2026-08-10T11:43:29+00:00 2025-09-30 346565596 ERNST & YOUNG US LLP 101 E WASHINGTON ST PHOENIX AZ 85004 990 2024-10-01 951684089 SCRIPPS HEALTH SCRI 8585545712 4555 EXECUTIVE DR SAN DIEGO CA 92121 CHRISTOPHER VAN GORDER PRESIDENT & CEO/TRUSTEE 2026-08-10 false STEVEN T RUTTI P00775456 6023223000 2026-07-29 2024 2025-03-06 01:10:19Z CHRISTOPHER VAN GORDER 4555 EXECUTIVE DR SAN DIEGO CA 92121 7132894446 false X WWW.SCRIPPS.ORG X 1924 CA FOUNDED IN 1924 BY PHILANTHROPIST ELLEN BROWNING SCRIPPS, SCRIPPS HEALTH IS A $4.8 BILLION, PRIVATE NOT-FOR-PROFIT INTEGRATED HEALTH SYSTEM IN SAN DIEGO, CA. (SEE SCH O) 16 15 20217 2520 15753003 438952 43068436 67400850 4574697762 4584021245 123981850 356155050 127717495 126978508 4869465543 5134555653 1507500 997683 0 2010509221 2114257295 0 0 8719596 2513892493 2580407382 4525909214 4695662360 343556329 438893293 9124382316 9647312670 3089779778 2924383026 6034602538 6722929644 SEE SCHEDULE O false false 4256539300 997683 4688544301 SEE SCHEDULE O. 1771662 0 2590335 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. 4258310962 true true false true false false true true false true true true false false 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 834 0 true 20217 true true true false false false false true true false false false false true false X 16 15 false false false false false false false true true false 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 3631482 0 58297 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 (PART YEAR) 1.0 13.0 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 COUNSEL 49.0 1.0 X 1218320 0 59265 BRETT TANDE TREASURER / CORP EXEC VP, CFO 54.0 1.0 X 1450122 0 62346 MIELLE SCHWARTZ EXECUTIVE ASSISTANT SR 40.0 0 X 90680 0 36568 MONIQUE GONZALEZ EXECUTIVE ASSISTANT TO THE CEO 50.0 0 X 112595 0 51940 ANIL KESWANI CORP EVP, CHF MED&OPS OFF-AMB 50.0 0.0 X 1302787 0 65750 BARBARA PRICE CORP SR VP, PLANNING/STRATEGY 50.0 0 X 1096779 0 72153 CARL ETTER CORP SR VP, REGION CHIEF EXEC 50.0 0 X 1720345 0 58026 ERIC COLE CORP SR VP, HUMAN RESOURCES 50.0 0 X 1039021 0 53099 GHAZALA SHARIEFF CORP EVP, CHF MED&OPS OFF-ACUTE 50.0 0 X 1553595 0 62279 JOHN ENGLE CORP SR VP, CHIEF DEVELOPMENT OFFICER 50.0 0 X 864644 0 60418 JUNE KOMAR CORP EXEC VP, STRATEGY & ADMIN (PART YEAR) 50.0 0 X 1173585 0 41287 RICHARD NEALE CORP EXEC VP, CHIEF GROWTH OFFICER 40.0 10.0 X 1180497 0 68449 SHANE THIELMAN CORP SR VP, CIDO 50.0 0 X 941851 0 68595 THOMAS BUCHHOLZ CORP SR VP, ONCOLOGY SERVICES 50.0 0 X 1386946 0 47351 THOMAS GAMMIERE CORP SR VP, REGION CHIEF EXEC 50.0 0 X 1026181 0 60769 CRAIG M UEJO CORP VP, CHIEF QUALITY OFFICER 50.0 0 X 690631 0 61491 GERALD SODERSTROM CORP SR VP, AUDIT / COMPLIANCE/RISK 50.0 0 X 706256 0 62018 JOHN POOLE CORP VP, SYSTEM IMPROVEMENT 50.0 0 X 769256 0 15984 SHERMAN T MOORE CORP VP, BUSINESS DEVELOPMENT 50.0 0 X 669719 0 62040 TRACY CHU CORP VP, POP HLTH/ACO 50.0 0 X 768281 0 41225 LISA RISSERTHAKUR FORMER KEY EMPLOYEE 0.0 0 X 489746 0 0 23883319 0 1169350 5537 true true false SCRIPPS CLINIC MEDICAL GROUP INC 10666 N TORREY PINES RD LA JOLLA CA 92037 PHYSICIAN SERVICES 529391052 SCRIPPS COASTAL MEDICAL GROUP 501 WASHINGTON AVE SAN DIEGO CA 92103 PHYSICIAN SERVICES 85618018 MEDIMPACT HEALTHCARE SYSTEMS 10181 SCRIPPS GATEWAY CT SAN DIEGO CA 92131 PHARMACEUTICAL SERVICES 59006302 SCRIPPS HEALTH INPATIENT PROVIDERS MED GROUP 4555 EXECUTIVE DR SAN DIEGO CA 92121 PHYSICIAN SERVICES 57964872 DPC CONSTRUCTION 1450 VETERANS BLVD REDWOOD CITY CA 94063 CONSTRUCTION SERVICES 44951433 137 298068 2283432 64819350 3171304 67400850 HEALTHCARE DELIVERY REV 622110 4389130976 4387417237 1713739 PROVIDER FEE REVENUE 622110 67864194 67864194 CAPITATION PREMIUM 622110 44174661 44174661 PHARMACEUTICAL REVENUE 446110 27248916 27248916 JOINT VENTURE REVENUE 900099 21213849 21213849 34388649 33974546 414103 0 4584021245 131079348 -1495773 132575121 0 0 2222313806 1997238104 225075702 0 225075702 225075702 1354384 298068 1100689 253695 253695 ALL OTHER REVENUE 900099 69044509 64383131 170890 4490488 MANAGEMENT SERVICES 561110 57680304 42730260 14950044 0 0 0 0 126724813 5134555653 4689006794 15753003 362395006 X 997683 997683 24708686 24708686 234401 234401 1750387007 1544571129 200362195 5453683 64144990 55687846 8300532 156612 147463258 147007408 455850 127318953 111257792 15788935 272226 9653685 3225550 6427412 723 1288886 14480 1265507 8899 765130 765130 7621923 7621923 939283014 928520806 10409674 352534 2225488 64870 2160618 91514595 78971830 11762498 780267 67761659 23599429 44162230 115869958 105073383 10626396 170179 46598117 40699712 5898405 183716128 163098819 20617309 28351193 28332103 19090 MEDICAL SUPPLIES 846152530 846152530 REPAIRS & MAINTENANCE 99132558 41601178 57500861 30519 ASSET IMPAIRMENT 92533115 92533115 HOSPITAL FEE PROGRAM 35986006 35986006 11953397 10915293 0 1038104 4695662360 4258310962 428631802 8719596 664366806 647035604 6731561 9019737 680894472 746359094 23751894 24539910 0 0 72129893 72924437 50374375 57082061 4671895920 1802569032 2760750938 2869326888 3349918598 3791881962 854913000 1028676000 75271371 84480046 45109895 45109895 540169513 270877036 9124382316 9647312670 730059359 717768568 1416000000 1383054000 0 0 7378392 3290000 936342027 820270458 3089779778 2924383026 X 5778276035 6455077667 256326503 267851977 6034602538 6722929644 9124382316 9647312670 X 438893293 229345255 20088558 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false true 222954 true 330250 false true 421925 975129 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; LOCAL LAND USE ISSUES LIKE THE LOCAL LANDUSE ADVOACY FOR FUTURE HOSPITAL CONSTRUCTION PROJECTS IN SAN MARCOS. 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, ALLIANCE OF CATHOLIC HEALTH CARE. 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 X 1 16.0 1 0 1 true 370.0 1258 true 0 742881 X false 146116426 734195 17908526 0 4337844 1309160 159112143 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 0.0 1.0 0.0 false false 44458644 163614504 208073148 2517497720 817456943 1700040777 82856399 58775590 24080809 1457318039 924443419 532874620 406150614 1893080 404257534 2869326888 CLOSELY-HELD EQUITY INTERESTS FINANCIAL DERIVATIVES MULTI-STRATEGY FUNDS 499667000 F PRIVATE EQUITY FUNDS 481009000 F LIMITED PARTNERSHIP 48000000 F 1028676000 FEDERAL INCOME TAXES TAXABLE DEBT 549348640 LEASE LIABILITIES 142393701 SELF-INSURED MALPRACTICE LIABILITY 56540674 SELF-INSURED WORKER'S COMPENSATION 35723849 ASSET RETIREMENT OBLIGATION 21150549 ANNUITY AND UNITRUSTS 11878331 DEFERRED RETIREMENT 2676163 PROVIDER FEE LIABILITY 180547 DEPOSITS AND CONTINGENCIES 378004 820270458 X 0 0 0 0 0 0 0 0 0 0 0 0 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: $42,035,135 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, 2025 OR 2024. 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 2020 IN MAJOR TAX JURISDICTIONS. NORTH AMERICA (CANADA & MEXICO ONLY) 0 23 PROGRAM SERVICES RECONSTRUCTIVE SURGERY 387886 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS 713167884 EUROPE (INCLUDING ICELAND AND GREENLAND) 0 0 INVESTMENTS 71317126 0 23 0 0 0 23 784872896 0 784872896 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; EUROPE (INCLUDING ICELAND AND GREENLAND)-ACCRUAL; NORTH AMERICA (CANADA & MEXICO ONLY)-ACCRUAL CANDLELIGHT BALL 682266 156598 525668 113087 18223 552160 CLINIC GOLF 426676 96185 330491 114290 2500 46551 3 543510 45285 498225 152836 11525 89517 1652452 298068 1354384 380213 32248 688228 1100689 253695 true true X true X true X true true true false true true 0 0 18663224 0 18663224 0.00397 0 0 521162252 298065911 223096341 0.04751 0 0 0 0 0 0.0 0 0 539825476 298065911 241759565 0.05149 0 0 9599327 2441782 7157545 0.00152 0 0 58618967 12948325 45670642 0.00973 0 0 17228058 13871139 3356919 0.00071 0 0 18842407 13008479 5833928 0.00124 0 0 1027760 0 1027760 0.00022 0 0 105316519 42269725 63046794 0.01343 0 0 645141995 340335636 304806359 0.06491 47432 47432 0.00001 58388 58388 0.00001 29300 29300 0.00001 0 0.0 93025 29850 63175 0.00001 0 0.0 0 0.0 444603 108207 336396 0.00007 0 0.0 0 0 672748 138057 534691 0.00011 true 78414318 689133247 828981695 -139848448 X true true SCRIPPS ENCINITAS SURGERY CENTER AMBULATORY SURGERY CENTER 0.5747 0 0.2011 SCRIPPS MEMORIAL XIMED MEDICAL MEDICAL OFFICE BUILDING 0.153 0 0.772 SCRIPPS MERCY ASC AMBULATORY SURGERY CENTER 0.825 0 0.175 SCRIPPSUSP SURGERY CENTERS AMBULATORY SURGERY CENTER 0.5 0 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 VIBRA HOSPITAL OF SAN DIEGO (DBA SELECT HOSPITAL OF SAN DIEGO) 555 WASHINGTON ST SAN DIEGO CA 92103 WWW.SELECTSPECIALTYHOSPITALS.COM 1466122 X B A 4 false false true X X X X X X X X X 24 true true true true X https://www.scripps.org/about-us/scripps-in-the-community X true 24 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 24 true true true true X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/ https://www.scripps.org/about-us/scripps-in-the-community X true 24 true https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/ 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/?ty=xt X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/?ty=xt X https://www.selectspecialtyhospitals.com/locations-and-tours/ca/san-diego/san-diego/?ty=xt X X X X X true X false X X X false X X false false SCHEDULE H, PART V, SECTION B, LINE 3E 2025 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS 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. 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. 2025 CHNA TOP COMMUNITY NEEDS THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY. THE FINDINGS COME DIRECTLY FROM THE CHNA PROCESS AND SERVE AS THE FOUNDATION FOR THE STRATEGIES OUTLINED IN THE HOSPITALS IMPLEMENTATION STRATEGY. THE 2025 CHNA IDENTIFIED THAT SAN DIEGANS ARE EXPERIENCING DEBILITATING STRESS. CHRONIC STRESS WAS CONSISTENTLY HIGHLIGHTED AS A SIGNIFICANT THEME ACROSS ALL METHODS OF DATA COLLECTION. THIS STRESS, THE COMMUNITY SAID, IS CAUSED BY THE HIGH COST OF LIVING IN SAN DIEGO, RISING LEVELS OF RACISM, PREJUDICE, AND DISCRIMINATION, ONGOING CHALLENGES FROM COVID 19, AND RECENT PUBLIC HEALTH EMERGENCIES. THIS STRESS HAS RESULTED IN A HEALTH CARE SYSTEM TRYING TO HELP MORE PATIENTS WHILE HEALTH CARE WORKERS ARE, THEMSELVES, EXPERIENCING HARDSHIP. CHRONIC STRESS IS RECOGNIZED AS A PRIMARY FINDING, INDICATING ITS ROLE AS A BARRIER AFFECTING COMMUNITY MEMBERS CAPACITY TO MANAGE THEIR HEALTH AND HEALTHCARE EFFECTIVELY. THE 2025 CHNA ALSO EXPLORED WAYS IN WHICH HOSPITALS AND HEALTHCARE SYSTEMS COULD ALLEVIATE CHRONIC STRESS TO ENHANCE COMMUNITY HEALTH. SEVERAL HEALTH IMPROVEMENT STRATEGIES WERE RECOMMENDED, WHICH ARE HIGHLIGHTED AS OTHER KEY FINDINGS. THESE STRATEGIES AIM TO ADDRESS THE IDENTIFIED BARRIERS AND IMPROVE THE OVERALL WELL-BEING OF THE COMMUNITY. OTHER KEY FINDINGS LISTED BELOW IN NO SPECIFIC ORDER: HELP MANAGING HEALTH CONDITIONS. THE COMMUNITY NAMED SEVERAL SPECIFIC HEALTH CONDITIONS THEY NEED MORE ASSISTANCE WITH MANAGING (ASTHMA, BLOOD PRESSURE, CANCER, DENTAL HEALTH, DIABETES, MENTAL HEALTH) A DIFFERENT KIND OF HEALTH EXPERIENCE. THEY NEED HEALTH CARE TO BE RESPECTFUL OF THEIR TIME, TO OFFER CARE WHEN THEY NEED IT. THEY WANT EASIER WAYS TO GET TO HEALTH CARE, A BETTER RELATIONSHIP WITH CARE PROVIDERS AND HELP WITH NAVIGATING SYSTEMS. THIS, THEY INDICATED, WAS WHERE THE HEALTH CARE COMMUNITY SHOULD BE CONCENTRATING ITS EFFORTS. PROTECTION AND CARE FOR THEIR SERVICE PROVIDERS. WHILE ASKING FOR CHANGE IN THE WAY THEY EXPERIENCE HEALTH CARE, THE COMMUNITY WAS ALSO EMPHATIC THAT THEY APPRECIATE THEIR HEALTH CARE WORKERS, UNDERSTAND THE PRESSURES THEY ARE UNDER, AND WANT THEM TO BE CARED FOR AS WELL. THEY OFFERED PRAISE FOR HEALTH CARE WORKERS AND CONCERN ABOUT STAFF SHORTAGES, WORKER BURN-OUT, AND VICARIOUS TRAUMA. RECOGNITION AND ASSISTANCE WITH DISABILITES AND TRAUMA. ONE IN 10 SAN DIEGANS LIVES WITH A DISABILITY, AND MANY HAVE EXPERIENCED TRAUMATIC EVENTS. THE COMMUNITY EMPHASIZED THAT PEOPLE WHO ARE DISABLED OR LIVING WITH TRAUMA NEED ACCOMMODATIONS, COMPASSION, AND ASSISTANCE WITH RESOURCES. HELP WITH CRISES. SAN DIEGO COUNTY RESIDENTS HAVE EXPERIENCED SIGNIFICANT CLIMATE-RELATED AND PUBLIC HEALTH CRISES IN RECENT YEARS AND EXPRESSED AN URGENT NEED FOR HELP ADDRESSING THESE CRISES, INCLUDING BETTER DATA COLLECTION AND MORE RESOURCES. BETTER DATA COLLECTION SHARING AND COORDINATION. THE COMMUNITY NEEDS BETTER DATA COLLECTION, SHARING, AND COORDINATION ACROSS SYSTEMS, INCLUDING HOSPITALS AND COMMUNITY CLINICS, SOCIAL SERVICE PROVIDERS, AND SCHOOLS. THE LACK OF DATA COORDINATION CREATES UNNECESSARY CHALLENGES TO GOOD HEALTH. LESS