2012-05-10T09:50:25-04:00 2011-06-30 ERNST & YOUNG US LLP 18111 VON KARMAN AVENUE SUITE 1000 IRVINE CA 92612 990 2010-07-01 951914489 ST MARY MEDICAL CENTER STMA 7602422311 18300 HIGHWAY 18 APPLE VALLEY CA 92307 JASON BARKER 2012-05-09 9497942300 2010 2016-02-24 21:20:13Z JASON L BARKER 292901415 false 0928 X WWW.STMARYAPPLEVALLEY.COM X 1953 CA WE ARE COMMITTED TO EXTENDING THE HEALING MINISTRY OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. 15 10 1867 220 21057 5212 1211350 1912620 264515588 285858558 3384255 4792693 109703 140716 269220896 292704587 2437281 3121856 0 0 120592440 133982243 0 0 1058335 125300880 115766457 248330601 252870556 20890295 39834031 211973662 262302057 100034268 103538865 111939394 158763192 X SEE SCHEDULE O false false 230480270 3121856 285858558 SEE SCHEDULE O 230480270 true true false true false false false false true true false false false true true false true false false true false false false true false true true true false true false false false false false false false false false false false false false true true true false false true 326 1 true 1867 true true true false false false false true true false false false false X 15 10 false false false false true true true true true false false true false false false true true false CA X SHAWN CURTIS DIR OF FINANCE 7609468742 18300 HIGHWAY 18 APPLE VALLEY CA 92308 X VINCENT AJANWACHUKU MD 2.0 X 33594 0 0 VIRGIL BARNES 2.0 X 0 0 0 ROSELLA BERNAL 2.0 X 0 0 0 STEPHEN GILBERT 2.0 X 0 566206 50806 SISTER MARTHA ANN FITZPATRICK 2.0 X 0 0 0 SISTER THERESA LAMETTEREY 2.0 X 0 0 0 JOHN HULTERSTROM 2.0 X 0 0 0 SISTER KATHLEEN MALONEY 2.0 X 0 0 0 DIANA CARLONI O'MALLEY 2.0 X 0 0 0 HARBANS SINGH MD 2.0 X 0 0 0 ROB TURNER 2.0 X 0 0 0 WANDA WILBURN MD 2.0 X 11550 0 0 BROTHER PETER GELFER 2.0 X 0 0 0 ERIC MORENO 2.0 X 0 0 0 SYED RAZA MD 2.0 X 35590 0 0 BROTHER IGNATIUS SUDOL 2.0 X 0 0 0 JASON BARKER 50.0 X X 0 564732 24006 DAVID O'BRIEN 50.0 X 582606 0 22313 EDWARD WONG 50.0 X 564153 0 24153 JOHN PERRING-MULLIGAN 50.0 X 261280 0 21037 JAMES KYLE 50.0 X 404250 0 31526 STEPHEN ECKBERG 50.0 X 335149 0 35174 RANDY BEVILACQUA 50.0 X 288915 0 25788 MARILYN DRONE 50.0 X 279356 0 25263 VANBOTRA HUANG 50.0 X 200495 0 13862 EDWARD MEDINA 40.0 X 186740 0 34680 MARILYN PLATT 40.0 X 181980 0 17386 LAURIE ROBERTS 50.0 X 181657 0 25139 GLORIA PEAK 50.0 X 177293 0 28252 DONALD MILLER 0.0 X 0 670985 21003 3724608 1801923 400388 201 true true false INTELISTAF TRAVEL 901 YAMATO ROAD STE 110 BOCA RATON FL 33431 NURSING REGISTRY 7067345 MS ILBEIGI AND ASSOC MD INC 18300 HIGHWAY 18 APPLE VALLEY CA 92307 MEDICAL SERVICES 1692333 HIGH DESERT PRIMARY CARE 17095 MAIN STREET HESPERIA CA 92345 MEDICAL SERVICES 1517918 INLAND CARDIOTHORACIC SURGICAL 401 E HIGHLAND AVE STE 251 SAN BERNARDINO CA 92404 MEDICAL SERVICES 1077150 UNIVERSAL HOSPITAL SERVICES 9853 PACIFIC HEIGHTS BLVD STE E SAN DIEGO CA 92121 RENTAL SERVICES 1028185 148 102485 862657 147532 799946 1912620 NET PATIENT SERVICE REVENUE 622110 267450818 267450818 CAPITATION PREMIUM REVENUE 622110 17774504 17774504 CAFETERIA 722210 498701 498701 MOB RENTAL 531120 92301 92301 LABORATORY 621500 21057 21057 21177 21177 285858558 175117 175117 0 0 4617576 0 4617576 4617576 4617576 337544 102485 196828 140716 140716 0 0 0 292704587 285837501 21057 4933409 3121856 3121856 0 0 0 3234690 2225593 785064 224033 0 89008563 83594194 5281760 132609 4774527 4275530 477356 21641 29438210 27991225 1321655 125330 7526253 7064534 431415 30304 12164521 11607574 556947 1885309 154124 1731185 221803 221803 35848 35848 0 0 34456399 29382818 4622036 451545 417561 22988 394573 42725330 42458532 250944 15854 276751 244890 31395 466 0 2556255 2265215 291040 426268 294917 110893 20458 0 77256 31106 44260 1890 2492185 2492185 0 8122101 7616884 502530 2687 2709760 2709760 CAPITATION REINSURANCE 115981 115981 ALL OTHER EXPENSES 7083129 5484276 1567335 31518 252870556 230480270 21331951 1058335 18142741 23199277 23649084 36430743 366000 947400 34075243 38893617 1351932 1443925 3402591 2958239 612972 577110 198923726 96271360 92988361 102652366 34127707 48672815 3257031 6526565 211973662 262302057 31139950 31800409 68894318 71738456 100034268 103538865 X 107877131 152376460 4062263 6386732 111939394 158763192 211973662 262302057 X 39834031 6989767 X X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 35848 35848 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE AMOUNT ON LINE 1I IS THE PORTION OF DUES PAID TO HOSPITAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. DURING THE PAST YEAR, THE ST. JOSEPH HEALTH SYSTEM HAS CONDUCTED AN ADVOCACY EFFORT WHICH INCLUDED MINIMAL LOBBYING ACTIVITY. THESE INCLUDED MEETING WITH LOCAL, STATE, AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS; AND COMMUNICATIONS TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. 