2011-08-10T18:35:05-05:00 2010-09-30 Ernst & Young US LLP 4370 La Jolla Village Dr Suite 500 San Diego CA 92122 990 2009-10-01 330449527 Grossmont Hospital Corporation GROS 8584995150 8695 Spectrum Center Blvd San Diego CA 921231489 Kari Cornicelli 6197404465 2011-08-08 0 8585357200 2009 2016-02-24 21:20:13Z Michele Tarbet 8695 Spectrum Center Blvd San Diego CA 921231489 541427849 0 X www.sharp.com X 1991 CA Grossmont Hospital provides inpatient and outpatient medical services to the community. 15 10 3605 1375 1093413 96004 28836222 12469119 466333741 492267761 4314964 3076034 1002134 963940 500487061 508776854 1154616 196412 0 227926836 248174477 0 1077424 229861484 244014951 458942936 492385840 41544125 16391014 397628055 417950079 117674964 116822154 279953091 301127925 See Schedule O. 0 0 453081441 196412 492267761 Grossmont Hospital provides inpatient and outpatient services to the community. Patient days were 121,354 and outpatient visits were 245,485 for the twelve months ended 9/30/10.See Community Benefits Report on Schedule O. 453081441 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 1 0 0 3605 1 1 1 0 0 0 0 0 0 0 0 15 10 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X Staci Dickerson 8584995150 8695 Spectrum Center Blvd San Diego CA 921231489 X Tom Cantor 2.00 X 0 0 0 Sunita V Cooke 3.00 X 0 0 0 Craig Engstrand 2.00 X 0 0 0 Jerry Fazio 2.00 X 0 0 0 Dave Grundstrom 1.00 X 0 0 0 Peter Hanson MD 6.00 X X 0 45000 0 Tom Karlo 4.00 X X 0 0 0 LeRoy Knutson 2.00 X 0 0 0 Marc Kobernick MD 2.00 X 0 37500 0 Michael Long MD 3.00 X 0 0 0 Deborah McElravy 1.00 X 0 0 0 Mike Murphy 2.00 X X 0 1361469 80638 Jim Parker 2.00 X X 0 0 0 Omero Suarez 2.00 X 0 0 0 Philip Szold MD 2.00 X X 0 0 0 Michele Tarbet 55.00 X X 0 719796 35871 Robert Yarris 2.00 X 0 0 0 Ann Pumpian 3.00 X 0 926397 36429 Carlisle C Lewis III 8.00 X 0 803492 43399 Kari Cornicelli 55.00 X 0 211988 25881 Maryann Cone 50.00 X 0 295082 35481 Suzanne K Johnson 40.00 X 0 206625 14139 Janet L Hanley 50.00 X 0 181207 23615 Patrick J Craychee 40.00 X 184101 0 21295 Vincent J Balesteri 57.00 X 243052 0 29168 Jay E Carlson 58.00 X 203890 0 28187 Bruce D Schmidt 45.00 X 198193 0 30395 Diane M Detro 60.00 X 192767 0 25918 Juven M Degiso 59.00 X 184410 0 25295 Kathleen R Lencioni 0.00 X 0 389203 2854 1206413 5177759 458565 307 1 1 1 0 3105591 9343623 19905 8928623 12469119 Medicare/Medicaid 900099 243121983 243121983 Patient Services 900099 242113691 242113691 Medical Office Lease 531120 3700587 3700587 Reference Lab 621500 1093413 1093413 Parking Lot Revenue 812930 1037874 1037874 1200213 1200213 492267761 2545957 2545957 33145647 35425 32633442 17553 512205 17872 530077 530077 Auxiliary 453220 801502 801502 Cash Discounts 900099 90911 90911 Cell Phone Tower Renta 531390 64564 64564 6963 6963 963940 508776854 491174348 1093413 4039974 196412 196412 2099636 1137303 962333 174283 174283 198600546 194782723 3817823 9150125 8948177 201948 23043404 22456376 587028 15106483 14820518 285965 18370553 17198115 1172438 1043268 1043268 5613832 5613832 37212 37212 99665 99665 38627111 37729016 898095 4533473 79803 4453670 81625193 81196258 428935 16745161 16242806 502355 8916383 7536989 1379394 539753 524282 15471 404306 136248 268058 2191707 1152382 1039325 22035080 15526834 6508246 2453357 1979460 473897 Bad Debt 16263251 16263251 Management Services 15403009 8106918 7296091 Repairs & Maintenance 5856665 5464210 392455 Fundraising Expenses 1077424 1077424 Medical Staff/Auxiliary 778495 778495 1400053 650582 749471 492385840 453081441 38226975 1077424 2872863 1728567 34880725 31251749 45530812 43318011 544092 410280 9127292 9056292 2563350 2640104 415740650 210514274 198454437 205226376 89205980 104942276 679083 802256 13769421 18574168 397628055 417950079 35042509 35897077 7278002 7459302 15500000 15500000 59854453 57965775 117674964 116822154 X 270623412 290817398 8030795 8339996 1298884 1970531 279953091 301127925 397628055 417950079 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 37212 37212 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: Grossmont Hospital Corporation (GHC) pays annual dues to the California Hospital Association (CHA), the Healthcare Association of San Diego and Imperial Counties (HASDIC), the American Hospital Association (AHA) and the California Hospice and Palliative Care Association (CHAPCA). CHA, HASDIC, AHA, and CHAPCA have determined that a portion of their membership dues are used for lobbying purposes. GHC's FY 2010 portion of annual dues calculated to have been used for lobbying was $37,212. 2331612 821647 268716 385 3421590 2245171 75087 11354 2331612 0.15000 0.85000 0 1 1 581843 581843 257753499 109221128 148532371 5655360 2278127 3377233 122404319 91334238 31070081 29345629 7680781 21664848 205226376 Long Term Pension Liability 21815526 Workers' Compensation Liability 299914 Other Liabilities 59379 Mark to Market Swap 843962 Capital Leases Payable 130248 Allocated Tax Exempt Bonds 34816746 57965775 508776854 492385840 16391014 4059563 724257 4783820 21174834 500507410 4059563 4059563 496447847 99665 12229342 12329007 508776854 491362868 0 491362868 99665 923307 1022972 492385840 Part V, Line 4: Description of Intended Use of Endowment Funds: Grossmont Hospital Foundation holds 21 board designated and permanent endowments for Grossmont Hospital Corporation that are restricted for a variety of purposes, such as hospice and hospice homes, diabetes, nursing education, cancer treatement, hospital equipment and technology, and more. Part XI, Line 8 - Other Adjustments: Change in minimum pension liability: -592498. Beneficial Interest in Grossmont Hospital Foundation: 1559456. Grossmont Imaging LLC (Book/Tax Difference): -242701. Part XII, Line 4b - Other Adjustments: Prop G - Donations of Capital/Donations for Capital Purchases: 9343623. Donations used to Purchase Capital Equipment: 1719295. Medical Staff/Auxiliary Revenue: 923723. Grossmont Imaging LLC Book/Tax Difference: 242701. Part XIII, Line 4b - Other Adjustments: Medical Staff/Auxiliary Expenses: 923307. Sharp recognizes tax benefits from any uncertain tax positions only if it is more likely than not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. Sharp records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period that the more likely than not threshold is not met. Sharp recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more likely than not recognition criteria. At September 30, 2010 and 2009, no such assets or liabilities were recorded. 1 1 X 1 X 1 X 0 1 1 0 1 1 27217141 640295 26576846 0.05580 98491981 57104212 41387769 0.08690 16300273 7659200 8641073 0.01810 142009395 65403707 76605688 0.16080 820962 820962 0.00170 801302 801302 0.00170 71309773 55704320 15605453 0.03280 3574 3574 0.00000 152036 152036 0.00030 73087647 55704320 17383327 0.03650 215097042 121108027 93989015 0.19730 42215 42215 0.00010 52274 52274 0.00010 94489 94489 0.00020 0 1338757 0 111870523 112849829 -979306 X 1 1 Grossmont Imaging LLC Joint Venture-Diagnostic Imaging 0.50000 0.00000 0.50000 Grossmont Hospital Corporation

