2025-08-08T06:48:34+00:00 2024-09-30 346565596 ERNST & YOUNG US LLP 101 E WASHINGTON ST PHOENIX AZ 85004 990 2023-10-01 951684089 SCRIPPS HEALTH SCRI 8585545712 4555 EXECUTIVE DR SAN DIEGO CA 92121 CHRISTOPHER VAN GORDER PRESIDENT & CEO/TRUSTEE 2025-08-08 false Steven T Rutti P00775456 6023223000 2025-07-24 2023 2025-03-06 01:10:19Z X CHRISTOPHER VAN GORDER 4555 EXECUTIVE DR SAN DIEGO CA 92121 5679171352 false X WWW.SCRIPPS.ORG X 1924 CA Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4.9 billion, private not-for-profit integrated health system in San Diego, Ca. (see Sch O) 17 16 20408 1522 30574038 3892225 75146449 43068436 3851530919 4574697762 86554526 123981850 126977440 127717495 4140209334 4869465543 535437 1507500 0 1841634102 2010509221 0 8756658 2247895981 2513892493 4090065520 4525909214 50143814 343556329 7496795108 9124382316 2391449190 3089779778 5105345918 6034602538 SEE SCHEDULE O false false 4048891514 1507500 4669120872 SEE SCHEDULE O. 1576284 0 2592060 The Maxwell H. and Muriel Gluck Child Care center provides child care and pre-school education for the benefit of individuals in the community of San Diego, including employees and patients of the nonprofit 501(C)(3) entities of Scripps Health and Scripps Research Institute. Special emphasis is placed on a variety of learning and play activities in the musical and visual arts field. 4050467798 true true false true false true true false true true true false true true true false true false true true false false false true false true true true false true true false false false false false true false false true true true false false false true true true true false false true 789 0 true 20408 true true true false false false false true true false false false false true false X 17 16 false false false false false false false true true false false true true true true true true true true true true CA X BRETT TANDE 8586787227 4555 EXECUTIVE DR SAN DIEGO CA 92121 Christopher Van Gorder President / CEO 58.0 2.0 X X 4288837 0 53166 Don Goldman Trustee, Vice Chair 13.0 1.0 X X 0 0 0 Kevin T Hamilton Trustee, Chair 13.0 1.0 X X 0 0 0 Dan Feldman TRUSTEE 13.0 1.0 X 0 0 0 Elliot A Scott TRUSTEE 13.0 1.0 X 0 0 0 Gene H Barduson TRUSTEE 13.0 1.0 X 0 0 0 Honorable Irma Gonzalez TRUSTEE 13.0 1.0 X 0 0 0 Jan Caldwell TRUSTEE 13.0 1.0 X 0 0 0 Jeff Bowman TRUSTEE 13.0 1.0 X 0 0 0 John Boyer PhD TRUSTEE 13.0 1.0 X 0 0 0 Nicole A Clay TRUSTEE 13.0 1.0 X 0 0 0 Richard C Bigelow TRUSTEE 13.0 1.0 X 0 0 0 Richard Vortmann TRUSTEE 13.0 1.0 X 0 0 0 Robert Buell Esq TRUSTEE 13.0 1.0 X 0 0 0 Shireen Matthews Esq TRUSTEE 13.0 1.0 X 0 0 0 Theodore Thomas MD TRUSTEE 13.0 1.0 X 0 0 0 William D Gore TRUSTEE 13.0 1.0 X 0 0 0 Bradley Ellis Corp Sr. VP Chief Legal Officer 49.0 1.0 X 1217297 0 52990 Brett Tande Treasurer / Exec VP, CFO 54.0 1.0 X 1271424 0 55883 Mielle Schwartz Executive Assistant SR 40.0 0 X 85205 0 40822 Monique Gonzalez Executive Assistant to the CEO 50.0 0 X 112636 0 23795 Anil Keswani Corp EVP Chief Med & Ops Officer AMB 50.0 0.0 X 1262283 0 59584 Barbara Price Corp Sr VP, Bus&Serv Line Dev 50.0 0 X 1176303 0 65603 Carl Etter Chief Executive, Sr VP 50.0 0 X 1729020 0 52236 Eric Cole Corp Sr. VP, Human Resources 50.0 0 X 1032624 0 50095 Ghazala Sharieff Corp EVP Chief Med & Ops Officer Acute 50.0 0 X 1609519 0 52997 John Engle Corp Sr. VP, Chief Development 50.0 0 X 922832 0 55383 June Komar Corp Exec VP, Strategy & Admin 50.0 0 X 1253157 0 38170 Lisa RisserThakur Corp Sr. VP, Ancillary Ops (part year) 50.0 0 X 1602599 0 14713 Richard Neale Corp Exec VP, Chief Growth Officer 40.0 10.0 X 1269444 0 58981 Shane Thielman Corp SVP CIDO 50.0 0 X 957238 0 62253 Thomas Buchholz Corp Sr. VP, MD Anderson 50.0 0 X 1466771 0 42908 Thomas Gammiere Chief Executive, Sr VP 50.0 0 X 1113458 0 55575 Craig M Uejo Corp VP, Chief Quality Officer 50.0 0 X 695590 0 55546 Gerald Soderstrom Corp SVP Audit/Compliance 50.0 0 X 722139 0 56099 John Poole Corp VP, System Improvement 50.0 0 X 800718 0 31325 Sherman T Moore Corp VP, Business Development 50.0 0 X 673010 0 55447 Tracy Chu Corp VP, POP Hlth CHF EXEC/ACO 50.0 0 X 789595 0 34777 Richard Rothberger Former Officer 0.0 0 X 430289 0 0 Shawn Forrester FORMER KEY EMPLOYEE 0.0 0.0 X 342211 0 0 26824199 0 1068348 5576 true true false Scripps Clinic Medical Group Inc 10666 N Torrey Pines Rd La Jolla CA 92037 Physician Services 485629411 Scripps Coastal Medical Group 501 Washington Ave San Diego CA 92103 Physician Services 91559847 Scripps Health Inpatient Providers Med Group 4555 Executive Dr San Diego CA 92121 Physician Services 52880729 MedImpact Healthcare Systems 10181 Scripps Gateway Ct San Diego CA 92131 Pharmaceutical Services 52218312 DPC Construction 1450 Veterans Blvd Redwood City CA 94063 Construction Services 31162813 139 437369 11118091 31512976 1334862 43068436 HEALTHCARE DELIVERY REV 622110 4145604542 4144143452 1461090 PROVIDER FEE REVENUE 622110 297816293 297816293 CAPITATION PREMIUM 622110 71146644 71146644 JOINT VENTURE REVENUE 900099 30220542 30220542 RENTAL INCOME - MOB 531120 12241725 12241725 17668016 17015924 652092 0 4574697762 93151157 93151157 0 0 839382317 808551624 30830693 0 30830693 30830693 1302887 437369 1154185 148702 148702 MANAGEMENT SERVICES 561110 58113441 29842298 28271143 ALL OTHER REVENUE 900099 43484175 41201695 189713 2092767 PHARMACEUTICAL REVENUE 446110 25971177 25971177 0 0 0 0 127568793 4869465543 4669599750 30574038 126223319 X 1507500 1507500 20921162 20921162 216270 216270 1676018448 1444664381 226004838 5349229 59596504 50423221 8992605 180678 132887992 132414459 473533 120868845 103994242 16575324 299279 11746342 4742426 6999283 4633 1304245 1289052 15193 502081 502081 6008502 6008502 935551921 875923870 59197784 430267 1951240 1950614 626 89492761 75868140 12785944 838677 68922416 35835540 33086876 112632098 95808115 16744792 79191 40457026 35231253 5225773 175766845 156551591 19215254 16248983 16229518 19465 MEDICAL SUPPLIES 784995757 784994722 1035 HOSPITAL FEE PROGRAM 213400447 213400447 REPAIRS & MAINTENANCE 44187945 13220625 30949139 18181 ALL OTHER EXPENSES 10723884 9657748 1066136 0 0 0 0 4525909214 4050467798 466684758 8756658 328877965 664366806 7714518 6731561 626510398 680894472 22987129 23751894 0 0 76645463 72129893 53130912 50374375 4478754162 1718003224 2613087085 2760750938 2558568903 3349918598 720177000 854913000 74349869 75271371 45109895 45109895 369635971 540169513 7496795108 9124382316 592625617 730059359 711154000 1416000000 0 0 187426010 7378392 900243563 936342027 2391449190 3089779778 X 4851868923 5778276035 253476995 256326503 5105345918 6034602538 7496795108 9124382316 X 343556329 628011453 -42311162 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 87393 true 265600 false true 341588 694581 false Schedule C, Part II-B, Line 1b PERSONS AT SCRIPPS HEALTH EXCEEDED 5% OF TOTAL TIME SPENT ON DIRECT CONTACT WITH LEGISLATORS, STAFF AND GOVERNMENT OFFICIALS TO ENGAGE IN LOBBYING ACTIVITIES Schedule C, Part II-B, Line 1f DISCLOSURE OF A TRANSFER OF SCRIPPS FUNDS IN CALIFORNIA HOSPITAL ASSOCIATION (CHA) ACCOUNT TO THE CALIFORNIA HOSPITALS COMMITTEE ON ISSUES (CHCI) ACCOUNT. Schedule C, Part II-B, Line 1g VALUE DETERMINED UTILIZING GROSS-UP METHOD FOR DIRECT LOBBYING COSTS. LOBBYING LABOR COSTS OF PARTIAL TIME FOR (2) PERSONS AT SCRIPPS HEALTH X 175% + ALLOCABLE THIRD-PARTY COSTS (JGC CONSULTING, SD LAND LAWYERS) SPENT ON DIRECT CONTACT WITH LEGISLATORS, STAFF AND GOVERNMENT OFFICIALS TO ENGAGE IN LOBBYING ACTIVITIES ARE REFERENCED HERE. Schedule C, Part II-B, Line 1i OTHER ACTIVITIES APPROXIMATE VALUE CONSIDERS A PORTION OF THE DUES OF MEMBER ORGANIZATIONS SPENT ON LOBBYING IN ADDITION TO ANY TRAVEL EXPENSES OCCURRED FOR GOVERNMENT RELATIONS: SENIOR DIRECTOR, GOVERNMENT RELATIONS; DIRECTOR, COMMUNITY AND GOVERNMENT RELATIONS RELATED TO LOBBYING ACTIVITIES. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Government Relations INFORMATION AND EDUCATION SCRIPPS HEALTH ON ITS OWN BEHALF AND AS A MEMBER OF SEVERAL HOSPITAL ASSOCIATIONS AND HEALTH CARE ORGANIZATIONS PARTICIPATES IN PUBLIC AFFAIRS AND ADVOCACY ACTIVITIES. SOME ACTIVITY IS INDIVIDUALLY OR COLLECTIVELY CONDUCTED BY AND SPECIFICALLY ON BEHALF OF SCRIPPS HEALTH. OTHER ACTIVITY IS ORGANIZED BY THESE INVOLVED ORGANIZATIONS SUPPORTED BY SCRIPPS HEALTH PARTICIPATION. THIS ACTIVITY INCLUDES BRIEFING OF LEGISLATORS AND LEGISLATIVE STAFF MEMBERS (FEDERAL, STATE AND LOCAL) ON MATTERS AFFECTING HEALTH CARE AND HEALTH CARE OPERATIONS. MEETINGS OCCUR IN PUBLIC OFFICIAL OFFICES, AT SCRIPPS FACILITIES AND IN VARIOUS OTHER VENUES OF OPPORTUNITY. ACTIVITY IS ON FEDERAL, STATE AND LOCAL LEVELS AND LOCATIONS. SUCH MATTERS INCLUDE: BUDGET AND FISCAL POLICY IMPACTS; MEDICARE AND MEDICAID REIMBURSEMENT MATTERS; PROVIDER FEES AND OTHER ASSESSMENTS; DATA MANAGEMENT AND REPORTING; QUALITY AND PATIENT SAFETY MATTERS, HEALTH INFORMATION TECHNOLOGY, EMERGENCY DEPARTMENT OPERATIONS AND IMPACTS; COST SHIFT IMPACTS AND OTHER SAFETY NET ISSUES; COMMUNITY BENEFIT PROGRAMS; GRADUATE MEDICAL EDUCATION; SITE-NEUTRAL PRICING; ACCOUNTABLE CARE ORGANIZATIONS; VIOLENCE AGAINST HEALTH CARE WORKERS; HEALTH CARE WORKERS MINIMUM WAGE; SIESMIC MANDATES; BEHAVIORAL HEALTH CLINICAL WORKFORCE AND OTHER OPERATIONAL ISSUES; HOMELESSNESS; LOCAL LAND USE ISSUES LIKE THE CONDITIONAL USE PERMITS FOR MERCY SAN DIEGO AND ENCINITAS HOSPITAL CONSTRUCTION PROJECTS. THE ORGANIZATION STAFFS A GOVERNMENT RELATIONS DEPARTMENT THAT COORDINATES INFORMATION AND EDUCATION PROGRAMS ON PUBLIC POLICY AND ADVOCACY MATTERS. ALL WORK IS FOCUSED ON ISSUES. NO ACTIVITY ADDRESSES PARTISAN MATTERS, CANDIDATES OR POLITICAL ACTIVITIES. NO CORPORATE ACTIVITY ADDRESSED PARTISAN CAMPAIGNS. DIRECT COMMUNICATION (MEETINGS, EMAIL, CALLS, LETTERS) WITH SAN DIEGO LEGISLATIVE DELEGATIONS - FEDERAL AND STATE. ON SAN DIEGO LOCAL LEVEL EMPLOYED SD LAND LAWYERS TO REPRESENT INTERESTS ON LAND DEVELOPMENT NEEDS. ON CALIFORNIA STATE LEVEL EMPLOYED LOBBY FIRM JGC GOVERNMENT RELATIONS TO REPRESENT INTERESTS ON CERTAIN MEASURES. SCRIPPS DOES NOT EMPLOY FEDERAL LOBBYISTS. LOBBY FIRM ALSO WORKED WITH OTHER HEALTH SYSTEM CONTRACT LOBBYISTS AND CALIFORNIA HOSPITAL ASSOCIATION LOBBY TEAM ON SELECTED LEGISLATION. WORKED IN CONCERT WITH STATE AND NATIONAL HEALTH CARE ORGANIZATIONS THAT CONDUCTED LOBBY PROGRAMS, INCLUDING: AMERICAN HOSPITAL ASSOCIATION, CALIFORNIA HOSPITAL ASSOCIATION, HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES, PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS, ALLIANCE OF CATHOLIC HEALTH CARE. SCRIPPS HEALTH DID NOT FILE FORM 5768 UNDER SECTION 501(H). THERE ARE TESTS FOR TAX EXEMPTION - A "SUBSTANTIAL PART TEST AN "EXPENDITURE TEST." AS A 501(C)(3) ORGANIZATION, WE CAN OPT TO FOLLOW THE GUIDELINE THAT "NO SUBSTANTIAL PART" OF OUR ACTIVITIES ARE CARRIED ON TO INFLUENCE LEGISLATION. UNDER SECTION 501(H), ELIGIBLE 501(C)(3) ORGANIZATIONS CAN ELECT TO MAKE LIMITED EXPENDITURES TO INFLUENCE LEGISLATION. THE "EXPENDITURE TEST" IS SUBJECT TO AMOUNTS PERMITTED BY THAT SECTION. WHILE OUR EXPENDITURES FALL WELL BELOW THE LIMITS, WE ALSO EXPEND WHAT IS GENERALLY CONSIDERED AS NO SUBSTANTIAL PART ON SUCH EXPENDITURES. THEREFORE, WE OPT NOT TO FILE FORM 5768, THE FORM REQUIRED UNDER SECTION 501(H). NATIONAL, STATE & LOCAL ORGANIZATIONS WITH WHICH SCRIPPS HEALTH PARTICIPATES IN PART IN LOBBY ACTIVITIES: AMERICAN HOSPITAL ASSOCIATION CALIFORNIA HOSPITAL ASSOCIATION HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES PRIVATE ESSENTIAL ACCESS COMMUNITY HOSPITALS ALLIANCE FOR CATHOLIC HEALTH CARE ASSOCIATION OF ACADEMIC MEDICAL CENTERS (AAMC) SAN DIEGO REGIONAL CHAMBER OF COMMERCE NATIONAL ASSOCIATION FOR ACCOUNTABLE CARE ORGANIZATIONS (NAACOS) X 1 16.0 1 0 1 true 327.0 2840 true 0 742881 X false 126146630 47685 25766761 0 4515635 1329015 146116426 117874000 208670 13935117 0 4548650 1322507 126146630 140886000 1207385 -19713562 0 3181443 1324380 117874000 129880000 540474 15126128 897549 2574215 1188838 140886000 121490000 -141903 12705109 874375 2148726 1150105 129880000 0.0 1.0 0.0 false false 47458644 163614505 211073149 1897942935 807082914 1090860021 80985159 55025616 25959543 1355107771 854001615 501106156 933645148 1893079 931752069 2760750938 MULTI-STRATEGY FUNDS 425032000 F PRIVATE EQUITY FUNDS 381881000 F LIMITED PARTNERSHIP 48000000 F 854913000 RIGHT OF USE - OPERATING 222991228 PROVIDER FEE RECEIVABLE 132402877 DEFERRED INVESTMENTS 10839904 CONTRACT RECEIVABLES 3389320 DEFERRED RENT RECEIVABLE 1142763 ART INVESTMENTS 742881 OTHER LONG TERM ASSETS 31989194 DUE FROM MEDICAL GROUPS 3148162 TRUSTEE HELD FUNDS 133523184 540169513 TAXABLE DEBT 549508380 LEASE LIABILITIES 203202524 SELF-INSURED MALPRACTICE LIABILITY 58629000 SELF-INSURED WORKER'S COMPENSATION 34640228 ASSET RETIREMENT OBLIGATION 20214613 ANNUITY AND UNITRUSTS 13338934 DEFERRED RETIREMENT 3023951 PROVIDER FEE LIABILITY 53415145 DEPOSITS AND CONTINGENCIES 369252 936342027 X Schedule D, Part II, Line 9 Conservation easements financial reporting THE HISTORICAL STRUCTURE THAT IS CONSIDERED TO BE A CONSERVATION EASEMENT IS REPORTED IN THE MERCY HOSPITAL ENTITY OF THE CONSOLIDATED FINANCIAL STATEMENTS. Schedule D, Part III, Line 4 Collections of art - description of collections Scripps Health accepts and maintains gifts-in-kind contributions for art and sculptures ("Collections"). Collections donated with an appraised value greater than $10,000 are recorded in the general ledger and classified as Other Assets and Donor without Restriction Contributions. The Collections are maintained by Scripps Health and are publicly displayed. An annual inventory to assess condition of the Collections is performed. Scripps does not intend to sell the collections for any financial benefit. Scripps Health's Collections provides a clear contribution to make and offer opportunities in delivery of better health, wellbeing and improved experience for patients, service users and staff across the system. Schedule D, Part V, Line 4 Intended uses of endowment funds CONTRIBUTIONS RECEIVED FOR CAPITAL PROJECTS, INCLUDING BUILDING PROJECTS, MAJOR RENOVATIONS, AND EQUIPMENT PURCHASES: $636,131 CONTRIBUTIONS RECEIVED TO FUND GRADUATE MEDICAL EDUCATION PROGRAMS, FELLOWS, AND LECTURE SERIES: $17,026,946 CONTRIBUTIONS RECEIVED FOR USE IN THE SPECIFIC DEPARTMENTS OR DIVISIONS IN THE HOSPITALS AND/OR CLINICS: $41,310,940 CONTRIBUTIONS RECEIVED TO COVER THE COST OF HEALTHCARE PROVIDED TO INDIVIDUALS WITHOUT INSURANCE OR THE MEANS FOR PAYING FOR THEIR CARE: $12,785,414 CONTRIBUTIONS RECEIVED TO FUND RESEARCH PROJECTS IN SPECIFIC AREAS OR DIVISIONS: $13,325,510 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote SCRIPPS HEALTH IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, SCRIPPS HEALTH IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OF BUSINESS, REGULARLY CARRIED ON, AND NOT IN THE FURTHERANCE OF THE PURPOSED FOR WHICH IT WAS GRANTED EXEMPTION. UNDER FASB ASC 740, INCOME TAXES, THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS MAY BE RECOGNIZED 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. THE ORGANIZATION 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 MET. THE ORGANIZATION 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. NO SIGNIFICANT TAX LIABILITY FOR TAXES, INTEREST OR PENALTIES AND NO SIGNIFICANT TAX ASSETS FOR TAX BENEFITS WAS ACCRUED AT SEPTEMBER 30, 2024 OR 2023. SCRIPPS HEALTH CURRENTLY FILES FORM 990 (INFORMATIONAL RETURN OF ORGANIZATIONS EXEMPT FROM INCOME TAXES) AND FORM 990T (BUSINESS INCOME TAX RETURN FOR AN EXEMPT ORGANIZATION) IN THE U.S. FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. SCRIPPS HEALTH IS NOT SUBJECT TO INCOME TAX EXAMINATIONS PRIOR TO 2019 IN MAJOR TAX JURISDICTIONS. North America (Canada & Mexico only) 0 23 Program Services Reconstructive surgery 365978 Central America and the Caribbean 0 0 Investments 529323662 Europe (Including Iceland and Greenland) 0 0 Investments 56270218 East Asia and the Pacific 0 4 Program Services Med Care & Training 13240 0 27 0 0 0 27 585973098 0 585973098 true false true true true false Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual; EAST ASIA AND THE PACIFIC-Accrual; EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; NORTH AMERICA (CANADA & MEXICO ONLY)-Accrual Candlelight Ball 595704 188581 407123 177967 750 269743 Mercy Ball 506245 154608 351637 413983 14745 24905 2 638307 94180 544127 219829 12290 19973 1740256 437369 1302887 811779 27785 314621 1154185 148702 true true X true X true X true true true false true true 0 0 17768459 0 17768459 0.0039 0 0 518033677 368938817 149094860 0.0329 0 0 0 0 0 0.0 0 0 535802136 368938817 166863319 0.0369 0 0 13126493 2225030 10901463 0.0024 0 0 58893858 11234589 47659269 0.0105 0 0 17427234 14326757 3100477 0.0007 0 0 17569425 12577867 4991558 0.0011 0 0 1485542 0 1485542 0.0003 0 0 108502552 40364243 68138309 0.0151 0 0 644304688 409303060 235001628 0.0519 42384 42384 0.0000 31443 31443 0.0000 13000 13000 0.0000 0 0.0 106384 25935 80449 0.0000 0 0.0 0 0.0 331021 111045 219976 0.0000 0 0.0 0 0 524232 136980 387252 0.0001 true 55524239 612958842 702551375 -89592533 X true true SCRIPPS ENCINITAS SURGERY CENTER AMBULATORY SURGERY CENTER 0.5747 0.2011 SCRIPPS MEMORIAL XIMED MEDICAL MEDICAL OFFICE BUILDING 0.153 0.772 SCRIPPS MERCY ASC AMBULATORY SURGERY CENTER 0.825 0.175 SCRIPPSUSP SURGERY CENTERS AMBULATORY SURGERY CENTER 0.5 0.36 5 2 SCRIPPS MERCY HOSPITAL 4077 5TH AVENUE SAN DIEGO CA 92103 WWW.SCRIPPS.ORG 090000074 X X X X X A 1 SCRIPPS MEMORIAL HOSPITAL LA JOLLA 9888 GENESEE AVENUE LA JOLLA CA 92037 WWW.SCRIPPS.ORG 080000050 X X X X X A 4 SCRIPPS MEMORIAL HOSPITAL ENCINITAS 354 SANTA FE DRIVE SAN DIEGO CA 92034 WWW.SCRIPPS.ORG 080000148 X X X X X A 3 SCRIPPS GREEN HOSPITAL 10666 NORTH TORREY PINES RD SAN DIEGO CA 92037 WWW.SCRIPPS.ORG 080000139 X X X X A 5 SELECT SPECIALTY HOSPITAL - SAN DIEGO 555 WASHINGTON ST SAN DIEGO CA 92103 WWW.SELECTSPECIALTYHOSPITALS.COM 090000404 X B A 4 false false true X X X X X X X X X 21 true true true true X https://www.scripps.org/about-us/scripps-in-the-community X true 22 true https://www.scripps.org/about-us/scripps-in-the-community false true X 200.0 400.0 X X X X true true X X X X true X https://www.scripps.org/patients-and-visitors/help-paying-your-bill X https://www.scripps.org/patients-and-visitors/help-paying-your-bill X https://www.scripps.org/patients-and-visitors/help-paying-your-bill X X X X X X X true X false X X X X true X false false B 1 false false true X X X X X X X X X 22 true true true true X https://www.selectspecialtyhospitals.com/-/media/project/selectmedical/inpatients/selectspecialty/fi X https://www.scripps.org/about-us/scripps-in-the-community X true 22 true https://www.scripps.org/about-us/scripps-in-the-community false true X 200.0 400.0 X X X X true true X X X X true X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/ X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/ X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/ X X X X X X X true X false X X X true X false false Schedule H, Part V, Section B, Line 3E 2022 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH HEALTH CONDITIONS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED, THE MAGNITUDE/SCALE OF THE NEED; DISPARITIES OR INEQUITIES AND CHANGE OVER TIME. THOSE HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT MET THE LARGEST NUMBER OF CRITERIA WERE THEN SELECTED AS TOP PRIORITY COMMUNITY HEALTH NEEDS. THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY, LISTED BELOW IN ALPHABETICAL ORDER: -ACCESS TO HEALTH CARE -AGING CARE & SUPPORT -BEHAVIORAL HEALTH -CHILDREN & YOUTH WELLBEING -CHRONIC HEALTH CONDITIONS -COMMUNITY SAFETY -ECONOMIC STABILITY WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY: A MULTI-FACETED, MULTI-STAKEHOLDER PLAN THAT ADDRESSES COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE AND OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - REPORTING GROUP A. COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO SOLICIT INPUT FROM A WIDE RANGE OF STAKEHOLDERS SO THAT THE SAMPLE WAS AS REPRESENTATIVE AS POSSIBLE OF THOSE FACING INEQUITIES IN SAN DIEGO COUNTY. SPECIAL EFFORTS WERE MADE TO INCLUDE COMMUNITY MEMBERS FROM GROUPS THAT EXPERIENCE HEALTH DISPARITIES AND SERVICE PROVIDERS WHO WORK WITH THOSE VULNERABLE POPULATIONS. A TOTAL OF 841 INDIVIDUALS PARTICIPATED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. INPUT FROM THE COMMUNITY WAS GATHERED THROUGH THE FOLLOWING EFFORTS: - WORKING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS. - CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTH CARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL (KFH)-SAN DIEGO). - CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS. - DISTRIBUTING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT STAFF. THE CHNA COMMITTEE WORKED WITH COMMUNITY PARTNERS TO PLAN COMMUNITY ENGAGEMENT ACTIVITIES WITH STAKEHOLDERS REPRESENTING EVERY REGION OF SAN DIEGO COUNTY AND ALL AGE GROUPS. IN ADDITION, THE CHNA COMMITTEE EXPLICITLY SOUGHT TO ENGAGE A WIDE VARIETY OF STAKEHOLDERS REPRESENTING NUMEROUS, DIVERSE RACIAL AND ETHNIC GROUPS. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE USED TO IDENTIFY AND EXPLORE PRIORITY HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO CARE, AND COMMUNITY ASSETS AND RESOURCES, WITH INTERVIEWS AND FOCUS GROUPS CONDUCTED BETWEEN OCTOBER 2021 AND APRIL 2022. INTERVIEWERS AND FACILITATORS EMPLOYED THE QUESTIONS DEVELOPED AND APPROVED BY THE CHNA COMMITTEE TO GENERATE DISCUSSION ABOUT SPECIFIC COMMUNITY HEALTH NEEDS, AS WELL AS OPEN ENDED QUESTIONS FOR BROADER DISCUSSIONS. BROAD QUESTIONS ABOUT HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH WERE ASKED AT THE BEGINNING OF EACH DISCUSSION, FOLLOWED BY MORE SPECIFIC QUESTIONS TARGETED FOR THE PARTICIPANTS. QUESTIONS VARIED DEPENDING ON THE EXPERTISE AND/OR SPECIFIC INTERESTS OF THE PERSON OR GROUP PARTICIPATING IN EACH INTERVIEW AND FOCUS GROUP. FOCUS GROUPS AND INTERVIEWS WERE CONDUCTED VIA ZOOM. INCENTIVES, IN THE FORM OF GIFT CARDS, WERE ALSO PROVIDED WHEN THE GROUPS WERE COMPRISED OF COMMUNITY RESIDENTS. EACH INTERVIEW AND FOCUS GROUP BEGAN WITH A DISCUSSION ABOUT THE PURPOSE AND PROCESS OF THE CHNA. THE INTERVIEWER OBTAINED VERBAL AND VISUAL CONSENT TO PROCEED (AND, IN SOME CASES, RECORD) AND ASSURED PARTICIPANTS THAT THEIR PARTICIPATION WAS VOLUNTARY AND THAT THEIR FEEDBACK WOULD BE ANONYMOUS. INTERPRETATIVE AND TRANSLATION SERVICES WERE ARRANGED FOR ANY GROUP THAT REQUESTED THEM. ONE FOCUS GROUP WAS CONDUCTED IN SPANISH BY A FACILITATOR THROUGH SIMULTANEOUS ENGLISH AND SPANISH INTERPRETATION. ONLINE COMMUNITY SURVEY THE CHNA ONLINE COMMUNITY SURVEY WAS USED TO SUPPORT PRIORITIZATION OF HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH BASED ON COMMUNITY FEEDBACK ABOUT WHAT SURVEY RESPONDENTS VIEWED AS THE MOST IMPORTANT OR MOST SERIOUS CHALLENGES. THE SURVEY WAS DISTRIBUTED VIA EMAIL TO TARGETED COMMUNITY- BASED ORGANIZATIONS, SOCIAL SERVICE PROVIDERS, RESIDENT-LED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, GOVERNMENT AGENCIES, GRANTMAKING ORGANIZATIONS, AND HOSPITALS AND HEALTH SYSTEMS THAT SERVE A DIVERSE ARRAY OF PEOPLE IN SAN DIEGO COUNTY. WHEN POSSIBLE, THESE ORGANIZATIONS SHARED THE LINK TO THE SURVEY WITH THE CLIENTS THEY SERVED. EMAIL RECIPIENTS WERE ALSO ENCOURAGED TO SHARE THE SURVEY WITH THEIR COLLEAGUES. THE SURVEY - OPEN FROM FEBRUARY 14 TO MARCH 30, 2022 - WAS ALSO WIDELY SHARED THROUGH SOCIAL EMAIL AND RESHARED BY COMMUNITY-BASED ORGANIZATIONS. THE SURVEY WAS DESIGNED TO BE TAKEN BY COMMUNITY MEMBERS AND WAS TRANSLATED FROM ENGLISH INTO FIVE ADDITIONAL LANGUAGES: ARABIC, SPANISH, SOMALI, TAGALOG, AND VIETNAMESE. MIDCITY CAN, A COMMUNITY-BASED ORGANIZATION LOCATED IN CITY HEIGHTS, WAS CONTRACTED TO COMPLETE THE TRANSLATIONS. RESEARCH PARTNERS AT THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT THE SAN DIEGO STATE UNIVERSITY (SDSU) SCHOOL OF PUBLIC HEALTH (SPH) FACILITATED TWO FOCUS GROUPS WITH COMMUNITY HEALTH WORKERS (CHWS). THE IPH CONDUCTED BOTH FOCUS GROUPS THROUGH ZOOM. ALL FOCUS GROUP PARTICIPANTS WERE COMMUNITY HEALTH WORKERS WORKING FOR A COVID-19 CONTACT TRACING PROGRAM. FOCUS GROUP PARTICIPANTS WERE RECRUITED THROUGH MULTIPLE AVENUES, INCLUDING ANNOUNCEMENTS IN THE COUNTY OF SAN DIEGO HHSA'S COMMUNITY HEALTH WORKER COLLABORATIVE NEWSLETTER, DISSEMINATED BY THE COUNTY TO PROVIDE UPDATES ON COVID-19 COMMUNICATION AND OUTREACH SERVICES TO THE INDIVIDUALS WORKING ON ONE OF THE COUNTY COVID-19 CONTRACTS. IN ADDITION, EMAILS WERE DISSEMINATED DIRECTLY TO ALL CHWS ON THE COMMUNITIES FIGHTING COVID! PROJECT AT SDSU, AND EMAILS WERE SENT TO THE LEADS ON EIGHT DIFFERENT COUNTY COVID-19 CONTRACTS, REQUESTING THAT THEY DISSEMINATE THE INFORMATION TO THEIR CHWS OR OUTREACH WORKERS. THE ANNOUNCEMENT INCLUDED AN INTEREST FORM THAT ASKED FOR THE PERSON'S CONTACT INFORMATION, DAY OF THE WEEK AND TIME OF DAY THAT WORKED BEST FOR THEM, TYPE OF GIFT CARD THEY WOULD LIKE TO RECEIVE AS A THANK YOU, AND A BRIEF DESCRIPTION OF THE TYPE OF WORK THEY CURRENTLY DO. FOCUS GROUP PARTICIPANTS WERE ASKED OPEN-ENDED QUESTIONS ABOUT IDENTIFYING SPECIFIC HEALTH CONDITIONS OF CONCERN, ABOUT INEQUITIES IN THE COMMUNITY, AND ABOUT THE NEEDS OF YOUTH AND SENIORS. GIFT CARDS WERE EMAILED TWO DAYS AFTER THE FOCUS GROUP AS A THANK YOU TO ALL PARTICIPANTS. PROMOTORAS AND COMMUNITY HEALTH WORKER INTERVIEWS/ACCESS TO HEALTH CARE INTERVIEWS TO ENSURE THE REPORT INCLUDED DIRECT COMMUNITY MEMBER FEEDBACK FROM RACIAL AND ETHNIC GROUPS EXPERIENCING DISPARATE HEALTH OUTCOMES, THE CHNA COMMITTEE EMPLOYED A NEW STRATEGY TO PARTNER WITH COMMUNITY-BASED ORGANIZATIONS THAT WORK WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS. THE ONLINE COMMUNITY SURVEY WAS ADAPTED WITH A SUBSET OF THE SURVEY QUESTIONS FOR USE AS A DATA COLLECTION TOOL. THE SAN DIEGO REFUGEE COMMUNITIES COALITION AND THE CHICANO FEDERATION WERE SELECTED TO RECRUIT INTERESTED COMMUNITY HEALTH WORKERS AND PROMOTORAS TO CONDUCT THE INTERVIEWS. HASD&IC STAFF ATTENDED A SAN DIEGO REFUGEE COMMUNITIES COALITION WEEKLY COMMUNITY HEALTH WORKER MEETING TO PROVIDE TRAINING ON THE GOALS OF THE CHNA AND HOW TO ADMINISTER THE INTERVIEW. HASD&IC STAFF ALSO PROVIDED TRAINING TO THE CHICANO FEDERATION PROMOTORAS. PROMOTORAS AND COMMUNITY HEALTH WORKERS CONDUCTED INTERVIEWS EITHER IN PERSON OR OVER THE PHONE. INTERVIEWERS ASKED OPEN-ENDED QUESTIONS ABOUT THE FOLLOWING: HEALTH NEEDS, SOCIAL NEEDS, ACCESS TO CARE CHALLENGES, AND WHAT HOSPITALS COULD DO TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. INTERVIEWERS THEN CODED RESPONSES AND INPUT THEM IN AN ONLINE DATA COLLECTION TOOL. PRICE PHILANTHROPIES FOUNDATION GENEROUSLY PROVIDED GRANTS TO BOTH ORGANIZATIONS TO COMPENSATE PROMOTORAS AND COMMUNITY HEALTH WORKERS FOR COMPLETING INTERVIEWS. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - REPORTING GROUP A. 2022 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS. THE CHNA RESPONDS TO IRS REGULATORY REQUIREMENTS THAT PRIVATE NOT-FOR-PROFIT (TAX-EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE MAJORITY OF 2022 CHNA COLLABORATIVE MEMBERS ARE HOSPITALS AND HEALTH SYSTEMS THAT ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO PARTICIPATED IN THE COLLECTIVE EFFORT TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF SAN DIEGO COMMUNITIES. PARTICIPATING HOSPITAL AND HEALTH SYSTEMS SUPPORTED THE CHNA PROCESS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY WORKGROUP, THE COMMUNITY NEEDS ASSESSMENT COMMITTEE, AND THE HASD&IC BOARD OF DIRECTORs. * ALVARADO HOSPITAL MEDICAL CENTER * ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM * AURORA BEHAVIORAL HEALTH CARE SAN DIEGO * GROSSMONT HEALTHCARE DISTRICT * KAISER PERMANENTE SAN DIEGO * PALOMAR HEALTH * PARADISE VALLEY HOSPITAL/BAYVIEW BEHAVIORAL HEALTH CAMPUS * RADY CHILDREN'S HOSPITAL - SAN DIEGO * SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL * SCRIPPS HEALTH * SHARP HEALTHCARE * TRI-CITY MEDICAL CENTER * UC SAN DIEGO HEALTH * VA SAN DIEGO HEALTHCARE SYSTEM * SELECT SPECIALTY HOSPITAL Schedule H, Part V, Section B, Line 6b Facility A, 1 Facility A, 1 - REPORTING GROUP A. THE HOSPITAL ASSOCIATION FOR SAN DIEGO AND IMPERIAL COUNTIES(HASD&IC) CONTRACTED WITH THE FOLLOWING RESEARCH PARTNERS ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. PATRICIA SINAY FROM COMMUNITY INVESTMENT STRATEGIES (CIS) SUPPORTED THE HOSPITAL ASSOCIATION TEAM WITH QUALITATIVE RESEARCH AND REPORT WRITING. CIS PROVIDES STRATEGIC VISIONING & PLANNING, MANAGEMENT TRAINING, AND PROGRAM IMPLEMENTATION SERVICES TO NONPROFITS, BUSINESSES, GOVERNMENTS, AND PHILANTHROPY. AS A LATINA IMMIGRANT, PATRICIA SPECIALIZES IN INCLUSIVE, CROSS-SECTOR EFFORTS THAT STRENGTHEN THE GREATER GOOD FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES. HASD&IC CONTRACTED WITH THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU). IN THE LAST 20 YEARS, THE IPH HAS PARTNERED WITH OVER 70 LOCAL, STATE, NATIONAL AND INTERNATIONAL PUBLIC AND PRIVATE COMMUNITY-BASED AGENCIES AND ORGANIZATIONS REPRESENTING MORE THAN 120 MULTIPLE-YEAR CONTRACTS WITH A WIDE VARIETY OF NEEDS AND METHODOLOGIES. THE IPH HAS EXPERTISE IN QUALITATIVE AND QUANTITATIVE COMMUNITY-BASED RESEARCH METHODS. IN ADDITION, THE IPH HAS EXTENSIVE EXPERIENCE IN SUCCESSFUL COMMUNITY ENGAGEMENT WITH DIVERSE GROUPS, INCLUDING NON-ENGLISH SPEAKERS. THE IPH HAS BEEN WORKING ACROSS CULTURES AND WITH VULNERABLE POPULATIONS FOR 25 YEARS, INCLUDING PROGRAMS WITH ASIAN AND PACIFIC ISLANDER COMMUNITIES, AFRICAN-AMERICAN COMMUNITIES, EAST AFRICAN COMMUNITIES, LATINO COMMUNITIES, NATIVE AMERICAN COMMUNITIES, LOW-INCOME COMMUNITIES, GAY, BISEXUAL, TRANSGENDER INDIVIDUALS, PEOPLE LIVING WITH HIV/AIDS, INDIVIDUALS EXPERIENCING HOMELESSNESS, ADOLESCENTS WHO ARE PREGNANT OR PARENTING, AND SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, AMONG OTHERS. IPH STAFF HAVE SPECIAL EXPERTISE IN CONDUCTING CULTURALLY COMPETENT WORK AND EXPLORING SENSITIVE ISSUES. IPH COMMUNITY ENGAGEMENT EFFORTS HAVE INCLUDED PERFORMING KEY INFORMANT INTERVIEWS, LEADING FOCUS GROUPS, FACILITATING TOWN HALL MEETINGS, AND CONDUCTING PATIENT AND PROVIDER INTERVIEWS. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - REPORTING GROUP A. SCRIPPS HEALTH IMPLEMENTATION STRATEGY SUMMARY AND COMMUNITY NEEDS IDENTIFIED. WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY: A MULTI-FACETED, MULTI-STAKEHOLDER PLAN THAT ADDRESSES COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE OBJECTIVES THAT CAN BE CONDUCTED TO IMPROVE COMMUNITY HEALTH OUTCOMES. THIS THREE-YEAR IMPLEMENTATION STRATEGY (FY23-FY25) ADDRESSES THE NEEDS IDENTIFIED IN THE 2022 CHNA, WITH FY24 REPRESENTING THE SECOND YEAR OF REPORTING. EVALUATION OF ACTIVITIES SCRIPPS EVALUATES THE IMPLEMENTATION STRATEGY ANNUALLY TO ENSURE A FLEXIBLE APPROACH FOR ADDRESSING NEEDS IDENTIFIED IN THE CHNA. THIS EVALUATION ASSESSES RESOURCES, INTERVENTIONS, AND PROGRESS TOWARD ACHIEVING THE STRATEGY'S GOALS AND OUTCOME MEASURES, ADJUSTING AS NECESSARY. MONITORING PLANS ARE CUSTOMIZED FOR EACH OBJECTIVE AND INVOLVE COLLECTING TRACKING MEASURES, SUCH AS PARTICIPATION RATES, SATISFACTION LEVELS, GOAL COMPLETION, PEOPLE SERVED, AND FINANCIAL CONTRIBUTIONS TO ASSESS REACH AND PROGRESS. WHERE FEASIBLE, SCRIPPS WILL ALSO EVALUATE OUTCOME METRICS TO MEASURE THE IMPACT OF INITIATIVES ON HEALTH-RELATED OUTCOMES. CHALLENGES ENCOUNTERED ARE DOCUMENTED, AND ADJUSTMENTS ARE MADE AS NEEDED. ADDITIONALLY, SCRIPPS HEALTH FILES THE IMPLEMENTATION STRATEGY ANNUALLY WITH THE IRS VIA FORM 990 SCHEDULE H. RESOURCE COMMITMENTS TO EFFECTIVELY IMPLEMENT THESE STRATEGIES AND ACTIVITIES. SCRIPPS WILL COMMIT FINANCIAL AND IN-KIND RESOURCES, SUCH AS SPECIFIC PROGRAMS AND SERVICES AND STAFF TIME AS APPROPRIATE. COMMUNITY NEEDS SCRIPPS IS ADDRESSING THE HEALTH FOCUS AREAS IDENTIFIED WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS, AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. SCRIPPS IS ADDRESSING ACCESS TO CARE, AGING CARE & SUPPORT, BEHAVIORAL HEALTH, CHILDREN & YOUTH WELLBEING, CHRONIC HEALTH CONDITIONS WHICH INCLUDES CARDIOVASCULAR DISEASE, CANCER AND DIABETES, COMMUNITY SAFETY AND ECONOMIC STABILITY IN THE FY23-FY25 IMPLEMENTATION STRATEGY. SCRIPPS ADDRESSES MANY OF THE SOCIAL DETERMINANTS OF HEALTH WITHIN THE HEALTH CONDITIONS IDENTIFIED SUCH AS, COMMUNITY AND SOCIAL SUPPORT, FOOD INSECURITY, TRANSPORTATION, EDUCATION, AND HOMELESSNESS. COMMUNITY NEEDS SCRIPPS IS NOT DIRECTLY ADDRESSING HOMELESSNESS AND HOUSING INSTABILITY ARE IDENTIFIED AS IMPORTANT FACTORS WITHIN THE CHNA FINDINGS. HOMELESSNESS AND HOUSING ARE NOT DIRECTLY ADDRESSED IN THE SCRIPPS IMPLEMENTATION STRATEGY AS WE FOCUS OUR RESOURCES ON MORE DIRECT HEALTH ISSUES AND CONDITIONS IN ACCORDANCE WITH OUR EXPERTISE AND MISSION. SCRIPPS HAS NOT DIRECTLY DEVELOPED PROGRAMS THAT SPECIFICALLY ADDRESS HOUSING INSECURITY, BUT THIS IS ADDRESSED AS PART OF OUR CARE TO PATIENTS. WHEN PATIENTS' HOUSING NEEDS ARE IDENTIFIED, THE SCRIPPS MULTIDISCIPLINARY TEAM WORKS TO ADDRESS THE NEED. ADDITIONALLY, THE SCRIPPS HEALTH SYSTEM HAS SOCIAL WORK AND CASE MANAGEMENT RESOURCES IN PLACE THROUGHOUT THE INPATIENT SETTING THAT ADDRESS THIS UNMET NEED BY CONNECTING PATIENTS TO MORE PERMANENT SOURCES OF INCOME, HOUSING, AND OTHER SELF-RELIANCE MEASURES. SCRIPPS WORK TO ADDRESS HOUSING INSECURITY IS LARGELY DONE VIA COLLABORATION AND REFERRALS TO COMMUNITY PARTNERS. IN ADDITION TO THE ABOVE INDIRECT MEASURES, SCRIPPS IS ALSO ADDRESSING THESE COMMUNITY NEEDS IN ACCORDANCE WITH CALIFORNIA'S REGULATIONS, SUCH AS SB 1152 DISCHARGE PLANNING FOR HOMELESS PATIENTS. THIS 2019 REGULATION REQUIRES HOSPITALS TO IMPLEMENT A SET OF REQUIREMENTS REGARDING DISCHARGE PLANNING FOR THEIR HOMELESS PATIENTS. SCRIPPS IS FULFILLING THIS REQUIREMENT BY PROVIDING PACKAGED MEALS, WEATHER-APPROPRIATE CLOTHING, TRANSPORTATION, DISCHARGE MEDICATIONS AND/OR PRESCRIPTIONS, INFECTIOUS DISEASE SCREENINGS AND VACCINATIONS, REFERRALS FOR BEHAVIORAL HEALTH AND OTHER REFERRALS TO SHELTERS OR HOUSING. SCRIPPS HEALTH REMAINS COMMITTED TO THE CARE AND IMPROVEMENT OF HEALTH FOR ALL SAN DIEGANS AND WILL LOOK TO CONTINUE THE SEARCH OF NEW OPPORTUNITIES AND NEW PARTNERSHIPS TO ADDRESS THESE AND FUTURE NEEDS. DETAIL ON THE STRATEGIES, INITIATIVES, MEASURES OF IMPLEMENTATION AND METRICS USED TO EVALUATE THE EFFECTIVENESS OF THE COMMUNITY NEEDS IS IDENTIFIED THROUGH SCRIPPS SPECIALTY HOSPITAL 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS CORRESPONDING IMPLEMENTATION STRATEGY. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC FY23-FY25 IMPLEMENTATION STRATEGY REPORT AT SCRIPPS.ORG. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - REPORTING GROUP A. * FINANCIAL ASSISTANCE (CHARITY CARE): FOR PATIENTS WITHOUT INSURANCE WHO EARN LESS THAN 200% OF THE FEDERAL POVERTY LEVEL, WE WILL FULLY FORGIVE THE ENTIRE BILL. * DISCOUNTED PAYMENT: FOR PATIENTS WHO EARN BETWEEN 201% AND 400% OF THE FEDERAL POVERTY LEVEL, WE WILL FORGIVE A PORTION OF YOUR BILL. SCRIPPS WILL NOT BILL QUALIFIED PATIENTS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE MORE THAN THE AMOUNT WE GENERALLY BILL PATIENTS HAVING MEDICARE COVERAGE * WHENEVER POSSIBLE, ELIGIBILITY DETERMINATION IS MADE WITHIN 20 BUSINESS DAYS OF RECEIVING DOCUMENTATION INCLUDING LANGUAGE TRANSLATIONS IF NECESSARY. THE SENIOR DIRECTOR OF PATIENT FINANCIAL SERVICES IS THE AUTHORITY FOR DETERMINING THAT THE HOSPITAL HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE. * PATIENTS ARE INFORMED OF THE ASSISTANCE DETAILS. THE ELIGIBILITY DETERMINATION IS VALID FOR SIX MONTHS FROM THE DATE OF DETERMINATION UNLESS CIRCUMSTANCES CHANGE. Schedule H, Part V, Section B, Line 16 Facility A, 1 Facility A, 1 - REPORTING GROUP A. * POSTERS ALERTING INDIVIDUALS TO SCRIPPS FINANCIAL ASSISTANCE AND CHARITY CARE PROGRAMS ARE DISPLAYED IN REGISTRATION AREAS IN THE HOSPITALS, INCLUDING THE EMERGENCY DEPARTMENTS, OUTPATIENT SETTINGS, AND MAIN ADMISSION AREAS. * SCRIPPS WORKS WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO INFORM THOSE LIKELY TO NEED FINANCIAL HELP. THE SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS AVAILABLE AT COMMUNITY EVENTS AND IS PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. * SCRIPPS WEBSITE PROMINENTLY DISPLAYS LINKS TO "HELPING PAY YOUR BILL". INFORMATION AND RESOURCES ARE AVAILABLE IN MULTIPLE LANGUAGES. INFORMATION INCLUDES BUT IS NOT LIMITED TO; FINANCIAL ASSISTANCE OPTIONS, LANGUAGE ASSISTANCE, CONSUMER ASSISTANCE, AND GOVERNMENT SPONSORED PROGRAMS AND SCRIPPS RESOURCES CAN BE FOUND. * SCRIPPS FINANCIAL ASSISTANCE POLICIES AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW. Schedule H, Part V, Section B, Line 3E 2022 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH HEALTH CONDITIONS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED, THE MAGNITUDE/SCALE OF THE NEED; DISPARITIES OR INEQUITIES AND CHANGE OVER TIME. THOSE HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH (SDOH) THAT MET THE LARGEST NUMBER OF CRITERIA WERE THEN SELECTED AS TOP PRIORITY COMMUNITY HEALTH NEEDS. THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY, LISTED BELOW IN ALPHABETICAL ORDER: - ACCESS TO HEALTH CARE - AGING CARE & SUPPORT - BEHAVIORAL HEALTH - CHILDREN & YOUTH WELLBEING - CHRONIC HEALTH CONDITIONS - COMMUNITY SAFETY - ECONOMIC STABILITY Schedule H, Part V, Section B, Line 5 Facility B, 1 Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. COMMUNITY ENGAGEMENT THE PRIMARY OBJECTIVE OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO GATHER INPUT FROM A DIVERSE RANGE OF STAKEHOLDERS TO ENSURE THAT THE SAMPLE REPRESENTED THOSE EXPERIENCING HEALTH INEQUITIES IN SAN DIEGO COUNTY AS COMPREHENSIVELY AS POSSIBLE. SPECIAL EFFORTS WERE MADE TO INCLUDE COMMUNITY MEMBERS FROM DEMOGRAPHIC GROUPS FACING HEALTH DISPARITIES AND SERVICE PROVIDERS WORKING WITH VULNERABLE POPULATIONS. IN TOTAL, 841 INDIVIDUALS PARTICIPATED IN THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. COMMUNITY INPUT WAS COLLECTED THROUGH VARIOUS METHODS, INCLUDING: - COLLABORATING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS. - ORGANIZING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH A BROAD SPECTRUM OF STAKEHOLDERS, INCLUDING COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTHCARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL - SAN DIEGO). - HOSTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS. - ADMINISTERING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT PERSONNEL. THE EXTENSIVE PROCESS UNDERTAKEN FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT ENSURED THE GATHERING OF INPUT AND INSIGHTS FROM A WIDE ARRAY OF PERSPECTIVES, THUS CONTRIBUTING TO A MORE COMPREHENSIVE UNDERSTANDING OF THE HEALTH NEEDS AND DISPARITIES WITHIN THE SAN DIEGO COUNTY COMMUNITY. TO ACHIEVE THIS, THE CHNA COMMITTEE COLLABORATED WITH COMMUNITY PARTNERS TO PLAN COMMUNITY ENGAGEMENT ACTIVITIES THAT INVOLVED STAKEHOLDERS FROM EVERY REGION OF SAN DIEGO COUNTY AND ACROSS ALL AGE GROUPS. FURTHERMORE, THE COMMITTEE ACTIVELY SOUGHT TO ENGAGE A BROAD SPECTRUM OF STAKEHOLDERS REPRESENTING DIVERSE RACIAL AND ETHNIC GROUPS. THIS INCLUSIVE AND THOROUGH APPROACH TO COMMUNITY ENGAGEMENT HELPED ENSURE THAT THE ASSESSMENT ACCURATELY REPRESENTED THE HEALTH-RELATED CONCERNS AND DISPARITIES EXPERIENCED BY THE ENTIRE COMMUNITY. KEY INFORMANT INTERVIEWS AND FOCUS GROUPS PLAYED A CRUCIAL ROLE IN IDENTIFYING AND EXPLORING PRIORITY HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO CARE, AND COMMUNITY ASSETS AND RESOURCES. THESE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED BETWEEN OCTOBER 2021 AND APRIL 2022. THE INTERVIEWERS AND FACILITATORS UTILIZED QUESTIONS DEVELOPED AND APPROVED BY THE CHNA COMMITTEE TO GUIDE DISCUSSIONS ON SPECIFIC COMMUNITY HEALTH NEEDS. OPEN-ENDED QUESTIONS WERE ALSO USED TO FACILITATE BROADER CONVERSATIONS. THE QUESTIONS ASKED DURING THESE INTERVIEWS AND FOCUS GROUPS VARIED DEPENDING ON THE EXPERTISE AND INTERESTS OF THE PARTICIPANTS. THESE INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED THROUGH VIRTUAL MEETINGS ON ZOOM. INCENTIVES, TYPICALLY IN THE FORM OF GIFT CARDS, WERE PROVIDED TO PARTICIPANTS WHEN THEY WERE COMMUNITY RESIDENTS. EACH INTERVIEW AND FOCUS GROUP BEGAN WITH AN INTRODUCTION TO THE PURPOSE AND PROCESS OF THE CHNA. PARTICIPANTS PROVIDED VERBAL AND VISUAL CONSENT TO PROCEED, AND IN SOME CASES, RECORDINGS WERE MADE. PARTICIPANTS WERE ASSURED THAT THEIR INVOLVEMENT WAS VOLUNTARY, AND THEIR FEEDBACK WOULD REMAIN ANONYMOUS. INTERPRETATIVE AND TRANSLATION SERVICES WERE ARRANGED FOR GROUPS THAT REQUESTED THEM, ENSURING THAT LANGUAGE BARRIERS DID NOT HINDER PARTICIPATION. FOR INSTANCE, ONE FOCUS GROUP WAS CONDUCTED IN SPANISH WITH A FACILITATOR PROVIDING SIMULTANEOUS ENGLISH AND SPANISH INTERPRETATION TO ACCOMMODATE A DIVERSE PARTICIPANT BASE. ONLINE COMMUNITY SURVEY THE CHNA ONLINE COMMUNITY SURVEY WAS USED TO SUPPORT PRIORITIZATION OF HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH BASED ON COMMUNITY FEEDBACK ABOUT WHAT SURVEY RESPONDENTS VIEWED AS THE MOST IMPORTANT OR MOST SERIOUS CHALLENGES. THE SURVEY WAS DISTRIBUTED VIA EMAIL TO TARGETED COMMUNITY- BASED ORGANIZATIONS, SOCIAL SERVICE PROVIDERS, RESIDENT-LED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, GOVERNMENT AGENCIES, GRANTMAKING ORGANIZATIONS, AND HOSPITALS AND HEALTH SYSTEMS THAT SERVE A DIVERSE ARRAY OF PEOPLE IN SAN DIEGO COUNTY. WHEN POSSIBLE, THESE ORGANIZATIONS SHARED THE LINK TO THE SURVEY WITH THE CLIENTS THEY SERVED. EMAIL RECIPIENTS WERE ALSO ENCOURAGED TO SHARE THE SURVEY WITH THEIR COLLEAGUES. THE SURVEY - OPEN FROM FEBRUARY 14 TO MARCH 30, 2022 - WAS ALSO WIDELY SHARED THROUGH SOCIAL EMAIL AND RESHARED BY COMMUNITY- BASED ORGANIZATIONS. THE SURVEY WAS DESIGNED TO BE TAKEN BY COMMUNITY MEMBERS AND WAS TRANSLATED FROM ENGLISH INTO FIVE ADDITIONAL LANGUAGES: ARABIC, SPANISH, SOMALI, TAGALOG, AND VIETNAMESE. MID- CITY CAN, A COMMUNITY-BASED ORGANIZATION LOCATED IN CITY HEIGHTS, WAS CONTRACTED TO COMPLETE THE TRANSLATIONS. RESEARCH PARTNERS AT THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT THE SAN DIEGO STATE UNIVERSITY (SDSU) SCHOOL OF PUBLIC HEALTH (SPH) FACILITATED TWO FOCUS GROUPS WITH COMMUNITY HEALTH WORKERS (CHWS). THE IPH CONDUCTED BOTH FOCUS GROUPS THROUGH ZOOM. ALL FOCUS GROUP PARTICIPANTS WERE COMMUNITY HEALTH WORKERS WORKING FOR A COVID-19 CONTACT TRACING PROGRAM. FOCUS GROUP PARTICIPANTS WERE RECRUITED THROUGH MULTIPLE AVENUES, INCLUDING ANNOUNCEMENTS IN THE COUNTY OF SAN DIEGO HHSA'S COMMUNITY HEALTH WORKER COLLABORATIVE NEWSLETTER, DISSEMINATED BY THE COUNTY TO PROVIDE UPDATES ON COVID-19 COMMUNICATION AND OUTREACH SERVICES TO THE INDIVIDUALS WORKING ON ONE OF THE COUNTY COVID-19 CONTRACTS. IN ADDITION, EMAILS WERE DISSEMINATED DIRECTLY TO ALL CHWS ON THE COMMUNITIES FIGHTING COVID! PROJECT AT SDSU, AND EMAILS WERE SENT TO THE LEADS ON EIGHT DIFFERENT COUNTY COVID-19 CONTRACTS, REQUESTING THAT THEY DISSEMINATE THE INFORMATION TO THEIR CHWS OR OUTREACH WORKERS THE ANNOUNCEMENT INCLUDED AN INTEREST FORM THAT ASKED FOR THE PERSON'S CONTACT INFORMATION, DAY OF THE WEEK AND TIME OF DAY THAT WORKED BEST FOR THEM, TYPE OF GIFT CARD THEY WOULD LIKE TO RECEIVE AS A THANK YOU, AND A BRIEF DESCRIPTION OF THE TYPE OF WORK THEY CURRENTLY DO. FOCUS GROUP PARTICIPANTS WERE ASKED OPEN-ENDED QUESTIONS ABOUT IDENTIFYING SPECIFIC HEALTH CONDITIONS OF CONCERN, ABOUT INEQUITIES IN THE COMMUNITY, AND ABOUT THE NEEDS OF YOUTH AND SENIORS. GIFT CARDS WERE EMAILED TWO DAYS AFTER THE FOCUS GROUP AS A THANK YOU TO ALL PARTICIPANTS. PROMOTORAS AND COMMUNITY HEALTH WORKER INTERVIEWS/ACCESS TO HEALTH CARE INTERVIEWS TO ENSURE THE REPORT INCLUDED DIRECT COMMUNITY MEMBER FEEDBACK FROM RACIAL AND ETHNIC GROUPS EXPERIENCING DISPARATE HEALTH OUTCOMES, THE CHNA COMMITTEE EMPLOYED A NEW STRATEGY TO PARTNER WITH COMMUNITY BASED ORGANIZATIONS THAT WORK WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS. THE ONLINE COMMUNITY SURVEY WAS ADAPTED WITH A SUBSET OF THE SURVEY QUESTIONS FOR USE AS A DATA COLLECTION TOOL. THE SAN DIEGO REFUGEE COMMUNITIES COALITION AND THE CHICANO FEDERATION WERE SELECTED TO RECRUIT INTERESTED COMMUNITY HEALTH WORKERS AND PROMOTORAS TO CONDUCT THE INTERVIEWS. HASD&IC STAFF ATTENDED A SAN DIEGO REFUGEE COMMUNITIES COALITION WEEKLY COMMUNITY HEALTH WORKER MEETING TO PROVIDE TRAINING ON THE GOALS OF THE CHNA AND HOW TO ADMINISTER THE INTERVIEW. HASD&IC STAFF ALSO PROVIDED TRAINING TO THE CHICANO FEDERATION PROMOTORAS. PROMOTORAS AND COMMUNITY HEALTH WORKERS CONDUCTED INTERVIEWS EITHER IN PERSON OR OVER THE PHONE. INTERVIEWERS ASKED OPEN-ENDED QUESTIONS ABOUT THE FOLLOWING: HEALTH NEEDS, SOCIAL NEEDS, ACCESS TO CARE CHALLENGES, AND WHAT HOSPITALS COULD DO TO IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY. INTERVIEWERS THEN CODED RESPONSES AND INPUT THEM IN AN ONLINE DATA COLLECTION TOOL. PRICE PHILANTHROPIES FOUNDATION GENEROUSLY PROVIDED GRANTS TO BOTH ORGANIZATIONS TO COMPENSATE PROMOTORAS AND COMMUNITY HEALTH WORKERS FOR COMPLETING INTERVIEWS. Schedule H, Part V, Section B, Line 6a Facility B, 1 Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. 2022 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS THE CHNA RESPONDS TO IRS REGULATORY REQUIREMENTS THAT PRIVATE NOT-FOR-PROFIT (TAX- EXEMPT) HOSPITALS CONDUCT A HEALTH NEEDS ASSESSMENT IN THE COMMUNITY ONCE EVERY THREE YEARS. ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE MAJORITY OF 2022 CHNA COLLABORATIVE MEMBERS ARE HOSPITALS AND HEALTH SYSTEMS THAT ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO PARTICIPATED IN THE COLLECTIVE EFFORT TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF SAN DIEGO COMMUNITIES. PARTICIPATING HOSPITAL AND HEALTH SYSTEMS SUPPORTED THE CHNA PROCESS THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT ADVISORY WORKGROUP, THE COMMUNITY NEEDS ASSESSMENT COMMITTEE, AND THE HASD&IC BOARD OF DIRECTORS. - ALVARADO HOSPITAL MEDICAL CENTER - ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM - AURORA BEHAVIORAL HEALTH CARE SAN DIEGO - GROSSMONT HEALTHCARE DISTRICT - KAISER PERMANENTE SAN DIEGO - PALOMAR HEALTH - PARADISE VALLEY HOSPITAL/BAYVIEW BEHAVIORAL HEALTH CAMPUS - RADY CHILDREN'S HOSPITAL - SAN DIEGO - SAN DIEGO COUNTY PSYCHIATRIC HOSPITAL - SCRIPPS HEALTH - SHARP HEALTHCARE - TRI-CITY MEDICAL CENTER - UC SAN DIEGO HEALTH - VA SAN DIEGO HEALTHCARE SYSTEM - SELECT SPECIALTY HOSPITAL Schedule H, Part V, Section B, Line 6b Facility B, 1 Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. THE HOSPITAL ASSOCIATION FOR SAN DIEGO AND IMPERIAL COUNTIES(HASD&IC) CONTRACTED WITH THE FOLLOWING RESEARCH PARTNERS ON THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. PATRICIA SINAY FROM COMMUNITY INVESTMENT STRATEGIES (CIS) SUPPORTED THE HOSPITAL ASSOCIATION TEAM WITH QUALITATIVE RESEARCH AND REPORT WRITING. CIS PROVIDES STRATEGIC VISIONING & PLANNING, MANAGEMENT TRAINING, AND PROGRAM IMPLEMENTATION SERVICES TO NONPROFITS, BUSINESSES, GOVERNMENTS, AND PHILANTHROPY. AS A LATINA IMMIGRANT, PATRICIA SPECIALIZES IN INCLUSIVE, CROSS-SECTOR EFFORTS THAT STRENGTHEN THE GREATER GOOD FOR INDIVIDUALS, FAMILIES, AND COMMUNITIES. HASD&IC CONTRACTED WITH THE INSTITUTE FOR PUBLIC HEALTH (IPH) AT SAN DIEGO STATE UNIVERSITY (SDSU). IN THE LAST 20 YEARS, THE IPH HAS PARTNERED WITH OVER 70 LOCAL, STATE, NATIONAL AND INTERNATIONAL PUBLIC AND PRIVATE COMMUNITY-BASED AGENCIES AND ORGANIZATIONS REPRESENTING MORE THAN 120 MULTIPLE-YEAR CONTRACTS WITH A WIDE VARIETY OF NEEDS AND METHODOLOGIES. THE IPH HAS EXPERTISE IN QUALITATIVE AND QUANTITATIVE COMMUNITY-BASED RESEARCH METHODS. IN ADDITION, THE IPH HAS EXTENSIVE EXPERIENCE IN SUCCESSFUL COMMUNITY ENGAGEMENT WITH DIVERSE GROUPS, INCLUDING NON-ENGLISH SPEAKERS. THE IPH HAS BEEN WORKING ACROSS CULTURES AND WITH VULNERABLE POPULATIONS FOR 25 YEARS, INCLUDING PROGRAMS WITH ASIAN AND PACIFIC ISLANDER COMMUNITIES, AFRICAN-AMERICAN COMMUNITIES, EAST AFRICAN COMMUNITIES, LATINO COMMUNITIES, NATIVE AMERICAN COMMUNITIES, LOW-INCOME COMMUNITIES, GAY, BISEXUAL, TRANSGENDER INDIVIDUALS, PEOPLE LIVING WITH HIV/AIDS, INDIVIDUALS EXPERIENCING HOMELESSNESS, ADOLESCENTS WHO ARE PREGNANT OR PARENTING, AND SURVIVORS OF DOMESTIC VIOLENCE AND SEXUAL ASSAULT, AMONG OTHERS. IPH STAFF HAVE SPECIAL EXPERTISE IN CONDUCTING CULTURALLY COMPETENT WORK AND EXPLORING SENSITIVE ISSUES. IPH COMMUNITY ENGAGEMENT EFFORTS HAVE INCLUDED PERFORMING KEY INFORMANT INTERVIEWS, LEADING FOCUS GROUPS, FACILITATING TOWN HALL MEETINGS, AND CONDUCTING PATIENT AND PROVIDER INTERVIEWS Schedule H, Part V, Section B, Line 11 Facility B, 1 Facility B, 1 - REPORTING GROUP B - SELECT HOSPITAL. SCRIPPS HEALTH AND SELECT HOSPITAL IMPLEMENTATION STRATEGY SUMMARY AND COMMUNITY NEEDS IDENTIFIED. WITH THE 2022 CHNA COMPLETE AND HEALTH PRIORITY AREAS IDENTIFIED; SCRIPPS HEALTH AND SELECT HOSPITAL HAVE DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY; A MULTI-FACETED, MULTI- STAKEHOLDER PLAN THAT ADDRESSES THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THE CHNA. THE IMPLEMENTATION STRATEGY TRANSLATES THE RESEARCH AND ANALYSIS PRESENTED IN THE ASSESSMENT INTO ACTUAL, MEASURABLE OBJECTIVES THAT CAN BE CARRIED OUT TO IMPROVE COMMUNITY HEALTH OUTCOMES. SCRIPPS AND SELECT SPECIALTY HOSPITAL EVALUATES THE IMPLEMENTATION STRATEGY ANNUALLY BECAUSE A FLEXIBLE APPROACH IS WELL-SUITED TO DEVELOPING A RESPONSE TO THE SCRIPPS CHNA. THE EVALUATION OF THE IMPLEMENTATION STRATEGY ASSESSES AVAILABLE RESOURCES AND INTERVENTIONS AND ADJUSTS AS NEEDED TO ACHIEVE THE IMPLEMENTATION STRATEGY'S STATED GOALS AND OUTCOME MEASURES. PLANS TO MONITOR THE IMPLEMENTATION STRATEGY ARE ALSO TAILORED TO EACH OBJECTIVE AND INCLUDE THE COLLECTION AND DOCUMENTATION OF TRACKING MEASURES. SCRIPPS AND SELECT DESCRIBE ANY CHALLENGES ENCOUNTERED TO ACHIEVE THE OUTCOMES AND MAKES MODIFICATIONS AS NEEDED. IN ADDITION, SCRIPPS HEALTH IMPLEMENTATION STRATEGY IS FILED ANNUALLY WITH THE INTERNAL REVENUE SERVICE USING FORM 990 SCHEDULE H. COMMUNITY NEEDS SCRIPPS IS ADDRESSING THE HEALTH FOCUS AREAS IDENTIFIED WERE DETERMINED THROUGH DATA COLLECTION, ANALYSIS, AND A PRIORITIZATION PROCESS THAT INCORPORATED COMMUNITY INPUT. SCRIPPS IS ADDRESSING ACCESS TO CARE, AGING CARE & SUPPORT, BEHAVIORAL HEALTH, CHILDREN & YOUTH WELLBEING, CHRONIC HEALTH CONDITIONS WHICH INCLUDES CARDIOVASCULAR DISEASE, CANCER AND DIABETES, COMMUNITY SAFETY AND ECONOMIC STABILITY IN THE FY23-25 IMPLEMENTATION STRATEGY. SCRIPPS ADDRESSES MANY OF THE SOCIAL DETERMINANTS OF HEALTH WITHIN THE HEALTH CONDITIONS IDENTIFIED SUCH AS, COMMUNITY AND SOCIAL SUPPORT, FOOD INSECURITY, TRANSPORTATION, EDUCATION, AND HOMELESSNESS. COMMUNITY NEEDS SCRIPPS IS NOT DIRECTLY ADDRESSING HOMELESSNESS AND HOUSING INSTABILITY ARE IDENTIFIED AS IMPORTANT FACTORS WITHIN THE CHNA FINDINGS. HOMELESSNESS AND HOUSING ARE NOT DIRECTLY ADDRESSED IN THE SCRIPPS IMPLEMENTATION STRATEGY AS WE FOCUS OUR RESOURCES ON MORE DIRECT HEALTH ISSUES AND CONDITIONS IN ACCORDANCE WITH OUR EXPERTISE AND MISSION. SCRIPPS HAS NOT DIRECTLY DEVELOPED PROGRAMS THAT SPECIFICALLY ADDRESS HOUSING INSECURITY, BUT THIS IS ADDRESSED AS PART OF OUR CARE TO PATIENTS. WHEN PATIENTS' HOUSING NEEDS ARE IDENTIFIED, THE SCRIPPS MULTIDISCIPLINARY TEAM WORKS TO ADDRESS THE NEED. ADDITIONALLY, THE SCRIPPS HEALTH SYSTEM HAS SOCIAL WORK AND CASE MANAGEMENT RESOURCES IN PLACE THROUGHOUT THE INPATIENT SETTING THAT ADDRESS THIS UNMET NEED BY CONNECTING PATIENTS TO MORE PERMANENT SOURCES OF INCOME, HOUSING, AND OTHER SELF-RELIANCE MEASURES. SCRIPPS WORK TO ADDRESS HOUSING INSECURITY IS LARGELY DONE VIA COLLABORATION AND REFERRALS TO COMMUNITY PARTNERS. IN ADDITION TO THE ABOVE INDIRECT MEASURES, SCRIPPS IS ALSO ADDRESSING THESE COMMUNITY NEEDS IN ACCORDANCE WITH CALIFORNIA'S REGULATIONS, SUCH AS SB 1152 DISCHARGE PLANNING FOR HOMELESS PATIENTS. THIS 2019 REGULATION REQUIRES HOSPITALS TO IMPLEMENT A SET OF REQUIREMENTS REGARDING DISCHARGE PLANNING FOR THEIR HOMELESS PATIENTS. SCRIPPS IS FULFILLING THIS REQUIREMENT BY PROVIDING PACKAGED MEALS, WEATHER-APPROPRIATE CLOTHING, TRANSPORTATION, DISCHARGE MEDICATIONS AND/OR PRESCRIPTIONS, INFECTIOUS DISEASE SCREENINGS AND VACCINATIONS, REFERRALS FOR BEHAVIORAL HEALTH AND OTHER REFERRALS TO SHELTERS OR HOUSING. SCRIPPS HEALTH REMAINS COMMITTED TO THE CARE AND IMPROVEMENT OF HEALTH FOR ALL SAN DIEGANS AND WILL LOOK TO CONTINUE THE SEARCH OF NEW OPPORTUNITIES AND NEW PARTNERSHIPS TO ADDRESS THESE AND FUTURE NEEDS. DETAIL ON THE STRATEGIES, INITIATIVES, MEASURES OF IMPLEMENTATION AND METRICS USED TO EVALUATE THE EFFECTIVENESS OF THE COMMUNITY NEEDS IS IDENTIFIED THROUGH SCRIPPS SPECIALTY HOSPITAL 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND ITS CORRESPONDING IMPLEMENTATION STRATEGY. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTPS://WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE-COMMUNITY__ASSESSING-COMMUNITY-NEEDS Schedule H, Part V, Section B, Line 16 Facility B, 1 Facility B, 1 - REPORTING GROUP B. SELECT SPECIALTY HOSPITAL SAN DIEGO PROVIDES FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE TO PATIENTS WHO ARE UNABLE TO PAY. THE FOLLOWING IS A SUMMARY OF FINANCIAL ASSISTANCE AVAILABLE AT SELECT SPECIALTY HOSPITAL SAN DIEGO. FINANCIAL ASSISTANCE OFFERED IF YOU DO NOT HAVE INSURANCE, WE PROVIDE FINANCIAL ASSISTANCE FOR MEDICALLY NECESSARY CARE. ELIGIBLE CARE INCLUDES MEDICALLY NECESSARY SERVICES AS DEFINED BY MEDICARE (SERVICES OR ITEMS REASONABLE AND NECESSARY FOR THE DIAGNOSIS OR TREATMENT OF ILLNESS OR INJURY). TO RECEIVE FINANCIAL ASSISTANCE, YOU MUST MEET ONE OF THE FOLLOWING CRITERIA: (A) ARE A U.S. CITIZEN; OR (B) CARRY A UNITED STATES PERMANENT RESIDENT CARD (USCIS FORM I-551); OR (C) LIVE WITHIN 50 MILES OF THE FACILITY. YOU WILL RECEIVE FREE CARE, OR 100% WRITE OFF OF PATIENT LIABILITY AFTER INSURANCE HAS PAID, IF YOUR FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY INCOME GUIDELINES. WRITE OFF OF THE DISCOUNTED FINANCIAL ASSISTANCE AMOUNT WHICH IS CALCULATED AS A PERCENTAGE OF TOTAL GROSS CHARGES MAY ALSO BE AVAILABLE FOR UNINSURED AND CERTAIN OTHER PATIENTS WITH FAMILY INCOME UP TO 400% OF THE FEDERAL POVERTY INCOME GUIDELINES. IF FAMILY INCOME IS OVER 400% OF FEDERAL POVERTY INCOME GUIDELINES, FINANCIAL ASSISTANCE MAY STILL BE CONSIDERED. ALL APPLICANTS WILL BE SCREENED FOR MEDICAID COVERAGE AND MUST COOPERATE WITH THE MEDICAID REPRESENTATIVES TO BE CONSIDERED FOR FINANCIAL ASSISTANCE. ADDITIONAL WAYS TO QUALIFY IF YOU DO NOT MEET THE INCOME CRITERIA ABOVE, REGARDLESS OF YOUR INSURANCE STATUS, YOU WILL BE CONSIDERED ON A CASE-BY-CASE BASIS FOR FINANCIAL ASSISTANCE. CONTACT US TO DISCUSS EXCEPTIONAL PERSONAL OR FINANCIAL CIRCUMSTANCES, OR IF THERE ARE SPECIAL MEDICAL CIRCUMSTANCES WHERE TREATMENT CAN ONLY BE PROVIDED BY SELECT SPECIALTY HOSPITAL SAN DIEGO MEDICAL STAFF. WHAT YOU WILL BE CHARGED IF YOU RECEIVE FINANCIAL ASSISTANCE UNDER OUR POLICY, YOU WILL NOT BE CHARGED MORE FOR MEDICALLY NECESSARY CARE THAN THE AMOUNT WE GENERALLY BILL PATIENTS HAVING MEDICARE COVERAGE. HOW TO OBTAIN COPIES OF OUR POLICY AND APPLICATION. YOU MAY OBTAIN A COPY OF OUR FULL FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY, AND APPLICATION FORM FREE OF CHARGE IN ANY OF THE FOLLOWING WAYS: IN OUR ADMISSIONS AREAS OF OUR FACILITY AT 555 WASHINGTON STREET, SAN DIEGO, CA 92103; ONLINE AT HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/PATIENTS-AND-CAREGIVERS/FINANCIAL-ASSISTANCE OR BY CALLING OUR ADMISSIONS DEPARTMENT AT 619-686-4525. HOW TO APPLY AND OBTAIN ASSISTANCE YOU MAY APPLY AT ANY POINT IN THE ADMISSION OR BILLING PROCESS BY COMPLETING AND SUBMITTING AN APPLICATION, AND PROVIDING INCOME INFORMATION. ALL FINANCIAL ASSISTANCE APPLICATIONS, WHETHER COMPLETED IN PERSON, ONLINE, DELIVERED OR MAILED, WILL BE FORWARDED TO OUR CENTRAL BUSINESS OFFICE FOR EVALUATION AND PROCESSING. IF YOU NEED ANY HELP IN APPLYING, PLEASE CONTACT OUR ADMISSIONS DEPARTMENT AT THE FACILITY OR CALL OUR CENTRAL BUSINESS OFFICE AT 888.868.1103. COPIES OF OUR FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND THIS SUMMARY ARE AVAILABLE IN ENGLISH AND SPANISH. Schedule H, Part V, Section B, Line 20 Facility B, 1 Facility B, 1 - Reporting Group B. Select Specialty Hospital does not make presumptive eligibility determinations. Reasonable efforts to determine eligibility include: notification to the patient of the Policy upon admission and in written and oral communications with the patient regarding the patient's bill, an effort to notify the individual by telephone about the Policy and the process for applying for assistance at least 30 days before taking action to initiate any lawsuit, and a written response to any financial assistance application for assistance under this Policy submitted within 240 days of the first billing statement with respect to the unpaid balance or, if later, the date on which a collection agency working on behalf of Select Specialty Hospital San Diego returns the unpaid balance to the Hospital. 45 Scripps Clinic - Torrey Pines 10666 N Torrey Pines Rd La Jolla CA 92037 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Rancho Bernardo 15004 Innovation Dr San Diego CA 92128 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Carmel Valley 3811 Valley Center Dr San Diego CA 92130 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Medical Lab 9235 Waples St 150 San Diego CA 92121 LABORATORY SERVICES Scripps Clinic - Jefferson 2205 Vista Way Oceanside CA 92054 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Anderson Medical Pavilion 9898 Genesse Ave La Jolla CA 92037 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Encinitas 310 Santa Fe Dr Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Mission Valley 7565 Mission Valley Rd San Diego CA 92108 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Hospital Medical Services 10140 Campus Point Dr San Diego CA 92121 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - La Jolla Memorial Campus 9850 Genesee Ave Ximed Bldg 600 San Diego CA 92121 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Encinitas 477 N El Camino Real Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Jefferson 2205 Vista Way Oceanside CA 92054 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC Hillcrest 501 Washington St San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Rancho San Diego 10862 Calle Verde La Mesa CA 91941 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Carlsbad 2176 Salk Ave Carlsbad CA 92008 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Oceanside 4318 Mission Ave Oceanside CA 92057 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps CL Radiation Therapy Ctr - Vista 916 Sycamore Ave 100 Vista CA 92082 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Mercy ASC 550 Washington St 1st Fl San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Del Mar 12395 El Camino Real 317 Del Mar CA 92130 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT La Jolla Radiology - La Jolla 9888 Genesee Ave La Jolla CA 92037 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Cedar 130 Cedar Rd Vista CA 92083 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Encinitas OP Rehab Clinical 1092 El Camino Real Encinitas CA 92024 REHABILITATION SERVICES SCMC - Encinitas OBGYN 332 Santa Fe Dr 115 Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Encinitas Surgery Center LLC 320 Santa Fe Dr LL1-2 Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT La Jolla Radiology - Encinitas 354 Sant Fe Dr Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Eastlake 971 Lane Ave Chula Vista CA 91914 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Mercy Campus 4020 Fifth Ave 401 San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Cardio&Thor Surg Ctr - La Jolla 9850 Genesee Ave 560 La Jolla CA 92037 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - San Marcos 111 Campus Way Ste 301 San Marcos CA 92078 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Santee 278 Town Center Pkwy 105 Santee CA 92071 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Liberty Station 2445 Truxtun Rd San Diego CA 92106 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - San Diego OBGYN 2918 Fifth Ave San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - La Jolla OBGYN 9850 Genesee Ave 170 San Diego CA 92121 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT SCMC - Solana Beach 380 Steven Ave 100 Solana Beach CA 92075 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - MD Anderson Cancer Ctr 10670 John Jay Hopkins Drive La Jolla CA 92121 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Hillcrest Surgery 4060 Fourth Ave 330 San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Cardio&Thor Surg Ctr - Hillcrest 501 Washington St 525 San Diego CA 92103 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps CL Radiation Therapy Ctr - Encinitas 477 N El Camino Real D100 Encinitas CA 92024 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Eastlake Specialty 971 Lane Ave Chula Vista CA 91914 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Coronado 1317 A Ynes Place Coronado CA 92118 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Cedar Specialty 130 Cedar Rd Vista CA 92083 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - Chula Vista 450 Fourth Ave Chula Vista CA 91910 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Clinic - UTC 9333 Genesee Ave 170 San Diego CA 92121 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Scripps Home Health Services 9619 Chesapeake Dr 300 San Diego CA 92123 HOME HEALTH SERVICES Scripps USP Surgery Centers LLC 15305 Dallas Pkwy Addison TX 75001 PRIMARY AND SPECIALTY CARE SERVICES IN AN AMBULATORY ENVIRONMENT Schedule H, Part I, Line 3c AT LEAST ONE OF THE FOLLOWING CRITERIA MUST BE MET TO QUALIFY FOR FINANCIAL ASSISTANCE FOR FULL OR PARTIAL BILL COVERAGE: * THE PAYMENT AMOUNT IS NOT COVERED OR REIMBURSED BY MEDI-CAL, MEDICARE OR ANY OTHER THIRD-PARTY INSURANCE. * IN THE PAST 12 MONTHS, THE DOCUMENTED ANNUAL OUT-OF-POCKET MEDICAL EXPENSES AFTER INSURANCE COVERAGE WAS HIGHER THAN 10% OF THE FAMILY INCOME. * THE PATIENT HAS HIGH MEDICAL COSTS AS DEFINED BY STATE AND FEDERAL REGULATIONS. * INCOME IS BELOW 400% OF THE FEDERAL POVERTY LEVEL (FPL). * PATIENTS DETERMINED TO BE "HOMELESS NOT PARTICIPATING IN ANOTHER FINANCIAL ASSISTANCE PROGRAM WILL BE GRANTED 100 PERCENT FINANCIAL ASSISTANCE. IF THE HOSPITAL IS UNABLE TO OBTAIN ADEQUATE INFORMATION AFTER ATTEMPTS TO ESTABLISH ABILITY TO PAY, THE PATIENT MAY BE GRANTED FINANCIAL ASSISTANCE ONLY AFTER BILLING AND/OR OTHER ATTEMPTS TO COLLECT INFORMATION HAVE BEEN MADE. Schedule H, Part I, Line 6a SCHEDULE H, PART I, LINE 6A THE 2024 COMMUNITY BENEFIT REPORT WAS ADOPTED BY THE SCRIPPS BOARD ON MARCH 2024 AND MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. SCRIPPS HEALTH COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN FISCAL YEAR 2022 AS REQUIRED BY STATE AND FEDERAL LAW. THE SCRIPPS HEALTH BOARD AND SELECT HOSPITAL MANAGEMENT COMMITTEE APPROVED AN AMENDED 2022 CHNA AND A FY23-FY25 IMPLEMENTATION STRATEGY IN DECEMBER 2023 AND JANUARY 2024, RESPECTIVELY. THE REVISIONS NOW INCLUDE SELECT HOSPITAL IN THE PLAN. THE CHNA WAS MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. Schedule H, Part II DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY F8-WORKFORCE DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 8. MANA DE SAN DIEGO (MANASD) SCRIPPS PROVIDED SPONSORSHIP MEMBERSHIP ANNUAL FEES. MANA DE SAN DIEGO (MANASD) IS THE LARGEST CHAPTER OF A NATIONAL LATINA ORGANIZATION. ESTABLISHED IN 1986, ITS MISSION IS TO TRANSFORM COMMUNITIES BY EMPOWERING LATINAS TO ACHIEVE UPWARD MOBILITY AND A BETTER QUALITY OF LIFE. MANA SHORT FOR "HERMANA," THE SPANISH WORD FOR SISTER, IS A DYNAMIC SISTERHOOD OF LATINAS BOUND TOGETHER BY COMMON CULTURE AND GOALS. IN THIRTY-EIGHT YEARS, MANASD HAS BUILT A BELOVED COMMUNITY OF SUPPORT TO EMPOWER LATINAS THROUGH EDUCATION, LEADERSHIP DEVELOPMENT, COMMUNITY SERVICE, AND ADVOCACY. FROM ITS FLAGSHIP HERMANITAS PROGRAM SERVING LATINA MIDDLE AND HIGH SCHOOL STUDENTS, TO THE LATINA SUCCESS LEADERSHIP PROGRAM FOCUSED ON MID-LEVEL PROFESSIONALS, MANASD SERVES LATINAS AT EVERY STAGE OF THEIR LIVES. THROUGH MANASD PROGRAMS, LATINAS REACH THEIR GOALS AND GAIN THE RESOURCES TO NOT ONLY PROVIDE FOR THEMSELVES AND THEIR FAMILIES BUT TO RECIPROCATE AND PAY IT FORWARD IN A VARIETY OF WAYS THAT CONTRIBUTE TO THRIVING COMMUNITIES THROUGHOUT OUR REGION. WHEN A LATINA SUCCEEDS, SHE CREATES GENERATIONAL CHANGE THAT BENEFITS OUR ENTIRE REGION. NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION SCRIPPS SPONSORED A FUNDRAISER FOR THE NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION. SUPPORT PROVIDES SCHOLARSHIP FUNDS FOR THE NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION (NCAAWA) TO SUPPORT GIRLS AND WOMEN OF AFRICAN AMERICAN DESCENT. THE PROGRAM HAS HELPED HUNDREDS OF WOMEN RECEIVE CAREER, VOCATIONAL AND TECHNICAL EDUCATION, IN ADDITION TO LIFE SKILLS AND HEALTH AWARENESS. NCAAWA HAS BEEN ASSISTING WOMEN REENTERING THE WORKFORCE AND GRADUATING SENIORS TO ACHIEVE THEIR EDUCATIONAL GOALS THROUGH FUNDRAISING EFFORTS. PROGRAM EFFORTS HAVE ENABLED HUNDREDS OF WOMEN TO LEAD HEALTHY, FULFILLING, AND SELF-SUFFICIENT LIVES. UNIVERSITY CITY HIGH SCHOOL EXPLORATION PROGRAM SCRIPPS PARTNERS WITH UC HIGH SCHOOL EXPLORATION PROGRAM TO PROVIDE OPPORTUNITIES FOR STUDENTS TO LEARN ABOUT CAREERS IN HEALTHCARE. SCRIPPS AND THE CENTER FOR LEARNING & INNOVATION PARTNERED WITH UC HIGH SCHOOL HEALTH ESSENTIALS TO PROVIDE WORKFORCE PREPAREDNESS IN A HEALTHCARE SETTING AS AN EXTENSION OF THEIR CLASSROOM LEARNING EXPERIENCE. TWO EVENTS WERE HELD IN SEPTEMBER. THE FIRST WAS AN ED/TRAUMA TOUR AND SECOND WAS A BIOMED PANEL PRESENTATION TO THE STUDENTS. BOTH EVENTS HELD 67 STUDENTS AND SCRIPPS STAFF CONTRIBUTED A TOTAL OF 20 HOURS TO THE EVENTS. YOUNG LEADERS IN HEALTHCARE PROGRAM SCRIPPS ENCINITAS HOSTED THE YOUNG LEADERS IN HEALTH CARE PROGRAM FOR LOCAL HIGH SCHOOL STUDENTS DURING THE 2023-2024 SCHOOL YEAR. THE PROGRAM INCLUDED 9 MEETINGS WITH OVER 590 PARTICIPANTS IN TOTAL, COVERING VARIOUS HEALTH-RELATED TOPICS AND PRESENTATIONS. AFTER COMPLETING THIS INITIATIVE, STUDENTS CAN APPLY FOR THE HIGH SCHOOL EXPLORER SUMMER INTERNSHIP PROGRAM. SCRIPPS HIGH SCHOOL EXPLORATION INTERNSHIP PROGRAM SCRIPPS HEALTH INITIATED THE SCRIPPS HIGH SCHOOL EXPLORATION INTERNSHIP PROGRAM TO ENGAGE YOUNG INDIVIDUALS AND CULTIVATE THEIR INTEREST IN HEALTHCARE PROFESSIONS FACING A SHORTAGE OF SKILLED PROFESSIONALS. TWENTY-FIVE STUDENTS GAINED EXPOSURE TO VARIOUS HOSPITAL DEPARTMENTS, INCLUDING THE EMERGENCY ROOM AND SURGERY, ALLOWING THEM TO EXPLORE DIFFERENT CAREER POSSIBILITIES IN HEALTHCARE WHILE ALSO ACQUIRING VALUABLE INSIGHTS INTO HEALTH AND HEALING. SCRIPPS SCHOOL TO HEALTH CAREER PATHWAY PROGRAMS SCRIPPS MERCY HOSPITAL CHULA VISTA INTRODUCED A DIVERSE ARRAY OF YOUTH INTO HEALTH PROFESSIONS ACTIVITIES, BENEFITING over 1,600+ YOUNG INDIVIDUALS. THESE ACTIVITIES ENCOMPASS MENTORING PROGRAMS, CLASSROOM PRESENTATIONS BY HEALTH PROFESSIONALS, SURGICAL OBSERVATIONS, PARTICIPATION IN THE CRISTO REY WORK STUDY PROGRAM, AND INVOLVEMENT IN THE SCRIPPS HEALTH CAREERS OPPORTUNITY CAMP. Schedule H, Part VI, Line 2 NEEDS ASSESSMENT (CONTINUATION) QUANTITATIVE DATA INCLUDED: * CALIFORNIA'S DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) LIMITED DATA SETS, 2017-2019 SPEEDTRACK * COMMUNITY NEED INDEX (CNI) * PUBLIC HEALTH ALLIANCE OF SOUTHERN CALIFORNIA HEALTHY PLACES INDEX (HPI) * DATA FROM NATIONAL AND STATE -WIDE DATA SETS WERE ANALYZED INCLUDING SAN DIEGO MORTALITY AND MORBIDITY DATA, AND DATA RELATED TO SOCIAL DETERMINANTS OF HEALTH. THE HPI AND THE CNI WERE USED TO IDENTIFY THE MOST UNDER-RESOURCED GEOGRAPHIC COMMUNITIES. THIS INFORMATION HELPED GUIDE THE COMMUNITY ENGAGEMENT PROCESS, INCLUDING SELECTING COMMUNITIES FROM WHICH TO SOLICIT INPUT AND DEVELOPING RELEVANT AND MEANINGFUL ENGAGEMENT TOPICS AND QUESTIONS. DATA FROM THE COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY, INCLUDING THE FOLLOWING REPORTS AND DASHBOARDS WERE ALSO USED: REPORTS * COUNTY OF SAN DIEGO COMMUNITY HEALTH STATISTICS * HEALTH DISPARITIES EXECUTIVE SUMMARY REPORT * RACIAL EQUITY: FRAMEWORK AND OUTCOMES BRIEF * SAN DIEGO COUNTY SELF-SUFFICIENCY STANDARD, HOUSEHOLD WITH TWO ADULTS, ONE PRESCHOOL-AGE CHILD, AND ONE SCHOOL-AGE CHILD, 2021 * OVERDOSE DATA TO ACTION (OD2A) COMMUNITY HEALTH STATISTICS DASHBOARDS * LGBTQ HEALTH AND WELL-BEING DASHBOARDS * HEALTH EQUITY DASHBOARD SERIES: RACIAL EQUITY DASHBOARDS * SAN DIEGO COUNTY SELF-SUFFICIENCY STANDARD DASHBOARD * COVID-19 IN SAN DIEGO COUNTY QUALITATIVE DATA - COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO SOLICIT INPUT FROM A WIDE RANGE OF STAKEHOLDERS SO THAT THE SAMPLE WAS AS REPRESENTATIVE AS POSSIBLE OF THOSE FACING INEQUITIES IN SAN DIEGO COUNTY. A TOTAL OF 841 INDIVIDUALS PARTICIPATED IN THE 2022 CHNA. INPUT FROM THE COMMUNITY WAS GATHERED THROUGH THE FOLLOWING DISCUSSIONS: * WORKING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS * CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, CIVIC LEADERS, AND HEALTH CARE LEADERS (CONDUCTED IN COLLABORATION WITH KAISER FOUNDATION HOSPITAL (KFH)-SAN DIEGO) * CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH HOSPITAL AND HEALTH SYSTEM CLINICIANS, CASE MANAGERS, SOCIAL WORKERS, AND EXECUTIVE LEADERS * DISTRIBUTING AN ONLINE SURVEY TO COMMUNITY MEMBERS, HOSPITAL STAFF, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, AND LOCAL GOVERNMENT STAFF FOUNDATIONAL CHALLENGES THE 2022 CHNA RECOGNIZED HEALTH DISPARITIES AND WORKFORCE SHORTAGES AS FOUNDATIONAL CHALLENGES THAT ARE CONTRIBUTING TO THE GROWTH OF EVERY HEALTH NEED. HEALTH DISPARITIES DECADES OF RESEARCH HAS DEMONSTRATED THAT EVEN IN PRE-PANDEMIC TIMES, SOME COMMUNITIES AND POPULATIONS HAVE MUCH POORER HEALTH CARE AND OUTCOMES THAN OTHER COMMUNITIES OR POPULATIONS. THESE MAY BE ISSUES OF ACCESS ROOTED IN GEOGRAPHY, ISSUES OF FINANCE AND INSURANCE COVERAGE, OR SYSTEMIC ISSUES ROOTED IN RACISM AND DISCRIMINATION. FOR EXAMPLE, "FRONTLINE" WORKERS (PEOPLE WHO ARE MOST INVOLVED IN DIRECT CUSTOMER CONTACT) COULD NOT WORK FROM HOME DURING THE PANDEMIC AND WERE AT HIGHER RISK OF COVID EXPOSURE. THIS CONTRIBUTED TO DISPROPORTIONATELY HIGHER MORTALITY RATES COMPARED TO GROUPS THAT COULD WORK FROM HOME OR QUIT WORK. IN ADDITION, THE HEALTH OF SAN DIEGANS WHO WERE VULNERABLE BEFORE THE PANDEMIC - SUCH AS PEOPLE EXPERIENCING HOMELESSNESS, ISOLATED SENIORS, LGBTQ+ YOUTH, AND CHILDREN WITH SPECIAL NEEDS - DETERIORATED MORE ACUTELY AS THEY LOST ACCESS TO CRITICAL SERVICES AND FACED NEW BARRIERS TO THEIR SAFETY AND ECONOMIC STABILITY. WORKFORCE SHORTAGES COMMUNITY ENGAGEMENT PARTICIPANTS IN PREVIOUS CHNAS OFTEN MENTIONED THE NEED FOR MORE HEALTH CARE PROVIDERS, MOSTLY WITH A VIEW TOWARD BOLSTERING WORKFORCE PIPELINES. IN THE 2022 CHNA FOCUS GROUPS AND INTERVIEWS, WORKFORCE SHORTAGES WERE CONSISTENTLY AT THE FRONT OF DISCUSSIONS. IN MOST OCCUPATIONS, WORKERS ARE EXPERIENCING EXHAUSTION, EMOTIONAL TRAUMA, AND A SENSE OF "FEELING BURNED OUT AFTER OVER TWO YEARS OF THE COVID PANDEMIC." CLINICAL WORKERS AND SOCIAL WORK STAFF AT ALL LEVELS OF HEALTH CARE DELIVERY FACED THE SAME CHALLENGES AND FRUSTRATIONS, AS WORKFORCE SHORTAGES AND THE INCREASED MEDICAL DEMANDS OF COVID STRESSED HEALTH CARE SERVICES ACROSS THE REGION. KEY UNDERLYING THEMES STIGMA AS IN OUR 2019 CHNA FINDINGS, STIGMA AND THE BARRIERS IT CREATES AROSE ACROSS COMMUNITY ENGAGEMENT DISCUSSIONS IN 2022. STIGMA IMPACTS THE WAY PEOPLE ACCESS NEEDED SERVICES (CALFRESH, MEDI-CAL, OTHER ECONOMIC SUPPORT) THAT ADDRESS THE SOCIAL DETERMINANTS OF HEALTH. THIS IMPACTS THE ABILITY OF PEOPLE TO IMPROVE AND SUCCESSFULLY MANAGE HEALTH CONDITIONS. COMMUNITY ENGAGEMENT PARTICIPANTS EXPRESSED CONCERNS ABOUT THE IMPACT OF STIGMA IN RELATION TO SPECIFIC POPULATIONS INCLUDING LGBTQ+ COMMUNITIES, PEOPLE EXPERIENCING HOMELESSNESS, PEOPLE OF COLOR, SENIORS, MEDI-CAL BENEFICIARIES, AND SURVIVORS OF DOMESTIC VIOLENCE AND HUMAN TRAFFICKING. STIGMA WAS ALSO DISCUSSED IN RELATION TO SPECIFIC HEALTH CONDITIONS SUCH AS BEHAVIORAL HEALTH, CANCER, DIABETES, AND OBESITY. TRAUMA TRAUMA AND VICARIOUS TRAUMA , WERE CITED AS FACTORS CONTRIBUTING TO COMPASSION FATIGUE AND WORKFORCE BURNOUT IN COMMUNITY INTERVIEWS AND FOCUS GROUPS. TRAUMA OCCURS BOTH AT WORK AND AT HOME, AND CONSEQUENTLY, THERE MAY BE NO ESCAPE AND DOWNTIME FROM TRAUMATIC EXPERIENCES. TRAUMATIZED COMMUNITY MEMBERS ARE SEEKING ASSISTANCE FROM HEALTH CARE PROVIDERS AND COMMUNITY-BASED ORGANIZATIONS WHO THEMSELVES HAVE EXPERIENCED GREAT STRESS SINCE THE START OF THE PANDEMIC. COMMUNITY VOICE AND EXPERIENCES THE FINDINGS OF THE 2022 CHNA ATTEMPT TO RESPOND TO THE SAN DIEGO COMMUNITY NEEDS AND CONCERNS, AS IDENTIFIED THROUGH FOCUS GROUPS, KEY INFORMANT INTERVIEWS, INTERVIEWS REGARDING ACCESS TO CARE, AND AN ONLINE SURVEY. THE QUANTITATIVE RESEARCH AND THE COMMUNITY ENGAGEMENT CONFIRMED THE INTERCONNECTEDNESS OF THE SEVEN IDENTIFIED NEEDS. WHEN DISCUSSING THE FINDINGS, THE CHNA HIGHLIGHTS HOW THEY MAY DIFFER FOR SAN DIEGANS BASED ON THEIR EXPERIENCES. THESE DIFFERING EXPERIENCES MAY INCLUDE HOMELESSNESS, IMMIGRATION STATUS, GENDER AND SEXUAL ORIENTATION, AGE AND POVERTY. COMMUNITY RECOMMENDATIONS DURING THE ACCESS TO CARE INTERVIEWS AND IN THE ONLINE COMMUNITY SURVEY, WE ASKED "WHAT ARE THE MOST IMPORTANT THINGS THAT HOSPITALS AND HEALTH SYSTEMS COULD DO TO IMPROVE HEALTH AND WELL-BEING IN OUR COMMUNITY?" OVERWHELMINGLY, RESPONDENTS AGREED THAT THERE IS A CRITICAL NEED TO HELP PATIENTS NAVIGATE AVAILABLE SERVICES THAT WILL HELP IMPROVE THEIR HEALTH AND WELL-BEING. IN BOTH THE INTERVIEWS AND THE SURVEYS, OPTIONS THAT CENTERED AROUND IMPROVED PATIENT CARE ROSE TO THE TOP. MOST RESPONSES FELL INTO FOUR CATEGORIES: NAVIGATION AND SUPPORT, CULTURALLY APPROPRIATE, WORKFORCE DEVELOPMENT, AND COMMUNITY COLLABORATION. NEXT STEPS THE CHNA REPORT IS MADE AVAILABLE AS A RESOURCE TO THE BROADER COMMUNITY AND IS INTENDED TO SERVE AS A USEFUL RESOURCE TO BOTH RESIDENTS AND HEALTH CARE PROVIDERS TO FURTHER COMMUNITYWIDE HEALTH IMPROVEMENT EFFORTS. HASD&IC AND THE CHNA COMMITTEE ARE PROUD OF THEIR COLLABORATIVE RELATIONSHIPS WITH LOCAL COMMUNITY ORGANIZATIONS AND ARE COMMITTED TO REGULARLY SEEKING INPUT FROM THE COMMUNITY TO INFORM COMMUNITY HEALTH STRATEGIES. ADDITIONALLY, THE CHNA COMMITTEE IS ACTIVELY INVOLVED IN PLANNING THE 2025 CHNA, DEMONSTRATING THEIR COMMITMENT TO ONGOING ASSESSMENTS AND IMPROVEMENTS IN COMMUNITY HEALTH. THIS COMMITMENT ENSURES THAT THE ASSESSMENT REMAINS UP-TO-DATE AND RESPONSIVE TO THE EVOLVING NEEDS OF THE COMMUNITY. Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT SCRIPPS HEALTH COMMUNITY BENEFIT PLAN AND REPORT CAN BE FOUND AT:HTTP://WWW.SCRIPPS.ORG/ABOUT-US__SCRIPPS-IN-THE-COMMUNITY. THE FAP AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW. Schedule H, Part I, Line 7g Subsidized Health Services SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A FINANCIAL LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDI-CAL SHORTFALLS. NEVERTHELESS, THE SERVICE IS PROVIDED BECAUSE IT MEETS AN IDENTIFIED COMMUNITY NEED, WHICH IF NO LONGER OFFERED WOULD EITHER BE UNAVAILABLE IN THE AREA OR FALL TO GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION. SUBSIDIZED SERVICES DO NOT INCLUDE ANCILLARY SERVICES THAT SUPPORT LINES, SUCH AS LAB AND RADIOLOGY (IF THESE SERVICES ARE PROVIDED TO LOW-INCOME PERSONS, THEY ARE REPORTED AS CHARITY CARE/FINANCIAL ASSISTANCE). THE TOTAL EXPENSE FOR SUBSIDIZED HEALTH SERVICES FOR SCRIPPS MERCY FISCAL YEAR 2024 WAS $3,100,477. SUBSIDIZED HEALTH ONLY INCLUDES SCRIPPS INPATIENT BEHAVIORAL HEALTH. THE COSTS ASSOCIATED WITH THE SCRIPPS RESIDENT CLINIC AT FAMILY HEALTH CENTERS OF SAN DIEGO WAS MOVED TO THE PROFESSIONAL EDUCATION CATEGORY. SCRIPPS OFFERS INPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL, SAN DIEGO CAMPUS. THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM ALSO ACTIVELY SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINES 7G. SCRIPPS HEALTH OFFERS INPATIENT BEHAVIORAL HEALTH CARE FOR ADULTS ADMITTED THROUGH OUR EMERGENCY DEPARTMENTS OR URGENT CARE CENTERS. OUR OUTPATIENT BEHAVIORAL HEALTH SERVICES ARE AVAILABLE THROUGH PARTNERSHIPS WITH VARIOUS COMMUNITY ORGANIZATIONS. LIKE MANY BEHAVIORAL HEALTH PROGRAMS NATIONWIDE, FUNDING REMAINS A CHALLENGE, AS PAYMENT RATES HAVE NOT KEPT PACE WITH THE ACTUAL COST OF CARE. IN FISCAL YEAR 2024, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM REPORTED A TOTAL OPERATIONAL LOSS OF $8.3 MILLION, WITH $5 MILLION ATTRIBUTED TO MEDI-CAL, OR OTHER MEANS TESTED GOVERNMENT PROGRAMS AND CHARITY CARE. NOTABLY, 1.1% OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED, UNDERSCORING THE FINANCIAL PRESSURES FACED BY THESE PROGRAMS. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance SCRIPPS UNCOMPENSATED CARE METHODOLOGY FISCAL YEAR 2024. SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES TO PROVIDING LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. THE COSTS OF PROVIDING THESE SERVICES ARE NOT FULLY REIMBURSED. DURING FISCAL YEAR 2024, SCRIPPS CONTRIBUTED $587,766,140 IN UNCOMPENSATED HEALTH CARE, INCLUDING $17,768,458 IN CHARITY CARE, $562,399,773 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $7,597,909 IN BAD DEBT. SCHEDULE H METHODOLOGY - BAD DEBT AND MEDICARE SHORTFALLS ARE REPORTABLE UNDER THE SCHEDULE H GUIDELINES BUT DO NOT COUNT TOWARDS THE COMMUNITY BENEFIT TOTALS. THUS, THE CATEGORIES ARE REPORTED IN A SPECIFIC ORDER/HIERARCHY. CHARITY CARE AND UNDER-REIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS ARE COUNTED FIRST. CHARITY CARE METHODOLOGY - UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS CHARITY ADJUSTMENTS. THE FOLLOWING COSTS ARE EXCLUDED: COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. TRADITIONAL CHARITY CARE IS INCLUDED IN THE INTERNAL REVENUE SERVICE (IRS) FORM 990 SCHEDULE H PART I LINE 7A. MEDI-CAL SHORTFALL - THE SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE, MEDICARE PPO, MEDICARE HMO, MEDICARE CAPITATED PROGRAM AT THE HOSPITALS, MEDI-CAL, MEDI-CAL HMO, AND CMS PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS REVENUE FROM UNCOMPENSATED CARE POOLS INCLUDING MEDI-CAL DSH UNTIL JULY 2024. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE SYNTELLIS PERFORMANCE SOLUTIONS. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY ADJUSTMENTS AT COST FOR MEDI-CAL PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART I LINE 7B. IN THE STATE OF CALIFORNIA, THE MEDICAID PROGRAM IS CALLED MEDI-CAL. MEDICARE AND MEDICARE HMO HOSPITALS - SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE AND MEDICARE SENIOR PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE CAPITATION ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS OTHER REVENUE INCLUDING. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE MCKESSON HPM COST ACCOUNTING SYSTEM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION B. BAD DEBT METHODOLOGY - UNCOMPENSATED COST IS ESTIMATED BY APPLYING RATIO- COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD DEBT ADJUSTMENTS LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION A. SHORTFALL METHODOLOGY CLINICS - SHORTFALL IS DERIVED BY COMPUTING OPERATING MARGIN AT THE PATIENT LEVEL AND SUMMARIZING THE PATIENTS WITH MEDICARE AND MEDICARE SENIOR PRIMARY INSURANCE CARRIERS. OPERATING MARGIN IS DEFINED AS NET REVENUE LESS ALL VARIABLE, FIXED, AND OVERHEAD COSTS. PROFITABILITY IS ESTIMATED AS FOLLOWS: NET REVENUE IS EQUIVALENT TO PAYMENTS PLUS AN ESTIMATION OF THE CAPITATION ACCOUNT BALANCE FOR ALL OPEN ACCOUNTS, PLUS OTHER REVENUE INCLUDING. COST IS DERIVED USING THE RELATIVE VALUE ALLOCATION METHODOLOGY PER THE MCKESSON HPM COST ACCOUNTING SYSTEM. THESE COSTS ARE INCLUDED IN THE IRS FORM 990 SCHEDULE H PART III SECTION B. SELECT HOSPITAL - SCRIPPS HAS A 24.5% OWNERSHIP PERCENTAGE WITH SELECT HOSPITAL. THEREFORE, SCRIPPS REPORTED AMOUNTS IN SCHEDULE H, PARTS I THROUGH III, FROM SELECT HOSPITAL BASED ON SCRIPPS OWNERSHIP PERCENTAGE. Schedule H, Part II Community Building Activities F1 - PHYSICAL IMPROVEMENTS AND HOUSING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 1 LEADERSHIP RETREAT VOLUNTEER SERVICE DAY SCRIPPS MERCY HOSPITAL ORGANIZED A LEADERSHIP RETREAT THAT OFFERED LEADERS THE OPPORTUNITY TO CONTRIBUTE TO COMMUNITY SERVICE INITIATIVES BY PAINTING, CLEANING, AND IMPROVING FACILITIES OPERATED BY NOT-FOR-PROFIT HOMELESS SERVICE PROVIDERS. THESE PROJECTS WERE CONDUCTED IN COLLABORATION WITH ORGANIZATIONS SUCH AS CASA DE MISERICORDIA, FATHER JOE'S VILLAGE, MAMA'S KITCHEN, MERCY HOUSING & GARDENS, AND RESCUE MISSION. F2 - ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP: COMMUNITY BOARDS AND ORGANIZATIONS SCRIPPS PARTICIPATED ON VARIOUS COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS, REPRESENTING THE ORGANIZATION'S POSITIONS ON HEALTH ISSUES AND ADDRESSING MATTERS CONCERNING HEALTH AND SAFETY WITHIN THE COMMUNITY. MERCY SAN DIEGO: COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS SCRIPPS MERCY SAN DIEGO PARTICIPATED ON VARIOUS COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS, INCLUDING THE SAN DIEGO DOWNTOWN PARTNERSHIP, SAN DIEGO REGIONAL TASK FORCE ON HOMELESSNESS, HILLCREST BUSINESS ASSOCIATION (HBA) IN SUPPORT OF ADVOCATING FOR SCRIPPS MERCY'S MISSION IN THE COMMUNITY. F3 - COMMUNITY SUPPORT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 3. THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL) SCRIPPS SPONSORED THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL) ANNUAL CONFERENCE. FOUNDED IN 2001, THE SOHL IS AN OFFICIAL COMBINED CHAPTER OF THE AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES (ACHE), AN INTERNATIONAL PROFESSIONAL SOCIETY OF MORE THAN 49,000 HEALTHCARE EXECUTIVES. SAN DIEGO LGBT PRIDE INC SCRIPPS SPONSORED THE ANNUAL SAN DIEGO LGBTQ PRIDE PARADE. SCRIPPS EMPLOYEES PARTICIPATED IN THE PARADE AND 5K WALK PRESENTED BY FRONT RUNNERS & WALKERS SAN DIEGO. SAN DIEGO PRIDE INCORPORATED AS A 501(C)(3) NONPROFIT ORGANIZATION IN 1994, AND TODAY IT CONTINUES TO BRING TOGETHER THE SKILLS, TALENTS, AND VISIONS OF OUR DIVERSE COMMUNITY THROUGH NUMEROUS PROGRAMS. CHICANO FEDERATION SCRIPPS SPONSORED THE "UNITY LUNCHEON "CESAR CHAVEZ DAY OF SERVICE". THE CHICANO FEDERATION OF SAN DIEGO COUNTY IS A NONPROFIT, COMMUNITY-BASED ORGANIZATION THAT OFFERS A RANGE OF FAMILY, CHILDCARE, HOUSING, COMMUNITY DEVELOPMENT AND ADVOCACY. SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP". AS PART OF THE ONGOING WORKPLACE VIOLENCE PREVENTION EFFORTS, SCRIPPS LA JOLLA HELD "COFFEE WITH A COP," AN OPEN DIALOGUE SESSION WITH THE SAN DIEGO POLICE DEPARTMENT. SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP". AS PART OF THE ONGOING WORKPLACE VIOLENCE PREVENTION EFFORTS, SCRIPPS MERCY HELD "COFFEE WITH A COP," AN OPEN DIALOGUE SESSION WITH THE SAN DIEGO POLICE DEPARTMENT TO BUILD RELATIONSHIPS. MERCY SD INITIALLY MET WITH THE POLICE CHIEF LIAISON AND THE ASSISTANT POLICE CHIEF WITH THE NEXT STEPS TO HOST A SAN DIEGO POLICE DEPARTMENT "COFFEE WITH A COP." TO BUILD RELATIONSHIPS WITH THE LOCAL POLICE DEPARTMENTS SCRIPPS MERCY CHULA VISTA HOSTED TWO "COFFEE WITH A COP" SESSIONS WITH THE CHULA VISTA POLICE DEPARTMENT. DISASTER PREPAREDNESS - COMMUNITY SUPPORT AND OUTREACH EDUCATION SCRIPPS LEADS IN DISASTER PREPAREDNESS, COLLABORATING WITH VARIOUS LEVELS OF GOVERNMENT AND COMMUNITY LEADERS. THESE EFFORTS FOCUS ON PLANNING FOR EMERGENCIES AND ACTIVELY PROMOTE COMMUNITY AWARENESS AND PARTICIPATION IN PREPAREDNESS ACTIVITIES TO HELP CARE FOR DISASTER VICTIMS. HOSPITAL INCIDENT COMMAND SYSTEM (HICS) NATIONAL ADVISORY COMMITTEE SCRIPPS HEALTH IS AN ACTIVE MEMBER IN THE HOSPITAL INCIDENT COMMAND SYSTEM NATIONAL ADVISORY COMMITTEE (HICS). THE TRAINING IS FOCUSED SPECIFICALLY ON HICS, AN INCIDENT MANAGEMENT SYSTEM THAT CAN BE USED BY HOSPITALS TO MANAGE THREATS, PLANNED EVENTS OR EMERGENCIES. SCRIPPS HOSTED A COURSE WHICH WAS OPENED TO THE COMMUNITY AND 39 PEOPLE ATTENDED. SAN DIEGO COUNTY AND STATE OF CALIFORNIA ADVISORY GROUPS SCRIPPS PARTICIPATED IN SAN DIEGO COUNTY AND STATE OF CALIFORNIA ADVISORY GROUPS TO PLAN, IMPLEMENT, AND EVALUATE KEY DISASTER PREPAREDNESS RESPONSE PLANS AND EXERCISES. IN ADDITION, SCRIPPS IS AN ADVISOR TO SAN DIEGO COUNTY FOR FEDERAL AND STATE GRANT DEVELOPMENT AND PLANNING. SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE(SDHDC) SCRIPPS HEALTH ACTIVELY COLLABORATES WITH THE SAN DIEGO HEALTHCARE COALITION ADVISORY COMMITTEE (SDHDC) TO IMPROVE EMERGENCY PREPAREDNESS AND RESPONSE PLANNING. SAN DIEGO COUNTY OPERATIONAL AREA FULL SCALE EXERCISE SCRIPPS PARTICIPATED IN THE SAN DIEGO REGIONAL FULL-SCALE EXERCISE, ENHANCING THE REGION'S RESPONSE TO COMPLEX MASS CASUALTY INCIDENTS. THE EXERCISE SIMULATED A PEDIATRIC SURGE FROM MULTIPLE INCIDENTS ACROSS SAN DIEGO COUNTY, INVOLVING VARIOUS AGENCIES, INCLUDING HOSPITALS. SAN DIEGO COUNTY COALITION SURGE TEST NO NOTICE EXERCISE SCRIPPS PARTICIPATED IN THE SAN DIEGO COUNTY COALITION SURGE TEST NO NOTICE EXERCISE, A DRILL SIMULATING AN ACTIVE SHOOTER SCENARIO INVOLVING APPROXIMATELY 100 PATIENTS, PREDOMINANTLY PEDIATRIC CASES. SAN DIEGO REGIONAL FULL-SCALE EXERCISE SCRIPPS PARTICIPATED IN THE COUNTY WIDE EXERCISE MEDICAL AND HEALTH FULL SCALE EXERCISE. ALL HOSPITALS PARTICIPATED, TESTED AND EVALUATED THE CAPABILITIES OF THE COMMAND CENTER AND THE RESPONSE PLAN FOR PATIENT SURGE AND EVACUATION. SCRIPPS MEDICAL RESPONSE TEAM (SMRT) SCRIPPS HAS A SYSTEM-WIDE DISASTER PREPAREDNESS PROGRAM THAT INCLUDES THE VOLUNTEER SCRIPPS MEDICAL RESPONSE TEAM (SMRT). SMRT IS READY TO DEPLOY WHEN REQUESTED BY THE CALIFORNIA MEDICAL ASSISTANCE TEAM (CAL-MAT) DURING STATE EMERGENCIES LIKE WILDFIRES OR EARTHQUAKES. ALTHOUGH THERE WERE NO DEPLOYMENTS IN 2024, THE TEAM REMAINS PREPARED FOR FUTURE CALLS FOR ASSISTANCE. F4 - ENVIRONMENTAL IMPROVEMENTS F5 - LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 5. F6 - COALITION BUILDING - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 6. CHULA VISTA COMMUNITY COLLABORATIVE (CVCC) SCRIPPS TOOK PART IN THE CHULA VISTA COMMUNITY COLLABORATIVE (CVCC), A MONTHLY GATHERING OF OVER 150 LOCAL ORGANIZATIONS FOCUSED ON IMPROVING RESIDENT HEALTH, SAFETY, ECONOMIC RESOURCES, LEADERSHIP EMPOWERMENT, ENVIRONMENTAL QUALITY, AND CULTURAL DIVERSITY IN THE COMMUNITY. STAFF DEDICATED 18 HOURS TO THIS COLLABORATIVE. SOUTH COUNTY ACTION NETWORK (SOCAN) SCRIPPS PARTICIPATED IN THE SOUTH COUNTY ACTION NETWORK (SOCAN), A COLLABORATIVE NETWORK OF INDIVIDUALS AND SERVICE PROVIDERS DEDICATED TO ADVOCATING FOR AND ENHANCING SERVICES FOR OLDER ADULTS AND ADULTS WITH DISABILITIES IN THE SOUTH COUNTY REGION. THERE ARE OVER 75 NETWORK PARTNERS. STAFF DEDICATED 9 HOURS TO THIS COLLABORATIVE. F7 - COMMUNITY HEALTH IMPROVEMENT ADVOCACY - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 7. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount UNCOMPENSATED COST IS DERIVED BY APPLYING RATIO-COST-TO-CHARGE (RCC) PERCENTAGES FOR THE HOSPITAL TO THE GROSS BAD DEBT ADJUSTMENTS, LESS RECOVERIES. THE FOLLOWING COSTS ARE EXCLUDED: BAD DEBT ADJUSTMENTS AT COST FOR MEDI-CAL AND CMS PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 2 REPRESENTS PATIENT CARE CHARGES WRITTEN OFF TO BAD DEBT WHERE THE PATIENT HAD THE ABILITY TO PAY. WHERE A PATIENT QUALIFIED FOR PARTIAL OR FULL CHARITY CARE, THE UNPAID AMOUNT IS NOT CONSIDERED BAD DEBT. WE BELIEVE THAT BAD DEBT PERTAINING TO PATIENT CARE CHARGES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGARDLESS OF WHETHER WE COLLECT PAYMENT FOR THE SERVICES PERFORMED. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BAD DEBT WRITE-OFFS REPRESENT THE AMOUNT A PATIENT OR OTHER PAYER CANNOT (OR WILL NOT) PAY OF ITS PORTION OF THE BILL. THE HOSPITAL CONSIDERS BAD DEBT UNRECOVERABLE AND, THEREFORE, IT DIRECTLY DECREASES REVENUE AND IS CONSIDERED A COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote FOOTNOTE FOR BAD DEBT EXPENSE THE ORGANIZATION ADOPTED THE ACCOUNTING STANDARD ADDRESSING THE PRESENTATION OF THE PROVISION FOR BAD DEBTS AS OF THE CURRENT REPORTING PERIOD AND AS SUCH, NET PATIENT SERVICE REVENUES ARE REPORTED NET OF THE PROVISION FOR BAD DEBTS ON THE STATEMENTS OF OPERATIONS. THE ORGANIZATION RECORDS ITS PROVISION FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL EXPERIENCE, AS WELL AS COLLECTION TRENDS FOR MAJOR PAYOR TYPES. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE AND MEDICARE HMO: HOSPITALS MEDICARE ALLOWABLE COSTS ARE DETERMINED USING A COST TO CHARGE RATIO. THE FOLLOWING COSTS ARE EXCLUDED: CHARITY AND BAD DEBT ADJUSTMENTS AT COST FOR MEDICARE AND MEDICARE SENIOR PATIENTS, COMMUNITY HEALTH SERVICES, PROFESSIONAL EDUCATION AND RESEARCH, SUBSIDIZED HEALTH SERVICES PROVIDED TO MEDICARE PATIENTS AND EXPENSES EXCLUDED IN THE MEDICARE COST REPORT. AS A NOT-FOR-PROFIT, COMMUNITY BENEFIT 501(C)(3) ORGANIZATION, SCRIPPS HEALTH'S PURPOSE IS TO MEET THE MEDICAL NEEDS OF THE COMMUNITIES SERVED. MEDICARE COVERS A SIGNIFICANT PROPORTION OF THE SAN DIEGO COMMUNITY PATIENT POPULATION, INPATIENT AND OUTPATIENT. THE LEVEL OF QUALITY AND ACCESS TO CARE IS THE SAME, REGARDLESS OF PAYER. HOSPITALS DO NOT DETERMINE THE LEVEL OF PAYMENT FOR MEDICARE; RATHER, IT IS SUBJECT TO GOVERNMENT REIMBURSEMENT POLICY. THERE IS A WELL-DOCUMENTED MEDICARE REIMBURSEMENT SHORTFALL OF PAYMENT FOR CARE NOT MEETING THE COST OF DELIVERING CARE. THAT SHORTFALL IS AN UNREIMBURSED AMOUNT THAT MUST BE ACCOUNTED FOR IN THE HOSPITAL'S FINANCIAL STATEMENTS. IT IS REAL AND SUBSTANTIAL. IT SHOULD BE ACCEPTED AS A SHORTFALL IN IRS REPORTING STANDARDS. SCRIPPS MUST ACCEPT THE PATIENTS REGARDLESS OF REIMBURSEMENT RATES FROM MEDICARE AND IF PATIENTS ARE NOT CARED FOR BY SCRIPPS IT IS LIKELY THAT ANOTHER COMMUNITY OR GOVERNMENT AGENCY WOULD HAVE TO COVER THE CARE OF THE PATIENT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ALL COLLECTION EFFORTS ARE SUSPENDED AS LONG AS THE PATIENT IS MAKING A GOOD FAITH EFFORT TO APPLY FOR A FEDERAL OR STATE PROGRAM OR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. COLLECTION EFFORTS WILL RESUME IF THE PATIENT FAILS TO COMPLY WITH REQUESTS MADE IN CONNECTION WITH THESE PROGRAMS. Schedule H, Part V, Section B, Line 16a FAP website A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16a URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16a URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/; Schedule H, Part V, Section B, Line 16b FAP Application website A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16b URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16b URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - SCRIPPS MEMORIAL HOSPITAL LA JOLLA: Line 16c URL: https://www.scripps.org/patients-and-visitors/help-paying-your-bill; B - SELECT SPECIALTY HOSPITAL - SAN DIEGO: Line 16c URL: https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/; Schedule H, Part VI, Line 2 Needs assessment NEEDS ASSESSMENT AS PART OF THE FEDERAL REPORTING REQUIREMENT FOR PRIVATE, NOT-FOR-PROFIT (TAX EXEMPT) HOSPITALS, SCRIPPS CONDUCTS A CONSOLIDATED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CORRESPONDING JOINT IMPLEMENTATION STRATEGY FOR ITS LICENSED HOSPITAL FACILITIES. THIS COMPREHENSIVE ACCOUNT OF HEALTH NEEDS IN THE COMMUNITY IS DESIGNED FOR HOSPITALS TO PLAN THEIR COMMUNITY BENEFIT PROGRAMS TOGETHER WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY-BASED ORGANIZATIONS, AND CONSUMER GROUPS. TO CARRY OUT THIS REGULATORY REQUIREMENT, SCRIPPS HAS BEEN ACTIVELY INVOLVED IN A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS. THIS PROCESS BEGAN IN 1995, IN ACCORDANCE WITH THE REQUIREMENTS OF SENATE BILL 697, COMMUNITY BENEFIT LEGISLATION THAT REQUIRES NOT-FOR-PROFIT HOSPITALS IN CALIFORNIA TO FILE A TRIENNIAL CHNA THAT IDENTIFIES COMMUNITY HEALTH NEEDS. FURTHER, SCRIPPS HEALTH 2022 COMMUNITY HEALTH NEEDS ASSESSMENT RESPONDS TO FEDERAL TAX LAW REQUIREMENTS SET FORTH IN INTERNAL REVENUE CODE SECTION 501(R) REQUIRING PRIVATE NOT-FOR-PROFIT (TAX-EXEMPT) HOSPITALS AS DESCRIBED IN CODE SECTION 501(C)3)TO CONDUCT AND MAKE PUBLIC A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND CORRESPONDING IMPLEMENTATION STRATEGY. THE IMPLEMENTATION STRATEGY IDENTIFIES, AND DETAILS CURRENT OR PLANNED STRATEGIES INTENDED TO ADDRESS THE NEEDS IDENTIFIED IN THE HOSPITAL'S CHNA. SCRIPPS HEALTH ACTIVELY PARTICIPATES IN THE COLLABORATIVE CHNA PROCESS LED BY THE HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES (HASD&IC). ALTHOUGH ONLY NOT-FOR-PROFIT 501(C)(3) HOSPITALS AND HEALTH SYSTEMS ARE SUBJECT TO STATE AND IRS REGULATORY REQUIREMENTS, THE 2022 CHNA COLLABORATIVE PROCESS ALSO INCLUDES HOSPITALS AND HEALTH SYSTEMS WHO ARE NOT SUBJECT TO ANY CHNA REQUIREMENTS BUT ARE DEEPLY ENGAGED IN THE COMMUNITIES THEY SERVE AND COMMITTED TO THE GOALS OF A COLLABORATIVE CHNA. THE 2022 CHNA INCLUDES EXTENSIVE QUANTITATIVE ANALYSIS OF SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND IN-PATIENT HOSPITAL DISCHARGE DATA AND OTHER SECONDARY SOURCES. TAKEN TOGETHER, THESE QUALITATIVE AND QUANTITATIVE APPROACHES ALLOWED THE CHNA COMMITTEE TO VIEW COMMUNITY NEEDS FROM MULTIPLE PERSPECTIVES. THE RESULTS OF THE 2022 CHNA WILL BE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. THE 2022 SCRIPPS HEALTH CHNA IS DESIGNED TO PROVIDE A DEEPER UNDERSTANDING OF BARRIERS TO HEALTH IMPROVEMENT IN SAN DIEGO COUNTY. KEEPING PATIENTS AT THE CENTER OF EVERYTHING WE DO, SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION WITH A WIDE RANGE OF PARTNERS AND LIKE-MINDED ORGANIZATIONS. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS, GOVERNMENT AGENCIES, BUSINESSES AND COMMUNITY CLINICS, SCRIPPS IS BETTER ABLE TO BUILD UPON EFFORTS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS. THEREFORE, THE REPORT WILL HELP US BETTER UNDERSTAND OUR COMMUNITY'S HEALTH NEEDS AND INFORM COMMUNITY BENEFIT PLANNING AND THE IMPLEMENTATION STRATEGY FOR SCRIPPS HEALTH. IN ADDITION, THE ASSESSMENT ALLOWS INTERESTED PARTIES AND MEMBERS OF THE COMMUNITY A MECHANISM TO ACCESS THE FULL SPECTRUM OF INFORMATION RELATIVE TO THE DEVELOPMENT OF THE SCRIPPS HEALTH 2022 COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. SCRIPPS HEALTH HOPES TO LEVERAGE THE INFORMATION COLLECTED FOR THIS REPORT TO BENEFIT THE COMMUNITY AT-LARGE IN OTHER FUTURE PLANNING INITIATIVES. FOR MORE INFORMATION ABOUT SCRIPPS HEALTH, PLEASE VISIT WWW.SCRIPPSHEALTH.ORG. PURPOSE THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS TO IDENTIFY, UNDERSTAND, AND PRIORITIZE THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS FACING INEQUITIES. THE RESULTS OF THE CHNA ARE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. IN ADDITION, POLICYMAKERS, CIVIC LEADERS, NONPROFIT EXECUTIVES, AND COMMUNITY INVESTORS ARE ENCOURAGED TO USE CHNAS IN THEIR ESSENTIAL WORK. CHNA GOVERNANCE THE HOSPITAL ASSOCIATION OF SAN DIEGO & COUNTIES (HASD&IC) BOARD OF DIRECTORS REPRESENTS ALL MEMBER SECTORS AND PROVIDES POLICY DIRECTION TO ENSURE THE INTERESTS OF MEMBER HOSPITALS AND HEALTH SYSTEMS ARE PRESERVED AND PROMOTED. THE CHNA ADVISORY WORKGROUP INCLUDED REPRESENTATIVES FROM EVERY PARTICIPATING HOSPITAL AND HEALTH SYSTEM AND PROVIDED OVERARCHING GUIDANCE REGARDING THE RESEARCH APPROACH AND COMMUNITY ENGAGEMENT. THE CHNA COMMITTEE WORKED CLOSELY WITH THE CHNA ADVISORY WORKGROUP AND REPORTS TO THE HASD&IC BOARD. METHODOLOGY THERE ARE SOCIAL DRIVERS OF HEALTH AND EQUITY AT ALL LEVELS: INDIVIDUAL, COMMUNITY, AND STRUCTURAL. HISTORICAL AND SYSTEMIC INEQUITIES DISPROPORTIONATELY IMPACT VULNERABLE POPULATIONS, INCLUDING PEOPLE OF COLOR, SOCIALLY DISADVANTAGED GROUPS, AND THOSE LIVING IN POVERTY. THE CHNA COMMITTEE COMPLETED AN EXTENSIVE REVIEW OF NATIONAL BEST PRACTICES AND EVIDENCE-BASED FRAMEWORKS TO DEVELOP A RESEARCH APPROACH TO HEALTH EQUITY. THE HEALTH EQUITY FRAMEWORK DESCRIBES THE CHNA ADVISORY WORKGROUP AND CHNA COMMITTEE'S SHARED VALUES AND COMMITMENT TO UNDERSTANDING THE SOCIAL DRIVERS OF HEALTH AND EQUITY THROUGH OUR COLLECTIVE RESEARCH, ANALYSIS, AND COMMUNITY ENGAGEMENT. RESEARCH METHODS AND APPROACH TO GAIN A DEEP AND MEANINGFUL UNDERSTANDING OF THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS, TWO PRIMARY METHODS WERE EMPLOYED IN THE 2022 CHNA: 1. QUANTITATIVE ANALYSES OF EXISTING PUBLICLY AVAILABLE DATA WERE CONDUCTED TO PROVIDE AN OVERARCHING VIEW OF CRITICAL HEALTH ISSUES ACROSS SAN DIEGO COUNTY. 