473913 56976 530889 420803 53110 473913 485207 -64404 420803 0.00000 0.00000 1.00000 false true true 30576944 30576944 87248942 40074271 47174671 179868 163314 16554 71461371 56033775 15427596 9456601 0 9456601 102652366 0 INTERCO WITH HEALTH SYSTEM BONDS 35315559 DUE TO 3RD PARTY PAYORS 19813638 PAYABLE TO AFFILIATES 15186899 CAPITAL LEASE 1419320 SECURITY DEPOSIT 3040 71738456 ENDOWMENT FUNDS USE SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS WERE DESIGNATED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS. CONSOLIDATED AUDIT FOOTNOTE FOR FIN 48 (ASC 740) SCHEDULE D, PART X, LINE 2 ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY OR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2011 OR 2010. Central America and the Caribbean 0 0 Program Services CAPTIVE INSURANCE 2275892 0 0 0 0 2275892 2275892 true false false false false false ACCOUNTING METHOD SCHEDULE F, PART I, LINE 3, COLUMN F THE ACCRUAL METHOD OF ACCOUNTING WAS USED TO DETERMINE THE AMOUNT IN COLUMN F. Annual Gala 300520 92800 207720 3947 4288 48984 29500 57722 Golf Trnmnt 61949 4525 57424 750 5500 5514 6608 1 77560 5160 72400 136 8656 25223 440029 102485 337544 4833 9788 63154 29500 89553 196828 140716 true true X true X true X 500. true true true false true true 12992 9423205 0 9423205 0.03730 37003 32705751 38687928 -5982177 0.02370 49995 42128956 38687928 3441028 0.01360 13296 4315494 636413 3679081 0.01450 156 16488 0 16488 0.00010 895 1412460 0 1412460 0.00560 14347 5744442 636413 5108029 0.02020 64342 47873398 39324341 8549057 0.03380 15314 0 15314 0.00630 1120 0 1120 0.00050 45274 0 45274 0.01850 104042 83496 20546 0.00840 165750 83496 82254 0.03370 true 2448149 0 44478866 35765631 8713235 X true true 1 1 ST MARY MEDICAL CENTER

18300 HIGHWAY 18 APPLE VALLEY CA 92307

X X X ST MARY MEDICAL CENTER 1 5 OUPATIENT SURGERY PAVILLION

18122 US HWY 18 APPLE VALLEY CA 92307

OUTPATIENT SERVICES WOUND CARE CENTER

16077 KAMANA ROAD APPLE VALLEY CA 92307

OUTPATIENT SERVICES HEALTHY BEGINNINGS CLINIC

18977 S OUTER HWY 18 A APPLE VALLEY CA 92307

OUTPATIENT SERVICES HESPERIA CLINIC

17091 MAIN STREET STE 100 HESPERIA CA 92345

OUTPATIENT SERVICES ADELANTO CLINIC

11424 CHAMBERLAIN WAY STE 89 ADELANTO CA 92301

OUTPATIENT SERVICES SCHEDULE H, PART I, LINE 7 THE AMOUNTS REPORTED IN THE TABLE WERE CALCULATED USING THE ORGANIZATION'S COST ACCOUNTING SYSTEM. SCHEDULE H, PART I, LINE 7B, COLUMN E THE CALIFORNIA HOSPITAL QUALITY ASSURANCE PROGRAM (THE PROGRAM) WAS SIGNED INTO LAW AND BECAME EFFECTIVE ON JANUARY 1, 2010. UNDER THE PROGRAM, $9,566,073 IN SUPPLEMENTAL PAYMENTS WAS RECEIVED IN FY11. THE SUPPLEMENTAL PAYMENTS ARE INCLUDED IN SCHEDULE H, PART I, LINE 7B, COLUMN (D) AS OFFSETTING REVENUE. THE NEGATIVE AMOUNT ON LINE 7B IS A RESULT OF THE PROGRAM, WHICH IS LIMITED IN NATURE, AND IS DESIGNED TO COMPENSATE FOR SERVICES PROVIDED OVER SEVERAL PRIOR PERIODS. SCHEDULE H, PART II THE HOSPITAL IS ENGAGED IN NUMEROUS COMMUNITY BUILDING EFFORTS. THE HOSPITAL SPONSORS A CAREER DEVELOPMENT PROGRAM FOR HIGH SCHOOL STUDENTS INTERESTED IN CLINICAL AND ADMINISTRATION HEALTHCARE CAREERS. THE HOSPITAL IS A MEMBER OF A COUNTY-WIDE INITIATIVE, THE ALLIANCE FOR EDUCATION, SPONSORED BY SAN BERNARDINO COUNTY DEPARTMENT OF EDUCATION. THESE PROGRAMS ARE IN RESPONSE TO DATA INDICATING SAN BERNARDINO LAGS BEHIND NEIGHBORING COUNTIES IN THE PERCENTAGE OF STUDENTS GRADUATING HIGH SCHOOL AND ENTERING COLLEGE. IN RESPONSE TO DATA INDICATING OBESITY IS A PRIMARY UNDERLYING CAUSE TO HEART DISEASE, THE HOSPITAL IS LEADING REGIONAL AND CITY COLLABORATIONS PROMOTING HEALTHIER FOOD OPTIONS, INCREASED ACCESS TO RECREATION AND POLICY ADVOCACY WHEREBY HEALTH PROMOTION/HEALTHY COMMUNITY PRINCIPLES ARE INCORPORATED INTO GENERAL PLANS. THIS EFFORT HAS RESULTED IN ONE CITY PASSING ITS FIRST NON-MOTORIZED TRANSPORTATION PLAN AND A SECOND CREATING RECREATION AND SPORTS PROGRAMS FOR ITS RESIDENTS. THE HOSPITAL'S ADVOCACY WORK HAS SUCCESSFULLY ASSISTED A LEADING MANAGED CARE PROVIDER TO OPEN A PRIMARY CARE CLINIC IN A COMMUNITY WITH VIRTUALLY NO HEALTHCARE PROVIDERS. THE HOSPITAL'S ADVOCACY WORK HAS ALSO BEEN DIRECTED TO BRING FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) TO THE REGION. CURRENTLY NO FQHC CENTERS OPERATE IN THE HOSPITAL'S SERVICE AREA. THE AVAILABILITY OF LOCAL FQHC CENTERS COULD ASSIST TO FIND MEDICAL HOMES FOR UNINSURED PATIENTS CURRENTLY RELYING ON HOSPITAL EMERGENCY ROOMS FOR THEIR URGENT CARE NEEDS. SCHEDULE H, PART III, LINE 4 THE ORGANIZATION RECOGNIZES THAT A PORTION OF THE UNINSURED OR UNDERINSURED PATIENT POPULATION MAY NOT ENGAGE IN THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION PROCESS. THEREFORE, THE ORGANIZATION ALSO USES AN AUTOMATED PREDICTIVE SCORING TOOL TO IDENTIFY AND QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE FOR ACCOUNTS THAT ARE INITIALLY CLASSIFIED AS BAD DEBT. COLLECTION ACTIONS ARE NOT PURSUED ON THESE ACCOUNTS ONCE THEY ARE RECLASSIFIED AS FINANCIAL ASSISTANCE. THERE IS NO OTHER AMOUNT OF BAD DEBT THAT SHOULD BE REPORTED AS FINANCIAL ASSISTANCE. FINANCIAL STATEMENT FOOTNOTE FOR BAD DEBT: THE ORGANIZATION RECEIVES PAYMENT FOR SERVICES RENDERED TO PATIENTS FROM FEDERAL AND STATE GOVERNMENTS UNDER THE MEDICARE AND MEDICAID PROGRAMS, PRIVATELY SPONSORED MANAGED CARE PROGRAMS FOR WHICH PAYMENT IS MADE BASED