Sharp Healthcare

“Director Considine, Director McMillan, Director Moore and Director Morton have a business relationship.”

“The final Form 990 is placed on the organization's intranet, prior to the filing date, where it is viewable for comment from all members of the governing body. The review process includes multiple levels of review including key corporate and entity finance department personnel comprised of the Director, Tax & Accounting, Vice President of Finance and Senior Vice President and Chief Financial Officer. Additionally, the organization contracts with Ernst & Young, an independent accounting firm, for review of the Form 990.”

“Sharp HealthCare has a written conflict of interest policy which has been reviewed and approved by the Sharp HealthCare governing board. Sharp HealthCare is committed to preventing any Participant of the Corporation from gaining any personal benefit from information received or from any transaction of Sharp. One component of the written conflict of interest policy requires that Board Members, Corporate Officers, Senior Vice Presidents and Chief Executive Officer(s) submit a conflict of interest statement annually to Legal Services/Senior Vice President of Legal Services who will review all statements. In addition, all Vice Presidents and any employees in the Purchasing/Supply Chain, Audit and Compliance, and Case Management/Discharge Planning departments are required to complete an online conflict of interest questionnaire annually that is reviewed by the Conflict Review Committee comprised of employees from Sharp's Legal, Compliance, and Internal Audit departments. In connection with any transaction or arrangement, which may create an actual or possible conflict of interest, the person shall disclose in writing the existence and nature of his/her financial interest and all material facts. Board Members, Corporate Officers, Senior Vice Presidents, and the Chief Executive Officer(s) shall make such disclosures directly to the Chairman of the Board, and to the members of the committee with the board designated powers considering the proposed transaction or arrangement. Upon disclosure of the financial interest and all material facts, the Board Member, Corporate Officer, Senior Vice President or the Chief Executive Officer(s) making such disclosures shall leave the board or the committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In certain instances, such as if someone takes a board seat on a competitor's board of directors or has a role with an organization whereby the information that they may obtain from Sharp would put them in a consistent conflict with their two roles, the conflict could call for the individual's removal from the board. The bylaws for the organization provide for the ability to remove directors in accordance with Section 5222 of the California Corporations Code. This can generally be done on a "for cause" or a "no cause" basis by the action of the member.”

“The Personnel Committee of Sharp HealthCare retains an independent compensation consulting firm to review the total compensation paid to executive management (CEO/President, Executive Vice President of Hospital Operations, and Senior Vice Presidents) and compares it to the total compensation paid to similar positions with like institutions. The information is presented to the Personnel Committee of the Board of Directors by the independent consultant. The Personnel Committee is comprised of Board members who are not physicians and who are not compensated in any way by the organization. The Personnel Committee approves the total compensation for the President/Chief Executive Officer and reviews and approves the compensation and compensation salary ranges for the remainder of the executive team. The Personnel Committee presents its decision to the Board of Directors. The Personnel Committee retains minutes of its meetings. The Compensation and Benefits department engages a third party independent consultant to conduct a compensation study covering officers and key employees. The independent third party compares base salaries to similar positions with like institutions. The information is reviewed by the Compensation and Benefits department and is presented to the President/Chief Executive Officer, the Executive Vice President of Hospital Operations and the appropriate Senior Vice President for review and approval. The compensation study was last conducted in November/December 2013.”

“Policies are considered proprietary information, however in Sharp HealthCare's publicly available Code of Conduct, Sharp outlines its Conflict of Interest policies in a user friendly manner. The annual audited financial statements of the consolidated group are published on the dacbond.com website (www.dacbond.com), are attached to the Form 990 filed for each of the Sharp hospitals, and are available upon request. The annual audited financial statements include combining schedules which disclose the financial results (Balance Sheet, Statement of Operations, Statement of Changes in Net Assets) for each entity of the consolidated group. Quarterly financial statements of Sharp's obligated group are published on the dacbond.com website (www.dacbond.com).”

“ORGANIZATION'S MOST SIGNIFICANT ACTIVITIES The organization's primary exempt purpose is to provide administrative support to its tax-exempt subsidiaries. In addition, outpatient services are provided to patients within the greater San Diego area through multispecialty medical group practices. Community members are offered a number of benefit services to assist them in obtaining treatment, and information is provided on topics ranging from disease prevention to improvement of health status.”

“To promote health care through supporting and/or operating, directly or through wholly-owned subsidiaries and other appropriate management arrangements, hospitals and other medically-related facilities and activities in the State of California. The specific and primary purposes for which this corporation is formed are to support and be responsive to the needs of its publicly supported, tax-exempt subsidiaries.”

