2013-11-14T18:42:15-06:00 2012-12-31 861065772 DELOITTE TAX LLP 555 MISSION STREET SAN FRANCISCO CA 94105 990 2012-01-01 941461843 JOHN MUIR HEALTH JOHN 9259393000 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 MICHAEL MOODY 9259393000 2013-11-13 1 MICHAEL P WALTON P00017550 4157834000 2012 2016-02-25 16:41:14Z MICHAEL MOODY 1400 TREAT BOULEVARD NO 300 WALNUT CREEK CA 94597 1396646433 0 X WWW.JOHNMUIRHEALTH.COM X 1958 CA TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION 15 10 6051 1600 6253354 -230277 27492781 4105048 1162125706 1195995964 33116812 47101504 30798086 42940493 1253533385 1290143009 1502693 6134770 0 0 642478848 659774951 0 0 0 508917496 496753347 1152899037 1162663068 100634348 127479941 1981626204 2150008139 924250543 934485305 1057375661 1215522834 X THE MISSION OF JOHN MUIR HEALTH IS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION. JOHN MUIR HEALTH OFFERS A WIDE ARRAY OF CLINICAL SERVICES AT ITS TWO ACUTE CARE HOSPITALS IN WALNUT CREEK AND CONCORD, BEHAVIORAL HEALTH CENTER, FOUR URGENT CARE CENTERS, ASSOCIATED CLINICS AND OUTPATIENT FACILITIES IN BRENTWOOD AND ROSSMOOR. KEY PROGRAMS INCLUDE EMERGENCY, TRAUMA, CARDIAC, CANCER, NEUROSCIENCES, ORTHOPEDICS, OBSTETRICS, AND REHABILITATION. 0 0 411262985 6134770 416746908 HOSPITAL SERVICES - GENERAL MEDICINE AND SURGERY. THE CORE OF JOHN MUIR HEALTH'S SERVICE TO THE COMMUNITY IS IN ITS GENERAL MEDICINE AND SURGERY PROGRAM, WHICH PROVIDES COMPREHENSIVE CARE FROM EMERGENCY SERVICES TO HIGH LEVEL CRITICAL CARE TO DISCHARGE SUPPORT AND HOME HEALTH FOR PATIENTS WITH A VARIETY OF CONDITIONS. JOHN MUIR MEDICAL CENTER, WALNUT CREEK SERVES AS THE ONLY COUNTY-DESIGNATED TRAUMA CENTER FOR THE AREA, WORKING CLOSELY WITH LOCAL EMERGENCY SERVICES LEADERS. NATIONAL RECOGNITIONS RECEIVED IN 2012 INCLUDE (1) RECOGNITION OF JOHN MUIR MEDICAL CENTER, WALNUT CREEK BY U.S. NEWS & WORLD REPORT FOR THE SIXTH YEAR IN A ROW AS ONE OF "AMERICA'S BEST HOSPITALS" FOR GASTROENTEROLOGY AND ORTHOPEDICS, (2) U.S. NEWS AND WORLD REPORT ALSO RANKED JOHN MUIR MEDICAL CENTER, WALNUT CREEK #2 AND JOHN MUIR MEDICAL CENTER, CONCORD #3 OUT OF ALL 45 HOSPITALS IN THE SAN FRANCISCO METROPOLITAN AREA BASED ON PATIENT SURVIVAL, PATIENT SAFETY, CARE-RELATED FACTORS SUCH AS NURSING AND PATIENT SERVICES, AND REPUTATION. THE TWO HOSPITALS WERE ALSO RANKED #7 AND #18 IN THE STATE OUT OF 400 HOSPITALS, (3) JOHN MUIR MEDICAL CENTER, WALNUT CREEK WAS NAMED ONE OF AMERICA'S 100 BEST HOSPITALS BY HEALTHGRADES, (4) JOHN MUIR MEDICAL CENTER, WALNUT CREEK WAS RANKED AMONG THE TOP FIVE PERCENT OF HOSPITALS NATIONALLY FOR QUALITY OF CARE BY HEALTHGRADES, IN ADDITION TO THE CLINICAL EXCELLENCE AWARD, FIVE-STAR RATINGS AND RANKINGS IN THE TOP 10% IN THE NATION WERE AWARDED FOR SEVERAL SERVICES, PROCEDURES AND TREATMENTS. OUR PROGRAM EMPHASIS IN 2012 WAS ON CONTINUED OUTREACH TO UNINSURED, UNDERSERVED, AND VULNERABLE POPULATIONS IN OUR SERVICE AREA THROUGH COMMUNITY PARTNERSHIPS TO PROVIDE DIRECT SERVICES INCLUDING GERIATRIC CARE COORDINATION, MOBILE DENTAL CLINIC, MOBILE HEALTH CLINIC, AND SUPPORT FOR TEEN PREGNANCY PROGRAMS, OPERATION ACCESS, VIOLENCE PREVENTION, AND PARISH-BASED NURSING ON THE HOSPITAL CAMPUSES. 90172512 134221507 CARDIOVASCULAR CARE IS THE SECOND LARGEST HOSPITAL-BASED SERVICE OF JOHN MUIR HEALTH. ACHIEVEMENTS IN 2012 INCLUDED RECOGNITION BY THE AMERICAN HEART ASSOCIATION OF JOHN MUIR HEALTH'S CONCORD AND WALNUT CREEK MEDICAL CENTERS FOR PROVIDING OUTSTANDING CARE TO HIGH RISK HEART ATTACK PATIENTS BY AWARDING THE MISSION LIFELINE GOLD PERFORMANCE ACHIEVEMENT AWARD FOR STEMI CARE. JOHN MUIR HEALTH'S MEDICAL CENTERS ALSO RECEIVED THE GOLD PLUS ACHIEVEMENT AWARD FOR HEART FAILURE CARE, AND THE GET WITH THE GUIDELINES PLATINUM AWARD FOR HEART ATTACK CARE. BOTH JOHN MUIR HEALTH MEDICAL CENTERS HOLD THE HIGHEST LEVEL OF ACCREDITATION FROM THE SOCIETY OF CHEST PAIN CENTERS AND ARE DESIGNATED AS HIGH-RISK HEART ATTACK (STEMI) RECEIVING CENTERS BY THE COUNTY DEPARTMENT OF EMERGENCY MEDICAL SERVICES. 121320430 132559799 WOMEN'S AND CHILDREN'S IS THE THIRD LARGEST PROGRAM WITHIN JOHN MUIR HEALTH. ACHIEVEMENTS IN 2012 INCLUDED, (1) REDUCED THE NUMBER OF TIMES CRITICALLY ILL NEWBORNS WERE TRANSFERRED TO OTHER HOSPITALS FOR PEDIATRIC SPECIALTY CARE AND MINOR SURGERIES BY ARRANGING FOR LOCAL CONSULTATIONS BY PEDIATRIC SPECIALISTS, (2) EXPERIENCED CONSISTENT GROWTH IN THE CENTER FOR WOMEN'S CONTINENCE AND PELVIC HEALTH RESULTING IN 70% OF PATIENTS REPORTING SUCCESSFUL TREATMENT WITHOUT INVASIVE SURGERY, (3) LAUNCHED THE PEDIATRIC NUTRITION PROGRAM OFFERING CONSULTATIONS, GROUP APPOINTMENTS AND COMMUNITY LECTURES ON PEDIATRIC NUTRITION TOPICS IN WALNUT CREEK AND BRENTWOOD, (4) IMPLEMENTED QUALITY IMPROVEMENT INITIATIVES INCLUDING DVT PROPHYLAXIS FOR GYN SURGERIES AND CASE TRACKING FOR SERIAL READMISSIONS FOR UROSEPSIS THROUGH THE CENTER FOR WOMEN'S CONTINENCE, (5) ESTABLISHED CHILD-FRIENDLY POLICIES TO SUPPORT PROCESSES FOR PEDIATRIC PATIENTS INCLUDING FAMILY CENTERED CARE, POLICIES FOR PROCEDURES AND ADMISSIONS TO JOHN MUIR HEALTH AND ACCOMMODATION FOR FAMILIES WHO HAVE CHILDREN ADMITTED TO THE HOSPITAL, (6) ADOPTED ELECTIVE LABOR INDUCTIONS ONLY FOR WOMEN >/= TO 39 WEEKS GESTATION PER RECOMMENDATIONS BY THE AMERICAN COLLEGE OF OBSTETRICS AND GYNECOLOGY. 398867068 512467750 CANCER SERVICES IS THE FOURTH LARGEST PROGRAM AT JOHN MUIR HEALTH, BUILDING ON A STRONG FOUNDATION THAT COMBINES ADVANCED TECHNOLOGY, OUTSTANDING PATIENT OUTCOMES AND PERSONALIZED, COMPASSIONATE CARE. JOHN MUIR HEALTH IS ONE OF THE BAY AREAS MOST RESPECTED AND PROGRESSIVE CENTERS FOR CANCER CARE. JOHN MUIR HEALTH HAS A THREE-YEAR ACCREDITATION WITH COMMENDATION AS AN INTEGRATED NETWORK CANCER PROGRAM FROM THE AMERICAN COLLEGE OF SURGEONS COMMISSION ON CANCER, A CONSORTIUM OF PROFESSIONAL ORGANIZATIONS DEDICATED TO IMPROVING SURVIVAL AND QUALITY OF LIFE FOR CANCER PATIENTS. JOHN MUIR HEALTH IS ALSO ONE OF FOUR INSTITUTIONS NATIONWIDE TO BE RECOGNIZED AS A CERTIFIED QUALITY BREAST CENTER OF EXCELLENCE BY THE NATIONAL CONSORTIUM OF BREAST CANCER AND IS ACCREDITED BY THE AMERICAN COLLEGE OF SURGEONS/COMMISSION ON CANCER AS A NATIONAL ACCREDITED PROGRAM OF BREAST CENTERS (NAPBC). IN 2011, WE OPENED THE THERESA M CAYGILL BREAST HEALTH CENTER AT JOHN MUIR MEDICAL CENTER, WALNUT CREEK, WHICH AUGMENTS EXISTING SERVICES BY OFFERING COMPREHENSIVE BREAST HEALTH INFORMATION AND RESOURCES IN ONE CONVENIENT LOCATION FOR THE COMMUNITY, PATIENT AND THEIR FAMILIES FOR THE COMMUNITY. JOHN MUIR HEALTH PROVIDES FREE BREAST CANCER SCREENING AND DIAGNOSTIC SERVICES THROUGH CALIFORNIA'S EVERY WOMAN COUNTS PROGRAM, WHICH IS ADMINISTERED AT JOHN MUIR MEDICAL CENTER, CONCORD'S BREAST HEALTH CENTER. 