patient interaction, where students are trained in Tender Loving Care (TLC) functions and then paired with a CNA on nursing floors. Students were able to view the CNA conduct patient ambulation, personal hygiene, etc. In FY 2012, fifty-eight 10th graders, twenty-three 11th graders and ten 12th graders participated in the Level II TLC program, experiencing college-level clinical rotations, TLC function patient care and mentoring. Students were placed in a new assignment every four to six weeks to view a variety of patient care experiences, and also took additional health-related coursework at San Diego Mesa College, including anatomy, physiology, medical terminology and human behavior courses. In FY 2012 12th graders continued to receive training in First Touch(r) - the patient-centered model of care provided by SGH to help ease patient anxiety and increase trust in their caregiver. In addition, SGH staff provided HSHMC students instruction on educational requirements, career ladder development and job requirements. At the end of the academic year, SGH staff provided HSHMC students, their loved ones, community leaders and hospital mentors a symposium that showcased the lessons learned throughout the program. Also in FY 2012, SGH provided more than 820 students from colleges and universities throughout San Diego with various placement and professional development opportunities. Throughout the academic year, more than 615 nursing students spent more than 82,000 hours at SGH, including both time spent both in clinical rotations and individual preceptor training. Among the nursing programs, academic partners included SDSU, PLNU, University of San Diego, National University, California State University-San Marcos, and Kaplan College. Allied health students spent nearly 41,000 hours on the Sharp Grossmont Hospital campus, and came from academic institutions throughout San Diego including Grossmont College, EMSTA College, Palomar College, San Diego Mesa College, NU, USC and SDSU, among others. Additionally, SGH and Sharp Memorial Hospital have partnered to provide one of only two new Mobile Intensive Care Nurse (MICN) training programs in SDC. Together, the hospitals offer an extensive six-week training program - open to any San Diego base station emergency nurse - three to four times a year. Participants received certification through County Emergency Medical Services (EMS) upon successful completion of a 48-hour classroom component, a passing score of 85 percent or higher on the County EMS final examination of SDC protocols, and completion of mandatory ride-along hours in a paramedic unit. FY 2013 Plan SGH will do the following: * In collaboration with GUHSD, participate in the HESI * Expand integration of First Touch program into 10th, 11th and 12th grades * Continue to track and report outcomes of HSHMC students and graduates to promote long-term program sustainability * Continue to provide internship and professional development opportunities to college and university students throughout San Diego Identified Community Need: Support During the Transition of Care Process for High-Risk, Underserved and Underfunded Patients Rationale references the findings of the 2010 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale * Health care access and delivery were identified as the most important overarching health issues (when considering a total of four overarching health issues) in the 2010 CHNA. * According to the 2010 CHNA, 22.2 percent of those 18 to 64 years of age in the County's east region are uninsured. Persons most likely to be uninsured in the east region include Latinos (63.3 percent), those ages 18 to 24 years (52.5 percent), and those under 100 percent of the Federal Poverty Level (71.8 percent). * According to data collected by the Grossmont Hospital Corporation for FY 2010 Operating and Capital Budget, the overall East County uninsured population was 14.5 percent, with an expected projected growth of 10 percent. The average unemployment rate in the cities of El Cajon, La Mesa, Lakeside, Lemon Grove, Santee, and Spring Valley was 11.3 percent (Labor Market Information, State of California Employment Development Department). * According to the Bureau of Labor Statistics, 43.9 percent of unemployed persons nationally, remained so for 27 weeks or greater. * According to the 2010 CHNA, in the County's east region for those 18 to 64 years of age, the most common sources of health insurance coverage include employment-based coverage (62.4 percent) and public programs (12 percent). * The cost of living in California is 35 percent above the U.S. average, with health spending per capita in California growing by 5.9 percent between 1994 to 2004 (CHA Special Report, October 2011). * According to the 2010 CHNA, by the year 2020, the County's east region is projected to grow by 8.8 percent overall, including a 20 percent growth among African-Americans, Asians and Latinos, and a 43 percent growth among persons aged 65 years or older. * According to the 2010 CHNA, demand for emergency department services in the SDC increased by 11.9 percent, from 582,129 to 651,595 visits, between 2006 and 2009. * In FY 2010, SGH discharged 10,213 unfunded or underfunded inpatients and treated a total of 121,354 unfunded or underfunded patients. * In 2010, California hospitals provided more than $12.5 billion in uncompensated care (CHA Special Report, October 2011). * In 2010, the health insurance benefits available under the Consolidated Omnibus Budget Reconciliation Act (COBRA) cost a single person in California between $375 to $470 per month; for a family of three or more in California, COBRA costs ranged from $1,123 to $1,406.51 per month. These rates represent anywhere from 20 to 78 percent of a person's income (2010 COBRA Self-Pay Rates, Motion Picture Industry Pension & Health Plans). * Community clinics in SDC have experienced rising rates of primary care clinic utilization. According to the 2010 CHNA, the number of persons utilizing the clinics increased by 14.4 percent between 2008 and 2009. Measurable Objectives