5555 Grossmont Center Drive La Mesa CA 91942

X X X Grossmont Imaging LLC

8881 Fletcher Parkway Suite 102 La Mesa CA 91942

Joint Venture-Diagnostic Imaging Grossmont Imaging LLC

9640 Mission Gorge Rd Suite H Santee CA 92071

Joint Venture-Diagnostic Imaging LakeView Hospice Home

9472 Loren Drive La Mesa CA 91942

Hospice Home ParkView Hospice Home

5788 Lyden Way San Diego CA 92120

Hospice Home PMB Medical Office Building

8860 Center Drive Suite 100 La Mesa CA 91942

Outpatient Services PMB Medical Office Building

8860 Center Drive Suite 200 La Mesa CA 91942

Outpatient Services - Infusion Briar Patch

9000 Wakarusa Road La Mesa CA 91942

Outpatient Services Grossmont Medical Plaza

5525 Grossmont Center Drive Suite LL La Mesa CA 91942

Outpatient Services Sharp Hospice Care

8881 Fletcher Parkway Suite 336 La Mesa CA 91942

Hospice Part I, Line 6a: Grossmont Hospital Corporation's community benefit report is prepared by Sharp HealthCare. Part I, Line 7: Ratio of cost to charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger without exclusions, thus representing direct revenue and expense plus allocations from Overhead departments. The RCC by department was then applied to the applicable department revenue by payer to obtain the fully weighted cost by payer. Part I, Line 7f: Bad Debt expense of $16,263,251 was excluded from total expenses for column (f) calculation. Part III, Line 4: Bad Debt represents amounts that go unpaid where the patient was determined to have the ability to pay. If an inability to pay is demonstrated, then full or partial Charity is granted and not considered Bad Debt. Discounts are reported separately and are not considered Bad Debt. If a patient does not pay the discounted rate then the discount is reversed and the full charges are sent to collections and at this time would be recorded as Bad Debt. Bad Debt at Cost should be included as a Community Benefit because, like other shortfall programs, we are required to accept these patients through the Emergency Room or as a referral with "good faith" in collecting. Ratio of cost to charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger without exclusions, thus representing direct revenue and expense plus allocations from Overhead departments. The RCC by department was then applied to the self pay revenue associated with bad debt accounts.Grossmont Hospital Corporation consolidates into Sharp HealthCare's audited financial statements. The audited financial statements of Sharp HealthCare do not include a footnote discussing bad debt expense, accounts receivable, or allowance for doubtful accounts. Sharp HealthCare's audited financial statements include an expense line on the Combined Statement of Operations titled Provision for Doubtful Accounts. Additionally, the accounts receivable line on the Combined Balance Sheet details the amount of allowance for doubtful accounts that is netted against the receivable balance. Part III, Line 8: Medicare shortfall should be included as a community benefit because participation in the Medicare program requires all patients be accepted whether through the Emergency Room or as a referral and we must accept the Medicare established rates whether they cover the cost or not. Ratio of cost to charges (RCC) were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger without exclusions, thus representing direct revenue and expense plus allocations from Overhead departments. The RCC by department was then applied to the applicable department revenue by payer to obtain the fully weighted cost by payer. Part III, Line 9b: It is Sharp's policy to recall/cancel accounts assigned to a collection agency if it is determined, at any time, a patient is eligible for Financial Assistance or Charity care. Part III, Line 3: No figure is reported on Part III, line 3 (estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's charity care policy) due to all amounts attributable to patients eligible under the charity care policy being reported as charity.Part III, Line 7: The organization incurred additional Medicare shortfall that is not allowed to be reported on Part III, line 7, due to the definition of Medicare shortfall as prescribed by the IRS. This additional shortfall arises from the use of the Medicare cost report data which excludes fee based services, non-billable services, and disallowed operating expenses which the organization has determined to be revenues and expenses of the Medicare program and should be included in the total shortfall. A reconciliation of what the organization classifies as Medicare shortfall is as follows:Medicare revenue received reported on Parts I & III $142,204,489Medicare allowable costs reported on Parts I & III $156,100,158Shortfall included on Parts I & III $(13,895,669)Actual Medicare revenue received $141,889,331Actual Medicare cost $168,638,703Actual Medicare shortfall $(26,749,372)Additional Medicare shortfall not on Parts I & III $(12,853,703)Part VI, Line 8:Sharp HealthCare prepares an annual Community Benefits Report in accordance with the requirements of California Senate Bill (SB) 697, community benefits legislation (According to SB 697, hospitals under the common control of a single corporation or another entity may file a consolidated report with the Calif. Office of Statewide Health Planning and Development (OSHPD)). Sharp HealthCare submits an annual Community Benefits Report to the Calif. OSHPD.The Sharp HealthCare Fiscal Year 2010 Community Benefits Plan and Report is available online at www.sharp.com/community. Part VI, Line 2: Since 1995, Sharp has participated in a countywide collaborative - including a broad range of hospitals and health care organizations - to conduct a triennial community needs assessment. Findings from the community health needs assessments conducted by the Community Health Improvement Partners (CHIP) and the expertise in programs and services of each Sharp hospital form the basis for community benefits planning at Sharp.In 2007, the CHIP Needs Assessment Committee, under the direction of the CHIP Steering Committee, determined a methodology and approach to the needs assessment, which included information from the following sources:*Analysis of health-related statistics gathered and analyzed by the County of San Diego Health and Human Services Agency (HHSA), supplemented by data from the California Health Interview Survey (CHIS), the California Office of Statewide Health Planning and Development (OSHPD), the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System and Behavior Risk Surveillance System*Review of health-related scientific literature*Review of results of facilitated discussions held with seven focus groups representing a cross-section of the San Diego County community*Results of a process used by members of CHIP to set priorities among various health issuesIn order to determine the priority needs of the community, the 2007 Community Health Needs Assessment conducted by CHIP was reviewed by each Sharp hospital and used to determine priority needs for their communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing services, in addition to the unique regional, age group and/or health topics.Specifically, Sharp Grossmont Hospital reviewed the needs assessment priorities, specifically focusing on issues relevant to their region and subregional areas with the goal of matching community benefits programs and services to the unique needs of the region with special attention to:*Stroke education and screening*Heart and vascular disease education and screening*Cancer education and participation in clinical trials*Diabetes education and testing*Outreach for flu vaccinations*Health education and screening for seniors*Prevention of unintentional injuries*Special support services for hospice patients and their loved ones, and the community*Collaboration with local schools to promote interest in health care careers*Women's and prenatal health services and education*Orthopaedic / osteoporosis education and screeningIn addition, Sharp Grossmont Hospital:*Incorporates community priorities and community input into its strategic plan and develops service line specific goals*Estimates an annual budget for community programs and services based on community needs, the prior year's experience and current funding levels*Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided, such as education, screenings and flu shots *Prepares and distributes information on community benefits programs and services through its foundation and community newsletters*Consults with representatives from a variety of departments, to discuss, plan and implement community activities Part VI, Line 3: Sharp HealthCare's financial assistance policy is in furtherance of its charitable mission. The policy identifies eligibility for, and circumstances under which, financial assistance will be extended to Sharp HealthCare's hospital patients for medically necessary services. Information regarding the availability of charity care and financial assistance is posted at all emergent/urgent access points of the hospital.All patients should be screened at the time of admission or at registration for ability to pay for services, including whether or not they are candidates for Financial Assistance. Care for patients presenting with a known or possible emergency medical condition or in active labor shall not be delayed in order to assess financial status. For those patients arriving via the emergency room, once stabilization has occurred, an unfunded patient is provided with information regarding public funding options and information on Sharp HealthCare's financial assistance policy. Every unfunded urgent/emergent patient is provided with information on qualifications, in addition to an application for financial assistance/charity care.All self pay patients are informed again regarding the availability of financial assistance on each patient statement. The availability of financial assistance and the application to apply are readily accessible on the Sharp.com website.In order to both inform patients of the various programs they may be entitled to, and assist them in the application process, Uncompensated Care Specialists provide patient(s) with a Financial Assistance Form. The Uncompensated Care Specialists direct the patient (or their guarantor) to complete a Patient Financial Statement, include specified financial items for both the patient and spouse (if any), direct the patient to return all information within ten days and document in patient's account history notes the substance of any patient discussions and that the Patient Financial Statement was provided.Following internal processing of the Financial Assistance Form, Sharp Uncompensated Care Specialists and/or Private Pay Representatives notify patient of Financial Assistance Application results, document the decision in all approved and denied Financial Assistance Accounts and secure payment arrangements for remaining balance of partial Financial Assistance or denied Financial Assistance accounts. All follow-up and patient interaction is documented in the patient's account history notes."Charity Care" is that portion of Sharp HealthCare's charges for medically necessary patient care services provided by a hospital that a patient (either individually or through a third party payer) is unable to pay. Charity Care does not include bad debt, contractual adjustments, or un-reimbursed costs of providing care to patients eligible under government programs for health care services to low-income and medically indigent patients."Financial Assistance," means any reduction of charges for medically necessary services as defined herein that may be made by Sharp HealthCare either for, or on behalf of, a patient who applies to Sharp HealthCare for Financial Assistance and meets Sharp HealthCare's financial eligibility requirements or criteria as described in this policy. For purposes of the policy Financial Assistance includes "charity care" which means a 100% reduction in charges for medically necessary services and "partial charity care" which means a reduction in a portion of charges for such services. Part VI, Line 4: The community served by Sharp Grossmont Hospital includes the entire East Region of San Diego County, including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. Approximately five percent of the population lives in remote or rural areas of this region. The race/ethnicity breakdown of the community served by Grossmont Hospital is: 51.6% White; 27.1% Hispanic; 7.8% Black; 8.9% Asian/Pacific Islander; and 0.6% Native American. In 2005, 92 percent of children and 80 percent of nonelderly adults had health insurance in the East Region, failing to meet the Healthy People 2010 national targets for health insurance coverage. Part VI, Line 5: Grossmont Hospital Corporation at times provides a provision for housing for vulnerable patients upon discharge from the hospital.Grossmont Hospital Corporation incurred expenses for disaster preparedness training and capital expenditures. Part VI, Line 6: Grossmont Hospital Corporation has an open medical staff and a community board. Surplus funds generated by hospital operations are re-invested by the organization to fund capital improvements and acquire state of the art medical equipment with the intent of continually improving patient care. Part VI, Line 7: Sharp HealthCare is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals, three specialty hospitals, two affiliated medical groups, 22 medical clinics, five urgent care facilities, four skilled nursing facilities, two inpatient rehabilitation programs, home health, hospice and home infusion programs, numerous outpatient facilities and programs, and a variety of other community health education programs and related services. Sharp also has a Knox-Keene-licensed health maintenance organization, Sharp Health Plan. Serving a population of approximately three million in San Diego County, Sharp operates 1,848 beds, has approximately 2,600 Sharp-affiliated physicians and nearly 15,000 employees.It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patient expectations and are provided in a caring, convenient, cost-effective and accessible manner. Sharp will be recognized by employees, physicians, patients, volunteers and the community as the best place to work, the best place to practice medicine and the best place to receive care. Sharp is known as an excellent community citizen embodying an organization of people working together to do the right thing every day to improve the health and well being of those it serves. Sharp Grossmont Hospital is the largest provider of health care services in San Diego's East County, and operates one of the busiest emergency rooms in San Diego County. Sharp Grossmont Hospital received Magnet Designation for Nursing Excellence by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program is the highest level of honor awarded by the ANCC and is accepted nationally as the gold standard in nursing excellence. CA 1 Neighborhood Healthcare 425 North Date StreetSte 203 Escondido CA 92025 952796316 501(c)(3) 20000 Sponsorship - Pace Setter Gala San Diego East County Chamber of Commerce 201 S Magnolia Ave El Cajon CA 92020 951494069 501(c)(6) 6000 Sponsorship - Summer Healthcare Saturday, Women in Leadership Luncheon East County Family YMCA 8881 Dallas Street La Mesa CA 91942 952039198 501(c)(3) 5100 Sponsorship - 2010 Programs, Gala Boys & Girls Club of East County 8820 Tamberly Way Santee CA 92071 952088013 501(c)(3) 10000 Sponsorship - Ball Grossmont Hospital Foundation 8695 Spectrum Center Blvd San Diego CA 92123 330124488 501(c)(3) 61812 Program Support 4 1 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The Management team evaluates requests for contributions from outside organizations taking into account how they align with the organization's mission. No monitoring is done after grants are made. X 1 1 0 1 0 0 0 0 0 0 0 Peter Hanson MD 0 45000 0 0 0 0 0 0 0 0 0 45000 0 0 Marc Kobernick MD 0 37500 0 0 0 0 0 0 0 0 0 37500 0 0 Mike Murphy 0 856592 0 142121 0 362756 0 67041 0 13597 0 1442107 0 329757 Michele Tarbet 0 444506 0 62726 0 212564 0 22274 0 13597 0 755667 0 196064 Ann Pumpian 0 506875 0 80701 0 338821 0 23388 0 13041 0 962826 0 305821 Carlisle C Lewis III 0 439221 0 75851 0 288420 0 30468 0 12931 0 846891 0 255420 Kari Cornicelli 0 186412 0 25000 0 576 0 11879 0 14002 0 237869 0 0 Maryann Cone 0 238884 0 30181 0 26017 0 21686 0 13795 0 330563 0 0 Suzanne K Johnson 0 173803 0 25570 0 7252 0 237 0 13902 0 220764 0 0 Janet L Hanley 0 165912 0 14852 0 443 0 9790 0 13825 0 204822 0 0 Patrick J Craychee 158343 0 16818 0 8940 0 8579 0 12716 0 205396 0 0 0 Vincent J Balesteri 227430 0 9316 0 6306 0 23558 0 5610 0 272220 0 0 0 Jay E Carlson 203150 0 316 0 424 0 19073 0 9114 0 232077 0 0 0 Bruce D Schmidt 181393 0 11319 0 5481 0 16557 0 13838 0 228588 0 0 0 Diane M Detro 192005 0 316 0 446 0 16137 0 9781 0 218685 0 0 0 Juven M Degiso 183854 0 316 0 240 0 11953 0 13342 0 209705 0 0 0 Kathleen R Lencioni 0 259933 0 48528 0 80742 0 1790 0 1064 0 392057 0 50242 Part I, Line 1a Non-management staff were paid superior performance bonuses which were grossed up so the net payment would be a specified amount based on each staff member's productive hours worked during the year. The net payments per staff member ranged from $50 to $200. Part I, Line 4b: Sharp HealthCare ("Company") sponsored the Executive Flexible Benefit Plan ("Old Plan") detailed below to provide designated executives with a reasonable level of benefits, while providing those executives with a greater choice of benefits. The Old Plan was restated effective December 31, 2008, and all participant balances held in the Capital Accumulation Account at that time were paid out to the participants in February 2009. The Old Plan was administered on a Plan Year basis of January 1 to December 31. Changes in Flexible Benefit Options were permitted annually, effective January 1 of the new Plan Year. The Old Plan was available to the Chief Executive Officer, Executive Vice President of Hospital Operations, and Senior Vice Presidents. The Flexible Benefit Allowance available to each participant each plan year equaled the sum of the following: - A company provided base allowance equal to 12% of the participant's base salary - A participant deferral up to 6% of the participant's pre-tax base salary for such plan year as elected by the participant - A company match should the participant make an elective deferral for a plan year. The company match begins at 2% for the first 1% elective deferral and increases 0.5% for each additional 1% elective deferral, to a maximum match of 4.5% on a 6% elective deferral. - A participant may convert up to 10 paid leave days for additional Flexible Benefit Allowance each Plan Year. Each paid leave day shall be converted to Flexible Benefit Allowance at the rate of the participant's base salary divided by 260. The participant made the benefit election for a Plan Year by submitting to the Company, prior to the end of the preceding calendar year, a completed written election in the form provided by the Company. A participant's benefit election for any Plan Year was irrevocable. A participant could apply the Flexible Benefit Allowance to obtain long-term disability coverage, long-term care coverage, flexible survivor coverage/accumulation benefits (life insurance), and/or have the Flexible Benefit Allowance credited to a Capital Accumulation Account. For each such credit to a Capital Accumulation Account, the participant designated a deferred vesting date that was the earlier of (i) the date the participant elected that was at least five years after the first day of the Plan Year for which such election is made, or (ii) the later of the participant's 64th birthday or two years after the first day of such Plan Year. The participant could elect to postpone the original deferred vesting date for each Capital Accumulation Account one time by selecting a new deferred vesting date that was at least five years after the original deferred vesting date. If the participant (i) voluntarily separated from service with the Company, or (ii) was involuntarily separated from service with reasonable cause, the participant was entitled to receive Capital Accumulation Account benefits only if the participant did not enter into competition with the Company during the 24-month period following the participant's separation from service. If the participant entered into competition with the Company during such period, the participant forfeited all rights to receive any unpaid Capital Accumulation Account benefit under this Plan. Sharp HealthCare ("Company") sponsors an Executive Flexible Benefit Plan ("New Plan") to provide designated executives with a reasonable level of benefits in return for their continued employment with the Company. The New Plan is administered on a Plan Year basis of January 1 to December 31. Changes in Flexible Benefit Options are permitted annually, effective January 1 of the new Plan Year. The provisions of the New Plan, which were restated effective as of December 31, 2008, are described below as restated. The New Plan is available to the Chief Executive Officer, Executive Vice President of Hospital Operations, and Senior Vice Presidents. The Flexible Benefit Allowance available to each participant each plan year shall equal the sum of the following: - A company provided base allowance equal to 18% of the participant's base salary - A participant deferral up to 6% of the participant's pre-tax base salary for such plan year as elected by the participant - A company match should the participant make an elective deferral for a plan year. The company match begins at 2% for the first 1% elective deferral and increases 0.5% for each additional 1% elective deferral, to a maximum match of 4.5% on a 6% elective deferral. The New Plan allows participants to use the Flexible Benefit Allowance to purchase additional long-term disability coverage, long-term care coverage, and flexible survivor coverage/accumulation benefits (life insurance). Participants in the flexible survivor coverage/accumulation benefits plan previously could elect to apply Flexible Benefit Allowance to acquire additional survivor coverage, or toward deposits to the Supplemental Survivor Accumulation Benefit Plan ("SSAB") to fund post-retirement survivor benefits, subject to the ERISA limit provided their policies were issued prior to September 18, 2003. The Company shall automatically continue whatever elective coverage and additional deposit elections that were in place for the SSAB during the 2008 plan year. No elective coverage or additional deposits were available to participants whose policies were issued on or after September 18, 2003. Any Flexible Benefit Allowance that remains after purchasing these additional coverages shall be paid to the participant in cash in equal installments throughout the Plan Year, not less frequently than quarterly. If the participant separates from service during the Plan Year, the participant forfeits any unpaid Allowance. For calendar year 2009, the following individuals had deferrals, distributions, or both. Michael Murphy: distributions - $329,757 Ann Pumpian: distributions - $305,821 Carlisle C. Lewis III: distributions - $255,420 Michele Tarbet: distributions - $196,064 Kathleen Lencioni: distributions - $50,242 Supplemental Information Part III Compensation was paid to Dr. Peter Hanson through Peter B Hanson MD Inc., for medical director services, by Grossmont Hospital Corporation. He was compensated directly by Peter B Hanson MD Inc. Supplemental Information Part III Compensation was paid to Dr. Marc Kobernick through his professional corporation, for medical director and chief of staff services, by Grossmont Hospital Corporation. He was compensated directly by the professional corporation. Supplemental Information Part III Part I, Line 3: The Compensation Committee of Sharp HealthCare, the parent organization, establishes the compensation of the Chief Executive Officer. The Compensation Committee engages independent compensation consultants and the amount is approved by both the Compensation Committee and Board of Directors. Cynthia Szold See Schedule O 111735 Employment 0 Stephen Hanley See Schedule O 34925 Employment 0 Katelyn Cone See Schedule O 22204 Employment 0 Grossmont Imaging LLC See Schedule O 365874 See Sch. O 0 X ED/CCU Building 12 1813303 Cost X Diagnostic Treatment Building 12 2012305 Cost X Central Power Plant 12 2958616 Cost X East Tower 12 1975329 Cost X Vans 3 143989 Cost X Supplies 3 25081 Cost 0 0 1 0 Method for Determining Number of Contributors: Part I, Column (b): Number of Contributions Form 990, Part VI, Section A, line 2 Directors Craig Engstrand and Jerry Fazio have a business relationship. Michele Tarbet, Kari Cornicelli, and Anthony Damico were all directors on the governing board of the Grossmont Imaging Joint Venture. Form 990, Part VI, Section A, line 6 Sharp HealthCare (FEIN 95-6077327)is the sole member of Grossmont Hospital Corporation. Form 990, Part VI, Section A, line 7a Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members. Form 990, Part VI, Section A, line 7b Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members. Sharp HealthCare also retains the approval rights afforded members for certain significant transactions (e.g. dissolution or sale or transfer of all or substantially all of the assets.) Form 990, Part VI, Section B, line 11 The final Form 990 is placed on the organization's intranet, prior to the filing date, where it is viewable for comment from all members of the governing body. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the Director of Accounting & Tax, Vice President of Finance, Senior Vice President and Chief Financial Officer, and entity Chief Financial Officer. Additionally, the organization contracts with Ernst & Young, an independent accounting firm, for review of the Form 990. Form 990, Part VI, Section B, line 12c The Corporation is committed to preventing any Participant of the Corporation from gaining any personal benefit from information received or from any transaction of Sharp. Board Members, Corporate Officers, Senior Vice Presidents and Chief Executive Officer(s) submit a conflict of interest statement annually to Legal Services/Senior Vice President of Legal Services who will review all statements. In addition, all Vice Presidents and any employees in the Purchasing/Supply Chain, Audit and Compliance, and Case Management/Discharge Planning departments are required to complete an online conflict of interest questionnaire annually that is reviewed by the Conflict Review Committee comprised of employees from Sharp's Legal, Compliance, and Internal Audit departments. In connection with any transaction or arrangement, which may create an actual or possible conflict of interest, the person shall disclose in writing the existence and nature of his/her financial interest and all material facts. Board Members, Corporate Officers, Senior Vice Presidents, and the Chief Executive Officer(s) shall make such disclosures directly to the Chairman of the Sharp HealthCare Board, and to the members of the committee with the board designated powers considering the proposed transaction or arrangement. Upon disclosure of the financial interest and all material facts, the Board Member, Corporate Officer, Senior Vice President or the Chief Executive Officer(s) making such disclosures shall leave the board or the committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In certain instances, such as if someone takes a board seat on a competitor's board of directors or has a role with an organization whereby the information that they may obtain from Sharp would put them in a consistent conflict with their two roles, the conflict could call for the individual's removal from the board. The bylaws for the organization provide for the ability to remove directors in accordance with Section 5222 of the California Corporations Code. This can generally be done on a "for cause" or a "no cause" basis by the action of the member. Form 990, Part VI, Section B, line 15 The Personnel Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (CEO/President, Executive Vice President of Hospital Operations, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Personnel Committee of the Board of Directors by the independent consultant. The Personnel Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Personnel Committee approves the total compensation for the President/Chief Executive Officer and reviews and approves the compensation and compensation salary ranges for the remainder of the executive team. The Personnel Committee presents its decision to the Board of Directors. The Personnel Committee retains minutes of its meetings. The Compensation and Benefits department engages a third party independent consultant to conduct a compensation study covering officers and key employees. The independent third party compares base salaries to similar positions with like institutions. The information is reviewed by the Compensation and Benefits department and is presented to the President/Chief Executive Officer, the Executive Vice President of Hospital Operations and the appropriate Senior Vice President for review and approval. The compensation study was last conducted in February/March 2011, and November/December 2008 before that. Form 990, Part VI, Section C, line 19 Policies are considered proprietary information, however in Sharp HealthCare's publicly available Code of Conduct, Sharp outlines its Conflict of Interest policies in a user friendly manner. The annual audited financial statements of the consolidated group are published on the dacbond.com website (www.dacbond.com) and are available upon request. The annual audited financial statements include combining schedules which disclose the financial results (Balance Sheet, Statement of Operations, Statement of Changes in Net Assets) for each entity of the consolidated group. Quarterly financial statements of Sharp's obligated group are published on the dacbond.com website (www.dacbond.com). Form 990, Part XI, Line 3a: Sharp HealthCare, on a consolidated basis, was required to undergo an audit as set forth in the Single Audit Act and OMB Circular A-133, and such an audit was performed as required. Form 990, Part III, Line 1: To establish, maintain, conduct, and operate a hospital or hospitals related, associated and complimentary facilities and services, such as, but not limited to, skilled nursing, extended care, outpatient care, home care, and other health care programs, activities, services and facilities. To carry on any educational activities related to rendering care to the sick and injured, or to the promotion of health. To promote and carry on scientific research related to the care of the sick and injured, or to the promotion of health. To participate in any activity designed and carried on to promote the general health of the community. To operate and maintain this corporation and its assets for the benefit of the communities served by Grossmont Hospital District, a political subdivision of the State of California, organized pursuant to Local Hospital District Law (Division 23 of the California Health & Safety Code), and which is located in San Diego County, California. Generally do anything and everything necessary, expedient or incidental to the foregoing. Form 990, Part IV, Line 24a: Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327). This organization's allocated portion is included in Part X, Line 25. Form 990, Part VII, Section A: Hours per week dedicated to related organizations The following officers and directors dedicated hours to the following organizations which are related to Grossmont Hospital Corporation: Michael Murphy - 48-Sharp HealthCare, 2-Sharp Memorial Hospital, 2-Sharp Chula Vista Medical Center, 2-Sharp Coronado Hospital and Healthcare Center, 2-Sharp Health Plan, 2-Sharp HealthCare Foundation Carlisle C. Lewis III - 50-Sharp HealthCare, 10-Sharp Memorial Hospital, 5-Sharp Chula Vista Medical Center, 5-Sharp Coronado Hospital and Healthcare Center Ann Pumpian - 45-Sharp HealthCare, 3-Sharp Memorial Hospital, 3-Sharp Chula Vista Medical Center, 3-Sharp Coronado Hospital and HealthCare Center, 5-Sharp Health Plan Peter Hanson, M.D. - 6-Sharp HealthCare Kathleen Lencioni - 50-Sharp Memorial Hospital Michele Tarbet - 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Kari Cornicelli - 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Maryann Cone - 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Suzanne Johnson - 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Janet Hanley - 100% of hours reported on Part VII are dedicated to Grossmont Hospital Corporation. Form 990, Part VII, Section B: Independent contractors are paid under Sharp HealthCare's tax identification number (95-6077327) and are reported on Sharp HealthCare's tax return. Form 990, Part X, Line 25: Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, the tax exempt bond balances are reported on the Sharp HealthCare return (EIN 95-6077327) and this organization has reported zero on Form 990, Part X, Line 20 and has reported the allocated balance on Line 25. Schedule L, Part IV: Cynthia Szold, an employee of Grossmont Hospital Corporation, is married to Philip Szold, a director on the Grossmont Hospital Corporation Board. Stephen Hanley, an employee of Grossmont Hospital Corporation, is the son of Janet Hanley, a key employee of Grossmont Hospital Corporation. Katelyn Cone, an employee of Grossmont Hospital Corporation, is the daughter of Maryann Cone, a key employee of Grossmont Hospital Corporation. Kari Cornicelli, Chief Financial Officer of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation. Michele Tarbet, Chief Executive Officer of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation. Anthony Damico, a key employee of Grossmont Hospital Corporation, sits on the Board of Directors of Grossmont Imaging LLC, a partnership 50% owned by Grossmont Hospital Corporation. Schedule R, Part V, Line 2: Sharp Coronado Hospital and Healthcare Center - transaction type A(i) - $5,164 The amounts in Schedule R, Part V, Line 2 were determined using the accrual basis of accounting. Form 990, Part III, Line 4a: Community Benefits Report An Overview of Sharp HealthCare Sharp is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals; three specialty hospitals; two affiliated medical groups; 20 medical clinics; five urgent care facilities; three skilled nursing facilities; two inpatient rehabilitation centers; home health, hospice, and home infusion programs; numerous outpatient facilities and programs; and a variety of other community health education programs and related services. Sharp offers a full continuum of care, including: emergency care, home care, hospice care, inpatient care, long-term care, mental health care, outpatient care, primary and specialty care, rehabilitation, and urgent care. Sharp also has a Knox-Keene-licensed health maintenance organization, Sharp Health Plan (SHP). Serving a population of approximately 3 million in San Diego County, as of September 30, 2010, Sharp is licensed to operate 2,060 beds, has approximately 2,600 Sharp-affiliated physicians and nearly 15,000 employees. FOUR ACUTE-CARE HOSPITALS: Sharp Chula Vista Medical Center (343 beds) The largest provider of health care services in south San Diego County, one of the fastest growing areas in California, Sharp Chula Vista Medical Center (SCVMC) operates the busiest Emergency Department (ED) in San Diego's South Bay and is the closest hospital to the busiest international border in the world. Sharp Coronado Hospital and Healthcare Center (204 beds) Sharp Coronado Hospital and Healthcare Center (SCHHC), an acute-care hospital, provides services that include sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, hospice, and emergency services. Sharp Grossmont Hospital (536 beds) Sharp Grossmont Hospital (SGH) is the largest provider of health care services in San Diego's East County, and has one of the busiest EDs in San Diego County. Sharp Memorial Hospital (643 beds) A regional tertiary care leader, Sharp Memorial Hospital (SMH) provides specialized care in trauma, oncology, orthopaedics, organ transplantation, cardiology, and rehabilitation. THREE SPECIALTY-CARE HOSPITALS: Sharp Mary Birch Hospital for Women & Newborns (169 beds) A freestanding women's hospital specializing in obstetrics, gynecology, gynecologic oncology, and neonatal intensive care, Sharp Mary Birch Hospital for Women & Newborns (SMBHWN) delivers more babies than any other private hospital in California. Sharp Mesa Vista Hospital (149 beds) The largest private freestanding psychiatric hospital in California, Sharp Mesa Vista Hospital (SMV) is a premier provider of behavioral health services. Sharp Vista Pacifica Hospital (16 beds) Sharp Vista Pacifica (SVP) is San Diego County's only licensed chemical dependency recovery hospital. Collectively, the operations of SMH, SMBHWN, SMV, and SVP are reported under the nonprofit public benefit corporation of SMH. The operations of Sharp Rees-Stealy Medical Centers (SRS) are included within the nonprofit public benefit corporation of Sharp, the parent organization. The operations of Sharp Grossmont Hospital (SGH) are reported under the nonprofit public benefit corporation Grossmont Hospital Corporation. Mission Statement It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patient expectations, and are provided in a caring, convenient, cost-effective, and accessible manner. Vision Sharp's vision is to transform the health care experience through a culture of caring, quality, service, innovation, and excellence. Sharp will be recognized by employees, physicians, patients, volunteers, and the community as the best place to work, the best place to practice medicine, and the best place to receive care. Sharp will be known as an excellent community citizen, embodying an organization of people working together to do the right thing every day to improve the health and well being of those it serves. Sharp will become the best health system in the universe. Values *Integrity -Trustworthiness, Respect, Commitment to Organizational Values, and Decision Making *Caring -Service Orientation, Communication, Teamwork and Collaboration, Serving and Developing Others, and Celebration *Innovation -Creativity, Continuous Improvement, Initiating Breakthroughs, and Self-Development *Excellence -Quality, Safety, Operational and Service Excellence, Financial Results, and Accountability Culture: The Sharp Experience For more than 10 years, Sharp has been on a journey to transform the health care experience. Through a sweeping organizational improvement initiative called The Sharp Experience, the entire Sharp team has recommitted to purpose, worthwhile work, and making a difference, and to the fundamentals that have made Sharp one of the nation's top-ranked health care systems. This renewed sense of direction has added discipline and focus to every part of the organization. Sharp is San Diego's health care leader because it remains focused on the most important element of the health care equation: the people. Through this extraordinary initiative, Sharp is transforming the health care experience in San Diego by striving to be: *The best place to work: Attracting and retaining highly skilled and passionate staff members who are focused on providing quality health care and building a culture of teamwork, recognition, celebration, and professional and personal growth. This commitment to serving patients and supporting one another will make Sharp "the best health system in the universe." *The best place to practice medicine: Creating an environment in which physicians enjoy positive, collaborative relationships with nurses and other caregivers; experience unsurpassed service as valued customers; have access to state-of-the-art equipment and cutting-edge technology; and enjoy the camaraderie of the highest-caliber medical staff at San Diego's preeminent medical institution. *The best place to receive care: Providing a new standard of service in the health care industry, much like that of a five-star hotel; employing service-oriented individuals who see it as their privilege to exceed the expectations of every patient - treating them with the utmost care, compassion and respect; and creating healing environments that are pleasant, soothing, safe, immaculate, and easy to access and navigate. Through all of this transformation, Sharp will continue to live its mission to care for all people, with special concern for the underserved and San Diego's diverse population. This is something Sharp has been doing for more than half a century. Pillars of Excellence The six pillars listed below are a visible testament to Sharp's commitment to become the best health care system in the universe by achieving excellence in these areas: Quality-Demonstrate and improve clinical excellence and patient safety to set community standards and exceed patient expectations Service-Create exceptional experiences at every touch point for customers, physicians, and partners by demonstrating service excellence People-Create a workforce culture that attracts, retains, and promotes the best and brightest people, who are committed to Sharp's mission, vision, and values Finance-Achieve financial results to ensure Sharp's ability to provide quality health care services, new technology, and investment in the organization Growth-Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements, and support innovative development Community-Be an exemplary community citizen Awards Sharp recently received the following recognition: Sharp is a recipient of the 2007 Malcolm Baldrige National Quality Award, the nation's highest Presidential honor for quality and organizational performance excellence. Sharp is the first health care system in California and eighth in the nation to receive this recognition. Sharp was named the No. 1 "best integrated health-care network" in California and No. 13 nationally by Modern Healthcare magazine in 2011. The rankings are part of the "Top 100 Most Highly Integrated Healthcare Networks (IHN)," an annual survey conducted by health care data analyst SDI. This is the 13th year running that Sharp has placed among the top in the state in the survey. Sharp was ranked 47th by Modern Healthcare in its 2008 "100 Best Places to Work." The awards and honors program recognizes workplaces in health care that enable employees to perform at their optimum level to provide patients and customers with the best possible care and services. SGH was named "Best Hospital" by San Diego Union-Tribune readers participating in the paper's "Best of San Diego" Readers Poll published August 2, 2010, and SMH was ranked 3rd. This marks the 3rd year in a row that Sharp received this honor. SGH and SMH have both received MAGNET Designation for Nursing Excellence by the ANCC. The Magnet Recognition Program is the highest level of honor bestowed by the ANCC and is accepted nationally as the gold standard in nursing excellence. Sharp was named one of the nation's "Most Wired" health care systems from 1998 through 2009 by Hospitals & Health Networks magazine in the annual Most Wired Survey and Benchmark Study. "Most Wired" hospitals are committed to using technology to enhance quality of care for both patients and staff. In July 2010, SMH was named the "Most Beautiful Hospital in America" by Soliant Health, one of the largest medical staffing companies in the country. With over 10,000 votes from visitors to the Soliant Health website, SMH was voted to the top of the second annual "20 Most Beautiful Hospitals in America" list. In 2010 Sharp received the Morehead Apex Workplace of Distinction Award. Morehead awards the health care industry's top achievers by objectively identifying the highest performers and acknowledging their contributions to health care. Morehead recognizes clients who have reached and sustained the 90th percentile on their employee engagement surveys in the current calendar year. Sharp reached the 98th percentile in 2010. Patient Access to Care Programs Uninsured patients with no ability to pay, and insured patients with inadequate coverage and no ability to pay, receive financial assistance for medically necessary services through Sharp's Financial Assistance Program. Sharp does not refuse any patient requiring emergency medical care. In FY 2010, Sharp began providing services to assist every unfunded patient received in the emergency room in finding coverage options. Patients use a quick, simple online questionnaire through the Foundation for Health Coverage Education to generate personalized coverage options that are filed in their account for future reference and accessibility. Also in FY 2010, Sharp began offering ClearBalance - a specialized loan program for patients facing high medical bills. Through this collaboration with San Diego-based CSI Financial Services, both insured and uninsured patients have the opportunity to secure small bank loans in order to pay off their medical bills in low monthly payments - as low as $25 per month - and thus prevent unpaid accounts from going to collections. Through this program, Sharp provides a more affordable alternative for patients that struggle with the ability to resolve their hospital bills. In addition, Sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients receive assistance regarding transportation and placement, as well as connections to community resources. Through a collaboration with the San Diego Rescue Mission, SCHHC, SGH, and SMH discharge their chronically homeless patients to the Rescue Mission's Recuperative Care Unit, where patients not only receive follow-up medical care through Sharp in a safe environment, but through the organization's programs they also receive psychiatric care, substance abuse counseling, and guidance to help get them off the street. In addition, since December 2008, SCVMC has partnered with Family Health Centers of San Diego (FHCSD)to provide timely access to primary care and behavioral health services by establishing medical homes for low-income, medically uninsured, and underserved patients in the South Bay that present in the SCVMC ED. The program seeks to: support Safety Net patients suffering from chronic conditions to better manage their pain, diseases, and overall health care; educate Safety Net patients about obtaining affordable medications through a community clinic; increase patient access and timely referrals to primary care and behavioral health services; increase patient access to follow-up primary care services and establish a medical home at either FHCSD - Chula Vista Clinic or other clinics; and offer enhanced access to transportation resources to the hospital and/or clinics. Since the grant with FHCSD, SCVMC has served a total of 1,248 Safety Net patients, 55 percent of whom were referred to the FHCSD - Chula Vista Clinic. Health Professions Training Internships Students and recent health care graduates are a valuable asset to the community, and Sharp demonstrates a deep investment in these potential and newest members of the health care workforce through internships, financial aid, and career pipeline programs. In FY 2010, there were 4,745 student interns within the Sharp system, providing more than 550,000 hours in disciplines that include nursing, allied health, and professional educational programs. Sharp provides education and training programs for students in the continuum of nursing (e.g., critical care, medical/surgical, behavioral health, women's services, and wound care) and allied health professions such as rehabilitation therapies (speech, physical, occupational, and recreational therapy), pharmacy, dietetics, lab, imaging (all the radiology professions), social work, psychology, and public health. Students from local community colleges such as Grossmont College, Mesa College, and Southwestern College (SWC); local and national university campuses such as San Diego State University (SDSU), University of California, San Diego (UCSD), University of San Diego (USD), Point Loma Nazarene University (PLNU), and University of Oklahoma (OU); and vocational schools such as Kaplan College participate