398867068 512467750 1021622995 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 0 0 0 1 687 0 1 6051 1 1 1 0 0 0 0 1 1 0 0 0 0 0 X 15 10 1 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X X MICHAEL MOODY 9259393000 1400 TREAT BLVD WALNUT CREEK CA 94597 CATHERINE O KUTSURIS 5.00 X X 0 0 0 DAVID L GOLDSMITH 5.00 X X 0 0 0 PHILIP J BATCHELOR 5.00 X X 0 0 0 THOMAS G RUNDALL PHD 5.00 X X 0 0 0 WILLIAM F CRONK 5.00 X X 0 0 0 F RYAN ANDERSON MD 5.00 X 0 0 0 LINDA BEST 5.00 X 0 0 0 ROBERT E EDMONDSON 5.00 X 0 0 0 MARILYN M GARDNER 5.00 X 0 0 0 DEBORAH L KERLIN MD 5.00 X 0 0 0 RONALD K MULLIN 5.00 X 0 0 0 STUART B SHIKORA MD 5.00 X 0 0 0 SAN S YUAN MD 5.00 X 0 0 0 PATRICIA CURTIN 5.00 X 0 0 0 CALVIN KNIGHT 60.00 X X 1303701 0 653194 MICHAEL MOODY 60.00 X 601383 0 262640 IRVING PIKE MD 60.00 X 412901 0 104176 NANCY OLSON 60.00 X 547265 0 220235 JANE WILLEMSEN 60.00 X 693271 0 287227 MICHAEL THOMAS 60.00 X 639610 0 287388 ALICE A VILLANUEVA 60.00 X 503974 0 190810 MARTI TARNOWSKI 60.00 X 504629 0 205114 CHRISTIAN PASS 60.00 X 453340 0 172013 MICHAEL MONALDO 60.00 X 417682 0 178234 DEBRA PENDERGAST 60.00 X 442109 0 139585 PAUL SWENSON 60.00 X 408257 0 2879 KENNETH MEEHAN 60.00 X 889144 0 291539 ERIC SAFF 60.00 X 625930 0 7448 NEIL MILLER 60.00 X 307120 0 1329 8750316 0 3003811 2507 1 1 0 CROSS COUNTRY STAFFING LA LOCKBOX FILE 50941 LOS ANGELES CA 90074 STAFFING SERVICES 4498761 MEDICAL ANESTHESIA CONSULTANTS MEDICAL PO BOX 512107 LOS ANGELES CA 90051 MEDICAL SERVICES 4470985 DELOITTE CONSULTING GROUP LLC PO BOX 7247-6447 PHILADELPHIA PA 19170 CONSULTING SERVICES 3847340 NURSEFINDERS INC PO BOX 910738 DALLAS TX 75391 STAFFING SERVICES 3128289 ARUP LABORATORIES PO BOX 2794 SALT LAKE CITY UT 84127 MEDICAL SERVICES 2643683 137 39600 3507537 557911 4105048 PATIENT REVENUE 900099 949456710 949456710 MEDICARE REVENUE 900099 240131281 240131281 PREMIUM REVENUE 900099 6407973 6407973 1195995964 391113 391113 6344038 825940 5518098 5518098 5518098 152168469 105458078 46710391 46710391 46710391 146662 39600 53693 92969 92969 120319 165713 -45394 -45394 OTHER OPERATING REVENU 900099 37374820 31121466 6253354 37374820 1290143009 1273827821 6253354 5956786 6134770 6134770 507793661 462236411 45557250 25187236 21961872 3225364 101545798 89339950 12205848 25248256 22436513 2811743 4980198 2132668 2847530 383798 191899 191899 17215607 16308693 906914 2189170 1759475 429695 19518351 19518351 34359753 32496315 1863438 7729869 4539891 3189978 SUPPLIES 130711340 128795883 1915457 PURCHASED SERVICES 112347586 79145156 33202430 BAD DEBT EXPENSE 58179583 58179583 PROFESSIONAL FEES 44585908 43843065 742843 64552184 32602500 31949684 1162663068 1021622995 141040073 0 56707883 122027751 221115614 223441904 6449109 7023087 19126301 14409227 1448162453 523847124 934384156 924315329 668605188 761702200 75237953 97088641 1981626204 2150008139 175301868 186041473 515128142 428436740 89800000 233820533 230207092 924250543 934485305 X 1056463407 1214386265 912254 1136569 1057375661 1215522834 1981626204 2150008139 X 127479941 34832237 -12378005 8213000 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 69377 1 12172 0 1 1095 82644 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: JOHN MUIR HEALTH CONTRIBUTED $69,377 TO CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) SPONSORED BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) IN 2012 TO SUPPORT LOBBYING EFFORTS. JOHN MUIR HEALTH EXECUTIVES ALSO COMMENT ON PROPOSED LEGISLATION OF STATE AND LOCAL GOVERNMENTAL BODIES THAT AFFECT THE HEALTH CARE INDUSTRY IN CONTRA COSTA COUNTY. JOHN MUIR HEALTH HAS JOINT VENTURE PARTNERS THAT CONTRIBUTE TO A PAC THAT SUPPORTS BALLOT MEASURES. JOHN MUIR HEALTH IS REPORTING THE AMOUNT OF CONTRIBUTIONS ATTRIBUTABLE TO THEIR PARTICIPATION IN THE JOINT VENTURES. 17002903 2037125 859349 3546075 16353302 37397465 4810336 10029 25214927 17002903 28132000 9915590 599321 1249446 37397465 33638031 12706231 1333441 19545703 28132000 33409949 3165122 -2340525 596515 33638031 0.27000 0.73000 0 1 1 34416748 34416748 902113987 218845658 683268329 8151648 3743013 4408635 472329199 301258453 171070746 31150871 31150871 924315329 WORKERS COMPENSATION 54194425 POST RETIREMENT COMP BENEFITS 51406182 PENSION LIABILITY 86237116 OTHER NON-CURRENT LIABILITIES 38369369 230207092 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ORGANIZATION'S ENDOWMENT FUNDS (TERM AND PERMANENT) HELD BY THE JOHN MUIR HEALTH FOUNDATION ARE USED FOR RESTRICTED PURPOSES AS DIRECTED BY THE DONOR UPON RECEIPT OF THEIR DONATION. INCOME EARNED FROM PERMANENT ENDOWMENT FUNDS WITHOUT RESTRICTION AS TO PURPOSE ARE USED TO SUPPORT PATIENT CARE PROGRAMS AND SERVICES OF JOHN MUIR HEALTH. TERM ENDOWMENTS AND INCOME EARNED FROM OTHER PERMANENT ENDOWMENTS ARE RESTRICTED BY THE DONOR FOR USE IN PROGRAMS INCLUDING NURSING EDUCATION, CARDIAC CARE EQUIPMENT, RADIATION ONCOLOGY, WOMEN'S HEALTH CENTER EDUCATION, AND THE JOHN MUIR HEALTH BUILDING PROGRAM. CENTRAL AMERICA AND THE CARIBBEAN - INVESTMENTS 75756591 0 0 0 0 0 0 75756591 0 75756591 1 0 1 0 1 0 GOLF TOURNAMENT 186262 39600 146662 46765 6928 186262 39600 146662 46765 6928 53693 92969 1 1 X 1 X 400.000000000000 1 X 1 1 1 0 1 1 24166112 24166112 0.02090 40225916 40225916 0.03470 64392028 64392028 0.05560 9580426 343348 9237078 0.00800 3792776 3792776 0.00330 1424426 1424426 0.00120 1372581 1372581 0.00120 2851732 4427 2847305 0.00250 19021941 347775 18674166 0.01620 83413969 347775 83066194 0.07180 2893 2893 0.00000 96042 96042 0.00010 8763 8763 0.00000 555653 555653 0.00050 663351 663351 0.00060 0 58179583 240131281 417906318 -177775037 1 1 1 ASPEN SURGERY CENTER LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY CENTER 0.33000 0.01000 0.43000 2 BRENTWOOD SURGERY CENTER LLC OPERATES A MULTISPECIALTY AMBULATORY SURGERY CENTER 0.38000 0.00000 0.35000 3 MT DIABLO SURGERY CENTER LLC OPERATES AN AMBULATORY SURGERY CENTER 0.32000 0.00000 0.47000 4 MUIR DIABLO OCCUPATIONAL MEDICINE OPERATES AN OUTPATIENT OCCUPATIONAL HEALTH CLINIC 0.50000 0.00000 0.50000 2 1 JOHN MUIR MEDICAL CENTER WALNUT CREEK

1601 YGNACIO VALLEY ROAD WALNUT CREEK CA 94598

X X X 2 JOHN MUIR MEDICAL CENTER CONCORD

2540 EAST STREET CONCORD CA 94520

X X X JOHN MUIR MEDICAL CENTER WALNUT CREEK 1 1 X X X X X X X X 10 1 1 1 X X X X X X X X 0 0 1 1 400.000000000000 1 350.000000000000 1 X X X X X X X 1 1 X X X X X 1 0 1 X 0 0 JOHN MUIR MEDICAL CENTER CONCORD 2 1 X X X X X X X X 10 1 1 1 X X X X X X X X 0 0 1 1 400.000000000000 1 350.000000000000 1 X X X X X X X 1 1 X X X X X 1 0 1 X 0 0 PART I, LINE 3C: THE MAJORITY OF CHARITY CARE IS GIVEN BASED EITHER ON THE FEDERAL POVERTY GUIDELINES ("FPG") AS CALCULATED FROM DOCUMENTATION AND STATEMENTS MADE ON AN INTERNAL JOHN MUIR HEALTH CHARITY CARE APPLICATION, OR ON THE FPG AS ESTIMATED BY A CONTRACTED THIRD PARTY. THE THIRD PARTY HAS DEVELOPED AN ALGORITHM BASED ON ESTIMATED HOUSEHOLD INCOME, WHICH IS THEN TRANSLATED INTO FPG FOR THE HOUSEHOLD. JOHN MUIR HEALTH HAS NO INPUT INTO THE CRITERIA USED FOR THE ALGORITHM, WHICH IS THE SAME CALCULATION USED BY THE CONTRACTED THIRD PARTY FOR ALL OF THEIR CLIENTS NATIONWIDE. OTHER CRITERIA USED IS BASED ON THE PATIENT'S ELIGIBILITY FOR LOW-INCOME PROGRAMS THAT HAVE THE SAME OR MORE STRICT (LOWER) INCOME CRITERIA AS THE JOHN MUIR HEALTH CHARITY CARE PROGRAM. THIS INCLUDES PATIENTS WHO ARE QUALIFIED WITHIN SIX MONTHS OF THE DATE OF SERVICE FOR THE CALIFORNIA MEDICAID (MEDI-CAL) PROGRAM, OR FOR THE COUNTY'S MEDICALLY INDIGENT PROGRAM. IN ADDITION TO FORMAL QUALIFICATION IN A RECOGNIZED PROGRAM SERVING THE LOW-INCOME AND INDIGENT POPULATION, CHARITY CARE IS ALSO EXTENDED TO PATIENTS SEEN IN OUR EMERGENCY DEPARTMENTS AND WHO HAVE BEEN DOCUMENTED IN THE MEDICAL RECORD AS BEING HOMELESS, OR HAVE A LACK OF HOUSING. CHARITY CARE IS ALSO APPLIED TO OUTSTANDING BALANCES FOR EMERGENCY SERVICES RENDERED TO