		* Connect high-risk patients and community members to community resources and organizations for low-cost medical equipment, housing options and follow-up care * Assist high-risk, underfunded patients with access to durable medical equipment (DME) * Assist economically disadvantaged individuals through transportation and pharmaceutical assistance * Collaborate with community organizations to provide follow-up medical care, financial assistance, psychiatric and social services to chronically homeless individuals * Establish a follow-up program to support underserved patients with complex medical needs who are at high risk for readmission after transition from hospital to home FY 2012 Report of Activities In FY 2012 SGH continued to provide post-acute care facilitation for high-risk patients, including individuals who were homeless or without a safe home environment. Individuals received referrals to and assistance from a variety of local resources and organizations that provided support with transportation, placement, medical equipment, medications, as well as outpatient dialysis and nursing home stays. SGH referred high-risk patients, families and community members to churches, shelters and other community resources for food, safe shelter and other resources. For unemployed and underfunded patients, or for those who simply cannot afford the expense of a wheelchair, walker or cane due to a fixed income, SGH has committed to improving access to DME for high-risk patients upon discharge. SGH case managers actively recruit DME donations from the community in order to provide for patients in need. In FY 2012, SGH staff participated in the Summer Healthcare Saturday event at Grossmont Center and provided education to community members about the importance of DME, the impact of DME for those in need, as well as the guidelines for donation. Also in FY 2012 SGH began including information on DME in the pre-recorded message that callers to SGH hear when they are placed on hold. SGH case managers and social workers provide and track DME items to patients who are uninsured, underinsured or who are otherwise unable to afford the equipment required to keep them safe and healthy. To assist economically disadvantaged individuals, in FY 2012 SGH provided more than $158,000 in free medications, transportation, lodging and financial assistance through its Project HELP funds. These funds assisted more than 4,000 individuals in FY 2012. In addition, SGH pharmacists assisted more than 200 economically disadvantaged patients with various outpatient prescriptions valued at approximately $160,000. In FY 2012, SGH continued to collaborate with community organizations to provide services to chronically homeless patients. Through its collaboration with the San Diego Rescue Mission, SGH discharged chronically homeless patients to the Rescue Mission's Recuperative Care Unit. This program allows chronically homeless patients to receive follow-up care through SGH in a safe space, and also provides psychiatric care, substance abuse counseling and guidance from the Rescue Mission's programs in order to help these patients get back on their feet. Additionally, SGH continued its partnership with Father Joe's Villages to support Project SOAR. This project is designed to facilitate and expedite the processing of social security and disability applications for homeless individuals with urgent health issues. With assistance from SGH case managers, eligible homeless patients are transitioned to Project SOAR in order to ensure they obtain timely access to income and medical care benefits. SGH also works with Gardner Group to assist high-risk patients in their home with the completion of enrollment forms for government assistance programs. In addition, in FY 2012 SGH piloted the Care Transitions Intervention Program (CTI) for its Medicare patients in need. CTI is a four-week evidence-based program, supporting underserved patients with complex medical needs who are at high risk for readmission after transition from the hospital to their homes. The program includes education provided by one hospital and one home visit, as well as a series of follow-up phone calls by a trained RN Transition Coach using the Coleman Care Transitions(r) Model. In this model, the Transition Coach provides patient coaching and motivational interviewing techniques to help improve patient self-management skills. Topics covered include information about medications, diet and other discharge orders, as well as how to identify problems early on to avoid costly and unnecessary trips to the ED. Through this program, patients with chronic health conditions develop improved capacity in the areas of medication management, personal health record maintenance, knowledge of "red flags," and follow-up care with primary care providers and specialists. In FY 2012, 34 patients were enrolled in the CTI Program. FY 2013 Plan SGH will do the following: * Continue to provide post-acute care facilitation to high-risk patients * Continue and expand the DME donations project to improve access to necessary medical equipment for high-risk patients who cannot afford DME * Continue to administer Project HELP funds to those in need * Continue to collaborate with community organizations to provide medical care, financial assistance, psychiatric and social services to chronically homeless patients * With federal funding, expand the CTI program to all of Sharp HealthCare's acute care hospitals, and further expand the program to include community agencies and other local health care providers and hospitals SGH Program and Service Highlights * 24-hour emergency services with heliport and paramedic base station - designated STEMI Center * Acute care * Ambulatory care services, including infusion therapy * Behavioral Health Unit * Breast Health Center, including mammography * Cardiac services, recognized by the American Heart Association - GWTG * Cardiac Training Center * CT scan * David and Donna Long Center for Cancer Treatment * EEG and EKG * Endoscopy unit * Grossmont Plaza Outpatient Surgery Center * Group and art therapies * Home health * Home infusion therapy * Hospice * Hyperbaric treatment * Intensive Care Unit * LakeView Home * Neonatal Intensive Care Unit * Orthopedics * Outpatient diabetes services, recognized by the American Diabetes Association * Outpatient Imaging Centers * Laboratory services (inpatient and outpatient) * ParkView Home * Pathology services * Pediatric services * Pulmonary services * Radiology services * Rehabilitation Center * Robotic surgery * Senior Resource Center * Sleep Disorders Center * Spiritual care services * Stroke Center * Surgical services * Transitional Care Unit * Van services * Vascular services * Women's Health Center * Wound Care Center 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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
Sharp HealthCare (SHC)
8695 Spectrum Center Blvd	San Diego	CA	921231489	956077327	Healthcare Organization	CA	501 (c)(3)	3	SharpCare	0
Sharp Memorial Hospital (SMH)
8695 Spectrum Center Blvd	San Diego	CA	921231489	953782169	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 HealthCare Foundation (SHF)
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
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 Coronado Hospital and Healthcare Center
8695 Spectrum Center Blvd	San Diego	CA	921231489	950651579	Hospital	CA	501 (c)(3)	3	Sharp HealthCare	1
Sharp Care
8695 Spectrum Center Blvd	San Diego	CA	921231489	611637133	Healthcare Organization	CA	501 (c)(3)	3	SharpCare	0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Grossmont Imaging LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	7777 Alvarado Road Suite 108	AddressLine1
City	La Mesa	City
State	CA	State
ZIP Code	91941	ZIPCode

