2013-11-11T17:13:14-06:00 2012-12-31 952648289 VAVRINEKTRINEDAY & CO LLP 8270 ASPEN STREET RANCHO CUCAMONGA CA 91730 990 2012-01-01 951547003 VERDUGO HILLS HOSPITAL VERD 8187907100 1812 VERDUGO BLVD GLENDALE CA 91208 CINDY TROUSDALE 8187907100 2013-11-11 1 CATHERINE L GRAY P01294460 9094664410 2012 2016-03-07 17:11:31Z CINDY TROUSDALE 1812 VERDUGO BLVD GLENDALE CA 91208 84259626 0 X WWW.VERDUGOHILLSHOSPITAL.ORG X 1969 CA TO PROVIDE PERSONALIZED AND COST-EFECTIVE HIGH-QUALITY SERVICES THAT MEET THE COMMUNITY'S NEEDS FOR HEALTHCARE IN A HEALTHCARE ENVIRONMENT THAT COMPELS PATIENTS AND STAFF TO BECOME AMBASSADORS FOR THE HOSPITAL 18 18 831 250 913811 138673 426633 85076 80163673 84057978 524157 16496 -5867 -10726 81108596 84148824 0 0 0 0 42620497 41987127 0 0 0 37248400 41901729 79868897 83888856 1239699 259968 41456186 42666648 18410708 18798222 23045478 23868426 TO PROVIDE PERSONALIZED AND COST-EFFECTIVE HIGH-QUALITY SERVICES THAT MEET THE COMMUNITY'S NEED FOR HEALTHCARE 0 0 79261927 83144167 VERDUGO HILLS HOSPITAL OPERATES A 158-BED HOSPITAL DESIGNATED FOR GENERAL ACUTE-CARE.THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES FOR GLENDALE, LA CANADA, AND THE SURROUNDING COMMUNITIES 79261927 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 84 0 1 831 1 1 1 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X THE ORGANIZATION 8189524659 1812 VERDUGO BLVD GLENDALE CA 91208 CARL W RAGGIO 0.30 X 0 0 0 ANNSLEY C STRONG 0.30 X 0 0 0 CHARLES W MASON 0.30 X X 0 0 0 LEONARD LABELLA 40.00 X X 423800 0 1320429 KAREN MC ILVENA 0.30 X 0 0 0 DARRELL SPENCE 0.30 X 0 0 0 ROBERT DEVELLE 0.30 X X 0 0 0 STEVEN L HARTFORD MD 0.30 X 0 0 0 TODD E ANDREWS 0.30 X 0 0 0 ALLAN PERRY JR MD 0.30 X 0 0 0 DAVID TASHMAN MD 0.30 X 0 0 0 S LEE ROSS 0.30 X 0 0 0 SAM LONGO JR 0.30 X 0 0 0 LARRY DUMAS 0.30 X 0 0 0 DAVID SAGAL 0.30 X X 0 0 0 STEVE WILDER 0.30 X X 0 0 0 EDWARD WOPSHALL 0.30 X 0 0 0 CRAIG MORITZ MD 0.30 X 0 0 0 CYNTHIA TROUSDALE 40.00 X 245255 0 7298 PAUL CELUCH 40.00 X 170370 0 12438 JUDITH MC CURDY 40.00 X 215835 0 3147 YULANDA DAVIS-QUARRIE 0.30 40.00 X 0 185508 22089 DUANE SCOTT CAMERON 40.00 X 147423 0 6120 DEBRA LEE BROWN 40.00 X 142284 0 21506 SUSAN FABER 40.00 X 140596 0 11813 ERNIE DEMIS 40.00 X 142684 0 0 STELLA LIU 40.00 X 149449 0 11892 1777696 185508 1416732 50 0 1 0 HOSPITAL SYSTEMS 2245 N GREEN VALLEY PARKWAY HENDERSON NV 89014 PROGRAMMING 504599 COGDELL SPENCER 4401 BARCLAY DOWNS DR 300 CHARLOTTE NC 28201 RENT 364764 FUTURENET TECHNOLOGIES 222 E HUNTINGTON DR SUITE 200 MONROVIA CA 91016 TRANSCRIPTION 251201 DAVIS WRIGHT TREMAINE LLP 865 S FIGUEROA LOS ANGELES CA 90017 LEGAL 246465 FONDA AND FRASER LP 100 W BROADWAY SUITE 650 GLENDALE CA 91210 LEGAL 109881 5 85076 85076 NET PATIENT REVENUE 900099 84057978 83144167 913811 84057978 16496 16496 100076 110802 -10726 -10726 84148824 83144167 913811 5770 1055260 1055260 34702187 34702187 3554121 3554121 2675559 2675559 261564 261564 122500 122500 536767 218244 318523 158941 158941 1511693 1511693 23513 23513 458622 458622 2470953 2470953 1891587 1891587 UBIT TAX 33643 33643 SUPPLIES 12987629 12987629 PURCHASED SERVICES 7744780 7744780 HOSPITAL PROGRAM FEE 6823642 6823642 6875895 6660220 