DOCUMENTED MINOR AND ELDERLY VICTIMS OF ABUSE, BASED ON COMPASSION AS JOHN MUIR HEALTH HAS NO KNOWLEDGE OF THE CURRENT HOME ENVIRONMENT OF THESE PATIENTS. WE ALSO HAVE A PARTNERSHIP WITH A COMMUNITY PROGRAM, OPERATION ACCESS, WHICH SERVES THE LOW-INCOME INDIVIDUALS IN OUR COUNTY, TO PROVIDE FREE CARE ON A REFERRED, CASE-BY-CASE BASIS. OPERATION ACCESS HAS ALREADY PERFORMED THE SCREENING OF THEIR REFERRED PATIENTS FOR INCOME ELIGIBILITY. JMH CONTINUED A PARTNERSHIP WITH LA CLINICA DE LA RAZA TO PROVIDE SPECIALTY CARE FOR UNINSURED AND LOW INCOME PATIENTS. LA CLINICA DE LA RAZA HAS ALREADY PERFORMED SCREENING OF THEIR REFERRED PATIENTS FOR INCOME ELIGIBILITY.PART I, LINE 4: DOES THE ORGANIZATION'S POLICY PROVIDE FREE OR DISCOUNTED CARE TO THE "MEDICALLY INDIGENT".WE PROVIDE HEALTH CARE TO THE MOST VULNERABLE INDIVIDUALS OF OUR COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY THROUGH OUR MEDICAL CENTERS IN WALNUT CREEK AND CONCORD AND THE BEHAVIORAL HEALTH CENTER. THIS INCLUDES THE CRITICAL EMERGENCY AND TRAUMA SERVICES AT OUR MEDICAL CENTER CAMPUSES. JOHN MUIR HEALTH HAS A NUMBER OF PROGRAMS TO HELP OUR PATIENTS WITH THEIR MEDICAL BILLS FOR SERVICES THEY RECEIVE AT ONE OF OUR MEDICAL CENTERS. THESE PROGRAMS INCLUDE A PATIENT ASSISTANCE PROGRAM TO ABSORB PART, OR ALL, OF THE BILL BASED ON INCOME AND OTHER PROGRAM GUIDELINES, ASSISTANCE ENROLLING IN A NUMBER OF INSURANCE PROGRAMS, AND EXTENDED PAYMENT PLANS.JOHN MUIR HEALTH MAY ALSO ASSIGN ACCOUNTS TO PRESUMPTIVE CHARITY, WITHOUT A PATIENT ASSISTANCE APPLICATION SUBMITTED BY THE PATIENT, BASED ON PREDETERMINED CRITERIA COLLECTED FROM APPROVED SOURCES. THIS CRITERIA INCLUDES:THE PATIENT HAVING DOCUMENTED IN HIS/HER MEDICAL RECORD AS BEING HOMELESS OR VERIFICATION RECEIVED THROUGH THE MEDICAL CENTER OR A FAMILY MEMBER THAT THE PATIENT IS CURRENTLY INCARCERATED.ORTHE PATIENT QUALIFIES FOR A GOVERNMENT PROGRAM WITH ELIGIBILITY REQUIREMENTS THAT REASONABLY MEET THE QUALIFICATIONS FOR THE JOHN MUIR HEALTH CHARITY CARE PROGRAM WITHIN SIX (6) MONTHS OF THE DATE THE PATIENT RECEIVED SERVICES AT THE MEDICAL CENTER.ORAFTER NORMAL COLLECTION EFFORTS HAVE NOT PRODUCED ANY PAYMENT, AND JOHN MUIR HEALTH HAS IDENTIFIED WITH REASONABLE EFFORT AND ASSURANCE THAT THE PATIENT'S ESTIMATED INCOME IS AT 250 PERCENT OR LESS OF THE FPL (FEDERAL POVERTY LEVEL). PART I, LINE 7: JOHN MUIR HEALTH HAS ADOPTED THE GUIDELINES DEVELOPED BY THE CATHOLIC HEALTHCARE ASSOCIATION AND VHA INC. FOR REPORTING THE ECONOMIC VALUE OF ITS COMMUNITY BENEFITS CONTRIBUTIONS. PART I, L7 COL(F): INCLUDED ON FORM 990, PART IX LINE 25 IS BAD DEBT EXPENSE TOTALING $58,179,583. THIS AMOUNT WAS EXCLUDED BEFORE CALCULATING THE PERCENTAGES FOUND IN COLUMN (F). PART II: JOHN MUIR HEALTH'S COMMUNITY BUILDING PROGRAMS AND ACTIVITIES ADDRESS SOCIOECONOMIC BARRIERS TO OPTIMAL PHYSICAL AND MENTAL HEALTH SUCH AS JOBS, EDUCATION, POVERTY, LANGUAGE, CULTURE, RACE, ETHNICITY, TRANSPORTATION, ETC. OUR PRIMARY AREAS OF FOCUS ARE THE CONCORD COMMUNITY ECONOMIC DEVELOPMENT ORGANIZATION AND WORKFORCE DEVELOPMENT.CONCORD COMMUNITY ECONOMIC DEVELOPMENT ORGANIZATION (DOING BUSINESS AS - MICHAEL CHAVEZ CENTER AND MONUMENT COMMUNITY PARTNERSHIP)(CCEDO)THE MONUMENT COMMUNITY COMPRISES A DISTINCTIVE SOCIO-ECONOMIC DEMOGRAPHIC WITH UNIQUE CHALLENGES. MANY RESIDENTS FACE LANGUAGE, EDUCATION AND CULTURAL BARRIERS, WHILE HAVING LIMITED ACCESS TO THE RESOURCES NECESSARY TO OVERCOME THESE BARRIERS.THE CCEDO'S MISSION IS TO ACTIVELY ENGAGE WITH THE MONUMENT COMMUNITY TO PROVIDE TRAINING AND TOOLS, IN ORDER FOR PEOPLE TO BECOME:1. ECONOMICALLY SELF-SUFFICIENT2. HEALTHY AND SAFE 3. CIVICALLY ENGAGED4. CONNECTED TO EACH OTHER, AND 5. COMMITTED TO LIFELONG LEARNING.CCEDO WORKS TO INVOLVE RESIDENTS OF ALL AGES, ETHNICITIES AND IMMIGRATION STATUS AS EQUAL PARTNERS WITH LOCAL PUBLIC AND PRIVATE ORGANIZATIONS IN PRODUCTIVE, ACTION-BASED COLLABORATION. THROUGH THREE PRIMARY PROGRAM AREAS THE ORGANIZATION WORKS TOWARDS ITS GOAL OF A VIBRANT COMMUNITY WITH A HEALTHY AND STRONG QUALITY OF LIFE: 1. ECONOMIC DEVELOPMENT2. HEALTHY LIVING3. CIVIC ENGAGEMENTSPECIFIC PROGRAMS INCLUDE CAREER DEVELOPMENT; DAY LABOR; TECHNOLOGY TRAINING; HEALTHY EATING ACTIVE LIVING (HEAL); VITA TAX ASSISTANCE; MONUMENT HEALTH FAIR; LEADERSHIP DEVELOPMENT; NEIGHBORHOOD ACTION TEAMS; AND THE FACILITATION OF RESIDENT & SERVICE NETWORKSWORKFORCE DEVELOPMENTJOHN MUIR HEALTH WORKS WITH A WIDE RANGE OF ORGANIZATIONS TO SUPPORT GREATER EXPOSURE OF YOUTH TO HEALTH CAREERS THROUGH A SPEAKERS' BUREAU, HEALTH CAREER FAIRS, WORKSHOPS, PRESENTATIONS AND HANDS ON LEARNING OPPORTUNITIES IN THE FOLLOWING AREAS:1. REGISTERED NURSING2. MEDICAL ASSISTANTS3. MEDICAL IMAGING TECHNOLOGY4. SONOGRAPHERS5. LAB PROFESSIONS, E.G. CLINICAL LAB SCIENTISTS, MEDICAL LAB TECHS6. PHARMACISTS AND PHARMACY TECHS7. RESPIRATORY THERAPISTS8. PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY PARTNERS:1. 23 AREA HIGH SCHOOLS AND HEALTH ACADEMIES. 2. CONTRA COSTA ECONOMIC PARTNERSHIP (CCEP), HELP TO REACH UNDERSERVED STUDENTS.3. CONTRA COSTA OFFICE OF EDUCATION'S YOUTH DEVELOPMENT SERVICES =SUMMER INTERN PROGRAM.4. SAMUEL MERRITT COLLEGE.5. CONTRA COSTA COLLEGES ( DIABLO VALLEY AND LOS MEDANOS COLLEGE).6. EAST COUNTY BUSINESS AND EDUCATION ALLIANCE.7. CALIFORNIA STATE UNIVERSITY, EAST BAY. PART III, LINE 4: THE ORGANIZATION DOES NOT ISSUE SEPARATE, INDEPENDENT AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS INCLUDED IN CONSOLIDATED, INDEPENDENT AUDITED FINANCIAL STATEMENTS THAT DO NOT INCLUDE A DESCRIPTION OF BAD DEBT EXPENSE. BAD DEBT COST IS DETERMINED USING THE COST-TO-CHARGE METHODOLOGY. THE ORGANIZATION DOES NOT INCLUDE BAD DEBT IN COMMUNITY BENEFIT. PART III, LINE 8: THE ORGANIZATION DOES NOT TREAT MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE COST TO CHARGE RATIOS USED TO COMPUTE THE MEDICARE SHORTFALLS ARE FROM THE 2012 MEDICARE COST REPORT FILED WITH CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS). PART III, LINE 9B: OTHER THAN SENDING STATEMENTS AND NOTIFICATIONS TO THE PATIENT, JOHN MUIR HEALTH DOES NOT CONDUCT PATIENT-OWED COLLECTIONS INTERNALLY. THESE TYPES OF FUNCTIONS ARE OUTSOURCED TO AN OUTSIDE AGENCY. THE COLLECTION POLICY IS IN THE FORM OF, AND INCORPORATED INTO, THE CONTRACT AGREEMENT WITH THE OUTSIDE AGENCY AS A FULL ADDENDUM TO THE CONTRACT, WITH A SEPARATE SIGNATURE LINE FOR JOHN MUIR HEALTH AND THE AGENCY AS PART OF THE ADDENDUM. IN ADDITION TO THE CUSTOMIZED, JOHN MUIR HEALTH COLLECTION GUIDELINES, THE ADDENDUM ALSO CONTAINS THE COLLECTION CRITERIA AND REQUIREMENTS FOUND IN CALIFORNIA LAW UNDER ASSEMBLY BILL 774. JOHN MUIR MEDICAL CENTER WALNUT CREEK PART V, SECTION B, LINE 20D: IF IT IS DETERMINED THAT A PATIENT IS ELIGIBLE FOR JOHN MUIR HEALTH'S FINANCIAL ASSISTANCE PLAN, ANY BILLS PREVIOUSLY SENT TO THAT PATIENT ARE RECALCULATED TO $0. JOHN MUIR MEDICAL CENTER CONCORD PART V, SECTION B, LINE 20D: IF IT IS DETERMINED THAT A PATIENT IS ELIGIBLE FOR JOHN MUIR HEALTH'S FINANCIAL ASSISTANCE PLAN, ANY BILLS PREVIOUSLY SENT TO THAT PATIENT ARE RECALCULATED TO $0. PART VI, LINE 2: HOW DO WE DETERMINE THE NEEDS OF OUR COMMUNITY?AS PART OF THE CALIFORNIA SB697 TRIENNIAL CYCLE, A COMPREHENSIVE COMMUNITY ASSESSMENT WAS COMPLETED IN 2010. THE 2010 COMMUNITY ASSESSMENT WAS COMPLETED THROUGH A COLLABORATIVE