2011-05-12T15:18:50-04:00 2010-06-30 ERNST & YOUNG US LLP 18111 VON KARMAN AVENUE SUITE 1000 IRVINE CA 92612 990 2009-07-01 951914489 ST MARY MEDICAL CENTER STMA 7602422311 18300 HIGHWAY 18 APPLE VALLEY CA 92307 Edward Wong 2011-05-12 9497942300 2009 2016-02-24 21:20:13Z JASON L BARKER 18300 HIGHWAY 18 APPLE VALLEY CA 92307 269407769 false 0928 X WWW.STMARY4HEALTH.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 communitites we serve. 16 10 1718 222 31046 9027 2475043 1211350 230759734 264515588 -4089018 3384255 34585 109703 229180344 269220896 722007 2437281 0 0 111602559 120592440 0 0 869493 109236954 125300880 221561520 248330601 7618824 20890295 188782379 211973662 100097859 100034268 88684520 111939394 SEE SCHEDULE O false false 227509370 2437281 264484542 SEE SCHEDULE O 227509370 true true false true false false false false true true false true false false false false false false true false true true false true false false false false false false false false false false false false false true true false false true 278 3 true 1718 true true true false false false false true true false false false 16 10 false false true false true true true true true false false true true true true true true true true false CA X SHAWN CURTIS DIR OF FINANCE 7602422311 18300 HIGHWAY 18 APPLE VALLEY CA 92308 VINCENT AJANWACHUKU MD 2.0 X 80117 0 0 VIRGIL BARNES 2.0 X 0 0 0 ROSELLA BERNAL 2.0 X 0 0 0 NANDA BISWAS MD 2.0 X 24384 0 0 SISTER MARTHAANN FITZPATRICK 2.0 X 0 0 0 BROTHER GARY HILL 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 ANNETTE WALKER 2.0 X 0 463805 14464 WANDA WILBURN MD 2.0 X 15019 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 63480 0 0 BROTHER IGNATIUS SUDOL 2.0 X 0 0 0 STEVE GILBERT 2.0 X 0 531789 51983 JASON BARKER 50.0 X X 0 544857 25446 EDWARD WONG 50.0 X 525973 0 24225 DAVID O'BRIEN 50.0 X 492265 0 27491 JOHN PERRING-MULLIGAN 50.0 X 250506 0 19351 JAMES KYLE 50.0 X 434827 0 17579 STEPHEN ECKBERG 50.0 X 324063 0 33517 MARILYN DRONE 50.0 X 283432 0 9816 ROBERT DIEHL 50.0 X 255967 0 27817 DAVID PRINGLE 50.0 X 250375 0 10319 RANDY BEVILACQUA 50.0 X 230385 0 21608 DOREEN HARDY 50.0 X 209608 0 23823 NORMAN SOTTO 36.0 X 193290 0 7577 EDWARD MEDINA 40.0 X 181534 0 31190 LEE GARDNER 40.0 X 173993 0 22524 ROSALINA REYES 36.0 X 170051 0 18052 EVANI TAN 40.0 X 167462 0 3902 DONALD MILLER 0.0 X 0 511779 20988 JUDITH AUSTIN 0.0 X 226931 0 17451 4553662 2052230 429123 191 true true false INTELISTAF TRAVEL 901 YAMATO ROAD STE 110 BOCA RATON FL 33431 Medical Staffing 4730545 US NURSING CORP 6501 S FIDDLERS GREEN CIRCLE STE GREENWOOD VILLAGE CO 80111 Staffing Solutions 1081780 INLAND CARDIOTHORACIC SURGICAL 401 E HIGHLAND AVENUE SUITE 251 SAN BERNARDINO CA 92404 Perfusion Services 1052850 ANGELICA CORPORATION-COLTON 925 S8TH ST COLTON CA 92324 Linen & Laundry SVCS 861331 Anesthesia Consultants of the Deser 18300 US HIGHWAY 18 APPLE VALLEY CA 92307 MEDICAL DIRECTOR SVC 660000 74 104014 624686 490593 -7943 2500 1211350 NET PATIENT SERVICE REVENUE 622110 263734260 263734260 CAFETERIA 722210 500085 500085 FINANCE CHARGES FOR PATIENT A/R 900099 162631 162631 LABORATORY 621511 31046 31046 MOB RENTAL 531120 19323 19323 68243 68243 264515588 314986 314986 0 0 3069219 3069219 3069269 3069269 296576 104014 186873 109703 109703 0 0 0 269220896 264484542 31046 3493958 2437281 2437281 0 0 0 3045010 830630 2095242 119138 0 79548458 76425264 2914530 208664 4370892 4030890 318253 21749 26824430 25220095 1478849 125486 6803650 6368911 407185 27554 5572026 4041341 1530685 790956 283807 507149 141884 141884 27040 27040 0 0 31695396 27318186 4119465 257745 434966 434966 40380499 40212704 150972 16823 268349 246793 20983 573 0 2225349 2092508 132841 335885 249005 76298 10582 0 144344 141717 582 2045 2613244 2613244 3447275 1482328 1930474 34473 7975437 7480047 493257 2133 1997294 1997294 Bad Debt expense 19796033 19796033 Capitation Reinsurance 92846 92846 All other expenses 7362057 6118700 1200829 42528 248330601 227509370 19951738 869493 16091429 18142741 9961508 23649084 2668625 366000 31474339 34075243 1295263 1351932 3037815 3402591 496209 612972 182047018 89058657 91951082 92988361 30752992 34127707 1053117 3257031 188782379 211973662 26838121 31139950 73259738 68894318 100097859 100034268 X 83082639 107877131 5601881 4062263 88684520 111939394 188782379 211973662 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 27040 27040 false LOBBYING ACTIVITIES PART II-B, LINE 1I 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. 420803 53110 473913 485207 -64404 420803 0.00000 0.00000 1.00000 false true true 30576944 30576944 81082633 36890673 44191960 179867 130204 49663 66644973 52037780 14607193 3562601 0 3562601 92988361 0 DUE TO 3RD PARTY PAYORS 12083810 ASBESTOS REMOVAL LIABILITY 379794 PAYABLE TO AFFILIATES 19233730 INTERCO WITH HEALTH SYSTEM BONDS 35776464 CAPITAL LEASE 1420520 68894318 ENDOWMENT FUNDS USE SCHEDULE D PART V ENDOWMENT FUNDS WERE DESIGNATED TO PROVIDE SCHOLARSHIP FUNDS FOR NURSING STUDENTS. ANNUAL GALA 272691 92510 180181 2775 4586 46451 28000 56379 GOLF TOURNAMENT 61859 5834 56025 1082 5990 6079 19815 1 66040 5670 60370 212 10563 4941 400590 104014 296576 4069 10576 63093 28000 81135 186873 109703 true true X true X true X 500. true true true false true true 7527 7540775 0 7540775 0.03300 15624 27512603 25536887 1975716 0.00860 0 0 0 0 0.00000 23151 35053378 25536887 9516491 0.04160 18601 281643 1210 280433 0.00120 400 20897 20897 0.00010 35257 3572400 726245 2846155 0.01250 0 0 0 0 0.00000 3862 24771 0 24771 0.00010 58120 3899711 727455 3172256 0.01390 81271 38953089 26264342 12688747 0.05550 72596 0 72596 0.00030 244 0 244 0.00000 16323 0 16323 0.00010 5232 0 5232 0.00000 3828 0 3828 0.00000 98223 0 98223 0.00040 true 4949008 0 49303268 54629560 -5326292 X true true ST MARY MEDICAL CENTER

