2024-08-15T13:36:19+00:00 2023-09-30 346565596 Ernst & Young US LLP 4365 Executive Drive Suite 1600 San Diego CA 92121 990 2022-10-01 330449527 Grossmont Hospital Corporation GROS 8584995150 8695 Spectrum Center Blvd San Diego CA 921231489 William S Evans SVP MARKET CEO 2024-08-15 false Debra Heiskala P00649485 8585357200 2022 2024-08-08 14:25:15Z Sharp Grossmont Hospital William S Evans 8695 Spectrum Center Blvd San Diego CA 921231489 1054258701 false X www.sharp.com X 1991 CA Grossmont Hospital provides inpatient and outpatient medical services to the community. 15 13 0 331 0 0 16755044 10999705 923202330 961615660 16873201 32968968 2760802 3349864 959591377 1008934197 574628 1344222 0 436764905 488776329 0 1378531 479437832 471838150 916777365 961958701 42814012 46975496 1328827177 1442867520 210933459 248560002 1117893718 1194307518 See Schedule O. false false 897104984 1344222 961615660 Grossmont Hospital provides inpatient and outpatient services to the community. Patient days were 145,039 and outpatient visits were 309,442 for the twelve months ended 9/30/23. See Community Benefit Report on Schedule O. 897104984 true true false true false false false false true true false false false true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true X 0 0 0 false false false false false false false false false false false false X 15 13 true false false false true true true true true false false true true true true true true true true true true CA X Jennifer Gardyne 8584995150 8695 Spectrum Center Blvd San Diego CA 92123 Christopher D Howard PRESIDENT & CEO SHC 2.0 50.0 X X 0 2581520 19123 Dee Ammon SECRETARY 1.0 1.0 X X 0 0 0 Randolph Lenac CHAIR 2.0 2.0 X X 0 0 0 Robert Ayres TREASURER 2.0 0 X X 0 0 0 Valerie Shadroff VICE CHAIR 1.0 0 X X 0 0 0 William S Evans SVP MARKET CEO 20.0 30.0 X X 0 1194031 22231 Brian Moore MD DIRECTOR 2.0 2.0 X 1656 231 0 Brittany Gardner DIRECTOR 2.0 0 X 0 0 0 Diane R Keltner DIRECTOR 1.0 0 X 0 0 0 John Fonseca DIRECTOR 1.0 1.0 X 0 0 0 Odie Goward DIRECTOR 1.0 0 X 0 0 0 Patricia Fortin DIRECTOR 1.0 0 X 0 0 0 Paul Abou MD DIRECTOR THRU 12/2022 1.0 0 X 52250 0 0 Ron Oberndorfer DIRECTOR 2.0 0 X 0 0 0 Shakeel Kazi DIRECTOR 2.0 0 X 0 0 0 Steve Allsing MD DIRECTOR AS OF 01/2023 2.0 0 X 60000 0 0 Daniel J Kindron CHIEF FINANCE-MARKET GROWTH OFFICER-SGH 40.0 0.0 X 0 344776 15463 Doug Watson SVP & CFO SHC AS OF 6/26/23 2.0 50.0 X 0 0 0 Rick L Grossman SVP GENERAL COUNSEL 3.0 50.0 X 0 1229363 10412 Staci L Dickerson SVP & CFO SHC THRU 07/01/2023 2.0 56.0 X 0 1334159 32943 Ali Zanial DIR PHARMACY GHC 50.0 0.0 X 0 313817 28978 Anthony Damico COO GHC 50.0 0.0 X 0 473640 32166 Jason Broad VP PERFORMANCE 30.0 20.0 X 0 300371 31449 Louise White VP PATIENT CARE GHC 50.0 1.0 X 0 420961 33814 Suzanne Johnson VP HOSPICE 40.0 0.0 X 0 342617 25674 Cathy Prante DIR PROF DVLPMNT/NURSING OPS 40.0 0.0 X 0 290977 29315 Lanie Outlaw LD CLINICAL NURSE 50.0 0.0 X 0 282316 36142 Marguerite Paradis DIR EMERG SVCS/CRITICAL CARE 40.0 0.0 X 0 299762 28818 Nancy Greengold CMO GHC 55.0 5.0 X 0 652850 27267 Patrick Guo LEAD MED RAD PHYSICIST 40.0 0.0 X 0 306750 21480 113906 10368141 395275 1454 false true true 0 8102294 2897411 9073 10999705 MEDICARE/MEDICAID 900099 477133047 477133047 NET PATIENT SERVICES 900099 431918932 431918932 SPECIALTY PHARMACY 900099 46379931 46379931 MEDICAL OFFICE LEASE 531120 3864434 3864434 OTHER PHARMACY 900099 1784407 1784407 534909 534909 0 0 961615660 14667540 14667540 0 0 63513413 112519 45320924 3580 18192489 108939 18301428 18301428 PARKING 812930 1265895 1265895 AUXILIARY 453220 903797 903797 POWER GENERATION 221000 351905 351905 828267 0 0 828267 3349864 1008934197 961615660 0 36318832 1344222 1344222 3605515 1824209 1781306 394791696 388722931 6068765 15805576 14871523 934053 45892411 45173413 718998 28681131 28242019 439112 29287800 27386224 1901576 1302956 203020 1099936 10961673 10961673 78087 78087 349172 349172 60230838 58502801 1728037 0 5258894 104374 5154520 19778784 18992773 786011 42811752 41527399 1284353 21845536 18406702 3438834 578846 571665 7181 619991 54891 565100 317498 317498 41830590 37502928 4327662 3290146 2081029 1209117 MEDICAL SUPPLIES 128450334 128450334 MEDI-CAL PROVIDER TAX 52140365 52140365 SYSTEM ALLOCATION 41015648 23077403 17938245 REPAIRS AND MAINTENANCE 5938832 5545288 393544 5750408 2061973 2309904 1378531 961958701 897104984 63475186 1378531 5209090 4363644 67307095 56628341 0 0 253061473 323416389 0 0 0 0 0 0 14621461 15051783 6934433 7176307 871215793 450875337 422277029 420340456 502072250 558174491 599686 235896 39037606 39002813 0 0 17707054 18477400 1328827177 1442867520 93268740 84457397 0 0 5820641 5725221 0 0 0 0 0 0 0 0 0 0 111844078 158377384 210933459 248560002 X 1090567456 1167103551 27326262 27203967 0 0 0 0 0 0 1117893718 1194307518 1328827177 1442867520 X 46975496 28035398 1402906 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 78087 78087 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Grossmont Hospital Corporation (GHC) pays annual dues to the California Hospital Association (CHA), the Healthcare Association of San Diego and Imperial Counties (HASD&IC), the California Association of Hospitals and Health Systems (CAHHS), the American Hospital Association (AHA) and the California Hospice and Palliative Care Association (CHAPCA). CHA, HASD&IC, CAHHS, AHA, and CHAPCA have determined that a portion of their membership dues are used for lobbying purposes. GHC's FY 2023 portion of annual dues calculated to have been used for lobbying was $78,087. 6966109 3000 913201 288997 7593313 8526925 1500 -1367530 194786 6966109 6960496 1000 1792448 227019 8526925 5694549 767192 714828 216073 6960496 5379320 114642 203625 3038 5694549 0.68 0.32 0.0 false true true 581843 581843 597980489 300975025 297005464 11880337 7724728 4155609 166072014 129579959 36492055 94701110 12595625 82105485 420340456 LONG TERM PENSION LIABILITY 3188882 LONG TERM WORKERS' COMPENSATION LIABILITY 256935 INTERCOMPANY PAYABLE 83460846 ALLOCATED TAX EXEMPT BONDS 51890285 PROGRAM RESERVES 1999021 OPERATING LEASE OBLIGATIONS 17469950 FINANCE LEASE OBLIGATIONS 111465 158377384 X 1027656266 28035398 -1378532 26656866 1000999400 349172 7585625 7934797 1008934197 956506423 0 0 956506423 349172 5103106 5452278 961958701 Schedule D, Part V, Line 4 Intended uses of endowment funds Grossmont Hospital Foundation holds 24 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 treatment, hospital equipment and technology, and more. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The principal operations of Sharp are exempt from taxation pursuant to Section 501(c)(3) of the Internal Revenue Code and related California provisions. 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, 2023 and 2022, no such assets or liabilities were recorded. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 FUNDRAISING EXPENSES - -1378532 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements DONATIONS OF CAPITAL/DONATIONS FOR CAPITAL - 3856944 MEDICAL STAFF/AUXILIARY REVENUE - 1111049 PENSION EXPENSES - 2617632 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements MEDICAL STAFF/AUXILIARY EXPENSES - 1106942 PENSION EXPENSES - 2617632 FUNDRAISING EXPENSES - 1378532 true true X true X true X false true true false true true 6004276 6004276 0.0062 348005756 331733515 16272241 0.0169 779080 773329 5751 0.0000 0 0 354789112 332506844 22282268 0.0231 1015834 1015834 0.0011 217971 217971 0.0002 69438339 45126390 24311949 0.0252 11 11 0 0.0 1193746 1193746 0.0012 0 0 71865901 45126401 26739500 0.0277 0 0 426655013 377633245 49021768 0.0508 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 7231170 0 132625502 167564307 -34938805 X true true GROSSMONT IMAGING LLC JOINT VENTURE-DIAGNOSTIC IMAGING 0.5 0.0 0.5 1 1 GROSSMONT HOSPITAL CORPORATION 5555 GROSSMONT CENTER DRIVE LA MESA CA 91942 WWW.SHARP.COM/GROSSMONT 080000006 X X X GROSSMONT HOSPITAL CORPORATION 1 false false true X X X X X X X X X 22 true true true true X https://www.sharp.com/about/community/community-benefits/health-needs-assessments.cfm X true 22 true https://www.sharp.com/about/community/community-benefits/health-needs-assessments.cfm false true X 200.0 400.0 X X X true true X X X true X https://www.sharp.com/PATIENT/BILLING/FINANCIAL-ASSISTANCE.CFM X https://www.sharp.com/PATIENT/BILLING/FINANCIAL-ASSISTANCE.CFM X https://www.sharp.com/patient/billing/financial-assistance.cfm X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - GROSSMONT HOSPITAL CORPORATION. Based on the results of the community health statistics scan and feedback from community partners received during the FY2022 CHNA planning process, a number of community engagement activities were conducted across San Diego County as part of the collaborative, countywide FY2022 CHNA - led under the auspices of the Hospital Association of San Diego & Imperial Counites (HASD&IC) through the FY2022 CHNA Committee, of which Sharp was Chair. Additional community engagement activities were conducted specific to Sharp/SGH, in order to provide a more comprehensive understanding of identified health needs - including their associated social determinants of health (SDOH) and potential system and policy changes that may impact them - for the patients and community members served by the hospital. The CHNA process also included a detailed analysis of how these top needs impact the health of San Diego residents. Community engagement activities of the collaborative FY2022 CHNA included 16 focus groups (90 participants), key informant interviews (26 participants), and an online survey (502 respondents) as well as Community Health Worker and promotora interviews (223 participants) which targeted stakeholders from every region of San Diego County, all age groups, and numerous racial and ethnic groups. Collaboration with the County of San Diego Health & Human Services Agency, Public Health Services was vital to this process. Community engagement participants included county public health officers, health care and social service providers, and members of community-based organizations, including advocacy groups that represent communities facing inequities. A total of 841 individuals participated in the FY2022 collaborative CHNA. In addition to participation and leadership in the collaborative HASD&IC FY2022 CHNA process, Sharp contracted separately with the Institute for Public Health (IPH) at San Diego State University (SDSU) to collect input from Sharp HealthCare providers as well as from patients and community members served by Sharp hospitals, including SGH. This input focused on the health and equity issues that were identified in Sharp's 2019 CHNA, including the impact of COVID-19 on those issues. This included two surveys designed in partnership with IPH engaging a total of 92 Sharp providers and 16 HR staff. Lastly, the SGH FY2022 CHNA community engagement process included a robust online survey conducted through the Sharp Insight Community. The Sharp Insight Community is a private online environment for Sharp patients and their families, community members, Sharp employees, and Sharp-affiliated physicians. The FY2022 CHNA Sharp Insight Community online survey sought to obtain feedback on the top health and social needs faced by community members in lieu of COVID-19, as well as assess their awareness of community outreach programs offered by Sharp. The online survey also provided participants the opportunity to provide specific suggestions for Sharp to improve community health and well-being. A total of 619 community members completed the Sharp Insight Community Survey. SGH/Sharp-specific community engagement activities concluded in Spring 2022. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - GROSSMONT HOSPITAL CORPORATION. The HASD&IC Board of Directors convened a CHNA Committee to plan and implement the collaborative FY2022 CHNA process. The CHNA Committee is comprised of representatives from the following hospitals and health care systems: * Kaiser Foundation Hospital - San Diego * Rady Children's Hospital - San Diego * Scripps Health (Vice Chair) * Sharp HealthCare (Chair) * Tri-City Medical Center * University of California San Diego Health * Grossmont Healthcare District The process and findings of the collaborative HASD&IC FY2022 CHNA significantly informed the SGH 2022 CHNA and was further supported by additional data analysis and community engagement activities specific to the community served by SGH (the latter is described in Question 5). Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - GROSSMONT HOSPITAL CORPORATION. The Sharp Grossmont Hospital FY2022 Community Health Needs Assessment (CHNA) examines the health needs of the community members it serves in San Diego County. SGH's FY2022 CHNA process and findings are based on the collaborative Hospital Association of San Diego and Imperial Counties (HASD&IC) FY2022 Community Health Needs Assessment process and findings for San Diego County. This collaborative process was conducted under the auspices of HASD&IC and was further supported by additional data analysis and community engagement activities specific to the community served by SGH (the latter is described in Question 5). Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - GROSSMONT HOSPITAL. The findings of SGH's FY2022 Community Health Needs Assessment (CHNA) further dove into priority health needs impacting the communities served by SGH, particularly those community members facing inequities, as well as provided insight gathered from direct conversations with the community. Through the SGH FY2022 CHNA, the following priority health needs were identified for the communities served by SGH (listed in alphabetical order): * Access to Health Care * Aging Care & Support * Behavioral Health * Children & Youth Well-Being * Chronic Health Conditions * Community Safety * Economic Stability * Maternal and Prenatal Care, including High-Risk Pregnancy SGH reviewed findings from its FY2022 CHNA to assist in the design and implementation of programs and services provided at SGH for community members. In identifying these priorities, SGH considered the expertise and mission of its programs and services, as well as the needs of the unique, ever-changing demographics and health topics that comprise SGH's service area and region (San Diego County's east region). SGH provides programming and services that specifically address these needs, either directly or indirectly. SGH provides behavioral health services to SDC's east region through clinical programs for adults and older adults, including individuals living with psychosis, depression, grief, anxiety, traumatic