PROCESS INITIATED BY THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA AND COMMUNITY HOSPITALS IN CONTRA COSTA COUNTY. PARTICIPANTS INCLUDED JOHN MUIR HEALTH, KAISER PERMANENTE AND SUTTER DELTA MEDICAL CENTER. CONDUCTED BY THE COMMUNITY HEALTH ASSESSMENT, PLANNING AND EVALUATION GROUP OF CONTRA COSTA HEALTH SERVICES (CHAPE), THE 2010 QUANTITATIVE ASSESSMENT COMPILED EXISTING DATA BASED ON COLLABORATIVE OBJECTIVES. THE COMMUNITY INDICATOR REPORT CAN BE FOUND AT WWW.JOHNMUIRHEALTH.COM AND WWW.CCHEALTH.ORG. UPON REQUEST FROM THE PUBIC OR MEDIA, JOHN MUIR HEALTH WILL ALSO ASSIST THE REQUESTOR IN FINDING THE COUNTY HEALTH INFORMATION THEY NEED. IN ADDITION TO THE QUANTITATIVE PORTION OF THE COMMUNITY ASSESSMENT, JOHN MUIR HEALTH AND KAISER PERMANENTE JOINTLY CONDUCTED A SURVEY OF LOW INCOME RESIDENTS THROUGH THE FOLLOWING COMMUNITY ORGANIZATIONS THAT SERVE VULNERABLE POPULATIONS:1. CHD PROMATORAS AND HEALTH CONDUCTORS2. FAMILIAS UNIDAS3. FIRST 5 REGIONAL4. LA CLINICA DE LA RAZA5. MONUMENT COMMUNITY PARTNERSHIP6. MONUMENT CRISIS CENTER7. PLANNED PARENTHOOD- SHASTA/DIABLO8. SENIOR OUTREACH SERVICES/MEALS ON WHEELS 9. WIC- CONCORDJOHN MUIR HEALTH USED VARIOUS OTHER MECHANISMS TO INCORPORATE COMMUNITY INPUT INTO THE ANNUAL COMMUNITY BENEFIT PLAN. DURING 2010, JOHN MUIR HEALTH KEPT ABREAST OF CURRENT HEALTH ISSUES OF IMPORTANCE TO THE COMMUNITY BY ACTIVE PARTICIPATION AND COMMUNICATION WITH A VARIETY OF COMMUNITY GROUPS.IN ADDITION, JOHN MUIR HEALTH DEVELOPS PARTNERSHIPS TO ADDRESS HEALTH ISSUES IDENTIFIED THROUGH ITS INTERNAL EMERGENCY DEPARTMENT DATA. THE JOHN MUIR MEDICAL CENTER, CONCORD EMERGENCY DEPARTMENT REFERRAL LIAISON AND JOHN MUIR MEDICAL CENTER, WALNUT CREEK BEYOND VIOLENCE PROGRAMS WERE BOTH DEVELOPED IN THIS WAY. COMMUNITY ORGANIZATIONS ALSO SEEK OUT JOHN MUIR HEALTH AS A PARTNER. IN 2008 THE COMMUNITY NURSE PROGRAM WAS DEVELOPED BASED ON THE 2007 COMMUNITY ASSESSMENT THAT IDENTIFIED CHILDHOOD OBESITY AND DIABETES PREVENTION AS AREAS OF FOCUS IN SCHOOLS. AFTER THE PROGRAM'S SUCCESS, A SECOND SCHOOL DISTRICT ASKED JOHN MUIR HEALTH TO EXPAND ITS COMMUNITY NURSING PROGRAM INTO THEIR DISTRICT DURING 2010. WHERE ARE THE NEEDS GREATEST?THE 2010 COMMUNITY HEALTH ASSESSMENT IDENTIFIED SEVERAL HEALTH DISPARITIES IN CENTRAL AND EASTERN CONTRA COSTA COUNTY INCLUDING:1. CANCER DEATHS IN ANTIOCH, CONCORD, OAKLEY, PITTSBURG AND BRENTWOOD2. HEART DISEASE DEATHS IN ANTIOCH, OAKLEY, PITTSBURG, CONCORD AND MARTINEZ3. STROKE DEATHS IN ANTIOCH, PITTSBURG, CONCORD AND OAKLEY4. BREAST CANCER DEATHS IN BRENTWOOD, ANTIOCH, PITTSBURG AND CONCORD5. LUNG CANCER DEATHS IN OAKLEY, ANTIOCH, PITTSBURG AND CONCORD 6. TEEN BIRTH RATES IN ANTIOCH, CONCORD, BAY POINT AND BRENTWOOD7. OVERWEIGHT 5TH GRADERS IN ANTIOCH AND PITTSBURG8. DIABETES DEATH IN ANTIOCH AND PITTSBURG9. NON-FATAL ASSAULT HOSPITALIZATIONS IN ANTIOCH, PITTSBURG, RICHMOND AND CONCORD10. HOMICIDE DEATHS IN ANTIOCH AND PITTSBURG11. HOSPITALIZATION DUE TO FALL AGE 65+ IN ANTIOCH, PLEASANT HILL, MARTINEZ, CONCORD AND WALNUT CREEK12. AFRICAN AMERICANS ARE MOST SIGNIFICANTLY IMPACTED BY HEALTH DISPARITIES AND HAVE A SHORTER LIFE EXPECTANCYWHERE IS JOHN MUIR FOCUSING ITS EFFORTS?JOHN MUIR HEALTH SELECTS ITS FOCUS AREAS BASED ON THE COMMUNITY ASSESSMENT, INTERNAL DATA AND COMMUNITY PARTNER INPUT. SINCE 2007, NEW PROGRAMS HAVE SPECIFICALLY FOCUSED ON PROGRAMS THAT ADDRESS THE NEEDS OF VULNERABLE POPULATIONS USING THREE FUNDING CRITERIA. THE FIRST FUNDING CRITERION IS THAT THE PROGRAM SERVES VULNERABLE POPULATIONS DEFINED AS POPULATIONS WITH ONE OR MORE OF THE FOLLOWING CHARACTERISTICS:1. EVIDENCED-BASED DISPARITIES IN HEALTH OUTCOMES.2. SIGNIFICANT BARRIERS TO CARE3. ECONOMICALLY DISADVANTAGEDOUR SECOND FUNDING CRITERION REQUIRES THAT PROGRAMS ARE DELIVERED THROUGH PARTNERSHIPS WITH COMMUNITY BASED ORGANIZATIONS, OTHER PROVIDERS, PUBLIC AGENCIES OR BUSINESS ORGANIZATIONS. OUR THIRD FUNDING CRITERION CALLS FOR SELECTING PROGRAMS WE BELIEVE WILL POSITIVELY IMPACT THE HEALTH OF THE COMMUNITY IN A MEASURABLE WAY. COMMUNITY BENEFIT STAFF AND LEADERSHIP REPRESENTING VARIOUS PARTS OF JOHN MUIR HEALTH REVIEWS THE COMMUNITY ASSESSMENT DATA, PROGRAM EVALUATIONS AND REQUESTS FOR NEW PROGRAMS USING OUR FUNDING CRITERIA. RECOMMENDATIONS FOR PROGRAM FUNDING IN THE ANNUAL BUDGET PROCESS ARE A MADE AS A RESULT OF THIS PROCESS. GOALS FOR 20121. TO IMPROVE ACCESS TO HEALTH CARE FOR LOW INCOME RESIDENTS2. TO HAVE MEASURABLE IMPACT ON HEALTH OF THE COMMUNITYSTRATEGIES1. INCREASE DIRECT CARE, CHARITY CARE AND SUBSIDIZED CARE2. INCREASE ACCESS TO CARE THROUGH ENROLLMENT PROGRAMS3. SUPPORT PREVENTION, EARLY DIAGNOSIS, EARLY INTERVENTION AND MAXIMIZE PARTICIPANT IMPACTBECAUSE THE UNMET HEALTH CARE NEEDS ARE ALWAYS GREATER THAN ANY ONE OR ANY COMBINATION OF PROVIDERS CAN ADDRESS, JOHN MUIR HEALTH PRIORITIZES ITS FOCUS AND PROGRAM SELECTION USING THE FOLLOWING SELECTION CRITERIA:1. INCIDENCE/PREVALENCE (HOW MANY PEOPLE ARE AFFECTED?)2. THERE ARE FEW RESOURCES TARGETING THE IDENTIFIED ISSUE3. JOHN MUIR HEALTH IS WELL-POSITIONED TO ADDRESS THIS ISSUE OR IS PREPARING TO BE WELL-POSITIONED FOR HEALTH CARE REFORM4. IF WE WERE TO ADDRESS THIS ISSUE, WILL WE HAVE A VISIBLE IMPACT 5. LEVERAGING PARTNERSHIPS AND COMMUNITY RESOURCESTHERE ARE A NUMBER OF REASONS JOHN MUIR HEALTH DID NOT ADDRESS ALL OF THE NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED NEEDS ASSESSMENT. SLOW RECOVERY OF THE ECONOMY, CHANGES IN THE DELIVERY SYSTEM IN CONTRA COSTA COUNTY UNDER HEALTH CARE REFORM AND REDUCTIONS IN MEDICARE PAYMENTS REQUIRE ALL HEALTH SYSTEMS TO MAKE STRATEGIC CHOICES TO FOCUS COMMUNITY BENEFIT CONTRIBUTIONS ON THE GREATEST NEEDS IN THE COMMUNITY AND TO MAXIMIZE THE POSITIVE IMPACT OF THOSE CONTRIBUTIONS. JOHN MUIR HEALTH ACKNOWLEDGES THAT THE HEALTH NEEDS OF VULNERABLE RESIDENTS IN CENTRAL AND EAST CONTRA COSTA COUNTY CANNOT BE MET BY ANY ONE PUBLIC OR PRIVATE ORGANIZATION. JOHN MUIR HEALTH SELECTS FOCUS AREAS AND PROGRAMS BASED ON ITS CLINICAL AND ORGANIZATIONAL STRENGTHS, THE AVAILABILITY AND WILLINGNESS OF APPROPRIATE COMMUNITY ORGANIZATION PARTNERS, THE INCIDENCE AND PREVALENCE OF THE NEED, THE POTENTIAL FOR MAKING A POSITIVE IMPACT AND AVAILABLE FINANCIAL AND STAFF RESOURCES. PART VI, LINE 3: JOHN MUIR HEALTH HAS SIGNAGE POSTED IN PATIENT ACCESS AREAS/LOBBIES INFORMING PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR THEIR HEALTH CARE BILLS AND ELIGIBILITY, SERVICES TO AID THE PATIENT IN QUALIFYING FOR AN APPROPRIATE ASSISTANCE PROGRAM IN THE EMERGENCY DEPARTMENT. ALL PATIENTS RECEIVE A "PATIENT ASSISTANCE" BROCHURE, WHICH IDENTIFIES VARIOUS FINANCIAL ASSISTANCE PROGRAMS AVAILABLE TO THE PATIENT, INCLUDING THE JOHN MUIR HEALTH CHARITY CARE PROGRAM AS WELL AS PROGRAMS THROUGH GOVERNMENT AGENCIES (STATE, COUNTY, ETC). THE BROCHURE ALSO LISTS CONTACT INFORMATION FOR THESE PROGRAMS. PATIENTS IN THE EMERGENCY DEPARTMENT TALK TO A TRAINED FINANCIAL COUNSELOR, AND, IF APPROPRIATE, ARE ALSO ASKED TO SIGN A FORM ACKNOWLEDGING RECEIPT OF THE PATIENT ASSISTANCE MATERIALS, OR DECLINING TO ACCEPT THE MATERIAL. TRAINED FINANCIAL COUNSELORS ARE ALSO AVAILABLE FOR PATIENTS WHO DO NOT PRESENT FOR SERVICES THROUGH THE EMERGENCY DEPARTMENT. THE APPLICATION FORM AND A COPY OF THE POLICY FOR THE JOHN MUIR HEALTH CHARITY CARE PROGRAM IS ALSO