18300 HIGHWAY 18 APPLE VALLEY CA 92307

X X X HEALTHY BEGINNINGS

18977 S OUTER HWY 18 A APPLE VALLEY CA 92307

OUTPATIENT SVC OUTPATIENT SURGERY PAVILLION

18122 US HWY 18 APPLE VALLEY CA 92307

OUTPATIENT SVC ADELANTO CLINIC

11424 CHAMBERLAIN WAY STE 89 ADELANTO CA 92301

OUTPATIENT SVC HESPERIA CLINIC

17091 MAIN STREET STE 100 HESPERIA CA 92345

OUTPATIENT SVC WOUND CARE CENTER

16077 KAMANA ROAD APPLE VALLEY CA 92307

OUTPATIENT SVC APPLE VALLEY COMMUNITY HEALTH CLINIC

18077 Outer Hwy 18 Suite 100 APPLE VALLEY CA 92307

COMMUNITY CLINIC FOR UNINSURED AND LOW INCOME POPULATION Adelanto Community Health Clinic

11424 Chamberlaine Way Suite 11 Adelanto CA 92301

COMMUNITY CLINIC FOR UNINSURED AND LOW INCOME POPULATION Hesperia-St Mary Community Health CliNIC

17071 Main Street HESPERIA CA 92345

COMMUNITY CLINIC FOR UNINSURED AND LOW INCOME POPULATION A COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2 FOR CHARITY CARE AND UNREIMBURSED MEDICAID COSTS. ALL OTHER COSTS WERE ACTUALS, INCLUDING DIRECT OFFSETTING REVENUES. OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) WERE $248,330,601. THE BAD DEBT INCLUDED IN THIS AMOUNT WAS $19,796,033. THIS LEFT US WITH TOTAL EXPENSES OF $228,534,568 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). Financial Statement Footnote Describing 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 CONTINUALLY MONITORS AND ADJUSTS THE RESERVES ASSOCIATED WITH RECEIVABLES. THE ORGANIZATION ESTIMATES BAD DEBT EXPENSE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED ON HISTORICAL COLLECTION EXPERIENCE. A 40% DISCOUNT IS PROVIDED TO ALL SELF PAY PATIENTS. 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. A COST-TO-CHARGE RATIO WAS DERIVED FROM THE FY09 MEDICARE COST REPORT FILED AND WAS USED IN DETERMINING FY10 MEDICARE COST WITH ADJUSTMENTS TO CHARGES AND COSTS TO DERIVE THE FY10 COST-TO-CHARGE RATIO. PRIOR TO ADVANCING ANY ACCOUNT FOR EXTERNAL COLLECTION, THE ORGANIZATION PERFORMS AN EVALUATION TO IDENTIFY IF THE ACCOUNT QUALIFIES FOR CHARITY CARE. ALL ACCOUNTS ARE SCREENED FOR CHARITY CARE ELIGIBILTY USING CRITERIA THAT CONSIDERS INSURANCE COVERAGE, CREDIT RATING, PAYMENT ACTIVITY, AND VALID SOCIAL SECURITY NUMBER AND/OR ACCURATE RESIDENCE ADDRESS. EVERY THREE YEARS ST. MARY MEDICAL CENTER CONDUCTS A COMPREHENSIVE NEEDS ASSESSMENT. THE ASSESSMENT IS DESIGNED AND COMPLETED WITH ASSISTANCE OF 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 ASSESSMENT 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 ASSESSMENT 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. THE ORGANIZATION POSTS NOTICES INFORMING THE PUBLIC OF THE FINANACIAL 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. 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 TWAO 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 DISEASES ACCOUNT 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'S FOUNDATION HAS BEEN RAISING FUNDS AND THE HOSPITAL 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 PATIENT'S 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 PARTICIPATES IN A COUNTY-WIDE COLLABORATION ENROLLING UNINSURED CHILDREN IN PARTNERSHIP WITH SCHOOLS AND CHURCHES. ADDITIONALLY, THE HOSPITAL PARTICIPATES IN A COUNTY CLINIC COLLABORATIVE TO INCREASE THE NUMBER OF COMMUNITY CLINICS PROVIDING PRIMARY CARE SERVICES TO LOW INCOME POPULATIONS. 