in Sharp's health professions training. Table 1 presents the students and student hours at each of the Sharp entities in FY 2010. Table 1: Sharp HealthCare Internships - FY 2010 Sharp Chula Vista Medical Center Nursing 859 Students 57,304 Group Hours 17,613 Precepted Hours Ancillary 142 Students 35,695 Hours Total 1,001 Students 110,612 Hours Sharp Coronado Hospital and Healthcare Center Nursing 493 Students 53,664 Group Hours 2,548 Precepted Hours Ancillary 100 Students 19,796 Hours Total 593 Students 76,008 Hours Sharp Grossmont Hospital Nursing 913 Students 58,750 Group Hours 22,755 Precepted Hours Ancillary 237 Students 47,544 Hours Total 1,150 Students 129,049 Hours Sharp Mary Birch Hospital for Women & Newborns Nursing 231 Students 11,876 Group Hours 12,024 Precepted Hours Ancillary 26 Students 6,529 Hours Total 257 Students 30,429 Hours Sharp Memorial Hospital Nursing 738 Students 44,571 Group Hours 23,827 Precepted Hours Ancillary 323 Students 67,399 Hours Total 1,061 Students 135,797 Hours Sharp Mesa Vista Hospital Nursing 328 Students 25,870 Group Hours 2,857 Precepted Hours Ancillary 11 Students 3,666 Hours Total 339 Students 32,393 Hours Sharp HealthCare Nursing 199 Students 0 Group Hours 8,990 Precepted Hours Ancillary 145 Students 26,778 Hours Total 344 Students 35,768 Hours Total Nursing 3,761 Students 252,035 Group Hours 90,614 Precepted Hours Ancillary 984 Students 207,407 Hours Total 4,745 Students 550,056 Hours College Collaborations Sharp's partnership with the OU College of Nursing, SDSU and SWC provides clinical, real-world experience in San Diego County for students enrolled in the OU Online Accelerated Second Degree Bachelor of Science in Nursing (BSN) Program and the OU Career Mobility Registered Nurse (RN) to BSN Program. The partnership seeks to boost the number of new nurse graduates by offering programs with increased flexibility and access for students. The Accelerated Second Degree BSN Program is for individuals with a bachelor's degree or higher in a non-nursing major. The program includes more than 600 hours of online coursework and nearly 900 hours of clinical experience at Sharp facilities. Candidates may earn a BSN from OU in 14 months, as well as become eligible to sit for the National Council Licensing Examination for Registered Nurses (NCLEX-RN). The Career Mobility RN to BSN Program offers licensed RNs an accelerated education to achieve a BSN from OU within nine months, providing them with greater opportunity for career mobility and advancement. The Career Mobility RN to BSN Program began in May 2006, and the OU Online Accelerated Second Degree BSN Program began in August 2007. The first Career Mobility RN to BSN class graduated students in May 2007. In December 2008, the first Accelerated Second Degree BSN class graduated students. The Health Academy The SCVMC Health Academy educates the next generation of health care professionals by introducing local elementary school students to a wide variety of health care careers. Since 2005, this program has provided hospital tours to hundreds of fifth graders who have benefited from interactive learning in various areas of the hospital, including the laboratory, pharmacy, and billing departments. In the fall of 2008, a two-year grant from the California Endowment allowed for the expansion of the program to provide a diversity initiative to high school students. The Health Care Career Pipeline Partnership (HCCPP) represents collaboration among the hospital, Barrio Logan College Institute (BLCI), San Ysidro High School (SYHS), SWC, Harder and Associates, and the San Diego chapter of the National Association of Hispanic Nurses. The program has had tremendous success since its inception, and in FY 2009, SCVMC won a partnership award from the San Diego Science Alliance for its work in the HCCPP. The award recognizes a San Diego business or employer that partners with youth in the community. Health Sciences High and Middle College Sharp has teamed up as an industry partner with charter school Health Sciences High and Middle College (HSHMC) to provide students broad exposure to careers available in health care. During FY 2010, 386 HSHMC students participated on Sharp campuses for a total of more than 102,000 student hours. The collaboration between Sharp and HSHMC prepares high school students to consider and enter health science and medical technology careers within the following five career pathways: Biotechnology Research and Development, Diagnostic Services, Health Informatics, Support Services, and Therapeutic Services. During a 16-week period, supervised students rotate through instructional pods in various departments such as nursing, ob/gyn, occupational and physical therapy, behavioral health, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), imaging, rehabilitation, laboratory, pharmacy, pulmonary, cardiac services, and operations. HSHMC students not only receive hands-on experience in patient care, but also guidance from Sharp staff on professionalism, career ladder development, and job/education requirements. HSHMC students earn high school diplomas, complete college entrance requirements, and have opportunities to earn community college credits, degrees, or vocational certificates. With the HSHMC program, Sharp links students with health care professionals through job shadowing and internships, to explore real-world applications of their school-based knowledge and skills. The program began in 2007 with HSHMC students on the campuses of SGH and SMH, and expanded to include SMV and SMBHWN in 2009, and to SCHHC in 2010. Lectures and Continuing Education Sharp contributes to the academic environment of many colleges and universities in San Diego. In FY 2010, Sharp staff committed more than 500 hours providing lectures, courses, and presentations on numerous college/university campuses throughout San Diego. Through the delivery of a variety of guest lectures, including The Role of the Clinical Nurse Specialist at PLNU, Conceptual Basis of Professional Nursing Practice at USD, health information lectures at Mesa College, pharmacy practice lectures at UCSD, and a variety of health administration lectures to public health graduate students at SDSU, Sharp staff remain active and engaged with San Diego's academic health care community. Sharp's Continuing Medical Education (CME) department assesses, designs, implements, and evaluates educational and training initiatives for Sharp's affiliated physicians, pharmacists, and other health professionals to better serve the health care needs of the San Diego community. In FY 2010 the professionals at Sharp HealthCare CME invested more than 930 hours in myriad CME activities open to San Diego health care providers, ranging from annual conferences on patient safety, diabetes, breast cancer, and end-of-life care, to presentations on Just Culture and Transforming Primary Care Through Patient-Centered Medical Homes. In addition, the Outcomes Research Institute (ORI) at Sharp was formed to measure long-term results of care and to promote and develop best practices for health care delivery for members of the professional health care community. With both inpatient and ambulatory locations and a diverse patient population, Sharp is well-positioned to study care processes and outcomes in a "real world" setting, reflecting an authentic picture of the health care environment. Among its current and future goals, the ORI aims to analyze the relationships between processes and outcomes for treatments, interventions, and quality improvement initiatives as well as to develop and disseminate knowledge regarding effective approaches to quality care delivery in the health care community. Volunteer Service Sharp Lends a Hand In FY 2010, Sharp continued its systemwide community service program, Sharp Lends a Hand, to further support the San Diego communities it serves. In October 2009, Sharp promoted the program both internally and in the community, requesting project ideas that: focused on improving the health and well-being of San Diego in a broad, positive way; relied on Sharp for volunteer labor only; supported nonprofit initiatives, community activities or other programs that serve the residents of San Diego County; and had a completion date by September 30, 2010. Sharp employees voted on the qualified projects posted on SharpNET. They selected six projects: Stand Down for Homeless Veterans, San Diego Food Bank, California Coastal Cleanup, Special Olympics, YWCA Becky's House, and the Monarch School. In support of these projects, more than 1,600 Sharp employees, family members, and friends volunteered nearly 5,500 hours. During three days in July 2010, 425 Sharp employees, family members, and friends provided support, medical services, and companionship, to hundreds of homeless veterans at Stand Down for Homeless Veterans, an annual event sponsored by Veterans Village of San Diego. The San Diego Food Bank feeds people in need throughout San Diego County, and advocates and educates the public about hunger-related issues. During March, May, and August 2010, 831 Sharp Lends a Hand volunteers inspected and sorted donated food, assembled boxes, and cleaned the San Diego Food Bank warehouse. In addition, in 2010 Sharp employees collected 413 pounds of food for the San Diego Food Bank, enough to feed 323 people. Becky's House provides emergency shelter and transitional housing to women and children who have been victimized by domestic violence. Fifteen Sharp Lends a Hand volunteers gave the shelter some much needed "tender love and care," by painting one of the transition housing units and children's play areas in February 2010. The Monarch School provides education, health care, food, clothing, and personal hygiene for some of San Diego's estimated 2,200 homeless and at-risk children. In August 2010, a small group of Sharp Lends a Hand volunteers helped by painting and cleaning the school grounds and classrooms. More than 125 Sharp Lends a Hand volunteers provided assistance to San Diego County's Special Olympics year-round training and athletic competitions. Special Olympics of San Diego County has more than 1,400 athletes of all ages. The program provides sports training and athletic competition for all children and adults with intellectual disabilities. The volunteers assisted with timekeeping, score-keeping and cheerleading during the Spring Games, which included swimming, basketball, and bocce ball competitions. The Sharp Lends a Hand team participated with I Love a Clean San Diego and San Diego Coastkeeper to put the sparkle back in the San Diego community through the California Coastal Cleanup. More than 200 volunteers of all ages helped keep San Diego's coast a beautiful place to live and play by picking up and removing trash and debris from 16 selected sites in our communities. Sharp Humanitarian Service Program In FY 2010, 22 Sharp employees were funded through Sharp's Humanitarian Service Program. This program allows employees to participate in service programs that provide health care and/or other supportive services to underserved or adversely affected populations. In FY 2010, Sharp employees devoted their time and energy to organizations that included Wheels for the World, which provides wheelchairs to people with disabilities in developing countries, including Egypt and Ghana. Sharp staff worked out of a regional hospital in rural Ghana (West Africa) at a seating and positioning clinic where patients - many who had been crawling for most of their lives - received therapy sessions and their first wheelchairs. Sharp staff also participated in the Mission of Natuvu Creek, a nonprofit charitable foundation that in 10 years expanded its original clinic to a state-of-the-art medical and dental facility on the eastern coast of Vanua Levu, Fiji's second largest island. The facility serves the vastly underserved region of 250,000, where people travel by boat, bus, trucks, and foot - often up to 14 hours - to receive care. Sharp staff provided various services, including eye exams and eye surgeries (cataract / pterygium). Through the Sharp Humanitarian Service Program, Sharp staff provided extensive support and expertise to victims of the earthquakes that devastated Haiti in January 2010. Sharp-affiliated physicians and Sharp staff provided medical services including wound care, post-op treatment, neurological and orthopedic rehabilitation, occupational therapy, and general public health service, as well as equipment and supplies to those in need. Sharp staff often devoted around-the-clock hours to care for patients affected by the earthquakes - whose ages ranged from neonates to the elderly - at various sites throughout Haiti. At the Hospital de Adventiste in Carrefours, Haiti, Sharp staff worked in an ER triage setting treating between 150 and 200 patients per day. Sharp staff also traveled to the project Medishare field hospital in Port-au-Prince to provide critical care, trauma care, and ICU treatment. In Milot, Haiti, Sharp staff provided physical therapy and education to earthquake survivors, including training amputees on how to use their new prostheses, leading group exercise classes, and providing activities for children. Staff provided care, comfort, support, and hope amidst a situation of complete and utter chaos, including the challenges of limited medical supplies and unsanitary living conditions. A systemwide effort was also developed to provide all Sharp employees with the opportunity to offer a variety of resources, including funds, food, water, medical supplies, and equipment to assist those areas of Haiti impacted by the earthquakes. In addition, a team of four physicians from the SGH medical staff provided critical medical services to a badly damaged but still-standing abandoned hospital in Port-au-Prince. The team encountered more than 1,500 people crowded into a tent city on the grounds, many with serious injuries. In just over four days, the physicians performed more than 40 procedures - many of them limb - and life-saving - and treated several hundred more victims non-operatively. By the time they departed, the physicians were able to get four operating rooms functioning again in order to set the stage for additional medical volunteers to treat more victims. In addition, the Sharp Humanitarian Program continued its support of and participation in a medical mission trip to Joyaba, Guatemala through HELPS International, a nonprofit relief organization. The medical/surgical team delivered needed medical care to rural Guatemala during their medical mission, providing a range of critical services, both basic and complex, including treatments for a variety of infections and diseases, such as cancer; an array of surgeries, including cataract surgery and amputation; and a multitude of screenings and diagnoses for patients who had not seen a physician in years - many in their entire lives. This effort began in FY 2009, when a Sharp-affiliated surgeon led a team of 94 medical and surgical professionals from Southern California on a medical mission trip to Joyaba. Community Walks Sharp is a proud supporter of the American Heart Association (AHA) annual Heart Walk. In September 2010, more than 1,000 walkers represented Sharp at the San Diego Heart Walk held in Balboa Park. Sharp was seated the No. 1 Heart Walk team in San Diego and the AHA Western Region Affiliates, raising more than $180,000 for the American Heart Association. Sharp Volunteers Sharp volunteers are a critical component of Sharp's dedication to the San Diego community. Sharp provides a multitude of volunteer opportunities throughout San Diego County for individuals to serve the community, meet new people, and assist programs ranging from pediatrics to Senior Resource Centers. Volunteers devote their time and compassion to patients as well as to the general public, and are an essential element to many of Sharp's programs, events, and initiatives. Sharp volunteers spend their time within hospitals, in the community, and in support of the Sharp HealthCare Foundation, Grossmont Hospital Foundation, and Coronado Hospital Foundation. Sharp employees also donate time to Sharp as volunteers for the Sharp organization. In FY 2010, there were more than 2,200 total volunteers across the Sharp system, contributing 268,958 hours of their time in service to Sharp and its initiatives. More than 22,000 of these hours were provided externally to the San Diego community through activities such as delivering meals to homebound seniors and assisting with health fairs and events. Table 2 details the number of volunteers and the hours provided in service to each of Sharp's entities, as well as Sharp HospiceCare, specifically for patient and community support. Volunteers also spent additional hours supporting Sharp's three foundations for events such as Grossmont Hospital Foundation's annual Golf Tournament; the SMBHWN Stewardship Committee; galas held for SCVMC, SCHHC, and SGH; and other events in support of Sharp entities and services. Table 2: Sharp Volunteers and Volunteer Hours - FY 2010 Sharp Chula Vista Medical Center 325 Volunteers (Individuals) 49,000 Volunteer Hours Sharp Coronado Hospital and Healthcare Center 165 Volunteers (Individuals) 7,396 Volunteer Hours Sharp Grossmont Hospital 902 Volunteers (Individuals) 122,814 Volunteer Hours Sharp Mary Birch Hospital for Women & Newborns 95 Volunteers (Individuals) 15,470 Volunteer Hours Sharp Memorial Hospital 555 Volunteers (Individuals) 67,115 Volunteer Hours Sharp Mesa Vista Hospital 28 Volunteers (Individuals) 2,686 Volunteer Hours Sharp HealthCare 37 Volunteers (Individuals) 4,477 Volunteer Hours TOTAL 2,107 Volunteers (Individuals) 268,958 Volunteer Hours Sharp employees also volunteer their time for the Cabrillo Credit Union Sharp Division Board, the Sharp and Children's MRI Board, the UCSD Medical Center/Sharp Bone Marrow Transplant Program Board, Grossmont Imaging LLC Board, and the SCVMC - SDI Imaging Center. In addition, volunteers on Sharp's auxiliary boards and the various Sharp entity Boards volunteer their time to provide program oversight, administration, and decision-making regarding financial resources. In FY 2010, 142 community members contributed their time to Sharp's Boards. All Ways Green Initiative As San Diego's largest private employer, Sharp recognizes that the health of its patients and employees is directly tied to the health of their environment. Sharp has developed a systemwide program called All Ways Green, aimed at improving energy efficiency, water conservation, and waste minimization, as well as the promotion of other initiatives that lower its carbon footprint. According to the Environmental Protection Agency (EPA), inpatient hospital facilities are now the second most energy-intensive industry after food service and sales, with energy utilization 2.7 times greater than that of office buildings on a square-foot basis. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and must provide service during power outages, natural disasters, and other emergencies. Given this reality, over the past year, Sharp has embarked on several green initiatives to enhance energy efficiency, such as: retrofitting to energy efficient lighting, Energy Star Program participation, energy efficient plant motor replacements, equipment modernization, and training of staff to conserve energy. SMH and SMBHWN qualified in FY 2010 for the American Society for Healthcare Engineering Energy Efficiency Commitment award for reducing energy use by 15 percent. SCVMC earned the EPA Energy Star Award and the San Diego Gas and Electric Energy Champion Award for Innovative Technology in FY 2010. In an effort to conserve natural resources, Sharp has researched and implemented infrastructure changes to ensure Sharp's facilities are optimally operated while monitoring and measuring water consumption. Such changes include: installation of motion-sensing faucets, drip irrigation systems, mist eliminators, and drought-resistant plants and other redesigns of landscaping. These changes have been implemented operationally with no negative impact to patient care, resulting in significant dollar savings and reduced natural resource consumption. Sharp employees also donated or recycled personal cell phones and proceeds were donated to the Community Health Improvement Partners (CHIP) Gift of Health program to provide medical and dental care for uninsured children in San Diego. In addition, Sharp employees were encouraged to recycle personal eyeglasses and sunglasses to provide to the Lion's Club Recycle Sight program, which distributes recycled glasses to people in need both locally and globally. In April of FY 2010, as a part of Earth Week, SCHHC held an Office Supply Swap as part of Spring Cleaning Day. Employees stocked and reused unwanted office supplies instead of tossing them into the trash. Employees were also encouraged to participate in both the CHIP Gift of Health program and the Lion's Club Recycle Sight program as part of the Spring Cleaning Day event. The EPA and Hospitals for a Healthy Environment have reported that each patient generates approximately 15 pounds of waste each day, while U.S. medical centers generate approximately 2 million tons of waste each year. In recognition of this dramatic environmental impact, Sharp has implemented a waste minimization and recycling program. One of the measures implemented to reduce waste was a single-stream recycling program at all Sharp entities. Facilities also began using reusable sharps containers that can be reused up to 500 times, as well as sterile processing equipment that allows for the elimination of blue wrapped instrument trays. At the Sharp Metropolitan Medical Campus (SMMC), employees spearheaded a program to have volunteers pick-up unwanted flower vases following patient discharge to reuse them in the hospital gift shop. Early successes in waste reduction have been significant: recycling at all Sharp facilities currently diverts some 6.2 million pounds of trash from local landfills each year. Table 3 presents the quantity of recycling at Sharp. Table 3: Sharp HealthCare Recycling Sharp Grossmont Hospital 1,560,948 Recycled Weight Per Year (lbs.) Sharp Chula Vista Medical Center 277,344 Recycled Weight Per Year (lbs.) Sharp Coronado Hospital and Healthcare Center 218,636 Recycled Weight Per Year (lbs.) Sharp Metropolitan Medical Campus 1,778,720 Recycled Weight Per Year (lbs.) Total Sharp HealthCare 6,239,840 Recycled Weight Per Year (lbs.) In FY 2010, Sharp promoted various other All Ways Green initiatives to enhance environmental responsibility. Green building designs are utilized throughout the Sharp system; SMMC, for example, participates in a Paperlite Project and placed a Green Garden on the roof of SMH. Sharp is also implementing sustainable food practices such as removal of styrofoam, reduction of plastics, and use of green-label soaps and cleaners. Sharp also promotes sustainable agricultural practices and access to healthy foods by holding frequent organic farmers' markets. The implementation of van pooling, ride sharing, and public transit programs contributes to the reduction of Sharp's transportation emissions. Sharp leadership continues to promote a culture of environmental responsibility and provides education and outreach to employees to improve the health of those they serve as well as their own. Table 4 further highlights the All Ways Green efforts at Sharp entities. Going forward, the All Ways Green initiative will continue to investigate other green opportunities. Green purchasing methods will be explored as a first line of defense to reduce waste volume and toxicity by addressing less packaging, fewer toxic materials, and more recyclable packaging. All Ways Green will also investigate the opportunity to recycle large amounts of sterile blue wrap used by Surgical Services and other procedural departments, and will partner with San Diego County to become the only health care company to perform a study on food waste composting. Table 4: All Ways Green Initiatives by Sharp Entity - FY 2010 SMH/SMBHWN Energy Efficiency -Lighting retrofit -Energy Star -Energy-efficient motors installed Water