ON TERMS DEFINED UNDER FORMAL CONTRACTS, AND OTHER PAYORS. THE ORGANIZATION BELIEVES THERE ARE NO SIGNIFICANT RISKS ASSOCIATED WITH RECEIVABLES FROM GOVERNMENT PROGRAMS. RECEIVABLES FROM CONTRACTED AND OTHERS ARE FROM VARIOUS PAYORS WHO ARE SUBJECT TO DIFFERING ECONOMIC CONDITIONS, AND DO NOT REPRESENT ANY CONCENTRATED RISKS TO THE ORGANIZATION. THE ORGANIZATION ANALYZES ITS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE BAD DEBT AMOUNT REPORTED WAS DETERMINED USING THE ORGANIZATION'S OVERALL COST-TO-CHARGE RATIO. SCHEDULE H, PART III, LINE 8 AS A CATHOLIC HEALTH CARE MINISTRY, THE ORGANIZATION FOLLOWS THE CATHOLIC HEALTH ASSOCIATION'S COMMUNITY BENEFIT REPORTING GUIDELINES AND THEREFORE DOES NOT REPORT MEDICARE AS A COMMUNITY BENEFIT. MEDICARE COSTS ARE DETERMINED USING THE MEDICARE COST REPORT SUBMITTED FOR THE FISCAL YEAR USING CMS STANDARD COSTING METHODS. THIS METHOD INCLUDES SPECIFIC STEP-DOWN ALLOCATION PROCESSES WHICH ARE APPLIED TO CALCULATE ALLOWABLE MEDICARE COSTS. SCHEDULE H, PART III, LINE 9B ST. MARY MEDICAL CENTER PATIENT ACCOUNTS ARE NOT FORWARDED TO COLLECTION STATUS WHEN THE PATIENT MAKES A GOOD FAITH EFFORT TO RESOLVE OUTSTANDING ACCOUNT BALANCES. SUCH EFFORTS INCLUDE APPLYING FOR FINANCIAL ASSISTANCE, NEGOTIATING A PAYMENT PLAN, OR APPLYING FOR MEDICAID COVERAGE. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMS AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIES FOR CHARITY CARE. ACCOUNTS FOR PATIENTS WHO QUALIFY FOR CHARITY CARE ARE WRITTEN OFF AND COLLECTION EFFORTS ARE NOT PURSUED. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 EVERY THREE YEARS ST. MARY MEDICAL CENTER CONDUCTS A COMPREHENSIVE NEEDS ASSESSMENT. THE ASSESSMENT IS DESIGNED AND COMPLETED WITH ASSISTANCE FROM OUTSIDE ORGANIZATIONS, INCLUDING A CONTRACTED HEALTH CONSULTING FIRM. THE HOSPITAL DEVELOPS A NEEDS ASSESSMENT PROCESS IN COLLABORATION WITH OTHER LOCAL HOSPITALS, COMMUNITY ORGANIZATIONS AND THE COUNTY DEPARTMENT OF PUBLIC HEALTH IN AN EFFORT TO ADVANCE COUNTY-LEVEL HEALTH INITIATIVES SUCH AS CARDIAC DISEASE AND ACCESS TO CARE. HEALTH AND SOCIOECONOMIC DATA IS COLLECTED AND ASSESSED FOR COMMUNITIES WITHIN THE HOSPITAL'S PRIMARY AND SECONDARY MARKETS AND MAPPING IS CONDUCTED AT THE ZIP CODE AND, WHERE POSSIBLE, THE BLOCK GROUP LEVEL. COMMUNITY BENEFIT PROGRAMS AND ACTIVITIES ARE THEN TARGETED TO NEIGHBORHOODS AND/OR POPULATIONS IDENTIFIED WITH THE GREATEST NEEDS. THE HOSPITAL'S COMMUNITY BENEFITS COMMITTEE REVIEWS THE PROCESS FOR COLLECTING HEALTH DATA, PRIORITIZING NEEDS AND APPROVES KEY COMMUNITY BENEFIT PROGRAMS. ALL HOSPITAL NEEDS ASSESSMENTS ARE PLACED ON THE HOSPITAL'S INTERNET SITE FOR PUBLIC USE. NEEDS ASSESSMENTS ARE PROVIDED TO COMMUNITY ORGANIZATIONS TO ASSIST IN GRANT WRITING AND ADVOCACY. PRIORITY FINDINGS FROM NEEDS ASSESSMENTS RESULTED IN THE HOSPITAL DEVELOPING PROGRAMS IN EXPANDING ACCESS TO CARE FOR THE UNINSURED, PROGRAMS DIRECTED TOWARD CHILDHOOD OBESITY, CONDUCTING COMMUNITY BUILDING EFFORTS TO IMPROVE PUBLIC ACCESS TO HEALTHIER FOODS AND INCREASED PHYSICAL ACTIVITY, ENROLLING UNINSURED CHILDREN, ASSISTING PERSONS IN ECONOMIC CRISIS AND OPERATING A HEALTH CAREER ACADEMY. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI, LINE 3 THE ORGANIZATION POSTS NOTICES INFORMING THE PUBLIC OF THE FINANCIAL ASSISTANCE PROGRAM. NOTICES ARE POSTED IN HIGH VOLUME INPATIENT AND OUTPATIENT SERVICE AREAS. NOTICES ARE ALSO POSTED AT LOCATIONS WHERE A PATIENT MAY PAY THEIR BILL. NOTICES INCLUDE CONTACT INFORMATION ON HOW A PATIENT CAN OBTAIN MORE INFORMATION ON FINANCIAL ASSISTANCE AS WELL AS WHERE TO APPLY FOR ASSISTANCE. THESE NOTICES ARE POSTED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGES THAT ARE REPRESENTATIVE OF 5% OR GREATER OF PATIENTS IN THE HOSPITAL'S SERVICE AREA. ALL PATIENTS WHO DEMONSTRATE LACK OF FINANCIAL COVERAGE BY THIRD PARTY INSURERS ARE OFFERED AN OPPORTUNITY TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND IS OFFERED INFORMATION, ASSISTANCE, AND REFERRAL AS APPROPRIATE TO GOVERNMENT SPONSORED PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 THE HOSPITAL'S SERVICE AREA COVERS A PORTION OF THE HIGH DESERT REGION OF SAN BERNARDINO COUNTY AND IS THE FIFTH LARGEST COUNTY BY POPULATION IN CALIFORNIA. THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: 92301, 92307, 92308, 92311, 92344, 92345, 92356, 92392, 92394 AND 92395. IN 2009 THE POPULATION WAS ESTIMATED AT 390,933 WITH A PROJECTED GROWTH OF 463,000 RESIDENTS BY 2014. THE LARGEST ETHNIC GROUP (48%) IS HISPANIC. MEDIAN HOUSEHOLD INCOME IS $48,911. APPROXIMATELY 25% OF THE POPULATION EARNS LESS THAN $25,000 AND 40% OF THE POPULATION IS BETWEEN THE AGES OF 25-54. MOST RECENT ECONOMIC DATA INDICATES THE AREA'S UNEMPLOYMENT RATE IS 14%. THE COMMUNITY IS SERVED BY TWO FOR PROFIT AND TWO NOT FOR PROFIT HOSPITALS. IN CALIFORNIA, SAN BERNARDINO COUNTY HAS THE HIGHEST DEATH RATE FROM HEART DISEASE AS COMPARED TO OTHER REGIONS IN THE STATE. DEATH CAUSED BY HEART DISEASE ACCOUNTS FOR 30% OF ALL DEATHS IN THE COUNTY. THE HOSPITAL OFFERS COMPLETE CARDIAC CARE INCLUDING