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 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. THE COSTS OF THESE PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINES 3, 4, 5, 6 AND 9. THE HOSPITAL IS ACTIVE WITH A RANGE OF HEALTH ADVOCACY INCLUDING STATE LEVEL SUPPORT OF THE HEALTHY FAMILIES HEALTH INSURANCE PROGRAM FOR CHILDREN. WORKING IN COLLABORATION WITH OTHER HEALTH AGENCIES THE HOSPITAL HAS ORGANIZED A LOCAL CHILDREN'S HEALTH COALITION. THE PURPOSE OF THE COALITION IS TO ENROLL UNINSURED CHILDREN AT LOCAL SCHOOLS AND CHURCHES. HOSPITAL LEADERS CONTINUE WORKING WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO DEVELOP AND MAINTAIN A SUCCESSFUL HOSPITAL FEE PROGRAM THEREBY ENABLING THE STATE OF CALIFORNIA TO SECURE ADDITIONAL FEDERAL MEDI-CAL DOLLARS TO MAINTAIN THE PROGRAM. THE HOSPITAL HAS BEEN WORKING ON A SAN BERNARDINO COUNTY-WIDE EFFORT LEAD BY THE HEALTH DEPARTMENT AND LOCAL HOSPITAL ASSOCIATION TO COLLABORATE ON CONDUCTING COMMUNITY NEEDS ASSESSMENTS AND IMPLEMENTING COMMUNITY BENEFIT INITIATIVES AROUND KEY LAGGING HEALTH INDICATORS INCLUDING HEART DISEASE, STROKE AND OBESITY. THE HOSPITAL HAS BEEN WORKING WITH SAN BERNARDINO COUNTY PUBLIC HEALTH OFFICIALS ON OPENING TRAUMA SERVICES TO THE COMMUNITY PRESENTLY NONE EXIST. THE HOSPITAL IS THE LARGEST LOCAL FUNDER OF SERVICE ORGANIZATIONS PROVIDING FOOD, HOUSING AND UTILITY ASSISTANCE TO THE AREA'S HOMELESS AND UNEMPLOYED. THE HOSPITAL SUBSIDIZES A CALL PANEL TO ENSURE UNINSURED PATIENTS ARE PROVIDED HEALTH CARE BY PHYSICIANS. THE HOSPITAL HAS AN OPEN MEDICAL STAFF, A BOARD COMPRISED OF LOCAL RESIDENTS, HOSPITAL OFFICERS AND SYSTEM OFFICE EMPLOYEES. SURPLUS FUNDS ARE PUT BACK INTO THE HOSPITAL THROUGH CAPITAL INVESTMENT AND 10% IS TITHED ANNUALLY WHICH ARE FUNDS USED TO PROVIDE SERVICES TO THE POOR AND BROADER COMMUNITIES. GIVING BACK TO THE COMMUNITY PERMEATES EVERY ASPECT OF OUR ORGANIZATION. AS A MEMBER OF THE FAITH-BASED HEALTHY MINISTRY OF ST. JOSEPH HEALTH SYSTEM, WE HAVE A FUNDING STREAM TO ADDRESS THE NEEDS OF THE ECONOMICALLY POOR AND VULNERABLE IN THE COMMUNITIES WE SERVE. ON AN ANNUAL BASIS, 10 PERCENT OF OUR NET OPERATING INCOME IS DEVOTED TO FUND COMMUNITY PROGRAMS FOR THE ECONOMICALLY POOR. THE ST. JOSEPH HEALTH SYSTEM FOUNDATION, A MEMBER OF ST. JOSEPH HEALTH SYSTEM, IS CHARGED WITH THE DISTRIBUTION OF THESE FUNDS. IN ADDITION TO DEVOTING A PERCENTAGE OF OUR NET OPERATING INCOME TO COMMUNITY BENEFIT SERVICES FOR THE ECONOMICALLY POOR, WE STRIVE TO ANNUALLY BUDGET A PORTION OF OUR TOTAL OPERATING EXPENSES FOR HEALTHY COMMUNITIES AND COMMUNITY HEALTH EFFORTS. CA true CATHOLIC CHARITIES 1450 N D STREET SAN BERNARDINO CA 92405 953516461 501(c)(3) 36600 PROGRAM SUPPORT ST JOHN OF GOD 13333 PALMDALE RD VICTORVILLE CA 92392 953806996 501(c)(3) 48000 PROGRAM SUPPORT St Joseph Health System Foundation 500 S Main Street Orange CA 928684507 330143024 501(c)(3) 2350181 CARE FOR THE POOR 3 0 DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS FORM 990, SCHEDULE I COMMUNITY BENEFIT COMMITTEE OVERSEES/MONITORS GRANT USAGE ON A MONTHLY BASIS. X true true true true false false false false false true false DONALD MILLER 0 262544 0 81786 0 167449 0 19382 0 1606 0 532767 0 89956 ANNETTE WALKER 0 302031 0 94806 0 66968 0 9610 0 4854 0 478269 0 0 STEVE GILBERT 0 336774 0 96417 0 98598 0 22000 0 29983 0 583772 0 0 JASON BARKER 0 319841 0 130787 0 94229 0 9800 0 15646 0 570303 0 8011 EDWARD WONG 307040 0 103504 0 115429 0 22033 0 2192 0 550198 0 0 0 DAVID O'BRIEN 321801 0 108087 0 62377 0 9793 0 17698 0 519756 0 0 0 JAMES KYLE 271440 0 89511 0 73876 0 6179 0 11400 0 452406 0 0 0 STEPHEN ECKBERG 202388 0 67241 0 54434 0 17054 0 16463 0 357580 0 0 0 MARILYN DRONE 180516 0 59224 0 43692 0 9687 0 129 0 293248 0 0 0 ROBERT DIEHL 154265 0 52537 0 49165 0 8431 0 19386 0 283784 0 9413 0 JOHN PERRING-MULLIGAN 160595 0 52980 0 36931 0 8322 0 11029 0 269857 0 0 0 DAVID PRINGLE 55676 0 53642 0 141057 0 3785 0 6534 0 260694 0 0 0 RANDY BEVILACQUA 143361 0 47110 0 39914 0 11501 0 10107 0 251993 0 0 0 