215675 83888856 79261927 4626929 0 1544636 3966756 10619890 9838887 1211974 1202643 1198927 1416701 87688238 69515994 17417014 18172244 5133765 2623907 4329980 5445510 41456186 42666648 8969961 6686988 532796 331141 1000142 9109606 10578296 18410708 18798222 X 20958180 21124930 560385 963108 1526913 1780388 23045478 23868426 41456186 42666648 X 259968 562980 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 797277 797277 84746515 69515994 15230521 2144446 2144446 18172244 INVESTMENTS OTHER 2623907 C 2623907 BENEFICIAL INTEREST IN VERDUGO HILLS HOSP FOUNDATION 3885108 DEFERRED LOAN COSTS 273005 OTHER RECEIVABLE 418209 INTERCOMPANY RECEIVABLE 629888 OTHER 239300 5445510 ACCRUED PROFESSIONAL LIABILITY 1427847 ACCRUED WORKERS COMPENSATION 579371 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 771078 NOTE PAYABLE-ROSS ENERGY LLC 7800000 10578296 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: HEALTH SERVICES HAS ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740 THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINITY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN AND PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN BE RECOGNIZED IN THE FINANCIAL STATMENTS ONLY IF, BASED ON ITS MERITS, THE POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT BY TAXING AUTHORITIES. MANAGEMENT BELIVES THAT ALL TAX POSITIONS TAKEN TO DATE ARE HIGHLY CERTAIN, AND, ACCORDINGLY, NO ACCOUNTING ADJUSTMENTS HAVE BEEN MADE TO THE FINANCIAL STATEMENTS, PART XI, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD PART XII, LINE 2D - OTHER ADJUSTMENTS: COST OF GOODS SOLD 1 1 1 X 1 X 1 1 1 0 1 1 2094413 2094413 0.02590 401862 401862 0.00500 2065006 2065006 0.02550 4561281 4561281 0.05640 307510 307510 0.00380 166086 166086 0.00210 473596 473596 0.00590 5034877 5034877 0.06230 1 2893000 539618 25969599 28034605 -2065006 X 1 1 1 1 VERDUGO HILLS HOSPITAL

1812 VERDUGO BLVD GLENDALE CA 91208

X X X X SKILLED NURSING,OUTPATIENT SURGERY & DIAGNOSTIC VERDUGO HILLS HOSPITAL 1 1 X X X X X X 10 1 1 1 X X X X X X X X 0 0 1 1 200.000000000000 1 350.000000000000 1 X X X X X X X 1 1 X X X X X X 1 0 1 X 0 0 PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2892941. PART II: N/A PART III, LINE 4: NO FOOTNOTE IN AUDITED FINANCIALS, CHARITY WRITE-OFFS ARE NOT RECORDED AS BAD BEBT BUT AS A REDUCTION IN REVENUE PART III, LINE 8: MEDICARE AS FILED COST REPORT WHICH USES COST TO CHARGE RATIO PART III, LINE 9B: PATIENTS ARE GIVEN GUIDELINES AND FORMS AT TIME OF ADDMISSION/REGISTRATION- PATIENTS ARE ASKED TO CONTACT US IN ORDER TO DETERMINE IF THEY QUALIFY FOR CHARITY DISCOUNTS-GUIDELINES AND FORMS ARE MAILED TO THE PATIENTS. VERDUGO HILLS HOSPITAL PART V, SECTION B, LINE 3: VICE PRESIDENT OF PATIENT SERVICES AND THE VICE PRESIDENT OF THE FOUNDATION PARTICIPATED IN THE IMPLENTATION AND EXECUTION OF A COMMUNITY WIDE NEEDS ASSESSMENT. THIS WAS DONE THROUGH ATTENDING AND ACTIVE PARTICPATION IN MEETINGS DESIGNED TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY. VERDUGO HILLS HOSPITAL PART V, SECTION B, LINE 4: GLENDALE MEMORIAL HOSPITALGLENDALE ADVENTIST HOSPITAL VERDUGO HILLS HOSPITAL PART V, SECTION B, LINE 7: DUE TO FINANCIAL CONSTRAINTS