FULL-SERVICE DIAGNOSTIC AND TREATMENT PROGRAMS AND IS DESIGNATED BY SAN BERNARDINO COUNTY AS A SEGMENT ELEVATION MYOCARDIAL INFRACTION (STEMI) RECEIVING CENTER. IN RESPONSE TO HEALTH DATA INDICATING HIGH OBESITY RATES, THE HOSPITAL HAS BEEN RAISING FUNDS AND THE HOSPITAL BEGAN IMPLEMENTING OBESITY PROGRAMS TARGETED TO YOUNG FAMILIES. ADDITIONALLY, THE HOSPITAL HAS COORDINATED A HEALTHY HIGH DESERT CAMPAIGN IN REGIONAL EFFORT PROMOTING THE ADOPTION OF HEALTHIER EATING AND MORE ACTIVE LIFESTYLES. THE HOSPITAL OPERATES THREE COMMUNITY CLINICS AND A MOBILE MEDICAL VAN TO ASSIST UNINSURED PATIENTS WHERE THE BARRIERS OF NO TRANSPORTATION OR INSURANCE LIMITS ACCESS TO CARE. THE NUMBER OF UNINSURED CHILDREN, ESTIMATED AT 34,000 IN SAN BERNARDINO COUNTY, RANKS AS THE FIFTH LARGEST IN CALIFORNIA. IT IS ESTIMATED THAT 75% OF UNINSURED CHILDREN ARE ELIGIBLE FOR LOW COST HEALTH INSURANCE PROGRAMS. THE HOSPITAL, IN PARTNERSHIP WITH SCHOOLS AND CHURCHES, PARTICIPATES IN A COUNTY-WIDE COLLABORATION ENROLLING UNINSURED CHILDREN IN LOW COST HEALTH INSURANCE PROGRAMS. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN A COUNTY CLINIC COLLABORATIVE TO INCREASE THE NUMBER OF COMMUNITY CLINICS PROVIDING PRIMARY CARE SERVICES TO LOW INCOME POPULATIONS. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI, LINE 5 THE GOVERNING BODY IS COMPRISED OF A MAJORITY OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA AND WHO ARE NOT EMPLOYEES, CONTRACTORS, OR FAMILY MEMBERS. THE SUB-COMMITTEE OF THE BOARD OF TRUSTEES, KNOWN AS THE COMMUNITY BENEFIT COMMITTEE, OVERSEES THE DEVELOPMENT AND IMPLEMENTATION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY BENEFIT PLAN EVERY THREE YEARS, AS WELL AS AN ANNUAL COMMUNITY BENEFIT REPORT. THE COMMITTEE ALSO PROVIDES GENERAL DIRECTION TO ST. MARY MEDICAL CENTER REGARDING: 1) BUDGETING DECISIONS, 2) COMMUNITY BENEFIT PROGRAM CONTENT, 3) COMMUNITY BENEFIT PROGRAM DESIGN, 4) TARGET GEOGRAPHIC/POPULATION, 5) PROGRAM CONTINUATION OR DISCONTINUATION, 6) FUND DEVELOPMENT SUPPORT, AND 7) COMMUNITY-WIDE ENGAGEMENT. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. GIVING BACK TO THE COMMUNITY IS INTEGRATED INTO EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTH MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE PROVIDE FREE AND DISCOUNTED CARE VIA OUR FINANCIAL ASSISTANCE PROGRAM AND HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS TO PROVIDE QUALITY CARE TO ALL OUR PATIENTS, REGARDLESS OF ABILITY TO PAY. WE BELIEVE THAT NO ONE SHOULD DELAY SEEKING NEEDED MEDICAL CARE BECAUSE THEY LACK HEALTH INSURANCE. THAT IS WHY ST. MARY MEDICAL CENTER, AS A MINISTRY OF ST. JOSEPH HEALTH SYSTEM, HAS A PATIENT FINANCIAL ASSISTANCE PROGRAM THAT PROVIDES FREE OR DISCOUNTED SERVICES TO ELIGIBLE PATIENTS. ON AN ANNUAL BASIS, TEN PERCENT OF OUR NET INCOME IS DEVOTED TO FUND COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR (CARE FOR THE POOR FUNDS). SPECIFICALLY, FUNDS ARE USED FOR OUTREACH PROGRAMS, DEFINED AS THOSE SERVICES THAT ADDRESS A SPECIFIC UNMET HEALTH NEED AND ARE SEPARATE FROM TRADITIONAL ACUTE CARE SERVICES. IN ADDITION TO DEVOTING A PERCENTAGE OF OUR NET INCOME TO COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR VIA CARE FOR THE POOR FUNDS, WE STRIVE TO ANNUALLY BUDGET A PORTION OF OUR TOTAL OPERATING EXPENSES FOR HEALTHY COMMUNITIES AND COMMUNITY HEALTH EFFORTS. DURING THE PAST YEAR, ST. MARY MEDICAL CENTER DEDICATED $3,418,844 IN COMMUNITY HEALTH IMPROVEMENT SERVICES FOR VULNERABLE POPULATIONS AND PROVIDED $1,054 IN COMMUNITY BUILDING FOR VULNERABLE POPULATIONS AND $12,260 IN CASH AND IN-KIND SERVICES. FUNDS MADE POSSIBLE THE OPERATION OF THREE FIXED COMMUNITY CLINICS AND THE OPERATION OF ONE MOBILE MEDICAL CLINIC PROVIDING LOW INCOME AND UNINSURED PERSONS PRE-NATAL CARE, PRIMARY CARE AND COMPREHENSIVE DIABETES CARE, BEHAVIORIAL COUNSELING AND CANCER SCREENING SERVICES. ADDITIONALLY, $71,014 FUNDED COMMUNITY HEALTH IMPROVEMENT SERVICES PROVIDED TO THE BROADER COMMUNITY AS WELL AS $81,200 IN COMMUNITY BUILDING SERVICES WHICH INCLUDED CHILD OBESITY PROGRAMS AND FOUR HEALTHY CITY CAMPAIGNS ADDRESSING THE LACK OF FRESH PRODUCE AND LIMITED PUBLIC ACCESS TO PARKS AND RECREATION PROGRAMS. FINALLY, THE HOSPITAL PROVIDED $16,488 IN HEALTH RESEARCH, EDUCATION AND TRAINING TO OPERATE A HEALTH CARE ACADEMY FOR HIGH SCHOOL YOUTH CONSIDERING A CAREER IN MEDICINE. (DATA SOURCE IS FY2011 COMMUNITY BENEFIT REPORT) AFFILIATED HEALTH CARE SYSTEM SCHEDULE H, PART VI, LINE 6 ST. MARY MEDICAL CENTER IS A HEALING MINISTRY OF ST. JOSEPH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY. ST. JOSEPH HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. EACH ASSOCIATED MINISTRY WORKS TO LIVE OUT ITS MISSION OF IMPROVING THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITIES IT SERVES. IN 1986, ST. JOSEPH HEALTH SYSTEM CREATED A PLAN AND BEGAN AN EFFORT TO FURTHER ITS COMMITMENT TO NEIGHBORS IN NEED. WITH A VISION OF REACHING BEYOND THE WALLS OF ITS HEALTHCARE FACILITIES AND TRANSCENDING TRADITIONAL EFFORTS OF PROVIDING FREE CARE FOR THOSE IN NEED OF ACUTE SERVICES, ST. JOSEPH HEALTH SYSTEM CREATED THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO IMPROVE THE HEALTH OF LOW-INCOME INDIVIDUALS RESIDING IN LOCAL COMMUNITIES. OUR FOUNDATIONAL DOCUMENT, A VISION OF VALUES, FORMALIZES A PROCESS THROUGH WHICH THE HOSPITAL MINISTRIES RETURN TEN PERCENT OF THEIR NET INCOME TO THE ST. JOSEPH HEALTH SYSTEM FOUNDATION TO SUPPORT OUTREACH EFFORTS FOR THE MATERIALLY POOR. THE FOUNDATION FUNDS PROGRAMS THAT EXEMPLIFY THE FOUR CORE VALUES OF ST. JOSEPH HEALTH SYSTEM: SERVICE, EXCELLENCE, DIGNITY, AND JUSTICE. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 CALIFORNIA MINISTRIES REPORT TO CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT IN ACCORDANCE WITH CALIFORNIA SENATE BILL 697. true CATHOLIC CHARITIES 1450 N D STREET SAN BERNARDINO CA 92405 953516461 501(c)(3) 36600 PROVIDE SUPPORT TO INDIGENT POPULATION ST JOHN OF GOD 13333 PALMDALE RD VICTORVILLE CA 92392 953806996 501(c)(3) 48000 PROVIDE SUPPORT TO INDIGENT POPULATION ST JOSEPH HEALTH SYSTEM FOUNDATION 500 S MAIN STREET ORANGE CA 928684507 330143024 501(c)(3) 1636600 CARE FOR THE POOR CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K ST STE 800 SACRAMENTO CA 95814 941498697 501(c)(3) 1398156 CA HOSPITAL FEE PROGRAM 4 0 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 COMMUNITY BENEFIT COMMITTEE OVERSEES/MONITORS GRANT USAGE ON A MONTHLY BASIS. X X true true false true false false false false false true false DONALD MILLER 0 267111 0 84794 0 319080 0 19579 0 1424 0 691988 0 185883 STEPHEN GILBERT 0 326984 0 99931 0 139291 0 22018 0 28788 0 617012 0 0 JASON BARKER 0 316797 0 105138 0 142797 0 9800 0 14206 0 588738 0 0 DAVID O'BRIEN 319876 0 86878 0 175852 0 12235 0 10078 0 604919 0 0 0 EDWARD WONG 308970 0 83195 0 171988 0 22023 0 2130 0 588306 0 0 0 JAMES KYLE 256384 0 71948 0 75918 0 9686 0 21840 0 435776 0 0 0 STEPHEN ECKBERG 197434 0 54047 0 83668 0 17131 0 18043 0 370323 0 0 0 RANDY BEVILACQUA 166818 0 37866 0 84231 0 14538 0 11250 0 314703 0 0 0 MARILYN DRONE 175421 0 47603 0 56332 0 9411 0 15852 0 304619 0 0 0 JOHN PERRING-MULLIGAN 156432 0 42585 0 62263 0 8738 0 12299 0 282317 0 0 0 VANBOTRA HUANG 177796 0 18217 0 4482 0 2246 0 11616 0 214357 0 0 0 EDWARD MEDINA 181610 0 0 0 5130 0 17109 0 17571 0 221420 0 0 0 MARILYN PLATT 112632 0 5686 0 63662 0 11962 0 5424 0 199366 0 0 0 LAURIE ROBERTS 136516 0 9288 0 35853 0 13820 0 11319 0 206796 0 0 0 GLORIA PEAK 138639 0 9509 0 29145 0 12420 0 15832 0 205545 0 0 0 SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A TAX INDEMNIFICATIONS AND GROSS-UP PAYMENTS GIFT CARDS PROVIDED TO EMPLOYEES DURING CHRISTMAS AND THROUGHOUT THE YEAR FOR REWARD AND RECOGNITION ARE GROSSED UP AND TAXES ARE PAID BY THE MINISTRY. DISCRETIONARY SPENDING ACCOUNT EXECUTIVES RECEIVE A PERCENTAGE OF BASE COMPENSATION FOR DISCRETIONARY SPENDING. THESE AMOUNTS ARE INCLUDED IN OTHER REPORTABLE COMPENSATION. SCHEDULE J, PART I, LINE 3 THE ORGANIZATION'S CHIEF EXECUTIVE OFFICER IS PAID BY ITS TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM, AND IS DISCLOSED AS A PERSON BY A RELATED ORGANIZATION. SEE SCHEDULE O FOR 990, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. SCHEDULE J, PART I, LINE 4B EXECUTIVES COULD PARTICIPATE IN A NON-QUALIFIED DEFERRED COMPENSATION PLAN UNDER INTERNAL REVENUE CODE 457(F). THE PLAN WAS FROZEN EFFECTIVE DECEMBER 31, 2007 AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED TO THE PLAN. THIS PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENT FROM THE 457(F) PLAN DURING THE YEAR: DONALD MILLER - $185,883 SCHEDULE J, PART I, LINE 7 A PORTION OF THE EXECUTIVE'S SALARY IS PLACED "AT-RISK" AND IS NOT AWARDED UNLESS SPECIFIC STRATEGIC OBJECTIVE TARGETS ARE MET OR EXCEEDED. THE AT-RISK EXECUTIVE PLAN IS DESIGNED TO MOTIVATE AND REWARD EXECUTIVES FOR TEAM PERFORMANCE THAT SUPPORTS THE STRATEGIC GOALS AND SUCCESSFUL PERFORMANCE OF ST. JOSEPH HEALTH SYSTEM. AT-RISK PAY IS AWARDED TO ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER BASED ON ACHIEVING OR SURPASSING SPECIFIC GOALS THAT ARE PREDETERMINED BY THE BOARD OF TRUSTEES PRIOR TO THE BEGINNING OF THE FISCAL YEAR. THE GOALS INCLUDE OUR STRATEGIC OBJECTIVES OF PERFECT CARE, SACRED ENCOUNTERS, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. ORGANIZATION'S MISSION PART I, LINE 1 & PART III, LINE 1 AS A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM (SJHS), ST. MARY MEDICAL CENTER IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE OF PEOPLE IN THE COMMUNITIES WE SERVE. PROGRAM SERVICE ACCOMPLISHMENTS PART III, LINE 4 REALIZING OUR MISSION AS A NOT-FOR-PROFIT, ST. MARY MEDICAL CENTER HAS BEEN MEETING THE HEALTH AND QUALITY OF LIFE NEEDS OF THE LOCAL COMMUNITY FOR OVER 56 YEARS. SERVING THE COMMUNITIES OF ADELANTO, APPLE VALLEY, HESPERIA, VICTORVILLE AND MULTIPLE UNINCORPORATED AREAS OF SAN BERNARDINO COUNTY, ST. MARY MEDICAL CENTER IS AN ACUTE CARE HOSPITAL THAT PROVIDES QUALITY CARE IN COMPREHENSIVE INPATIENT AND OUTPATIENT CARE IN THE AREAS OF PAIN MANAGEMENT, PULMONARY REHABILITATION AND WOUND CARE. IT IS DESIGNATED BY SAN