BURDEN ON EMERGENCY DEPARTMENTS. THE COMMUNITY IS CONCERNED ABOUT THE CAPACITY OF SAN DIEGO COUNTY'S EMERGENCY DEPARTMENTS (EDS), NOTING THAT MANY PEOPLE MUST RELY ON THEM FOR CARE THAT COULD BE MANAGED OUTSIDE OF EMERGENCY SETTINGS. THE COMMUNITY REPORTED SEVERAL UNDERLYING CAUSES FOR THIS USAGE, INCLUDING DIFFICULTY OBTAINING PRIMARY AND SPECIALTY CARE IN A TIMELY MANNER AND A LACK OF ALTERNATIVE OPTIONS FOR ACUTE CONDITIONS LIKE MENTAL HEALTH. COMMUNITY NEEDS SCRIPPS IS ADDRESSING AND NOT DIRECTLY ADDRESSING TO BETTER SERVE SAN DIEGO COUNTY RESIDENTS FACING HEALTH INEQUITIES, SCRIPPS USES THE FINDINGS FROM THE HOSPITAL ASSOCIATION 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE THE DEVELOPMENT AND REFINEMENT OF HOSPITAL PROGRAMS AND STRATEGIES. HEALTH PRIORITIES IN THE CHNA WERE IDENTIFIED THROUGH A COMPREHENSIVE PROCESS INVOLVING RESEARCH, DATA COLLECTION, ANALYSIS, COMMUNITY INPUT, AND PRIORITIZATION. SCRIPPS WILL ADDRESS ALL IDENTIFIED PRIORITIES FROM THE 2025 CHNA EXCEPT FOR DENTAL HEALTH AND ASTHMA. WHILE DENTAL HEALTH IS A CRITICAL COMPONENT OF OVERALL WELL-BEING, IT FALLS OUTSIDE THE DIRECT CLINICAL SCOPE OF SCRIPPS AND IS MORE APPROPRIATELY ADDRESSED BY DENTAL PROVIDERS. ASTHMA, THOUGH A SIGNIFICANT ISSUE, IS PRIMARILY MANAGED IN OUTPATIENT SETTINGS THROUGH SCRIPPS CLINIC MEDICAL GROUP'S ALLERGY, ASTHMA & IMMUNOLOGY SPECIALISTS. AS THERE IS CURRENTLY NO COORDINATED, COMMUNITY-WIDE ASTHMA INITIATIVE THAT ALIGNS WITH HOSPITAL-BASED STRATEGIES, IT WILL NOT BE INCLUDED IN THIS IMPLEMENTATION CYCLE. SCRIPPS WILL CONTINUE TO COLLABORATE WITH PARTNERS BETTER POSITIONED TO MEET THIS NEED. SCRIPPS DIRECTS ITS RESOURCES TOWARD INITIATIVES THAT ALIGN WITH ITS MISSION, CLINICAL STRENGTHS, AND AREAS OF EXPERTISE. THIS INCLUDES ADDRESSING KEY REGIONAL HEALTH ISSUES, INTEGRATING CHNA FINDINGS INTO EXISTING PROGRAMS, AND COLLABORATING WITH COMMUNITY PARTNERS ON SHARED PRIORITIES. TO GUIDE THIS WORK, SCRIPPS HAS GROUPED THE CHNA IDENTIFIED NEEDS INTO THREE FOCUS AREAS: MANAGING HEALTH CONDITIONS, IMPROVING ACCESS TO CARE AND ENHANCING COMMUNITY SAFETY. MANY OF THESE HEALTH CONCERNS ARE CLOSELY TIED TO SOCIAL DETERMINANTS OF HEALTH, SUCH AS FOOD INSECURITY, HOUSING, TRANSPORTATION, EDUCATION, AND SOCIAL SUPPORT, WHICH SCRIPPS ADDRESSES THROUGH A BROAD RANGE OF PROGRAMS AND PARTNERSHIPS. SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY A, 1 FACILITY A, 1 - REPORTING GROUP A. DESCRIPTION: COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO GATHER INPUT FROM A BROAD AND REPRESENTATIVE SAMPLE OF SAN DIEGO COUNTY RESIDENTS, WITH A FOCUS ON THOSE EXPERIENCING HEALTH INEQUITIES. SPECIAL EFFORTS WERE MADE TO INCLUDE BOTH COMMUNITY MEMBERS FROM HISTORICALLY UNDERSERVED POPULATIONS AND SERVICE PROVIDERS WHO WORK CLOSELY WITH THEM. IN TOTAL, FEEDBACK WAS GATHERED FROM 1,625 COMMUNITY MEMBERS ACROSS THE REGION. ENGAGEMENT METHODS THE CHNA TEAM, LED BY RESEARCHERS AT THE IPH, COLLECTED DATA THROUGH FOCUS GROUPS, KEY INFORMANT INTERVIEWS, FIELD INTERVIEWS, AND AN ONLINE SURVEY DESCRIBED BELOW. THESE PRIMARY DATA COLLECTION EFFORTS WERE COMPLEMENTED BY THE REVIEW OF PUBLICLY AVAILABLE DEMOGRAPHIC DATA, HOSPITAL AND EMERGENCY DEPARTMENT DISCHARGE RECORDS, AND RELEVANT PUBLISHED RESEARCH TO DEVELOP A COMPREHENSIVE UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THIS MIXED-METHODS APPROACH AIMED TO ANSWER TWO CENTRAL QUESTIONS: * WHAT ARE THE MOST PRESSING NEEDS OF OUR COMMUNITY? * HOW CAN HOSPITALS AND HEALTH SYSTEMS HELP ADDRESS THOSE NEEDS? A CENTRAL GOAL OF THE 2025 CHNA WAS TO INVOLVE COMMUNITY HEALTH WORKERS (CHWS), LOCAL PARTNERS, AND COMMUNITY MEMBERS AS RESEARCH COLLABORATORS. SDRCC AND SDCPC PLAYED KEY ROLES IN DESIGNING CULTURALLY SENSITIVE DATA COLLECTION TOOLS, CONDUCTING INTERVIEWS, AND SUPPORTING DATA ANALYSIS. THEIR EFFORTS HELPED ENSURE THIS WAS THE MOST REPRESENTATIVE CHNA SAMPLE IN SAN DIEGO TO DATE. COMMUNITY INPUT * 465 FIELD INTERVIEWS CONDUCTED BY THE SAN DIEGO REFUGEE COMMUNITIES COALITION (SDRCC) AND SAN DIEGO COUNTY PROMOTORES COALITION (SDCPC) * 1,037 ONLINE SURVEY RESPONSES * 123 PARTICIPANTS IN 40 FOCUS GROUPS AND KEY INFORMANT INTERVIEWS FIELD INTERVIEWS SHORT, IN-PERSON FIELD INTERVIEWS WERE CONDUCTED IN PUBLIC SPACES SUCH AS TRANSIT STOPS AND STORE ENTRANCES TO ENGAGE INDIVIDUALS NOT TYPICALLY CONNECTED TO MEDICAL OR SOCIAL SERVICE SYSTEMS. PARTICIPANTS WERE ELIGIBLE IF THEY WERE 18 YEARS OR OLDER AND LIVED IN SAN DIEGO COUNTY. AS A THANK-YOU, PARTICIPANTS RECEIVED A GIFT CARD. FIELD INTERVIEWS INCLUDED THREE "TRACKS," ALLOWING PARTICIPANTS TO SHARE CONCERNS RELATED TO: * THEIR CHILDREN * THEMSELVES OR A LOVED ONE * THE BROADER COMMUNITY THE TOOL WAS DEVELOPED COLLABORATIVELY WITH CHWS AND TRANSLATED INTO SPANISH. INTERVIEWS WERE ALSO CONDUCTED IN OVER 20 LANGUAGES THANKS TO MULTILINGUAL INTERVIEWERS. DEPENDING ON RESPONSES AND TRANSLATION NEEDS, INTERVIEWS LASTED FROM 5 TO 45 MINUTES. FOCUS GROUPS AND KEY INFORMANT INTERVIEWS POPULATIONS OF FOCUS WERE SELECTED USING FINDINGS FROM THE 2022 CHNA, THE HEALTHY PLACES INDEX, AND RESEARCH ON HEALTH DISPARITIES. PARTICIPANTS WERE RECRUITED USING PURPOSIVE SAMPLING THROUGH TRUSTED COMMUNITY ORGANIZATIONS AND PROFESSIONAL NETWORKS. FOCUS GROUPS AND INTERVIEWS WERE SEMI-STRUCTURED TO ALLOW FOR OPEN DISCUSSION WHILE ENSURING CORE RESEARCH QUESTIONS WERE ADDRESSED. TOPICS INCLUDED: * PRESSING HEALTH AND SOCIAL NEEDS * EXISTING SERVICES AND GAPS * COMMUNITY SUGGESTIONS * RECOMMENDATIONS FOR HOSPITALS AND HEALTH SYSTEMS ALL SESSIONS WERE FACILITATED BY RESEARCHERS FROM IPH WITH EXPERTISE IN QUALITATIVE METHODS. INTERVIEWS WERE CONDUCTED OVER ZOOM (EXCEPT FOR ONE IN-PERSON GROUP), RECORDED WITH CONSENT, AND TRANSCRIBED. TWO RESEARCHERS INDEPENDENTLY ANALYZED TRANSCRIPTS USING ITERATIVE THEMATIC ANALYSIS, COMBINING DEDUCTIVE AND INDUCTIVE CODING TO IDENTIFY MAJOR THEMES, SUBTHEMES, AND ILLUSTRATIVE QUOTES. THE TEAM MET TO REFINE THE FINDINGS, AND FOLLOW-UP WAS CONDUCTED WITH PARTICIPANTS WHEN NEEDED FOR CLARIFICATION. ONLINE SURVEY THE ONLINE SURVEY WAS ADAPTED FROM THE 2022 CHNA SURVEY AND OFFERED IN ENGLISH AND SPANISH. IT WAS DISTRIBUTED VIA: * COMMUNITY PARTNERS * THE COUNTY OF SAN DIEGO'S LIVE WELL REGIONAL GROUPS * PUBLIC HEALTH LISTSERVS AND REGIONAL COMMUNITY UPDATES A SNOWBALL SAMPLING STRATEGY WAS USED, ENCOURAGING ORGANIZATIONS TO SHARE THE LINK WITH STAFF AND CLIENTS. THE SURVEY WAS COMPLETED 1,037 TIMES, HELPING BROADEN PARTICIPATION BEYOND THOSE REACHED THROUGH INTERVIEWS AND FOCUS GROUPS. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY A, 1 FACILITY A, 1 - REPORTING GROUP A. 2025 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPRESENTS A COUNTYWIDE COLLABORATIVE EFFORT AMONG ALL HOSPITALS AND HEALTH CARE SYSTEMS IN SAN DIEGO COUNTY TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF LOCAL COMMUNITIES. THE MAJORITY OF 2025 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. FINDINGS FROM THE CHNA ARE USED TO DEVELOP, ENHANCE, AND EXPAND HEALTH AND SOCIAL SERVICE PROGRAMS ACROSS THE REGION. THE 2025 CHNA WAS GUIDED BY A HEALTH EQUITY FRAMEWORK AND EMPHASIZED COMMUNITY-BASED PARTICIPATORY RESEARCH THAT IS ACADEMIC, ANALYTICAL, ACTIONABLE, AND ACCOUNTABLE. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL, AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO COUNTY PARTICIPATED IN THIS INITIATIVE. THEIR SUPPORT CAME THROUGH ACTIVE INVOLVEMENT IN THE COMMUNITY NEEDS ASSESSMENT COMMITTEE AND SUPPORTED THE HASD&IC BOARD OF DIRECTORS. PARTICIPATING HOSPITALS AND HEALTH SYSTEMS: * ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM * AURORA BEHAVIORAL HEALTH CARE SAN DIEGO * GROSSMONT HEALTHCARE DISTRICT * KAISER PERMANENTE SAN DIEGO * PALOMAR HEALTH * PARADISE VALLEY HOSPITAL * 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. RESEARCH AND COLLABORATION PARTNERS FOR THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) CONTRACTED WITH THE SAN DIEGO STATE UNIVERSITY (SDSU) INSTITUTE FOR PUBLIC HEALTH (IPH). AS THE PRACTICE ARM OF THE SDSU SCHOOL OF PUBLIC HEALTH, IPH FACILITATES PUBLIC HEALTH PRACTICE ACROSS SAN DIEGO COMMUNITIES. TOGETHER, HASD&IC AND IPH LED THE RESEARCH DESIGN, DATA COLLECTION, ANALYSIS, AND SUMMARY OF FINDINGS FOR THIS REPORT. IN ADDITION TO PARTICIPATING IN THE HASD&IC FACILITATED CHNA COLLABORATIVE, KAISER PERMANENTE - SAN DIEGO, ZION, AND SAN MARCOS MEDICAL CENTERS CONDUCTED THEIR OWN CHNAS IN PARTNERSHIP WITH HARDER+COMPANY COMMUNITY RESEARCH. THESE EFFORTS WERE INTENTIONALLY ALIGNED AND CONDUCTED SIMULTANEOUSLY, WITH CONTINUOUS FEEDBACK BETWEEN BOTH RESEARCH TEAMS. THIS COORDINATION ENSURED THAT THEIR WORK WAS COMPLEMENTARY RATHER THAN DUPLICATIVE. BY LEVERAGING ONE ANOTHER'S COMMUNITY RELATIONSHIPS AND SHARING DATA THROUGHOUT THE PROCESS, HASD&IC AND KAISER PERMANENTE EXPANDED COMMUNITY REPRESENTATION AND MADE MORE EFFICIENT USE OF RESOURCES. THIS INNOVATIVE AND COLLABORATIVE APPROACH RESULTED IN A MORE COMPREHENSIVE AND INCLUSIVE CHNA FOR ALL SAN DIEGO COUNTY HOSPITALS AND HEALTH CARE SYSTEMS. 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 COMPLETION OF THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IDENTIFICATION OF PRIORITY HEALTH AREAS, SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY-A MULTI-FACETED, MULTI-STAKEHOLDER PLAN DESIGNED TO ADDRESS THE COMMUNITY HEALTH NEEDS OUTLINED IN THE CHNA. THIS THREE-YEAR STRATEGY (FY26-FY28) TRANSLATES CHNA RESEARCH AND ANALYSIS INTO MEASURABLE, ACTIONABLE OBJECTIVES AIMED AT IMPROVING HEALTH OUTCOMES ACROSS SAN DIEGO COUNTY. EVALUATION AND RESOURCE COMMITMENT SCRIPPS HEALTH EVALUATES ITS IMPLEMENTATION STRATEGY ANNUALLY TO STAY RESPONSIVE TO EVOLVING COMMUNITY NEEDS. THIS INCLUDES REVIEWING PROGRAM INTERVENTIONS, RESOURCE ALLOCATIONS, AND PROGRESS TOWARD DEFINED GOALS. EACH OBJECTIVE INCLUDES A TAILORED MONITORING PLAN WITH KEY PERFORMANCE INDICATORS SUCH AS: * NUMBER OF PEOPLE SERVED * PARTICIPATION AND SATISFACTION RATES * FINANCIAL AND IN-KIND INVESTMENTS * MEASURABLE HEALTH OUTCOMES, WHERE FEASIBLE CHALLENGES ARE DOCUMENTED AND ADDRESSED THROUGH PROGRAM MODIFICATIONS TO MAINTAIN EFFECTIVENESS. SCRIPPS ALSO SUBMITS ITS IMPLEMENTATION STRATEGY ANNUALLY TO THE IRS VIA FORM 990, SCHEDULE H, AND SUPPORTS THIS WORK THROUGH BOTH FINANCIAL AND IN-KIND CONTRIBUTIONS, INCLUDING STAFF TIME, DIRECT SERVICES, AND COMMUNITY PROGRAMS COMMUNITY NEEDS SCRIPPS IS ADDRESSING AND NOT DIRECTLY ADDRESSING TO BETTER SERVE SAN DIEGO COUNTY RESIDENTS FACING HEALTH INEQUITIES, SCRIPPS USES THE FINDINGS FROM THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE THE DEVELOPMENT AND REFINEMENT OF HOSPITAL PROGRAMS AND STRATEGIES. HEALTH PRIORITIES IN THE CHNA WERE IDENTIFIED THROUGH A COMPREHENSIVE PROCESS INVOLVING RESEARCH, DATA COLLECTION, ANALYSIS, COMMUNITY INPUT, AND PRIORITIZATION. SCRIPPS' IMPLEMENTATION STRATEGY (IS) ADDRESSES ALL IDENTIFIED PRIORITIES FROM THE 2025 CHNA EXCEPT FOR DENTAL HEALTH AND ASTHMA. WHILE DENTAL HEALTH IS A CRITICAL COMPONENT OF OVERALL WELL-BEING, IT FALLS OUTSIDE THE DIRECT CLINICAL SCOPE OF SCRIPPS AND IS MORE APPROPRIATELY ADDRESSED BY DENTAL PROVIDERS. ASTHMA, THOUGH A SIGNIFICANT ISSUE, IS PRIMARILY MANAGED IN OUTPATIENT SETTINGS THROUGH SCRIPPS CLINIC MEDICAL GROUP'S ALLERGY, ASTHMA & IMMUNOLOGY SPECIALISTS. AS THERE IS CURRENTLY NO COORDINATED, COMMUNITY-WIDE ASTHMA INITIATIVE THAT ALIGNS WITH HOSPITAL-BASED STRATEGIES, IT WAS NOT INCLUDED IN THIS IMPLEMENTATION CYCLE. SCRIPPS WILL CONTINUE TO COLLABORATE WITH PARTNERS BETTER POSITIONED TO MEET THIS NEED. SCRIPPS DIRECTS ITS RESOURCES TOWARD INITIATIVES THAT ALIGN WITH ITS MISSION, CLINICAL STRENGTHS, AND AREAS OF EXPERTISE. THIS INCLUDES ADDRESSING KEY REGIONAL HEALTH ISSUES, INTEGRATING CHNA FINDINGS INTO EXISTING PROGRAMS, AND COLLABORATING WITH COMMUNITY PARTNERS ON SHARED PRIORITIES. TO GUIDE ITS EFFORTS, SCRIPPS HAS ORGANIZED CHNA-IDENTIFIED NEEDS INTO THREE PRIMARY FOCUS AREAS: 1. MANAGING HEALTH CONDITIONS * AGING CARE AND SUPPORT * BEHAVIORAL HEATH * CANCER * CARDIOVASCULAR DISEASE, STROKE, HYPERTENSION * DIABETES 2. IMPROVING ACCESS TO CARE * A DIFFERENT KIND OF HEALTHCARE EXPERIENCE * LESS BURDEN ON EMERGEMCY DEPARTMENTS * BETTER DATA COLLECTION, SHARING AND COORDINATION * RECOGNITION AND ASSISTANCE WITH DISABILITIES AND TRAUMA 3. ENHANCING COMMUNITY SAFETY * TRAUMA AND INJURY PREVENTION * PROTECTION AND CARE FOR SERVICE PROVIDERS * ENHANCE CRISIS SUPPORT MANY OF THESE NEEDS ARE LINKED TO SOCIAL DETERMINANTS OF HEALTH-INCLUDING FOOD INSECURITY, HOUSING INSTABILITY, TRANSPORTATION, EDUCATION, AND LACK OF SOCIAL SUPPORT-WHICH SCRIPPS ADDRESSES THROUGH A WIDE RANGE OF PROGRAMS AND PARTNERSHIPS. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC 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. * ALL PATIENTS ARE SCREENED FOR PAYMENT ABILITY AND PROGRAM ELIGIBILITY, INCLUDING FINANCIAL ASSISTANCE. SCRIPPS STAFF WILL: A. MAKE REASONABLE EFFORTS TO OBTAIN INFORMATION FROM PATIENTS TO DETERMINE IF THEIR HEALTH INSURANCE, WHETHER IT'S PRIVATE OR PUBLIC, MIGHT COVER ALL OR PART OF THEIR MEDICAL EXPENSES. B. PROVIDE UNINSURED PATIENTS WITH A "GOOD FAITH" ESTIMATE OF THE EXPECTED COSTS FOR MEDICAL SERVICES AND ITEMS, ALONG WITH A FINANCIAL ASSISTANCE APPLICATION. C. ASSIST PATIENTS IN DETERMINING IF THEY QUALIFY FOR MEDI-CAL, COUNTY MEDICAL SERVICES (CMS), THE CALIFORNIA HEALTH BENEFIT EXCHANGE, OR ANY OTHER THIRD-PARTY INSURANCE. D. PATIENTS APPLYING FOR CHARITY CARE SHOULD SEEK OUT AND APPLY FOR ANY AVAILABLE PUBLIC OR PRIVATE HEALTH INSURANCE. E. PATIENTS APPLYING FOR CHARITY CARE MUST COOPERATE WITH SCRIPPS HEALTH IN THE APPLICATION PROCESS. SCHEDULE H, PART V, SECTION B, LINE 3E 2025 CHNA PRIORITIZATION OF THE TOP COMMUNITY NEEDS 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. 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. 2025 CHNA TOP COMMUNITY NEEDS THROUGH THE PRIORITIZATION PROCESS DESCRIBED IN THE METHODOLOGY SECTION, THE CHNA COMMITTEE IDENTIFIED THE MOST CRITICAL TOP COMMUNITY NEEDS WITHIN SAN DIEGO COUNTY. THE FINDINGS COME DIRECTLY FROM THE CHNA PROCESS AND SERVE AS THE FOUNDATION FOR THE STRATEGIES OUTLINED IN THE HOSPITALS IMPLEMENTATION STRATEGY. THE 2025 CHNA IDENTIFIED THAT SAN DIEGANS ARE EXPERIENCING DEBILITATING STRESS. CHRONIC STRESS WAS CONSISTENTLY HIGHLIGHTED AS A SIGNIFICANT THEME ACROSS ALL METHODS OF DATA COLLECTION. THIS STRESS, THE COMMUNITY SAID, IS CAUSED BY THE HIGH COST OF LIVING IN SAN DIEGO, RISING LEVELS OF RACISM, PREJUDICE, AND DISCRIMINATION, ONGOING CHALLENGES FROM COVID 19, AND RECENT PUBLIC HEALTH EMERGENCIES. THIS STRESS HAS RESULTED IN A HEALTH CARE SYSTEM TRYING TO HELP MORE PATIENTS WHILE HEALTH CARE WORKERS ARE, THEMSELVES, EXPERIENCING HARDSHIP. CHRONIC STRESS IS RECOGNIZED AS A PRIMARY FINDING, INDICATING ITS ROLE AS A BARRIER AFFECTING COMMUNITY MEMBERS CAPACITY TO MANAGE THEIR HEALTH AND HEALTHCARE EFFECTIVELY. THE 2025 CHNA ALSO EXPLORED WAYS IN WHICH HOSPITALS AND HEALTHCARE SYSTEMS COULD ALLEVIATE CHRONIC STRESS TO ENHANCE COMMUNITY HEALTH. SEVERAL HEALTH IMPROVEMENT STRATEGIES WERE RECOMMENDED, WHICH ARE HIGHLIGHTED AS OTHER KEY FINDINGS. THESE STRATEGIES AIM TO ADDRESS THE IDENTIFIED BARRIERS AND IMPROVE THE OVERALL WELL-BEING OF THE COMMUNITY. OTHER KEY FINDINGS LISTED BELOW IN NO SPECIFIC ORDER: HELP MANAGING HEALTH CONDITIONS. THE COMMUNITY NAMED SEVERAL SPECIFIC HEALTH CONDITIONS THEY NEED MORE ASSISTANCE WITH MANAGING (ASTHMA, BLOOD PRESSURE, CANCER, DENTAL HEALTH, DIABETES, MENTAL HEALTH) A DIFFERENT KIND OF HEALTH EXPERIENCE. THEY NEED HEALTH CARE TO BE RESPECTFUL OF THEIR TIME, TO OFFER CARE WHEN THEY NEED IT. THEY WANT EASIER WAYS TO GET TO HEALTH CARE, A BETTER RELATIONSHIP WITH CARE PROVIDERS AND HELP WITH NAVIGATING SYSTEMS. THIS, THEY INDICATED, WAS WHERE THE HEALTH CARE COMMUNITY SHOULD BE CONCENTRATING ITS EFFORTS. PROTECTION AND CARE FOR THEIR SERVICE PROVIDERS. WHILE ASKING FOR CHANGE IN THE WAY THEY EXPERIENCE HEALTH CARE, THE COMMUNITY WAS ALSO EMPHATIC THAT THEY APPRECIATE THEIR HEALTH CARE WORKERS, UNDERSTAND THE PRESSURES THEY ARE UNDER, AND WANT THEM TO BE CARED FOR AS WELL. THEY OFFERED PRAISE FOR HEALTH CARE WORKERS AND CONCERN ABOUT STAFF SHORTAGES, WORKER BURN-OUT, AND VICARIOUS TRAUMA. RECOGNITION AND ASSISTANCE WITH DISABILITES AND TRAUMA. ONE IN 10 SAN DIEGANS LIVES WITH A DISABILITY, AND MANY HAVE EXPERIENCED TRAUMATIC EVENTS. THE COMMUNITY EMPHASIZED THAT PEOPLE WHO ARE DISABLED OR LIVING WITH TRAUMA NEED ACCOMMODATIONS, COMPASSION, AND ASSISTANCE WITH RESOURCES. HELP WITH CRISES. SAN DIEGO COUNTY RESIDENTS HAVE EXPERIENCED SIGNIFICANT CLIMATE-RELATED AND PUBLIC HEALTH CRISES IN RECENT YEARS AND EXPRESSED AN URGENT NEED FOR HELP ADDRESSING THESE CRISES, INCLUDING BETTER DATA COLLECTION AND MORE RESOURCES. BETTER DATA COLLECTION SHARING AND COORDINATION. THE COMMUNITY NEEDS BETTER DATA COLLECTION, SHARING, AND COORDINATION ACROSS SYSTEMS, INCLUDING HOSPITALS AND COMMUNITY CLINICS, SOCIAL SERVICE PROVIDERS, AND SCHOOLS. THE LACK OF DATA COORDINATION CREATES UNNECESSARY CHALLENGES TO GOOD HEALTH. LESS BURDEN ON EMERGENCY DEPARTMENTS. THE COMMUNITY IS CONCERNED ABOUT THE CAPACITY OF SAN DIEGO COUNTY'S EMERGENCY DEPARTMENTS (EDS), NOTING THAT MANY PEOPLE MUST RELY ON THEM FOR CARE THAT COULD BE MANAGED OUTSIDE OF EMERGENCY SETTINGS. THE COMMUNITY REPORTED SEVERAL UNDERLYING CAUSES FOR THIS USAGE, INCLUDING DIFFICULTY OBTAINING PRIMARY AND SPECIALTY CARE IN A TIMELY MANNER AND A LACK OF ALTERNATIVE OPTIONS FOR ACUTE CONDITIONS LIKE MENTAL HEALTH. COMMUNITY NEEDS SCRIPPS IS ADDRESSING AND NOT DIRECTLY ADDRESSING TO BETTER SERVE SAN DIEGO COUNTY RESIDENTS FACING HEALTH INEQUITIES, SCRIPPS USES THE FINDINGS FROM THE HOSPITAL ASSOCIATION 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE THE DEVELOPMENT AND REFINEMENT OF HOSPITAL PROGRAMS AND STRATEGIES. HEALTH PRIORITIES IN THE CHNA WERE IDENTIFIED THROUGH A COMPREHENSIVE PROCESS INVOLVING RESEARCH, DATA COLLECTION, ANALYSIS, COMMUNITY INPUT, AND PRIORITIZATION. SCRIPPS WILL ADDRESS ALL IDENTIFIED PRIORITIES FROM THE 2025 CHNA EXCEPT FOR DENTAL HEALTH AND ASTHMA. WHILE DENTAL HEALTH IS A CRITICAL COMPONENT OF OVERALL WELL-BEING, IT FALLS OUTSIDE THE DIRECT CLINICAL SCOPE OF SCRIPPS AND IS MORE APPROPRIATELY ADDRESSED BY DENTAL PROVIDERS. ASTHMA, THOUGH A SIGNIFICANT ISSUE, IS PRIMARILY MANAGED IN OUTPATIENT SETTINGS THROUGH SCRIPPS CLINIC MEDICAL GROUP'S ALLERGY, ASTHMA & IMMUNOLOGY SPECIALISTS. AS THERE IS CURRENTLY NO COORDINATED, COMMUNITY-WIDE ASTHMA INITIATIVE THAT ALIGNS WITH HOSPITAL-BASED STRATEGIES, IT WILL NOT BE INCLUDED IN THIS IMPLEMENTATION CYCLE. SCRIPPS WILL CONTINUE TO COLLABORATE WITH PARTNERS BETTER POSITIONED TO MEET THIS NEED. SCRIPPS DIRECTS ITS RESOURCES TOWARD INITIATIVES THAT ALIGN WITH ITS MISSION, CLINICAL STRENGTHS, AND AREAS OF EXPERTISE. THIS INCLUDES ADDRESSING KEY REGIONAL HEALTH ISSUES, INTEGRATING CHNA FINDINGS INTO EXISTING PROGRAMS, AND COLLABORATING WITH COMMUNITY PARTNERS ON SHARED PRIORITIES. TO GUIDE THIS WORK, SCRIPPS HAS GROUPED THE CHNA IDENTIFIED NEEDS INTO THREE FOCUS AREAS: MANAGING HEALTH CONDITIONS, IMPROVING ACCESS TO CARE AND ENHANCING COMMUNITY SAFETY. MANY OF THESE HEALTH CONCERNS ARE CLOSELY TIED TO SOCIAL DETERMINANTS OF HEALTH, SUCH AS FOOD INSECURITY, HOUSING, TRANSPORTATION, EDUCATION, AND SOCIAL SUPPORT, WHICH SCRIPPS ADDRESSES THROUGH A BROAD RANGE OF PROGRAMS AND PARTNERSHIPS. SCHEDULE H, PART V, SECTION B, LINE 5 FACILITY B, 1 FACILITY B, 1 - REPORTING GROUP B - SELECT HOSPITAL. DESCRIPTION: COMMUNITY ENGAGEMENT THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO GATHER INPUT FROM A BROAD AND REPRESENTATIVE SAMPLE OF SAN DIEGO COUNTY RESIDENTS, WITH A FOCUS ON THOSE EXPERIENCING HEALTH INEQUITIES. SPECIAL EFFORTS WERE MADE TO INCLUDE BOTH COMMUNITY MEMBERS FROM HISTORICALLY UNDERSERVED POPULATIONS AND SERVICE PROVIDERS WHO WORK CLOSELY WITH THEM. IN TOTAL, FEEDBACK WAS GATHERED FROM 1,625 COMMUNITY MEMBERS ACROSS THE REGION. ENGAGEMENT METHODS THE CHNA TEAM, LED BY RESEARCHERS AT THE IPH, COLLECTED DATA THROUGH FOCUS GROUPS, KEY INFORMANT INTERVIEWS, FIELD INTERVIEWS, AND AN ONLINE SURVEY DESCRIBED BELOW. THESE PRIMARY DATA COLLECTION EFFORTS WERE COMPLEMENTED BY THE REVIEW OF PUBLICLY AVAILABLE DEMOGRAPHIC DATA, HOSPITAL AND EMERGENCY DEPARTMENT DISCHARGE RECORDS, AND RELEVANT PUBLISHED RESEARCH TO DEVELOP A COMPREHENSIVE UNDERSTANDING OF COMMUNITY HEALTH NEEDS. THIS MIXED-METHODS APPROACH AIMED TO ANSWER TWO CENTRAL QUESTIONS: * WHAT ARE THE MOST PRESSING NEEDS OF OUR COMMUNITY? * HOW CAN HOSPITALS AND HEALTH SYSTEMS HELP ADDRESS THOSE NEEDS? A CENTRAL GOAL OF THE 2025 CHNA WAS TO INVOLVE COMMUNITY HEALTH WORKERS (CHWS), LOCAL PARTNERS, AND COMMUNITY MEMBERS AS RESEARCH COLLABORATORS. SDRCC AND SDCPC PLAYED KEY ROLES IN DESIGNING CULTURALLY SENSITIVE DATA COLLECTION TOOLS, CONDUCTING INTERVIEWS, AND SUPPORTING DATA ANALYSIS. THEIR EFFORTS HELPED ENSURE THIS WAS THE MOST REPRESENTATIVE CHNA SAMPLE IN SAN DIEGO TO DATE. COMMUNITY INPUT * 465 FIELD INTERVIEWS CONDUCTED BY THE SAN DIEGO REFUGEE COMMUNITIES COALITION (SDRCC) AND SAN DIEGO COUNTY PROMOTORES COALITION (SDCPC) * 1,037 ONLINE SURVEY RESPONSES * 123 PARTICIPANTS IN 40 FOCUS GROUPS AND KEY INFORMANT INTERVIEWS FIELD INTERVIEWS SHORT, IN-PERSON FIELD INTERVIEWS WERE CONDUCTED IN PUBLIC SPACES SUCH AS TRANSIT STOPS AND STORE ENTRANCES TO ENGAGE INDIVIDUALS NOT TYPICALLY CONNECTED TO MEDICAL OR SOCIAL SERVICE SYSTEMS. PARTICIPANTS WERE ELIGIBLE IF THEY WERE 18 YEARS OR OLDER AND LIVED IN SAN DIEGO COUNTY. AS A THANK-YOU, PARTICIPANTS RECEIVED A GIFT CARD. FIELD INTERVIEWS INCLUDED THREE "TRACKS," ALLOWING PARTICIPANTS TO SHARE CONCERNS RELATED TO: * THEIR CHILDREN * THEMSELVES OR A LOVED ONE * THE BROADER COMMUNITY THE TOOL WAS DEVELOPED COLLABORATIVELY WITH CHWS AND TRANSLATED INTO SPANISH. INTERVIEWS WERE ALSO CONDUCTED IN OVER 20 LANGUAGES THANKS TO MULTILINGUAL INTERVIEWERS. DEPENDING ON RESPONSES AND TRANSLATION NEEDS, INTERVIEWS LASTED FROM 5 TO 45 MINUTES. FOCUS GROUPS AND KEY INFORMANT INTERVIEWS POPULATIONS OF FOCUS WERE SELECTED USING FINDINGS FROM THE 2022 CHNA, THE HEALTHY PLACES INDEX, AND RESEARCH ON HEALTH DISPARITIES. PARTICIPANTS WERE RECRUITED USING PURPOSIVE SAMPLING THROUGH TRUSTED COMMUNITY ORGANIZATIONS AND PROFESSIONAL NETWORKS. FOCUS GROUPS AND INTERVIEWS WERE SEMI-STRUCTURED TO ALLOW FOR OPEN DISCUSSION WHILE ENSURING CORE RESEARCH QUESTIONS WERE ADDRESSED. TOPICS INCLUDED: * PRESSING HEALTH AND SOCIAL NEEDS * EXISTING SERVICES AND GAPS * COMMUNITY SUGGESTIONS * RECOMMENDATIONS FOR HOSPITALS AND HEALTH SYSTEMS ALL SESSIONS WERE FACILITATED BY RESEARCHERS FROM IPH WITH EXPERTISE IN QUALITATIVE METHODS. INTERVIEWS WERE CONDUCTED OVER ZOOM (EXCEPT FOR ONE IN-PERSON GROUP), RECORDED WITH CONSENT, AND TRANSCRIBED. TWO RESEARCHERS INDEPENDENTLY ANALYZED TRANSCRIPTS USING ITERATIVE THEMATIC ANALYSIS, COMBINING DEDUCTIVE AND INDUCTIVE CODING TO IDENTIFY MAJOR THEMES, SUBTHEMES, AND ILLUSTRATIVE QUOTES. THE TEAM MET TO REFINE THE FINDINGS, AND FOLLOW-UP WAS CONDUCTED WITH PARTICIPANTS WHEN NEEDED FOR CLARIFICATION. ONLINE SURVEY THE ONLINE SURVEY WAS ADAPTED FROM THE 2022 CHNA SURVEY AND OFFERED IN ENGLISH AND SPANISH. IT WAS DISTRIBUTED VIA: * COMMUNITY PARTNERS * THE COUNTY OF SAN DIEGO'S LIVE WELL REGIONAL GROUPS * PUBLIC HEALTH LISTSERVS AND REGIONAL COMMUNITY UPDATES A SNOWBALL SAMPLING STRATEGY WAS USED, ENCOURAGING ORGANIZATIONS TO SHARE THE LINK WITH STAFF AND CLIENTS. THE SURVEY WAS COMPLETED 1,037 TIMES, HELPING BROADEN PARTICIPATION BEYOND THOSE REACHED THROUGH INTERVIEWS AND FOCUS GROUPS. SCHEDULE H, PART V, SECTION B, LINE 6A FACILITY B, 1 FACILITY B, 1 - REPORTING GROUP B - SELECT HOSPITAL. 2025 CHNA PARTICIPATING HOSPITALS AND HEALTH SYSTEMS THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPRESENTS A COUNTYWIDE COLLABORATIVE EFFORT AMONG ALL HOSPITALS AND HEALTH CARE SYSTEMS IN SAN DIEGO COUNTY TO BETTER UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF LOCAL COMMUNITIES. THE MAJORITY OF 2025 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. FINDINGS FROM THE CHNA ARE USED TO DEVELOP, ENHANCE, AND EXPAND HEALTH AND SOCIAL SERVICE PROGRAMS ACROSS THE REGION. THE 2025 CHNA WAS GUIDED BY A HEALTH EQUITY FRAMEWORK AND EMPHASIZED COMMUNITY-BASED PARTICIPATORY RESEARCH THAT IS ACADEMIC, ANALYTICAL, ACTIONABLE, AND ACCOUNTABLE. EVERY HEALTH SYSTEM, HEALTH DISTRICT, PRIVATE HOSPITAL, AND BEHAVIORAL HEALTH HOSPITAL IN SAN DIEGO COUNTY PARTICIPATED IN THIS INITIATIVE. THEIR SUPPORT CAME THROUGH ACTIVE INVOLVEMENT IN THE COMMUNITY NEEDS ASSESSMENT COMMITTEE AND SUPPORTED THE HASD&IC BOARD OF DIRECTORS. PARTICIPATING HOSPITALS AND HEALTH SYSTEMS: * ALVARADO PARKWAY INSTITUTE BEHAVIORAL HEALTH SYSTEM * AURORA BEHAVIORAL HEALTH CARE SAN DIEGO * GROSSMONT HEALTHCARE DISTRICT * KAISER PERMANENTE SAN DIEGO * PALOMAR HEALTH * PARADISE VALLEY HOSPITAL * 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. RESEARCH AND COLLABORATION PARTNERS FOR THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) CONTRACTED WITH THE SAN DIEGO STATE UNIVERSITY (SDSU) INSTITUTE FOR PUBLIC HEALTH (IPH). AS THE PRACTICE ARM OF THE SDSU SCHOOL OF PUBLIC HEALTH, IPH FACILITATES PUBLIC HEALTH PRACTICE ACROSS SAN DIEGO COMMUNITIES. TOGETHER, HASD&IC AND IPH LED THE RESEARCH DESIGN, DATA COLLECTION, ANALYSIS, AND SUMMARY OF FINDINGS FOR THIS REPORT. IN ADDITION TO PARTICIPATING IN THE HASD&IC FACILITATED CHNA COLLABORATIVE, KAISER PERMANENTE - SAN DIEGO, ZION, AND SAN MARCOS MEDICAL CENTERS CONDUCTED THEIR OWN CHNAS IN PARTNERSHIP WITH HARDER+COMPANY COMMUNITY RESEARCH. THESE EFFORTS WERE INTENTIONALLY ALIGNED AND CONDUCTED SIMULTANEOUSLY, WITH CONTINUOUS FEEDBACK BETWEEN BOTH RESEARCH TEAMS. THIS COORDINATION ENSURED THAT THEIR WORK WAS COMPLEMENTARY RATHER THAN DUPLICATIVE. BY LEVERAGING ONE ANOTHER'S COMMUNITY RELATIONSHIPS AND SHARING DATA THROUGHOUT THE PROCESS, HASD&IC AND KAISER PERMANENTE EXPANDED COMMUNITY REPRESENTATION AND MADE MORE EFFICIENT USE OF RESOURCES. THIS INNOVATIVE AND COLLABORATIVE APPROACH RESULTED IN A MORE COMPREHENSIVE AND INCLUSIVE CHNA FOR ALL SAN DIEGO COUNTY HOSPITALS AND HEALTH CARE SYSTEMS. 