AVAILABLE IN THE EMERGENCY DEPARTMENT AS WELL AS THE MAJOR PATIENT ACCESS AREAS AND THE BUSINESS OFFICE.NOTIFICATION THAT PROGRAMS, INCLUDING CHARITY CARE, ARE AVAILABLE IS ALSO PRINTED ON PATIENT BILLING STATMENTS, ACCOMPANIED BY THE ABILITY FOR A PATIENT TO REQUEST THE VARIOUS PROGRAM MATERIALS BE SENT TO HIS/HER HOME. CONTACT INFORMATION IS ALSO LISTED ON THE PATIENT STATMENT. INFORMATION ON THE HEALTH SYSTEM'S CHARITY CARE PROGRAM IS POSTED ON THE JOHN MUIR HEALTH INTERNET WEBSITE AS WELL.PATIENTS ADMITTED TO THE HOSPITAL, AND WHO HAVE NO THIRD PARTY INSURANCE LISTED, ARE INTERVIEWED BY TRAINED FINANCIAL COUNSELORS DURING THEIR HOSPITAL STAY TO INFORM THEM OF THE VARIOUS PROGRAMS WHICH ARE AVAILABLE, AND DETERMINE IF THE PATIENT WOULD LIKE ASSISTANCE TO OBTAIN ELIGIBILITY FOR THE STATE MEDICAID (MEDI-CAL) PROGRAM, STATE DISABILITY, CHARITY CARE OR OTHER AVAILABLE PROGRAMS IN THE COUNTY. THIS ELIGIBILITY ASSISTANCE, WHICH INCLUDES HELP IN FILLING OUT THE APPLICATIONS, GATHERING REQUIRED DOCUMENTS, AND TRANSPORTAION TO ELIGIBILITY APPOINTMENTS, IF NECESSARY, IS OFFERED AT NO CHARGE TO THE PATIENT. IN ADDITION, PATIENT ACCOUNTING REPRESENTATIVES MAY ALSO CONTACT PATIENTS AFTER DISCHARGE TO ASK ABOUT PAYMENT ARRANGEMENTS AND TO INFORM THEM OF THE CHARITY CARE PROGRAM IF THE PATIENT NEEDS ASSISTANCE IN PAYING FOR THE MEDICAL BILLS. PART VI, LINE 4: HOW DO WE DEFINE OUR COMMUNITY?JOHN MUIR HEALTH'S PRIMARY AND SECONDARY SERVICE AREA EXTENDS FROM SOUTHERN SOLANO COUNTY INTO EASTERN CONTRA COSTA COUNTY AND SOUTH TO SAN RAMON IN SOUTHERN CONTRA COSTA COUNTY. THE COMMUNITIES THAT COMPRISE THE PRIMARY SERVICE AREA INCLUDE CONCORD, WALNUT CREEK, PLEASANT HILL, MARTINEZ, LAFAYETTE, DANVILLE, ALAMO, ORINDA, MORAGA AND CLAYTON. THE COMMUNITIES THAT COMPRISE THE SECONDARY SERVICE AREA INCLUDE BRENTWOOD, OAKLEY, DISCOVERY BAY, BYRON, KNIGHTSEN, BETHEL ISLAND, BENICIA, PITTSBURG, BAY POINT, ANTIOCH AND SAN RAMON. JOHN MUIR HEALTH'S TRAUMA CENTER SERVES ALL OF CONTRA COSTA COUNTY, AS WELL AS SOUTHERN SOLANO COUNTY AND IS THE BACKUP TRAUMA CENTER FOR ALAMEDA COUNTY.THE PRIMARY FOCUS OF OUR COMMUNITY BENEFIT PROGRAMS IS ON THE NEEDS OF VULNERABLE POPULATIONS. WE DEFINE VULNERABLE POPULATIONS AS THOSE WITH EVIDENCED-BASED DISPARITIES IN HEALTH OUTCOMES, SIGNIFICANT BARRIERS TO CARE AND THE ECONOMICALLY DISADVANTAGED. THESE CRITERIA RESULT IN A PRIMARY COMMUNITY BENEFIT SERVICE AREA THAT INCLUDES THE COMMUNITIES OF THE MONUMENT AREA IN CONCORD AND THE EASTERN CONTRA COSTA COUNTY CITIES OF BAY POINT, PITTSBURG, ANTIOCH, OAKLEY, BRENTWOOD AND FARTHER EAST PARTS OF UNINCORPORATED CONTRA COSTA COUNTY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHJOHN MUIR HEALTH IS A NOT-FOR-PROFIT, COMMUNITY-BASED ORGANIZATION THAT IS GOVERNED LOCALLY BY THOSE WHO LIVE IN THE COMMUNITIES WE SERVE. COMMUNITY RESIDENTS ARE ACTIVELY INVOLVED IN OUR VARIOUS BOARDS AND BOARD COMMITTEES. OUR FOCUS REMAINS FIRMLY ON IMPROVING THE HEALTH OF THE PEOPLE OF CONTRA COSTA COUNTY. AS A NOT-FOR-PROFIT ORGANIZATION, THERE ARE NO SHAREHOLDERS WHO BENEFIT FROM OUR FINANCIAL SURPLUSES. INSTEAD, WE REINVEST ANY SURPLUSES INTO THE COMMUNITY WITH NEW PROGRAM IMPLEMENTATION, ADVANCED TECHNOLOGY, COMMUNITY SERVICES AND BUILDING PROJECTS. AS ONE OF THE LARGEST EMPLOYEES IN THE COUNTY WITH OVER 6,000 EMPLOYEES, JOHN MUIR HEALTH ALSO CONTRIBUTES SIGNIFICANTLY TO THE ECONOMIC VITALITY OF THE COUNTY. JOHN MUIR MEDICAL CENTER, WALNUT CREEK ALSO SERVES AS CONTRA COSTA COUNTY'S ONLY TRAUMA CENTER, WHICH REPRESENTS AN ENORMOUS FINANCIAL AND SERVICE COMMITMENT TO THE ENTIRE REGION. OUR EMERGENCY DEPARTMENTS SERVE ALL RESIDENTS REGARDLESS OF THEIR ABILITY TO PAY. JOHN MUIR HEALTH IS RECOGNIZED AS A PREEMINENT PROVIDER OF REGIONAL CARDIOVASCULAR, ORTHOPEDICS, NEUROSCIENCES, CANCER, EMERGENCY, TRAUMA AND OBSTETRIC CARE. OTHER AREAS OF SPECIALTY INCLUDE GENERAL SURGERY, ADVANCED ENDOSCOPIC AND ROBOTIC SURGERY AND WEIGHT-LOSS SURGERY. OTHER SPECIALTY SERVICES PROVIDED IN CONTRA COSTA COUNTY ONLY BY JOHN MUIR HEALTH INCLUDE HIGH RISK NEONATAL SERVICES, INPATIENT PSYCHIATRIC SERVICES INCLUDING CHILD AND ADOLESCENT SERVICES, AND SUBSTANCE ABUSE SERVICES. OUR MEDICAL STAFFS ARE OPEN TO QUALIFIED PHYSICIANS IN THE COMMUNITY. AS A NOT-FOR -PROFIT HEALTH SYSTEM, JOHN MUIR HEALTH HAS AN OBLIGATION TO MAKE A CHARITABLE CONTRIBUTION TO THE COMMUNITY, BUT OUR COMMITMENT TO KEEPING THE COMMUNITIES WE SERVE HEALTHY GOES FAR DEEPER THAN THAT. JOHN MUIR HEALTH'S MISSION TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE WITH QUALITY AND COMPASSION ACCURATELY REFLECTS OUR COMMUNITY HEALTH EFFORTS AS A CORPORATE LEADER AND COMMUNITY PARTNER. IN 2012, APPROXIMATELY 88% OF JOHN MUIR HEALTH'S COMMUNITY BENEFIT ACTIVITIES WERE SPECIFICALLY TARGETED TO THOSE INDIVIDUALS AND FAMILIES THAT EXPERIENCE SOCIAL AND ECONOMIC BARRIERS THAT PRECLUDE THEIR ACCESS TO NECESSARY HEALTH CARE SERVICES. IT IS THE EXPERTISE PROVIDED BY COMMUNITY-BASED ORGANIZATIONS, COUPLED WITH JOHN MUIR HEALTH'S RESOURCES AND COMMITMENT TO SERVE THE COMMUNITY, THAT PROVIDE THE GREATEST OPPORTUNITY FOR SUCCESS IN ADDRESSING THE MANY UNMET HEALTH NEEDS AND HEALTH DISPARITIES IN CENTRAL AND EASTERN CONTRA COSTA COUNTY.THIS LOCAL COMMITMENT IS EXPRESSED IN THE MANY INITIATIVES WE DELIVER TO THE COMMUNITY, INCLUDING MEDICAL SERVICES FOR VULNERABLE POPULATIONS IN THE COUNTY. FOR MANY INDIVIDUALS AND FAMILIES WITH NO INSURANCE AND LIMITED MEANS, JOHN MUIR HEALTH PROVIDES CHARITY CARE. IN 2012, WE PROVIDED $24.3 MILLION IN CHARITY CARE COSTS. JOHN MUIR HEALTH ALSO ABSORBED $42.4 MILLION, THE FINANCIAL COST OF PROVIDING CARE TO INDIVIDUALS THAT EXCEEDS THE REIMBURSEMENTS WE RECEIVE FROM MEDI-CAL. IN ADDITION TO THIS DIRECT DELIVERY OF CARE, JOHN MUIR HEALTH PROVIDES BROAD FINANCIAL AND TECHNICAL SUPPORT TO PROMOTE COMMUNITY WELLNESS. EACH YEAR THE ORGANIZATION CONTRIBUTES MORE THAN $1.6 MILLION TO THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND. THE FUND'S GOAL IS TO FOSTER SYSTEMIC CHANGE THAT IMPROVES THE HEALTH OF PEOPLE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES IN CENTRAL AND EASTERN CONTRA COSTA COUNTY. BY WORKING WITH LEADING COMMUNITY GROUPS, JOHN MUIR HEALTH HAS HELPED FOSTER MANY INNOVATIVE HEALTH CARE PROGRAMS, INCLUDING OUR MOBILE HEALTH CLINIC, THE DENTAL COLLABORATIVE OF CONTRA COSTA WHICH OPERATES A MOBILE DENTAL CLINIC, SENIOR SERVICES, THE FAITH AND HEALTH PARTNERSHIP AND COMMUNITY NURSES IN ELEMENTARY SCHOOLS IN PITTSBURG AND CONCORD.IN 2012, WE CONTINUED OUR PARTNERSHIPS WITH LA CLINICA DE LA RAZA AND THE CONTRA COSTA HEALTH SERVICES DEPARTMENT TO SERVE LOW-INCOME RESIDENTS THROUGH THE JOHN MUIR MOBILE HEALTH CLINIC AND THE DENTAL COLLABORATIVE OF CONTRA COSTA. THROUGH A PARTNERSHIP WITH LA CLINICA DE LA RAZA, JOHN MUIR HEALTH PROVIDED SPECIALTY CARE FOR UNINSURED AND LOW INCOME PATIENTS. ACCESS TO SPECIALTY CARE HAS BEEN IDENTIFIED AS ONE OF THE GREATEST HEALTH CARE NEEDS OF LOW INCOME, UNINSURED RESIDENTS. JOHN MUIR HEALTH ALSO SEEKS TO SERVE AT-RISK, OLDER ADULTS IN THE COMMUNITY. AMONG THE PROGRAMS WE SUPPORT ARE THE CARING HANDS VOLUNTEER CAREGIVER PROGRAM, WHICH CREATES ONE-TO-ONE MATCHES BETWEEN VOLUNTEERS AND SENIORS WHO ARE FRAIL, ISOLATED, AND/OR DISABLED. FREE, NON-MEDICAL, IN-HOME ASSISTANCE ENABLES THESE SENIORS