BERNARDINO COUNTY AS A STEMI RECEIVING CENTER AND BY THE WORLD HEALTH ORGANIZATION AS BABY FRIENDLY WHILE ALSO OFFERING COMMUNITY HEALTH SERVICES OPERATING THREE FIXED CLINICS AND A MOBILE MEDICAL SERVICE. WITH OVER 1,500 EMPLOYEES COMMITTED TO REALIZING THE MISSION, ST. MARY MEDICAL CENTER IS ONE OF THE LARGEST EMPLOYERS IN THE REGION. ST. MARY MEDICAL CENTER, A MEMBER OF THE ST. JOSEPH HEALTH SYSTEM, IS COMMITTED TO EXTENDING THE HEALING MINISTRY OF JESUS IN THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE. THIS MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. THE SISTERS OF ST. JOSEPH OF ORANGE TRACE THEIR ROOTS BACK TO 17TH CENTURY FRANCE AND THE UNIQUE VISION OF A JESUIT PRIEST NAMED JEAN-PIERRE MEDAILLE. HE SOUGHT TO ORGANIZE AN ORDER OF RELIGIOUS WOMEN WHO, RATHER THAN REMAINING SAFELY CLOISTERED IN A CONVENT, VENTURED OUT INTO THE COMMUNITY TO SEEK OUT "THE DEAR NEIGHBORS" AND MINISTER TO THEIR NEEDS. THE CONGREGATION MANAGED TO SURVIVE THE TURBULENCE OF THE FRENCH REVOLUTION AND EVENTUALLY EXPANDED, NOT ONLY THROUGHOUT FRANCE, BUT THROUGHOUT THE WORLD. IN 1912 A SMALL GROUP OF SISTERS OF ST. JOSEPH WENT TO EUREKA, CALIFORNIA, AT THE INVITATION OF THE LOCAL BISHOP, TO ESTABLISH A SCHOOL. A FEW YEARS LATER, THE GREAT INFLUENZA EPIDEMIC OF 1918 CAUSED THE SISTERS TO TEMPORARILY SET ASIDE THEIR EDUCATION EFFORTS TO CARE FOR THE ILL. THEY REALIZED IMMEDIATELY THAT THE SMALL COMMUNITY DESPERATELY NEEDED A HOSPITAL. THROUGH BOLD FAITH, FORESIGHT, AND FLEXIBILITY IN 1920, THE SISTERS OPENED THE 28-BED ST. JOSEPH HOSPITAL OF EUREKA, THE FIRST ST. JOSEPH HEALTH SYSTEM MINISTRY. TODAY THE ST. JOSEPH HEALTH SYSTEM IS AN INTEGRATED HEALTHCARE DELIVERY SYSTEM SPONSORED BY THE ST. JOSEPH HEALTH MINISTRY AND ORGANIZED INTO THREE REGIONS: NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO. THE SYSTEM INCLUDES 14 ACUTE CARE HOSPITALS, HOME HEALTH AGENCIES, HOSPICE CARE, OUTPATIENT SERVICES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. OUR MISSION IS REALIZED THROUGH THE DELIVERY OF QUALITY IN-PATIENT AND OUT-PATIENT SERVICES, AND FOCUSED COMMUNITY INITIATIVES AND PROGRAMS THAT ARE DEDICATED TO IMPROVING THE LIVES OF ALL WE SERVE. THREE MISSION OUTCOMES ST. MARY MEDICAL CENTER IS COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: EVERY INTERACTION WILL BE EXPERIENCED AS A SACRED ENCOUNTER. THE GOAL OF SACRED ENCOUNTER HAS A DIRECT CONNECTION TO THE OVERALL MISSION. OUR VALUE OF DIGNITY CALLS FOR US TO RESPECT EACH PERSON AS AN INHERENTLY VALUABLE MEMBER OF THE HUMAN COMMUNITY AND AS A UNIQUE EXPRESSION OF LIFE. WE STRIVE TO DO THIS BY KEEPING AT THE FOREFRONT OF OUR MINDS THE UNDERSTANDING OF THE IMPACT WE CAN HAVE ON ONE ANOTHER WITH EVERY ACTION WE TAKE. ST. MARY MEDICAL CENTER IS EMPLOYING A SPOTLIGHTING TECHNIQUE TO VISUALLY CAPTURE WHEN SACRED CARE IS PROVIDED TO PATIENTS DURING THEIR HOSPITAL STAY. THE INITIATIVE IS OCCURRING AT THE UNIT LEVEL ACROSS THE HOSPITAL. SPOTLIGHTING OCCURS BY CAPTURING A SPECIFIC SEGMENT OF A PATIENT'S EXPERIENCE WHERE A MEMORY OF SACRED CARE IS CREATED. STAFF ARE TRAINED TO RE-CREATE THE SPOTLIGHTING EXPERIENCE TO BENEFIT OTHER PATIENTS. THE PROCESS OF SACRED ENCOUNTERS IS TIED TO IMPROVING THE HOSPITAL'S HCAHPS AND PATIENT SATISFACTION SCORES. ALL PATIENTS WILL RECEIVE PERFECT CARE. IT IS OUR ATTENTION TO DETAIL AND THE SMALLEST IMPERFECTIONS OF EACH PATIENT'S EXPERIENCE THAT DRIVES A DEEPER UNDERSTANDING AND ULTIMATELY A SUSTAINABLE APPROACH TO THE ACHIEVEMENT OF PERFECT CARE. ST. MARY MEDICAL CENTER IS IMPLEMENTING LEAN AND SIX SIGMA PRINCIPLES TO IMPROVE HOSPITAL PROCESSES ACROSS MULTIPLE DEPARTMENTS. ADDITIONALLY THE HOSPITAL IS IMPLEMENTING ADHERENCE TO PRACTICING EVIDENCE-BASED MEDICINE IN KEY QUALITY METRICS, INCLUDING, BUT NOT LIMITED TO: WRONG SITE SURGERY, RETAINED FOREIGN BODIES, PREVENTABLE VENTILATOR ASSISTED PNEUMONIA, BIRTH TRAUMA, PRESSURE ULCERS AND REDUCING HOSPITAL ACQUIRED CONDITIONS. ST. MARY MEDICAL CENTER IS WORKING TO IMPROVE PATIENT THROUGHPUT WITH SEVERAL PROCESS IMPROVEMENT EFFORTS AND ALSO ACHIEVE MEANINGFUL USE STAGE 1 BY JUNE 2012. THE COMMUNITIES WE SERVE WILL BE AMONG THE HEALTHIEST IN OUR NATION. WE SEEK TO DEVELOP COMMUNITY HEALTH INITIATIVES THAT IMPACT LONG-TERM HEALTH ACROSS THE ENTIRE COMMUNITY. ST. MARY MEDICAL CENTER IS PURSUING A NUMBER OF PROGRAMS ADDRESSING THE HEALTH AND WELL BEING OF THE COMMUNITY. THE HOSPITAL OPERATES THREE COMMUNITY CLINICS AND A MOBILE VAN SERVING THE REGION'S UNINSURED. THE HOSPITAL FUNDS COMMUNITY PARTNERS ADDRESSING POVERTY, HUNGER, DOMESTIC VIOLENCE AND HOMELESSNESS. THE HOSPITAL ALSO IMPLEMENTED KEY PROGRAMS ADDRESSING HEALTH ISSUES, SUCH AS DIABETES AND OBESITY, AS WELL AS HEALTH INSURANCE, EDUCATION AND CAREER DEVELOPMENT. PROGRAM SERVICE ACCOMPLISHMENTS NAME: CHILD OBESITY GOAL: ACHIEVE A 10% REDUCTION IN THE PERCENTAGE OF OBESE CHILDREN AGES 3 TO 5 YEARS OLD KEY PARTNERS: LOCAL HEAD START PROGRAMS AND PRE SCHOOLS SERVING LOW INCOME FAMILIES ACCOMPLISHMENTS: THE HOSPITAL IS ACHIEVING A 10% REDUCTION IN CHILD OBESITY BY IMPLEMENTATION OF A HEALTHY