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 COMPLETION OF THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IDENTIFICATION OF PRIORITY HEALTH AREAS. COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IDENTIFICATION OF PRIORITY HEALTH AREAS. SCRIPPS HEALTH HAS DEVELOPED A CORRESPONDING IMPLEMENTATION STRATEGY-A MULTI-FACETED, MULTI-STAKEHOLDER PLAN DESIGNED TO ADDRESS THE COMMUNITY HEALTH NEEDS OUTLINED IN THE CHNA. THIS THREE-YEAR STRATEGY (FY26-FY28) TRANSLATES CHNA RESEARCH AND ANALYSIS INTO MEASURABLE, ACTIONABLE OBJECTIVES AIMED AT IMPROVING HEALTH OUTCOMES ACROSS SAN DIEGO COUNTY. EVALUATION AND RESOURCE COMMITMENT SCRIPPS HEALTH EVALUATES ITS IMPLEMENTATION STRATEGY ANNUALLY TO STAY RESPONSIVE TO EVOLVING COMMUNITY NEEDS. THIS INCLUDES REVIEWING PROGRAM INTERVENTIONS, RESOURCE ALLOCATIONS, AND PROGRESS TOWARD DEFINED GOALS. EACH OBJECTIVE INCLUDES A TAILORED MONITORING PLAN WITH KEY PERFORMANCE INDICATORS SUCH AS: * NUMBER OF PEOPLE SERVED * PARTICIPATION AND SATISFACTION RATES * FINANCIAL AND IN-KIND INVESTMENTS * MEASURABLE HEALTH OUTCOMES, WHERE FEASIBLE CHALLENGES ARE DOCUMENTED AND ADDRESSED THROUGH PROGRAM MODIFICATIONS TO MAINTAIN EFFECTIVENESS. SCRIPPS ALSO SUBMITS ITS IMPLEMENTATION STRATEGY ANNUALLY TO THE IRS VIA FORM 990, SCHEDULE H, AND SUPPORTS THIS WORK THROUGH BOTH FINANCIAL AND IN-KIND CONTRIBUTIONS, INCLUDING STAFF TIME, DIRECT SERVICES, AND COMMUNITY PROGRAMS COMMUNITY NEEDS SCRIPPS IS ADDRESSING AND NOT DIRECTLY ADDRESSING TO BETTER SERVE SAN DIEGO COUNTY RESIDENTS FACING HEALTH INEQUITIES, SCRIPPS USES THE FINDINGS FROM THE 2025 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE THE DEVELOPMENT AND REFINEMENT OF HOSPITAL PROGRAMS AND STRATEGIES. HEALTH PRIORITIES IN THE CHNA WERE IDENTIFIED THROUGH A COMPREHENSIVE PROCESS INVOLVING RESEARCH, DATA COLLECTION, ANALYSIS, COMMUNITY INPUT, AND PRIORITIZATION. SCRIPPS' IMPLEMENTATION STRATEGY (IS) ADDRESSES ALL IDENTIFIED PRIORITIES FROM THE 2025 CHNA EXCEPT FOR DENTAL HEALTH AND ASTHMA. WHILE DENTAL HEALTH IS A CRITICAL COMPONENT OF OVERALL WELL-BEING, IT FALLS OUTSIDE THE DIRECT CLINICAL SCOPE OF SCRIPPS AND IS MORE APPROPRIATELY ADDRESSED BY DENTAL PROVIDERS. ASTHMA, THOUGH A SIGNIFICANT ISSUE, IS PRIMARILY MANAGED IN OUTPATIENT SETTINGS THROUGH SCRIPPS CLINIC MEDICAL GROUP'S ALLERGY, ASTHMA & IMMUNOLOGY SPECIALISTS. AS THERE IS CURRENTLY NO COORDINATED, COMMUNITY-WIDE ASTHMA INITIATIVE THAT ALIGNS WITH HOSPITAL-BASED STRATEGIES, IT WAS NOT INCLUDED IN THIS IMPLEMENTATION CYCLE. SCRIPPS WILL CONTINUE TO COLLABORATE WITH PARTNERS BETTER POSITIONED TO MEET THIS NEED. SCRIPPS DIRECTS ITS RESOURCES TOWARD INITIATIVES THAT ALIGN WITH ITS MISSION, CLINICAL STRENGTHS, AND AREAS OF EXPERTISE. THIS INCLUDES ADDRESSING KEY REGIONAL HEALTH ISSUES, INTEGRATING CHNA FINDINGS INTO EXISTING PROGRAMS, AND COLLABORATING WITH COMMUNITY PARTNERS ON SHARED PRIORITIES. TO GUIDE ITS EFFORTS, SCRIPPS HAS ORGANIZED CHNA-IDENTIFIED NEEDS INTO THREE PRIMARY FOCUS AREAS: 1. MANAGING HEALTH CONDITIONS * AGING CARE AND SUPPORT * BEHAVIORAL HEATH * CANCER * CARDIOVASCULAR DISEASE, STROKE, HYPERTENSION * DIABETES 2. IMPROVING ACCESS TO CARE * A DIFFERENT KIND OF HEALTHCARE EXPERIENCE * LESS BURDEN ON EMERGEMCY DEPARTMENTS * BETTER DATA COLLECTION, SHARING AND COORDINATION * RECOGNITION AND ASSISTANCE WITH DISABILITIES AND TRAUMA 3. ENHANCING COMMUNITY SAFETY * TRAUMA AND INJURY PREVENTION * PROTECTION AND CARE FOR SERVICE PROVIDERS * ENHANCE CRISIS SUPPORT MANY OF THESE NEEDS ARE LINKED TO SOCIAL DETERMINANTS OF HEALTH-INCLUDING FOOD INSECURITY, HOUSING INSTABILITY, TRANSPORTATION, EDUCATION, AND LACK OF SOCIAL SUPPORT-WHICH SCRIPPS ADDRESSES THROUGH A WIDE RANGE OF PROGRAMS AND PARTNERSHIPS. THE COMPLETE REPORTS ARE AVAILABLE TO THE PUBLIC AT SCRIPPS.ORG. 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. 44 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 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 AS A TAX-EXEMPT HEALTH CARE SYSTEM, SCRIPPS TAKES PRIDE IN ITS SERVICE TO THE COMMUNITY. THE SCRIPPS SYSTEM IS GOVERNED BY A 16-MEMBERVOLUNTEER BOARD OF TRUSTEES. THIS SINGLE POINT OF AUTHORITY FOR ORGANIZATIONAL POLICY ENSURES A UNIFIED APPROACH TO SERVING PATIENTS ACROSS THE REGION. THE 2025 COMMUNITY BENEFIT PLAN AND REPORT WAS ADOPTED BY THE SCRIPPS BOARD ON MARCH 2025 AND MADE PUBLIC ON HTTPS://WWW.SCRIPPS.ORG/ABOUT-US/SCRIPPS-IN-THE-COMMUNITY. THE SCRIPPS HEALTH BOARD OF TRUSTEES AND THE STRATEGIC PLANNING COMMITTEE OF THE BOARD APPROVED BOTH THE TRIENNIAL 2025 CHNA REPORT AND CORRESPONDING FY26-FY28 IMPLEMENTATION STRATEGY DURING ITS 2024 TAX YEAR AS REQUIRED BY STATE AND FEDERAL LAW. THE CHNA AND IMPLEMENTATION STRATEGY REPORTS ARE POSTED SEPARATELY ON THE SCRIPPS HEALTH AND SELECT HOSPITAL WEBSITES, SCRIPPS HEALTH CHNA REPORT AND SELECT HOSPITAL - SAN DIEGO CHNA REPORT. SCHEDULE H, PART II DESCRIBE HOW COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY LEGISLATIVE DAY AT THE SCRIPPS MERCY HOSPITAL CHULA VISTA SCRIPPS HOSTED 11 LEGISLATIVE STAFFERS FROM LOCAL, STATE, AND FEDERAL OFFICES AT SCRIPPS MERCY HOSPITAL CHULA, SHOWCASING THE CHULA VISTA WELLBEING CENTER'S SCHOOL TO HEALTH CAREER PATHWAY PROGRAM. DURING THE VISIT, 22 SWEETWATER HIGH SCHOOL STUDENTS PARTICIPATED IN A HANDS-ON CASTING AND SPLINTING SESSION WHICH ALLOWED THE STAFFERS TO OBSERVE AND ENGAGE DIRECTLY WITH THE STUDENTS AND SCRIPPS STAFF. THE EVENT HIGHLIGHTED SCRIPPS' COMMUNITY BENEFIT INITIATIVES, INCLUDING EFFORTS TO SUPPORT HEALTH EQUITY, INTRODUCE HIGH SCHOOL STUDENTS TO HEALTHCARE CAREERS, AND SHARE UPDATES ON THE EMERGENCY DEPARTMENT EXPANSION AND LEADERSHIP CHANGES. MANA DE SAN DIEGO (MANASD) SCRIPPS SPONSORED MANASD, THE LARGEST CHAPTER OF A NATIONAL LATINA ORGANIZATION FOUNDED IN 1986. MANASD'S MISSION IS TO EMPOWER LATINAS FOR UPWARD MOBILITY AND A BETTER QUALITY OF LIFE. THIS SISTERHOOD SUPPORTS LATINAS THROUGH EDUCATION, LEADERSHIP DEVELOPMENT, COMMUNITY SERVICE, AND ADVOCACY. PROGRAMS LIKE THE HERMANITAS INITIATIVE FOR MIDDLE AND HIGH SCHOOL STUDENTS AND THE LATINA SUCCESS LEADERSHIP PROGRAM FOR MID-LEVEL PROFESSIONALS HELP LATINAS AT ALL STAGES OF LIFE. NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION SCRIPPS SPONSORED A FUNDRAISER SUPPORTING SCHOLARSHIPS FOR GIRLS AND WOMEN OF AFRICAN AMERICAN DESCENT. THE PROGRAM HELPS WOMEN PURSUE CAREER, VOCATIONAL, AND TECHNICAL EDUCATION WHILE PROMOTING LIFE SKILLS AND HEALTH AWARENESS. THROUGH ITS EFFORTS, NCAAWA HAS ENABLED HUNDREDS OF WOMEN TO REENTER THE WORKFORCE, COMPLETE THEIR EDUCATION, AND LEAD HEALTHY, SELF-SUFFICIENT LIVES. SAN YSIDRO WOMEN'S CLUB SCRIPPS SPONSORED THE SAN YSIDRO WOMEN'S CLUB FIESTA CELEBRATING ITS 25TH ANNIVERSARY RANCHERA. OVER THE PAST 25 YEARS, THE CLUB HAS PROUDLY AWARDED MORE THAN 600 SCHOLARSHIPS TO HARDWORKING STUDENTS FROM SAN YSIDRO HIGH SCHOOL. 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. EACH YEAR, 25-30 STUDENTS GAIN EXPOSURE TO VARIOUS HOSPITAL AND CLINICAL DEPARTMENTS, INCLUDING THE EMERGENCY ROOM AND SURGERY, ALLOWING THEM TO EXPLORE DIFFERENT CAREER POSSIBILITIES IN HEALTH CARE WHILE ALSO ACQUIRING VALUABLE INSIGHTS INTO HEALTH AND HEALING. IN TOTAL, SCRIPPS DEDICATED 2,875 HOURS TO THE PROGRAM, WITH EACH STUDENT COMPLETING 120 HOURS ALONGSIDE A SCRIPPS HOST. THE PROGRAM ALSO EXPANDED SITES TO TWO ADDITIONAL SITES: SCRIPPS CLINIC RANCHO BERNARDO AND SCRIPPS CLINIC JEFFERSON. SCRIPPS SCHOOL TO HEALTH CAREER PATHWAY PROGRAMS SCRIPPS MERCY HOSPITAL CHULA VISTA INTRODUCED A DIVERSE ARRAY OF YOUTH INTO HEALTH PROFESSIONS ACTIVITIES, BENEFITING OVER 2,175 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. 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. YOUNG LEADERS IN HEALTHCARE PROGRAM SCRIPPS ENCINITAS HOSTED THE YOUNG LEADERS IN HEALTH CARE PROGRAM FOR LOCAL HIGH SCHOOL STUDENTS DURING THE 2024-2025 SCHOOL YEAR. THE PROGRAM INCLUDED EIGHT MEETINGS WITH MORE THAN 802 PARTICIPANTS IN TOTAL, COVERING VARIOUS HEALTH-RELATED TOPICS AND PRESENTATIONS. AFTER COMPLETING THIS INITIATIVE, STUDENTS CAN APPLY FOR THE HIGH SCHOOL EXPLORATION SUMMER INTERNSHIP PROGRAM. 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 2025 WAS $3,356,919. 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 2025, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM REPORTED A TOTAL OPERATIONAL LOSS OF $9.4 MILLION, WITH $5.8 MILLION ATTRIBUTED TO MEDI-CAL, OR OTHER MEANS TESTED GOVERNMENT PROGRAMS AND CHARITY CARE. NOTABLY, 1.2% OF PATIENTS IN THE INPATIENT UNIT WERE UNINSURED, UNDERSCORING THE FINANCIAL PRESSURES FACED BY THESE PROGRAMS. PROVIDE AN EXPLANATION OF THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED FOR EACH LINE IN PART I, LINE 7 TABLE SCRIPPS UNCOMPENSATED CARE METHODOLOGY FISCAL YEAR 2025. 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 2025, SCRIPPS CONTRIBUTED $752,318,951 IN UNCOMPENSATED HEALTH CARE, INCLUDING $18,663,224IN CHARITY CARE, $721,588,751 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $12,066,976 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. 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 I, LINE 7 COSTING METHODOLOGY USED TO CALCULATE FINANCIAL ASSISTANCE SCRIPPS UNCOMPENSATED CARE METHODOLOGY FISCAL YEAR 2025. 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 2025, SCRIPPS CONTRIBUTED $752,318,951 IN UNCOMPENSATED HEALTH CARE, INCLUDING $18,663,224IN CHARITY CARE, $721,588,751 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $12,066,976 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. 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 ORGANIZED A LEADERSHIP RETREAT VOLUNTEER SERVICE DAY, WHERE LEADERS PAINTED, CLEANED, AND IMPROVED FACILITIES AT NONPROFIT HOMELESS SERVICE PROVIDERS SUCH AS LA MAESTRA GARDEN OF LIFE, SOUTH BAY COMMUNITY SERVICES, FATHER JOE'S VILLAGES, AND MERCY HOUSING & GARDENS. F2 - ECONOMIC DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 2 EXECUTIVE LEADERSHIP: COMMUNITY BOARDS AND BUSINESS 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. CELEBRANDO LATINAS CELEBRANDO LATINAS IS THE LARGEST LATINA CONFERENCE IN SPANISH NATIONWIDE. ITS AN EMPOWERING EXPERIENCE OF MOTIVATION AND EDUCATION FOR LATINA WOMEN. CELEBRANDO LATINAS IS AN UNFORGETTABLE AND UNIQUE DAY COMPLETELY IN SPANISH. NETWORKING, RESOURCES, HEALTH AND WELLNESS TESTING AND INFORMATION AND MUCH MORE. 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 SERVICES. DISASTER PREPAREDNESS - ACTIVE SHOOTER DRILL (VIOLENT THREAT EXERCISE CONDUCTED AT NEW LA JOLLA TOWER) SCRIPPS SECURITY AND CLINICAL STAFF PARTNERED WITH LOCAL AND FEDERAL LAW ENFORCEMENT-INCLUDING THE FBI, DEA, AND LOCAL FIRE AND POLICE DEPARTMENTS-FOR AN ACTIVE SHOOTER DRILL AT THE NEW LA JOLLA TOWER. THE EXERCISE ALLOWED FIRST RESPONDERS TO TRAIN IN A REALISTIC HOSPITAL ENVIRONMENT, WITH SCRIPPS EMPLOYEES VOLUNTEERING AS MOCK PATIENTS, STAFF, AND FAMILY MEMBERS. SCRIPPS HAS A LONG HISTORY OF SUPPORTING SUCH PREPAREDNESS EFFORTS, THROUGHOUT THE PAST TWO DECADES. IN FY25, 125 INDIVIDUALS PARTICIPATED IN THE DRILL WITH 1,300 STAFF HOURS. 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. EQUALITY CALIFORNIA SCRIPPS SPONSORED THE EQUALITY CALIFORNIA "EQUALITY AWARDS" SAN DIEGO. EQUALITY CALIFORNIA IS THE NATION'S LARGEST STATEWIDE LGBTQIA+ CIVIL RIGHTS ORGANIZATION. EQUALITY CALIFORNIA BRINGS THE VOICES OF LGBTQIA+ PEOPLE AND ALLIES TO INSTITUTIONS OF POWER IN CALIFORNIA AND ACROSS THE UNITED STATES, STRIVING TO CREATE A WORLD THAT IS HEALTHY, JUST, AND FULLY EQUAL FOR ALL LGBTQIA+ PEOPLE. 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. LGBTQIA+ VICTORY INSTITUTE SCRIPPS SPONSORED A FUNDRAISING EVENT "CHAMPAGNE BRUNCH FUNDRAISER". LGBTQIA+ VICTORY INSTITUTE WORKS TO ACHIEVE AND SUSTAIN EQUALITY THROUGH LEADERSHIP DEVELOPMENT, TRAININGS, RESEARCH AND CONVENINGS. 