stress and other behavioral health conditions. SGH also provides a dedicated psychiatric assessment team in the emergency department (ED) and acute care as well as hospital-based outpatient programs that serve individuals dealing with a variety of behavioral health issues. Beyond these clinical services, SGH lacks the resources to comprehensively meet the need for community education and support in behavioral health (including substance use). Consequently, the community education and support elements of behavioral health care are addressed through the programs and services provided through Sharp Mesa Vista Hospital and Sharp McDonald Center, which are the major providers of behavioral health and substance use treatment services in SDC. SGH addresses chronic health conditions by providing education and healthy lifestyle programs as part of care for cardiovascular disease (CVD), diabetes, obesity and other health issues influenced by healthy weight and exercise. In addition, Sharp Rees-Stealy Medical Centers clinics throughout SDC - including SDC's east region - provide structured weight management and health education programs to community members, such as smoking cessation and stress management, long-term support for weight management and personalized weight-loss programs. SGH's most recent implementation strategy (FY 2024 - FY 2027), available online at https://www.sharp.com/about/community/community-benefits/health-needs-assessments.cfm details specific programs that SGH provides to address needs identified in its FY2022 CHNA. These programs are detailed further in the SGH section of Sharp HealthCare's FY 2023 Community Benefit Plan and Report, available for public viewing/download at: https://www.sharp.com/about/community/community-benefits/benefit-report.cfm. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - Grossmont Hospital. Grossmont Hospital does not make presumptive FAP-eligibility determinations based on third-party information as defined in section 501(r)-6(c)(2). Instead, Grossmont Hospital makes reasonable efforts based on notification and processing of applications as defined in 501(r)-6(c)(3). 10 BRIAR PATCH 9000 WAKARUSA ROAD LA MESA CA 91942 OUTPATIENT SERVICES GROSSMONT MEDICAL PLAZA 5525 GROSSMONT CENTER DRIVE LA MESA CA 91942 OUTPATIENT SERVICES PMB MEDICAL OFFICE BUILDING 8860 CENTER DRIVE SUITE 100 LA MESA CA 91942 OUTPATIENT SERVICES SHARP HOSPICE CARE 8881 FLETCHER PARKWAY SUITE 336 LA MESA CA 91942 HOSPICE BONITAVIEW HOSPICE HOME 3850 VALLEY VISTA ROAD BONITA CA 91902 HOSPICE HOME GROSSMONT IMAGING LLC 8881 FLETHCER PARKWAY SUITE 102 LA MESA CA 91942 JOINT VENTURE - DIAGNOSTIC IMAGING GROSSMONT IMAGING LLC 9640 MISSION GORGE ROAD SUITE H SANTEE CA 92071 JOINT VENTURE - DIAGNOSTIC IMAGING PARKVIEW HOSPICE HOME 5788 LYDEN WAY SAN DIEGO CA 92120 HOSPICE HOME LAKEVIEW HOSPICE HOME 9472 LOREN DRIVE LA MESA CA 91942 HOSPICE HOME PMB MEDICAL OFFICE BUILDING 8860 CENTER DRIVE SUITE 200 LA MESA CA 91942 OUTPATIENT SERVICES - INFUSION Schedule H, Part III, Line 7 The organization incurred additional Medicare shortfall that is not allowed to be reported on Parts I and III, 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 and III $177,751,892 Medicare allowable costs reported on Parts I and III $230,380,488 Shortfall included on Parts I and III ($52,628,596) Actual Medicare revenue received $180,196,590 Actual Medicare cost $238,373,357 Actual Medicare shortfall ($58,176,767) Additional Medicare shortfall not on Parts I and III ($5,548,171) Schedule H, Part VI, Line 5 Sharp Grossmont Hospital 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. Further, as San Diego's largest private employer, Sharp promotes a culture of environmental responsibility through education, outreach, and collaboration with San Diego earth-friendly businesses to help identify best practices reduce the costs of green practices and facilitate implementation of sustainable initiatives. Through various strategies, in FY 2023 SGH diverted nearly 2.9 million pounds of waste, more than 45% of its generated waste. Sharp believes the promotion of healthy food choices is necessary to improve the health of patients, employees and the community. Sharp works closely with its food service partner, Sodexo, to innovate practices and encourage consumers to adopt habits that reduce chronic disease risk factors and minimize waste. Sharp and Sodexo have developed the following goals related to sustainable food practices: * A 50% reduction in total diversion from the landfill by 2030, which include food donations and organic waste recycled in compost collection. * At least 15% of total purchases are sourced from sustainable suppliers, which includes dollars spent on local, sustainable, organic animal proteins and produce. During FY 2023, Sharp diverted approximately 509,000 lbs from the landfill and purchased approximately 52% of animal protein and produce from local, sustainable and organic sources. Sharp also contributes to the health and safety of the San Diego community through essential emergency and disaster planning activities and services. Sharp's disaster preparedness team provides education to staff, community members and community health professionals, and collaborates with numerous state and local organizations to prepare the community for a potential emergency or disaster. FY 2023 efforts are described below. Sharp's disaster preparedness team led monthly Amateur Radio Emergency Service (ARES) trainings for the community. ARES consists of licensed volunteers who provide advanced radio operations during severe region-wide disasters. Additionally, during the year, multiple Sharp entities hosted personnel from the County's Public Health Preparedness and Response (PHPR) Branch and Office of Emergency Services to orient and educate these community partners on Sharp's disaster preparedness efforts. Sharp partnered with the County of San Diego - including the Emergency Medical Services, PHPR, and Medical Operations Center branches - as well as other regional health care partners in several disaster preparedness exercises. The San Diego Regional Medical & Health Wildfire Evacuation & Surge Full-Scale Exercise tested the San Diego region's ability to respond and evacuate patients in the event of large-scale wildfires. Sharp conducted a drill at each of its acute care hospitals and SRSMC locations and represented health care operations on behalf of the exercise planning committee. In addition, Sharp served on the planning team for the San Diego County Medical and Health Facility Pediatric Surge Tabletop Exercise, a Full-Scale Extended Rain and Flooding Exercise, and a Burn Surge Tabletop Exercise. Further, Sharp provided expertise and collaboration in the planning process for the San Diego International Airport's required full-scale exercise focused on patient reunification. Members of Sharp's disaster leadership team donate their time to various state and local organizations and committees. In FY 2023, this included the County of San Diego Emergency Medical Care Committee, the California Hospital Association (CHA) Emergency Management Advisory Committee, the California Department of Public Health's (CDPH) Joint Advisory Committee, the Ronald McDonald House Operations Committee, the CDPH Statewide Medical and Health