JUDITH AUSTIN 0 0 0 0 226931 0 0 0 17451 0 244382 0 0 0 DOREEN HARDY 119138 0 46998 0 43472 0 10732 0 13091 0 233431 0 1130 0 NORMAN SOTTO 186598 0 0 0 6692 0 7577 0 0 0 200867 0 0 0 EDWARD MEDINA 176956 0 0 0 4578 0 16530 0 14660 0 212724 0 0 0 LEE GARDNER 161379 0 6587 0 6027 0 12022 0 10502 0 196517 0 0 0 ROSALINA REYES 158901 0 0 0 11150 0 13267 0 4785 0 188103 0 0 0 EVANI TAN 145798 0 10000 0 11664 0 0 0 3902 0 171364 0 0 0 SUPPLEMENTAL INFORMATION SCHEDULE J, PART I, LINE 1A ST. JOSEPH HEALTH SYSTEM ALLOWS FOR COMPANION TRAVEL FOR CERTAIN PRE-APPROVED, MINISTRY SPONSORED EVENTS. COMPANION TRAVEL IS TREATED AS TAXABLE COMPENSATION IN MOST CASES. IN THE CASE THAT COMPANION TRAVEL IS NOT TREATED AS TAXABLE COMPENSATION, THE INDIVIDUAL IS PROVIDING A SERVICE TO THE HEALTH SYSTEM AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. MEMBERS OF THE BOARD AND EXECUTIVE MANAGEMENT TEAM ARE SELECTED TO PARTICIPATE IN AN ANNUAL PILGRIMAGE TO LE PUY, FRANCE, WHERE THE SISTERS' FIRST CONGREGATION WAS FORMED. THE PURPOSE OF THE PILGRIMAGE IS FOR THE ORGANIZATION'S LEADERS TO DEVELOP A DEEPER UNDERSTANDING OF THE ROOTS AND HERITAGE OF THE ORGANIZATION IN ORDER TO CARRY OUT THE MISSION. COMPANION TRAVEL IS CONSIDERED TO BE AN ESSENTIAL PART OF THIS EXPERIENCE AND THE COMPANION ACTS AS A REPRESENTATIVE WITH KNOWLEDGE OF THE COMMUNITIES AND MINISTRIES WE SERVE. THE FOLLOWING TRUSTEES AND OFFICERS RECEIVED A BENEFIT FOR COMPANION TRAVEL THAT WAS INTENDED TO BE COMPENSATION. THE BENEFITS WERE PAID BY ST. MARY MEDICAL CENTER'S TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM. JASON BARKER - $4,225 DONALD MILLER - $4,213 ANNETTE WALKER - $6,757 DESCRIPTION TAX INDEMNIFICATION THE ORGANIZATION PROVIDED GIFT CARDS FOR GROSS-UP PAYMENTS OF $25 FOR CERTAIN EMPLOYEES. THE AMOUNT WAS INCLUDED IN COMPENSATION REPORTED. DESCRIPTION OF CEO PAID BY EXEMPT PARENT 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 PAID BY A RELATED ORGANIZATION. SEE SCHEDULE O, PART VI, LINE 15A FOR THE PROCESS THAT IS COMPLETED BY THE ST. JOSEPH HEALTH SYSTEM. DESCRIPTION OF SEVERANCE PAYMENT OR CONTROL PAYMENT SCHEDULE J, PART I, LINE 4A THIS INCLUDES SEVERANCE PAY TO THE FOLLOWING: JUDITH AUSTIN, FORMER CHIEF NURSING OFFICER WAS PAID $226,931 IN SEVERANCE PAY. DESCRIPTION OF A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 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. AMOUNTS PAID OUT: ROBERT DIEHL: $ 9,413 DOREEN HARDY: $ 1,130 DONALD MILLER: $89,956 JASON BARKER: $ 8,011 DESCRIBE ANY NON-FIXED PAYMENTS PROVIDED 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 ENCOUNTERES, AND HEALTHIEST COMMUNITIES AS WELL AS FISCAL STEWARDSHIP. EACH OF THESE FACTORS IS TAKEN INTO CONSIDERATION WHEN DETERMINING THE PERCENTAGE OF AT-RISK PAY. DESCRIBE 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. 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. PROGRAM SERVICE ACCOMPLISHMENTS PART III, LINES 4A-D GROUNDED IN OUR COMMITMENT TO COMMUNITY 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. THAT MISSION HAS GUIDED OUR CATHOLIC HEALTHCARE MINISTRY SINCE THE OPENING OF OUR FIRST HOSPITAL IN EUREKA, CALIFORNIA NEARLY 100 YEARS AGO. BUT THE ROOTS OF ST. MARY MEDICAL CENTER AND THE LESSONS TO SERVE OUR DEAR NEIGHBORS DATE BACK TO THE YEAR 1650 WHEN THE SISTERS' FIRST CONGREGATION WAS FORMED IN LE PUY, FRANCE. SINCE THAT TIME, THE PEOPLE OF OUR ORGANIZATION CONTINUE TO ASSESS THE NEEDS OF THE COMMUNITIES WE SERVE, BUILD COLLABORATIVE PARTNERSHIPS WITH LOCAL RESIDENTS, BUSINESS AND COMMUNITY NOT-FOR-PROFITS, AND TOGETHER THROUGH THOSE PARTNERSHIPS, MEET COMMUNITY NEEDS. THE HEALTH SYSTEM IS ORGANIZED INTO THREE REGIONS--NORTHERN CALIFORNIA, SOUTHERN