“Tax Exempt Bonds are issued for the Sharp HealthCare Obligated Group. As a result, all tax exempt bond balances, including those allocated to other members of the Obligated Group, are reported on the Sharp HealthCare return (EIN 95-6077327). The Sharp HealthCare Obligated Group is comprised of Sharp HealthCare (EIN 95-6077327), Sharp Memorial Hospital (EIN 95-3782169), Grossmont Hospital Corporation (EIN 33-0449527), and Sharp Chula Vista Medical Center (EIN 95-2367304).”

“Medical Fees: Program service expenses 244,935,124. Management and general expenses 119,091. Fundraising expenses 0. Total expenses 245,054,215. Registry: Program service expenses 83,946. Management and general expenses 1,611,469. Fundraising expenses 0. Total expenses 1,695,415. Purchased Services: Program service expenses 113,687,356. Management and general expenses 18,843,016. Fundraising expenses 0. Total expenses 132,530,372.”

“Current Year Other Comprehensive Income -6,565,350. Beneficial Interest in Sharp HealthCare Foundation 6,725,085. Book/tax difference on partnership interest - MRI -107,782. Book/tax difference on partnership interest - Sharp ACO, LLC -6,335. Book/tax difference on partnership interest - BMT Program -1,202,077.”

“Attachment to 2013 Form 990 and Form 5471 Transferee Corporation's Information Statement Filed in Accordance with Reg. Section 1.351-3(b) Transferor Name: SHARP HEALTHCARE Taxable Year End: 9/30/2014 FEIN: 95-6077327 Transferee Name: CONTINUOUS QUALITY INSURANCE SPC (FKA CONTINUOUS QUALITY INSURANCE COMPANY, LTD.) FEIN: N/A Transferee Address: 23 LIME TREE BAY AVENUE, P.O. Box 1363, GRAND CAYMAN CAYMAN ISLANDS, BRITISH WEST INDIES This statement is being filed with Sharp HealthCare, the transferee's, Form 5471, Information Return of U.S. Persons, with respect to the transferee, for the taxable year ended 9/30/2014. This statement is filed in accordance with Reg. Section 1.351-3(b) to disclose the details of property transferred to the above controlled corporation. The exchange took place during the year ended 9/30/2014. 1. Property received from the transferor: Contribution of cash. 2. The cost or other basis thereof in the hands of the transferor adjusted to the date of transfer: $ 6,804,705.81 Transferee's Corporation Stock: N/A 4. Securities of the transferee corporation: N/A 5. Amount of money paid in the exchange to the transferor: N/A 6. Other property passing to the transferor in the exchange: N/A 7. Each of the transferor's liabilities assumed by the transferee corporation: N/A Attachment to 2013 Form 990 and Form 5471 Transferor Corporation's Information Statement Filed in Accordance with Reg. Section 1.351-3(a) Transferor Name: SHARP HEALTHCARE Taxable Year End: 9/30/2014 FEIN: 95-6077327 Transferee Name: CONTINUOUS QUALITY INSURANCE SPC (FKA CONTINUOUS QUALITY INSURANCE COMPANY, LTD.) FEIN: N/A Transferee Address: PO BOX 1092, GRAND CAYMAN CAYMAN ISLANDS, BRITISH WEST INDIES This statement is being filed with Sharp HealthCare, the transferor's, Form 5471, Information Return of U.S. Persons, with respect to the transferor for the taxable year ended 9/30/2014. This statement is also being filed with Sharp HealthCare, the transferor's, Form 990, Return of Organization Exempt from Income Tax. This statement is filed in accordance with Reg. Section 1.351-3(a) to disclose the details of property transferred to the above controlled corporation. The exchange took place during the tax year ended 9/30/2014. 1. Property transferred to the transferee: Contribution of $6,804,705.81 cash 2. Information with respect to the transferee corporation's stock: (i) The kind of stock and preferences: N/A (ii) The number of shares of each class at the date of the exchange: Before the exchange: N/A After the exchange: N/A (iii) The fair market value per share of each class at the date of the exchange: N/A 3. Securities of the transferee corporation received in the exchange: N/A 4. Amount of money received: N/A 5. Other property received: N/A 6. Liabilities of the transferor assumed by the transferee Corporation: N/A”