TO STAY IN THEIR HOMES AND REMAIN INDEPENDENT AND SAFE. THE FALL PREVENTION PROGRAM OF CONTRA COSTA COUNTY, WHICH IS ALSO SUPPORTED BY JOHN MUIR HEALTH, WORKS WITH SENIOR GROUPS TO GENERATE AWARENESS AND REDUCE INJURIES DUE TO FALLS THROUGH HOME SAFETY ASSESSMENTS AND HOME MODIFICATIONS FOR LOW INCOME SENIORS. COMMUNITY BENEFITS ALSO INCLUDE HEALTH PROFESSIONS EDUCATION PROGRAMS IN THE AREAS OF NURSING, PHYSICAL THERAPY, ULTRASOUND TECHNOLOGY, RADIOLOGIC TECHNOLOGY, REHABILITATION AND CLINICAL PASTORAL CARE.JOHN MUIR HEALTH SERVED OVER 178,699 RESIDENTS THROUGH OUR COMMUNITY BENEFIT PROGRAMS IN 2012.THE JOHN MUIR HEALTH FOUNDATION RAISES FUNDS TO OFFSET THE COST OF CAPITAL AND OPERATING EXPENSES FOR JOHN MUIR HEALTH PROGRAMS AND IN THIS WAY MITIGATES THE COST OF CARE PROVIDED AND ASSISTS JOHN MUIR HEALTH IN MAINTAINING STATE-OF -THE-ART FACILITIES, EQUIPMENT AND PROGRAMS FOR THE COMMUNITY. PART VI, LINE 6: JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND1399 YGNACIO VALLEY ROAD, SUITE 36, WALNUT CREEK, CATHE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND IS THE COMMUNITY BENEFIT GRANT-MAKING ARM OF JOHN MUIR HEALTH. THE FUND'S GOAL IS TO FOSTER SYSTEMIC CHANGE THAT IMPROVES THE HEALTH OF PEOPLE IN CENTRAL AND EASTERN CONTRA COSTA COUNTY WHO ARE UN- OR UNDER-INSURED, HAVE LIMITED ACCESS TO HEALTH CARE, ARE MOST AT-RISK FOR POOR HEALTH, AND ARE MOST LIKELY TO EXPERIENCE HEALTH CARE DISPARITIES. TO ACCOMPLISH THIS GOAL, THE FUND DEVELOPED A FUNDING PROCESS THAT NURTURES LONG-TERM PARTNERSHIPS WITH AND AMONG COMMUNITY-BASED ORGANIZATIONS. THIS LEADS TO VISIONARY HEALTH INITIATIVES THAT BUILD AND SUSTAIN THE CAPACITY TO DELIVER ON THE PROMISE OF GOOD HEALTH AND AFFORDABLE HEALTH CARE FOR ALL. FROM 1997, THE YEAR THE COMMUNITY HEALTH FUND WAS FORMED, THROUGH 2012, THE FUND HAS GRANTED OVER $20 MILLION JOHN MUIR HEALTH COMMUNITY BENEFIT DOLLARS INTO LOCAL COMMUNITY-BASED HEALTH PROJECTS. MORE DETAILED INFORMATION ABOUT THE FUND, ITS GOVERNANCE, GRANT PROGRAM AND COMMUNITY BENEFIT REPORTS CAN BE FOUND ON ITS WEBSITE: WWW.JMMDCOMMUNITYHEALTHFUND.COM. EXECUTIVE DIRECTOR IS LILLIAN ROSELIN.JOHN MUIR PHYSICIAN NETWORK1350 TREAT BOULEVARD, SUITE 450, WALNUT CREEK, CA THE JOHN MUIR PHYSICIAN NETWORK IS A NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION, WHOSE SOLE CORPORATE MEMBER IS JOHN MUIR HEALTH. SINCE ITS INCEPTION IN 1996, IT HAS BECOME ONE OF THE LARGEST PROVIDERS OF PHYSICIAN AND ALLIED HEALTH SERVICES IN NORTHERN CALIFORNIA, WITH MORE THAN 900 PRIMARY CARE AND SPECIALTY PHYSICIANS WHO DELIVER COORDINATED PATIENT CARE. PHYSICIANS ASSOCIATED WITH THE PHYSICIAN NETWORK BELONG TO EITHER JOHN MUIR MEDICAL GROUP (JMMG) OR MUIR MEDICAL GROUP IPA, INC. THE PHYSICIAN NETWORK OWNS AND OPERATES PRIMARY CARE PRACTICES CENTERS STAFFED BY JMMG PHYSICIANS IN NUMEROUS LOCATIONS FROM BRENTWOOD TO PLEASANTON. JMMG ALSO PROVIDES HOSPITALISTS (IN-PATIENT MEDICAL SERVICES) AT JOHN MUIR HEALTH'S HOSPITALS. THE PHYSICIAN NETWORK IS ACTIVE IN COMMUNITY SERVICE, HEALTH EDUCATION AND CLINICAL RESEARCH. THE PHYSICIAN NETWORK CURRENTLY HOLDS CONTRACTS WITH SIX MAJOR HEALTH PLANS FOR MORE THAN 50,000 COMMERCIAL AND SENIOR HMO MEMBERS. ADDITIONALLY, THE PHYSICIAN NETWORK PROVIDES A PHYSICIAN PANEL, MEDICAL MANAGEMENT AND CLAIMS SERVICES FOR MORE THAN 9,000 JOHN MUIR HEALTH EMPLOYEES AND DEPENDENTS PARTICIPATING IN THE EXCLUSIVE PROVIDER ORGANIZATION HEALTH PLAN. THE PHYSICIAN NETWORK MANAGES HEALTH PLAN CONTRACTING FOR JOHN MUIR HEALTH AND ITS HOSPITALS AND ENGAGES IN PHYSICIAN RECRUITMENT TO MEET COMMUNITY NEEDS. THE PHYSICIAN NETWORK ALSO OPERATES THE JMH MEDICARE ACO WHICH PROVIDES FOR COORDINATION OF CARE FOR ITS MEDICARE ACO MEMBERS. HAROLD HUSKINS IS THE PRESIDENT AND CHIEF ADMINISTRATIVE OFFICER OF THE JOHN MUIR PHYSICIAN NETWORK. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF THE JOHN MUIR PHYSICIAN NETWORK. JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER2740 GRANT STREET, CONCORD, CAJOHN MUIR HEALTH OFFERS COMPLETE INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH PROGRAMS AND SERVICES THROUGH THE JOHN MUIR BEHAVIORAL HEALTH CENTER, THE HEALTH SYSTEM'S FULLY ACCREDITED, 73-BED PSYCHIATRIC HOSPITAL LOCATED IN CONCORD. THE JOHN MUIR HEALTH BEHAVIORAL HEALTH CENTER OFFERS PSYCHIATRIC TREATMENT FOR ADULTS, CHILDREN AND ADOLESCENTS WHO EXPERIENCE EMOTIONAL OR BEHAVIORAL PROBLEMS. FOR THOSE WHO ARE DEPENDENT ON ALCOHOL OR DRUGS, THE BEHAVIORAL HEALTH CENTER OFFERS A FULL ARRAY OF CHEMICAL DEPENDENCY TREATMENT PROGRAMS. JOHN MUIR BEHAVIORAL HEALTH CENTER IS ACCREDITED BY THE JOINT COMMISSION. CHIEF OPERATING OFFICER IS LIZ STALLINGS. JOHN MUIR HEALTH FOUNDATION1400 TREAT, WALNUT CREEK, CATHE FOUNDATION RAISES FUNDS FOR PROGRAMS AND PROJECTS OF JOHN MUIR HEALTH, INCLUDING VARIOUS EDUCATION PROGRAMS, OPERATIONS, BUILDINGS AND EQUIPMENT. JOHN MUIR HEALTH IS THE SOLE CORPORATE MEMBER OF JOHN MUIR HEALTH FOUNDATION. THE FOUNDATION'S PRESIDENT IS PATRICK CAREW. REPORTS FILED WITH STATES PART VI, LINE 7 CA 1 JOHN MUIRMT DIABLO COMMUNITY HEALTH FUND 1399 YGNACIO VALLEY ROAD SUITE 36 WALNUT CREEK CA 94598 911788973 501(C)(3) 2521097 CASH VALUE COMMUNITY GRANTS JOHN MUIR BEHAVIORAL HEALTH 1400 TREAT BOULEVARD WALNUT CREEK CA 94597 680249685 501(C)(3) 3613673 CASH VALUE GENERAL SUPPORT 2 0 SCHOLARSHIPS 17 47000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: JOHN MUIR HEALTH AND FINANCIAL MANAGEMENT MONITOR THE USE OF THE RESTRICTED FUNDS TO MEET THE INTENDED PURPOSES. SCHOLARSHIPS MADE IN FURTHERANCE OF THE ORGANIZATION'S EXEMPT PURPOSE ARE SUBJECT TO CONDITIONS ESTABLISHED TO ENSURE THAT INDIVIDUALS RECEIVING SCHOLARSHIPS ARE ADEQUATELY INVESTIGATED TO VERIFY THEY ARE QUALIFIED RECIPIENTS. X X 1 1 X X X X 1 1 0 0 0 1 1 0 0 CALVIN KNIGHT 834970 0 362831 0 105900 0 625905 0 27289 0 1956895 0 362831 0 MICHAEL MOODY 410142 0 177597 0 13644 0 236582 0 26058 0 864023 0 177597 0 IRVING PIKE MD 304621 0 0 0 108280 0 87162 0 17014 0 517077 0 0 0 NANCY OLSON 358374 0 156163 0 32728 0 204372 0 15863 0 767500 0 156163 0 JANE WILLEMSEN 420581 0 255435 0 17255 0 267873 0 19354 0 980498 0 255435 0 MICHAEL THOMAS 396229 0 232871 0 10510 0 263583 0 23805 0 926998 0 232871 0 ALICE A VILLANUEVA 331469 0 149858 0 22647 0 168215 0 22595 0 694784 0 149858 0 MARTI TARNOWSKI 318118 0 135717 0 50794 0 183498 0 21616 0 709743 0 135717 0 CHRISTIAN PASS 295285 0 123386 0 34669 0 147673 0 24340 0 625353 0 123386 0 MICHAEL MONALDO 278215 0 135358 0 4109 0 157111 0 21123 0 595916 0 135358 0 DEBRA PENDERGAST 306000 0 107772 0 28337 0 117398 0 22187 0 581694 0 107772 0 PAUL SWENSON 29396 0 321903 0 56958 0 717 0 2162 0 411136 0 321903 0 KENNETH MEEHAN 242227 0 347383 0 299534 0 263871 0 27668 0 1180683 0 339487 0 ERIC SAFF 89190 0 156609 0 380131 0 1488 0 5960 0 633378 0 156609 0 NEIL MILLER 53078 0 155604 0 98438 0 0 0 1329 0 308449 0 155604 0 PART I, LINE 1A THE COMPANY HAS A POLICY WHEREBY CERTAIN PAYMENTS TO EMPLOYEES AND MEMBERS OF THE BOARD OF DIRECTORS ARE GROSSED UP. THESE PAYMENTS ARE NOT A USUAL OCCURRENCE AND ARE EVALUATED AND APPROVED BY THE CEO OR CFO. ADDITIONALLY, FOR CERTAIN MEMBERS OF MANAGEMENT THAT ARE RECRUITED FROM OUTSIDE OF THE AREA A HOUSING ALLOWANCE CAN BE PROVIDED AS PART OF THE RECRUITMENT PROCESS. EACH RECRUITMENT IS EVALUATED ON