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 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 AND STATE OF CALIFRONIA 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 PRIDE INC SCRIPPS SPONSORED THE ANNUAL SAN DIEGO LGBTQIA+ PRIDE PARADE. SCRIPPS EMPLOYEES PARTICPATED 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. 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. IN FY25,500 PEOPLE WERE SERVED. 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 2025, 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 24 HOURS TO THIS COLLABORATIVE. COMMUNITY ENGAGEMENT PARTNERSHIPS AND ADVISORY BOARDS THROUGH COMMUNITY ADVISORY BOARDS (CABS) GATHER INPUT FROM COMMUNITY MEMBERS, ENSURING PROGRAMS AND INITIATIVES ARE ALIGNED WITH COMMUNITY PRIORITIES AND PROVIDE VALUABLE INPUT ON RESEARCH PROJECTS, PROGRAM DESIGN, AND EVALUATION, ULTIMATELY LEADING TO MORE EFFECTIVE AND CULTURALLY SENSITIVE INTERVENTIONS. 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 12 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. F8-WORKFORCE DEVELOPMENT - THE COSTS ASSOCIATED WITH THE FOLLOWING PROGRAMS ARE REPORTED ON SCHEDULE H, PART II, LINE 8. CRISTO REY WORK STUDY PROGRAM SCRIPPS COLLABORATES WITH CRISTO REY SAN DIEGO HIGH SCHOOL, A COLLEGE-PREPARATORY SCHOOL SERVING STUDENTS FROM BOTH SIDES OF THE BORDER. CRISTO REY FOLLOWS A UNIQUE MODEL WHERE STUDENTS ATTEND CLASSES FOUR DAYS A WEEK AND SPEND THE FIFTH DAY WORKING IN PROFESSIONAL SETTINGS-SUCH AS LAW FIRMS, LABS, AND HOSPITALS. THIS PROGRAM INTRODUCES STUDENTS TO HEALTHCARE CAREERS, PROVIDES INSIGHTS INTO HOSPITAL OPERATIONS, AND DEVELOPS JOB READINESS SKILLS, HELPING PREPARE THEM FOR FUTURE CAREERS IN HEALTH AND LEADERSHIP ROLES. IN FY25, SCRIPPS SPONSORED EIGHT STUDENTS TO WORK IN VARIOUS DEPARTMENTS AT MERCY CHULA VISTA, MERCY SD AND THE SCRIPPS WELL-BEING CENTER. 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 ADJUSTMNTS 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 BENFIT BECAUSE THESE PATIENTS RECEIVE TREATMENT REGRDLESS 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 - VIBRA HOSPITAL OF SAN DIEGO (DBA SELECT HOSPITAL OF SAN DIEGO): LINE 16A URL: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/CA/SAN-DIEGO/SAN-DIEGO/?TY=XT; 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 - VIBRA HOSPITAL OF SAN DIEGO (DBA SELECT HOSPITAL OF SAN DIEGO): LINE 16B URL: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/CA/SAN-DIEGO/SAN-DIEGO/?TY=XT; 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 - VIBRA HOSPITAL OF SAN DIEGO (DBA SELECT HOSPITAL OF SAN DIEGO): LINE 16C URL: HTTPS://WWW.SELECTSPECIALTYHOSPITALS.COM/LOCATIONS-AND-TOURS/CA/SAN-DIEGO/SAN-DIEGO/?TY=XT; SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT NEEDS ASSESSMENT AS PART OF FEDERAL REPORTING REQUIREMENTS FOR PRIVATE, NOT-FOR-PROFIT (TAX-EXEMPT) HOSPITALS, SCRIPPS HEALTH CONDUCTS A CONSOLIDATED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND A CORRESPONDING JOINT IMPLEMENTATION STRATEGY FOR ITS LICENSED HOSPITAL FACILITIES. THESE EFFORTS ARE DESIGNED TO SUPPORT PLANNING FOR COMMUNITY BENEFIT PROGRAMS IN COLLABORATION WITH OTHER LOCAL HEALTH CARE INSTITUTIONS, COMMUNITY-BASED ORGANIZATIONS, AND CONSUMER GROUPS. SCRIPPS HAS BEEN ACTIVELY ENGAGED IN THE TRIENNIAL CHNA PROCESS SINCE 1995, IN COMPLIANCE WITH CALIFORNIA SENATE BILL 697, WHICH REQUIRES NONPROFIT HOSPITALS TO IDENTIFY AND RESPOND TO COMMUNITY HEALTH NEEDS. ADDITIONALLY, THE 2025 SCRIPPS HEALTH CHNA MEETS THE FEDERAL REQUIREMENTS OF INTERNAL REVENUE CODE SECTION 501(R), WHICH MANDATES THAT TAX-EXEMPT HOSPITALS UNDER SECTION 501(C)(3) CONDUCT AND PUBLICLY REPORT A CHNA AND ASSOCIATED IMPLEMENTATION STRATEGY EVERY THREE YEARS. THE IMPLEMENTATION STRATEGY IDENTIFIES THE HOSPITAL'S PLANNED OR ONGOING ACTIVITIES TO ADDRESS THE NEEDS OUTLINED IN THE CHNA. SCRIPPS HEALTH PARTICIPATES IN A REGIONAL COLLABORATIVE CHNA PROCESS LED BY THE HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES (HASD&IC). ALTHOUGH CHNA COMPLIANCE IS ONLY REQUIRED FOR 501(C)(3) HOSPITALS, THE COLLABORATIVE MODEL REFLECTS A SHARED COMMITMENT TO IDENTIFYING AND ADDRESSING THE REGION'S MOST PRESSING HEALTH NEEDS. PURPOSE OF THE 2025 CHNA THE 2025 CHNA INCLUDES EXTENSIVE QUANTITATIVE ANALYSIS OF EMERGENCY DEPARTMENT AND INPATIENT HOSPITAL DISCHARGE DATA, ALONG WITH OTHER SECONDARY DATA SOURCES, PAIRED WITH QUALITATIVE INSIGHTS FROM BROAD COMMUNITY ENGAGEMENT EFFORTS. THIS MIXED-METHODS APPROACH ALLOWS THE CHNA TO CAPTURE A COMPREHENSIVE AND MULTIDIMENSIONAL PICTURE OF COMMUNITY HEALTH NEEDS ACROSS SAN DIEGO COUNTY. THE 2025 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. THE CHNA REPORT IS ALSO A RESOURCE FOR STAKEHOLDERS, ADVANCING TRANSPARENCY, ACCESSIBILITY, AND INFORMED COLLABORATION ACROSS SECTORS. THE FINDINGS WILL HELP GUIDE BOTH THE FY26-FY28 IMPLEMENTATION STRATEGY AND FUTURE PLANNING INITIATIVES. FOR MORE INFORMATION, VISIT WWW.SCRIPPSHEALTH.ORG. COMMUNITY DESCRIPTION PER IRS REGULATIONS, THE CHNA MUST DEFINE THE COMMUNITY SERVED BY THE HOSPITAL(S). GIVEN THE REGIONAL SCOPE OF THE COLLABORATIVE CHNA PROCESS, SAN DIEGO COUNTY AS A WHOLE IS CONSIDERED THE COMMUNITY SERVED. THE CHNA PRIORITIZED ENGAGING POPULATIONS AT HEIGHTENED RISK OF HEALTH INEQUITIES, INCLUDING: - RESIDENTS IN RURAL AREAS - PEOPLE EXPERIENCING HOMELESSNESS - OLDER ADULTS - CHILDREN AND YOUTH - INDIVIDUALS IMPACTED BY HUMAN TRAFFICKING RESEARCH METHODS AND APPROACH TO UNDERSTAND THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS, THE CHNA USED TWO PRIMARY METHODS: 1. QUANTITATIVE ANALYSIS PUBLICLY AVAILABLE DATA SOURCES WERE ANALYZED TO: - DESCRIBE THE DEMOGRAPHICS AND HEALTH CONDITIONS OF SAN DIEGO COUNTY - INFORM THE DESIGN OF THE COMMUNITY ENGAGEMENT STRATEGY - SUPPORT THE PRIORITIZATION OF HEALTH ISSUES AMONG UNDERSERVED POPULATIONS 2. QUALITATIVE COMMUNITY ENGAGEMENT A WIDE RANGE OF COMMUNITY MEMBERS AND STAKEHOLDERS WERE ENGAGED TO BETTER UNDERSTAND LIVED EXPERIENCES AND BARRIERS TO HEALTH. THIS APPROACH ENSURED THE INCLUSION OF VOICES MOST IMPACTED BY INEQUITIES AND INFORMED THE PRIORITIZATION OF HEALTH NEEDS. PRIORITIZATION ONCE INITIAL DATA ANALYSIS WAS COMPLETE, THE CHNA COMMITTEE IDENTIFIED KEY HEALTH NEEDS USING THE FOLLOWING CRITERIA: - SEVERITY - POTENTIAL TO CAUSE DEATH, DISABILITY, OR REDUCED QUALITY OF LIFE - MAGNITUDE - NUMBER OF PEOPLE AFFECTED - DISPARITIES - IMPACT ON POPULATIONS FACING SOCIAL OR ECONOMIC BARRIERS (E.G., GEOGRAPHY, RACE/ETHNICITY, CITIZENSHIP STATUS, LANGUAGE, INCOME, AGE, GENDER, SEXUAL ORIENTATION) - TREND - WHETHER THE CONDITION IS IMPROVING, STABLE, OR WORSENING OVER TIME COMMUNITY RECOMMENDATIONS - WHAT IS ALREADY WORKING COMMUNITY MEMBERS WERE ASKED TO IDENTIFY PROGRAMS AND SERVICES THEY FOUND EFFECTIVE AND WOULD LIKE TO SEE EXPANDED. CURRENT SUCCESSES INCLUDE 1. PARTNERSHIPS BETWEEN SCHOOLS AND CLINICS 2. DENTAL OFFICES IN CLINICS WITH A SLIDING FEE SCALE 3. HOME VISITS FOR CHORNIC CONDITION MANGEMENT 4. MOBILE HEALTH SERVICES 5. TAXI VOUCHER PROGRAMS 6. VOLUNTARY IDENTIFICATION FOR DISABLED INDIVIDUALS COMMUNITY SUGGESTIONS THE COMMUNITY ALSO MADE SEVERAL SUGGESTIONS FOR WAYS IN WHICH HOSPITALS AND HEALTH CARE SYSTEMS COULD HELP REDUCE THEIR STRESS AND IMPROVE THEIR HEALTH. 1. SUPPORT FOR PATIENTS - IMPROVE CARE NAVIGATION - ENABLE REAL-TIME FEEDBACK ABOUT CARE EXPERIENCES - ENCOURAGE AND SUPPORT PATIENT ADVOCATES DURING MEDICAL APPOINTMENTS - DESIGNATE STAFF TO ADDRESS DISABILITY ACCOMMODATIONS AND RIGHTS CONCERNS 2. SUPPORT FOR HEALTH CARE WORKERS - INCREASE COMMUNITY INVOLVEMENT - OFFER ADDITIONAL TRAINING AND EDUCATION - REDUCE STAFF TURNOVER AND BURNOUT 3. DISCHARGE ENHANCEMENT - EXPAND ACCESS TO MEDICATIONS UPON DISCHARGE - IMPROVE DISCHARGE COORDINATION - INCREASE RECUPERATIVE CARE BEDS AND HOME-BASED SERVICES - IMPLEMENT POST-DISCHARGE HOME VISITS 4. SYSTEMIC EFFORTS - ADVOCATE FOR POLICY CHANGE THAT ADDRESSES ROOT CAUSES OF POOR HEALTH - INCREASE COMMUNITY CONSULTATION AND TRANSPARENCY - ENGAGE IN ONGOING DIALOGUE WITH RESIDENTS TO INFORM HEALTH STRATEGIES NEXT STEPS THE CHNA REPORT IS PUBLICLY AVAILABLE AS A RESOURCE FOR BOTH RESIDENTS AND SERVICE PROVIDERS WORKING TO IMPROVE COMMUNITY HEALTH. HASD&IC AND THE CHNA COMMITTEE REMAIN COMMITTED TO ENGAGING THE COMMUNITY REGULARLY TO GUIDE THE DEVELOPMENT OF FUTURE HEALTH INITIATIVES. PLANNING FOR THE 2028 CHNA IS ALREADY UNDERWAY, DEMONSTRATING A CONTINUED COMMITMENT TO ITERATIVE LEARNING, TIMELY REASSESSMENT, AND IMPROVING HEALTH OUTCOMES ACROSS SAN DIEGO COUNTY. 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 - ASUMMARY 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 THIER 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 2025, SCRIPPS PROVIDED 3,179,701 OUTPATIENT VISITS AND 72,896 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 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 FOUR ACUTE-CARE HOSPITALS ON FIVE 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),MEDI-CAL 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 2025 COMMUNITY BENEFIT PLAN AND REPORT WITH THESE CATEGORIES. FOR FULL CATEGORY DEFINITIONS AND ACCOUNTING METHODS SEE IRS SCHEDULE H (FORM 990)(2024) INSTRUCTIONS. COVERING THE PERIOD OF FISCAL YEAR 2025 (OCTOBER 1, 2024, THROUGH SEPTEMBER 30, 2025), SCRIPPS CONTRIBUTED $815,900,436 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 $752,318,951 IN UNCOMPENSATED HEALTH CARE, INCLUDING $18,663,224 IN CHARITY CARE, $721,588,751 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $12,066,976 IN BAD DEBT. - SCRIPPS INVESTED $7,157,545 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 2025, SCRIPPS INVESTED $45,670,641 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 $5,833,928 IN HEALTH RESEARCH AND SCRIPPS CLINIC AND CLINICAL RESEARCH SERVICES SUPPORTED MORE THAN 45 PRINCIPAL INVESTIGATORS AND ABOUT 111 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 $1,027,760 CASH, GRANTS AND IN-KIND CONTRIBUTIONS MADE BY THE ORGANIZATION TO COMMUNITY GROUPS AND NONPROFIT ORGANIZATIONS. - SCRIPPS INVESTED $3,356,919 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 650,000 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 3,300 AFFILIATED PHYSICIANS AND MORE THAN 17,600 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 (GME) 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 OUR 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. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT CA true CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT) 1215 K STREET STE 800 SACRAMENTO CA 95814 951684089 501(C)3 479521 CA HOSPITAL FEE PROGRAM CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA) 1764 SAN DIEGO AVE STE 200 SAN DIEGO CA 92110 751835298 501(C)3 120000 PROGRAM SUPPORT RAD-AID INTERNATIONAL 8004 ELLINGSON DR CHEVY CHASE MD 20815 263914931 501(C)3 21000 FMV DONATION OF EQUIPMENT PROGRAM SUPPORT FAMILY HEALTH CENTER OF SD INTERNAL MEDICINE OUTPATIENT TEACHING CLINIC PAR TNERSHIP 823 GATEWAY CENTER WAY SAN DIEGO CA 92012 952833205 501(C)3 309000 PROGRAM SUPPORT FACILITATING ACCESS TO COORDINATED TRANSPORTATION 516 CIVIC CENTER DR OCEANSIDE CA 92054 320173841 501(C)3 7500 PROGRAM SUPPORT FATHER JOE'S VILLAGES 3350 E STREET SAN DIEGO CA 92102 223746050 501(C)3 8162 FMV DONATION OF BLANKETS AND SOCKS PROGRAM SUPPORT SAN YSIDRO HEALTH CENTER 3350 E STREET SAN DIEGO CA 92102 223746050 501(C)3 25000 PROGRAM SUPPORT FAMILY HEALTH CENTER OF SD - SPIRIT OF THE BARRIO 823 GATEWAY CENTER WAY SAN DIEGO CA 92012 952833205 501(C)3 7500 PROGRAM SUPPORT THE SAN DIEGO LGBT COMMUNITY CENTER 3909 CENTRE STREET SAN DIEGO CA 92103 237332048 501(C)3 10000 PROGRAM SUPPORT LA MAESTRA FAMILY CLINIC 4060 FAIRMOUNT AVE SAN DIEGO CA 92105 330473171 501(C)3 10000 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 DR. MAIL CODE HQ301, 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 true true X X X X X X true true false false false false false false false CHRISTOPHER VAN GORDER PRESIDENT / CEO 2257067 0 1270818 0 103597 0 24500 0 33797 0 3689779 0 0 0 BRADLEY ELLIS CORP SR VP, CHIEF LEGAL COUNSEL 1014864 0 184547 0 18909 0 24500 0 34765 0 1277585 0 0 0 MONIQUE GONZALEZ EXECUTIVE ASSISTANT TO THE CEO 106706 0 2518 0 3371 0 8824 0 43116 0 164535 0 0 0 BRETT TANDE TREASURER / CORP EXEC VP, CFO 1161044 0 230709 0 58369 0 14000 0 48346 0 1512468 0 0 0 LISA RISSERTHAKUR FORMER KEY EMPLOYEE 320930 0 146098 0 22718 0 0 0 0 0 489746 0 0 0 ANIL KESWANI CORP EVP, CHF MED&OPS OFF-AMB 1022396 0 220203 0 60188 0 17500 0 48250 0 1368537 0 0 0 THOMAS BUCHHOLZ CORP SR VP, ONCOLOGY SERVICES 1136419 0 234544 0 15983 0 14000 0 33351 0 1434297 0 0 0 ERIC COLE CORP SR VP, HUMAN RESOURCES 799458 0 190331 0 49232 0 17500 0 35599 0 1092120 0 0 0 JOHN ENGLE CORP SR VP, CHIEF DEVELOPMENT OFFICER 645649 0 158962 0 60033 0 24500 0 35918 0 925062 0 0 0 CARL ETTER CORP SR VP, REGION CHIEF EXEC 1368692 0 244557 0 107096 0 24500 0 33526 0 1778371 0 0 0 THOMAS GAMMIERE CORP SR VP, REGION CHIEF EXEC 792649 0 200259 0 33273 0 24500 0 36269 0 1086950 0 0 0 JUNE KOMAR CORP EXEC VP, STRATEGY & ADMIN (PART YEAR) 765171 0 362111 0 46303 0 24500 0 16787 0 1214872 0 0 0 RICHARD NEALE CORP EXEC VP, CHIEF GROWTH OFFICER 891316 0 232716 0 56465 0 21000 0 47449 0 1248946 0 0 0 BARBARA PRICE CORP SR VP, PLANNING/STRATEGY 843852 0 210057 0 42870 0 24500 0 47653 0 1168932 0 0 0 GHAZALA SHARIEFF CORP EVP, CHF MED&OPS OFF-ACUTE 1268778 0 264017 0 20800 0 17500 0 44779 0 1615874 0 0 0 SHANE THIELMAN CORP SR VP, CIDO 715151 0 177354 0 49346 0 21000 0 47595 0 1010446 0 0 0 TRACY CHU CORP VP, POP HLTH/ACO 639028 0 118359 0 10894 0 24500 0 16725 0 809506 0 0 0 SHERMAN T MOORE CORP VP, BUSINESS DEVELOPMENT 547832 0 99296 0 22591 0 14000 0 48040 0 731759 0 0 0 JOHN POOLE CORP VP, SYSTEM IMPROVEMENT 637484 0 118396 0 13376 0 14000 0 1984 0 785240 0 0 0 GERALD SODERSTROM CORP SR VP, AUDIT / COMPLIANCE/RISK 550777 0 118772 0 36707 0 14000 0 48018 0 768274 0 0 0 CRAIG M UEJO CORP VP, CHIEF QUALITY OFFICER 545236 0 133596 0 11799 0 14000 0 47491 0 752122 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 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 $234. 