CALIFORNIA, AND WEST TEXAS/EASTERN NEW MEXICO - AND CONSISTS OF 14 ACUTE CARE HOSPITALS, AS WELL AS HOME HEALTH AGENCIES, HOSPICE CARE, OUT-PATIENT SERVICES, SKILLED NURSING FACILITIES, COMMUNITY CLINICS, AND PHYSICIAN ORGANIZATIONS. WHO WE ARE AND WHAT WE DO ST. MARY MEDICAL CENTER IS A 190 BED ACUTE CARE HOSPITAL, SERVING THE HIGH-DESERT REGION OF SAN BERNARDINO COUNTY. DURING FISCAL YEAR 2010, WE SAW INCREASED DEMANDS FROM LOCAL RESIDENTS WITHIN OUR COMMUNITIES FOR COMMUNITY BENEFIT PROGRAMS AND CHARITY CARE CONTRIBUTIONS THAT OUR ORGANIZATION MAKES EACH YEAR. IN SPITE OF THE MANY FINANCIAL CHALLENGES WITHIN OUR ORGANIZATION AND THE NATION DUE TO THE ECONOMIC DOWNTURN, WE CONTINUED TO MEET THE NEEDS OF LOCAL RESIDENTS WHO FOUND THEMSELVES UNEMPLOYED AND IN MANY CASES ALSO UNINSURED AND IN NEED OF HEALTHCARE AND OTHER COMMUNITY-BASED SERVICES. IN FISCAL YEAR 2010, WE INVESTED A TOTAL OF $16,954,000 (7.6% OF OUR TOTAL OPERATING EXPENSES) IN COMMUNITY BENEFIT (INCLUDING CHARITY CARE, UNPAID COST TO STATE AND LOCAL PROGRAMS AND COMMUNITY BENEFIT SERVICES TO THE LOW-INCOME AND BROADER COMMUNITY), IN ALIGNMENT WITH CATHOLIC HEALTH ASSOCIATION GUIDELINES. IN ADDITION, UNPAID COST OF MEDICARE PROGRAMS TOTALED $5,412,500. THREE MISSION OUTCOMES AS A MINISTRY OF THE ST. JOSEPH HEALTH SYSTEM WE ARE COMMITTED TO THREE SYSTEMWIDE MISSION OUTCOMES: - MAKING EVERY ENCOUNTER WITH OUR COMMUNITY A SACRED ENCOUNTER, ST. MARY MEDICAL CENTER IS LARGEST LOCAL FUNDING PROVIDER TO PARTNERS SERVING THE HOMELESS AND HUNGRY AT A TIME WHEN LOCAL UNEMPLOYMENT RATE EXCEEDED 14% AND REPORTS FOR ASSISTANCE FOOD AND HOUSING ASSISTANCE SOARED. - PROVIDING TO OUR PATIENTS IN THE COMMUNITY WITH PERFECT CARE, AND ST. MARY MEDICAL CENTER IS BUILDING ON ITS BABY FRIENDLY DESIGNATION BY IMPROVING THE PERCENTAGE OF WOMEN IN THE COMMUNITY WHO ARE PROVIDING BREAST MILK TO THEIR INFANTS IN THE FIRST SIX MONTHS OF LIFE. - MAKING THE COMMUNITY WE SERVE AMONG THE HEALTHIEST COMMUNITIES IN THE U.S. ST. MARY MEDICAL CENTER IS LEADING A LARGE HEALTH COLLABERATIVE KNOWN AS "HEALTHY HIGH DESERT" WHICH, IN TURN, HAS CREATED THREE HEALTH CITY CAMPAIGNS ADDRESSING THE PROBLEMS OF OBESITY, UNHEALTHY FOOD AND LIMITED ACCESS TO PHYSICAL ACTIVITY. FINANCIAL ASSISTANCE POLICY (TRADITIONAL CHARITY CARE) 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. Joseph Health System has a Patient Financial Assistance Program that provides free or discounted services to eligible patients. In FY 10, St. Mary Medical Center, 11,708,000 charity care. ORGANIZATIONAL COMMITMENT AS A VALUES BASED ORGANIZATION, ST. MARY MEDICAL CENTER HAS A LONG-STANDING COMMITMENT TO THE COMMUNITY. FY 10 COMMUNITY BENEFIT INITIATIVES AND/OR PROGRAMS NAME OF INITIATIVE OR PROGRAM: EXPANDING HEALTH ACCESS TO UNINSURED PERSONS GOAL: INCREASE UNINSURED ACCESS TO PRIMARY HEALTH CARE SERVICES KEY COMMUNITY PARTNERS: SEVEN SCHOOL DISTRICTS, THREE PHYSICAN VOLUNTEERS, MULTIPLE LOCAL CHURHCES, SAN BERNARDINO COUNTY DEPARTMENT OF PUBLIC HEALTH, FIRST 5 OF SAN BERNARDINO COUNTY FY10 ACCOMPLISHMENTS: 28,695 PATIENTS SERVED. 29% INCREASE IN PATIENTS USING HOSPITAL'S MOBILE VAN PROGRAM. DOUBLING OF PATIENTS (10,873) PROVIDED CANCER DETECTION SERVICES QUANTIFIABLE COMMUNITY BENEFIT 28,695 PATIENTS NAME OF INITIATIVE OR PROGRAM: CHILDREN'S HEALTH INSURANCE ENROLLMENT GOAL: INSURE UNINSURED CHILDREN INTO SAFETY NET HEALTH INSURANCE PROGRAMS KEY COMMUNITY PARTNERS: SEVEN SCHOOL DISTRICTS, CHURCHES, PHYSICANS, INLAND EMPIRE HEALTH PLAN, FIRST FIVE OF SAN BERNARDINO COUNTY, MOLINA HEALTH CARE FY10 ACCOMPLISHMENTS: ENROLLED 689 CHILDREN. RECRUITED ONE PHYSICAN PARTNER OFFERING HEALTH SERVICES TO UNINSURED. SECURED ADDITIONAL FUNDING