Conservation -Drip irrigation -Mist eliminators -Water reduction systems Waste Minimization -Reprocessing -Recycling -Reusable supplies Education and Outreach -Recycling education -Green Steering Committee SMV/SVP Energy Efficiency -Lighting retrofit -Motor and pump replacements Water Conservation -Landscape usage reduction -Drought-resistant plants Waste Minimization -Recycling -Waste reduction -Styrofoam elimination Education and Outreach -Earth Day activities -Green champions SGH Energy Efficiency -Lighting retrofit Water Conservation -Hardscaping of entire campus Waste Minimization -Recycling -Sustainable supplies Education and Outreach -Update and enforce No Smoking Policy SCVMC Energy Efficiency -Energy Star -Lighting retrofit -Energy-efficient chillers/motors Water Conservation -Irrigation minimization -Water-saving devices Waste Minimization -Recycling -Compactor renovation Education and Outreach -Recycling/ride sharing promotion SCHHC Energy Efficiency -Lighting retrofit -Elevator/chiller modernizations -A/C replacement Water Conservation -Landscape usage reduction Waste Minimization -Recycling -Reusable supplies -Reprocessing Education and Outreach -Green Committee -Recycling education SRS Energy Efficiency -Lighting retrofit -Energy audits Water Conservation -Landscape usage reduction -Low-flow systems Waste Minimization -Recycling Education and Outreach -Green Teams -Contractor education SHP Energy Efficiency -Lighting retrofit Water Conservation -Watersaving devices Waste Minimization -Recycling -Spring Cleaning events Education and Outreach -Earth Day activities -Mass transit education Sharp System Services Energy Efficiency -Energy efficient chillers/motors -Thermostat control software Water Conservation -Water audits -Landscape usage reduction and retention Waste Minimization -Green Grocer's market -Recycling Education and Outreach -Sharp- sponsored mass transit and carpooling program Executive Summary This Executive Summary provides an overview of community benefits planning at Sharp, a listing of community needs addressed in this Community Benefits Report, and a summary of community benefits programs and services provided by Sharp in FY 2010 (October 1, 2009, through September 30, 2010). In addition, the summary reports the economic value of community benefits provided by Sharp, according to the framework specifically identified in SB 697, for the following: *Sharp Chula Vista Medical Center *Sharp Coronado Hospital and Healthcare Center *Sharp Grossmont Hospital *Sharp Mary Birch Hospital for Women & Newborns *Sharp Memorial Hospital *Sharp Mesa Vista Hospital and Sharp Vista Pacifica Hospital *Sharp Health Plan Community Benefits Planning at Sharp HealthCare Sharp bases its community benefits planning on the triennial community health needs assessment conducted by CHIP combined with the expertise in programs and services of each Sharp hospital. Listing of Community Needs Addressed in This Community Benefits Report The following community needs are addressed by one or more Sharp hospitals in this Community Benefits Report: *Access to care for individuals without a medical provider *Focused education and screening programs on health conditions such as heart and vascular disease, stroke, cancer, diabetes, preterm delivery, unintentional injuries, and behavioral health *Health education and screening activities for seniors *Outreach for flu vaccinations *Special support services for hospice patients and their loved ones, and for the community *Support of community nonprofit health organizations *Education and training of health care professionals *Collaboration with local schools to promote interest in health care careers *Welfare of seniors and disabled people *Cancer education, patient navigator services, and participation in clinical trials *Women's and prenatal health services and education *Meeting the needs of new mothers and their loved ones *Mental health and substance abuse education for the community Highlights of Community Benefits Provided by Sharp in FY 2010 Some examples of community benefits programs and services provided by Sharp hospitals and entities in FY 2010 include: * Unreimbursed Medical Care Services, including uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as Medi-Cal, Medicare, San Diego County Indigent Medical Services, Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and TRICARE - the regionally managed health care program for active duty and retired members of the uniformed services, their loved ones, and survivors; and unreimbursed costs of workers' compensation programs. Also included is financial support for onsite workers to process Medi-Cal eligibility forms. * Other Benefits for Vulnerable Populations, including van transportation for patients to and from medical appointments; financial and other support to community clinics to assist in providing health services, and improving access to health services; Project HELP; Project CARE; contribution of time to Habitat for Humanity, Stand Down for Homeless Veterans, and the San Diego Food Bank; financial and other support to the Sharp Humanitarian Service Program; and other assistance for the needy. * Other Benefits for the Broader Community, including health education and information, and participation in community health fairs and events addressing the unique needs of the community, plus providing flu vaccinations, and health screenings. Sharp collaborated with local schools to promote interest in health care careers; made Sharp facilities available for use by community groups at no charge; and executive leadership and staff actively participated in numerous community organizations, committees, and coalitions to improve the health of the community. See Appendix A for a listing of Sharp's involvement in community organizations. * Health Research, Education, and Training Programs, including education and training programs for medical, nursing, and other health care professionals. To increase the pool of nursing graduates, Sharp and other area health care providers continued sponsorship of health-related programs, classes, and professors at SDSU (Nurses Now Partnership) and UCSD. Sharp also partnered with SWC, SDSU, and OU College of Nursing to provide clinical experience in San Diego County for students enrolled in the OU Online Accelerated Second Degree BSN Program. Additionally, Sharp continued its five-year agreement with SDSU for financial support of the Sharp Human Patient Simulation Center, to provide specialized education to nursing students. Sharp again collaborated with Rady Children's Hospital - San Diego and Scripps Health in support of the National Partnership for Smoke-Free Families, a program designed to help pregnant smokers quit to improve their health and protect the health of their unborn babies. Economic Value of Community Benefits Provided in FY 2010 In FY 2010, Sharp provided a total of $335,902,803 in community benefits programs and services that were unreimbursed. Table 1 displays a summary of unreimbursed costs based on the categories specifically identified in SB 697. Table 1: Total Economic Value of Community Benefits Provided Sharp HealthCare Overall - FY 2010 Senate Bill 697 Category Programs and Services Included in Senate Bill 697 Category Estimated FY 2010 Unreimbursed Costs Medical Care Services Shortfall in Medi-Cal $103,262,633 Shortfall in Medicare $130,524,487 Shortfall in San Diego County Indigent Medical Services $20,523,325 Shortfall in CHAMPVA/TRICARE $2,974,042 Shortfall in Workers' Compensation $32,238 Charity Care and Bad Debt $68,018,776 Other Benefits for Vulnerable Populations Patient transportation and other assistance for the needy $2,762,738 Other Benefits for the Broader Community Health education and information, support groups, health fairs, meeting room space, donations of time to community organizations and cost of fundraising for community events $3,512,152 Health Research, Education, and Training Programs Education and training programs for students, interns, and health care professionals $4,292,412 TOTAL $335,902,803 Table 2 shows a listing of these unreimbursed costs provided by each Sharp entity. Table 2: Total Economic Value of Community Benefits Provided Sharp HealthCare Entities - FY 2010 Sharp HealthCare Entity Estimated FY 2010 Unreimbursed Costs Sharp Chula Vista Medical Center $56,892,548 Sharp Coronado Hospital and Healthcare Center $12,067,980 Sharp Grossmont Hospital $120,399,912 Sharp Mary Birch Hospital for Women & Newborns $12,645,038 Sharp Memorial Hospital $127,321,223 Sharp Mesa Vista Hospital and Sharp Vista Pacifica Hospital $6,377,573 Sharp Health Plan $198,529 ALL ENTITIES $335,902,803 Table 3 includes a summary of unreimbursed costs for each Sharp entity based on the categories specifically identified in SB 697. As shown in Table 2, Sharp leads the community in unreimbursed medical care services, among San Diego County's SB 697 hospitals and health care systems. Table 3: FY 2010 Detailed Economic Value of Community Benefits at Sharp HealthCare Entities Based on Senate Bill 697 Categories Sharp HealthCare Entity SENATE BILL 697 CATEGORY Medical Care Services Other Benefits for Vulnerable Populations Other Benefits for the Broader Community Health Research, Education, and Training Programs Estimated FY 2010 Unreimbursed Costs Sharp Chula Vista Medical Center $54,823,957 $420,052 $706,335 $942,204 $56,892,548 Sharp Coronado Hospital and Healthcare Center $11,533,012 $30,148 $222,267 $282,553 $12,067,980 Sharp Grossmont Hospital $117,408,760 $622,104 $1,190,540 $1,178,508 $120,399,912 Sharp Mary Birch Hospital for Women & Newborns $11,926,989 $40,935 $245,425 $431,689 $12,645,038 Sharp Memorial Hospital $124,442,978 $811,068 $835,835 $1,231,342 $127,321,223 Sharp Mesa Vista Hospital and Sharp Vista Pacifica Hospital $5,199,805 $812,369 $157,598 $207,801 $6,377,573 Sharp Health Plan - $26,063 $154,151 $18,315 $198,529 ALL ENTITIES $325,335,501 $2,762,739 $3,512,151 $4,292,412 $335,902,803 Community Benefits Planning Process Each year, Sharp bases its community benefits planning on findings from the community health needs assessments conducted by CHIP and the expertise in programs and services of each Sharp hospital. Methodology to Conduct the 2007 Community Health Needs Assessment Since 1995, Sharp has participated in a countywide collaborative - including a broad range of hospitals, health care organizations, and community agencies - to conduct a triennial community needs assessment. In 2007, the CHIP Needs Assessment Committee, under the direction of the CHIP Steering Committee, determined a methodology and approach to the needs assessment, which included information from the following sources: *Analysis of health-related statistics gathered and analyzed by the County of San Diego Health and Human Services Agency (HHSA), supplemented by data from the California Health Interview Survey (CHIS), the California OSHPD and the Centers for Disease Control and Prevention's (CDC) Youth Risk Behavior Surveillance System and Behavior Risk Surveillance System *Review of health-related scientific literature *Review of results of facilitated discussions held with seven focus groups representing a cross-section of the San Diego County community *Results of a process used by members of CHIP to set priorities among various health issues Determination of Priority Community Needs: Sharp HealthCare Each Sharp hospital reviewed the 2007 Community Health Needs Assessment conducted by CHIP and used it to determine priority needs for their hospital's communities. In identifying these priorities, each entity considered the expertise and mission of the hospital in providing services, in addition to the unique regional, age group, and/or health topics that comprise the entity's service area. For example, the specialty hospitals - SMBHWN, SMV, and SVP - reviewed the needs assessment priorities, specifically focusing on issues relevant to women and infants, behavioral health, and substance abuse, respectively. Sharp's general acute care hospitals reviewed the needs assessment with a focus on the region and/or subregional areas, with the goal of matching community benefit programs and services to the unique needs of the region. Steps Completed to Prepare an Annual Community Benefits Report On an annual basis, each Sharp hospital performs the following steps in the preparation of its Community Benefits Report: *Establishes and/or reviews hospital-specific measurable objectives *Verifies the need for an ongoing focus on identified community needs and/or adds new identified community needs *Reports on activities conducted in the prior fiscal year - FY 2010 Report of Activities *Develops a plan for the upcoming fiscal year, including specific steps to be undertaken - FY 2011 Plan *Reports and categorizes the economic value of community benefits provided in FY 2010, according to the framework specifically identified in SB 697 *Reviews and approves a Community Benefits Plan *Distributes the Community Benefits Report to members of the Sharp Board of Directors and Sharp hospital boards of directors, highlighting activities provided in the prior fiscal year as well as specific action steps to be undertaken in the upcoming fiscal year Ongoing Commitment to CHIP In support of its ongoing commitment to working with others on addressing community health priorities to improve the health status of San Diego County residents, Sharp remains active in CHIP efforts. In addition to the CHIP Board, Sharp executive leadership and other staff are actively involved in the following CHIP committees and work teams: Public Policy Committee, Care Coordination Work Committee, Steering Committee, Needs Assessment Committee, Access to Care Committee, Access to Care Health Literacy Initiative, Behavioral Health Work Team, Immunize San Diego Coalition, San Diego Diabetes Coalition, San Diego County Childhood Obesity Initiative (SDCOI), SDCOI Healthy Eating, Active Communities, and Safety Net Connect. Sharp Grossmont Hospital *SGH is located at 5555 Grossmont Center Drive, in La Mesa, ZIP code 91942. *Sharp HospiceCare is located at 8881 Fletcher Parkway, in La Mesa, ZIP code 91942. FY 2010 Community Benefits Program Highlights SGH provided a total of $120,399,912 in community benefits in FY 2010. See Table 1 for a summary of unreimbursed costs based on the categories identified in SB 697. Table 1: Economic Value of Community Benefits Provided Sharp Grossmont Hospital - FY 2010 Senate Bill 697 Category Programs and Services Included in Senate Bill 697 Category Estimated FY 2010 Unreimbursed Costs Medical Care Services Shortfall in Medi-Cal, financial support for onsite workers to process Medi-Cal eligibility forms $41,889,275 Shortfall in Medicare $36,405,640 Shortfall in San Diego County Indigent Medical Services $9,349,520 Shortfall in CHAMPVA/TRICARE $458,521 Charity Care and Bad Debt $29,305,804 Other Benefits for Vulnerable Populations Patient transportation, Project HELP, contribution of funds to a community clinic, and other assistance for the needy $622,104 Other Benefits for the Broader Community Health education and information, health screenings, health fairs, flu vaccinations, support groups, meeting room space, donations of time to community organizations, and cost of fundraising for community events $1,190,540 Health Research, Education, and Training Programs Education and training programs for students, interns, and health care professionals $1,178,508 TOTAL $120,399,912 Key highlights: *Unreimbursed Medical Care Services, including uncompensated care for patients who are unable to pay for services; the unreimbursed costs of public programs such as Medi-Cal, Medicare, and San Diego County Indigent Medical Services; and financial support for onsite workers to process Medi-Cal eligibility forms. *Other Benefits for Vulnerable Populations, including van transportation for patients to and from medical appointments; financial and other support to Neighborhood Healthcare; Project HELP; Project CARE; contribution of time to Habitat for Humanity, Stand Down for Homeless Veterans, and the San Diego Food Bank; the Sharp Humanitarian Service Program; and other assistance for the needy. *Other Benefits for the Broader Community, including health education and information on a variety of topics, participation in community health fairs and events and health screenings for stroke, blood pressure, and diabetes. A dedicated Senior Resource Center offered flu vaccinations and specialized education and information. SGH staff collaborated with local schools to promote interest in health care careers. SGH also offered meeting room space at no charge to community groups. In addition, staff at the hospital actively participated in community boards, committees, and civic organizations, such as AIS, La Mesa Park and Recreation Foundation, Communities Against Substance Abuse, East County Chamber of Commerce, Neighborhood Healthcare Community Clinics, Santee Chamber of Commerce, Salvation Army Kroc Center Board, Meals on Wheels Advisory Board, San Diego Nutrition Council, San Diego County Social Services Advisory Board, and YMCA. See Appendix A for a listing of Sharp community involvement. *Health Research, Education, and Training Programs, including education and training of health care professionals, student and intern supervision, and financial support of SDSU Human Patient Simulation Center, Nurses Now Partnership, and Partnership for Smoke-Free Families. Definition of Community The community served by SGH includes the entire East Region of San Diego County, including the sub-regional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley, and Mountain Empire. Approximately 5 percent of the population lives in remote or rural areas of this region. Description of Community Health In 2005, 92 percent of children and 80 percent of nonelderly adults had health insurance in the East Region, failing to meet the HP 2010 national targets for health insurance coverage. See Table 2 for a summary of key indicators of access to care. Table 2: Health Care Access in East Region - 2005 Description Rate Year 2010 Target Health Insurance Coverage Children 0 to 17 Years 92% 100% Adults 18 to 64 Years 80% 100% Have Regular Source of Medical Care Children 0 to 17 Years 90% 85% Adults 18 to 64 Years 87% 85% Source: Charting the Course V: 2007 San Diego County Health Needs Assessment; 2005 CHIS. Heart disease and cancer were the top two leading causes of death in the East Region. See Table 3 for a summary of leading causes of death in the East Region. Table 3: Leading Causes of Death in the East Region 2008 Cause of Death Number of Deaths Percent of Total Deaths Heart disease 924 25.0% Cancer (all sites) 847 23.0% Alzheimer's disease 255 6.9% Chronic lower respiratory diseases 237 6.4% Stroke 205 5.6% Unintentional injuries (all types) 186 5.0% Diabetes 108 2.9% Chronic liver disease and cirrhosis 69 1.9% Suicide 66 1.8% Essential hypertension and hypertensive renal disease 57 1.5% Influenza and pneumonia 48 1.3% Nephritis, nephorotic syndrome and nephrosis 39 1.1% Parkinson's disease 35 0.9% Viral hepatitis 21 0.6% Neoplasms - in situ, benign or unknown behavior 17 0.5% All Other Deaths 575 15.6% Total Deaths 3,689 100.0% Notes: Ranking of leading causes of death based on the countywide rank among San Diego residents in 2008. Source: County of San Diego, HHSA, Public Health Services, Community Epidemiology Branch. Community Benefits Planning Process In addition to the steps outlined regarding community benefits planning, SGH: *Incorporates community priorities and community input into its strategic plan and develops service line-specific goals *Estimates an annual budget for community programs and services based on community needs, the prior year's experience, and current funding levels *Prepares and distributes a monthly report of community activities to its board of directors, describing community benefits provided such as education, screenings, and flu vaccinations *Prepares and distributes information on community benefits programs and services through its foundation and community newsletters *Consults with representatives from a variety of departments, to discuss, plan, and implement community activities Priority Community Needs Addressed in Community Benefits Report SGH's Community Benefits Report addresses the following identified community needs: *Stroke education and screening *Heart and vascular disease education and screening *Cancer education and participation in clinical trials *Diabetes education and testing *Outreach for flu vaccinations *Health education and screening for seniors *Prevention of unintentional injuries *Special support services for hospice patients and their loved ones, and the community *Collaboration with local schools to promote interest in health care careers *Women's and prenatal health services and education *Orthopaedic / osteoporosis education and screening For each priority community need identified above, subsequent pages include a summary of the rationale and importance of the need, measurable objective(s), FY 2010 Report of Activities conducted in support of the objective(s), and FY 2011 Plan of Activities. Identified Community Need: Stroke Education and Screening -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Stroke is a leading cause of disability and the fourth leading cause of death in San Diego County. *CHIP members identified heart disease and stroke as the most important health issue for senior adults 65 years of age and older. *On average, there were 204 deaths a year due to stroke in the East Region during the three-year period from 2005 through 2007. In San Diego County, the age-adjusted death rate due to stroke during this period was 38.8 deaths per 100,000 population, lower than the HP 2010 target of 50.0 deaths per 100,000. *In 2008 there were 1,133 hospitalizations due to stroke in the East Region; the rate of hospitalizations for stroke was 244 per 100,000 population. The stroke hospitalization rate in the region was among the highest in San Diego County's regions and higher than the County average of 206.2 stroke hospitalizations per 100,000 population. *In FY 2008, there were 213 stroke-related ED visits in the East Region. The rate of visits was 45.9 per 100,000 population. The stroke-related ED visit rate in the region was comparable to the County average of 42.0 per 100,000 population. *Behavioral and social risk factors associated with heart disease and stroke deaths include poor nutrition, lack of physical activity, lack of appropriate medical care, substance abuse, and stressful circumstances. Intermediate outcomes associated with these conditions include high blood pressure, high cholesterol, diabetes, obesity, and cardiovascular disease, according to findings presented in the 2004 Community Health Needs Assessment. *Although the east suburban area has the same percentage of seniors age 65 and over as the county of San Diego (11 percent), a higher percentage (15.2 percent) of the east rural area population is seniors. SGH cared for 810 stroke and transient ischemic attack patients in FY 2010. Measurable Objective *Provide stroke education and screening services for the community, with an emphasis on seniors. FY 2010 Report of Activities Note: SGH is certified by The Joint Commission as a Primary Stroke Center. The program is nationally recognized for its outreach, education, and thorough screening procedures, as well as documentation of its success rate. Sharp Grossmont Hospital is a recipient of the American Heart Association's Get With the Guidelines (GWTG) Silver and Silver Plus Achievement Awards for Stroke. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with stroke patients. SGH's Stroke Center conducted stroke screening and educational events to educate the public on stroke risk factors, warning signs, and appropriate interventions, including arrival at hospitals within early onset of symptoms. In FY 2010, the hospital conducted seven community screenings and three community stroke education presentations in East San Diego County. A total of 155 patients participated in stroke screenings and education was provided to an additional 530 people at educational programs and health fairs. The events were held at the Sharp Grossmont Senior Resource Center; East County Senior Health Fair; Super Saturday Health Fair at Grossmont Center; Lions, Tigers, and Bears Donor Recognition Day; and the Women's Health Fair at St. Peter's Chaldean Church. SGH provided education and advised behavior modification, including smoking cessation, weight reduction, and stress reduction for community members with health risk factors identified during the stroke screenings. In October 2009, SGH provided blood pressure screenings and stroke education at the Lakeside Fire Department Open House. Topics included signs and symptoms of stroke and the critical issue of contacting emergency responders/911. Nearly 200 community members attended the event. In addition, SGH provided an EMT training lecture during the event. In FY 2010, the SGH Outpatient Rehabilitation Department offered a stroke support group at no charge to participants. In addition, SGH actively participated in the quarterly San Diego County Stroke Consortium, a collaborative effort to improve San Diego County stroke care and discuss issues impacting stroke care in San Diego County. SGH also provided expert speakers on stroke and interventional radiology procedures at SGH's Vascular Symposium. FY 2011 Plan SGH Stroke Center will conduct the following: *Participate in stroke screening and education events in East San Diego County *Provide education for individuals with identified risk factors *Offer a stroke support group, in conjunction with the hospital's Outpatient Rehabilitation Department *Participate with other hospitals in San Diego County in the Stroke Consortium *Collaborate with the State of California to develop a Stroke Center Registry *Provide at least two physician speaking events around stroke care and prevention *Participate in SGH Vascular Conference for community physicians *Present a poster at the 2011 International Stroke Conference Identified Community Need: Heart and Vascular Disease Education and Screening -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Heart disease is the leading cause of death in San Diego County, as in the nation. Heart disease is a leading cause of premature disability among U.S. workers. CHIP members identified heart disease and stroke as the most important health issue for senior adults 65 years and older. *Vascular disease affects approximately 12 percent of the population in the U.S., but most people do not have symptoms. Among persons over age 55 years, 10 to 25 percent are affected. Those with vascular disease have a six-fold higher death rate due to cardiovascular disease than those without vascular disease. *On average, there were 679 deaths a year due to heart disease in the East Region during the three-year period from 2005 through 2007. In San Diego County, the age-adjusted death rate due to coronary heart disease during this period was 120.4 deaths per 100,000 population, lower than the HP 2010 target of 162.0 deaths per 100,000. *In 2005, there were 1,914 hospitalizations due to coronary heart disease in the East Region; a rate of 412.3 per 100,000 population. The hospitalization rate in the region was among the highest in San Diego County's regions and higher than the County average of 317.0 coronary heart disease hospitalizations per 100,000 population. In FY 2008, there were 172 coronary heart disease-related ED visits in the East Region. The rate of visits was 37.0 per 100,000 population. The coronary heart disease-related ED visit rate in the region was the highest of the regions with a County average of 26.3 per 100,000 population. *In 2007, 8.7 percent of adults in the East Region participating in the 2007 CHIS indicated that they were ever diagnosed with heart disease, higher than the County experience of 6.4 percent. *Participants in the 2007 Community Health Needs Assessment focus groups recognized the importance of various types of health screenings such as blood pressure checks, eating well, and lowering cholesterol in preventing disease. *Behavioral and social risk factors associated with heart disease and stroke deaths include overweight/obesity, poor nutrition, lack of physical activity, lack of appropriate medical care, smoking or tobacco smoke exposure, excessive alcohol consumption, and stressful circumstances. Intermediate outcomes associated with these conditions include high blood pressure, high cholesterol, diabetes, obesity, and cardiovascular disease, according to findings presented in the 2004 Community Health Needs Assessment. Measurable Objectives *Provide heart and vascular education and screening services for the community, with an emphasis on adults, women, and seniors. *Participate in programs to improve the care and outcomes of individuals with heart and vascular disease. FY 2010 Report of Activities Note: In FY 2010, SGH was recognized as a Blue Cross Blue Distinction Center for Cardiac Care for demonstrated expertise in delivering quality cardiac health care. SGH is also a recipient of the American Heart Association's GWTG Gold Performance Achievement Award for Coronary Artery Disease and Heart Failure. The American Heart Association's GWTG is a national effort focused on ensuring that evidence-based therapies are used with heart attack and congestive heart failure patients. SGH offered two community education lectures in September 2010 titled Vascular Disease Silent Killers, serving 94 people. In conjunction with the seminars, the vascular team provided 130 attendees with a complimentary Ankle Brachial Index (ABI) screening for peripheral arterial disease. Educational topics included risk factors for heart disease, lifestyle modifications to decrease risk factors for heart and vascular disease and various cardiac diagnoses, and treatment plans. There were also three congestive heart failure (CHF) classes held in FY 2010, serving 18 people. Topics of the CHF classes included exercise, nutrition, treatment plans, and symptoms. In addition, SGH's cardiac rehabilitation department served more than 400 community members through bimonthly cardiac education classes. In FY 2010, SGH's cardiac rehabilitation program participated in the Super Saturday Health Fair at Grossmont Center, as well as the Santee Senior Health Fair, serving a total of 118 community members. In addition, SGH offered cardiovascular disease preventative screenings from February 2010 through September 2010, serving 224 people. SGH's cardiac rehabilitation department also conducted five flu vaccination clinics for heart disease patients and high-risk adults serving 84 people, as well as a blood pressure screening day for Go Red for Women, which focused on women and recognition of heart disease risk, serving 54 people. In FY 2010, SGH provided expert speakers on heart disease and heart failure for various professional events, including SGH's Cardiac Symposium, and SGH's Vascular Symposium. In addition, SGH's cardiac rehabilitation department provided speakers for community lectures to the SGH Senior Resource Center (serving 24 people), as well as for Mended Hearts - an organization that provides support, services, and resources to heart patients through visiting programs, support group meetings, and educational forums. In FY 2010, SGH participated in several programs to improve the care and outcomes of individuals with heart and vascular disease. To assist in improving care for acutely ill patients in the County, SGH provided data on STEMI (ST Elevation myocardial infarction or acute heart attack) to San Diego County Emergency Medical Services (EMS). In addition, the hospital completed the second year of a National Institutes of Health (NIH) research study of premature heart disease in women age 55 and younger, known as VIRGO (Variation in Recovery: Role of Gender on Outcomes in Young AMI patients). In FY 2010, SGH successfully enrolled four patients and screened 19, with goals to complete enrollment in FY 2011. In FY 2010, SGH enrolled in the GWTG ACTION registry for heart attack patients, sponsored by the AHA and American College of Cardiology. FY 2011 Plan SGH will conduct the following: *Provide free bimonthly cardiac education classes *Provide three congestive heart failure education classes (complimentary) *Provide free community lectures on heart and vascular disease *Provide free cardiac education and/or screening events through participation in one to two community events such as health fairs and lectures *Provide weekly preventive vascular screenings with the addition of a cardiac screening *Provide a complimentary flu vaccination clinic to cardiac rehabilitation patients and other senior community members *Offer educational speakers to the professional community on topics such as performance improvements in CHF and acute myocardial infarction, as invited *Continue GWTG ACTION registry for heart failure patients, sponsored by the American Heart Association *Provide timely data on STEMI patients to San Diego County Emergency Medical Services *Enroll additional patients in the third and final year of the VIRGO observational research study conducted in conjunction with Yale University School of Medicine *Provide a continuing medical education conference on vascular disease for community physicians in November 2010 Identified Community Need: Cancer Education and Participation in Clinical Trials -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Cancer is the second leading cause of death in San Diego County, accounting for approximately a quarter of all deaths. *CHIP members identified cancer as the second most important health issue for two age groups - adults 25 to 64 years of age, and senior adults age 65 years and older. *On average, there were 826 deaths a year due to cancer (all sites) in the East Region during the three-year period from 2005 through 2007. In San Diego County, the age-adjusted death rate due to cancer during this period was 162.9 deaths per 100,000 population, failing to meet the HP 2010 target of 158.6 deaths per 100,000. *In 2007, 23 percent of all cancer deaths in the East Region were due to lung cancer, 7 percent to female breast cancer, 10 percent to colorectal cancer, 6 percent to prostate cancer, and less than 1 percent to cervical cancer. *Participants in the 2007 Community Health Needs Assessment focus groups recognized the importance of various types of cancer screenings, such as mammography, pap smears, and prostate examinations, in preventing disease. *Behavioral and social risk factors associated with cancer deaths include overweight/obesity, poor nutrition, lack of physical activity, lack of appropriate medical care, smoking or tobacco smoke exposure, exposure to carcinogens (e.g., radon, asbestos, and certain minerals), air pollution, and use of hormones or contraceptives, according to findings presented in the 2004 Community Health Needs Assessment. *Breast cancer patient navigation is an intervention that addresses barriers to quality standard care by providing individualized assistance to patients, cancer survivors, and their families. Measurable Objectives *Provide cancer education and support services to the community *Participate in cancer clinical trials, including screening and enrolling patients FY 2010 Report of Activities Note: The SGH Cancer Center is an accredited National Breast Center by the NAPBC. The NAPBC grants accreditation to only those centers that voluntarily commit to providing the best possible care to patients with diseases of the breast. In FY 2010, SGH Cancer Center participated in community cancer educational sessions. These events served more than 550 community members, and included East County Senior Service Provider Health Event; It's How We Live Festival; Power Shop for the Cure at Grossmont Center; East County Health Fair at Santee Trolley Station; Learn and Live Events for Breast, Colon and Prostate Cancer; Philanthropic Educational Organization (PEO) Women's Group Breast Cancer Talk; Waterford Terrace Senior Citizen Health Fair; Super Saturday Health Fair at Grossmont Center; and the Chaldean Women's Health Fair. Cancer Center employees also supported the following events: ACS Making Strides Against Breast Cancer Walk and the Susan G. Komen Race for the Cure in Balboa Park. In addition, staff served as health and science project judges for 15 student projects at the San Diego Science Fair. SGH Cancer Center continued to offer support programs for cancer patients, including the Cancer Center's breast cancer support group meetings. These meetings were held twice per month at no cost to participants, with an average attendance of 12 to 15 community members. In addition, the Look Good..Feel Better program provided quarterly classes to approximately 10 participants. In addition, SGH continued its Breast Health Navigator program, where an RN certified in breast health personally assists breast cancer patients in their navigation of the health care system, offering support, guidance, and connection to community resources. The Breast Health Navigator also played an active role in community education, providing presentations and educational resources about breast cancer, mammography guidelines, and early detection, at no charge to the San Diego community. During pre-lecture educational booths at free physician lectures such as Breast Cancer Awareness, the Navigator provided breast lump models, demonstrated breast self-exam technique and answered questions regarding breast health among community attendees. Through a variety of health fairs, educational presentations, community lectures and events, the Breast Health Navigator reached nearly 500 community members and providers in FY 2010. In FY 2010, SGH Cancer Center screened approximately 100 patients for participation in cancer clinical trials, and enrolled approximately 30 patients in cancer research studies. In addition, the SGH Cancer Center trained two California State University, Long Beach Bachelor of Science in Health Science students specializing in Radiation Therapy for 32 hours weekly for one semester each. FY 2011 Plan SGH Cancer Center will conduct the following: *Provide biweekly breast cancer support groups to participants at no charge *Provide free six- to eight-week Children's Lives Include Moments of Bravery (CLIMB) course for children ages 6 and older whose parents or grandparents have cancer *Provide quarterly Look Good..Feel Better classes *Continue to provide Breast Health Navigation, ongoing personalized education and information, support, and guidance to breast cancer patients and their loved ones as they move through the continuum of care *Coordinate a Power Shop for the Cure event to support the SGH Breast Health Navigator Program *Screen and enroll oncology patients in clinical trials for research studies *Provide educational lectures to the community on leading forms of cancer and radiation oncology treatment options *Provide educational information on cancers and available treatments by participating in health fairs and events with demonstrations on breast self-exams Identified Community Need: Diabetes Education and Testing -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *CHIP members identified diabetes as the third most important health issue overall as well as an important health issue among the four established age groups (0-14, 15-24, 25-64, and ages 65 and older). *On average, there were 122 deaths a year due to diabetes in the East Region during the three-year period from 2005 through 2007. In San Diego County, the age-adjusted death rate due to diabetes during this period was 20.0 deaths per 100,000 population. (Note: Diabetes is also a contributing cause of death.) *In 2008, there were 870 hospitalizations due to diabetes in the East Region; the rate of hospitalizations for diabetes was 187.4 per 100,000 population. The hospitalization rate in the region was the highest in San Diego County's regions and higher than the County average of 126.2 diabetes hospitalizations per 100,000 population. *In FY 2008, there were 680 diabetes-related ED visits in the East Region. The rate of visits was 146.5 per 100,000 population. The diabetes-related ED visit rate in the region was among the highest in San Diego County's regions and higher than the County average of 136.7 per 100,000 population. *In 2007, 5.8 percent of adults in the East Region participating in the 2007 CHIS indicated that they were ever diagnosed with diabetes. The rate was one of the lowest among San Diego County's regions and lower than the County experience of 6.3 percent of adults. The HP 2010 objective is to reduce the overall rate of diabetes to 2.5 cases per 100 population. *Behavioral and social risk factors associated with diabetes include lack of physical activity, poor nutrition, tobacco use, and lack of appropriate medical care. Other environmental risk factors include race/ethnicity, genetics and family history, poverty, and age greater than 45 years, according to findings presented in the 2004 Community Health Needs Assessment. Measurable Objective *Provide diabetes education and testing in the East Region of San Diego County. FY 2010 Report of Activities SGH Diabetes Education Program is recognized by the American Diabetes Association and meets national standards for excellence and quality in diabetes education. In FY 2010, the SGH Diabetes Education Program conducted three community educational lectures and 10 blood glucose screening events at hospital and offsite locations, testing 673 people. As a result of these screenings 121 people were identified with elevated blood glucose levels. Screening events were located throughout San Diego's East County, including: Waterford Terrace in La Mesa; San Carlos Baptist Church; the 11th Annual Senior Health Fair at the Santee Trolley Square; SGH Health Fair; Lions, Tigers and Bears Animal Rescue Health Fair in Alpine; Chaldean Community Health Fair at St. Peter Chaldean Cathedral; and the 12th Annual Native American Men's and Women's Wellness Conference in Lakeside. SGH's Diabetes Education Program conducted community lectures on diabetes at libraries, community centers, educational institutions, national conferences, and other hospitals. In addition, the SRS Diabetes Education Program conducted a screening event at the Vista Promotoras at Cuymaca College, and a Meet the Pharmacist event at the McGrath Family YMCA in Rancho San Diego, screening a total of 54 community members at these events. As a result of these screenings, 18 people were identified with elevated blood glucose levels. SGH's Diabetes Education Program conducted educational seminars for health care professionals on management of diabetes in hospitalized patients and outpatients and other topics, including prevention of diabetic heart disease, diabetes and renal failure, and the impacts of sleep disturbances and obesity on diabetics. In FY 2010, SGH's Diabetes Education Program provided targeted outreach to the newly immigrated Iraqi Chaldean population in San Diego. The program facilitated translation, as well as provided materials and resources to better understand the cultural needs of this newly immigrated population. The resources provided included an information binder on topics such as: How to Live Healthy with Diabetes; What You Need to Know About Diabetes; All About Blood Glucose for People with Type II Diabetes; All About Carbohydrate Counting; Getting the Very Best Care For Your Diabetes; All About Insulin Resistance; and All About Physical Activity with Diabetes. Handouts were provided in Arabic, Somali, Tagalog, and Vietnamese. Education was also provided to staff members regarding the different cultural needs of these populations. SGH's Diabetes program also provided outreach to the Native American population - a population targeted for having an increased risk of diabetes - at Barona Indian Reservation. FY 2011 Plan The SGH Diabetes Education Program will conduct the following: *Coordinate and implement blood glucose screenings at community and hospital sites in the East Region *Conduct educational lectures at various community venues *Support the American Diabetes Association - Step Out for Diabetes Walk *Continue to collaborate with the Diabetes Behavioral Institute to host community lectures that will assist diabetes patients and their loved ones *Conduct educational symposiums for health care professionals *Explore additional opportunities for culturally competent diabetes education and/or outreach to newly immigrated populations *Continue to provide lectures to multicultural elementary students that focus on healthy diets and weight management Identified Community Need: Outreach for Flu Vaccinations -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Pneumonia and influenza ranked as the ninth leading cause of death in San Diego County. *On average, there were 60 deaths a year in the East Region due to pneumonia and influenza during the three-year period from 2006 through 2008. In San Diego County, the age-adjusted death rate due to pneumonia and influenza during this period was 12.2 deaths per 100,000 population. *In San Diego County, an estimated 72 percent of seniors 65 years and older were vaccinated for influenza in 2007, failing to meet the HP 2010 target of at least 90 percent of adults 65 years and older vaccinated annually for influenza. *Participants in the 2007 Community Health Needs Assessment focus groups recognized the importance of flu vaccinations in preventing disease. *The CDC recommends annual vaccination against influenza for the following: people age 50 years and older, adults and children with a chronic health condition, children age 6 months up to their 19th birthday, pregnant women, people who live in nursing homes and other long-term care facilities, and people who live with or care for those at high risk for complications from flu, including: health care workers, household contacts of persons at high risk for complications from the flu, and household contacts and caregivers of children younger than 5 years of age. *Flu clinics offered in community settings at no/low cost improve access for those who may experience transportation, cost, or other barriers. Measurable Objectives *In collaboration with community partners, offer seasonal flu vaccination clinics at convenient locations for seniors and high-risk adults in the community. *Provide information at the seasonal flu clinics about other Senior Resource Center programs and other health education materials. FY 2010 Report of Activities In FY 2010, SGH's Senior Resource Center participated in the San Diego Immunization Coalition to educate high-risk adults about the importance of seasonal flu immunizations and to organize seasonal flu clinics at convenient locations for seniors and high-risk adults. SGH's Senior Resource Center coordinated notification of availability and provision of seasonal flu vaccines in selected community settings through activity reminders, newspaper notices, the HHSA Immunization Branch website, 211 San Diego telephone hotline, AIS, and through additional channels at the HHSA. The SGH Senior Resource Center provided 1,302 seasonal flu vaccinations at 19 community sites to high-risk adults with limited access to health care resources, including seniors and those with chronic illnesses. Sites included senior centers, mobile home parks, senior housing complexes, and various hospital departments. At these community sites, SGH provided activities calendars for the Senior Resource Center detailing upcoming community events, including blood pressure clinics, community senior programs, and Project CARE. FY 2011 Plan The SGH Senior Resource Center will conduct the following: *Participate in the San Diego County Immunization Coalition, working to identify sites to provide seasonal flu immunizations to high-risk adults *Work with community agencies to ensure seasonal flu immunizations are offered at sites convenient to seniors and chronically ill adults *Provide seasonal flu vaccinations at 16 community sites for seniors with limited mobility and access to transportation as well as high-risk adults, including low-income, minority, and