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 2024: LISA RISSER/THAKUR - $320,726 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. NO INDIVIDUALS RECEIVED PAYMENTS FROM THE SARA PLAN IN CALENDAR YEAR 2024. 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. CERTAIN EXECUTIVES OF SCRIPPS HEALTH PARTICIPATE IN A SPLIT DOLLAR LIFE INSURANCE ARRANGEMENT. SEE SCHEDULE L, PART V FOR A BROADER DESCRIPTION OF THE ARRANGEMENT. 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 49848930 0 0 2007 true false true true B 137420000 0 150000000 0 0 0 0 0 0 150000000 0 0 2016 false false true true C 28945000 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 0 false true B false false true true true true 0.0 0.0 0.0 false false 0 false true C false false true true true true 0.0 0.0 0.0 false false 0 false true D false false true true true true 0.0 0.0 0.0 false false 0 false true A false false false true true false 0 false false false 0 false true true B false false false true false false 0 false false false 0 false false true C false false false true false false 0 false false false 0 false false true D false false false true false false 0 false false false 0 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): PROCEEDS USED FOR CAPITAL EXPENDITURES INCURRED AT SCRIPPS MEMORIAL HOSPITAL - LA JOLLA, SCRIPPS ENCINITAS HOSPITAL, ENCINITAS, CALIFORNIA AND SCRIPPS CORPORATE HEADQUARTERS IN SAN DIEGO, CALIFORNIA. PROCEEDS WERE ALSO USED TO REFUND SERIES 2010B, 2010C, 2012A, 2012B, AND 2012C BONDS. 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 0 0 0 0 0 0 558400000 360559458 0 2024 true false false true B 0 0 191600000 0 0 0 0 0 0 191600000 0 0 2024 false false false true A false false true true true true 0.0 0.0 0.0 false false 0 false true B false false true true true true 0.0 0.0 0.0 false false 0 false true A false true false false false false 0 false false false 0 false false true B false true false false true false 0 false false false 0 false false true A true B true CHRIS VAN GORDER OFFICER CUMULATIVE DEF COMP (SEE PG 186) X 10023866 14592889 false true true JUNE KOMAR EXECUTIVE CUMULATIVE DEF COMP (SEE PG 186) X 2769010 4031165 false true true RICHARD SHERIDAN FORMER OFFICER CUMULATIVE DEF COMP (SEE PG 186) X 4063606 5915856 false true true 24539910 SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 528537555 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 126584217 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 90888081 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 75455062 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 64390368 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 21328223 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 7935280 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 6253423 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 3368261 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 1847969 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 513849 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 479224 CONSTRUCTION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 318000 MEDICAL SERVICES false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 283917 COMPENSATION false SUBSTANTIAL CONTRIBUTOR SUBSTANTIAL CONTRIBUTOR 186267 COMPENSATION false LINDSEY VAN GORDER SEE PART V 112070 SEE PART V false DAVID VAN GORDER SEE PART V 93217 SEE PART V false KATIE WOODHEAD EMPLOYEE / KEY EMPLOYEE'S DAUGHTER 29114 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 THREE PLAN PARTICIPANTS. EFFECTIVE APRIL 1, 2014, SCRIPPS HEALTH PROVIDED TO THOSE THREE EXECUTIVES DEFERRED SUPPLEMENTAL RETIREMENT BENEFITS THROUGH A SPLIT DOLLAR LIFE INSURANCE ARRANGEMENT. ALTHOUGH THE IRS REQUIRES REPORTING IN THE LOAN SECTION OF SCHEDULE L, NO FUNDS ARE TRANSFERRED TO THE EXECUTIVE. RATHER, THE FUNDS ARE SET ASIDE FOR THE INITIAL PREMIUM PAYMENTS OF SPLIT DOLLAR LIFE INSURANCE POLICIES. "LOAN" TREATMENT APPLIES BECAUSE AFTER THE EXECUTIVE HAS PASSED AWAY, SCRIPPS HEALTH RECOVERS ALL OF ITS PAYMENTS FOR THE INITIAL PREMIUMS. THE PARTICIPATING EXECUTIVES ARE SUBJECT TO TAXATION ANNUALLY FOR THE IMPUTED INTEREST. PART II INCLUDES ALL PARTICIPANTS IN THE SPLIT DOLLAR LIFE INSURANCE ARRANGEMENT THAT ARE INTERESTED PERSONS OF 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. 111 3079722 MARKET VALUE X TABLE FOR EXECUTIVE HEADQUARTERS 1 64282 MARKET VALUE X FITNESS EQUIPMENT 1 16000 MARKET VALUE X DONATED RESORT STAY (LODGING PACKAGE) 1 11300 MARKET VALUE 0 false true true SCHEDULE M, PART I COLUMN (B) SCRIPPS HEALTH IS REPORTING THE NUMBER OF ITEMS CONTRIBUTED 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. SCHEDULE M, PART I EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS SECURITIES - PUBLICLY TRADED - CONTRIBUTIONS BY DONOR OTHER - TABLE FOR EXECUTIVE HEADQUARTERS ITEM RECEIVED FORM 990, PART I, LINE 1 FORM 990, PART III, LINE 1 (CONTINUED) SCRIPPS TREATS OVER HALF A MILLION PATIENTS ANNUALLY THROUGH THE DEDICATION OF 3,000 AFFILIATED PHYSICIANS AND 17,600 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 $4.98 BILLION PRIVATE, TAX EXEMPT INTEGRATED HEALTH SYSTEM BASED IN SAN DIEGO, CALIFORNIA. SCRIPPS TREATS MORE THAN 650,000 PATIENTS ANNUALLY THROUGH THE DEDICATION OF MORE THAN 3,000 AFFILIATED PHYSICIANS AND MORE THAN 17,600 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 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 THREE HIGHLY RESPECTED GRADUATE MEDICAL EDUCATION (GME) PROGRAMS, SCRIPPS IS A LONGSTANDING MEMBER OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC). SCRIPPS 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. GOVERNANCE AS A TAX-EXEMPT HEALTH CARE SYSTEM, SCRIPPS TAKES PRIDE IN ITS SERVICE TO THE COMMUNITY. THE SCRIPPS SYSTEM IS GOVERNED BY A 17-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. 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 2025, SCRIPPS PROVIDED A TOTAL OF 3,179,701OUTPATIENT VISITS AND FACILITATED 72,896 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 CONDUCTS A TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO GUIDE ITS COMMUNITY BENEFIT PLANNING EFFORTS. THE CHNA IS DESIGNED TO IDENTIFY, UNDERSTAND, AND PRIORITIZE THE HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY RESIDENTS, PARTICULARLY THOSE EXPERIENCING INEQUITIES. THE FINDINGS FROM THE 2025 CHNA SERVE AS A BASIS FOR ADAPTING HOSPITAL PROGRAMS AND STRATEGIES TO MORE EFFECTIVELY ADDRESS THE HEALTH NEEDS OF THE COMMUNITY. THE 2025 CHNA PROCESS REVEALED SEVERAL KEY FINDINGS THAT INFORM THE SCRIPPS IMPLEMENTATION STRATEGY. ONE MAJOR THEME IDENTIFIED ACROSS VARIOUS QUALITATIVE DATA COLLECTION METHODS WAS CHRONIC STRESS, WHICH EMERGED AS A SIGNIFICANT BARRIER IMPACTING INDIVIDUALS' ABILITY TO MANAGE THEIR HEALTH AND ACCESS HEALTHCARE EFFECTIVELY. CHRONIC STRESS WAS RECOGNIZED AS A PRIMARY CONCERN REQUIRING ATTENTION TO IMPROVE COMMUNITY HEALTH OUTCOMES. IN ADDITION TO IDENTIFYING CHRONIC STRESS, THE CHNA EXPLORED ACTIONABLE STRATEGIES FOR HOSPITALS AND HEALTHCARE SYSTEMS TO HELP ALLEVIATE ITS EFFECTS. THESE RECOMMENDED STRATEGIES AIM TO ADDRESS BARRIERS, REDUCE STRESS, AND ENHANCE OVERALL COMMUNITY WELL-BEING. THESE FINDINGS FORM THE FOUNDATION FOR SCRIPPS HEALTH'S EFFORTS TO SUPPORT HEALTHIER COMMUNITIES ACROSS SAN DIEGO COUNTY. TO BETTER SERVE SAN DIEGO COUNTY RESIDENTS FACING THESE CHALLENGES, SCRIPPS IS USING THE 2025 CHNA FINDINGS TO GUIDE THE DEVELOPMENT AND REFINEMENT OF HOSPITAL PROGRAMS AND COMMUNITY BENEFIT INITIATIVES. KEY FINDINGS FROM THE 2025 CHNA THESE FINDINGS HIGHLIGHT THE CRITICAL AREAS WHERE SCRIPPS HEALTH CAN FOCUS ITS EFFORTS TO IMPROVE HEALTH EQUITY AND OUTCOMES FOR SAN DIEGO COUNTY RESIDENTS. BY ADDRESSING THESE PRIORITIES, SCRIPPS AIMS TO CREATE A MORE ACCESSIBLE, EQUITABLE, AND EFFECTIVE HEALTHCARE SYSTEM FOR ALL. 1. SUPPORT FOR MANAGING HEALTH CONDITIONS - INCREASED ACCESS TO HEALTH SCREENINGS - ASSISTANCE WITH CARE NAVIGATION AND COORDINATION - EFFORTS TO LOWER HEALTHCARE COSTS 2. A MORE PATIENT-CENTERED HEALTH EXPERIENCE - ACCESSIBLE, EMPATHETIC, AND CULTURALLY COMPETENT CARE - SHORTER WAIT TIMES AND CLEARER COMMUNICATION 3. CARE AND SUPPORT FOR HEALTHCARE PROVIDERS - RECOGNITION OF THE PRESSURES ON HEALTHCARE WORKERS - SUPPORT TO ENSURE THEIR WELL-BEING 4. RECOGNITION AND ASSISTANCE FOR DISABILITIES AND TRAUMA - IMPROVED ACCOMMODATIONS FOR INDIVIDUALS WITH DISABILITIES - INCREASED USE OF TRAUMA-SENSITIVE APPROACHES IN CARE 5. IMPROVED CRISIS RESPONSE - BETTER PLANNING AND TRACKING FOR CRISIS RESPONSE - ENHANCED DATA COLLECTION TO SUPPORT CRISIS INTERVENTIONS 6. ENHANCED DATA COLLECTION AND COORDINATION - ADDRESSING GAPS IN CARE CAUSED BY A LACK OF DATA SHARING - IMPROVING EFFICIENCY THROUGH BETTER COORDINATION ACROSS SYSTEMS 7. REDUCING EMERGENCY DEPARTMENT (ED) OVERLOAD - ADDRESSING OVERBURDENED EDS BY IMPROVING ACCESS TO PRIMARY AND SPECIALTY CARE FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) 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 OF TRUSTEES AND THE STRATEGIC PLANNING COMMITTEE OF THE BOARD APPROVED BOTH THE TRIENNIAL 2025 CHNA REPORT AND CORRESPONDING FY26-FY28 IMPLEMENTATION STRATEGY DURING ITS 2024 TAX YEAR AS REQUIRED BY STATE AND FEDERAL LAW. THE CHNA AND IMPLEMENTATION STRATEGY REPORTS ARE POSTED SEPARATELY ON THE SCRIPPS HEALTH AND SELECT HOSPITAL WEBSITES, SCRIPPS HEALTH CHNA REPORT AND SELECT HOSPITAL - SAN DIEGO CHNA REPORT. SCRIPPS HEALTH 2026 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 2026 COMMUNITY BENEFIT PLAN AND REPORT COVERS THE PERIOD OF FISCAL YEAR 2025 (OCTOBER 1, 2024, THROUGH SEPTEMBER 30, 2025). DURING THIS FISCAL YEAR, SCRIPPS DEVOTED $815,900,436 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 2026 COMMUNITY BENEFIT PLAN AND REPORT WITH THE IRS ESTABLISHED CATEGORIES AS DETAILED BELOW. COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS DURING FISCAL YEAR 2025 (OCTOBER 2024 TO SEPTEMBER 2025), SCRIPPS INVESTED $7,157,545 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 FY25. 