“Fiscal Year 2014 Community Benefits Report Section 1 An Overview of Sharp HealthCare Sharp HealthCare (Sharp or SHC) is an integrated, regional health care delivery system based in San Diego, Calif. The Sharp system includes four acute care hospitals; three specialty hospitals; two affiliated medical groups; 21 medical clinics; five urgent care facilities; three skilled nursing facilities; two inpatient rehabilitation centers; home health, hospice, and home infusion programs; numerous outpatient facilities and programs; and a variety of other community health education programs and related services. Sharp offers a full continuum of care, including: emergency care, home care, hospice care, inpatient care, long-term care, mental health care, outpatient care, primary and specialty care, rehabilitation, and urgent care. Sharp also has a Knox-Keene-licensed care service plan, Sharp Health Plan (SHP). Serving a population of approximately 3.2 million in San Diego County (SDC), as of September 30, 2014, Sharp is licensed to operate 2,087 beds, and has approximately 2,600 Sharp-affiliated physicians and nearly 17,000 employees. FOUR ACUTE CARE HOSPITALS: Sharp Chula Vista Medical Center (343 beds) The largest provider of health care services in San Diego's rapidly expanding South Bay, Sharp Chula Vista Medical Center (SCVMC) operates the region's busiest Emergency Department (ED) and is the closest hospital to the busiest international border in the world. SCVMC is home to the region's most comprehensive heart program, services for orthopedic care, women and infants and the only bloodless medicine and surgery center in SDC. Sharp Coronado Hospital and Healthcare Center (181 beds) Sharp Coronado Hospital and Healthcare Center (SCHHC) provides services that include sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, and hospice and emergency services. SCHHC is the largest provider of total joint surgeries in all of SDC. Sharp Grossmont Hospital (536 beds) Sharp Grossmont Hospital (SGH) is the largest provider of health care services in San Diego's East County, and has one of the busiest EDs in SDC. SGH is known for outstanding programs in heart care, orthopedics, rehabilitation, robotic surgery, stroke care and women's health. Sharp Memorial Hospital (656 beds) A regional tertiary care leader, Sharp Memorial Hospital (SMH) provides specialized care in trauma, oncology, orthopedics, organ transplantation, cardiology and rehabilitation. SMH houses San Diego's largest emergency and trauma center. THREE SPECIALTY CARE HOSPITALS: Sharp Mary Birch Hospital for Women & Newborns (206 beds) A freestanding women's hospital specializing in obstetrics, gynecology, gynecologic oncology, and neonatal intensive care, Sharp Mary Birch Hospital for Women & Newborns (SMBHWN) delivers more babies than any other private hospital in California. Sharp Mesa Vista Hospital (149 beds) The largest private freestanding psychiatric hospital in California, Sharp Mesa Vista Hospital (SMV) is a premier provider of behavioral health services. Sharp McDonald Center (16 beds) Sharp McDonald Center (SMC) is San Diego County's only licensed chemical dependency recovery hospital. Collectively, the operations of SMH, SMBHWN, SMV and SMC are reported under the not-for-profit public benefit corporation of SMH, and are referred to herein as the Sharp Metropolitan Medical Campus (SMMC). The operations of Sharp Rees-Stealy Medical Centers (SRS) are included within the not-for-profit public benefit corporation of Sharp, the parent organization. The operations of SGH are reported under the not-for-profit public benefit corporation of Grossmont Hospital Corporation. Mission Statement It is Sharp's mission to improve the health of those it serves with a commitment to excellence in all that it does. Sharp's goal is to offer quality care and services that set community standards, exceed patients' expectations and are provided in a caring, convenient, cos”

“With this learning, Sharp is now a seven-pillar organization - Quality, Safety, Service, People, Finance, Growth and Community. The foundational elements of Sharp's strategic plan have been enhanced to emphasize Sharp's desire to do no harm. This strategic plan continues Sharp's transformation of the health care experience, focusing on safe, high-quality and efficient care provided in a caring, convenient, cost-effective and accessible manner. The seven pillars listed below are a visible testament to Sharp's commitment to become the best health care system in the universe by achieving excellence in these areas: Demonstrate and improve clinical excellence to set industry standards and exceed customer expectations. Keep patients, employees and physicians safe and free from harm. Create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence. Create a values-driven culture that attracts, retains and promotes the best and brightest people, who are committed to Sharp's mission and vision. Achieve financial results to ensure Sharp's ability to provide quality health care services, new technology and investment in the organization. Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development. Be an exemplary community citizen by making a difference in the community and supporting the stewardship of our environment. Awards Sharp has received the following recognition: Sharp is a recipient of the 2007 Malcolm Baldrige National Quality Award, the nation's highest presidential honor for quality and organizational performance excellence. Sharp was the first health care system in California and eighth in the nation to receive this recognition. Sharp was recognized as one of the 2013 World's Most Ethical (WME) Companies by the Ethisphere Institute, the leading business ethics think-tank. The list highlights companies that outperform industry peers when it comes to ethical behavior. The 2013 WME companies are those that truly embrace ethical business practices and demonstrate industry leadership, forcing peers to follow suit or fall behind. Sharp was the only company in San Diego named to the list. Sharp was named the No. 1 "best integrated health care network" in California and No. 12 nationally by Modern Healthcare magazine in 2012. The rankings are part of the "Top 100 Most Highly Integrated Healthcare Networks (IHN)," a survey conducted by health care data analyst IMS Health. This was the 14th consecutive year that Sharp placed among the top in the state. Sharp HealthCare was named "Best Hospital Group" by U-T San Diego readers participating in the paper's 2014 "Best of San Diego" Readers Poll, and Sharp Rees-Stealy Medical Group was named "Best Medical Group" in 2014. SGH was named "Best Hospital," while SMH and SMBHWN were ranked second and fourth "Best Hospitals." SGH and SMH have both received MAGNET Designation for Nursing Excellence by the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program is the highest level of honor bestowed by the ANCC and is accepted nationally as the gold standard in nursing excellence. SMH was re-designated in March 2013. Sharp was named one of the nation's "Most Wired" health care systems from 2012 to 2014, as well as from 1999 to 2009, by Hospitals & Health Networks magazine's annual Most Wired Survey and Benchmark Study. "Most Wired" hospitals are committed to using technology to enhance quality of care for both patients and staff. In July 2010, SMH was named the "Most Beautiful Hospital in America" by Soliant Health, one of the largest medical staffing companies in the country. With over 10,000 votes from visitors to the Soliant Health website, SMH was voted to the top of the second annual "20 Most Beautiful Hospitals in America" list. In 2014, SCVMC and its onsite Birch Patrick Convalescent Center became the first co-located hospital and sk”