A CASE-BY-CASE BASED ON THE CURRENT MARKET AND THE QUALIFICATIONS OF THE CANDIDATE TO DETERMINE WHETHER OR NOT THE INCLUSION OF A HOUSING ALLOWANCE WILL BE PART OF THE RECRUITMENT PACKAGE. FOR CERTAIN MEMBERS OF MANAGEMENT A REIMBURSEMENT OF UP TO 50% OF HEALTH CLUB DUES IS AVAILABLE. THIS PERQUISITE IS INCLUDED AS PART OF THE EVALUATION OF THE ANNUAL COMPENSATION EVALUATION PROCESS. ALL COMPONENTS DISCUSSED IN THIS SECTION ARE TREATED AS TAXABLE INCOME FOR THE EMPLOYEE RECEIVING THE PAYMENT. PART I, LINE 1B THE CORPORATION, WITH THE OVERSIGHT AND APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, BASES A PORTION OF ANNUAL MANAGEMENT INCENTIVE PAYMENTS ON THE CONSOLIDATED NET EARNINGS TARGETS OF JOHN MUIR HEALTH. IN ADDTION TO THE CONSOLIDATED NET EARNINGS THE MANAGEMENT INCENTIVE PAYMENTS ARE BASED ON VARIOUS QUALITY AND PATIENT SATISFACTION METRICS. PAYMENTS TO MANAGEMENT PERSONNEL ARE MADE IN THE SUBSEQUENT YEAR BASED ON THE LEVEL OF ACHIEVEMENT OF ALL ELEMENTS OF THE INCENTIVE PROGRAM, OF WHICH NET EARNINGS TARGETS ARE A COMPONENT. THEREFORE, EACH YEAR AN ACCRUAL OF THE ESTIMATED PAYMENTS FOR MANAGEMENT INCENTIVES IS INCLUDED IN THE CALCULATION OF NET EARNINGS TARGETS FOR THAT YEAR. THE INCENTIVE PROGRAMS FOR THE MANAGEMENT OF JOHN MUIR HEALTH ARE DEVELOPED AND REVIEWED BY AN OUTSIDE CONSULTANT WHOSE EXPERTISE IS IN COMPENSATION AND WHO DEVELOPS MARKET DATA FOR SIMILAR ORGANIZATIONS AS A BASIS FOR THE CORPORATION'S INCENTIVE PROGRAM. THE INCENTIVE PROGRAM AND MARKET DATA IS REVIEWED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART I, LINE 3 THE CORPORATION, WITH THE OVERSIGHT AND APPROVAL OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, BASES A PORTION OF ANNUAL MANAGEMENT INCENTIVE PAYMENTS ON THE CONSOLIDATED NET EARNINGS TARGETS OF JOHN MUIR HEALTH. ADDITIONALLY, WHERE APPROPRIATE MANAGEMENT OVERSIGHT EXISTS, A PORTION OF AN EXECUTIVE'S MANAGEMENT INCENTIVE CAN ALSO BE BASED ON THE NET EARNINGS TARGETS OF THE RESPECTIVE OPERATING UNITS WITHIN THE CORPORATION. PAYMENTS TO MANAGEMENT PERSONNEL ARE MADE IN THE SUBSEQUENT YEAR BASED ON THE LEVEL OF ACHIEVEMENT OF ALL ELEMENTS OF THE INCENTIVE PROGRAM, OF WHICH NET EARNINGS TARGETS ARE A COMPONENT. THEREFORE, EACH YEAR AN ACCRUAL OF THE ESTIMATED PAYMENTS FOR MANAGEMENT INCENTIVES IS INCLUDED IN THE CALCULATION OF NET EARNINGS TARGETS FOR THAT YEAR. THE INCENTIVE PROGRAMS FOR THE MANAGEMENT OF JOHN MUIR HEALTH ARE DEVELOPED AND REVIEWED BY AN OUTSIDE CONSULTANT WHOSE EXPERTISE IS IN COMPENSATION AND WHO DEVELOPS MARKET DATA FOR SIMILAR ORGANIZATIONS AS A BASIS FOR THE CORPORATION'S INCENTIVE PROGRAM. THE INCENTIVE PROGRAM AND MARKET DATA IS REVIEWED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. PART I, LINES 4A-B JANE ANN WILLEMSEN $ 26,589 RESTORATION PLAN MICHAEL THOMAS $ 52,921 RESTORATION PLAN CALVIN KNIGHT $147,469 RESTORATION PLAN CHRISTIAN PASS $ 24,222 RESTORATION PLAN MARTI TARNOWSKI $ 48,039 RESTORATION PLAN MICHAEL D MOODY $ 63,592 RESTORATION PLAN NANCY OLSON $ 49,020 RESTORATION PLAN ALICE A VILLANUEVA $ 29,234 RESTORATION PLAN MICHAEL MONALDO $ 32,512 RESTORATION PLAN ERIC SAFF RECEIVED SEVERANCE OF $356,761. KEN MEEHAN RECEIVED SEVERANCE OF $282,598 SUPPLEMENTAL INFORMATION PART III SUPPLEMENTAL INFORMATION COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, OTHER OFFICERS AND KEY EMPLOYEES ARE ESTABLISHED ANNUALLY BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE UTILIZES AN OUTSIDE CONSULTANT WHO IS A COMPENSATION EXPERT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITIES AND THAT DATA IS USED BY THE COMPENSATION COMMITTEE TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. A CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130911J84 2005-05-10 50290253 SEE PART VI 0 0 0 B CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130911Y87 2006-06-14 203016972 SEE PART VI 0 0 0 C CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130795UC9 2008-05-02 145800000 SEE PART VI 0 0 0 D CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 130795N86 2009-10-29 101911852 SEE PART VI 0 0 0 A 20405000 50290253 908703 644000 48737550 1 0 1 1 B 231090613 23598317 2140116 205352180 2011 0 0 1 1 C 50700000 145800000 1155297 497539 144165164 1 0 1 1 D 3830000 101922259 1911852 99973171 37236 2011 0 0 0 1 A 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0.00010 0.00010 0 0 1 C 0 0 1 0 0 0.00010 0.00010 0 0 1 D 0 0 1 0 0 0.00010 0.00010 0 0 1 A 0 0 0 1 0 0 0 0 1 B 1 0 0 0 1 1 C 0 0 0 1 1 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 0 B 0 C 0 D 0 SCHEDULE K SUPPLENTAL INFORMATION DIFFERENCE BETWEEN THE ISSUE PRICE ( PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. PART I, LINE A, COLUMN (F) - TO PAY THE OUTSTANDING PRINCIPAL AMOUNT OF THE CITY OF WALNUT CREEK CERTIFICATES OF PARTICIPATION REFUNDING SERIES 1994, ORIGINALLY ISSUED 2/17/1994. PART I, LINE B, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSE OF (I) FINANCING AND REFINANCING THE COST OF ACQUISITION, CONSTRUCTION, IMPROVEMENT, EQUIPPING, RENOVATION, REHABILITATION, REMODELING AND OTHER CAPITAL PROJECTS ON OR ABOUT THE JOHN MUIR MEDICAL CENTER-WALNUT CREEK CAMPUS, (II) FINANCING VARIOUS ROUTINE CAPITAL EXPENDITURES AND THE COST OF ACQUISITION OF EQUIPMENT TO BE LOCATED ON THE JOHN MUIR MEDICAL CENTER-CONCORD CAMPUS, (III) PROVIDING FOR PAYMENT OF A PORTION OF INTEREST ON THE BONDS, AND (IV) PAYING CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. PART I, LINE C, COLUMN (D) - 5/2/08 AND 5/13/08. PART I, LINE C, COLUMN (F) - 2008 A AND B TO (I) REFUND AND PAY IN FULL THE OUTSTANDING PRINCIPAL AMOUNT OF THE $100,000,000 AGGREGATE PRINCIPAL AMOUNT CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BONDS (JOHN MUIR HEALTH) SERIES 2006 B AND SERIES 2006 C (THE "SERIES 2006 BONDS") ORIGINALLY ISSUED 6/14/2006 AND (II) TO PAY CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE BONDS. 2008 C TO (I) REFUND AND PAY IN FULL THE VARIABLE RATE PORTION OF THE CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY $90,000,000 CERTIFICATES OF PARTICIPATION, JOHN MUIR/MT. DIABLO HEALTH SYSTEM (1997) ORIGINALLY ISSUED 10/29/1997, IN THE OUTSTANDING PRINCIPAL AMOUNT OF $44,000,000 AND (II) TO PAY CERTAIN COSTS INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2008 C BONDS. PART I, LINE D, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSES OF (1) FINANCING THE CONSTRUCTION, IMPROVEMENT, EQUIPPING, RENOVATION, REHABILITATION, REMODELING AND OTHER CAPITAL PROJECTS ON OR ABOUT THE JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS AND ON OR ABOUT THE JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS AND (2) PAYING CERTAIN COSTS OF ISSUANCE. PART I, LINE E, COLUMN (F) - THE BONDS WERE ISSUED FOR THE PURPOSE OF REFUND AND PAYMENT IN FULL OF THE OUTSTANDING PRINCIPAL AMOUNT AND INTEREST DUE ON THE 1997 CERTIFICATES OF PARTICIPATION AND THE SERIES 2008B BONDS ISSUED 10/29/1997 AND 5/2/2008 RESPECTIVELY. PART III, LINE 3B AND 3D - JOHN MUIR HEALTH ENGAGES BOND COUNSEL IN CONNECTION WITH PUBLIC DEBT OFFERINGS OR REFINANCING, DURING WHICH BOND COUNSEL REVIEWS MANAGEMENT OR SERVICE CONTRACTS RELATED TO FINANCED PROPERTY. PART IV, LINE 6, COLUMN B - SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. PART V - IN MAY 2012, JOHN MUIR HEALTH ENTERED