Exercise Workgroup, and the San Diego International Airport Aviation Security and Public Safety Department. Through participation in the U.S. Department of Health and Human Services' Public Health Emergency Hospital Preparedness Program (HPP), Sharp provides resources, trainings and information to prepare non-hospital entities in SDC for a collaborative response to an emergency or disaster. The HPP seeks to continually identify and develop relationships with health care entities, nonprofit organizations, law enforcement, military installations and other organizations that serve SDC and are located near partner health care facilities. This includes Sharp's participation in the County of San Diego Healthcare Disaster Coalition, a multi-agency group of representatives who assist the county in improving mitigation, preparedness, response and recovery activities during emergencies and disasters. As part of this coalition in FY 2023, Sharp's disaster preparedness team participated in the HPP budget, decontamination, and SharePoint subcommittees. The HPP budget subcommittee strives to improve readiness by building supply caches of readily available health care supplies that can be used during a disaster. In addition, the decontamination subcommittee aims to standardize equipment and processes for hospitals, while the SharePoint subcommittee is designed to build a coalition SharePoint site to provide members with disaster health care education and information. To collaboratively address public health threats, Sharp continued to participate in a workgroup alongside Scripps Health, Palomar Health, UC San Diego Health, Kaiser Permanente San Diego, HASD&IC and CHA to share best practices in patient care; strategies to ensure provider safety and well-being; and plans for a continuously successful disaster response that aligns with current public health guidelines. The group continues to collaborate with federal partners to formalize a cybersecurity readiness plan for San Diego hospitals and other health care delivery systems to effectively respond in the event of a cybersecurity incident. Sharp's disaster leadership collaboratively steers the Highly Infectious Disease Advisory Committee. This committee prepares the Sharp workforce to care for patients infected with COVID-19 and other emerging infectious diseases. This committee remains in close contact with local, state and national health officials to report and monitor cases as well as secure sustainable supply chains for necessary equipment and supplies. The Highly Infectious Disease Advisory Committee also disseminates relevant guidance and recommendations to Sharp's workforce, community partners and patients. Sharp supports the safety efforts of California and the County of San Diego through maintenance and storage of a federally funded decontamination trailer at SGH for use during mass decontamination events. Although the trailer is strategically located at SGH to respond to the needs of East County, it can be relocated elsewhere in the event of an emergency. Additionally, all Sharp hospitals are prepared for an emergency with backup water supplies that will last up to 96 hours in the event of an interruption to the system's normal water supply. Sharp also supports the community's response capabilities in the event of chemical or biological disasters by hosting federally supervised CHEMPACKs, which contain medications that can be used to treat symptoms of exposure to nerve agents. Further, Sharp hosts and maintains multiple disaster ventilators in addition to critical supplies necessary to care for patients who may present with a high-consequence infectious disease, such as Ebola. Schedule H, Part I, Line 6a Community benefit report prepared by related organization Sharp Healthcare Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance Historical charity care percentages are applied to current revenues to estimate charity on a monthly basis. Actual charity transactions are applied against the estimate and any increase or decrease over estimated amounts is accounted for. Other Cost includes State/County programs included in the S-10 for Medicare Cost Reporting primarily for prison/in custody patient care. RCC were calculated using the Medicare Cost Report from Worksheet C. The Revenue and Expense tie to the general ledger with no exclusions, so worksheet C represents direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payer to obtain the fully weighted cost by payer. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE HOSPITAL ADOPTED THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ACCOUNTING STANDARDS UPDATE 2014-09 TOPIC 606 (ASU 606) EFFECTIVE OCTOBER 1, 2018. ASU 606 AND THE HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION (HFMA) DIFFERENTIATE BAD DEBT FROM IMPLICIT PRICE CONSESSIONS. THE HOSPITAL MAKES A DETERMINATION REGARDING A PRICE CONCESSION TO STANDARD PRICING ON A PORTFOLIO BASIS. THE IMPLICIT PRICE CONCESSIONS INCLUDED IN ESTIMATING THE TRANSACTION PRICE REPRESENT THE DIFFERENCE BETWEEN AMOUNTS BILLED TO PATIENTS AND THE AMOUNTS SHARP EXPECTS TO COLLECT BASED ON COLLECTION HISTORY WITH EACH PORTFOLIO OF PATIENTS. PATIENT SERVICE REVENUE IS RECORDED NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS, INCLUDING AN ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. BAD DEBT IS RECORDED AS AN OPERATING EXPENSE AND RESULTS WHEN A PATIENT, DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES, IS UNWILLING TO DO SO. FOR THE TAX YEAR ENDED SEPTEMBER 30, 2023, THE HOSPITAL DETERMINED $7,231,170 AS BAD DEBT EXPENSE. BAD DEBT EXPENSE IS NETTED AGAINST REVENUE. AS SUCH, $0.00 WAS BACKED OUT OF TOTAL EXPENSES FOR COLUMN (F) CALCULATION. ALSO APPLIES TO SCHEDULE H, PART I, LINE 7, COLUMN F. Schedule H, Part III, Line 3 Bad Debt Expense Methodology 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. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote FN4: Net Patient Service Revenues Patient Service Revenues Sharp has agreements with third-party payors that provide for payments to Sharp at amounts different from its established rates. Inpatient and outpatient services provided to patients not covered by third-party payors are paid based on Sharp's policies and the patient's ability to pay. Sharp reduces the transaction price by implicit price concessions to uninsured patients and patients with uninsured balances, such as copays and deductibles. The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts. Sharp expects to collect based on its collection history with this portfolio of patients. Subsequent changes to the estimates are considered variable consideration and are included in patient service revenue when information becomes available. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs Medicare 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 Grossmont Hospital Corporation 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 with no exclusions, representing direct revenue and expense plus stepdown from Overhead departments. The RCC by CMS line was then applied to the applicable revenue departments broken down by payor to obtain the fully weighted cost by payer. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Sharp does not initiate collection activities on accounts known to be eligible for Financial Assistance or Charity care. It is also Sharp's policy to recall/cancel accounts assigned to a collection agency if it is determined, at any time, a patient account is eligible for Financial Assistance or Charity care. Schedule H, Part V, Section B, Line 16a FAP website - GROSSMONT HOSPITAL CORPORATION: Line 16a URL: https://www.sharp.com/PATIENT/BILLING/FINANCIAL-ASSISTANCE.CFM; Schedule H, Part V, Section B, Line 16b FAP Application website - GROSSMONT HOSPITAL CORPORATION: Line 16b URL: https://www.sharp.com/PATIENT/BILLING/FINANCIAL-ASSISTANCE.CFM; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - GROSSMONT HOSPITAL CORPORATION: Line 16c URL: https://www.sharp.com/patient/billing/financial-assistance.cfm; Schedule H, Part VI, Line 2 Needs assessment Sharp HealthCare (Sharp) has been a long-time partner in the process of identifying and responding to the health needs of the San Diego community. This partnership has included a broad range of hospitals, health care organizations, and community agencies in order to conduct triennial Community Health Needs Assessments (CHNAs) more than 25 years. Sharp hospitals, including Sharp Grossmont Hospital (SGH), base their community benefit and community health programs on both the findings of these needs assessments and the combination of expertise in programs and services offered and the knowledge of the populations and communities served by each Sharp hospital. The complete FY2022 Community Health Needs Assessment for SGH is available online at: https://www.sharp.com/about/community/community-benefits/health-needs-assessments.cfm or by contacting Sharp HealthCare Community Benefit at: communitybenefits@sharp.com. SGH reviewed its CHNA and used the assessment to help inform priority needs for members of the communities it serves. In identifying these priorities, SGH also considered the expertise and mission of its programs and services, as well as the needs of the unique, ever-changing demographics and health topics that comprise SGH's service area and region. SGH is committed to the health and well-being of its community, and the findings of SGH's most recent (FY2022) CHNA help inform the activities and services provided by SGH to improve the health of its community members. These programs are detailed in SGH's FY 24-FY 27 implementation strategy, which are available online to the community at: https://www.sharp.com/about/community/community-benefits/health-needs-assessments.cfm. SGH provides behavioral health services to SDC's east region through clinical programs for adults and older adults, including individuals living with psychosis, depression, grief, anxiety, traumatic stress and other disorders. SGH also provides a dedicated psychiatric assessment team in the emergency department (ED) and acute care, as well as hospital-based outpatient programs that serve individuals dealing with a variety of behavioral health issues. However, beyond these clinical services, SGH does not have the resources to comprehensively meet the need for community education and support around the identified health need of behavioral health. Consequently, the community education and support elements of behavioral health care are addressed through the programs and services provided through Sharp Mesa Vista Hospital and Sharp McDonald Center, which are the major providers of behavioral health and chemical dependency services in SDC. The identified health need of obesity is not specifically targeted in education, however is addressed through general nutrition and exercise education and resources provided at SGH, as well as programs that address a healthy lifestyle as part of care for heart disease, diabetes and other health issues influenced by healthy weight and exercise. In addition, Sharp Rees-Stealy clinics throughout SDC - including the region served by SGH - provide structured weight management and health education programs to community members, such as smoking cessation and stress management; long-term support for weight management and fat loss; and personalized weight-loss programs. Please refer to Part V, Sections B and C, for additional details on the process, findings and strategies to address findings from the FY2022 SGH CHNA. Programs that address CHNA-identified needs are also detailed in the SGH section of Sharp HealthCare's FY 2023 Community Benefit Plan and Report, available for public viewing/download at: https://www.sharp.com/about/community/community-benefits/benefit-report.cfm. In addition, 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 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 Schedule H, Part VI, Line 3 Patient education of eligibility for assistance 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. "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. 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. 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. Schedule H, Part VI, Line 4 Community information The community served by SGH includes the entire east region of San Diego County (SDC), including the subregional areas of Jamul, Spring Valley, Lemon Grove, La Mesa, El Cajon, Santee, Lakeside, Harbison Canyon, Crest, Alpine, Laguna-Pine Valley and Mountain Empire. In addition, much of the region includes remote, unincorporated communities. Approximately 5% of the population lives in remote or rural areas of the region. In addition, there were 97,387 residents ages 65 and older in SDC's east region, representing 17.9% of the total regional population. Between 2023 and 2028, it is anticipated that the east region's senior population will grow by 13.0%. For SGH's FY2022 CHNA process, the IBM/Dignity Health Community Need Index (CNI) was utilized to identify communities with greater health disparity within the county. The CNI identifies the severity of health disparity for every ZIP code in the United States (U.S.) based on specific barriers to health care access including education, income, culture/language, insurance and housing. As such, the CNI demonstrates the link between community need, access to care and preventable hospitalizations. According to the CNI, communities served by SGH with especially high need include, but are not limited to, La Mesa, Lemon Grove, Spring Valley, Encanto and Mountain Empire. In 2021, 12.1% of the east region population reported living below 100% of the federal poverty level (FPL), which was higher than SDC overall (10.7%). The unemployment rate in SDC's east region was 7.2%, which was higher than the rate for SDC overall (6.2%). In addition, 7.2% of households received Supplemental Security Income, also higher than SDC overall (5.0%). According to the San Diego Hunger Coalition, nutrition insecurity has not changed for almost a year due to historic increases in the cost of living. As of March 2023, 23% of San Diegans experienced nutrition insecurity and 28% of children lived in nutrition insecure households. In 2020, 11.2% of households in the east region received Supplemental Nutrition Assistance Program (SNAP) benefits, while 18.5% of the population lived at or below 138% FPL and were eligible for the program. These rates were higher than SDC overall (7.1% of households participated in SNAP benefits while 16.7% of households lived at or below 138% FPL). In 2021, 11.6% of households in the east region received