TO CONTINUE COUNTY-WIDE COLLABERATIVE ON CHILDREN'S ACCESS TO HEALTH CARE QUANTIFIABLE COMMUNITY BENEFIT: 689 CHILDREN ENROLLED INTO SAFETY NET HEALTH INSURANCE NAME OF INITIATIVE OR PROGRAM: ASSISTING PERSONS IN CRISIS GOAL: STABILIZE FAMILIES IN ECONOMIC CRISIS AS RESULT OF UNEMPLOYMENT AND/OR HOMELESSNESS KEY COMMUNITY PARTNERS: ST. JOHN OF GOD, CATHOLIC CHARITIES OF SAN BERNARDINO/RIVERSIDE COUNTIES, COMMUNITY TOOLBOX, THE LORD'S TABLE FY10 ACCOMPLISHMENTS: THE HOSPITAL PROVIDED $86,500 IN HOUSING, FOOD AND UTILITY ASSISTANCE AND ASSISTED PARTNERS IN SECURING AN ADDITIONAL $100,000 GRANT TO SERVE PERSONS IN ECONOMIC CRISIS. NAME OF INITIATIVE OR PROGRAM: CHILDHOOD OBESITY GOAL: REDUCE PREVELENCE OF CHILDHOOD OBESITY IN HIGH DESERT KEY COMMUNITY PARTNERS: SJHS, FIRST 5 OF SAN BERNARDINO COUNTY, SAN BERNARDINO COUNTY HEAD START/PRE SCHOOL DEPARTMENT, HIGH DESERT PRIMARY CARE, HIGH DESERT VALLEY PEDIATRICS, ALLIANCE PHYSICANS, SAN BERNARDINO COUNTY HEALTH CITY INTIAITIVE, TOWN OF APPLE VALLEY, CITY OF ADELANTO, CITY OF VICTORVILLE. ADELANTO SCHOOL DISTRICT FY10 ACCOMPLISHMENTS: SECURED $90,000 FUNDS AWARDED TO THREE CITIES TO BEGIN ADDRESSING CHILDHOOD OBESITY THROUGH INCREASED PHYSICAL ACTIVITY AND IMPROVED PUBLIC ACCESS TO HEALTHIER FOODS. STARTED VICTOR VALLEY COLLABERATIVE NAMED HEALTHY HIGH DESERT. SECURED $186,000 IN FUNDING TO HELP RESIDENTS ADVOCATE FOR FRESH PRODUCE AND INCREASED ACCESS TO PHYSICAL ACTIVITY. SUCCESSFULLY ADVOCATED FOR CITY OF VICTORVILLE PASSAGE OF FIRST NON-MOTORIZED TRAILWAY SYSTEM (73 MILES) IN CITY OF OVER 100,000 RESIDENTS. ASSISTED CITY OF ADELANTO IN FORMATION OF ITS FIRST PARK AND RECREATION MASTER PLAN AND OPENING OF REGION'S FIRST BICYCLE-SKATEPARK. IN FY 10 ST. MARY MEDICAL CENTER CONTRIBUTED OVER $18 MILLION IN UNSPONSORED QUANTIFIABLE COMMUNITY BENEFIT: TRADITIONAL CHARITY CARE $7,540,775 UNREIMBURSED MEDICAID $1,975,716 UNREIMBURSED COSTS - OTHER MEANS TESTED GOVERNMENT PROGRAMS $0 COMMUNITY SERVICES FOR THE LOW-INCOME $12,448,255 COMMUNITY SERVICES FOR THE BROADER COMMUNITY $338,642 *IN ALIGNMENT WITH CATHOLIC HEALTH ASSOCIATION COMMUNITY BENEFIT REPORTING GUIDELINES UNPAID COST FOR MEDICARE PATIENTS $5,412,500 FOR MORE INFORMATION ON ST. MARY MEDICAL CENTER: WWW.STMARYAPPLEVALLEY.COM FOR MORE INFORMATION ON THE ST. JOSEPH HEALTH SYSTEM GO TO: WWW.STJOE.ORG CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, LINE 4 THE ORGANIZATION'S BYLAWS WERE UPDATED TO DEFINE AND CLARIFY BOARD DUTIES AND OFFICER ROLES. IN ADDITION, THE LIST OF RESERVED RIGHTS WAS EXPANDED TO INCLUDE PROCESSES LEADING UP TO ACTION ON RESERVED RIGHTS. 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 AND 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 11 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(S) OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS THEN DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE APRIL 2011 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. 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. OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN Form 990, Part VI, Lines 15a & b 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 JUNE 2010. 