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. - ADDRESSING CARDIOVASCULAR DISEASE AND SUDDEN CARDIAC ARREST (SCA) IN TEENS: A PARTNERSHIP WITH THE ERIC PAREDES SAVE A LIFE FOUNDATION FOCUSED ON SCREENING FOR SCA IN TEENAGERS. - AMERICAN RED CROSS BLOOD DRIVES: A PARTNERSHIP FACILITATED BLOOD DONATION DRIVES. - 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. - CANCER PROGRAMS AND SUPPORT SERVICES: THESE SERVICES INCLUDED COUNSELING, SUPPORT GROUPS, COMPLEMENTARY THERAPIES, AND EDUCATIONAL WORKSHOPS. - 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. - ENGAGEMENT IN COMMUNITY INITIATIVES: SCRIPPS EXECUTIVE LEADERSHIP AND STAFF ACTIVELY PARTICIPATED IN VARIOUS COMMUNITY ORGANIZATIONS, COMMITTEES, AND COALITIONS TO ENHANCE COMMUNITY HEALTH. - 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. - FOOD INSECURITY SUPPORT: ASSISTANCE INCLUDED CALFRESH SCREENING, THE SCRIPPS MERCY WIC PROGRAM, AND IDENTIFICATION OF SOCIAL DETERMINANTS OF HEALTH. - GRADUATE MEDICAL EDUCATION DIVERSITY, EQUITY, INCLUSION, AND BELONGING COMMITTEE: THIS COMMITTEE AND CURRICULUM FOSTER A MORE DIVERSE HEALTHCARE WORKFORCE BY ENSURING THAT RESIDENTS AND FELLOWS ARE EDUCATED IN AN ENVIRONMENT THAT REFLECTS AND RESPECTS DIVERSITY. - HEALTH EDUCATION AND COMMUNITY ENGAGEMENT: SCRIPPS DELIVERED CLASSES, PREVENTION LECTURES, SUPPORT GROUPS, AND PARTICIPATED IN HEALTH FAIRS AND EVENTS TO ADDRESS COMMUNITY NEEDS. - HEART HEALTH AND CARDIOVASCULAR DISEASE PREVENTION: ACTIVITIES AND PROGRAMS TARGETED HEART HEALTH, STROKE, AND CARDIOVASCULAR DISEASE PREVENTION AND TREATMENT. - MEDICAL LEGAL PARTNERSHIP WITH CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY: THIS PARTNERSHIP EDUCATED CONSUMERS ON HEALTHCARE BENEFITS, ELIGIBILITY, AND COVERAGE PROGRAM CHANGES. - MEDICATION PATIENT FINANCIAL ASSISTANCE PROGRAM: THE PROGRAM SERVES UNINSURED, UNDERINSURED, AND INSURED PATIENTS BY IDENTIFYING GRANTS AND MANUFACTURER FUNDING FOR COSTLY MEDICATIONS, ENSURING ACCESS WITHOUT FINANCIAL HARDSHIP. - MEDICALLY TAILORED MEALS: SCRIPPS REFERS CONGESTIVE HEART FAILURE (CHF) PATIENTS TO MAMA'S KITCHEN FOR MEDICALLY TAILORED MEALS AIMED AT REDUCING HOSPITAL READMISSIONS AND ENHANCING QUALITY OF LIFE. - MOBILE HEALTH AND RESOURCE FAIR IN SOUTHEAST SAN DIEGO: SCRIPPS PARTNERED WITH THIS YMCA-BASED FAIR TO ADDRESS HEALTHCARE NEEDS, OFFERING CARDIOVASCULAR AND NEUROCOGNITIVE SCREENINGS, RESOURCES, AND BREAST CANCER SCREENING REFERRALS TO UNDERSERVED POPULATIONS. - PROMOTORAS IN ACTION: PREVENTION, EDUCATION, AND WELLNESS: THIS COMMUNITY-BASED INITIATIVE TRAINS 20 COMMUNITY HEALTH WORKERS-KNOWN AS PROMOTORAS-WHO SHARE CULTURALLY RELEVANT HEALTH INFORMATION AND CONNECT RESIDENTS TO HEALTHCARE RESOURCES IN SAN DIEGO'S SOUTH BAY. - RECUPERATIVE CARE PARTNERSHIPS: THIS INITIATIVE OFFERED SAFE DISCHARGES FOR CHRONICALLY HOMELESS PATIENTS WITH ONGOING MEDICAL NEEDS. - RESIDENTS AT SCRIPPS GREEN COMMUNITY SERVICE PROJECTS: RESIDENTS PARTICIPATED IN GROUP-LED INITIATIVES ADDRESSING SOCIAL BARRIERS TO HEALTH AS PART OF THE INTERNAL MEDICINE CURRICULUM. - SERVICES FOR SENIORS: PROGRAMS INCLUDED FALL PREVENTION, WELLNESS EDUCATION, AND THE ADVANCED CARE CLINIC FOR ADULTS WITH MULTIPLE CHRONIC DISEASES. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) - SCRIPPS MERCY SAN DIEGO INTERNAL MEDICINE FACULTY AND RESIDENTS FLU VACCINE OUTREACH: IN FY2025, FACULTY AND RESIDENTS ADMINISTERED FLU VACCINES TO 68 SHELTER RESIDENTS FROM LOCAL COMMUNITY-BASED PROGRAMS. - SUBSTANCE USE DISORDER SERVICE (SUDS): SUDS NURSES ASSISTED PATIENTS AT RISK FOR OR EXPERIENCING DETOX FROM ADDICTIVE SUBSTANCES WITHIN THE SCRIPPS HEALTH SYSTEM. - SUPPORT FOR COMMUNITY CLINICS: SPONSORSHIPS, GRANTS, AND CLINICAL PARTNERSHIPS WERE PROVIDED TO COMMUNITY CLINICS TO ENHANCE HEALTHCARE ACCESS AND SERVICES. - SUPPORTIVE MENTAL HEALTH SERVICES: THESE SERVICES WERE OFFERED AT LOCAL COMMUNITY-BASED CLINICS. - TEACHING HEALTH CENTER PSYCHIATRIC RESIDENCY PROGRAM: THIS PROGRAM ADDRESSES THE PSYCHIATRIST SHORTAGE AND ENHANCES BEHAVIORAL HEALTH SERVICES IN SAN DIEGO. IN COLLABORATION WITH FHCSD, SCRIPPS MERCY HOSPITAL HOSTS SIX PGY-1 RESIDENTS FOR TRAINING IN CO-OCCURRING MEDICAL AND BEHAVIORAL HEALTH CONDITIONS DURING ACADEMIC YEAR 2024-2025. - TRANSPORTATION SERVICES: SCRIPPS PARTNERED WITH FACILITATING ACCESS TO COORDINATED TRANSPORTATION (FACT), INC. TO OFFER ON-DEMAND RIDES FOR PATIENTS TRAVELING TO MEDICAL APPOINTMENTS. 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 2025, SCRIPPS CONTRIBUTED $752,318,951 IN UNCOMPENSATED HEALTH CARE, INCLUDING $18,663,224 IN CHARITY CARE, $721,588,751 IN MEDI-CAL AND MEDICARE SHORTFALL, AND $12,066,976 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. 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. THE PROVIDER FEE PROGRAM FOR THE PERIOD OF JANUARY 1, 2025, THROUGH DECEMBER 31, 2025, IS PENDING APPROVAL BY THE FEDERAL GOVERNMENT. AS THE RELATED REVENUE AND EXPENSE HAVE NOT MET THE CRITERIA FOR RECOGNITION, THEY ARE NOT INCLUDED IN THE ORGANIZATION'S FINANCIAL STATEMENTS FOR 2025. INCLUDED IN THE RESULTS FOR THE YEAR ENDED SEPTEMBER 30, 2024, IS $25,936,000 OF NET PROVIDER FEE PROGRAM REVENUE RELATED TO THE TIMING OF PROGRAM APPROVAL FROM THE PREVIOUS FISCAL YEAR. SCRIPPS MERCY HOSPITAL (INCLUDING SAN DIEGO AND CHULA VISTA CAMPUSES) PROVIDES 55% 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 2025 (OCTOBER 2024 TO SEPTEMBER 2025), SCRIPPS INVESTED $45,670,641 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 FY25. 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 HEALTH IS KNOWN FOR PROVIDING HIGH QUALITY AND PATIENT-CENTERED CARE, WITH A LONG LEGACY OF IMPROVING THE HEALTH OF THE SAN DIEGO COMMUNITY. THAT LEGACY IS STRENGTHENED BY TRAINING NEW PHYSICIANS TO BE FUTURE LEADERS IN MEDICINE THROUGH ITS GRADUATE MEDICAL EDUCATION (GME). TODAY, SCRIPPS GME PROGRAM SPANS ALL FIVE HOSPITAL CAMPUSES AND SCRIPPS CLINIC. AFTER FOUR YEARS OF MEDICAL SCHOOL, NEW DOCTORS EMBARK ON A DEMANDING RESIDENCY PROGRAM LASTING FOUR TO FIVE YEARS. UNDER THE GUIDANCE OF EXPERIENCED ATTENDING PHYSICIANS, THEY ROTATE THROUGH VARIOUS HOSPITAL DEPARTMENTS, GAINING VITAL REAL-WORLD EXPERIENCE IN TRAUMA, INTENSIVE CARE, CARDIOLOGY, ONCOLOGY AND OTHER SPECIALTIES. THERE ARE RESIDENCY PROGRAMS FOR INTERNAL MEDICINE, FAMILY MEDICINE, TRANSITIONAL YEAR, PHARMACY AND PODIATRY AND FELLOWSHIPS AND SUBSPECIALTY TRAINING IN INTERNAL MEDICINE, FAMILY MEDICINE, CARDIOLOGY, DERMATOLOGY, PODIATRY, HEMATOLOGY/ONCOLOGY, ORTHOPEDICS, TRAUMA, PHARMACY, PALLIATIVE CARE, EMERGENCY AND SURGICAL CRITICAL CARE GASTROENTEROLOGY, ENDOCRINOLOGY AS WELL AS RESEARCH-FOCUSED PROGRAMS. THESE PROGRAMS ARE RENOWNED FOR THEIR COMMITMENT TO EXCELLENCE AND FEATURE A HANDS-ON CURRICULUM THAT PLACES A STRONG EMPHASIS ON PATIENT-CENTERED CARE. 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. RESIDENTS ROTATE THROUGH COMMUNITY-BASED FACILITIES ACROSS SAN DIEGO, GAINING EXPERIENCE ADDRESSING HEALTH DISPARITIES WHILE PROVIDING VITAL MEDICAL CARE. BEYOND CLINICAL WORK, THEY MENTOR HIGH SCHOOL STUDENTS, VOLUNTEER WITH SAN DIEGO REFUGEE TUTORING, AND SUPPORT NONPROFITS BY PROVIDING VACCINES TO INDIVIDUALS EXPERIENCING HOMELESSNESS AND DOMESTIC VIOLENCE-BUILDING BOTH COMMUNITY HEALTH AND THE NEXT GENERATION OF COMPASSIONATE MEDICAL LEADERS. IN FISCAL YEAR 2025, SCRIPPS ENROLLED A TOTAL OF 167 MEDICAL RESIDENTS, 48 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. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) 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. *COLLABORATE 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: *PREPARE DOCTORS FOR HOSPICE AND PALLIATIVE CARE. *DESIGNED FOR PHYSICIANS SEEKING A SUBSPECIALTY. *PROVIDES TRAINING FOR DIVERSE CARE SETTINGS. 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 2025, SCRIPPS HOSTED 1,473 STUDENTS WITHIN OUR SYSTEM AND PROVIDED 244,088 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 2025, SCRIPPS CLINIC MEDICAL GROUP HOSTED 86 PRECEPTORSHIP ROTATIONS FOR NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS, TOTALING 10,750 HOURS OF COMPLETED TRAINING. SIMILARLY, SCRIPPS COASTAL MEDICAL GROUP PROVIDED 20 PRECEPTORSHIP ROTATIONS, ACCOUNTING FOR 2,154 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 CAREER PATHWAY 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 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 2025 (OCTOBER 2024 TO SEPTEMBER 2025), SCRIPPS INVESTED $5,833,928 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. HEALTH OUTCOMES INFORMATION CENTER (HOIC) THE HEALTH OUTCOMES INFORMATION CENTER (HEIC) IS A KNOWLEDGE REPOSITORY FUNDED BY THE KRUEGER-WYETH (KW) AWARD, OFFERING DATA, RESEARCH, AND INSIGHTS ON HEALTH EQUITY. HOIC WAS CREATED IN 2023 TO IDENTIFY AND DEEPEN SCRIPPS UNDERSTANDING OF HEALTH DIFFERENCES IN CLINICAL QUALITY IN THE POPULATIONS SERVED BY SCRIPPS AND ACROSS THE REGION, AND TO SUPPORT SCRIPPS'S EFFORTS TO REDUCE THESE DIFFERENCES. IT IS A COLLECTION OF THE LATEST DATA, ORIGINAL ANALYTICS RESEARCH, AND BUSINESS INTELLIGENCE INFORMATION. IT SERVES AS A RESEARCH AND DEVELOPMENT RESOURCE FOR SCRIPPS GROUPS CURRENTLY PROVIDING EQUITY-FOCUSED CARE AND A SPRINGBOARD TO DEVELOP FUTURE ENTERPRISE HEALTH EQUITY STRATEGIES. THE GOAL IS TO ENHANCE AND SHARE THE COLLECTIVE KNOWLEDGE OF SCRIPPS REGIONAL AND LOCAL EFFORTS TO ADDRESS DIFFERENCES IN CLINICAL QUALITY, AREAS OF NEED AND OPPORTUNITY, AND THE HOLISTIC PROBLEMS AFFECTING PATIENTS IN THEIR COMMUNITIES BEYOND THE WALLS OF OUR HEALTH SYSTEM. HOIC IS SUPPORTED AND MAINTAINED BY THE HEALTH DATA SCIENCE TEAM IN CONJUNCTION WITH OTHER ANALYTICS GROUPS, THE SCRIPPS COLLABORATIVE FOR HEALTH EXCELLENCE (SCHE), AND THE COMMUNITY BENEFITS AND GOVERNMENT RELATIONS TEAMS. SCRIPPS COLLABORATIVE FOR HEALTH EXCELLENCE SCRIPPS COLLABORATIVE FOR HEALTH EXCELLENCE PROVIDES RESEARCH OPPORTUNITIES FOR HEALTH CARE PROFESSIONALS AND MEDICAL TRAINEES INTERESTED IN RESEARCH IN THE AREAS OF BREAST CANCER, CARDIOVASCULAR DISEASE, AND NEUROCOGNITIVE CONDITIONS. THE COLLABORATIVE PROMOTES BETTER HEALTH OUTCOMES THROUGH INITIATIVES AND KEY PROGRAMS THAT ARE FOCUSED ON WORKFORCE DIVERSITY, INCLUSION IN RESEARCH, AND ACCESS TO HIGH-QUALITY, CULTURALLY COMPETENT HEALTH CARE FOR PATIENTS FROM ALL BACKGROUNDS. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) CASH, GRANTS AND IN-KIND CONTRIBUTIONS SCRIPPS PROVIDED $1,027,760 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 FY25: - 211 SAN DIEGO CONNECTIONS LUNCHEON: SCRIPPS SPONSORED THE 211 SAN DIEGO LUNCHEON CELEBRATING 20 YEARS OF SERVICE. - AMERICAN HEART ASSOCIATION - GO RED FOR WOMEN LUNCHEON: SPONSORED TO UNITE WOMEN NATIONWIDE IN COMBATING HEART DISEASE AND STROKE, WHILE ADDRESSING LOCAL COMMUNITY NEEDS. - CALIFORNIA HEALTH FOUNDATION AND TRUST: SUPPORTED CHARITABLE HEALTHCARE ACTIVITIES IN HOSPITALS ACROSS CALIFORNIA. - CONSUMER CENTER FOR HEALTH EDUCATION AND ADVOCACY (CCHEA): FUNDED ASSISTANCE FOR LOW-INCOME, UNINSURED SCRIPPS MERCY PATIENTS IN OBTAINING HEALTHCARE BENEFITS, HELPING REDUCE UNCOMPENSATED CARE EXPENSES. - ERIC PAREDES SAVE A LIFE FOUNDATION: PARTNERED TO PREVENT SUDDEN CARDIAC ARREST IN MIDDLE AND HIGH SCHOOL STUDENTS ACROSS SAN DIEGO, PROVIDING GRANTS AND VOLUNTEERS FOR SCREENINGS. - FACILITATING ACCESS TO COORDINATED TRANSPORTATION (FACT): SCRIPPS SPONSORED FACT'S ANNUAL BOARD MEETING AND CONTINUES TO COLLABORATE WITH THE ORGANIZATION TO PROVIDE ON-DEMAND TRANSPORTATION SERVICES FOR PATIENTS. - FAMILY HEALTH CENTERS OF SAN DIEGO - PARTNERSHIP: ENHANCED HEALTHCARE SERVICES FOR UNDERSERVED PATIENTS AT THE INTERNAL MEDICINE OUTPATIENT CLINIC THROUGH A LONG-TERM AGREEMENT. - FAMILY HEALTH CENTERS OF SAN DIEGO - SPIRIT OF THE BARRIO: SPONSORED THIS COMMUNITY EVENT RAISING AWARENESS FOR HEALTHCARE ACCESS IN UNDERSERVED POPULATIONS. - FATHER JOE'S VILLAGES - NUTRITIONAL SUPPLEMENTS: SCRIPPS DONATED 50 CASES OF ENSURE NUTRITIONAL SUPPLEMENT TO SUPPORT RESIDENTS AND CLIENTS SERVED BY FATHER JOE'S VILLAGES. - FATHER JOE'S VILLAGES - SCRIPPS PAY IT FORWARD BLANKET DRIVE: HELD DURING SCRIPPS SPIRIT WEEK, THIS SYSTEMWIDE EFFORT COLLECTED AND DONATED 204 BLANKETS (VALUED AT $5,712) TO SUPPORT INDIVIDUALS EXPERIENCING HOMELESSNESS. DONATIONS WERE DISTRIBUTED THROUGH SHELTERS, DAY CENTERS, AND WEATHER-RESPONSE EVENTS. - FEEDING SAN DIEGO - EMERGENCY MEALS AND WATER: SCRIPPS MAINTAINS AN EMERGENCY SUPPLY OF MEALS AND WATER, REPLENISHING REGULARLY AND DONATING OLDER ITEMS. IN FY25, SCRIPPS DONATED 75 CASES OF WATER VALUED AT $435 TO FEEDING SAN DIEGO. - GREATER LA JOLLA MEALS ON WHEELS: PROVIDED OFFICE SPACE TO SUPPORT MEAL DELIVERIES FOR SENIORS AND INDIVIDUALS WITH DISABILITIES IN LA JOLLA. - HEALTHY START FAMILIES: BIRTH AND BEYOND: PARTNERED WITH GLOBAL COMMUNITIES/HEALTHY START BY PROVIDING SPACE FOR WEEKLY SESSIONS SUPPORTING CULTURALLY SENSITIVE CARE TO IMPROVE MATERNAL AND INFANT HEALTH OUTCOMES. - LA MAESTRA COMMUNITY HEALTH CENTER: DONATED TO SUPPORT LA MAESTRA'S ANNUAL FUNDRAISING EVENT BENEFITING COMMUNITY HEALTH PROGRAMS. - LIFELINE COMMUNITY SERVICES: SPONSORED THE 2025 VIVA LA VIDA! CELEBRATION FOR LIFELINE COMMUNITY SERVICES, WHICH DELIVERS OVER 35 CLINICALLY STRONG, EVIDENCE-BASED PROGRAMS ACROSS SAN DIEGO COUNTY. - MENTAL HEALTH ASSOCIATION OF SAN DIEGO - MEETING OF THE MINDS: SPONSORED THE ANNUAL CONFERENCE SERVING CONSUMERS, PROVIDERS, AND THE BROADER COMMUNITY. - OPERATION RESTORE SIGHT: DONATED OPTICAL LENSES AND SUPPLIES TO SUPPORT SIGHT RESTORATION EFFORTS. - RAD-AID INTERNATIONAL: DONATED BARCO MONITORS-HIGH-RESOLUTION DIAGNOSTIC DISPLAYS USED BY RADIOLOGISTS FOR MAMMOGRAPHY INTERPRETATION-TO ENHANCE RADIOLOGY CAPACITY. - SAN YSIDRO HEALTH CENTER: CONTINUED ANNUAL CORPORATE PARTNERSHIP, INCLUDING SPONSORSHIP OF THE SPRING INTO HEALTH BRUNCH. - THE SAN DIEGO LGBTQIA+ COMMUNITY CENTER: SPONSORED THIS NATIONALLY RECOGNIZED ORGANIZATION PROMOTING LGBTQIA+ HEALTH AND HUMAN RIGHTS, PROVIDING DIVERSE PROGRAMS AND SERVICES INCLUDING HIV SUPPORT. - TURKEY GIVEAWAY AND HEALTH RESOURCE FAIR: SCRIPPS SUPPORTED THE TURKEY GIVEAWAY AND HEALTH RESOURCE FAIR EVENT IN EAST SAN DIEGO DISTRIBUTED 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. 