Supplemental Nutrition Assistance Program (SNAP) benefits, while 18.1% of the population lived at or below 138% FPL and were eligible for the program. These rates were higher than SDC overall (7.6% of households participated in SNAP benefits while 16.2% of households lived at or below 138% FPL). In SDC's east region in 2021, 96.4% of children age 18 and under, 90.3% of young adults ages 19 to 25, 90.8% of adults ages 26 to 44, 92.9% of adults ages 45 to 64, and 98.9% of seniors age 65 and older had health insurance. Health insurance coverage for young adults ages 19 to 25 and adults ages 26 to 44 was lower than the Healthy People 2030 (HP2030) national target of 92.4% health insurance coverage. Schedule H, Part VI, Line 5 Promotion of community health See statement above. Schedule H, Part VI, Line 6 Affiliated health care system Sharp HealthCare (Sharp) is an integrated, regional health care delivery system based in San Diego, California. The Sharp system includes four acute care hospitals; three specialty hospitals; three affiliated medical groups; 28 medical centers; five urgent care centers; three skilled nursing facilities (SNF); two inpatient rehabilitation centers; home health, hospice and home infusion programs; numerous outpatient facilities and programs; three charitable foundations; and a variety of other community health education programs and related services. Sharp also offers individual and group health maintenance organization coverage through Sharp Health Plan (SHP). Serving a population of approximately 3.3 million in San Diego County (SDC), as of September 30, 2023, Sharp is licensed to operate 2,209 beds and has approximately 2,800 Sharp-affiliated physicians and 19,000 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 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 wellbeing of those it serves. In support of Sharp's organizational commitment to transform the health care experience, Sharp's Pillars of Excellence serve as a guide for its team members, providing framework and alignment for everything Sharp does. Since 2014, Sharp's Executive Steering and Board of Directors enhanced Sharp's safety focus, further driving the organization's emphasis on its culture of safety and incorporating the commitment to become a High Reliability Organization (HRO) in all aspects of the organization. At the core of HROs are five key concepts: * Sensitivity to operations * A reluctance to simplify * Preoccupation with failure * Deference to expertise * Resilience Applying high-reliability concepts in an organization begins when leaders at all levels start thinking about how the care they provide could improve. It begins with a culture of safety. With this learning, Sharp is a seven-pillar organization - Quality, Safety, Service, People, Finance, Growth and Community. The foundational elements of Sharp's strategic plan have been enhanced to emphasize Sharp's desire to do no harm. This strategic plan continues Sharp's transformation of the health care experience, focusing on safe, high-quality and efficient care provided in a caring, convenient, cost-effective and accessible manner. With 524 licensed beds, 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. SGH is known for outstanding programs in heart care, orthopedics, rehabilitation, robotic surgery, stroke care and women's health. 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. In addition, Planetree awarded the Gold Certification for Excellence in Person-Centered Care to SGH in 2018. Planetree is a coalition of more than 80 hospitals worldwide that are committed to improving medical care from the patient's perspective. Schedule H, Part VI, Line 7 State filing of community benefit report CA true CALIFORNIA HEALTH FOUNDATION TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498697 501 (C) (3) 1068062 MEDI-CAL PROGRAM GROSSMONT HOSPITAL FOUNDATION 8695 SPECTRUM CENTER BLVD SAN DIEGO CA 921231489 330124488 501 (C) (3) 112250 SPONSORSHIP - CONTINUING MEDICAL EDUCATION, GOLF TOURNAMENT, REGATTA AMERICAN HEART ASSOCIATION 7272 GREENVILLE AVENUE DALLAS TX 75231 135613797 501 (C) (3) 25000 SPONSORSHIP - GO RED FOR WOMEN AMERICAN LUNG ASSOCIATION 55 W WACKER DRIVE CHICAGO IL 60601 131632524 501 (C) (3) 100000 SPONSORSHIPS - GRAND SLAM, CHAMPIONS UNITE AND LUNG FORCE WALK LA MESA PARK & RECREATION FOUNDATION 8130 ALLISON AVENUE LA MESA CA 91942 330856480 501 (C) (3) 5000 DONATION FOR LOCAL EVENTS AND PROGRAMS 5 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. 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. false true false false false false false false false Christopher D Howard PRESIDENT & CEO SHC 0 1844229 0 678749 0 58542 0 0 0 19123 0 2600643 0 0 William S Evans SVP MARKET CEO 0 827620 0 312163 0 54248 0 0 0 22231 0 1216262 0 0 Staci L Dickerson SVP & CFO SHC THRU 07/01/2023 0 985023 0 326126 0 23010 0 10575 0 22368 0 1367102 0 0 Rick L Grossman SVP GENERAL COUNSEL 0 886600 0 292585 0 50178 0 0 0 10412 0 1239775 0 0 Daniel J Kindron CHIEF FINANCE-MARKET GROWTH OFFICER-SGH 0 265918 0 66437 0 12421 0 13545 0 1918 0 360239 0 0 Anthony Damico COO GHC 0 350106 0 97632 0 25902 0 22403 0 9763 0 505806 0 0 Louise White VP PATIENT CARE GHC 0 325201 0 86495 0 9265 0 17950 0 15864 0 454775 0 0 Suzanne Johnson VP HOSPICE 0 239545 0 66499 0 36573 0 16574 0 9100 0 368291 0 0 Ali Zanial DIR PHARMACY GHC 0 263155 0 50282 0 380 0 13881 0 15097 0 342795 0 0 Jason Broad VP PERFORMANCE 0 209640 0 60150 0 30581 0 22426 0 9023 0 331820 0 0 Nancy Greengold CMO GHC 0 475992 0 129305 0 47553 0 17330 0 9937 0 680117 0 0 Marguerite Paradis DIR EMERG SVCS/CRITICAL CARE 0 242096 0 46318 0 11348 0 13545 0 15273 0 328580 0 0 Patrick Guo LEAD MED RAD PHYSICIST 0 294363 0 0 0 12387 0 19942 0 1538 0 328230 0 0 Lanie Outlaw LD CLINICAL NURSE 0 272965 0 1316 0 8035 0 15678 0 20464 0 318458 0 0 Cathy Prante DIR PROF DVLPMNT/NURSING OPS 0 242414 0 46046 0 2517 0 13817 0 15498 0 320292 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation 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. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Sharp HealthCare ("Company") sponsors an Executive Flexible Benefit Plan ("Plan") to provide designated executives with a reasonable level of benefits in return for their continued employment with the Company. The 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 Plan, which were restated effective as of December 31, 2008, are described below as restated. The 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 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. During the year ended December 31, 2022, no participants received distributions from the plan. Form 990, Part III, Line 1 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 Healthcare 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 III, Line 4a Community Benefit Report See full Sharp HealthCare Annual Community Benefit Plan and Report at: https://www.sharp.com/about/community/community-benefits/benefit-report.cfm Sharp HealthCare (Sharp) is an integrated, regional health care delivery system based in San Diego, California. The Sharp system includes four acute care hospitals; three specialty hospitals; three affiliated medical groups; 23 medical centers; five urgent care centers; three skilled nursing facilities (SNF); two inpatient rehabilitation