THE ORGANIZATION WAS UNABLE TO ADDRESS ALL THE NEEDS IDENTIFIED BY THE NEEDS ASSESSMENT. ALSO SOME IDENTIFIED NEEDS ARE NOT HEALTHCARE RELATED. VERDUGO HILLS HOSPITAL PART V, SECTION B, LINE 20D: ORGANIZATION USES A DISCOUNTED MEDICARE COMPARABLE RATE PART VI, LINE 2: BI-ANNUAL COMMUNITY NEEDS ASSESSMENT REVIEW DONE BY A PROFESSIONAL JOINTLY WITH 2 OTHER HOSPITALS IN GLENDALE PART VI, LINE 3: THE FAIR PRICING POLICY IS DESCRIBED TO PATIENTS AND FAMILIES UNPON REGISTRATION, THE POLICY IS POSTED AND FORMS MAILED TO PATIENTS AT TIME OF INITIAL BILLING. PART VI, LINE 4: ANYONE WHO NEEDS MEDICAL SERVICES PART VI, LINE 5: OPEN MEDICAL STAFF, COMMUNITY BOARD, PHYSICIAN EDUCATION PROGRAMS, COMMUNITY MEETING ROOM SPACE, PUBLIC SPEAKING AT SCHOOLS AND SERVICE ORGANIZATIONS, MEMBERSHIP ON GLENDALE HEALTH COALITION, SURPLUS FUNDS REINVESTED ANNUALLY IN MEDICAL EQUIPMENT, FACILITIY IMPROVEMENTS, HEALTH FAIRS, SENIOR FLU CLINICS, ETC. PART VI, LINE 6: N/A REPORTS FILED WITH STATES PART VI, LINE 7 CA X X 0 0 0 0 0 0 0 0 0 LEONARD LABELLA 423800 0 0 0 0 0 1267356 0 53073 0 1744229 0 0 0 CYNTHIA TROUSDALE 245255 0 0 0 0 0 0 0 7298 0 252553 0 0 0 PAUL CELUCH 170370 0 0 0 0 0 0 0 12438 0 182808 0 0 0 JUDITH MC CURDY 215835 0 0 0 0 0 0 0 3147 0 218982 0 0 0 YULANDA DAVIS-QUARRIE 0 185508 0 0 0 0 0 0 0 22089 0 207597 0 0 DUANE SCOTT CAMERON 147423 0 0 0 0 0 0 0 6120 0 153543 0 0 0 DEBRA LEE BROWN 142284 0 0 0 0 0 0 0 21506 0 163790 0 0 0 SUSAN FABER 140596 0 0 0 0 0 0 0 11813 0 152409 0 0 0 STELLA LIU 149449 0 0 0 0 0 0 0 11892 0 161341 0 0 0 SUPPLEMENTAL INFORMATION PART III THE $1,267,356 PAID TO LEONARD LABELLA REPRESENTS DEFERRED COMPENSATION. A ROSS ENERGY LLC 2010-12-14 7800000 SEISMIC RETROFIT PROJECT AND EQUIPMENT LOAN 0 0 0 A 7800000 273005 479036 105331 442478 2012 0 0 0 1 A 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 SCHEDULE K SUPPLENTAL INFORMATION PRIVATE PLACEMENT DEBT ROSS ENERGY LLC S LEE ROSS BOARD MEMBER BOARD MEMBER OWN ROSS ENERGY LLC LOAN FOR REAL ESTATE REFINANCE AND SEISMIC RETROFIT 0 FORM 990, PART VI, SECTION B, LINE 11 990 RETURN WAS REVIEWED BY CFO BEFORE FILING OF THE RETURN. THE 990 WILL BE DISCUSSED AND REVIEWED BY THE FINANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURES ARE REVIEWED ANNUALLY, IF A CONFLICT ARISES THE BOARD MEMBER IS ASKED TO RECUSE HIMSELF FROM ALL DISCUSSIONS AND VOTING FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE COMMITTEE APPROVES TOP EXECUTIVE PAY CHANGES EACH YEAR USING HASC PAY SURVEY GUIDELINES FORM 990, PART VI, SECTION C, LINE 19 FORMS AND GOVERNING DOCUMENTS ARE AVAILABLE AT BUSINESS OFFICE DURING NORMAL BUSINESS HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: FOUNDATION ACTIVITY INCLUDED IN ENDING NET ASSETS 562,980. VERDUGO HILLS HOSPITAL FOUNDATION 1812 VERDUGO BLVD GLENDALE CA 91208 953247823 FOUNDATION CA 501(C)(3) 509(A)(2) 0 VERDUGO HILLS HEALTH SERVICES 1812 VERDUGO BLVD GLENDALE CA 91208 953837535 HEALTH ORGANIZATION CA 501(C)(3) 170(B)(1)(A)(III) 0 VERDUGO HILLS SUPPORT SERVICES 1812 VERDUGO BLVD GLENDALE CA 91208 953897853 PHARMACY SERVICES CA C 1.00000 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 VERDUGO HILLS FOUNDATION C 85076 ACTUAL AMOUNT