2. QUALITATIVE INFORMATION WAS GATHERED THROUGH A COMPREHENSIVE COMMUNITY ENGAGEMENT PROCESS TO UNDERSTAND PEOPLE'S LIVED EXPERIENCES AND NEEDS IN THE COMMUNITY. THE CHNA COMMITTEE REVIEWED THE FEEDBACK AND DATA TO PRIORITIZE THE TOP HEALTH NEEDS IN SAN DIEGO COUNTY. THE CHNA COMMITTEE COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. THE FOLLOWING DATA WAS USED IN THE PRIORITIZATION PROCESS: QUANTITATIVE DATA: * DATA AND ANALYSIS FROM HEALTH AND HUMAN SERVICES AGENCY, PUBLIC HEALTH SERVICES INCLUDING COMMUNITY HEALTH STATISTICS, HEALTH EQUITY DASHBOARDS, MORBIDITY & MORTALITY DATA * ANALYSIS OF SECONDARY DATA, HEALTH CONDITIONS, AND SOCIAL DETERMINANTS OF HEALTH (SDOH) * COUNTY OF SAN DIEGO LEADING CAUSES OF DEATH 2019 DATA * HOSPITAL DISCHARGE TREND DATA RETRIEVED FROM CALIFORNIA'S DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) LIMITED DATA SETS, 2017-2019 SPEEDTRACK QUALITATIVE DATA: * COMMUNITY GUIDANCE FROM CHNA PLANNING INTERVIEWS * COMMUNITY ENGAGEMENT FINDINGS FROM FOCUS GROUPS * COMMUNITY ENGAGEMENT FINDINGS FROM KEY INFORMANT INTERVIEWS * COMMUNITY ENGAGEMENT FINDINGS FROM INTERVIEWS AND FOCUS GROUPS WITH PROMOTORAS AND COMMUNITY HEALTH WORKERS (CHWS) * 2022 CHNA ONLINE COMMUNITY SURVEY SEVERAL CRITERIA WERE APPLIED TO THE DATA TO DETERMINE WHICH TOP COMMUNITY NEEDS WERE OF THE HIGHEST PRIORITY IN SAN DIEGO COUNTY. THESE CRITERIA INCLUDED: THE SEVERITY OF THE NEED: THIS REFERS TO HOW SEVERE THE HEALTH NEED IS (SUCH AS ITS POTENTIAL TO CAUSE DEATH OR DISABILITY) AND ITS DEGREE OF POOR PERFORMANCE AGAINST THE RELEVANT BENCHMARK. THE MAGNITUDE/SCALE OF THE NEED-THE MAGNITUDE REFERS TO THE NUMBER OF PEOPLE AFFECTED BY THE HEALTH NEED. DISPARITIES OR INEQUITIES-THIS REFERS TO DIFFERENCES IN HEALTH OUTCOMES BY SUBGROUPS. SUBGROUPS MAY BE BASED ON GEOGRAPHY, LANGUAGES, ETHNICITY, CULTURE, CITIZENSHIP STATUS, ECONOMIC STATUS, SEXUAL ORIENTATION, AGE, GENDER, OR OTHERS. AND CHANGE OVER TIME-THIS REFERS TO WHETHER THE NEED HAS IMPROVED, STAYED THE SAME, OR WORSENED. OVER THE COURSE OF SEVERAL MEETINGS, THE HASD&IC STAFF AND CHNA COMMITTEE MEMBERS COLLECTIVELY REVIEWED THE QUANTITATIVE AND QUALITATIVE DATA AND FINDINGS. EACH HEALTH CONDITION AND SOCIAL DETERMINANT OF HEALTH FOR WHICH THE COMMITTEE HAD DATA WAS CONSIDERED AND DISCUSSED IN TERMS OF THESE CRITERIA. THOSE COMMUNITY NEEDS THAT MET THE LARGEST NUMBER OF CRITERIA WERE CHOSEN AS TOP PRIORITIES. THE 2022 CHNA INCLUDED EXTENSIVE QUANTITATIVE ANALYSIS OF SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND IN-PATIENT HOSPITAL DISCHARGE DATA AND OTHER SECONDARY SOURCES. TAKEN TOGETHER, THESE QUALITATIVE AND QUANTITATIVE APPROACHES ALLOWED THE CHNA COMMITTEE TO VIEW COMMUNITY NEEDS FROM MULTIPLE PERSPECTIVES. THE RESULTS OF THE 2022 CHNA WILL BE USED TO INFORM AND ADAPT HOSPITAL PROGRAMS AND STRATEGIES TO BETTER MEET THE HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS. QUANTITATIVE DATA WERE USED FOR THREE PRIMARY PURPOSES: 1. DESCRIBE THE SAN DIEGO COUNTY COMMUNITY. 2. PLAN AND DESIGN THE COMMUNITY ENGAGEMENT PROCESS. 3. FACILITATE THE "PRIORITIZATION PROCESS" - IDENTIFYING THE MOST SERIOUS COMMUNITY HEALTH NEEDS OF SAN DIEGO COUNTY RESIDENTS FACING INEQUITIES. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE - POSTERS ALERTING INDIVIDUALS TO SCRIPPS FINANCIAL ASSISTANCE AND CHARITY CARE PROGRAMS ARE DISPLAYED IN REGISTRATION AREAS IN THE HOSPITALS, INCLUDING THE EMERGENCY DEPARTMENTS, OUTPATIENT SETTINGS, AND MAIN ADMISSION AREAS. - THE FOLLOWING FINANCIAL ASSISTANCE DOCUMENTS INFORMING PATIENTS OF THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE ARE AVAILABLE FOR ALL PATIENTS, BY ASKING A REPRESENTATIVE OR BY OBTAINING A COPY ONLINE AT SCRIPPS.ORG. -PATIENT FINANCIAL ASSISTANCE POLICY, INCLUDING DISCOUNTED PAYMENTS AND CHARITY CARE (FAP) -SCRIPPS PATIENT ACCOUNT MANAGEMENT, BILLING AND COLLECTIONS POLICY, S-FW-LD-5400. -SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY - A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY, IS OFFERED TO ALL PATIENTS AT REGISTRATION OR PRIOR TO DISCHARGE AND A COPY IS INCLUDED IN ALL BILLING STATEMENTS. SCRIPPS WILL MAIL A COPY TO THE PATIENT WITHIN 72 HOURS IF NOT RECEIVED AT THE HOSPITAL. - FINANCIAL ASSISTANCE APPLICATION WITH INSTRUCTIONS INFORMS INDIVIDUALS ABOUT CHARITY AND DISCOUNTED CARE. PAPER APPLICATIONS ARE AVAILABLE FREE OF CHARGE IN THE EMERGENCY DEPARTMENT AND MAIN REGISTRATION AREAS. PATIENTS MAY REQUEST A COPY BE SENT TO THEM ELECTRONICALLY. - THE DOCUMENTS LISTED ABOVE, ARE AVAILABLE ONLINE FREE OF CHARGE IN MULTIPLE LANGUAGES INCLUDING THE PRIMARY LANGUAGES OF PATIENT POPULATIONS WITH LIMITED ENGLISH PROFICIENCY (LEP). - SCRIPPS WORKS WITH THE CALIFORNIA HOSPITAL ASSOCIATION TO INFORM THOSE LIKELY TO NEED FINANCIAL HELP. THE SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS TO BE AVAILABLE AT COMMUNITY EVENTS AND IS PROVIDED TO LOCAL AGENCIES THAT OFFER CONSUMER ASSISTANCE. - SCRIPPS FINANCIAL ASSISTANCE POLICIES AND RELATED INFORMATION IS ALSO PROVIDED TO THE CALIFORNIA DEPARTMENT OF HEALTH CARE ACCESS AND INFORMATION (HCAI) AS REQUIRED BY LAW. - FACILITY POSTERS ALERT INDIVIDUALS TO FREE CONSUMER ADVOCACY ORGANIZATIONS THAT ARE AVAILABLE FOR ASSISTANCE IN UNDERSTANDING THE BILLING AND PAYMENT PROCESS. - SCRIPPS FINANCIAL ASSISTANCE NOTICE AND POLICY PLAIN LANGUAGE SUMMARY IS OFFERED ON ADMISSION AND PROVIDED AT DISCHARGE AND WITH EACH BILLING STATEMENT. THIS COMMUNICATION ALSO INFORMS INDIVIDUALS ABOUT: - GOVERNMENT-SPONSORED PROGRAMS THEY MAY QUALIFY FOR. - THE MEDI-CAL HOSPITAL PRESUMPTIVE ELIGIBILITY PROGRAM PROVIDES QUALIFIED INDIVIDUALS IMMEDIATE ACCESS TO TEMPORARY, NO-COST MEDI-CAL, APPLICATIONS ARE AVAILABLE FROM HOSPITAL REGISTRATION STAFF. CURRENT INCOME AND PROGRAM REQUIREMENTS CHANGE FREQUENTLY. TO OBTAIN ASSISTANCE WITH AN APPLICATION FOR MEDI-CAL, PLEASE CALL 1-866-262-9881. - THE CALIFORNIA HEALTH BENEFIT EXCHANGE MAY OFFER AN INSURANCE PLAN WITH THE HELP OF GOVERNMENT SUBSIDIES THAT REDUCE THE COST OF YOUR MONTHLY PREMIUM, DEPENDING ON YOUR INCOME LEVEL. TO LEARN MORE, VISIT COVEREDCA.COM OR CALL 1-800-300-1506. - HOSPITAL BILL COMPLAINT PROGRAM. THE HOSPITAL BILL COMPLAINT PROGRAM IS A STATE PROGRAM, WHICH REVIEWS HOSPITAL DECISIONS ABOUT WHETHER AN INDIVIDUAL QUALIFIES FOR HELP PAYING THEIR HOSPITAL BILL. A PATIENT MAY FILE A COMPLAINT WITH THE HOSPITAL BILL COMPLAINT PROGRAM, HOSPITALBILLPROGRAM.HCAI.CA.GOV - LOCAL CONSUMER ASSISTANCE. FREE CONSUMER ADVOCACY ORGANIZATIONS ASSIST PATIENTS IN UNDERSTANDING THE BILLING AND PAYMENT PROCESS. HEALTH CONSUMER ALLIANCE AT 888-804-3536, HEALTHCONSUMER.ORG FOR MORE INFORMATION. Schedule H, Part VI, Line 4 Community information SCRIPPS HEALTH COMMUNITY SERVED SCRIPPS HEALTH COMMUNITY SERVED HOSPITALS AND HEALTH CARE SYSTEMS DEFINE THE COMMUNITY SERVED AS THOSE INDIVIDUALS RESIDING WITHIN ITS SERVICE AREA. A HOSPITAL OR HEALTH CARE SYSTEM SERVICE AREA INCLUDES ALL RESIDENTS IN A DEFINED GEOGRAPHIC AREA SURROUNDING THE HOSPITAL AND DOES NOT EXCLUDE LOW INCOME OR UNDERSERVED POPULATIONS. SCRIPPS SERVES THE ENTIRE SAN DIEGO COUNTY REGION WITH SERVICES CONCENTRATED IN NORTH COASTAL, NORTH CENTRAL, CENTRAL AND SOUTHERN REGION OF SAN DIEGO. SCRIPPS PROVIDES SIGNIFICANT VOLUMES OF INPATIENT, EMERGENCY, OUTPATIENT, AND PRIMARY CARE. IN FISCAL YEAR 2024, SCRIPPS PROVIDED 3,168,633 OUTPATIENT VISITS AND 74,942 HOSPITAL DISCHARGES. COMMUNITY OUTREACH EFFORTS ARE FOCUSED IN THOSE AREAS WITH PROXIMITY TO A SCRIPPS FACILITY. THE HOSPITAL'S PATIENT POPULATION INCLUDES ALL WHO RECEIVE CARE WITHOUT REGARD TO INSURANCE COVERAGE OR ELIGIBILITY FOR ASSISTANCE. SCRIPPS MERCY HOSPITAL SAN DIEGO AND SCRIPPS MERCY HOSPITAL CHULA VISTA CAMPUSES ARE DESIGNATED BY THE GOVERNMENT AS OF JULY 2024 AS A DISPROPORTIONATE SHARE HOSPITAL, IN REFLECTING THE ECONOMICALLY DISADVANTAGED POPULATION THEY SERVE. BOTH HOSPITAL CAMPUSES PLAY IMPORTANT HEALTH CARE SERVICE ROLES IN THE CENTRAL/SOUTHERN SAN DIEGO COUNTY SERVICE AREA (RANGING FROM INTERSTATE 8 TO THE UNITED STATES-MEXICO BORDER). MORE THAN HALF OF PATIENTS AT SCRIPPS MERCY SAN DIEGO AND CHULA VISTA ARE COVERED BY GOVERNMENT INSURANCE, INCLUDING MEDICARE AND MEDI-CAL. Schedule H, Part VI, Line 5 Promotion of community health SCRIPPS PROVIDES A COMPREHENSIVE RANGE OF INPATIENT AND AMBULATORY SERVICES THROUGH OUR SYSTEM OF HOSPITALS AND CLINICS. SCRIPPS STRIVES TO IMPROVE COMMUNITY HEALTH THROUGH COLLABORATION WITH A WIDE RANGE OF PARTNERS AND LIKE-MINDED ORGANIZATIONS. WORKING WITH OTHER HEALTH SYSTEMS, COMMUNITY GROUPS AND ORGANIZATIONS, GOVERNMENT AGENCIES, BUSINESSES AND COMMUNITY CLINICS, SCRIPPS IS BETTER ABLE TO BUILD UPON EFFORTS TO ACHIEVE BROAD COMMUNITY HEALTH GOALS AND PARTNER WITH A WIDE VARIETY OF ORGANIZATIONS ON COMMUNITY HEALTH IMPROVEMENT PROGRAMS. OUR COLLABORATIONS EXTEND BEYOND OUR LOCAL COMMUNITY TO INCLUDE STATE, NATIONAL, AND GLOBAL EFFORTS IN DISASTER PREPAREDNESS AND RELIEF, EMERGENCY MEDICAL SERVICES, HEALTHCARE ADVOCACY, PHYSICIAN EDUCATION, AND DIRECT PATIENT CARE. IN ALL THAT WE DO, WE ARE COMMITTED TO QUALITY PATIENT OUTCOMES, SERVICE EXCELLENCE, OPERATING EFFICIENCY, CARING FOR THOSE IN NEED TODAY WHILE PLANNING FOR THE HEALTHCARE NEEDS OF FUTURE GENERATIONS. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES HAVE AN OPEN MEDICAL STAFF FOR ALL QUALIFIED PHYSICIANS. THE BOARD OF TRUSTEES HAS AUTHORITY TO APPROVE BYLAWS, RULES AND REGULATIONS FOR THE MEDICAL STAFF OF EACH HOSPITAL, SURGERY CENTER OR SIMILAR FACILITY, AND TO APPOINT, SUSPEND OR REMOVE ANY PHYSICIAN FROM THE MEDICAL STAFF. ALL FIVE ACUTE-CARE HOSPITAL CAMPUSES PARTICIPATE IN MEDI-CAL AND MEDICARE CONTRACTS. SCRIPPS SURPLUS FUNDS ARE REINVESTED BACK INTO THE SAN DIEGO COMMUNITY. SURPLUS FUNDS ARE UTILIZED FOR NEW FACILITIES, EQUIPMENT, SEISMIC RETROFITTING, PROFESSIONAL EDUCATION AND HEALTH RESEARCH, ACCESS TO PATIENT CARE AND COMMUNITY BENEFIT PROGRAMS. IRS FORM 990, SCHEDULE H INSTRUCTIONS DEFINE COMMUNITY BENEFIT AS ACTIVITIES OR PROGRAMS THAT RESPOND TO COMMUNITY HEALTH NEEDS AND SEEK TO ACHIEVE ONE OR MORE OF THE FOLLOWING OBJECTIVES: IMPROVING ACCESS TO HEALTH SERVICES, ENABLING LOW-INCOME PERSONS TO AFFORD HEALTH CARE, ENHANCING PUBLIC HEALTH, ADVANCING GENERALIZABLE KNOWLEDGE, EDUCATING HEALTH PROFESSIONALS, AND RELIEVING THE GOVERNMENT BURDEN TO IMPROVE HEALTH. MEDICARE SHORTFALL, BAD DEBT, AND COMMUNITY BUILDING ACTIVITIES ARE REPORTABLE UNDER SCHEDULE H GUIDELINES BUT ARE EXCLUDED FROM THE COMMUNITY BENEFIT TOTALS. HOWEVER, SCRIPPS INCLUDES THESE TOTALS IN OUR OVERALL COMMUNITY BENEFIT CALCULATIONS IN THE ANNUAL COMMUNITY BENEFIT PLAN AND REPORT. FOR MORE INFORMATION SEE HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. THE IRS IDENTIFIES CATEGORIES OF COMMUNITY BENEFIT THAT ARE REPORTABLE ON TAX-EXEMPT HOSPITALS FORM 990, SCHEDULE H: FINANCIAL ASSISTANCE AT COST (ALSO KNOWN AS CHARITY CARE), MEDICAL SHORTFALL, COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH, AND CASH AND IN-KIND CONTRIBUTIONS. SCRIPPS ALIGNED ITS 2024 COMMUNITY BENEFIT PLAN AND REPORT WITH THESE CATEGORIES. FOR FULL CATEGORY DEFINITIONS AND ACCOUNTING METHODS SEE IRS SCHEDULE H (FORM 990)(2023) INSTRUCTIONS. COVERING THE PERIOD OF FISCAL YEAR 2024 (OCTOBER 1, 2023, THROUGH SEPTEMBER 30, 2024), SCRIPPS CONTRIBUTED $656,291,701 IN COMMUNITY BENEFIT CONTRIBUTIONS AS DETAILED BELOW BY IRS CATEGORIES. - SCRIPPS CONTRIBUTES SIGNIFICANT RESOURCES PROVIDING LOW AND NO-COST HEALTH CARE FOR OUR PATIENTS IN NEED. THE COSTS OF PROVIDING THESE SERVICES ARE NOT FULLY REIMBURSED. DURING FISCAL YEAR 2024, SCRIPPS CONTRIBUTED $587,766,140 IN UNCOMPENSATED HEALTH CARE, INCLUDING $17,768,458 IN CHARITY CARE, $562,399,773 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $7,597,909 IN BAD DEBT. - SCRIPPS INVESTED $10,901,463 IN COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS. THIS INVESTMENT INCLUDES IN-LIEU OF FUNDS WHICH PROVIDES CRITICAL SUPPORT FOR VULNERABLE POPULATIONS, COVERING ESSENTIAL POST-DISCHARGE NEEDS FOR UNFUNDED OR UNDERFUNDED PATIENTS. THESE FUNDS HELP ENSURE ACCESS TO NECESSARY HEALTH CARE SUPPORT SERVICES BEYOND HOSPITAL CARE. - COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS INCLUDE PREVENTION AND WELLNESS PROGRAMS, SCREENINGS, HEALTH EDUCATION, SUPPORT GROUPS, HEALTH FAIRS AND OTHER PROGRAMS SUPPORTED BY OPERATIONAL FUNDS, GRANTS, AND IN-KIND DONATIONS AND PHILANTHROPY. CALCULATIONS ARE BASED ON COST, LESS "DIRECT OFFSETTING REVENUE," WHICH INCLUDES ANY REVENUE GENERATED BY THE ACTIVITY OR PROGRAM, SUCH AS PAYMENT OR REIMBURSEMENT FOR SERVICES PROVIDED TO PROGRAM PATIENTS. ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES, "DIRECT OFFSETTING REVENUE" ALSO INCLUDES RESTRICTED GRANTS OR CONTRIBUTIONS THAT THE ORGANIZATION USES TO PROVIDE A COMMUNITY BENEFIT. - EACH YEAR, SCRIPPS ALLOCATES RESOURCES TO ADVANCE HEALTH CARE SERVICES THROUGH HEALTH PROFESSIONAL EDUCATION. DURING FISCAL YEAR 2024, SCRIPPS INVESTED $47,659,269 IN PROFESSIONAL TRAINING PROGRAMS TO ENHANCE SERVICE DELIVERY AND TREATMENT PRACTICES IN SAN DIEGO COUNTY. THIS REFLECTS PROFESSIONAL EDUCATION FOR NON-SCRIPPS EMPLOYEES, INCLUDING GRADUATE MEDICAL EDUCATION, NURSING RESOURCE DEVELOPMENT AND OTHER HEALTH CARE PROFESSIONAL EDUCATION. - SCRIPPS INVESTED $4,991,558 IN HEALTH RESEARCH AND SCRIPPS CLINIC AND CLINICAL RESEARCH SERVICES SUPPORTED MORE THAN 43 PRINCIPAL INVESTIGATORS AND ABOUT 106 ACTIVE CLINICAL RESEARCH PROTOCOLS CROSSING INTERDISCIPLINARY DISEASE CATEGORIES. SCRIPPS HEALTH IS COMMITTED TO PROVIDING THE BEST POSSIBLE PATIENT CARE, AND RESEARCH IS A CRITICAL PART OF THAT MISSION. IN ADDITION TO BRINGING THE LATEST TREATMENTS TO OUR PATIENTS, THE KNOWLEDGE GAINED FROM THESE RESEARCH STUDIES ADVANCES THE QUALITY OF CARE FOR PEOPLE AROUND THE WORLD. SCRIPPS HEALTH PHYSICIANS STUDY NEW MEDICATIONS AND DEVICES, TRACK PATIENT OUTCOMES FOR YEARS OR EVEN DECADES AND GATHER EVIDENCE FOR SOPHISTICATED EDUCATION AND TREATMENT PROGRAMS. THIS INFORMATION IS THEN DISSEMINATED INTO THE SCRIPPS SYSTEM THROUGH GRADUATE AND CONTINUING MEDICAL EDUCATION AND TO THE SCIENTIFIC COMMUNITY THROUGH PEER-REVIEWED PUBLICATIONS. CALCULATIONS ARE BASED ON COST, LESS "DIRECT OFFSETTING REVENUE," WHICH INCLUDES ANY REVENUE GENERATED BY THE ACTIVITY OR PROGRAM, SUCH AS PAYMENT OR REIMBURSEMENT FOR SERVICES PROVIDED TO PROGRAM PATIENTS. ACCORDING TO THE SCHEDULE H 990 IRS GUIDELINES, "DIRECT OFFSETTING REVENUE" ALSO INCLUDES RESTRICTED GRANTS OR CONTRIBUTIONS THAT THE ORGANIZATION USES TO PROVIDE A COMMUNITY BENEFIT. * SCRIPPS INVESTED $1,485,542 CASH, GRANTS AND IN-KIND CONTRIBUTIONS MADE BY THE ORGANIZATION TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. * SCRIPPS INVESTED $3,100,477 IN SUBSIDIZED HEALTH SERVICES. THIS FIGURE INCLUDES SCRIPPS INPATIENT BEHAVIORAL HEALTH. SCRIPPS OFFERS INPATIENT ADULT BEHAVIORAL HEALTH SERVICES AT THE SCRIPPS MERCY HOSPITAL, SAN DIEGO CAMPUS. THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM ACTIVELY SUPPORTS COMMUNITY PROGRAMS TO REDUCE THE STIGMA OF MENTAL ILLNESS AND HELP AFFECTED INDIVIDUALS LIVE AND WORK IN THE COMMUNITY. SCRIPPS HEALTH OFFERS INPATIENT BEHAVIORAL HEALTH CARE FOR ADULTS ADMITTED THROUGH OUR EMERGENCY DEPARTMENTS OR URGENT CARE CENTERS. OUR OUTPATIENT BEHAVIORAL HEALTH SERVICES ARE AVAILABLE THROUGH PARTNERSHIPS WITH VARIOUS COMMUNITY ORGANIZATIONS. Schedule H, Part VI, Line 6 Affiliated health care system AFFILIATED HEALTH CARE SYSTEM FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $4.9 BILLION PRIVATE, TAX EXEMPT, INTEGRATED HEALTH SYSTEM BASED IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS MORE THAN 600,000 PATIENTS ANNUALLY AT ITS FOUR ACUTE-CARE HOSPITALS ON FIVE CAMPUSES, ALONG WITH A ROBUST NETWORK OF 32 OUTPATIENT CENTERS (INCLUDING 12 HEALTH EXPRESS LOCATIONS), PALLIATIVE CARE, CLINICAL RESEARCH, AND ANCILLARY SERVICES TO SERVE OUR SAN DIEGO COMMUNITY AND BEYOND. SCRIPPS IS ALSO ONE OF THE LARGEST EMPLOYERS IN SAN DIEGO, WITH 3,000 AFFILIATED PHYSICIANS AND MORE THAN 17,500 EMPLOYEES, AND IS RECOGNIZED AS ONE OF THE COUNTRY'S BEST COMPANIES TO WORK FOR. SCRIPPS OFFERS PAYER PRODUCTS AND POPULATION HEALTH SERVICES THROUGH SCRIPPS ACCOUNTABLE CARE ORGANIZATION, SCRIPPS HEALTH PLAN, AND CUSTOMIZED NARROW NETWORK PLANS IN COLLABORATION WITH THIRD-PARTY PAYERS. SCRIPPS HEALTH IS A LEADING PROVIDER OF MEDICAL CARE, DEDICATED TO IMPROVING COMMUNITY HEALTH AND ADVANCING MEDICINE IN SAN DIEGO COUNTY. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS, AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH AND IS THE ONLY HEALTH SYSTEM IN THE REGION WITH TWO LEVEL 1 TRAUMA CENTERS. BOTH SCRIPPS MERCY HOSPITAL IN SAN DIEGO AND SCRIPPS MEMORIAL HOSPITAL LA JOLLA HAVE BEEN VERIFIED AS LEVEL 1 TRAUMA CENTERS-THE HIGHEST DESIGNATION AWARDED BY THE AMERICAN COLLEGE OF SURGEONS (ACS), SIGNIFYING THE MOST COMPREHENSIVE LEVEL OF INJURY CARE AVAILABLE. WITH THESE DESIGNATIONS, SCRIPPS HEALTH NOW OPERATES TWO OF THE THREE LEVEL 1 ADULT TRAUMA CENTERS IN SAN DIEGO COUNTY. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONGSTANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. OUR HOSPITALS ARE CONSISTENTLY RANKED AMONG THE NATION'S BEST BY U.S. NEWS & WORLD REPORT AND NUMEROUS OTHER ORGANIZATIONS. SCRIPPS IS FREQUENTLY RECOGNIZED BY FORTUNE MAGAZINE, WORKING MOTHER MAGAZINE, AND THE ADVISORY BOARD AS ONE OF THE BEST PLACES IN THE NATION TO WORK. IMPORTANTLY, SCRIPPS CULTURE IS ONE OF CARING. THE SPIRIT AND CULTURE ESTABLISHED BY TWO PIONEERING FOUNDERS, ELLEN BROWNING SCRIPPS AND MOTHER MARY MICHAEL CUMMINGS, STILL DEFINE WHO WE ARE TODAY. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. EXCELLENCE IN PRIMARY AND SPECIALTY CARE THE SYSTEM IS KNOWN FOR ITS EXPERTISE IN VARIOUS AREAS, INCLUDING CANCER CARE, CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT, ORTHOPEDICS, WOMEN'S HEALTH, AND NEUROCOGNITIVE CARE. GENERATIONS OF SAN DIEGANS HAVE RELIED ON SCRIPPS FOR EXCELLENCE IN HEALTH CARE, STARTING WITH PRIMARY CARE DOCTORS WHO ACT AS THE PATIENT'S PERSONAL HEALTH ADVOCATE INCLUDING A FOCUS ON PREVENTIVE CARE AND WELLNESS. FOR PATIENTS' CONVENIENCE, SCRIPPS PHYSICIANS OFFER SEVERAL OPTIONS FOR ONGOING CARE, INCLUDING EXTENDED OFFICE HOURS, TELEMEDICINE OPTIONS, THREE URGENT CARE CENTERS AND HEALTH EXPRESS WALK-IN CLINICS THROUGHOUT THE COUNTY FOR SAME-DAY TREATMENT OF MINOR ILLNESSES AND INJURIES. WITH SOME OF THE MOST ADVANCED TECHNOLOGY AVAILABLE TODAY FOR THE DIAGNOSIS AND TREATMENT OF ACUTE AND CHRONIC ILLNESSES, SCRIPPS OFFERS PATIENTS A COMPLETE RANGE OF MEDICAL AND SURGICAL SERVICES INCLUDING MANY THAT HAVE BEEN NATIONALLY RECOGNIZED FOR CLINICAL QUALITY AND PATIENT OUTCOMES. GOVERNANCE As a tax-exempt health care system, Scripps takes pride in its service to the community. The Scripps system is governed by a 16-member, volunteer Board of Trustees. This single point of authority for organizational policy ensures a unified approach to serving patients across the region. ORGANIZATIONAL FOUNDATION Scripps provides a comprehensive range of inpatient and ambulatory services through our system of hospitals and clinics. In addition, Scripps participates in many partnerships with government and not-for-profit agencies across our region to improve our community's health. And our partnerships do not stop at our local borders. Our collaborations extend beyond our local community to include state, national, and global efforts in disaster preparedness and relief, emergency medical services, healthcare advocacy, physician education, and direct patient care. In all that we do, we are committed to quality patient outcomes, service excellence, operating efficiency, caring for those in need today while planning for the healthcare needs of future generations. Schedule H, Part VI, Line 7 State filing of community benefit report CA true California Health Found and Trust (CHFT) 1215 K Street Ste 800 Sacramento CA 95814 951684089 501(c)(3) 927000 CA Hospital Fee Program ConsR Cent for Health Edu and Advocacy (CCHEA) 1764 San Diego Ave Ste 200 San Diego CA 92110 751835298 501(c)(3) 120000 Program Support Enlisted Leadership Foundation - The Foundry 2307 Fenton Parkway Ste 107-208 San Diego CA 92018 465029314 501(c)(3) 35000 Program Support Family Health Center of San Diego Internal Medicine Outpatient Teaching Cl inic Partnership 823 Gateway Center Way San Diego CA 92012 952833205 501(c)(3) 309000 Program Support San Ysidro Health Center 3350 E Street San Diego CA 92102 223746050 501(c)(3) 25000 Program Support Family Health Centers of San Diego - Spirit of the Barrio 823 Gateway Center Way San Diego CA 92102 952833205 501(c)(3) 7500 Program Support The San Diego LGBT Community Center 3909 Centre St San Diego CA 92013 237332048 501(c)(3) 10000 Program Support Ministry of Jerusalem (Emergency Meals and Water) 100 North Sixth Street Ste 626B Minneapolis MI 55403 204092394 501(c)(3) 6000 FMV Donated blankets and socks Program Support Father Joe's Villages (Scripps Blanket and Sock Drive) 3350 E Street San Diego CA 92102 223746050 501(c)(3) 18000 FMV Donated water Program Support City of Hope 1500 E Duarte Rd Duarte CA 91010 953435919 501(c)(3) 50000 FMV Donation of Medical Equip Program Support 10 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. GRANTEE SHALL SUBMIT TO SCRIPPS HEALTH, ATTENTION DIRECTOR OF COMMUNITY BENEFIT SERVICES AT 4555 EXECUTIVE DRIVE, SAN DIEGO, CA 92121, THE FOLLOWING: A. A SEMI-ANNUAL SUMMARY PROGRESS REPORT AND A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT IS REQUIRED. REPORTS SHALL INCLUDE, BUT NOT BE LIMITED TO, PROGRESS MADE TOWARD MEETING OBJECTIVES OUTLINED IN THE GRANT APPLICATION. B. WITHIN THIRTY (30) DAYS FOLLOWING THE EXPIRATION DATE OF THE GRANT A FINAL PROGRESS REPORT SHALL BE SUBMITTED TO SCRIPPS HEALTH. IN ADDITION TO THE PROGRESS MADE TOWARD MEETING THE OBJECTIVES OUTLINED IN THE GRANT APPLICATION, THE FINAL REPORT SHOULD INCLUDE QUANTITATIVE AND QUALITATIVE RESULTS OF THE PROGRAM AGAINST ITS STATED GOALS AND OBJECTIVES. A LINE ITEM FINANCIAL ACCOUNTING OF THE GRANT DISBURSEMENT AGAINST THE BUDGET MUST BE INCLUDED AS PART OF THIS FINAL REPORT. C. THE GRANTEE SHALL PROVIDE SCRIPPS HEALTH WITH ANY ADDITIONAL INFORMATION OR PROGRESS UPDATES, RELATIVE TO GRANT PROJECT, AS REASONABLY REQUESTED. D. SCRIPPS HEALTH RESERVES THE RIGHT TO AUDIT EXPENDITURES AND SUPPORTING DOCUMENTATION. X X X X X true true X X X X X X true true false false false false false false false Christopher Van Gorder President / CEO 2010581 0 2113601 0 164655 0 23100 0 30066 0 4342003 0 0 0 Richard Rothberger Former Officer 0 0 430289 0 0 0 0 0 0 0 430289 0 0 0 Shawn Forrester FORMER KEY EMPLOYEE 178048 0 164163 0 0 0 0 0 0 0 342211 0 0 0 Bradley Ellis Corp Sr. VP Chief Legal Officer 952148 0 251136 0 14013 0 23100 0 29890 0 1270287 0 0 0 Brett Tande Treasurer / Exec VP, CFO 1062752 0 187269 0 21403 0 13200 0 42683 0 1327307 0 0 0 Anil Keswani Corp EVP Chief Med & Ops Officer AMB 901654 0 306200 0 54429 0 16500 0 43084 0 1321867 0 0 0 Richard Neale Corp Exec VP, Chief Growth Officer 867915 0 348980 0 52549 0 16500 0 42481 0 1328425 0 0 0 Thomas Buchholz Corp Sr. VP, MD Anderson 1089773 0 361242 0 15756 0 13200 0 29708 0 1509679 0 0 0 Thomas Gammiere Chief Executive, Sr VP 776120 0 306173 0 31165 0 23100 0 32475 0 1169033 0 0 0 June Komar Corp Exec VP, Strategy & Admin 740199 0 495738 0 17220 0 23100 0 15070 0 1291327 0 0 0 Barbara Price Corp Sr VP, Bus&Serv Line Dev 824550 0 309881 0 41872 0 23100 0 42503 0 1241906 0 0 0 Carl Etter Chief Executive, Sr VP 1330331 0 360747 0 37942 0 19800 0 32436 0 1781256 0 0 0 Lisa RisserThakur Corp Sr. VP, Ancillary Ops (part year) 583320 0 217712 0 801567 0 0 0 14713 0 1617312 0 748875 0 Eric Cole Corp Sr. VP, Human Resources 736706 0 249987 0 45931 0 13200 0 36895 0 1082719 0 0 0 John Engle Corp Sr. VP, Chief Development 628291 0 237398 0 57143 0 23100 0 32283 0 978215 0 0 0 Ghazala Sharieff Corp EVP Chief Med & Ops Officer Acute 1187577 0 363364 0 58578 0 13200 0 39797 0 1662516 0 0 0 Shane Thielman Corp SVP CIDO 684559 0 249411 0 23268 0 19800 0 42453 0 1019491 0 0 0 Tracy Chu Corp VP, POP Hlth CHF EXEC/ACO 605231 0 173993 0 10371 0 19800 0 14977 0 824372 0 0 0 Gerald Soderstrom Corp SVP Audit/Compliance 523521 0 180266 0 18352 0 13200 0 42899 0 778238 0 0 0 John Poole Corp VP, System Improvement 611822 0 175757 0 13139 0 13200 0 18125 0 832043 0 0 0 Craig M Uejo Corp VP, Chief Quality Officer 527723 0 156311 0 11556 0 13200 0 42346 0 751136 0 0 0 Sherman T Moore Corp VP, Business Development 515529 0 135965 0 21516 0 13200 0 42247 0 728457 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE TAX GROSS-UP PAYMENTS RELATED TO CERTAIN EXECUTIVE BENEFIT PROGRAMS. THESE AMOUNTS ARE INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2. Schedule J, Part I, Line 1a Discretionary spending account CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE AN AUTOMOBILE ALLOWANCE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2. Schedule J, Part I, Line 1a Housing allowance or residence for personal use ONE EXECUTIVE REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVED A HOUSING ALLOWANCE FOR LESS THAN ONE YEAR AS PART OF THEIR ONBOARDING COMPENSATION PACKAGE. THE ALLOWANCE IS INCLUDED IN TAXABLE WAGES AND REPORTED ON THE EXECUTIVE'S W-2. Schedule J, Part I, Line 1a Health or social club dues or initiation fees SCRIPPS HEALTH INCURS THE MEMBERSHIP COST OF A BUSINESS NETWORKING CLUB IN SAN DIEGO FOR ITS CHIEF EXECUTIVE OFFICER AT AN APPROXIMATE MONTHLY COST OF $200. THE MEMBERSHIP IS USED 100% FOR BUSINESS PURPOSES AND ACCORDINGLY, NO PART OF THIS BENEFIT IS INCLUDED WITHIN THE CHIEF EXECUTIVE OFFICER'S TAXABLE COMPENSATION. Schedule J, Part I, Line 1a Personal services CERTAIN EXECUTIVES REPORTED ON FORM 990, PART VII AND SCHEDULE J, PART II RECEIVE REIMBURSEMENT FOR FINANCIAL PLANNING SERVICES AND AN ANNUAL PHYSICAL. THE REIMBURSEMENT IS APPROPRIATELY INCLUDED IN TAXABLE WAGES AND REPORTED ON THEIR RESPECTIVE W-2 WHERE APPLICABLE. Schedule J, Part I, Line 4a Severance or change-of-control payment RECEIVE A SEVERANCE PAYMENT OR CHANGE-OF CONTROL PAYMENT THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY IN CALENDAR YEAR 2023: LISA RISSER/THAKUR - $217,266 SHAWN FORRESTER - $178,048 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan SCRIPPS HEALTH EXECUTIVE BENEFITS PROGRAM PROVIDES A 457F PLAN WITH A FLEXIBLE BENEFIT ALLOWANCE THAT CAN BE USED TO PURCHASE ADDITIONAL INSURANCE COVERAGE FOR CERTAIN EXECUTIVE LEVEL EMPLOYEES. ANY REMAINING BENEFIT ALLOWANCE CAN BE DEPOSITED INTO THE SUPPLEMENTAL ACCUMULATION RETIREMENT ACCOUNT (SARA) WITH A FUTURE VESTING DATE. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2023 INCLUDED IN OTHER REPORTABLE COMPENSATION IN SCHEDULE J, (B)(III): LISA RISSER/THAKUR - $748,875 EFFECTIVE JANUARY 1, 2021, SCRIPPS HEALTH TRANSITIONED PART OF ITS' EXECUTIVE BENEFITS PROGRAM FROM THE 457F PLAN TO A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). THIS SERP PROVIDES COMPETITIVE SUPPLEMENTAL RETIREMENT BENEFITS TO THE PARTICIPANTS TO ENCOURAGE CONTINUED EMPLOYMENT AND CONTINUED INTEREST IN THE SUCCESS OF THE SYSTEM. THE SYSTEM CREDITS A TARGETED PERCENT PER YEAR OF SERVICE, UP TO A MAXIMUM PERCENT OF THE FINAL AVERAGE SALARY AT AGE 70 FOR 25 YEARS OF SERVICE. THE TARGET BENEFIT IS OFFSET BY (I) BENEFITS UNDER THE FROZEN SARA PLAN, (II) THE SYSTEM-PAID PORTION OF SOCIAL SECURITY RETIREMENT BENEFITS, AND (III) QUALIFIED RETIREMENT PLANS ATTRIBUTABLE TO THE SYSTEM'S CREDITS UNDER THOSE PLANS. ALTHOUGH THE BENEFIT IS TARGETED AT AGE 70, THE SYSTEM MAY ELECT TO CONTINUE CREDITS TOWARD THE BENEFIT SO LONG AS THE PARTICIPANT REMAINS EMPLOYED WITH THE SYSTEM. A California Statewide Communities Development Authority 680164610 1309116Y1 2007-03-02 49995000 SEE PART VI false false true B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 000000000 2016-02-29 150000000 SEE PART VI false false false C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 000000000 2017-01-31 160000000 SEE PART VI false false false D CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 000000000 2019-11-15 99360000 SEE PART VI false false false A 500000 0 49995000 0 0 0 146070 0 0 49848390 0 0 2007 true false true true B 124970000 0 150000000 0 0 0 0 0 0 150000000 0 0 2016 false false true true C 13305000 0 160000000 0 0 0 0 0 0 0 160000000 0 2017 true false true true D 4185000 0 99360000 0 0 0 0 0 0 0 99360000 0 2019 true false true true A false false true true true true 0.0 0.0 0.0 false false true B false false true true true true 0.0 0.0 0.0 false false true C false false true true true true 0.0 0.0 0.0 false false true D false false true true true true 0.0 0.0 0.0 false false true A false false false true true false false true true B false false false true false false false false true C false false false true false false false false true D false false false true false false false false true A true B true C true D true Schedule K, Part I, Column (e) ISSUE PRICE BOND ISSUE 1-A (2007A): THE STATED PAR OF $49,995,000 DIFFERS FROM THE $149,875,000 REPORTED ON FORM 8038 AS THE $49,995,000 AMOUNT REPRESENTS THE SCRIPPS HEALTH'S PORTION ON IN A POOL BOND LOAN PROGRAM. Schedule K, Part III, Line 3b THE OBLIGOR'S LEGAL DEPARTMENT REVIEWS CONTRACTS AND AGREEMENTS TO ENSURE COMPLIANCE WITH PRIVATE BUSINESS USE REGULATIONS, ENGAGING OUTSIDE LEGAL COUNSEL, AS NECESSARY. Schedule K, Part IV, Line 6 BOND ISSUE 1-A (2007A): AN AMOUNT IN THE COST OF ISSUANCE FUND NOT EXCEEDING $100,000 WAS NOT DISBURSED UNTIL MAY 2008. Schedule K, Part V PROCEDURES TO UNDERTAKE CORRECTIVE ACTION THE ORGANIZATION HAS ADOPTED TAX-EXEMPT BOND COMPLIANCE PROCEDURES, INCLUDING PROCEDURES TO MONITOR PRIVATE BUSINESS USE OF FINANCED PROPERTY AND TAKING REMEDIAL ACTIONS, IF NECESSARY. THE ORGANIZATION IS AWARE OF THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS, AND HAS DISCUSSED THAT PROGRAM WITH COUNSEL. THE ORGANIZATION HAS REVISED ITS WRITTEN PROCEDURES TO SPECIFICALLY MAKE REFERENCE TO THE SERVICE'S VOLUNTARY CLOSING AGREEMENT PROGRAM FOR TAX-EXEMPT BONDS. Schedule K, Part I, Column (f) DESCRIPTION OF PURPOSE BOND ISSUE 1-A (2007A): POOL BOND. PROCEEDS WERE USED TO REFUND COMMERCIAL PAPER REVENUE NOTES, SERIES 2005A, WHICH WERE USED TO PURCHASE EQUIPMENT. BOND ISSUE 1-B (2016A/B): PROCEEDS USED FOR CAPITAL EXPENDITURES FOR HEALTHCARE BUILDINGS, RENOVATION AND EQUIPMENT. BOND ISSUE 1-C (2017A): THE $160,000,000 (2017A) REFUNDED THE 2008B-F BONDS. THE ISSUE DATE FOR THE 2008B-F BONDS WAS 8/14/2008. BOND ISSUE 1-D (2019A): THE 2019A ISSUE REFUNDED THE 2010A ISSUE. BOND ISSUE 1-A & 1-B (2024): EXPENSES INCURRED AT SCRIPPS MEMORIAL HOSPITAL - LA JOLLA, SCRIPPS ENCINITAS HOSPITAL, ENCINITAS, CALIFORNIA AND SCRIPPS CORPORATE HEADQUARTERS IN SAN DIEGO, CALIFORNIA. Schedule K, Part IV, Line 2c DATE THE REBATE COMPUTATION WAS PERFORMED BOND ISSUE 1-A (2007A): THE 2007A REBATE COMPUTATION WAS RECENTLY PERFORMED ON MARCH 2, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-B (2016A/C): THE 2016A/C REBATE COMPUTATION WAS RECENTLY PERFORMED ON FEBRUARY 28, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-C (2017A): THE 2017A REBATE COMPUTATION WAS RECENTLY PERFORMED ON JANUARY 31, 2024. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. BOND ISSUE 1-D (2019A) THE 2019A REBATE COMPUTATION WAS RECENTLY PERFORMED ON NOVEMBER 15, 2023. NO REBATE AMOUNT HAS ACCRUED AS OF THE END OF THE COMPUTATION PERIOD. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UL48 2024-02-07 918959458 SEE PART VI false false false B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UN95 2024-02-07 191600000 SEE PART VI false false false A 0 0 918959458 558400000 0 0 0 0 0 0 360556381 0 2024 true false false true B 0 0 191600000 191600000 0 0 0 0 0 0 0 0 2024 false false false true A false false true true true true 0.0 0.0 0.0 false false true B false false true true true true 0.0 0.0 0.0 false false true A false true false false false false false false true B false true false false true false false false true A true B true Chris Van Gorder Officer CUMULATIVE DEF COMP (SEE PG 186) X 10023866 14124288 false true true June Komar Executive CUMULATIVE DEF COMP (SEE PG 186) X 2769010 3901717 false true true Richard Sheridan Former Officer CUMULATIVE DEF COMP (SEE PG 186) X 4063606 5725889 false true true 23751894 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 514376954 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 46146546 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 21882619 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 11940161 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 9922561 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 8152997 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 5233886 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 3409995 Property Taxes false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 2500000 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 590287 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 580840 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 536900 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 496805 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 480500 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 411596 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 404306 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 385157 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 368000 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 315577 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 276887 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 204263 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 152961 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 131301 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 130670 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 115517 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 103040 MEDICAL SERVICES false LINDSEY VAN GORDER SEE PART V 101370 SEE PART V false DAVID VAN GORDER SEE PART V 81928 SEE PART V false KATIE WOODHEAD EMPLOYEE / KEY EMPLOYEE'S DAUGHTER 32971 SEE PART V false Schedule L, Part II LOANS TO AND FROM INTERESTED PERSONS EFFECTIVE JANUARY 1, 2014, SCRIPPS HEALTH FROZE ALL BENEFITS UNDER THE EXISTING SERP PLAN FOR FOUR PLAN PARTICIPANTS. EFFECTIVE APRIL 1, 2014, SCRIPPS HEALTH PROVIDED DEFERRED COMPENSATION ARRANGEMENTS TO THOSE FOUR EXECUTIVES IN THE FORM OF LOANS TO PURCHASE LIFE INSURANCE PRODUCTS TO FUND POST-RETIREMENT INCOME, WITH SUCH DEFERRED COMPENSATION ARRANGEMENTS REFLECTIVE OF THEIR CUMULATIVE SERVICE AT SCRIPPS HEALTH. Schedule L, Part IV BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS LINDSEY VAN GORDER, DAUGHTER-IN-LAW OF BOARD MEMBER AND OFFICER CHRIS VAN GORDER, IS EMPLOYED BY SCRIPPS HEALTH. DAVID VAN GORDER, SON OF BOARD MEMBER AND OFFICER CHRIS VAN GORDER, IS EMPLOYED BY SCRIPPS HEALTH. KATIE WOODHEAD, DAUGHTER OF KEY EMPLOYEE JOHN ENGLE, IS EMPLOYED BY SCRIPPS HEALTH. X 102 1334862 Market value 0 false true true Schedule M, Part I COLUMN (B) CONTRIBUTIONS REPORTED THE NUMBER OF TRANSACTION, WHICH MOST CLOSELY APPROXIMATES THE NUMBER OF ITEMS CONTRIBUTED, IS BEING REPORTED IN COLUMN B. Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions GIFTS OF SECURITIES ARE LIQUIDATED THROUGH LICENSED SECURITIES BROKERS. Form 990, Part I, Line 1 FORM 990, PART III, LINE 1 (CONTINUED) FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $4.3 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 3,000 AFFILIATED PHYSICIANS AND 17,500 EMPLOYEES AMONG ITS FIVE ACUTE-CARE HOSPITAL CAMPUSES, HOME HEALTH CARE, AND AN AMBULATORY CARE NETWORK OF CLINICS, PHYSICIANS' OFFICES AND OUTPATIENT CENTERS THROUGHOUT THE SAN DIEGO REGION. RECOGNIZED AS A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS IS ALSO AT THE FOREFRONT OF CLINICAL RESEARCH, GENOMIC MEDICINE, WIRELESS HEALTH AND GRADUATE MEDICAL EDUCATION. WITH THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION PROGRAMS, SCRIPPS IS A LONG STANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES. MORE INFORMATION CAN BE FOUND AT WWW.SCRIPPS.ORG. TODAY, THE HEALTH SYSTEM EXTENDS FROM CHULA VISTA TO OCEANSIDE, WITH 26 PRIMARY AND SPECIALTY CARE OUTPATIENT CENTERS. A LEADER IN THE PREVENTION, DIAGNOSIS AND TREATMENT OF DISEASE, SCRIPPS WAS NAMED BY TRUVEN IN 2013 AS ONE OF THE TOP 15 LARGE HEALTH SYSTEMS IN THE NATION FOR PROVIDING HIGH-QUALITY, SAFE AND EFFICIENT PATIENT CARE. ON THE FOREFRONT OF GENOMIC MEDICINE AND WIRELESS HEALTH TECHNOLOGY, THE ORGANIZATION IS DEDICATED TO IMPROVING COMMUNITY HEALTH WHILE ADVANCING MEDICINE THROUGH CLINICAL RESEARCH AND GRADUATE MEDICAL EDUCATION. SCRIPPS HAS ALSO EARNED A NATIONAL REPUTATION AS A PREMIER EMPLOYER, NAMED BY FORTUNE MAGAZINE AS ONE OF AMERICA'S "100 BEST COMPANIES TO WORK FOR" EVERY YEAR SINCE 2008. SCRIPPS HEALTH'S MISSION STATEMENT IS AS FOLLOWS: SCRIPPS STRIVES TO PROVIDE SUPERIOR HEALTH SERVICES IN A CARING ENVIRONMENT AND TO MAKE A POSITIVE MEASURABLE DIFFERENCE IN THE HEALTH OF INDIVIDUALS IN THE COMMUNITIES WE SERVE. WE DEVOTE OUR RESOURCES TO DELIVERING QUALITY, SAFE, COST-EFFECTIVE, AND SOCIALLY RESPONSIBLE HEALTH CARE SERVICES. WE ADVANCE CLINICAL RESEARCH, HEALTH EDUCATION, EDUCATION OF PHYSICIANS AND HEALTH CARE PROFESSIONALS, AND SPONSOR GRADUATE MEDICAL EDUCATION. WE COLLABORATE WITH OTHERS TO DELIVER THE CONTINUUM OF CARE THAT IMPROVES THE HEALTH OF OUR COMMUNITY. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS See Scripps Health Annual Community Benefit Plan and Report at Scripps Community Benefits - San Diego - Scripps Health. Founded in 1924 by philanthropist Ellen Browning Scripps, Scripps Health is a $4.9 billion private, tax exempt integrated health system based in San Diego, California. Scripps treats more than 600,000 patients annually through the dedication of more than 3,000 affiliated physicians and more than 17,500 employees. Scripps cares for people throughout the San Diego region with four acute care hospitals on five campuses, 32 outpatient clinics, and 12 Scripps HealthExpress sites. Scripps also offers payer products and population health services through Scripps Accountable Care Organization, Scripps Health Plan, and customized narrow network plans in collaboration with third-party payers. Scripps Health is a leading provider of medical care, improving community health and advancing medicine in San Diego County. Scripps is a recognized leader in the prevention, diagnosis and treatment of disease, and is at the forefront of clinical research and the only health system in the region with two level 1 trauma centers. With three highly respected graduate medical education programs, Scripps is a longstanding member of the Association of American Medical Colleges. Our hospitals are consistently ranked among the nation's best by U.S. News & World Report and numerous other organizations. Scripps is frequently recognized by Fortune magazine, Working Mother magazine, and the Advisory Board as one of the best places in the nation to work. Importantly, Scripps culture is one of caring. The spirit and culture established by two pioneering founders, Ellen Browning Scripps and Mother Mary Michael Cummings, still define who we are today. More information can be found at www.scripps.org. Excellence in Primary and Specialty Care The system is known for its expertise in various areas, including cancer care, cardiovascular disease prevention and treatment, orthopedics, women's health, and neurocognitive care. Generations of San Diegans have relied on Scripps for excellence in health care, starting with primary care doctors who act as the patient's personal health advocate including a focus on preventive care and wellness. For patients' convenience, Scripps physicians offer several options for ongoing care, including extended office hours, telemedicine options, three urgent care centers and HealthExpress walk-in clinics throughout the county for same-day treatment of minor illnesses and injuries. With some of the most advanced technology available today for the diagnosis and treatment of acute and chronic illnesses, Scripps offers patients a complete range of medical and surgical services including many that have been nationally recognized for clinical quality and patient outcomes. Organizational Foundation Scripps provides a comprehensive range of inpatient and ambulatory services through our system of hospitals and clinics. In addition, Scripps participates in many partnerships with government and not-for-profit agencies across our region to improve our community's health. And our partnerships do not stop at our local borders. Our collaborations extend beyond our local community to include state, national, and global efforts in disaster preparedness and relief, emergency medical services, healthcare advocacy, physician education, and direct patient care. In all that we do, we are committed to quality patient outcomes, service excellence, operating efficiency, caring for those in need today while planning for the healthcare needs of future generations. Scripps Health Community Served Hospitals and health systems define the community served as individuals residing within the service area, encompassing all residents in a specified geographic vicinity surrounding the hospital, without exclusion based on income or underserved status. Given the diverse range of hospitals in the region, the service area is designated as the entire County of San Diego for both Scripps and the Community Health Needs Assessment . The San Diego County Health and Human Service Agency (HHSA) organizes its planning areas into six geographic regions: Central, East, North Central, North Coastal, North Inland, and South. Scripps serves the entire San Diego County region with services concentrated in North Coastal, North Central, Central and Southern region of San Diego. Scripps provides significant volumes of inpatient, emergency, outpatient, specialty and primary care. In Fiscal Year 2024, Scripps provided a total of 3,168,633 outpatient visits and facilitated 74,942 hospital discharges. Community outreach efforts are focused in those areas with proximity to a Scripps facility. The hospital's patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. Scripps Health Community Health Needs Assessment Scripps Health bases its community benefit planning on its triennial community health needs assessment (CHNA). The CHNA aims to identify, understand, and prioritize the health-related needs of San Diego County residents facing inequities. The results of the 2022 CHNA are used to inform and adapt hospital programs and strategies better to meet the health needs of San Diego County residents. The following prioritized needs are addressed in the FY24 Community Benefit Plan and Report: - Access to Care (Community Outreach) and financial support for uninsured and underinsured community members. Increase and support access to health care services for the underserved through direct programs and partnerships with community-based organizations. - Aging Care and Support - health education, fall prevention support, social support and screening activities for seniors and others with aging concerns. - Behavioral Health - strengthen the continuum of integrated primary and mental health services for patients discharged from various hospital settings (medical and behavioral health inpatient and emergency care) through a variety of timely patient engagement strategies including the expansion of community-based behavioral health services adjacent to the hospital. - Children and Youth Wellbeing - education and training for community health care professionals and collaboration with local schools to promote interest and provide career pathways in health care. - Chronic Health Conditions - education, prevention and wellness programs, screening and support programs for chronic health conditions and various other health needs including, but not limited to, cardiovascular disease, stroke, cancer, diabetes, and obesity. - Community Safety - community education to decrease preventable deaths and injuries. - Economic Stability - improve outcomes for high-risk underfunded patients and community members through facilitated referrals and connection to other services in the community. - Scripps addresses many of the identified social determinants of health (SDOH) within the health conditions identified in the 2022 CHNA such as, community and social support, food insecurity, transportation, education, and homelessness. Select Specialty Hospital - San Diego Select Specialty Hospital San Diego is a 110-bed, free-standing critical illness recovery hospital (licensed by Medicare as a Long-Term Acute Care Hospital LTACH) which specializes in treating patients recovering from catastrophic critical illness. This unique level of acute hospital care focuses on pulmonary/ventilator liberation, and the treatment of medically complex, wound care, renal disorders, infectious disease, cardiac conditions, brain injury and other neurologic conditions. Select Specialty Hospital San Diego is part of Select Medical, one of the largest providers of post-acute recovery and rehabilitation in the United States. The Scripps Health Board and Select Hospital Management Committee approved an amended 2022 CHNA and a FY23-FY25 Implementation Strategy in December 2023 and January 2024, respectively. As Select Hospital is a calendar year-end taxpayer, their financial results will be incorporated in Scripps Health's IRS Form 990 based on the calendar year ended within Scripps Health's tax reporting year. (e.g., Select Hospital CY23 results of $4,438,138 community benefit contributions are included in Scripps Health's FY24 tax return). Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) Scripps Health 2025 Community Benefit Plan and Report The Scripps Community Benefit Plan and Report was developed in response to Senate Bill 697. Passed in 1994, the bill requires California's not-for-profit hospitals to annually describe and document the full range of community benefits they provide. The report incorporates not only documentation of community benefits, but also a more detailed explanation of the specific community benefit activities provided by our five acute-care hospital campuses, wellness centers and ambulatory care clinics. Scripps Health strives to improve community health through collaboration with a wide range of partners and like-minded organizations. Working with other health systems, community groups, government agencies, businesses and community clinics, Scripps is better able to build upon efforts to achieve broad community health goals and partner with a wide variety of organizations on community health improvement programs. The documented activities in this report reflect our commitments to improving the health of both our patients and the diverse communities of San Diego. As a longstanding member of these communities and as a not-for-profit community resource, our goal and responsibility are to assist all who seek care, particularly those who are vulnerable and lack support. This responsibility is an intrinsic part of our mission. Through our continued actions and community partnerships, we strive to enhance the quality of life across the entire community. Community Benefit Services are programs and services designed to improve health in communities. IRS Form 990, Schedule H instructions define community benefit as activities or programs that respond to community health needs and seek to achieve one or more of the following objectives: improving access to health services, enabling low-income persons to afford health care, enhancing public health, advancing generalizable knowledge, educating health professionals, and relieving the government burden to improve health. The 2025 Community Benefit Plan and Report covers the period of Fiscal Year 2024 (October 1, 2023, through September 30, 2024). During this fiscal year, Scripps devoted $656,291,701 to community benefit programs and services. Community outreach efforts are focused in those areas with proximity to a Scripps facility. Scripps hosts, sponsors, and participates in many community-building events throughout the year. Our programs emphasize community-based prevention efforts and use effective approaches to reach residents at the highest risk for health problems. Scripps aligns its 2025 Community Benefit Plan and Report with the IRS established categories as detailed below. Community Health Improvement Services and Community Benefit Operations During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $10,901,463 in community health improvement services and community benefit operations. This investment includes In-Lieu of Funds which provides critical support for vulnerable populations, covering essential post-discharge needs for unfunded or underfunded patients. These funds help ensure access to necessary health care support services beyond hospital care. Community Health Improvement Services and Community Benefit Operations include prevention and wellness programs, screenings, health education, support groups, health fairs and other programs supported by operational funds, grants, and in-kind donations and philanthropy. Calculations are based on cost, less "direct offsetting revenue," which includes any revenue generated by the activity or program, such as payment or reimbursement for services provided to program patients. According to the Schedule H 990 IRS guidelines, "direct offsetting revenue" also includes restricted grants or contributions that the organization uses to provide a community benefit. The following is a snapshot of Scripps community health improvement services provided in FY24. For more detailed information, see Scripps Health Annual Community Benefit Plan and Report at Scripps Community Benefits - San Diego - Scripps Health. These costs are included in the IRS Form 990 Schedule H Part I-line 7e, and 7i. - Recuperative Care Partnerships: This initiative offered safe discharges for chronically homeless patients with ongoing medical needs. - Father Joe's Village Street Health Project Collaboration: A joint effort with Scripps Mercy Hospital aimed at reaching unsheltered discharged patients for follow-up visits within their communities. - In FY 2024, Scripps Mercy San Diego Internal Medicine Faculty and Residents administered flu vaccines to 35 shelter residents from local programs, including the Salvation Army and San Diego Rescue Mission. This was the first year the residency program participated in the State General Fund Flu Vaccine Program, receiving vaccines at no cost for vulnerable populations. - Support for Community Clinics: Sponsorships, grants and clinical partnerships were provided to community clinics to enhance healthcare access and services. - Residents at Scripps Green participated in five unique community service projects this year, addressing social barriers to health through group-led initiatives as part of the Internal Medicine curriculum. - Scripps established a Graduate Medical Education Diversity, Equity, Inclusion, and Belonging Committee and curriculum, aimed at fostering a more diverse healthcare workforce. This initiative ensures that residents and fellows are educated in an environment that reflects and respects diversity." - American Red Cross Blood Drives: A partnership facilitated blood donation drives. - Medical Legal Partnership with Consumer Center for Health Education and Advocacy: This partnership educated consumers on healthcare benefits, eligibility, and coverage program changes. - Mobile Health and Resource Fair in Southeast San Diego: Scripps partnered with this resource fair at the YMCA to address healthcare needs, offering cardiovascular health and neurocognitive screenings, resources, and breast cancer screening referrals to underserved populations. - Services for Seniors: Programs included fall prevention, wellness education, and the Advanced Care Clinic for adults with multiple chronic diseases. - Behavioral Health Partnership with Family Health Centers of San Diego (FHCSD): This collaboration aimed to strengthen integrated primary and mental health services for Medi-Cal patients receiving care at Scripps Mercy Hospital. - In 2024, the Teaching Health Center Psychiatric Residency Program aims to address the psychiatrist shortage and enhances behavioral health services in the San Diego community, balancing psychotherapeutic techniques with psychopharmacology in its training. In collaboration with FHCSD Health Center Psychiatric Residency Program, Scripps Mercy Hospital has committed to host 6- PGY-1 Residents within the Hospital's Medical Service Floors for training in co-occurring medical and behavioral health conditions among patients during Academic Year 2024-2025. - Supportive Mental Health Services: These services were offered at local-based clinics. - Substance Use Disorder Service (SUDS): SUDS nurses assisted patients at risk for or experiencing detox from addictive substances within the Scripps Health system. - Cancer Programs and Support Services: These services included counseling, support groups, complementary therapies, and educational workshops. - Heart Health and Cardiovascular Disease Prevention: Activities and programs targeted heart health, stroke, and cardiovascular disease prevention and treatment. - Addressing Cardiovascular Disease and Sudden Cardiac Arrest (SCA) in Teens: A partnership with the Eric Paredes Save A Life Foundation focused on screening SCA in teenagers. - Diabetes Care Management Programs: Scripps provided comprehensive and culturally sensitive care to high-risk, underserved communities through Project Dulce, using a specialized team to counsel diabetes patients. - Health Education and Community Engagement: Scripps delivered various classes, prevention lectures, support groups, and participated in health fairs and events to address community needs. - Food Insecurity Support: Assistance included Cal-Fresh screening, Scripps Mercy WIC program, and identifying social determinants of health. - Transportation Services: Scripps partnered with Facilitating Access to Coordinated Transportation (FACT) Inc. to offer on-demand rides for patients traveling to medical appointments. - Engagement in Community Initiatives: Scripps executive leadership and staff actively participated in various community organizations, committees, and coalitions to enhance community health. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) Uncompensated Care Scripps contributes significant resources providing low and no cost health care for our patients in need. The costs of providing these services are not fully reimbursed. Uncompensated health care includes the sum of expenses associated with Charity Care, Medi-Cal and Other Means-Tested Government Programs, Medicare Shortfall and Bad Debt. Medicare Shortfall, Bad Debt and Community Building Activities are reportable under IRS guidelines but are not reportable in the community benefit totals. However, Scripps includes these totals in our overall community benefit calculations. During Fiscal Year 2024, Scripps contributed $587,766,140 in uncompensated health care, including $17,768,458 in charity care, $562,399,773 in Medi-Cal and Medicare shortfall, and $7,597,909 in bad debt. Charity care is included in the Internal Revenue Service (IRS) Form 990 Schedule H Part I Line 7a and Medi-Cal costs are included in Line 7b. This represents unreimbursed community benefit costs after the impact of the Medi-Cal Hospital Fee Program. The State of California enacted legislation for a provider fee program to fund certain Medi-Cal coverage expansions ("Provider Fee Program"). The Provider Fee Program charges hospitals a quality assurance fee that is used to obtain federal matching funds for Medi-Cal with the proceeds redistributed as supplemental payments to California hospitals that treat Medi-Cal patients. In December 2023, CMS approved the January 1, 2023, through December 31, 2024, Provider Fee Program VIII. The Organization's policy is to recognize program revenues and expenses on the accrual basis once the Federal waiver has been approved. Federal and state payments received from these programs are included as provider fee revenue in total patient service revenue, and fees paid or payable to the state and California Health Foundation and Trust are included in provider fee expense in operating expenses. Uncompensated health care costs are included in the IRS Form 990 Schedule H Part I-line 7a-7c. Scripps Mercy Hospital (including San Diego and Chula Vista campuses) provides 64% percent of the charity care within the Scripps system. The service area of Scripps Mercy Hospital reflects a higher proportion of economically disadvantaged individuals compared to the county average, with notably lower rates of insured adults and a significantly higher percentage of ethnic minorities, particularly Hispanic and Asian populations. Both hospital campuses play crucial roles in delivering healthcare services to the Central/Southern San Diego County area, ranging from Interstate 8 to the United States-Mexico border. Over half of the patients served by Scripps Mercy San Diego and Chula Vista are covered by government insurance programs, including Medicare and Medi-Cal. Health Professional Education Quality health care is highly dependent upon health education systems and medical research programs. Without the ability to train and inspire a new generation of health care providers, or to offer continuing education to existing health care professionals, the quality of health care will be diminished. Health Professional Education includes educational programs for physicians, interns and residents, medical students, nurses and nursing students, pastoral care trainees and other health professionals. This education is necessary to retain a state licenses or certification by boards in the individual's health profession specialty. Each year, Scripps allocates resources to advance health care services through health professional education. During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $47,659,269 in professional training programs to enhance service delivery and treatment practices in San Diego County. This figure reflects the costs associated with professional education for non-Scripps employees, including graduate medical education, nursing resource development and other health care professional education. These costs are included in the IRS Form 990 Schedule H Part I Lines 7f. The following is a snapshot of Scripps professional education services provided in FY24. Graduate Medical Education A key component of Scripps Mission is to advance the education of physicians and health care professionals and sponsor graduate medical education. By investing in these areas, we help secure quality care for our community. Scripps has been training future physicians longer than any other institution in San Diego. For more than 70 years physicians in Scripps graduate medical education programs have helped care for underserved populations throughout the region. Scripps offers a comprehensive range of graduate medical education programs at Scripps Mercy Hospital San Diego, Scripps Mercy Hospital Chula Vista, and Scripps Green Hospital. These programs are renowned for their commitment to excellence and feature a hands-on curriculum that places a strong emphasis on patient-centered care. They encompass a wide array of medical specialties, such as internal medicine, family medicine, podiatry, trauma, pharmacy, palliative care, emergency and surgical critical care, as well as research-focused programs. Scripps Graduate Medical Education programs serve our community in two equally important ways: providing much-needed medical care to the diverse patient population of San Diego County; and developing the talent and skills of new leaders in medicine, who together with Scripps will continue to break new ground in innovative, compassionate medical care. In Fiscal Year 2024, Scripps enrolled a total of 165 medical residents, 49 fellows across the Scripps health system, underscoring our commitment to medical education and community healthcare. Graduate Medical Education (GME). Scripps has a pharmacy residency program at Scripps Mercy Hospital and Scripps Memorial Hospital La Jolla which trains residents with Doctor of Pharmacy degrees. Additional Professional Education and Training Programs - Scripps Conference Services and CME: *Provides evidence-based, up-to-date, and clinically relevant CME courses. - Scripps Mercy EMS: *Offers hospital-based clinical internships and continuing education. *Collaborates with local and regional institutions. *Training for First Responders, EMTs, Paramedics, Law Enforcement, Military, Mobile Intensive Care Nurses, and Resident Physicians. - Scripps Mercy Hospital Trauma Services: *Part of a six-hospital trauma system. *Level 1 trauma center offering physician education and trauma research. *Offers graduate medical education in trauma and critical care. *Partners with Naval Medical Center San Diego and other healthcare providers. *Provides training for various residency programs. - Scripps Memorial Hospital La Jolla Trauma Program: *Part of a six-hospital trauma system. *Level 1 trauma center offering physician medical education and trauma physician training and conducts trauma research. *Provides hands-on training for residents and fellows. - Trauma Research Graduate Student Internship: *For students in public health, epidemiology, trauma, and related fields. *Involves constructing study samples, data analysis, and manuscript writing. *Runs concurrently with the Clinical Research Fellowship. - Scripps Whittier Diabetes Institute: *Offers education programs led by experts to enhance diabetes management knowledge. *Targets healthcare professionals, community partners, clinical providers, and peer educators. - UCSD/Scripps Health Hospice and Palliative Medicine Fellowship: *Prepares doctors for hospice and palliative care. *Designed for physicians seeking a subspecialty. *Provides training for diverse care settings. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) Nursing, Allied Health and Clinical Student Preceptorships Scripps commitment to ongoing learning and health care excellence extends beyond our organization. Our student programs help promote health care careers to a new generation, shape the future workforce and develop future leaders in our community. Interacting with health care professionals in the field expands education outside the classroom. Scripps employees play a significant role as preceptors by investing their time to create a valuable experience for the community. In Fiscal Year 2024, Scripps hosted 1,651 students within our system and provided 250,885 development hours spanning nursing and allied health settings. Scripps Clinic Medical Group and Scripps Coastal Medical Group are dedicated to offering meaningful clinical experiences for Nurse Practitioner and Physician Assistant students. In Fiscal Year 2024, Scripps Clinic Medical Group hosted 153 preceptorship rotations for nurse practitioners and physician assistants, totaling 19,030 hours of completed training. Similarly, Scripps Coastal Medical Group provided 31 preceptorship rotations, accounting for 6,716 hours of practical learning. These experiences empower students to apply their theoretical knowledge and critical thinking in a genuine healthcare environment. School Collaborations and Affiliations Scripps collaborates extensively with local educational institutions, offering students valuable exposure to healthcare roles alongside Scripps professionals. This includes affiliations with over 110 schools and programs, both clinical and nonclinical. An affiliation agreement committee evaluates new partnerships to meet community and workforce needs, ensuring a systemic approach to student placements. Student Pipeline Programs Scripps is dedicated to nurturing future healthcare professionals through a variety of youth-oriented initiatives, focusing on school-to-health career activities like mentoring, camps, job shadowing, health education classes, health chats, support groups, and health fairs. - Scripps School to Health Career Pathway Program: Engaged over 1,600 youths in mentoring programs, health professional presentations, surgery viewings, work-study programs, and Scripps Camp. - Internships and Educational Programs: Scripps collaborates with high schools and colleges to offer students opportunities to explore healthcare roles and gain hands-on experience. Nurses and staff play key roles, interacting with students daily. - Family Practice Medical Residents: Medical Residents deliver interactive classroom presentations on public health concerns, medically focused topics, and conduct hands-on clinical skills workshops at local high schools, enriching students' understanding of healthcare careers and medical practices. Health Research Scripps Health is committed to providing the best possible patient care, and research is a critical part of that mission. In addition to bringing the latest treatments to our patients, the knowledge gained from these research studies advances the quality of care for people around the world. Scripps Health physicians' study new medications and devices, track patient outcomes for years or even decades and gather evidence for sophisticated education and treatment programs. This information is then disseminated into the Scripps system through graduate and continuing medical education and to the scientific community through peer-reviewed publications. Scripps Health Research. During Fiscal Year 2024 (October 2023 to September 2024), Scripps invested $4, 991, 558 in health research as it is a critical part of our mission to provide the best care to patients, with many promising new treatments beginning in clinical trials. Internally funded research and research funded by tax-exempt, or government entities are eligible for reporting. Calculations are based on cost, less "direct offsetting revenue," which includes any revenue generated by the activity or program, such as payment or reimbursement for services provided to program patients. These costs are included in the IRS Form 990 Schedule H Part I 7h. Cash, Grants and In-Kind Contributions Scripps provided $1,485,542 in cash, grants and in-kind contributions to community groups and nonprofit organizations. These costs are included in the IRS Form 990 Schedule H Part I Lines 7 i. Below is a snapshot of Scripps sponsorships in FY24: - American Heart Association Go Red for Women Luncheon: Sponsored to unite women nationwide in combating heart disease and stroke, addressing local community needs. - Mental Health Association of San Diego - Meeting of the Minds: The Scripps Mercy Trauma Department played an active role in the planning, organization, and implementation of the conference. - The San Diego LGBT Community Center: Scripps sponsored the San Diego LGBT Community Center, which is one of the nation's largest and most active LGBT community centers. Their mission encompasses promoting LGBT health and human rights, providing a range of programs and services to the diverse San Diego LGBT community, including individuals of various demographics and those living with HIV. - Family Health Center of San Diego - Spirit of the Barrio: Scripps sponsored the event, which is hosted by Family Health Centers of San Diego, the event raises awareness for healthcare in underserved communities. - Family Health Center of San Diego Partnership: Enhanced healthcare services for the underserved at the Internal Medicine Outpatient Clinic through a long-term agreement. - La Maestra Casino Night: Donated to support the La Maestra Community Health Center's annual fundraiser. - San Ysidro Health Center: Sponsored a fundraising "Emerald Ball" to commemorate 55 years of providing high-quality health care for all and the social services for underserved populations. -Turkey Giveaway and Health Resource Fair: Scripps sponsored this event hosted by Assemblymember Dr. Akilah Weber's office. The event aimed to distribute 1,000 turkeys, along with produce and sides purchased from the San Diego Food Bank and Feeding San Diego, to provide complete Thanksgiving meals to the community. - Eric Paredes Save A Life Foundation: Partnered to prevent sudden cardiac arrest in middle and high schoolers in San Diego, providing grants and volunteers for screenings. - California Health Foundation and Trust: Supported charitable activities in hospitals across California. - Consumer Center for Health Education and Advocacy (CCHEA): Funded assistance for low-income uninsured Mercy patients in obtaining healthcare benefits, reducing uncompensated care expenses. - Emergency Meals and Water: Donated 750 cases of water valued at $18,000 to the Ministry of Jerusalem. - Scripps Pay it Forward Sock Drive: Collected 3,823 pairs of socks valued at $5,862 for Father Joe's Villages during Spirit Week to distribute to the homeless. Employees dedicated 80 hours of working time to this effort. - Scripps Health donated medical equipment to the City of Hope. - Greater La Jolla Meals on Wheels: Provided office space to support meal deliveries to seniors and disabled individuals in La Jolla. - Scripps La Jolla Emergency Department donated car seats to patients who have been in an automobile accident and their child's car seat has been rendered unsafe to use. - Scripps donated 31 boxes of books to the San Diego Public Library. - Scripps donated ophthalmology equipment to La Maestra Clinic. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) Subsidized Health Services Subsidized health services are those clinical services provided despite a financial loss to the organization, after removing losses associated with bad debt, financial assistance, Medi-Cal, and Other Means-Tested Government Programs, to meet an identified community need. Scripps Inpatient Behavioral is categorized as subsidized health. The total expense for subsidized health services for Scripps Fiscal Year 2024 was $3,100,477. Subsidized health only includes Scripps Inpatient Behavioral Health. Scripps offers inpatient adult behavioral health services at the Scripps Mercy Hospital, San Diego campus. The Scripps Mercy behavioral health program also actively supports community programs to reduce the stigma of mental illness and help affected individuals live and work in the community. These costs are included in the IRS Form 990 Schedule H Part I Lines 7g. Scripps Health offers inpatient behavioral health care for adults admitted through our emergency departments or urgent care centers. Our outpatient behavioral health services are available through partnerships with various community organizations. Like many behavioral health programs nationwide, funding remains a challenge, as payment rates have not kept pace with the actual cost of care. In Fiscal Year 2024, the Scripps Mercy Behavioral Health Program reported a total operational loss of $8.3 million, with $5 million attributed to Medi-Cal, or other means tested government programs and charity care. Notably, 1.1% of patients in the inpatient unit were uninsured, underscoring the financial pressures faced by these programs. - Scripps Mercy Inpatient Behavioral Health Scripps Mercy Hospital offers a 36-bed Psychiatric Adult Inpatient Unit for individuals suffering from acute psychiatric disorders who cannot live independently or pose a danger to themselves or others. This program helps patients, and their loved ones work through short-term crises, manage mental illness, and resume daily lives. - Outpatient Behavioral Health Services Partnership with Family Health Centers of San Diego (FHCSD): Established in 2016, this collaboration aims to enhance mental health care for Medi-Cal patients at Scripps Mercy Hospital. It integrates primary and mental health care, placing social workers and SUD counselors in emergency departments to connect patients with resources. FHCSD offers outpatient therapy near the hospital, while patients from Scripps Mercy Chula Vista and Mercy San Diego are referred for help with behavioral health issues such as addiction, loss, and anxiety, and other mental health issues. Community Building Activities Community Building Activities support community assets by offering the expertise and resources of the hospital organization. These activities may address the root causes of health problems or the determinants of health, such as education, homelessness, poverty, and the environment. In FY24, Scripps invested $387,252 in community building activities. The following are the community building activities that Scripps participated in. Physical Improvements / Housing - Leadership Retreat Volunteer Service Day: Leaders participated in community service projects for homeless service providers, including Casa de Misericordia, Father Joe's Village, and others. Economic Development - Community Boards: Scripps engaged in boards like the San Diego Downtown Partnership and Hillcrest Business Association to advocate for health and safety. Community Support - SOHL Conference: Sponsored the San Diego Organization of Healthcare Leaders annual event. - LGBT Pride Parade & Fundraisers: Sponsored the Pride Parade and events supporting LGBTQ+ leadership and advocacy. - Chicano Federation: Sponsored events supporting family, housing, and educational programs. - "Coffee with a Cop": Held dialogue sessions with the San Diego Police Department. - Advisory Board & Coalition Meetings: Participated in local boards, with over 700 members, addressing community needs. Disaster Preparedness - Community Outreach & Education: Led efforts in disaster preparedness and community readiness. - Scripps Medical Response Team (SMRT): A volunteer team prepared for state emergency deployments. - Emergency Drills: Participated in county-wide and state disaster response exercises. Coalition Building - Chula Vista Collaborative & SOCAN: Engaged with community groups focused on health, safety, and support for older adults and people with disabilities. Workforce Development - Mana De San Diego (MANASD): Sponsored the Latina empowerment organization. - North County African American Women's Association (NCAAWA): Supported education and career development for African American women and girls. - High School Programs: Hosted students for healthcare career exposure through internships and educational events. Advancing Health Equity The mission of Scripps Health is to provide superior health care services in a caring environment and to make a positive difference in the health of individuals throughout our diverse communities. That mission has been our driving force for the past 100 years and will always be at the heart of everything we do. Today, disparities exist in health care for people throughout the nation. Scripps is committed to reducing health care disparities by evaluating and addressing variations in clinical outcomes as part of our ongoing commitment to high quality care for our patients and community. The following are some of the FY24 highlights for health equity accomplishments. These efforts reflect Scripps commitment to advancing health equity through improved data collection, enhanced patient care, and community outreach. 1. Health Equity Data Improvements: - Exceeded targets for race, ethnicity, and language (REaL) data collection, achieving 110% of the goal. - Surpassed targets for sexual orientation and gender identity (SOGI) data collection, reaching 33% and 36.5%, respectively. - Implemented a system-wide ethnic background data collection process, increasing data capture by over 40%. 2. Social Determinants of Health (SDOH) Screening: - Rolled out SDOH screening across five hospitals, assessing food security, housing instability, and other key domains for patients 18+. - Established processes for responding to positive screens and connected patients with community resources post-discharge. 3. Interpreter Services & Compliance: - Improved utilization and documentation compliance of qualified interpreter use for our patients with preferred language other than English. - Streamlined processes and created detailed instructions for accessing remote and telehealth interpreter services, collaborated with Center For Learning colleagues to enhance education on Interpreter Services for new staff, and revised Epic documentation screens while publishing an updated Interpreter Services Tip Sheet. - Added the CyraCom application to bedside patient iPads initially at Scripps Mercy campuses and later expanded to all hospital campuses and conducted an annual regulatory review and enhancement of Scripps policy. CyraCom provides language interpretation and translation services. These services help organizations communicate with non-English-speaking individuals, ensuring compliance with language access laws and improving accessibility for diverse populations. - To enhance accountability and regulatory compliance, Scripps implemented a Power BI Inpatient Interpreter Services Dashboard and published two articles in internal communications to promote the use of qualified interpretation resources. This dashboard enables Scripps to ensure that interpretive services are provided and documented for those who need them, supporting adherence to regulatory standards. Additionally, it allows to identify areas performing well, enabling to learn best practices, and pinpoint areas needing improvement, allowing to tailor countermeasures effectively. 4. Heart Failure Management & Readmission Targets and Discharge Planning: - Met CMS targets for heart failure readmissions across all five Scripps hospitals. - Launched the Enhanced Discharge Planning Pilot for unhoused heart failure patients, providing tailored dietary education, follow-up appointment scheduling, transportation vouchers, and post-discharge phone calls by a pharmacist. - Partnered with the Scripps Well Being Center - Scripps Mercy Hospital, Chula Vista for post-discharge follow-ups, reducing heart failure readmission rates at Mercy SD and CV campuses. Collaborated with Mama's Kitchen to improve health outcomes and reduce readmissions for congestive heart failure patients, with 72 patients enrolled in FY24 and 123 total number of patients since the beginning of the study. 5. Breast Cancer Screening & Outreach: - Improved breast cancer screening rates among Spanish-speaking populations with targeted campaigns. - Conducted 28 outreach interviews to identify barriers to screening, with findings presented in a medical poster. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) 6. Community Health Partnerships & Outreach: - Mobile Health Initiative: Provided education and services to over 790 individuals, focusing on breast cancer prevention, early detection, and cardiovascular health. The health fair supports underserved communities, promotes preventive care, and helps identify effective ways to meet their healthcare needs. - Cognitive Health Screenings: Conducted screenings for over 150 community members at the monthly mobile health fair using a validated tool to assess cognitive decline in underinsured minorities. - Healthy Living Program: Engaged 690 participants in a heart disease prevention program. Led by Scripps staff and Promotoras, the program successfully met its goals and will expand in the next fiscal year. - Breast Cancer Awareness: Delivered educational sessions to 80 individuals in low-income, underserved communities across San Diego. - Scripps Well-Being Center: Served over 10,241 multicultural participants through support groups, classes, outreach, education, and other community health prevention programs. 7. Health Disparities Research and Interventions: - Funded eight research projects focused on health disparities, totaling $72,200 in grants. - Organized the second Annual Research Symposium, with 85+ attendees presenting health equity-focused research. 8. AB 1204 Hospital Equity Reporting: - In FY24, Scripps Health proactively set up the necessary infrastructure to comply with AB 1204, the Medical Equity Disclosure Act, which mandates the collection and reporting of healthcare disparities data. Ongoing Health Equity Programs and Services As Scripps undertakes the work of identifying and reducing disparities in clinical outcomes and ensuring our compliance with government directives regarding health equity, it is important to recognize that Scripps has been engaged in a broad range of programs and initiatives that address health disparities for the vulnerable population for many years. Evidence-based interventions are underway to address these core challenges. Below are some examples, with further details on these programs in the 2025 Scripps Community Benefit Plan and Report. - Aging Care and Support: Provide, proactive, medical, and social services to adults living with multiple chronic diseases. Partner with local senior centers, churches, and senior housing and conduct senior health chats that are designed to provide health education to the older adult community. - Behavioral Health: Establish initiatives to create a more robust behavioral health care system with emphasis on vocational training, reducing opioid use and substance abuse. - Cancer: Offer wig banks to support individuals undergoing cancer treatment and/or experiencing hair loss, transportation for appointments, lodging, Survivor's Day events, breast health outreach and education and more. - Cardiovascular Disease: Address cardiovascular disease through sudden cardiac arrest (SCA) screenings, virtual cardiac rehabilitation, cardiometabolic health education, and improving food insecurities. - Diabetes: Advocate for diabetes prevention, research and education through in-person and virtual programs and events for the various communities and patients impacted by the diabetes epidemic. - Maternal Child Health and High-Risk Pregnancy: Provide perinatology services, health education and awareness and other key programs to support the health of mothers, infants and families. - Professional Education: Support physician training and clinical research, residents and fellows through various residency programs and curriculum dedicated to uplifting health equity, reducing bias, and caring for the underserved. - Health Research: Identify how to measure health equity through the work of the Scripps Collaborative for Health Equity, related research grants, the Health Equity Information Center and more. - Youth Career Pathways/Pipeline Programs: Promote health care as a rewarding career to students via internship programs, outreach programs, scholars' programs and more. - Community Outreach: Help the homeless, food insecure, and un-insured/under-insured low-income patients through programs specifically designed to supplement their overall health care and living needs. Form 990, Part VI, Line 16a JOINT VENTURES SCRIPPS HEALTH HAS MAINTAINED A LONG STANDING PRACTICE OF REVIEWING ALL POTENTIAL JOINT VENTURE OR SIMILAR ARRANGEMENTS TO ENSURE THAT CONTRACT TERMS ARE CONSISTENT WITH THE PROTECTION OF ITS TAX-EXEMPT STATUS. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FORM 990 WAS PREPARED BY AN OUTSIDE ACCOUNTING FIRM WITH THE SUPPORT OF THE CORPORATE FINANCE TEAM WITH INPUT FROM HUMAN RESOURCES, FOUNDATION, AND LEGAL OFFICE. THE FORM 990 WAS REVIEWED BY THE PRESIDENT, LEGAL COUNSEL, CHIEF FINANCIAL OFFICER, AUDIT & COMPLIANCE COMMITTEE, HUMAN RESOURCES AND COMPENSATION COMMITTEE PRIOR TO FILING. IN ADDITION, A FULL COPY OF THE 990 WAS PROVIDED TO THE BOARD OF TRUSTEES VIA EMAIL IN ADVANCE OF FILING FORM 990 WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy WITHIN 60 DAYS OF HIRE AND ANNUALLY THEREAFTER ALL SUPERVISORS AND ABOVE; ALL EMPLOYEES IN THE SUPPLY CHAIN MANAGEMENT DEPARTMENT, AUDIT & COMPLIANCE SERVICES DEPARTMENT, AND CASE MANAGEMENT DEPARTMENT OR FUNCTION; AND ANY OTHER EMPLOYEE WHO IS IN A POSITION TO REFER PATIENTS THAT ARE FEDERALLY FUNDED HEALTHCARE BENEFICIARIES TO OTHER PROVIDERS AND SERVICES; AND OTHERS AS DETERMINED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE WILL BE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST COMMITMENT DISCLOSURE FORM. IT IS THE RESPONSIBILITY OF ANY EMPLOYEE WHO HAS A CHANGE IN OUTSIDE PROFESSIONAL ACTIVITIES, SIGNIFICANT FINANCIAL INTERESTS, OR POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR COMMITMENT SITUATIONS THAT ARISE DURING THE YEAR TO DISCLOSE THE INFORMATION TO THEIR SUPERVISORS AS SOON AS THE EMPLOYEE BECOMES AWARE OF THE POTENTIAL OR ACTUAL SITUATION CREATING A POSSIBLE CONFLICT OF INTEREST OR CONFLICT COMMITMENT. SUPERVISORS WILL ASSESS THE SITUATION AND REFER TO THEIR BUSINESS UNIT MANAGEMENT AND/OR THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE, AS APPROPRIATE. IN ADDITION, EACH PERSON ENTRUSTED WITH A POSITION OF RESPONSIBILITY IN THE GOVERNANCE AND MANAGEMENT IS REQUIRED TO COMPLETE AND SUBMIT DISCLOSURE STATEMENTS AS FOLLOWS: 1. INITIAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT (INITIAL DISCLOSURES) 2. ANNUAL CONFLICT OF INTEREST AND 990 TAX RETURN DISCLOSURE STATEMENT 3. SUBSEQUENT OCCURRENCES REPORTING UPON THE OCCURRENCE OF ANY NEW POTENTIAL CONFLICT OF INTEREST. ACTUAL OR POTENTIAL CONFLICT DISCLOSURES REGARDING EMPLOYEES ARE REVIEWED BY THE CONFLICTS AND BUSINESS PRACTICES REVIEW COMMITTEE. DISCLOSURES REQUIRING MITIGATION ARE DISCUSSED WITH THE BUSINESS UNIT CHIEF EXECUTIVE AND EMPLOYEE'S SUPERVISOR. LEGAL COUNSEL REVIEWS EACH BOARD OF TRUSTEES MEETING AGENDA PRIOR TO THE MEETING AND POTENTIAL CONFLICTS OF INTERESTS ARE IDENTIFIED, CONSIDERED AND AN APPROPRIATE COURSE OF ACTION IS DETERMINED BY THE MEMBER AND LEGAL COUNSEL WITH THE INVOLVEMENT OF THE PRESIDENT AND BOARD CHAIR, WHERE APPROPRIATE. COURSE OF ACTION MAY INCLUDE THE CONFLICTED BOARD MEMBER RECUSING THEMSELVES, ABSTAINING FROM VOTING AND/OR READING A STATEMENT INTO THE BOARD MINUTES REGARDING SUCH CONFLICT. AS IT RELATES TO BOARD OF TRUSTEES, WHEN A DETERMINATION IS THAT AN ACTUAL CONFLICT OF INTEREST EXISTS AND A COVERED INDIVIDUAL IS AN "INTERESTED PERSON" UNDER CALIFORNIA LAW, THE TRANSACTION BEING CONSIDERED WILL COMPLY WITH APPLICABLE STATUTORY REQUIREMENTS TO AVOID PARTICIPATION IN THE DECISION MAKING PROCESS BY THE COVERED INDIVIDUAL. THE MINUTES OF BOARD MEETINGS SHALL DOCUMENT ALL RECUSALS FROM DISCUSSION AND VOTING. Form 990, Part VI, Line 15a Process to establish compensation of top management official OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR PRESIDENT/CEO ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS +8.0% GEOGRAPHIC DIFFERENTIAL AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. THE BOARD SELECTS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 06, 2023, JANUARY 24, 2024, AND MARCH 24, 2024. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES. Form 990, Part VI, Line 15b Process to establish compensation of other employees OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN PURSUANT TO PROCEDURES REQUIRED BY TAX EQUITY AND FISCAL RESPONSIBILITY ACT OF 1983 (TEFRA), SCRIPPS HEALTH'S PROCEDURES ARE AS FOLLOWS: THE BOARD OF TRUSTEES REVIEWS EXECUTIVE COMPENSATION FOR OFFICERS AND ALL KEY EMPLOYEES ON AN ANNUAL BASIS UTILIZING COMPARABILITY DATA OBTAINED BY AN EXTERNAL CONSULTANT. IT IS THE PHILOSOPHY OF THE SCRIPPS BOARD OF TRUSTEES TO COMPENSATE THE CORPORATION'S EXECUTIVES FAIRLY RELATIVE TO THE MEDIAN COMPENSATION OF PEER ORGANIZATIONS OF SIMILAR SIZE AND COMPLEXITY, CONSIDERING AND MAKING APPROPRIATE ADJUSTMENTS FOR THE COST OF LIVING IN CALIFORNIA AND OTHER RELEVANT FACTORS. TO ACCOMPLISH THIS, THE BOARD HAS ADOPTED A PHILOSOPHY OF TARGETING EXECUTIVE SALARIES AT APPROXIMATELY THE 65TH PERCENTILE OF A NATIONAL PEER GROUP OF ORGANIZATIONS +8.0% GEOGRAPHIC DIFFERENTIAL AS DETERMINED THROUGH AN INDEPENDENT OUTSIDE CONSULTANT ENGAGED BY THE BOARD AND WILL RELY ON THEIR RECOMMENDATIONS USING A DATABASE OF INDEPENDENTLY COLLECTED DATA. THE PHILOSOPHY STATES: FOR PURPOSES OF EXECUTIVE COMPENSATION COMPARISONS, SCRIPPS WILL USE A NATIONAL PEER GROUP OF MEDICAL DELIVERY SYSTEMS OF SIMILAR REVENUE SIZE AND COMPLEXITY. THE PEER GROUP WILL BE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. SALARIES ARE TARGETED AT APPROXIMATELY THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP AND WILL REFLECT THE PERFORMANCE OF THE INDIVIDUAL. TOTAL CASH COMPENSATION IS POSITIONED AT APPROXIMATELY THE 75TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF THE PEER GROUP WHEN MAXIMUM LEVEL INCENTIVES ARE PAID FOR ACHIEVEMENT OF MAXIMUM LEVEL OF PREDETERMINED OBJECTIVES AGREED UPON BY THE BOARD. THE BOARD SELECTS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL FOR BASE COMPENSATION OF PEER GROUP ADJUSTED FOR COST OF LIVING OF URBAN WEST COAST MARKET AT THE 50TH PERCENTILE (I.E. THE 50TH PERCENTILE OF CALIFORNIA MARKET IS THE 65TH PERCENTILE +8.0% GEOGRAPHIC DIFFERENTIAL OF NATIONAL PEER MARKET AS OUR EXECUTIVE RECRUITMENT MARKET IS NATIONAL). ANNUALLY, TOTAL CASH COMPENSATION FOR EACH POSITION WILL NOT EXCEED THE BASE SALARY ESTABLISHED FOR THE PERIOD PLUS THE MAXIMUM INCENTIVE PERCENTAGE PAYOUT ALLOWABLE AS DETERMINED BY THE SCRIPPS MANAGEMENT INCENTIVE PLAN APPROVED BY THE BOARD OF TRUSTEES FOR THE RESPECTIVE POSITION. THE REPORT FROM THE EXTERNAL CONSULTANT ENGAGED TO REVIEW EXECUTIVE COMPENSATION IS PRESENTED TO THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ON AN ANNUAL BASIS AND THE MOST RECENT REPORT WAS REVIEWED ON DECEMBER 06, 2023, JANUARY 24, 2024, AND MARCH 24, 2024. REVIEW AND DISCUSSION OF SUCH REPORT IS DOCUMENTED IN THE MINUTES. Form 990, Part VI, Line 19 Required documents available to the public FINANCIAL STATEMENTS ARE POSTED QUARTERLY ON THE DAC (DIGITAL ASSURANCE CERTIFICATION) WEBSITE AND THE MUNICIPAL SECURITIES RULEMAKING BOARD'S (MSRB) ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE IN SATISFACTION OF CONTINUING DISCLOSURE REQUIREMENTS RELATING TO THE ORGANIZATION'S TAX-EXEMPT DEBT ISSUANCES. THE AUDITED FINANCIAL STATEMENTS ARE ALSO ATTACHED TO THIS FORM 990, IN ACCORDANCE WITH THE IRS INSTRUCTIONS. SCRIPPS HEALTH'S CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. Form 990, Part VIII, Line 2f Other Program Service Revenue OTHER REVENUE - Total Revenue: 17668016, Related or Exempt Function Revenue: 17015924, Unrelated Business Revenue: 652092, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees PHYS FEES-PROVIDER SVS AGRMENT - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 4845493, Fundraising Expenses: 0; OTHER PURCHASED SVS - NON MED - Total Expense: 94840871, Program Service Expense: 54119026, Management and General Expenses: 40458468, Fundraising Expenses: 263377; PHYSICIAN FEES - Total Expense: 88166272, Program Service Expense: 87537125, Management and General Expenses: 629147, Fundraising Expenses: 0; PURCHASED MEDICAL SERVICES - Total Expense: 30604161, Program Service Expense: 30604161, Management and General Expenses: 0, Fundraising Expenses: 0; ALL OTHER FEES FOR SERVICES - Total Expense: 44217091, Program Service Expense: 30785525, Management and General Expenses: 13264676, Fundraising Expenses: 166890; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN VALUE OF DEFERRED GIFTS - 205990; JOINT VENTURE DISTRIBUTION - 1305372; OTHER CHANGES IN NET ASSETS - -51; ROUNDING - 19347; Other - -43841820; SCRIPPS CLINIC BILLING LLC 4555 Executive Dr SAN DIEGO CA 92121 870797749 HLTHCR ADMIN CA 654975747 0 SCRIPPS HLTH SCRIPPS MERCY BILLING LLC 4555 Executive Dr SAN DIEGO CA 92121 870737748 HLTHCR ADMIN CA 96030712 0 SCRIPPS HLTH IMAGING HEALTHCARE SPECIALISTS LLC 4555 Executive Dr SAN DIEGO CA 92121 203872122 MED IMAGING CA 63064686 51780451 IHS HOLDING SCRIPPS HOSPITAL MEDICAL BILLING SERVICES LLC 4555 Executive Dr SAN DIEGO CA 92121 611677183 HLTHCR ADMIN CA 14185565 0 SCRIPPS HLTH SCRIPPS CARDIO&THORACTIC SURGERY BILLING 4555 Executive Dr SAN DIEGO CA 92121 270620996 HLTHCR ADMIN CA 3565701 0 SCRIPPS HLTH MAXWELL H & MURIEL GLUCK CHILD CARE CTR 4555 Executive Dr SAN DIEGO CA 92121 831953045 CHILDCARE CA 2291164 1557061 SCRIPPS HLTH SCRIPPS ACCOUNTABLE CARE ORGANIZATION 4555 Executive Dr SAN DIEGO CA 92121 364837442 HLTHCR ADMIN CA 1147000 5333999 SCRIPPS HLTH SCRIPPS ASC MANAGEMENT LLC 4555 Executive Dr SAN DIEGO CA 92121 831187975 HLTHCR ADMIN CA 0 0 SCRIPPS HLTH IHS HOLDING COMPANY LLC 4555 Executive Dr SAN DIEGO CA 92121 473437677 HLTHCR ADMIN CA 0 35779242 SCRIPPS HLTH SCRIPPS BEHAVIORAL HEALTH LLC 4555 Executive Dr SAN DIEGO CA 92121 834326624 HLTHCR ADMIN CA 0 0 SCRIPPS HLTH SCRIPPS HOME HEALTH & HOSPICE VENTURE 4555 Executive Dr SAN DIEGO CA 92121 841894278 HOME HEALTH/HOSPICE CA 993933 0 SCRIPPS HLTH HORIZON HOSPICE 4555 Executive Dr SAN DIEGO CA 92121 330220777 Dissolved December 2023 CA 501(c)(3) 10 SCRIPPS HEALTH true MERCY HOSPITAL FOUNDATION SAN DIEGO 4555 Executive Dr SAN DIEGO CA 92121 942958094 Dissolved August 2024 CA 501(c)(3) Type I SCRIPPS HEALTH true SCRIPPS HEALTH PLAN SERVICES INC 10790 Rancho Bernardo Rd SAN DIEGO CA 92127 330782099 HLTHCARE SVCS CA 501(c)(3) Type I SCRIPPS HEALTH true SCRIPPS ENCINITAS SURGERY CTR 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 205942958 AMBUL SURGERY CTR CA SCRIPPS HEALTH Related 5170731 2668928 false false 0.5538 SCRIPPSUSP SURGERY CTR 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 205942911 AMBUL SURGERY CTR CA NA Related 405557 1015110 false false 0.5 SCRIPPS MERCY AMBUL SURG CTR 4555 Executive Dr SAN DIEGO CA 92121 450503246 AMBUL SURGERY CTR CA SCRIPPS HEALTH Related 10427078 4906103 false true 0.825 SCRIPPS MEMORIAL XIMED MED CTR 9850 GENESEE AVE STE 900 LA JOLLA CA 92037 330475481 REAL ESTATE CA SCRIPPS HEALTH Related 801441 3923442 false true 0.153 Vibra Hospital of San Diego LLC 4714 Gettysburg Road Mechanicsburg PA 10755 261466122 LT ACUTE CARE PA SCRIPPS HEALTH Related -2440427 10971667 false false 0.245 CHARITABLE LEAD TRUST (1) 4555 Executive Dr SAN DIEGO CA 92121 HOSPITAL SUPPORT CA NA Trust true CHARITABLE REMAINDER TRUST (26) 4555 Executive Dr SAN DIEGO CA 92121 HOSPITAL SUPPORT CA NA Trust true true false false false false false false false false true false true true true false false true false false Scripps Health Plan Services (SHPS) M 71925487 Accrual Scripps Health Plan Services (SHPS) Q 26239938 Accrual Scripps Encinitas Surgery Center A 320297 Accrual Scripps Mercy Ambulatory Surgery Center A 322024 Accrual Scripps Health Plan Services (SHPS) J 135415 Accrual Scripps Health Plan Services (SHPS) L 359690370 Accrual Scripps Health Plan Services (SHPS) N 258817 Accrual