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 ANNETTE WALKER SERVES ON THE BOARD OF DIRECTORS OF ST. MARY MEDICAL CENTER (SMMC) AND IS AN EMPLOYEE OF ST. JOSEPH HEALTH SYSTEM (SJHS), THE TAX-EXEMPT PARENT OF SMMC. SHE DEVOTES 50 HOURS PER WEEK TO HER ROLE AS SVP OF STRATEGIC PLANNING AT SJHS. STEVE GILBERT SERVES ON THE BOARD OF DIRECTORS OF ST. MARY MEDICAL CENTER (SMMC) AND IS AN EMPLOYEE OF ST. JOSEPH HEALTH SYSTEM (SJHS), THE TAX-EXEMPT PARENT OF SMMC. HE DEVOTES 40 HOURS PER WEEK TO HIS ROLE AS VP OF FACILITIES AT SJHS. JASON BARKER SERVES AS CEO OF ST. MARY MEDICAL CENTER (SMMC). ALTHOUGH HE IS COMPENSATED BY THE TAX-EXEMPT PARENT, ST. JOSEPH HEALTH SYSTEM (SJHS), HE DEVOTES 50 HOURS PER WEEK TO SMMC AND NO HOURS TO SJHS. DONALD MILLER, FORMER CFO OF ST. MARY MEDICAL CENTER (SMMC) IS VP OF FINANCE AND CFO OF QUEEN OF THE VALLEY MEDICAL CENTER (QVMC), A BROTHER/SISTER ORGANIZATION OF SMMC. HE DEVOTES 50 HOURS PER WEEK TO HIS ROLE AS VP OF FINANCE AND CFO TO QVMC. OVERSIGHT OR SELECTION PROCESS FORM 990, PART XI, LINE 2C THE ST. JOSEPH HEALTH SYSTEM BOARD APPROVES THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT. TRANSACTIONS WITH RELATED ORGANIZATIONS FORM 990, SCHEDULE R, PART V, LINE 2 THE AMOUNTS REPORTED ON SCHEDULE R, PART V, LINE 2 ARE DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING. SECTION 409A RELIEF UNDER SECTION V.D OF IRS NOTICE 2008-113 OPERATIONAL DEFECTS (A) NAME AND SOCIAL SECURITY NUMBERS OF AFFECTED PARTICIPANTS: NOT APPLICABLE. (B) THE 409A FAILURE OCCURRED WITH RESPECT TO THE ST. JOSEPH HEALTH SYSTEM 457(F) PLAN ("PLAN"). (C) OPERATIONAL DEFECT (1): IN FEBRUARY 2010 IT WAS DISCOVERED THAT THE PLAN FAILED TO COMPLY WITH 409A BECAUSE IT PROVIDED FOR IMPERMISSIBLE ALTERNATIVE PAYMENT SCHEDULES FOR VOLUNTARY AND INVOLUNTARY SEPARATIONS FROM SERVICE AND DID NOT SPECIFY THAT PAYMENT WILL BE MADE ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. IN ACCORDANCE WITH VI.B, VII.C AND XI.A OF NOTICE 2010-6, THE PLAN WAS AMENDED EFFECTIVE AS OF JANUARY 1, 2009 TO APPLY THE TIMING RULE APPLICABLE TO INVOLUNTARY TERMINATIONS TO VOLUNTARY TERMINATIONS AND TO PROVIDE THAT PAYMENT WILL BE MADE ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT. THIS AMENDMENT WAS SIGNED BY THE EMPLOYER ON OCTOBER 6, 2010. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 60TH DAY FOLLOWING THE SEPARATION FROM SERVICE DATE FOR PARTICIPANTS WHO VOLUNTARILY TERMINATED ON OR AFTER JANUARY 1, 2009 AND ON OR BEFORE DECEMBER 31, 2009. THE PLAN COVERS ELIGIBLE EMPLOYEES OF PARTICIPATING EMPLOYERS. ST. MARY REGIONAL MEDICAL CENTER PARTICIPATES IN THE PLAN AND HAD ONE EMPLOYEE WHO VOLUNTARILY TERMINATED IN 2009. NAME: DAVID PRINGLE DATE OF WHEN THE FAILURE OCCURRED: 07/02/2010 12/31/2009 ACCOUNT BALANCE: $45,826 PAYMENT DATE: 12/17/2010 GROSS AMOUNT DISTRIBUTED*: $45,826 * DISTRIBUTIONS DID NOT INCLUDE ANY INTEREST EARNED AFTER DECEMBER 31, 2009 FOR PARTICIPANTS WHO TERMINATED IN 2009. OPERATIONAL DEFECT (2): IN 2010 IT WAS DISCOVERED THAT 3 PARTICIPANTS, EMPLOYED BY OTHER PARTICIPATING EMPLOYERS, WERE NOT TIMELY PAID THEIR PLAN ACCOUNTS FOLLOWING INVOLUNTARY TERMINATIONS IN 2009, AS REQUIRED BY THE PLAN. USUALLY, SUCH DISTRIBUTIONS ARE MADE WITHIN 30 DAYS FOLLOWING THE INVOLUNTARY TERMINATION DATE. THEREFORE, THE DATE ON WHICH THE FAILURE OCCURRED WAS THE 30TH DAY FOLLOWING THE INVOLUNTARY TERMINATION DATE. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN REVIEWED TO ASSURE THAT IN THE FUTURE PLAN BENEFITS ARE PAID PROMPTLY AFTER ALL INVOLUNTARY TERMINATIONS. ST. MARY REGIONAL MEDICAL CENTER DID NOT HAVE ANY EMPLOYEES WHO WERE INVOLUNTARILY TERMINATED AND NOT TIMELY PAID THEIR PLAN BENEFIT. (D) THE PLAN QUALIFIED FOR RELIEF UNDER VI.B, VII.C AND XI.A OF IRS NOTICE 2010-6 AND ON OCTOBER 6, 2010, A PLAN AMENDMENT WAS SIGNED. THE AMENDMENT PROVIDES THAT EFFECTIVE AS OF JANUARY 1, 2009, ALL BENEFITS WILL BE PAID IMMEDIATELY UPON AN INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND ON THE 60TH DAY FOLLOWING VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON COMPETE AGREEMENT. ANY PARTICIPANT WHO VOLUNTARILY SEPARATED FROM SERVICE ON OR AFTER JANUARY 1, 2009 AND ON OR BEFORE DECEMBER 31, 2009 WAS PAID HIS