centers; home health, hospice and home infusion programs; numerous outpatient facilities and programs; three charitable foundations; and a variety of other community health education programs and related services. Sharp also offers individual and group health maintenance organization coverage through Sharp Health Plan (SHP). Serving a population of approximately 3.3 million in San Diego County (SDC), as of September 30, 2023, Sharp is licensed to operate 2,209 beds and has approximately 2,800 Sharp-affiliated physicians and 19,200 employees. Mission It is Sharp's mission to improve the health of those we serve with a commitment to excellence in all that we do. Sharp's goal is to offer quality care and services that set community standards, exceed patients' expectations and are provided in a caring, convenient, cost-effective and accessible manner. Vision Sharp's vision is to become the best health system in the universe. Sharp will transform the health care experience and be recognized 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. This summary provides an overview of community benefit planning at Sharp, a listing of community needs addressed in this Community Benefit Plan and Report, and a summary of community benefit programs and services provided by Sharp in fiscal year (FY) 2023 (October 1, 2022, through September 30, 2023). In addition, the summary reports the economic value of community benefit provided by Sharp, according to the framework specifically identified in Senate Bill 697 (SB 697), for the following entities: Sharp Chula Vista Medical Center (EIN 95-2367304) Sharp Coronado Hospital and Healthcare Center (EIN 95-0651579) Sharp Grossmont Hospital (33-0449527) Sharp Mary Birch Hospital for Women & Newborns (EIN 95-3782169) Sharp Memorial Hospital (EIN 95-3782169) Sharp Mesa Vista Hospital and Sharp McDonald Center (EIN 95-3782169) Sharp Health Plan (EIN 33-0519730) Community Benefit Planning at Sharp HealthCare Sharp bases its community benefit planning on its triennial community health needs assessments (CHNA) combined with the expertise in programs and services of each Sharp hospital. Listing of Community Needs Addressed in the Sharp HealthCare Community Benefit Plan and Report, FY 2023 The following community needs are addressed by one or more Sharp hospitals in this Community Benefit Plan and Report: * Access to care and financial support for uninsured and underinsured community members and individuals without a medical provider * Programs and services that provide community and social support to address health equity challenges * Education, screening and support programs for chronic health conditions and other health needs, including but not limited to heart and vascular disease, stroke, cancer, diabetes, obesity and unintentional injuries * Aging care and support programs including health education, support and screening activities for seniors and caregivers * Safety and support programs for seniors and people with disabilities * End-of-life and advance care planning services for hospice patients and their loved ones and the community * Support for community nonprofit health and social service organizations * Education and training for community health care professionals * Student and intern supervision, education and support * Collaboration with local schools to promote interest and provide health career pathways * Cancer patient navigation services and participation in clinical trials * Women's and prenatal/postnatal health services, support and education, including services for high-risk pregnancies * Behavioral health and substance use education, screening and support for the community - including seniors and individuals experiencing homelessness * Provider education and protocol development to enhance community safety programming related to Trauma-Informed Care, human trafficking and related topics Economic Value of Community Benefit Provided in FY 2023 In FY 2023, Sharp provided a total of $570,261,806 in community benefit programs and unreimbursed services. This represents unreimbursed community benefit costs after the impact of the Medi-Cal Hospital Fee Program. Total economic value of community benefit provided by each Sharp HealthCare entity in FY 2023 was as follows: Sharp Chula Vista Medical Center - $135,407,856 Sharp Coronado Hospital and Healthcare Center - $22,678,269 Sharp Grossmont Hospital - $169,579,277 Sharp Mary Birch Hospital for Women & Newborns - $7,753,723 Sharp Memorial Hospital - $203,589,764 Sharp Mesa Vista Hospital and Sharp McDonald Center - $31,135,996 Sharp Health Plan - $116,921 TOTAL FOR ALL ENTITIES - $570,261,806 Economic Value of Community Benefit Provided in FY 2023 by SB 697 Category and by Sharp entity was as follows: Sharp Chula Vista Medical Center: Medical Care Services - $133,771,873 Other Benefits for Vulnerable Populations - $497,960 Other Benefits for the Broader Community - $255,774 Health Research, Education and Training Programs - $882,249 TOTAL - $135,407,856 Sharp Coronado Hospital and Healthcare Center: Medical Care Services - $22,249,311 Other Benefits for Vulnerable Populations - $133,729 Other Benefits for the Broader Community - $91,621 Health Research, Education and Training Programs - $203,608 TOTAL - $22,678,269 Sharp Grossmont Hospital: Medical Care Services - $167,044,628 Other Benefits for Vulnerable Populations - $1,371,932 Other Benefits for the Broader Community - $571,973 Health Research, Education and Training Programs - $590,744 TOTAL - $169,579,277 Sharp Mary Birch Hospital for Women & Newborns: Medical Care Services - $7,248,831 Other Benefits for Vulnerable Populations - $99,755 Other Benefits for the Broader Community - $298,300 Health Research, Education and Training Programs - $106,837 TOTAL - $7,753,723 Sharp Memorial Hospital: Medical Care Services - $201,391,646 Other Benefits for Vulnerable Populations - $986,556 Other Benefits for the Broader Community - $479,431 Health Research, Education and Training Programs - $732,131 TOTAL - $203,589,764 Sharp Mesa Vista Hospital and Sharp McDonald Center: Medical Care Services - $29,592,531 Other Benefits for Vulnerable Populations - $1,104,500 Other Benefits for the Broader Community - $100,852 Health Research, Education and Training Programs - $338,113 TOTAL - $31,135,996 Sharp Health Plan: Other Benefits for Vulnerable Populations - $23,810 Other Benefits for the Broader Community - $88,194 Health Research, Education and Training Programs - $4,917 TOTAL - $116,921 The following are examples of community benefit programs and services provided by Sharp hospitals and entities in FY 2023. Medical Care Services included uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as Medi-Cal, Medicare, County Medical Services (CMS), 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 service members and their families, loved ones and survivors, and unreimbursed costs of workers' compensation programs. Form 990, Part III, Line 4a Community Benefit Report Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; education as well as flu vaccinations for seniors; telephone reassurance and safety check program for isolated or homebound seniors and community members with disabilities; financial and other support to community clinics to assist in providing and improving