refugee populations *Coordinate the notification of seniors regarding the availability of seasonal flu vaccines and the provision of seasonal flu vaccines to high-risk individuals in select community settings *Direct seniors and other chronically ill adults to available seasonal flu clinics, including physicians' offices, pharmacies, and public health centers Identified Community Need: Health Education and Screening for Seniors -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *CHIP members identified heart disease and stroke, cancer, diabetes, arthritis, overweight and obesity, and chronic respiratory disease as the top six health issues facing seniors age 65 years and older. *In 2006, the top 10 leading causes of death among senior adults age 65 years and older in San Diego County were: heart disease, cancer, Alzheimer's disease, stroke, chronic lower respiratory diseases, diabetes, influenza and pneumonia, unintentional injuries, hypertension and hypertensive renal disease, and Parkinson's disease. *In 2008, rates of hospitalization among senior adults age 65 years and older in San Diego County were higher than the general population due to: coronary heart disease, cancer, stroke, diabetes, chronic lower respiratory diseases, non-fatal unintentional injuries (including falls), and arthritis and dorsopathy (diseases of the spine). *In FY 2008, the top causes of ED utilization among persons age 65 years and older were falls, arthritis, chronic lower respiratory diseases, diabetes, and stroke. *All 15 seniors participating in a 2007 Community Health Needs Assessment focus group reported having some type of medical insurance, including Medicare, Medi-Cal, VA coverage, or a private health insurance plan. *Older adults consume more ambulatory care, hospital services, nursing home services, and home health services than young people. *There are an estimated 4 million family caregivers in California today, according to the California Caregiver Resource Center. Whether aging Californians live in their own homes, with a relative, in an assisted-living residential facility, or in a nursing home, one of the keys to their care is family caregiving - defined as those family members and informal care providers who assist with the care of disabled elderly relatives. Reaching out to families and community members who are caring for an older adults helps to maintain the health of older adults as well as their caregivers. *Project CARE is a cooperative safety net designed to ensure the well-being and independence of older persons and persons with disabilities in the community, according to Project CARE of San Diego County. Through its component services, Project CARE helps people live independently in their homes. The East Region autonomously administers a local Project CARE site, located at SGH's Senior Resource Center, to meet its unique needs. Measurable Objectives *Host a variety of senior health education and screening programs *Produce calendars of activities four times a year. *Act as lead agency for East County Project CARE, a community service program that helps seniors stay in their homes. FY 2010 Report of Activities In FY 2010, the SGH Senior Resource Center provided free health education programs (1,244 people attended) and health screenings (594 people screened). Health education topics included: hearing, stroke, heart health and vascular disease, osteoporosis, hip replacement, weight loss, diabetes, senior services, Vial of Life, Advance Directives for Health Care, financial issues, memory loss, caregiver resources, end-of-life issues, Medicare, and urinary incontinence. Educational programs were offered at the hospital campus, the Grossmont Healthcare District Conference Center, and in various communities in East County. In addition, the hospital offered free monthly blood pressure screenings at community sites, along with six balance/fall prevention screenings, and four hand screenings. The hospital also offered health screenings for depression, lung function, hearing, peripheral artery disease, vascular disease, carotid artery disease, and abdominal aortic disease. From these screenings, 26 attendees with abnormal results were referred to physicians for follow-up. In addition, the hospital provided education for seniors on how to communicate with their providers, as well as education for caregivers. Calendars highlighting SGH's Senior Resource Center activities were mailed four times a year to approximately 7,000 households. The hospital distributed 600 Advance Directives for Health Care, as well as 1,850 Vials of Life, which provide important medical information to emergency personnel for seniors and disabled people living in their homes. Project CARE is a community program that includes the County's AIS, Jewish Family Services, San Diego Gas & Electric, local senior centers, sheriff and police, and many others. The Senior Resource Center provided daily computerized phone calls - at regularly scheduled times selected by participants - to an average of 40 East County seniors who live alone. A total of 10,760 phone calls were placed to seniors or disabled individuals in FY 2010. Staff completed 234 follow-up phone calls with friends or neighbors to ensure participants were okay if they were unable to reach the participants at home. With the help of the Project CARE program, three seniors - two stroke victims and one senior with a failure to thrive - were located in distress and brought to their local hospital for treatment during FY 2010. In May 2010, the Senior Resource Center partnered with the Arthritis Foundation to host the East County Arthritis Expo at the Grossmont Healthcare District that featured speakers on medications, exercise, and alternative treatments; 75 participants attended this event. In collaboration with the San Diego Caregiver Coalition, the Senior Resource Center provided a Caregiver Conference at the Foothillls United Methodist Church in La Mesa for 94 family caregivers, focusing on emotional issues, physical aspects of care giving, and community resources. The Senior Resource Center coordinated an end-of-life conference with Sharp HospiceCare - serving 109 individuals - including information on advance directives, end-of-life issues, and conversations with loved ones. The Senior Resource Center also participated in health fairs in Lakeside, Santee, La Mesa, and San Diego. In addition, the Senior Resource Center assisted in the planning and coordination of a Meet the Pharmacist event at the Rancho San Diego YMCA, serving 50 community members. The Senior Resource Center also participated in the AIS Aging Summit, which focused on the use of technology to support healthy aging and provided education to approximately 2,000 attendees. In FY 2010, the Senior Resource Center maintained active relationships with organizations serving seniors, enhancing networking among East County professionals and providing quality programming for seniors. These organizations included AIS (Project CARE, Health Promotion Committee, and Caregiver Coalition), East County Senior Service Providers, Meals-on-Wheels Greater San Diego, and the San Diego Immunization Coalition. The SGH Senior Resource Center also enhanced its educational resources on the Sharp.com website with the addition of monthly Healthy Aging podcast segments. Audio and video presentations offered important public information on fall prevention, maintaining brain health, advance directives, caregiving for older adults, and exercises to help seniors live a healthy and independent life. These podcasts were made possible by a grant from the PacifiCare/United Healthcare Charitable Commitment Program. FY 2011 Plan SGH's Senior Resource Center will conduct the following activities: *Provide resources at the Senior Resource Center to address relevant concerns of seniors, including health information and community resources through educational programs, monthly blood pressure clinics, and four to eight health screenings annually *Utilize Sharp experts in the field for 12 seminars per year that focus on issues of concern to seniors *Maintain daily contact through phone calls with individuals (many are home bound) in rural and suburban settings who are at risk for injury or illness, and continue supporting Project CARE services for the East County community *Participate in six community health fairs and special events targeting seniors *Coordinate two conferences - one dedicated to family caregiver issues in collaboration with San Diego Caregiver Coalition and one focused on end-of-life issues in collaboration with Sharp HospiceCare *Produce and distribute quarterly calendars highlighting events of interest to seniors and family caregivers *Provide 3,000 Vials of Life to seniors *Present an Advanced Directives and Health Care Decisions program to inform seniors about advance directives and other necessary documents available to communicate their end-of-life wishes Identified Community Need: Prevention of Unintentional Injuries -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Unintentional injuries - motor-vehicle crashes, drowning, poisoning, recreational and sports-related injuries, burns, choking, falls, unintentional shootings, and suffocation - are the leading cause of death for individuals under the age of 45 nationally and the sixth leading cause of death overall in San Diego County. *CHIP members identified injury and violence prevention as the fifth most important health issue overall, as well as an important health issue among each of the four established age groups (0-14, 15-24, 25-64, and ages 65 and older). *On average, there were 147 unintentional injury deaths a year in the East Region during the three-year period from 2005 through 2007. In San Diego County, the age-adjusted death rate due to unintentional injuries during this period was 29.6 deaths per 100,000 population, higher than the HP 2010 target of 17.1 deaths per 100,000. *In FY 2008, there were 25,466 unintentional injury-related ED visits in the East Region. The rate of visits was 5,485.3 per 100,000 population. The unintentional injury-related ED visit rate in the region was the highest among San Diego County's regions and higher than the County average of 4,764.4 per 100,000 population. *Behavioral and social risk factors associated with motor-vehicle-related deaths among individuals age 15 to 24 years include substance abuse, unsafe and inexperienced driving, nighttime driving, and failure to use seat belts, according to the findings presented in the 2004 Community Health Needs Assessment. Environmental methods of prevention, such as use of helmets while participating in sports activities, or operating motorcycles or bicycles; mandatory fencing around swimming pools; and child safety caps on medications, pesticides and home-cleaning chemicals, have been shown to be extremely effective in reducing deaths due to unintentional injuries. Educational efforts, teaching safety and violence prevention, are also known to effectively reduce injuries and fatalities. Measurable Objective *To offer an injury and violence prevention program for children, adolescents, and young adults throughout San Diego County. FY 2010 Report of Activities In FY 2010, ThinkFirst/Sharp on Survival participated in 49 programs at elementary, middle, and high schools in East County, serving 2,843 students. During these one- to two-hour classes, students learned about modes of injury, the anatomy and physiology of the brain and spinal cord, and disability awareness. They also heard personal testimonies from individuals, known as Voices for Injury Prevention (VIPs), with traumatic brain or spinal cord injuries. In addition, due to funding changes, ThinkFirst/Sharp on Survival offered schools multiple opportunities for learning. Schools were provided with a variety of lesson plans to choose from, including information on physical rehabilitation, careers in health care, and disability awareness panels to meet the needs of specific class curricula. On a regular basis, ThinkFirst/Sharp on Survival speaks to at-risk youth about the consequences of violence, gangs, reckless driving, and making poor choices. In addition, ThinkFirst/Sharp on Survival provided free helmet fittings in FY 2010 for 36 children attending the Canyon Rim Children's Center, a local day care facility. More than 50 percent of the students had helmets that did not fit them properly. Written information was also handed out to the parents of these children on proper fit. ThinkFirst/Sharp on Survival participated in four community events, serving 950 people. Community events included presentations for youth and their parents at health- and safety-related fairs and community groups. Additionally, over the course of two events - held in the fall and spring - 350 college students enrolled in SDSU's Disability in Society course benefited from receiving injury prevention education and learning about brain injury, spinal cord injury, and disability awareness. In addition, ThinkFirst/Sharp on Survival provided proper helmet fitting and booster seat education for the El Cajon Fire Department Safety Fair and Open House in October 2009, serving 300 people. ThinkFirst/Sharp on Survival also presented to a local Boy Scout troop of five adolescents, helping them earn a merit badge. FY 2011 Plan ThinkFirst/Sharp on Survival will do the following: *With funding support from grants, provide educational programming for local schools *With funding support from grants, increase community awareness of the program through attendance and participation at community events and health fairs *Continue to evolve program curricula to meet the needs of Health Career Pathway classes *Explore program curricula to meet the needs of AVID (Advancement via Individual Determination) classes in the Grossmont Unified High School District Identified Community Need: Special support services for hospice patients and their loved ones, and the community -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *A 2004 Journal of the American Medical Association (JAMA) study (Source: JAMA January 7, 2004) titled, Quality of End-of-Life Care and Last Place of Care," looked at 1,578 family members of people who died in the year 2000 of non-traumatic causes. Families were asked about the quality of patients' experiences at the last place where they spent more than 48 hours. Significant findings of the study include: More than one-third of those cared for by nursing homes, hospitals, and home health agencies reported either insufficient or problematic emotional support for the patient and/or family, compared to one-fifth of those in hospice. *As patients and their loved ones deal with death and dying, many experience intense grief over the loss of life, yet have the opportunity to experience a profound transformation. A hospice model - combining medical, spiritual, emotional, and other support services - can offer many patients and their families assistance, information, and strategies related to bereavement, grief, and healing. Measurable Objective *Provide counseling and support, education, and referral services to hospice patients and their loved ones, and to the community in San Diego County FY 2010 Report of Activities Sharp HospiceCare serves patients and their loved ones through a hospice model of care. In FY 2010, key services included: individual and family bereavement counseling and support, volunteer training programs, the Memory Bear Program, and community education and referral services. Below are some FY 2010 highlights of these. Using a flexible approach, Sharp HospiceCare offered a variety of bereavement service options, including professional bereavement counseling through individual/family and group therapy, education, support groups, and monthly newsletter mailings. In FY 2010, Sharp HospiceCare devoted more than 1,300 hours to home, office, and phone contacts made to patients and their loved ones, providing them with pre-bereavement and bereavement counseling services by professionals with specific training in grief and loss. In FY 2010, 14 bereavement support groups were provided free of charge, serving 224 participants. The various groups were facilitated by skilled mental health care professionals who specialize in the needs of the bereaved. A unique event entitled Healing Through the Holidays served 111 adults at five locations with presentations on coping with grief during the holiday season, spirituality during the holidays, and a family's grief journey through the holidays. In addition, a one-day women's retreat that focused on nourishing the mind, body, and spirit was held at the La Jolla Inn and attended by 38 community members. In further support of bereavement counseling, 1,377 people received 13 monthly issues of the bereavement support newsletter, Healing Through Grief, (for adults) and Journey to My Heart (for children under 12 years). In addition, Sharp HospiceCare bereavement counselors provided referrals to needed community services including ongoing mental health services, financial assistance, child protective services, drug and alcohol counseling, parent education courses, and anger management. Sharp HospiceCare provided extensive training for 85 new volunteers in FY 2010. Potential volunteers undergo a rigorous 40-hour training program to confirm their understanding of and commitment to hospice care. Including both new and returning volunteers, over 200 individuals served as Sharp HospiceCare volunteers during the past fiscal year. As part of the hospice interdisciplinary team, volunteers provided services through direct patient care as well as clerical and administrative support, devoting 6,745 hours in total to this project. In addition, volunteers acted as informal spokespeople in churches, groups, clubs, and other organizations, encouraging others to complete pre-planning for Durable Power of Attorney for Health Care and financial arrangements. In addition, Sharp HospiceCare coordinated a volunteer-run wig donation program that is open to community members who have suffered hair loss. The Sharp HospiceCare program supported volunteers with a volunteer support group (offered monthly) and recognition during National Volunteer Month and National Hospice Month. In addition, Sharp HospiceCare provided training and supervision to 13 premedical students through the Pre-Professional Program at SDSU during FY 2010. The Sharp HospiceCare Teen Volunteer Program trained 11 high school age teens (14 to 18 years old) during FY 2010. The teen program's special interest is in helping to create family videos, however, teens are also assigned special projects in the office or patient assignments at LakeView and ParkView homes. Sharp HospiceCare also hosted two interns from San Diego Metropolitan Regional & Technical High School during FY 2010. Students spent one six-hour shift per week in Sharp HospiceCare's administrative office, and another six-hour shift in a Sharp HospiceCare home. These students experienced hospice care through case conferences, interdisciplinary team (IDT) meetings, and a variety of other tasks. The Memory Bear Program, a component of the Volunteer Program, provides a unique keepsake for loved ones by making teddy bears from garments of the family member who has passed on. For surviving family members, these bears become permanent reminders of their loved ones. Sharp HospiceCare volunteers, who handcraft all bears stitch by stitch, devoted more than 5,000 hours to craft approximately 900 bears for nearly 300 families during FY 2010. In FY 2010, Sharp HospiceCare provided community and physician education for approximately 980 people. Topics included: end-of-life care and management; information about hospice; emergency response; the grieving process; hospice and dementia; hospice and depression; the importance of humor in hospice and end-of-life care; stress management and integrative therapies; pain management; death and dying; and hospice volunteer opportunities. In FY 2010, Sharp HospiceCare participated in multiple events and community forums at various sites throughout the San Diego community, including service clubs, senior centers, community centers, churches, libraries, colleges, and universities. In addition, Sharp HospiceCare - in collaboration with the SGH Senior Resource Center - provided three caregiver conferences throughout San Diego County. The conferences provided information on communicating end-of-life wishes, wills and trusts, spiritual planning, and advance care planning. Also in conjunction with the SGH Senior Resource Center, Sharp HospiceCare coordinated the End-of-Life Conference and offered resources on hospice care, financial planning, funeral planning, and advance care planning. In November 2009, Sharp HospiceCare hosted its fourth annual conference for San Diego end-of-life professionals entitled Mind, Body and Spirit - A Guide to End-of-Life Care. The conference - featuring a nationally renowned expert in grief and loss - provided 130 members of the health care community with education on the psychosocial, spiritual, emotional, and physical needs of patients at the end of life. Through the provision of practical methods for integration into their daily work, conference attendees received tools to minimize compassion burnout, and increase their job satisfaction and sense of well-being. In conjunction with the SGH Senior Resource Center, Sharp HospiceCare also participated in the AIS Aging Summit, which focused on technology and healthy aging. Sharp HospiceCare presented to more than 200 people at both local and national conferences, including the National Hospice and Palliative Care Association and the California Hospice and Palliative Care Association. Topics included management and leadership as well as the continuum of care. In addition, Sharp HospiceCare served as a training site for more than 100 nursing students as well as a social work student from the University of Oklahoma and Point Loma Nazarene University in FY 2010. Students partnered with Sharp HospiceCare case managers and staff during home visits, skilled nursing facility site visits, and supporting activities at LakeView and ParkView homes. FY 2011 Plan Sharp HospiceCare will do the following: *Offer individual and family bereavement counseling and support groups *Provide 13 bereavement mailings *Provide volunteer training programs for at least 75 adults and teens *Offer a Memory Bear program to serve 300 families *Conduct community education and referral services *Conduct monthly outreach activities to service clubs, community centers, churches, senior centers, health care facilities, colleges, and universities *Provide a National Hospice Month End-of-Life Conference in November *Continue to provide professional education on hospice-related topics to community providers *Continue to provide training opportunities for nursing students and interns Identified Community Need: Collaboration with Local Schools to Promote Interest in Health Care Careers -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *The demand for registered nurses and other health care personnel in the United States will continue to rise with the growing health care needs of the 78 million baby boomers that will begin to retire in 2010. The DHHS estimates that by 2020, there will be a need for 2.8 million nurses, 1 million more than the projected supply. In 2008, the U.S. Department of Labor ranked RN as the occupation with the highest demand rate. According to the CHA, San Diego County will face a significant shortage of RNs over the next 20 years; currently there is an estimated shortage of more than 2,000 nurses in the County. *The Department of Labor reports that allied health professions represent about 60 percent of the American health care work force and projects severe shortages of many allied health care professionals. Areas of particular need include technicians in respiratory therapy, radiology, and clinical laboratory. *There is a growing demand for health care workers who are sensitive to languages and cultures to improve access to care and health outcomes, and reduce disparities in health status. *According to the San Diego Workforce