CURRENT PLAN ACCOUNT BALANCE AFTER THE DATE THE AMENDMENT WAS SIGNED, BUT REDUCED FOR ANY INTEREST EARNED IN 2010 (IF ANY). AS ALLOWED BY NOTICE 2010-80, THE EMPLOYER SIGNED AN AMENDMENT ON DECEMBER 20, 2010 TO PROVIDE THAT PAYMENT WILL NO LONGER BE REQUIRED ON THE 60TH DAY FOLLOWING INVOLUNTARY SEPARATION FROM SERVICE, BUT WITHIN 60 DAYS FOLLOWING SEPARATION FROM SERVICE. HOWEVER, IF THE 60TH DAY FALLS IN THE SECOND TAX YEAR, PAYMENT WILL BE MADE IN THE SECOND TAX YEAR. THE PLAN'S ADMINISTRATIVE PROCEDURES HAVE BEEN CHANGED TO PAY PLAN ACCOUNTS IMMEDIATELY FOLLOWING A PARTICIPANT'S INVOLUNTARY SEPARATION FROM SERVICE (CURRENTLY THE STATUS QUO) AND WITHIN 60 DAYS FOLLOWING A VOLUNTARY SEPARATION FROM SERVICE PROVIDED THE PARTICIPANT RETURNS BY THIS DEADLINE A SIGNED NON-COMPETE AGREEMENT AND SUBJECT TO THE REQUIREMENT THAT IF THE 60TH DAY FALLS IN THE SECOND TAX YEAR THEN PAYMENT WILL BE MADE IN THE SECOND TAX YEAR. (E) THESE OPERATIONAL FAILURES ARE ELIGIBLE FOR THE CORRECTION UNDER THE TERMS OF IRS NOTICE 2008-113 AND THE EMPLOYER HAS TAKEN ALL ACTIONS REQUIRED, AND OTHERWISE MET ALL REQUIREMENTS, FOR SUCH CORRECTION. ST JOSEPH HEALTH SYSTEM 500 S MAIN STREET SUITE 700 ORANGE CA 928684507 953589356 HEALTHCARE CA 501(C)(3) 11, I NA REDWOOD MEMORIAL HOSPITAL 3300 RENNER DRIVE FORTUNA CA 95540 941384665 HEALTHCARE CA 501(C)(3) 3 SJHS ST JOSEPH HEALTH MINISTRY 500 S MAIN STREET STE 400 ORANGE CA 92868 271666576 RELIGIOUS ORG CA 501(C)(3) 1 NA SISTERS OF ST JOSEPH OF ORANGE 480 S BATAVIA ORANGE CA 92868 951643383 RELIGIOUS ORG CA 501(C)(3) 1 NA ST JUDE MEDICAL CENTER 101 EAST VALENCIA MESA DRIVE FULLERTON CA 92835 951643325 HEALTHCARE CA 501(C)(3) 3 SJHS QUEEN OF THE VALLEY MEDICAL CENTER 1000 TRANCAS STREET NAPA CA 94558 941243669 HEALTHCARE CA 501(C)(3) 3 SJHS SANTA ROSA MEMORIAL HOSPITAL 1165 MONTGOMERY DRIVE SANTA ROSA CA 95405 941231005 HEALTHCARE CA 501(C)(3) 3 SJHS ST JOSEPH HOSPITAL OF EUREKA 2700 DOLBEER STREET EUREKA CA 95501 941156596 HEALTHCARE CA 501(C)(3) 3 SJHS ST JOSEPH HOSPITAL OF ORANGE 1100 WEST STEWART DRIVE ORANGE CA 92868 951643359 HEALTHCARE CA 501(C)(3) 3 SJHS MISSION HOSPITAL REGIONAL MEDICAL CENTER 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 951643360 HEALTHCARE CA 501(C)(3) 3 SJHS COVENANT HEALTH SYSTEM 3615 19TH STREET LUBBOCK TX 79410 752765566 HEALTHCARE TX 501(C)(3) 3 SJHS ST JOSEPH HEALTH SYSTEM FOUNDATION 500 S MAIN STREET SUITE 1000 ORANGE CA 928684507 330143024 HEALTHCARE CA 501(c)(3) 7 SJHS ST JOSEPH HOME CARE NETWORK 170 PROFESSIONAL CENTER DRIVE B ROHNERT PARK CA 94928 680331084 HEALTHCARE CA 501(C)(3) 9 SJHS ST JOSEPH HERITAGE HEALTHCARE 279 E IMPERIAL HIGHWAY FULLERTON CA 92835 330185031 HEALTHCARE CA 501(C)(3) 3 SJHS ST JOSEPH PROF SRVS ENTERPRISES INC 500 S MAIN STREET SUITE 700 ORANGE CA 92868 330155323 MEDICAL SERVICES CA SJHS C CORP 0 0 0.00000 ST JOSEPH DIVERSIFIED VENTURES INC 500 S MAIN STREET SUITE 700 ORANGE CA 92868 330148989 MEDICAL SERVICES BD SJHS C-CORP 0 0 0.00000 American Unity Group Ltd 58 Par La-Villa Rd Hamilton HX BD Captive Insurance BD SJHS C Corp 0 0 0.00000 false true true false false false false false false false false false false false false false false false ST JOSEPH HEALTH SYSTEM FOUNDATION B 2350181 ST JOSEPH HEALTH SYSTEM FOUNDATION C 624686 Queen of the Valley Medical Center 0 Santa Rosa Memorial Hospital 0 St Joseph Hospital of Eureka 0 Redwood Memorial Hospital 0 St Jude Medical Center 0 St Joseph Hospital of Orange 0 Mission Hospital Regional Medical Center 0 Covenant Health System 0 St Joseph Professional Services Enterprises 0 St Joseph Diversified Ventures Inc 0 American Unity Group Ltd 0 ST JOSEPH HOME CARE NETWORK 0 ST JOSEPH HERITAGE HEALTHCARE 0