INTO AN AGREEMENT WITH THE CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY (CSCDA) IN WHICH JOHN MUIR HEALTH COVENANTS TO COMPLY WITH THE REQUIREMENTS AND PROCEDURES SET FORTH IN THE CSCDA POST-ISSUANCE TAX COMPLIANCE PROCEDURES FOR TAX EXEMPT BONDS. JOHN MUIR HEALTH IS ASSESSING THE NEED TO ESTABLISH WRITTEN PROCEDURES IN CONNECTION WITH THE COVENANT TO COMPLY. A CALIFORNIA STATEWIDE COMMUNITY DEVELOPMENT AUTHORITY 680164610 2012-05-23 89800000 SEE PART VI 0 0 0 A 89800000 502197 89170000 127803 1 0 0 1 A 0 0 1 0 0 0.00010 0.00010 0 0 1 A 0 0 0 1 1 0 0 0 1 A 0 CALVIN KNIGHT DIRECTOR HOUSING RELOCATION X 250000 175000 0 1 1 CHRISTIAN PASS HIGHEST COMPENSATED EMPLOYEE HOUSING RELOCATION X 75000 10417 0 1 1 DEBRA PENDERGAST HIGHEST COMPENSATED EMPLOYEE HOUSING RELOCATION X 125000 115833 0 1 1 301250 WOMEN'S PRIMARY HEALTH PHYSICIANS COMMOM BOARD MEMBER 760182 CONTRACT FOR PROFESSIONAL SERVICES 0 BETA HEALTH CARE GROUP FORMER EMPLOYEE IS BOARD MEMBER 3933841 CONTRACT FOR INSURANCE SERVICES 0 AMY ANDERSON SPOUSE OF A BOARD MEMBER 132143 EMPLOYEE 0 BAY AREA SURGICAL SPECIALIST BOARD MEMBER HAS OWNERSHIP INTEREST 3019915 CONTRACT FOR PROFESSIONAL SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 THOMAS RUNDALL (JMH SECRETARY AND DIRECTOR) IS A BOARD MEMBER OF ON LOK, INC., A NOT-FOR-PROFIT COMMUNITY ORGANIZATION WHICH EMPLOYS ROBERT EDMONSON (JMH DIRECTOR) AS CEO. FORM 990, PART VI, SECTION A, LINE 6 MT. DIABLO HEALTHCARE DISTRICT AND JOHN MUIR ASSOCIATION HAVE THE RIGHT TO APPROVE CERTAIN SIGNIFICANT CORPORATE ACTIONS (AS DESCRIBED IN SCHEDULE O). FORM 990, PART VI, SECTION A, LINE 7B THE BYLAWS OF JOHN MUIR HEALTH PROVIDE THAT JOHN MUIR HEALTH MAY NOT, WITHOUT THE PRIOR WRITTEN CONSENT OF THE MT. DIABLO HEALTHCARE DISTRICT, A POLITICAL SUBDIVISION OF THE STATE OF CALIFORNIA, AND THE JOHN MUIR ASSOCIATION, A CALIFORNIA NONPROFIT CORPORATION: (I) SELL, TRANSFER, OR OTHERWISE DISPOSE OF ALL OR SUBSTANTIALLY ALL THE ASSETS OF JOHN MUIR HEALTH; (II) ISSUE A MEMBERSHIP IN JOHN MUIR HEALTH TO ANY PERSON OR ENTITY; (III) MERGE WITH ANY OTHER PERSON OR ENTITY, UNLESS JOHN MUIR HEALTH IS THE SURVIVING CORPORATION IN THE MERGER; OR (IV) AMEND SECTION 5.6 OF THE BYLAWS OF JOHN MUIR HEALTH (WHICH OBLIGATES JOHN MUIR HEALTH TO, AMONG OTHER THINGS, PROVIDE AT LEAST ONE MILLION DOLLARS ($1,000,000) ANNUALLY TO FUND CERTAIN COMMUNITY BENEFIT PROJECTS SPONSORED BY THE JOHN MUIR/MT. DIABLO COMMUNITY HEALTH FUND). FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS SUFFICIENTLY IN ADVANCE OF THE FILING DEADLINE TO ENABLE A DETAILED AND CONSCIENTIOUS REVIEW BY ALL MEMBERS. AN OVERVIEW OF THE FORM 990, WITH SUFFICIENT DETAIL, IS PRESENTED TO THE BOARD WITH THE COMPLETED FORM 990. ALL QUESTIONS AND CONCERNS OF THE BOARD OF DIRECTORS WILL BE ADDRESSED BY THE CHIEF FINANCIAL OFFICER OR HIS DESIGNEE AND INCORPORATED INTO THE FORM 990 AS APPROPRIATE. AFTER ALL OF THE INPUT FROM THE BOARD OF DIRECTORS HAS BEEN APPROPRIATELY ADDRESSED, SENIOR MANAGEMENT OF JOHN MUIR HEALTH WILL FILE THE FINAL FORM 990 AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE JOHN MUIR HEALTH ("JMH") BOARD CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO BOARD MEMBERS, ALONG WITH A CONFLICT OF INTEREST DISCLOSURE FORM REQUIRED TO BE COMPLETED AND SIGNED. FOLLOWING DISTRIBUTION OF THE POLICY, THE GENERAL COUNSEL PROVIDES AN EDUCATIONAL SESSION RELATING TO BOARD MEMBER FIDUCIARY DUTIES AND CONFLICTS OF INTEREST COVERING, AMONG OTHER THINGS, REQUIRED DISCLOSURES AND THE PROCESS FOR APPROVAL OF TRANSACTIONS INVOLVING A POTENTIAL CONFLICT. DISCLOSED CONFLICTS ARE COMPILED IN A DOCUMENT AND REVIEWED BY THE BOARD CHAIR, PRESIDENT/CEO AND GENERAL COUNSEL. TOGETHER, THESE INDIVIDUALS MONITOR ANY POTENTIAL CONFLICTS AND THE GENERAL COUNSEL ATTENDS BOARD MEETINGS TO ENSURE COMPLIANCE WITH THE POLICY. TRANSACTIONS INVOLVING A POTENTIAL CONFLICT ARE REVIEWED AND APPROVED IN ADVANCE BY THE GENERAL COUNSEL, THE GOVERNANCE COMMITTEE, AND FOR CERTAIN TRANSACTIONS WITH CURRENT BOARD MEMBERS, THE BOARD. THE POLICY ALSO REQUIRES BOARD MEMBERS TO DISCLOSE ANY POTENTIAL CONFLICTS DURING THE YEAR. AS QUESTIONS ABOUT POTENTIAL CONFLICTS ARISE DURING THE YEAR, THE GENERAL COUNSEL REVIEWS THEM WITH THE AFFECTED BOARD MEMBER, THE PRESIDENT/CEO AND THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER, OTHER OFFICERS AND KEY EMPLOYEES IS ESTABLISHED ANNUALLY BY THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE UTILIZES AN OUTSIDE CONSULTANT WHO IS A COMPENSATION EXPERT. THE OUTSIDE CONSULTANT PROVIDES MARKET DATA FOR EACH INDIVIDUAL BASED UPON THEIR LEVEL OF RESPONSIBILITIES AND THAT DATA IS USED BY THE COMPENSATION COMMITTEE TO ESTABLISH THE ANNUAL COMPENSATION PACKAGE FOR EACH INDIVIDUAL. IT IS THE PHILOSOPHY OF THE ORGANIZATION TO ESTABLISH A COMPENSATION PACKAGE FOR EACH INDIVIDUAL THAT REFLECTS THE MEDIAN OF THE MARKET AS ESTABLISHED BY THE OUTSIDE CONSULTANT. FORM 990, PART VI, SECTION C, LINE 19 JOHN MUIR HEALTH PROVIDES FINANCIAL INFORMATION ON A QUARTERLY BASIS THROUGH VARIOUS BOND DISCLOSURE DATABASES. THIS FINANCIAL INFORMATION IS AVAILABLE FOR JOHN MUIR HEALTH ON A CONSOLIDATED AND CONSOLIDATING BASIS, INCLUDING SUBSIDIARIES. REQUESTS FOR THE PROVISION OF GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE DIRECTED TO OUR LEGAL DEPARTMENT FOR THE APPROPRIATE RESPONSE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN PENSION FUND LIABILITY 8,213,000. FORM 990, PART XII, LINES 3A AND 3B IN 2012, JOHN MUIR HEALTH WAS NOTIFIED THAT A PORTION OF A GRANT RECEIVED FROM THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES IN 2011 WAS FEDERALLY FUNDED. DUE TO THE TIMING OF THE NOTIFICATION IN 2012, JOHN MUIR HEALTH IS CURRENTLY ASSESSING THE AUDIT REQUIREMENTS RESULTING FROM THE RECEIPTS OF A FEDERAL AWARD UNDER THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. JOHN MUIR HEALTH FOUNDATION 1400 TREAT BLVD WALNUT CREEK CA 94597 942650855 SOLICITATION OF FUNDS FOR JOHN MUIR HEALTH CA 501(C)(3) 7 N/A 1 JOHN MUIR PHYSICIAN NETWORK 1400 TREAT BLVD WALNUT CREEK CA 94597 680360801 PROVIDE CLINIC SERVICES & MANAGE HEALTHCARE RISK OPERATIONS WITH JOHN MUIR CA 501(C)(3) 11 TYPE I N/A 1 JOHN MUIR BEHAVIORAL HEALTH 1400 TREAT BLVD WALNUT CREEK CA 94597 680249685 PROVIDE BEHAVIORAL HEALTH SERVICES INCLUDING MENTAL HEALTH & SUBSTANCE ABUSE CA 501(C)(3) 3 N/A 1 JOHN MUIRMT DIABLO COMMUNITY HEALTH FUND 1400 TREAT BLVD WALNUT CREEK CA 94597 911788973 PROVIDE GRANTS THAT ENHANCE HEALTHCARE SERVICES TO UNDERSERVED CA 501(C)(3) 11 TYPE III N/A 1 JOHN MUIR MAGNETIC IMAGING 1400 TREAT BLVD WALNUT CREEK CA 94598 680202020 DIAGNOSTIC IMAGING CA N/A RELATED 2420815 7943189 0 1 NEUROSCAN 115 LA CASA VIA STE 202 WALNUT CREEK CA 94598 680017617 DIAGNOSTIC IMAGING CA N/A RELATED 3235887 7911908 0 1 BAY AREA SURGICAL VENTURES 30 S WACKER DR STE 2302 CHICAGO IL 60606 203052802 MEDICAL SERVICES CA N/A RELATED 527251 2282779 0 0 CARIDIAN PHYSICIAN SERVICES INC 700 YGNACIO VALLEY BLVD WALNUT CREEK CA 94596 680297913 INACTIVE CA N/A C 1.00000 1 MT DIABLO PRACTICE MANAGEMENT 1400 TREAT BLVD WALNUT CREEK CA 94597 680031326 INACTIVE CA N/A C 1.00000 1 JOHN MUIRMT DIABLO PARENT COMPANY 1400 TREAT BLVD WALNUT CREEK CA 94597 900060434 INACTIVE CA N/A C 1.00000 1 1 1 1 0 0 0 0 0 0 1 1 1 1 0 1 1 1 0 0