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 2025 WAS $3,356,919. 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 2025, THE SCRIPPS MERCY BEHAVIORAL HEALTH PROGRAM REPORTED A TOTAL OPERATIONAL LOSS OF $9.4 MILLION, WITH $5.8 MILLION ATTRIBUTED TO MEDI-CAL, OR OTHER MEANS TESTED GOVERNMENT PROGRAMS AND CHARITY CARE. NOTABLY, 1.2% 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 FY25, SCRIPPS INVESTED $534,691 IN COMMUNITY BUILDING ACTIVITIES. THE FOLLOWING ARE THE COMMUNITY BUILDING ACTIVITIES THAT SCRIPPS PARTICIPATED IN. PHYSICAL IMPROVEMENTS / HOUSING - LEADERSHIP RETREAT VOLUNTEER SERVICE DAY: SCRIPPS LEADERS PARTICIPATED IN VOLUNTEER PROJECTS IMPROVING FACILITIES AT NONPROFIT HOMELESS SERVICE PROVIDERS. ECONOMIC DEVELOPMENT - EXECUTIVE LEADERSHIP: COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS: SCRIPPS LEADERS SERVED ON COMMUNITY BOARDS TO ADVOCATE FOR HEALTH AND SAFETY PRIORITIES. - MERCY SAN DIEGO: COMMUNITY BOARDS AND BUSINESS ORGANIZATIONS: SCRIPPS MERCY SAN DIEGO LEADERS ENGAGED WITH LOCAL BUSINESS AND CIVIC GROUPS TO ADVANCE HEALTH AND COMMUNITY WELL-BEING. COMMUNITY SUPPORT - CELEBRANDO LATINAS: SPONSORED THE NATION'S LARGEST SPANISH-LANGUAGE WOMEN'S EMPOWERMENT AND WELLNESS CONFERENCE. - CHICANO FEDERATION: SUPPORTED EVENTS PROMOTING FAMILY, HOUSING, EDUCATION, AND COMMUNITY DEVELOPMENT PROGRAMS. - DISASTER PREPAREDNESS - ACTIVE SHOOTER DRILL: PARTNERED WITH LAW ENFORCEMENT TO CONDUCT AN ACTIVE SHOOTER TRAINING EXERCISE AT SCRIPPS LA JOLLA. - DISASTER PREPAREDNESS - COMMUNITY SUPPORT AND OUTREACH EDUCATION: LED PREPAREDNESS OUTREACH TO STRENGTHEN COMMUNITY READINESS FOR EMERGENCIES. - EQUALITY CALIFORNIA: SPONSORED THE EQUALITY AWARDS RECOGNIZING LEADERSHIP IN ADVANCING LGBTQIA+ CIVIL RIGHTS. - HOSPITAL INCIDENT COMMAND SYSTEM (HICS) NATIONAL ADVISORY COMMITTEE: HOSTED AND PARTICIPATED IN NATIONAL HICS TRAINING TO IMPROVE EMERGENCY RESPONSE CAPACITY. - LGBTQIA+ VICTORY INSTITUTE: SPONSORED LEADERSHIP DEVELOPMENT AND ADVOCACY EVENTS PROMOTING LGBTQIA+ REPRESENTATION. - SAN DIEGO COUNTY ADVISORY GROUPS: SERVED ON ADVISORY GROUPS SUPPORTING COUNTYWIDE DISASTER PREPAREDNESS PLANNING. - SAN DIEGO COUNTY COALITION SURGE TEST: PARTICIPATED IN A REGIONAL EMERGENCY DRILL SIMULATING PEDIATRIC PATIENT SURGE. - SAN DIEGO COUNTY OPERATIONAL AREA FULL-SCALE EXERCISE: JOINED A REGIONAL MASS-CASUALTY PREPAREDNESS EXERCISE WITH HOSPITALS AND FIRST RESPONDERS. - SAN DIEGO HEALTHCARE DISASTER COALITION (SDHDC): COLLABORATED WITH REGIONAL PARTNERS TO STRENGTHEN EMERGENCY PREPAREDNESS AND COORDINATION. - SAN DIEGO LGBT PRIDE INC.: SPONSORED AND PARTICIPATED IN THE ANNUAL SAN DIEGO PRIDE PARADE AND 5K WALK. - SAN DIEGO REGIONAL FULL-SCALE EXERCISE: TOOK PART IN A COUNTYWIDE MEDICAL AND HEALTH EVACUATION DRILL TESTING COMMAND CENTER CAPABILITIES. - SCRIPPS MEDICAL RESPONSE TEAM (SMRT): MAINTAINED A VOLUNTEER EMERGENCY MEDICAL TEAM READY TO DEPLOY FOR STATEWIDE DISASTERS. - THE SAN DIEGO ORGANIZATION OF HEALTHCARE LEADERS (SOHL): SPONSORED THE ANNUAL HEALTHCARE LEADERSHIP AND EDUCATION CONFERENCE. COALITION BUILDING - CHULA VISTA COMMUNITY COLLABORATIVE (CVCC): PARTICIPATED IN MONTHLY COALITION MEETINGS FOCUSED ON COMMUNITY HEALTH, SAFETY, AND EMPOWERMENT. - SOUTH COUNTY ACTION NETWORK (SOCAN): PARTNERED WITH SERVICE PROVIDERS TO IMPROVE CARE AND ADVOCACY FOR OLDER ADULTS AND ADULTS WITH DISABILITIES. COMMUNITY HEALTH IMPROVEMENT ADVOCACY - COMMUNITY ENGAGEMENT PARTNERSHIPS AND ADVISORY BOARDS: GATHERED COMMUNITY INPUT TO INFORM SCRIPPS PROGRAMS AND ENSURE CULTURALLY RESPONSIVE INITIATIVES. WORKFORCE DEVELOPMENT - CRISTO REY WORK STUDY PROGRAM: HOSTED STUDENTS FOR PAID PROFESSIONAL EXPERIENCE IN HOSPITAL DEPARTMENTS TO ENCOURAGE HEALTHCARE CAREERS. - LEGISLATIVE DAY AT SCRIPPS MERCY HOSPITAL CHULA VISTA: ENGAGED LOCAL AND STATE POLICY STAFF IN HANDS-ON LEARNING ABOUT SCRIPPS' COMMUNITY BENEFIT PROGRAMS. - MANA DE SAN DIEGO (MANASD): SPONSORED PROGRAMS SUPPORTING LATINA LEADERSHIP, EDUCATION, AND CAREER ADVANCEMENT. - NORTH COUNTY AFRICAN AMERICAN WOMEN'S ASSOCIATION: SPONSORED SCHOLARSHIPS AND PROGRAMS SUPPORTING WOMEN AND GIRLS PURSUING EDUCATION AND WORKFORCE DEVELOPMENT. - SAN YSIDRO WOMEN'S CENTER: SPONSORED SCHOLARSHIP FUNDRAISING SUPPORTING LOCAL HIGH SCHOOL STUDENTS IN SAN YSIDRO. - SCRIPPS HIGH SCHOOL EXPLORATION INTERNSHIP PROGRAM: HOSTED HIGH SCHOOL STUDENTS FOR HOSPITAL-BASED INTERNSHIPS EXPLORING HEALTHCARE CAREERS. - SCRIPPS SCHOOL TO HEALTH CAREER PATHWAY PROGRAMS: INTRODUCED OVER 2,000 STUDENTS TO HEALTHCARE PROFESSIONS THROUGH MENTORING AND CLASSROOM ENGAGEMENT. - YOUNG LEADERS IN HEALTHCARE PROGRAM: PROVIDED HEALTH CAREER EDUCATION AND LEADERSHIP SESSIONS FOR HIGH SCHOOL STUDENTS IN NORTH COUNTY. ADVANCING HEALTH: PROGRAMS AND SERVICES SCRIPPS HAS BEEN ENGAGED IN A BROAD RANGE OF PROGRAMS AND INITIATIVES THAT PROMOTE BETTER HEALTH FOR PEOPLE THROUGHOUT OUR COMMUNITY FOR MANY YEARS. BELOW ARE SOME EXAMPLES, WITH FURTHER DETAILS ON THESE PROGRAMS IN THE 2026 SCRIPPS COMMUNITY BENEFIT PLAN AND REPORT. - AGING CARE AND SUPPORT: ENHANCE THE HEALTH, SAFETY, AND QUALITY OF LIFE FOR OLDER ADULTS AND INDIVIDUALS WITH AGING-RELATED CONCERNS THROUGH ACCESSIBLE, TARGETED PROGRAMS AND SERVICES. STRATEGIES INCLUDE PROACTIVE MEDICAL AND SOCIAL SUPPORT FOR ADULTS WITH MULTIPLE CHRONIC CONDITIONS, PARTNERSHIPS WITH SENIOR CENTERS, CHURCHES, AND SENIOR HOUSING, AND SENIOR HEALTH CHATS TO PROVIDE EDUCATION TO THE OLDER ADULT COMMUNITY. - BEHAVIORAL HEALTH: REDUCE THE IMPACT OF BEHAVIORAL HEALTH CONDITIONS BY STRENGTHENING THE CONTINUUM OF CARE AND INTEGRATING PRIMARY AND MENTAL HEALTH SERVICES TO IMPROVE PATIENT OUTCOMES. STRATEGIES INCLUDE EXPANDING COMMUNITY-BASED SUPPORT, VOCATIONAL TRAINING, AND INITIATIVES TO REDUCE OPIOID USE AND SUBSTANCE ABUSE. - CANCER: REDUCE THE IMPACT OF CANCER BY EXPANDING ACCESS TO EDUCATION, RESOURCES, AND SUPPORTIVE SERVICES THAT EMPOWER PATIENTS AND THE COMMUNITY. STRATEGIES INCLUDE FREE ONLINE NUTRITION AND FITNESS CLASSES, DIVERSE SUPPORT GROUPS, A DEDICATED WIG BOUTIQUE, AND AN EXTENSIVE RESOURCE LIBRARY. FORM 990, PART III, LINE 4A PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED) - CARDIOVASCULAR DISEASE: REDUCE THE PREVALENCE AND IMPACT OF CARDIOVASCULAR DISEASE, STROKE, AND HYPERTENSION THROUGH PREVENTION, EDUCATION, SCREENINGS, AND WELLNESS PROGRAMS, WHILE SUPPORTING INDIVIDUALS IN MANAGING CHRONIC CONDITIONS. STRATEGIES INCLUDE SUDDEN CARDIAC ARREST (SCA) SCREENINGS, VIRTUAL CARDIAC REHABILITATION, CARDIOMETABOLIC HEALTH EDUCATION, AND INITIATIVES TO IMPROVE FOOD SECURITY. - COMMUNITY OUTREACH: SUPPORT HOMELESS, FOOD-INSECURE, AND LOW-INCOME PATIENTS WHO ARE UNINSURED OR UNDER-INSURED THROUGH PROGRAMS DESIGNED TO SUPPLEMENT THEIR HEALTHCARE AND ADDRESS BROADER LIVING NEEDS. STRATEGIES INCLUDE PROVIDING TARGETED RESOURCES, CONNECTING PATIENTS WITH SUPPORTIVE SERVICES, AND OFFERING PROGRAMS THAT ENHANCE OVERALL HEALTH AND WELL-BEING. - DIABETES: REDUCE THE PREVALENCE AND IMPACT OF DIABETES THROUGH PREVENTION, EARLY DETECTION, QUALITY CARE, AND COMPREHENSIVE MANAGEMENT PROGRAMS, WITH A FOCUS ON VULNERABLE AND UNDERSERVED POPULATIONS. STRATEGIES INCLUDE EXPANDING ACCESS TO EDUCATION, SUPPORTING RESEARCH, AND DELIVERING BOTH IN-PERSON AND VIRTUAL PREVENTION AND MANAGEMENT PROGRAMS. - HEALTH CARE RESEARCH: IDENTIFY HOW TO MEASURE HEALTH OUTCOMES THROUGH THE WORK OF THE SCRIPPS COLLABORATIVE FOR HEALTH EXCELLENCE, RELATED RESEARCH GRANTS, THE HEALTH OUTCOMES CENTER, AND MORE. - 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: STRENGTHEN ACCESS TO CARE AND IMPROVE HEALTH OUTCOMES BY TRAINING FUTURE PHYSICIANS TO PROVIDE HIGH-QUALITY, COMPASSIONATE CARE AND FOSTER MEANINGFUL PARTNERSHIPS WITH UNDERSERVED COMMUNITIES. STRATEGIES INCLUDE SUPPORTING PHYSICIAN TRAINING, CLINICAL RESEARCH, RESIDENCY PROGRAMS, AND CURRICULA FOCUSED ON ADVANCING DIFFERENCES, REDUCING BIAS, AND CARING FOR VULNERABLE POPULATIONS. - YOUTH CAREER PATHWAYS/PIPELINE PROGRAMS: INSPIRE, PREPARE, AND SUSTAIN THE NEXT GENERATION OF HEALTHCARE PROFESSIONALS BY INVESTING IN PROGRAMS THAT PROVIDE EDUCATION, MENTORSHIP, TRAINING, AND CAREER DEVELOPMENT-WHILE SUPPORTING DIVERSITY AND CULTURAL COMPETENCE IN UNDERSERVED COMMUNITIES. STRATEGIES INCLUDE PROMOTING HEALTHCARE CAREERS THROUGH INTERNSHIPS, OUTREACH, SCHOLARS' PROGRAMS, AND RELATED INITIATIVES. 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 AND CONFLICT OF 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 OF 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 04, 2024, JANUARY 25, 2025, AND MARCH 27, 2025. 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 04, 2024, JANUARY 25, 2025, AND MARCH 27, 2025. 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: 20204770, RELATED OR EXEMPT FUNCTION REVENUE: 19790667, UNRELATED BUSINESS REVENUE: 414103, REVENUE EXCLUDED FROM TAX UNDER SECTIONS 512, 513, OR 514: ; RENTAL INCOME - MOB - TOTAL REVENUE: 14183879, RELATED OR EXEMPT FUNCTION REVENUE: 14183879, UNRELATED BUSINESS REVENUE: , 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: , FUNDRAISING EXPENSES: ; OTHER PURCHASED SVS - NON MED - TOTAL EXPENSE: 88288612, PROGRAM SERVICE EXPENSE: 77612039, MANAGEMENT AND GENERAL EXPENSES: 10324039, FUNDRAISING EXPENSES: 352534; PHYSICIAN FEES - TOTAL EXPENSE: XXX-XX-XXXX, PROGRAM SERVICE EXPENSE: XXX-XX-XXXX, MANAGEMENT AND GENERAL EXPENSES: 85635, FUNDRAISING EXPENSES: ; PURCHASED MEDICAL SERVICES - TOTAL EXPENSE: 32979686, PROGRAM SERVICE EXPENSE: 32979686, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; - TOTAL EXPENSE: , PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES CHANGE IN VALUE OF DEFERRED GIFTS - 11236050; JOINT VENTURE DISTRIBUTION - 957283; OTHER CHANGES IN NET ASSETS - -343998; ROUNDING - -2777; OTHER - 8242000; TOTAL - 20088558; SCRIPPS CLINIC BILLING LLC 4555 EXECUTIVE DR SAN DIEGO CA 92121 870797749 HLTHCR ADMIN CA 662289316 0 SCRIPPS HLTH SCRIPPS MERCY BILLING LLC 4555 EXECUTIVE DR SAN DIEGO CA 92121 870737748 HLTHCR ADMIN CA 94449390 0 SCRIPPS HLTH IMAGING HEALTHCARE SPECIALISTS LLC 4555 EXECUTIVE DR SAN DIEGO CA 92121 203872122 MED IMAGING CA 63210363 53520947 IHS HOLDING SCRIPPS HOSPITAL MEDICAL BILLING SERVICES LLC 4555 EXECUTIVE DR SAN DIEGO CA 92121 611677183 HLTHCR ADMIN CA 9867519 0 SCRIPPS HLTH SCRIPPS CARDIO&THORACTIC SURGERY BILLING 4555 EXECUTIVE DR SAN DIEGO CA 92121 270620996 HLTHCR ADMIN CA 6887671 0 SCRIPPS HLTH MAXWELL H & MURIEL GLUCK CHILD CARE CTR 4555 EXECUTIVE DR SAN DIEGO CA 92121 831953045 CHILDCARE CA 2446695 1741449 SCRIPPS HLTH SCRIPPS ACCOUNTABLE CARE ORGANIZATION 4555 EXECUTIVE DR SAN DIEGO CA 92121 364837442 HLTHCR ADMIN CA 2152236 4801339 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 35778368 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 1160538 0 SCRIPPS HLTH CARMEL VALLEY RISK MANAGEMENT LLC 677 ALA MOANA BOULEVARD SUITE 316 HONOLULU HI 96813 322842914 INSURANCE CAPTIVE HI 22794000 0 SCRIPPS HEALTH LA JOLLA COVE RISK MANAGEMENT LLC 677 ALA MOANA BOULEVARD SUITE 316 HONOLULU HI 96813 332813400 INSURANCE CAPTIVE HI 0 527258 SCRIPPS HEALTH 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 5058859 2395084 false false 0.575 SCRIPPSUSP SURGERY CTR 15305 DALLAS PKWY STE 1600 LB 28 ADDISON TX 75001 205942911 AMBUL SURGERY CTR CA NA RELATED 147955 887855 false false 0.5 SCRIPPS MERCY AMBUL SURG CTR 4555 EXECUTIVE DR SAN DIEGO CA 92121 450503246 AMBUL SURGERY CTR CA SCRIPPS HEALTH RELATED 8290115 3561855 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 212360 2264237 false true 0.1031 VIBRA HOSPITAL OF SAN DIEGO LLC 4714 GETTYSBURG ROAD MECHANICSBURG PA 10755 261466122 LT ACUTE CARE DE SCRIPPS HEALTH RELATED -84595 11700111 false false 0.245 CHARITABLE REMAINDER TRUST (27) 4555 EXECUTIVE DR SAN DIEGO CA 92121 HOSPITAL SUPPORT CA NA TRUST true CHARITABLE LEAD TRUST (1) 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 ENCINITAS SURGERY CENTER A 424274 ACCRUAL SCRIPPS MERCY AMBULATORY SURGERY CENTER A 241885 ACCRUAL SCRIPPS HEALTH PLAN SERVICES J 121470 ACCRUAL SCRIPPS HEALTH PLAN SERVICES L 281327462 ACCRUAL SCRIPPS HEALTH PLAN SERVICES M 58746349 ACCRUAL SCRIPPS HEALTH PLAN SERVICES Q 25100574 ACCRUAL SCRIPPS HEALTH PLAN SERVICES N 123765 FMV