access to health services; Project Hospital Emergency Liaison Program (Project HELP), which provides funding for medication and transportation to assist lower-income patients; contribution of time to the Jacobs & Cushman San Diego Food Bank, Feeding San Diego and Mama's Kitchen; the Sharp Humanitarian Service Program; and support services for patients experiencing homelessness and other health equity barriers. Other Benefits for the Broader Community included health education and information provided on-site, virtually and in partnership with community-based organizations; participation in community health fairs and events addressing the unique needs of the community; health screenings and support groups. Sharp also collaborated with local schools to promote interest in health care careers. Sharp executive leadership and staff also actively participated in numerous community organizations, committees and coalitions to improve the health of the community. See Appendix A of the Community Benefit Plan and Report for a listing of Sharp's involvement in community organizations. In addition, the category included costs associated with planning and operating community benefit programs, such as CHNA development and administration. Health Research, Education and Training Programs included education and training programs for medical, nursing and other health care students and professionals, as well as supervision and support for students and interns. Time was also devoted to generalizable health-related research projects that were made available to the broader health care community. Form 990, Part IV, Line 24a 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 V, Line 1a Independent contractors are paid under Sharp HealthCare's tax identification number (EIN 95-6077327) and are reported on Sharp HealthCare's tax return. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons WILLIAM S. EVANS, DANIEL KINDRON, AND ANTHONY DAMICO WERE ALL DIRECTORS ON THE GOVERNING BOARD OF THE GROSSMONT IMAGING JOINT VENTURE - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders Sharp HealthCare (FEIN 95-6077327) is the sole member of Grossmont Hospital Corporation. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Sharp HealthCare, as the sole member of the corporation, has the right to elect and remove most board members. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders 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, Line 11b Review of form 990 by governing body 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 board members are notified that the Form 990 is available on the intranet. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the Accounting Manager, Vice President of Finance, Senior Vice President and Chief Financial Officer, and entity Chief Financial Officer. Additionally, the organization contracts with Ernst & Young, and an independent accounting firm, for review of the Form 990. Form 990, Part VI, Line 12c Conflict of interest policy Grossmont Hospital has a written conflict of interest policy which has been reviewed and approved by the Grossmont Hospital governing board. Grossmont Hospital is committed to preventing any Participant of the Corporation from gaining any personal benefit from information received or from any transaction of Sharp. One component of the written conflict of interest policy requires that 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 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 a "no cause" basis by the action of the member. Form 990, Part VI, Line 15a Process to establish compensation of top management official The Compensation Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (President/Chief Executive Officer, Chief Operating Officer, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Compensation Committee of the Board of Directors by the independent consultant. The Compensation Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Compensation Committee creates and approves the organization's Executive Compensation Philosophies and Strategies statement and as part of this approves the total compensation for the President/Chief Executive Officer and reviews and approves the total compensation recommendations for the remaining executive team. The Compensation Committee presents its decision to the Board of Directors. The Compensation Committee retains minutes of its meetings. The study was last conducted in November 2023. The Compensation 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 department and is presented to the President/Chief Executive Officer, the Chief Operating Officer and the appropriate Senior Vice President for review and approval. This study was last conducted in January 2024. Form 990, Part VI, Line 15b Process to establish compensation of other employees The Compensation Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (President/Chief Executive Officer, Chief Operating Officer, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Compensation Committee of the Board of Directors by the independent consultant. The Compensation Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Compensation Committee creates and approves the organization's Executive Compensation Philosophies and Strategies statement and as part of this approves the total compensation for the President/Chief Executive Officer and reviews and approves the total compensation recommendations for the remaining executive team. The Compensation Committee presents its decision to the Board of Directors. The Compensation Committee retains minutes of its meetings. The study was last conducted in November 2023. The Compensation 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 department and is presented to the President/Chief Executive Officer, the Chief Operating Officer and the appropriate Senior Vice President for review and approval. This study was last conducted in January 2024. Form 990, Part VI, Line 19 Required documents available to the public The organization does not make its governing documents available to the general public. 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), are attached to the Form 990 filed for each of the Sharp hospitals, 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 VII, Section A PART VII, SECTION A Sharp Grossmont Hospital executives' salaries and wages are paid under Sharp HealthCare's tax ID number (EIN 95-6077327), and as such are also reported on Sharp HealthCare's Form 990. Form 990, Part VII, Section B, Line 1 Independent contractors are paid under Sharp HealthCare's tax identification number (EIN 95-6077327) and are reported on Sharp HealthCare's tax return. Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: 534909, Related or Exempt Function Revenue: 534909, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue - Total Revenue: 828267, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 828267; Form 990, Part X, Line 25 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. Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN MINIMUM PENSION LIABILITY - 1437700; BENEFICIAL INTEREST IN GROSSMONT HOSPITAL FOUNDATION - -34794; Form 5471 Form 5471 Form 5471 has been filed on behalf of Grossmont Hospital Corporation by Sharp HealthCare (EIN 95-6077327). 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