Partnership 2006 report titled, "San Diego's Health Care Sector: A Prescription for Strength," the health care sector is predicted to grow 23 percent between 2004 and 2013 in San Diego. Despite the expected growth, the challenge becomes filling open positions with qualified candidates. Projected shortfalls continue to increase as the population ages, current health care professionals approach retirement, and educational programs in the health care field remain inadequate to serve the demand. *One recommendation from the San Diego Workforce Partnership is the continued expansion of high school academies as a vehicle to encourage interest in the field. Measurable Objective *In collaboration with local schools, offer opportunities for students to explore a vast array of health care professions. FY 2010 Report of Activities In collaboration with Grossmont Union High School District, SGH participated in the Health-careers Exploration Summer Institute (HESI), providing 24 students with opportunities for classroom instruction, job shadowing observations, and limited hands-on experiences in hospital departments. At the conclusion of the Institute, students presented their experiences as case studies to family members, educators, and hospital staff; those completing the program received high school credits equal to two summer school sessions. In FY 2010, SGH expanded its student participation in the HSHMC program and provided early professional development for 199 students from a broad array of backgrounds in grades nine through 12. Students spent a total of approximately 90,000 hours with an estimated 50 health professionals in 33 different departments and nursing areas, and were in direct contact with health care professionals throughout the hospital. During each 16-week period, students were supervised in different levels of the HSHMC program as they rotated through instructional pods in areas such as nursing, obstetrics, occupational and physical therapy, behavioral health, SICU, MICU, imaging, rehabilitation, laboratory, pharmacy, pulmonary, cardiac services, and food services. Level I of the HSHMC program is the entry level for all students and is conducted over a 16-week period. Level I students - for FY 2010 , 64 ninth graders - shadow primarily in non-nursing areas of the hospital, including physical therapy, food services, laboratory, cardiac services, imaging, physician offices, pulmonary, pharmacy, and radiation therapy. Level II of the HSHMC program offers patient interaction, where students are trained in Tender Loving Care (TLC) functions and then paired with a Certified Nursing Assistant (CNA) on nursing floors. Students assisted the CNA with patient ambulation, personal hygiene, etc. In FY 2010, 60 10th graders, 60 11th graders and 15 12th graders participated in the Level II TLC program, experiencing college-level clinical rotations, hands-on experience, TLC function patient care, and mentoring. Students were placed in a new assignment every four to six weeks for a variety of patient care experiences, and also took additional health-related coursework at Mesa College, including Anatomy, Physiology, and Human Behavior courses. In addition, SGH staff provided HSHMC students instruction on educational requirements, career ladder development, and job requirements. At the end of the academic year, SGH staff provided HSHMC students, their loved ones, community leaders, and hospital mentors a symposium that showcased the lessons learned throughout the program. FY 2011 Plan SGH will do the following: *In collaboration with Grossmont Union High School District, participate in the HESI *Introduce the First Touch program - the process of making a personal connection with patients before beginning clinical activities - into the curriculum for students as part of the TLC function *Track and report outcomes of HSHMC students and graduates Identified Community Need: Women's and Prenatal Health Services and Education -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *According to a 2006 report by the CDC, progress in the United States to improve pregnancy outcomes - including low birth weight, premature birth, and infant mortality - has slowed, in part because of inconsistent delivery and implementation of interventions before pregnancy to detect, treat, and help women modify behaviors, health conditions, and risk factors that contribute to adverse maternal and infant outcomes. *Between 2005 and 2008, mothers in San Diego County beginning their prenatal care during their first trimester decreased from 87.2 percent to 81.3 percent, a 5.9 percent decrease. This is still well below the HP 2010 goal of 90 percent. *According to the CDC, maternal health conditions that are not addressed before a pregnancy can lead to complications for the mother and the infant. Several health-related factors known to cause adverse pregnancy outcomes include: uncontrolled diabetes around the time of conception, maternal obesity, maternal smoking during pregnancy, and maternal deficiency of folic acid. *Women who deliver prematurely, experience repeated miscarriages, or develop gestational diabetes are at increased risk of complications with subsequent pregnancies, according to the CDC. *According to the CDC, only 30 percent of women ages 18 years and older engage in regular leisure-time physical activity (CDC, 2008). *Nationally, 35 percent of women ages 20 and older are obese, and 30 percent of these women have hypertension (CDC, 2003-2006). *Data from the 2005 CHIS indicate that only 38.6 percent of San Diego County women ages 18 to 65 consume the recommended five or more servings of fruits and vegetables daily. *Only 18.1 percent of San Diego County adult women (ages 18 to 65) engage in moderate physical activity and 16.9 percent of adult women participate in vigorous physical activity (CHIS, 2007). Measurable Objectives *Conduct outreach and education activities for women on a variety of health topics as well as prenatal care and parenting skills. *Collaborate with community organizations to help raise awareness of women's health issues and services, as well as to provide low-income and underserved women in the San Diego community with critical prenatal services. *Participate in professional associations related to women's services and prenatal health and disseminate research. FY 2010 Report of Activities In FY 2010, SGH offered five wellness and prevention-related community classes that addressed women's health topics. These classes reached a total of 445 women in FY 2010. The range of topics for these classes included information on heart health, prevention of osteoporosis and arthritis, managing menopause symptoms, and the ever-popular cooking demonstrations that offer tips on nutrition, cooking, and how to select local seasonal ingredients. SGH provided free breastfeeding support groups to the community twice per week, reaching approximately 20-25 participants per session. SGH also offered weekly post-partum depression support groups for women and families struggling with the challenges and adaptations of having a newborn. Additionally, SGH offered a daily free New Mother education class that covered topics such as childbirth, parenting, care safety, and infant nutrition. SGH also hosted community events in FY 2010, including the Learn and Live events for breast, colon, and prostate cancer. In collaboration with the SGH radiation oncology department, SGH provided resources, speakers, and informational booths to promote women's and men's health. SGH participated in and partnered with a number of community organizations and advisory boards, including the local Association of Women's Health, Obstetric, and Neonatal Nurses (AWHONN) chapter, WIC, the California Teratogen Information Service (CTIS), Partnership for Smoke-Free Families, the Breast Feeding Coalition Advisory Board, and the Public Health Nurse Advisory Board. In FY 2010, SGH presented a poster on infant security entitled How Safe Are Our Babies? A Community Hospital's Innovative Approach to Hardwiring Infant Security at the National AWHONN Conference. SGH's Women's Health Center's Prenatal Clinic midwives provided in-kind help at Neighborhood Health Centers El Cajon, Mountain Health Centers, Family Health Centers, and Lakeside community health clinics. The SGH Prenatal Clinic participated in the California Department of Public Health (CDPH) Comprehensive Perinatal Services Program (CPSP) to offer comprehensive pre-natal clinical and social services to low-income, low-literacy women with Medi-Cal benefits. Translation services were offered for non-English speaking women. Services provided included health education, nutritional guidance, and psychological/social issue support. As part of this effort, patients with nutrition issues were referred to an SGH registered dietician and the SGH Diabetes Center, as needed. In addition, the SGH Women's Health Center partnered with Vista Hill ParentCare to assist drug-addicted patients with psychological and social issues during pregnancy. These approaches have been shown to reduce both low-birth-weight rates and health care costs in women and infants. FY 2011 Plan *Provide wellness and prevention classes *Provide cooking and nutrition classes on eating and staying healthy *Provide free breastfeeding support groups *Provide parenting education classes *Participate in community events such as Learn and Live events for breast and colon cancer *Provide medical services to low-income patients through the prenatal clinic *Participate in the Sharp Speaking of Women's Health Event in November 2010 Identified Community Need: Orthopaedic / Osteoporosis Education and Screening -Rationale references the findings of the 2007 Community Health Needs Assessment or the most recent San Diego County community health statistics, unless otherwise indicated. Rationale *Arthritis is the leading cause of disability in the United States and is associated with high levels of activity limitation, work disability, reduced quality of life, and high health care costs. As the baby-boomer generation ages, the anticipated overall number of cases of arthritis and osteoporosis will increase dramatically (CDC 2006). *According to the NIH, osteoporosis is responsible for more than 1.5 million fractures each year, including: 250,000 wrist fractures, 300,000 hip fractures, 700,000 vertebral fractures, and 300,000 fractures at other sites. *In 2010, the overall prevalence of osteoporosis among adults ages 50 is projected to be 12 percent (DHHS 2004). *According to a Healthy People 2010 Progress Review released in 2006, osteoporosis is responsible for more than $14 billion in health care costs annually. *According to the 2007 Community Health Needs Assessment, in the U.S., the age-adjusted prevalence of doctor-diagnosed arthritis is estimated to be 21.3 percent among adults ages 18 and over. *According to the CDC, 70 percent to 85 percent of people report back pain at some time in their lives, making it the most frequent cause of activity limitation for persons under the age of 45, the second most common reason for physician visits, the fifth most common reason for hospitalizations, and the third most common reason for surgical procedures (HP 2010). *In 2003, the total U.S. cost for arthritis and other rheumatic conditions was $127 billion. *Between 2000 and 2005, arthritis-related conditions were the principle diagnosis for 42,736 hospitalizations, averaging 7,123 hospitalizations annually. *During FY 2005/2006, the rate of arthritis-related ED utilization in San Diego County was 364.2 per 100,000 population, age-adjusted. *Females had a higher discharge rate for arthritis-related diagnoses than males (399.7 and 325.2 per 100,000 population, respectively). African Americans had a higher discharge rate for arthritis-related diagnoses than persons of other racial or ethnic groups, and persons ages 65 and over had higher ED discharge rates for arthritis-related diagnoses than younger persons. Measurable Objective Provide education on orthopaedics and osteoporosis to the community, with an emphasis on seniors. FY 2010 Report of Activities In FY 2010, SGH offered eight educational sessions on arthritis and hip and knee problems to nearly 400 community members. Topics included management of arthritis and hip/knee repair and treatment. Sessions were held at the Grossmont Healthcare District Conference Center. Attendance ranged from nearly 30 to more than 70 individuals at each event. In May 2010, an Arthritis Expo was also held at SGH, in conjunction with the SGH Senior Resource Center, and was attended by 80 community members. SGH offered specialized education on osteoporosis prevention and treatment to the community. In May 2010, SGH provided education describing the risks of osteoporosis as well as treatment and prevention options to nearly 50 community members. Sharp physicians provided education on the pathology of osteoporosis and its impact on daily activities, as well as how exercise, nutrition, and proper posture and body mechanics contribute to prevention. In July 2010, as part of its Women's Healthy Hour series of talks on women's health issues, SGH offered an informative session entitled: Bone Health, Reducing Your Risk. During this session, nearly 100 community members received education and tips to maintain good bone health. FY 2011 Plan *Continue to offer orthopeaedic, arthritis, and osteoporosis educational presentations to the community *Collaborate with the California HealthCare Foundation to develop a California Joint Replacement Registry SGH Program and Service Highlights *24-hour emergency services with heliport and paramedic base station designated STEMI Center *Acute care *Ambulatory care services, including infusion therapy *Behavioral health unit *Breast Health Center, including mammography *Cardiac services, recognized by the American Heart Association GWTG *Cardiac Training Center *CT scan *David and Donna Long Center for Cancer Treatment *EEG and EKG *Endoscopy unit *Grossmont Plaza Outpatient Surgery Center *Group and art therapies *Home health *Home infusion therapy *Hospice *Hyperbaric treatment *ICU *LakeView Home *NICU *Orthopaedics *Outpatient diabetes services, recognized by the American Diabetes Association *Outpatient Imaging Centers *Laboratory services (inpatient and outpatient) *ParkView Home *Pathology services *Pediatric services *Pulmonary services *Radiology services *Rehabilitation Center *Robotic surgery *Senior Resource Center *Sleep Disorders Center *Spiritual Care services *Stroke Center *Surgical services *Transitional Care Unit *Van services *Vascular services *Women's Health Center *Wound Care Center Appendix A Sharp HealthCare Involvement in Community Organizations The list below shows the involvement Sharp executive leadership and other staff in community organizations and coalitions in Fiscal Year 2010. Community organizations are listed alphabetically. *211 San Diego Board *Academy of Medical-Surgical Nurses *ACS *AIS *Alzehimer's Association *American Association of Critical Care Nurses San Diego Chapter *American College of Healthcare Executives *American Diabetes Association *American Health Information Management Association *American Heart Association *American Hospital Association *ALA *American Psychiatric Nurses Association *American Red Cross of San Diego *Arthritis Foundation *Association for Ambulatory Behavioral Health Care (National) *Association for Ambulatory Behavioral Health Care of Southern California *Association for Clinical Pastoral Education *Association of California Nurse Leaders *AWHONN *BLCI *Boys and Girls Club of San Diego *Breast Feeding Coalition Advisory Board *Breast Health Coordinators *California Association of Health Plans *California Association of Medical Staff Services *California Association of Physician Groups *California Dietetic Association, Member Council *California HealthCare Foundation *California Hospice and Palliative Care Association *CHA *California Society of Health System Pharmacists *California State Bar, Health Subcommittee *California Teratogen Information Service *California Women Lead *CHIP Access to Care Committee *CHIP Access to Care Committee Health Literacy *CHIP Access to Care Gift of Health *CHIP Behavioral Health Work Team *CHIP Board *CHIP Health Literacy Task Force *CHIP Needs Assessment Committee *CHIP Public Policy Committee *CHIP Steering Committee *Chula Vista Chamber of Commerce *Chula Vista Community Collaborative *City of Chula Vista Wellness Program *City of Poway - Housing Commission *College Area Pregnancy Services *Community Emergency Response Team *Consortium for Nursing Excellence, San Diego *Coronado Chapter of Rotary International *Coronado Christmas Parade *Coronado Flower Show *Creative Arts Consortium *CWISH *Cycle Eastlake *Diabetes Behavioral Institute *Disabled Services Advisory Board *DOVIA *East County Senior Service Providers *Ecolife Foundation *El Cajon Rotary *Emergency Nurses Association, San Diego Chapter *Employee Assistance Program Association *Family Health Centers of San Diego *First Five Commission *Gay Men's Spiritual Retreat Board *Grossmont College *Grossmont Healthcare District *Grossmont Union High School District *Health Care Communicators Board *Healthcare Financial Management Association San Diego/Imperial Chapter *Hospital Association of San Diego and Imperial Counties *HSHMC Board *Huntington's Disease Society of America *Immunize San Diego Coalition *Institute of Internal Auditors San Diego Chapter Board *International Lactation Consultants Association *Kiwanis Club of Bonita *Komen Board *Komen Breast Cancer Coalition Committee *Komen Race for the Cure Committee *La Mesa Lion's Club *La Mesa Park and Recreation Finance Committee *La Mesa Park and Recreation Foundation Board *LEAD, San Diego, Inc. *Leukemia & Lymphoma Society *March of Dimes *Meals-on-Wheels East County *Medical Library Group of Southern California and Arizona *Mended Hearts *Mental Health America Board *Mental Health Coalition *Mesa College *Miracle Babies *Mountain Health and Community Services, Inc. Board *NAMI *NAMI Schizophrenics in Transition Board of Directors *NANN *National Association of Hispanic Nurses, San Diego Chapter *National Association of Psychiatric Healthcare Systems *National Foundation for Trauma Care *National Hospice and Palliative Care Association *National Kidney Foundation *National Ovarian Cancer Coalition *National Perinatal Information Center *National Trauma Foundation Board *Neighborhood Healthcare Community Clinic - Board of Directors *NurseWeek *Parents for Addiction, Treatment, and Healing *Partnership for Philanthropic Planning of San Diego (formerly San Diego Planned Giving Roundtable) *Partnership for Smoke-Free Families *Peninsula Shepherd Senior Center *Perinatal Social Work Cluster *Planetree Board of Directors *Planned Parenthood of San Diego and Imperial Counties *Port of San Diego Marketing Committee *Premier, Inc. HIT Collaborative *Premier, Inc. Medication Use Committee *Professional Oncology Network *Project CARE Council *Public Health Nurse Advisory Board *Recovery Innovations of California *Regional Perinatal System *Residential Care Council *SAFE Foundation *Safety Net Connect *San Diegans for Healthcare Coverage *San Diego Healthcare Disaster Council *San Diego Asian Film Festival Foundation *San Diego Association for Diabetes Educators *San Diego Association of Directors of Volunteer Services *San Diego Association for Healthcare Recruitment *San Diego Blood Bank *San Diego Brain Injury Foundation *San Diego Breastfeeding Coalition *San Diego Caregiver Coalition *San Diego Center for Patient Safety Task Force *San Diego Chapter of Rotary International *San Diego City Parks and Recreation *San Diego Committee on Employment of People with Disabilities *San Diego Council of Hospital Volunteers *San Diego County Pharmacists Association *San Diego County Safety Net Workgroup *San Diego County Social Services Advisory Board *San Diego County Taxpayer Association *San Diego Delta Leadership Academy *San Diego Diabetes Coalition *San Diego Dietetic Association Board *San Diego East County Chamber of Commerce Board *San Diego Emergency Medical Care Committee *San Diego Eye Bank *San Diego Foundation *San Diego Health Information Association *San Diego Healthcare Disaster Council *San Diego Immigrants Rights Consortium *San Diego Interreligious Committee *San Diego Mental Health Coalition *San Diego North Chamber of Commerce *San Diego Nutrition Council *San Diego Organization of Healthcare Leaders, a local ACHE Chapter *San Diego Patient Safety Consortium *San Diego Regional Energy Office *San Diego Regional Homecare Council *San Diego Restorative Justice Mediation Program *San Diego Society for Human Resource Management *San Diego Society of Hospital Pharmacists, California Society of Health System Pharmacists Chapter *San Diego Urban League *San Diego-Imperial Council of Hospital Volunteers *San Diego Regional Chamber of Commerce *Santee Chamber of Commerce *Santee-Lakeside Rotary *Schizophrenics in Transition *Scoliosis Research Society *SDCOI *SDSU *SDSU Nursing Evidence-Based Practice Institute *Senior Community Centers of San Diego *Serra Foundation *Sidney Kimmel Cancer Center *Sigma Theta Tau International Honor Society of Nursing *Society of Trauma Nurses *South Bay Community Services *South Bay Community Services, Baby First Program *South County Economic Development Council *South County Education Board and Policy Committee *Southern California Association of Neonatal Nurses *Southern California Society of Gastroenterology Nurses and Associates *Susan G. Komen Breast Cancer Foundation *SYHS *The Meeting Place Clubhouse *The Polinsky Center *Trauma Intervention Programs of San Diego County, Inc. *Trauma Managers Association of California *Union of Pan Asian Communities *United Behavioral Health Medical Credentials Committee *United Way of San Diego County *UCSD *Vista Hill ParentCare *Wellpoint/US Behavioral Health Clinical Advisory Board *WIC *YMCA *YWCA Board of Directors *YWCA Executive Committee *YWCA In the Company of Women Luncheon *YWCA TWIN Event Sharp HealthCare (SHC) 8695 Spectrum Center Blvd San Diego CA 921231489 956077327 Healthcare Organization CA 501 (c)(3) 3 SharpCare Sharp Memorial Hospital (SMH) 8695 Spectrum Center Blvd San Diego CA 921231489 953782169 Hospital CA 501 (c)(3) 3 Sharp HealthCare Sharp Chula Vista Medical Center (SCVMC) 8695 Spectrum Center Blvd San Diego CA 921231489 952367304 Hospital CA 501 (c)(3) 3 Sharp HealthCare Sharp HealthCare Foundation (SHF) 8695 Spectrum Center Blvd San Diego CA 921231489 953492461 Healthcare Foundation CA 501 (c)(3) 7 Sharp HealthCare Grossmont Hospital Foundation 8695 Spectrum Center Blvd San Diego CA 921231489 330124488 Hospital Foundation CA 501 (c)(3) 7 N/A Sharp Health Plan (SHP) 8695 Spectrum Center Blvd San Diego CA 921231489 330519730 Health Plan CA 501 (c)(4) N/A Sharp HealthCare Sharp Coronado Hospital and Healthcare Center 8695 Spectrum Center Blvd San Diego CA 921231489 950651579 Hospital CA 501 (c)(3) 3 Sharp HealthCare SharpCare 8695 Spectrum Center Blvd San Diego CA 921231489 611637133 Healthcare Organization CA 501 (c)(3) (pending) 3 N/A Grossmont Imaging LLC 7777 Alvarado Road Suite 108 La Mesa CA 91941 202655131 Diagnostic Imaging CA N/A Related 290084 1887677 0 1 Continuous Quality Insurance SPC PO Box 1092 Grand Cayman CJ Captive Insurance Company CJ N/A C 1 1 1 1 0 0 0 0 1 0 1 1 1 1 1 1 1 1 Sharp Memorial Hospital K 1061008 Sharp Memorial Hospital L 3966747 Sharp Memorial Hospital O 100980 Sharp Memorial Hospital Q 76385 Sharp Chula Vista Medical Center L 584819 Sharp Chula Vista Medical Center K 754094 Sharp Chula Vista Medical Center N 75276 Sharp Chula Vista Medical Center Q 95529 Sharp Coronado Hospital and Healthcare Center A 5164 Sharp Coronado Hospital and Healthcare Center D 135000 Sharp Coronado Hospital and Healthcare Center L 263915 Sharp Coronado Hospital and Healthcare Center K 70656 Grossmont Hospital Foundation P 903181 Grossmont Hospital Foundation C 3088850 Grossmont Hospital Foundation B 1139236 Grossmont Hospital Foundation M 57274 Sharp Health Plan K 472085