Field	Value	IRS element (for citing)
EIN	202655131	EIN
Primary Activity	Diagnostic Imaging	PrimaryActivity
Legal Domicile State	CA	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Predominant Income Type	Related	PredominantIncomeType
Share Of Total Income	510910	ShareOfTotalIncome
Share Of EOY Assets	1743843	ShareOfEOYAssets
Disproportionate Allocations	0	DisproportionateAllocations
General Or Managing Partner	1	GeneralOrManagingPartner
Percentage Ownership	0.50000	PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Continuous Quality Insurance SPC	BusinessNameLine1

Address Foreign AddressForeign

Field	Value	IRS element (for citing)
Address Line1	PO Box 1092	AddressLine1
City	Grand Cayman	City
Country	CJ	Country

Field	Value	IRS element (for citing)
Primary Activity	Captive Insurance Company	PrimaryActivity
Legal Domicile Foreign Country	CJ	LegalDomicileForeignCountry
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C	TypeOfEntity

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	1	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	1	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (17 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Sharp Memorial Hospital
K	322879	Accrual
Sharp Memorial Hospital
L	3399109	Accrual
Sharp Memorial Hospital
O	94071	Accrual
Sharp Memorial Hospital
P	118010	Accrual
Sharp Memorial Hospital
R	159628	Accrual
Sharp Chula Vista Medical Center
L	1056205	Accrual
Sharp Chula Vista Medical Center
K	93451	Accrual
Sharp Chula Vista Medical Center
P	62908	Accrual
Sharp Coronado Hospital and Healthcare Center
A	4977	Accrual
Sharp Coronado Hospital and Healthcare Center
D	135000	Accrual
Sharp Coronado Hospital and Healthcare Center
L	107133	Accrual
Sharp Coronado Hospital and Healthcare Center
K	54139	Accrual
Grossmont Hospital Foundation
P	885451	Accrual
Grossmont Hospital Foundation
C	3953655	Accrual
Grossmont Hospital Foundation
B	1118619	Accrual
Grossmont Hospital Foundation
M	58592	Accrual
Sharp Health Plan
K	1123434	Accrual

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Return Reference	Part V, Line 2, Transaction 9:	ReturnReference
Explanation	The transaction between Grossmont Hospital Corporation and Sharp Coronado Hospital and Healthcare Center totaling $4,977 is transaction type A(i).	Explanation