FOR LIFE PROGRAM IN ELEVEN CLASSROOMS IMPACTING 132 CHILDREN. THE PROGRAM IS TEACHING SCHOOLS TO IMPROVE PHSYICAL ACTIVITY TIME AND HELPING PARENTS ADOPT HEALTHIER BEHAVIORS. CHILDREN IDENTIFIED AS OBESE AND OVERWEIGHT ARE PROVIDED INTENSIVE NUTRITION COUNSELING. THE HOSPITAL HAS ALSO ASSISTED FOUR COMMUNITIES TO START HEALTHY CITY CAMPAIGNS WHEREBY FRESH PRODUCE AND INCREASED ACCESS TO FREE RECREATION IS PROVIDED. THE HOSPITAL IS WORKING IN ONE COMMUNITY TO OPEN A 5 ACRE PARK. ADDITIONALLY, THE HOSPITAL HAS SUCCESSFULLY HELPED A SECOND COMMUNITY ADOPT ITS FIRST COMPREHENSIVE NON-MOTORIZED TRANSPORTATION PLAN THAT CALLS FOR DEVELOPMENT OF A 73 MILE SYSTEM OF BICYCLE AND WALKING PATHS. AT THE COUNTY LEVEL, THE HOSPITAL HAS SUCCESSFULLY ADVOCATED GRANT FUNDING BE DIRECTED TO CHILD OBESITY BY THE FIRST FIVE CHILDREN'S COMMISSION. NAME: COMPREHENSIVE DIABETES EDUCATION GOAL: PATIENTS MANAGE THEIR HGA1C LEVELS BELOW 7 A KEY PARTNERS: INLAND EMPIRE HEALTH PLAN, LOCAL PHYSICIANS ACCOMPLISHMENTS: THE HOSPITAL HAS IMPLEMENTED THE COMMUNITY'S ONLY COMPREHENSIVE DIABETES EDUCATION PROGRAM FOR LOW INCOME AND UNINSURED PERSONS. THE PROGRAM CURRENTLY SERVES 133 UNINSURED AND LOW INCOME PATIENTS. THE PROGRAM'S GOAL IS TO REDUCE EMERGENCY ROOM VISITS FOR UNCONTROLLED DIABETES BY TEACHING PATIENTS HOW TO MANAGE THEIR HGA1C LEVELS BELOW 7 AND 9 AND COMPLETING ANNUAL EYE AND FOOT EXAMS AS CALLED FOR BY HEALTHY PEOPLE 2020. THE PROGRAM IS CURRENTLY ACHIEVING HEALTHY PEOPLE 2020 GOALS FOR CONTROLLING HGA1C LEVELS AND COMPLETING ANNUAL EYE AND FOOT EXAMS. NAME: ACCESS TO CARE GOAL: ENROLL UNINSURED CHILDREN INTO SAFETY NET HEALTH INSURANCE KEY PARTNERS: SIX SCHOOLS, OUR LADY OF THE DESERT CATHOLIC CHURCH, LA SALLE MEDICAL CLINIC, INLAND EMPIRE HEALTH PLAN, COMMUNITY HEALTH ACTION NETWORK, THE GARDNER GROUP. ACCOMPLISHMENTS: THE HOSPITAL CONTINUES ITS REGIONAL LEADERSHIP TO ENROLL UNINSURED CHILDREN INTO SAFETY NET HEALTH INSURANCE PROGRAMS. THE HOSPITAL AND PARTNERS ENROLLED 951 CHILDREN IN A COUNTY WITH THE FIFTH LARGEST POPULATION OF UNINSURED CHILDREN IN THE STATE OF CALIFORNIA. THE HOSPITAL ALSO EXPANDED ITS PRIMARY CARE EFFORTS TO UNINSURED PATIENTS, INCLUDING RECRUITING PHYSICIANS AND COMMUNITY CLINICS TO OPEN PROGRAMS IN THE REGION. THE HOSPITAL'S COMMUNITY CLINIC PROGRAMS PROVIDED CARE TO 7,934 PATIENTS. NAME: EDUCATION GOAL: PROVIDE MENTORING TO AT-RISK CHILDREN IN LOW INCOME COMMUNITIES KEY PARTNERS: LOCAL ELEMENTARY AND HIGH SCHOOLS, VICTOR VALLEY COMMUNITY COLLEGE ACCOMPLISHMENTS: THE HOSPITAL PROVIDED 224 MENTORING SESSIONS TO AT-RISK CHILDREN IN THE LOCAL COMMUNITY. THE HOSPITAL ALSO GRADUATED ONE HEALTH CAREER CLASS OF 13 STUDENTS INTERESTED IN PURSUING A CAREER IN HEALTHCARE. THE HOSPITAL'S HEALTH CAREER PROGRAM IS THE ONLY ONE OPERATING IN THE REGION AND DEVELOPED TO ADDRESS THE SHORTAGE OF HEALTH PROFESSIONALS IN SAN BERNARDINO COUNTY. FOR MORE INFORMATION ABOUT ST. MARY MEDICAL CENTER, PLEASE VISIT WWW.STMARYAPPLEVALLEY.COM. FOR MORE INFORMATION ABOUT ST. JOSEPH HEALTH SYSTEM, PLEASE VISIT WWW.STJOE.ORG. DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6 ST JOSEPH HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER OF ST. MARY MEDICAL CENTER. DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, LINE 7A ST. MARY MEDICAL CENTER HAS A TIERED GOVERNANCE IN WHICH THE CORPORATE MEMBERS RESERVE THE RIGHT TO APPOINT TRUSTEES TO THE ST. MARY MEDICAL CENTER BOARD. ALL TRUSTEE APPOINTMENTS THAT COME FROM THE ST. MARY MEDICAL CENTER BOARD AS NOMINATIONS MUST BE APPROVED BY THE ST. JOSEPH HEALTH SYSTEM, AS THE CORPORATE MEMBER, AND THE ST. JOSEPH HEALTH MINISTRY, AS THE ORGANIZATIONAL SPONSOR. DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7B THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE ST. JOSEPH HEALTH SYSTEM MEMBER OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION AS APPLICABLE. THE FORM 990 IS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2012 MEETING. DURING THE FINANCE COMMITTEE MEETING, MANAGEMENT PRESENTS AND DISCUSSES CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. THE FINANCE COMMITTEE CHAIR THEN PROVIDES A SUMMARY AT THE FULL BOARD MEETING. ADOPTION OF CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12 THE CONFLICT OF INTEREST POLICY WAS DEVELOPED BY ST. JOSEPH HEALTH SYSTEM AND IMPLEMENTED BY ST. MARY MEDICAL CENTER. IT WILL BE ADOPTED BY THE ST. MARY MEDICAL CENTER BOARD ON MAY 23, 2012. DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ON THE CONFLICT OF INTEREST DISCLOSURE FORM THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICT OF INTEREST HE/SHE MAY HAVE. ADDITIONALLY, DISCLOSURES SHALL BE MADE PROMPTLY ANYTIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, SUCH CONFLICT IS DISCLOSED TO THE COMPLIANCE COMMITTEE. IF THE CONFLICT INVOLVES A MEMBER OF THAT COMMITTEE, THE REMAINING COMMITTEE MEMBERS WILL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. THE OFFICER, TRUSTEE, OR KEY EMPLOYEE MAY NOT BE PRESENT DURING ANY MEETING IN WHICH THE COMMITTEE CONDUCTS IS EVALUATION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER IN CONSULTATION WITH SJHS GENERAL COUNSEL WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. ADOPTION OF WHISTLEBLOWER POLICY FORM 990, PART VI, LINE 13 THE WHISTLEBLOWER POLICY WAS DEVELOPED BY ST. JOSEPH HEALTH SYSTEM AND IMPLEMENTED BY ST. MARY MEDICAL CENTER. IT WILL BE ADOPTED BY THE ST. MARY MEDICAL CENTER BOARD ON MAY 23, 2012. ADOPTION OF DOCUMENT RETENTION AND DESTRUCTION POLICY AND PROCEDURES FORM 990, PART VI, LINE 14 THE DOCUMENT RETENTION AND DESTRUCTION POLICY WAS DEVELOPED BY ST. JOSEPH HEALTH SYSTEM AND IMPLEMENTED BY ST. MARY MEDICAL CENTER. IT WILL BE ADOPTED BY THE ST. MARY MEDICAL CENTER BOARD ON MAY 23, 2012. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN FORM 990, PART VI, LINES 15A AND 15B THE EXECUTIVE COMPENSATION PROCESS AT ST. JOSEPH HEALTH SYSTEM IS ADMINISTERED BY A COMMITTEE OF INDEPENDENT TRUSTEES. THEY FOLLOW A BOARD-APPROVED CHARTER AND OVERALL EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER EMPOWERS THE SJHS BOARD WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND PROCESS ON BEHALF OF THE FULL BOARD OF TRUSTEES OF SJHS. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS THE RETENTION OF KEY MANAGEMENT TALENT. THE SJHS EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. SJHS PROVIDES COMPENSATION TO ITS SENIOR EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO FULFILL THEIR RESPONSIBILITY, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA. THEY USE THIS INFORMATION TO SUPPORT THEIR DECISIONS REGARDING ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE WORKLIFE COMMITTEE IS COMPRISED OF SEVERAL INDEPENDENT MEMBERS OF THE BOARD. THEY MEET AT LEAST 3 TIMES A YEAR AND MAKE ALL CRITICAL DECISIONS IN EXECUTIVE SESSION. THESE DECISIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. THE COMMITTEE IS EMPOWERED TO ENGAGE OUTSIDE COUNSEL AND CONSULTING SUPPORT AS NEEDED. THE WORKLIFE COMMITTEE PERFORMED ITS LAST COMPENSATION REVIEW FOR ASSISTANT VICE PRESIDENTS, VICE PRESIDENTS, SENIOR VICE PRESIDENTS, EXECUTIVE VICE PRESIDENTS, AND THE CHIEF EXECUTIVE OFFICER IN SEPTEMBER 2011. AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII STEPHEN GILBERT SERVES ON THE ST. MARY MEDICAL CENTER (SMMC) BOARD OF DIRECTORS AND IS AN EMPLOYEE OF ST. JOSEPH HEALTH SYSTEM (SJHS), THE TAX-EXEMPT PARENT OF SMMC. HE DEVOTES 50 HOURS PER WEEK TO HIS ROLE AS VP OF FACILITIES AT SJHS. JASON BARKER IS THE CEO/PRESIDENT OF SMMC. ALTHOUGH HE COMPENSATED BY SJHS, HE DEVOTES 50 HOURS PER WEEK TO SMMC AND NO HOURS TO SJHS. DONALD MILLER, FORMER VICE PRESIDENT AND CFO OF SMMC, IS THE CFO OF QUEEN OF THE VALLEY MEDICAL CENTER (QVMC) AND SERVED AS A TRUSTEE FOR PART OF THE YEAR ON THE BOARD OF ST. JOSEPH HOME CARE NETWORK (SJHCN). HE DEVOTES 50 HOURS PER WEEK TO QVMC AND 2 HOURS TO SJHCN. SISTER THERESA LAMETTEREY SERVES ON THE SMMC BOARD OF DIRECTORS AS WELL AS THE ST. JOSEPH HOSPITAL OF ORANGE BOARD OF DIRECTORS. SHE DEVOTES 2 HOURS PER WEEK TO EACH HOSPITAL. SISTER KATHLEEN MALONEY SERVES ON THE SMMC BOARD OF DIRECTORS AS WELL AS THE ST. JOSEPH HOSPITAL OF ORANGE BOARD OF DIRECTORS. SHE DEVOTES 2 HOURS PER WEEK TO EACH HOSPITAL. CHANGES IN NET ASSETS OR FUND BALANCE FORM 990, PART XI, LINE 5 UNREALIZED GAINS ON INVESTMENTS $ 7,094,610 EQUITY TRANSFER TO HHF ($ 1,200,000) SPEC CLINIC $ 570,976 EQUITY TRANSFER TO SJHS ($24,807,641) EQUITY TRANSFER FROM SJHS $25,000,000 EQUITY TRANSFER FROM RCS $ 361,718 EQUITY TRANSFER TO SJHO ($ 30,000) ROUNDING $ 104 ---------- TOTAL $ 6,989,767 OVERSIGHT OF SELECTION PROCESS FORM 990, PART XII, LINE 2C THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. 409A DOCUMENT CORRECTION UNDER VI.B, VII.C & XI.A OF IRS NOTICE 2010-06 DOCUMENT DEFECTS 1) NAME AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: NOT APPLICABLE. NONE OF THE EMPLOYEES ARE INSIDERS. 2) THE 409A FAILURE OCCURRED WITH RESPECT TO THE ST. JOSEPH HEALTH SYSTEM 457(F) PLAN ("PLAN"). 3) THE 409A PLAN FAILURES ARE ELIGIBLE FOR CORRECTION UNDER THE TERMS OF VI.B, VII.C AND XI.A OF IRS NOTICE 2010-6. THE EMPLOYER HAS TAKEN ALL ACTIONS REQUIRED BEFORE DECEMBER 31, 2010, AND OTHERWISE MET ALL REQUIREMENTS FOR SUCH CORRECTION. NO PARTICIPANT IS REQUIRED TO REPAY ANY AMOUNT TO THE PLAN IN A SUBSEQUENT TAX YEAR, NOR IS ANY AMOUNT REQUIRED TO BE INCLUDED IN INCOME UNDER 409A AS PART OF THE CORRECTION. THE CORRECTIVE AMENDMENT WAS SIGNED ON OCTOBER 6, 2010. THE DATE OF THE EVENT CAUSING THE AFFECTED PARTICIPANT TO INCLUDE HIS PLAN ACCOUNT IN GROSS INCOME WAS HIS VOLUNTARY TERMINATION DATE. 4) DESCRIPTION OF EACH FAILURE: NAME/SOCIAL SECURITY NUMBER: DAVID PRINGLE VOLUNTARY TERMINATION DATE: 5/2/2009 GROSS AMOUNT INVOLVED IN DOCUMENT FAILURE: $45,826 AMOUNT REPORTED AS INCLUDIBLE IN INCOME UNDER 409A: $0 PERCENTAGE OF AMOUNT INVOLVED IN DOCUMENT FAILURE REQUIRED TO BE INCLUDED IN INCOME UNDER 409A: 0% BECAUSE FORM 990 IS OPEN TO PUBLIC INSPECTION AND THE THREAT OF IDENTITY THEFT, SOCIAL SECURITY NUMBERS WILL BE PROVIDED BY SEPARATE COVER UPON WRITTEN REQUEST. 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