“Sharp provides services to help every unfunded patient received in the Emergency Department (ED) find opportunities for health coverage through PointCare a team of health coverage experts whose main product is a quick, web-based screening, enrollment and reporting technology designed to provide community members with health coverage and financial assistance options. At Sharp, patients use a simple online questionnaire through PointCare to generate personalized coverage options that are filed in their account for future reference and accessibility. The results of the questionnaire allow SHC staff to have an informed and supportive discussion about health care coverage with the patient, empowering them with options. From the inception of the program in FY 2010 through September 2014, Sharp helped guide approximately 70,200 self-pay patients through the maze of government health coverage programs while maintaining the patient's dignity throughout the process. In January, 2014 Sharp hospitals implemented an onsite process for real-time Medi-Cal eligibility determinations (Presumptive Eligibility). Sharp was the first hospital system in San Diego County to provide these services, and secured this benefit for 9,500 unfunded patients in the ED during FY 2014. In anticipation of Covered California's roll out, 28 members of Sharp's registration staff completed the State's Certified Enrollment Counselor Certification to better assist both patients and the general community navigate the Covered California website (CoveredCA.com) and plan enrollment. In addition, three Sharp hospitals SCVMC, SGH, and SMH qualify as covered entities for the 340B Drug Pricing Program administered by the Health Resources and Services Administration (HRSA). Hospital participation in the 340B Drug Pricing Program permits the purchase of outpatient drugs at reduced prices. The savings from this program are used to offset patient care costs for Sharp's most vulnerable patient populations, as well as to assist patient access to medications through the Patient Assistance Team. The Patient Assistance Team works hard to help those in need of assistance gain access to free or low-cost medications. Patients are identified through usage reports, or referred through case management, nursing, physicians or even other patients. If eligible, uninsured patients are offered assistance, which can help decrease readmissions resulting from lack of medication access. The team members research all options available, including programs offered by drug manufacturers, grant-based programs offered by foundations, copay assistance and other low-cost alternatives. Sharp also continues to offer ClearBalance a specialized loan program for patients facing high medical bills. Through this collaboration with San Diego-based CSI Financial Services, both insured and uninsured patients have the opportunity to secure small bank loans in order to pay off their medical bills in low monthly payments as low as $25 per month preventing unpaid accounts from going to collections. Through this program, Sharp provides a more affordable alternative for patients struggling to resolve their hospital bills. In addition, Sharp provides post-acute care facilitation for high-risk patients, including the homeless and patients lacking a safe home environment. Patients receive assistance with transportation and placement; connections to community resources; and financial support for medical equipment and medications, as well as outpatient dialysis and nursing home stays. Through collaboration with the San Diego Rescue Mission, SCHHC, SGH and SMH discharge their chronically homeless patients to the Rescue Mission's Recuperative Care Unit, where patients not only receive follow-up medical care through Sharp in a safe environment, but also receive psychiatric care, substance abuse counseling and guidance to help get them off the street. Community Health Screenings Sharp's dedication to improving community health ext”

“Table 1: Sharp HealthCare Internships FY 2014 Sharp Chula Vista Medical Center Nursing Students 920 Nursing Group Hours 60,905 Nursing Precepted Hours 20,616 Ancillary Students 193 Ancillary Hours 34,884 Total Students 1,113 Total Hours 116,405 Sharp Coronado Hospital and Healthcare Center Nursing Students 487 Nursing Group Hours 83,781 Nursing Precepted Hours 2,088 Ancillary Students 106 Ancillary Hours 22,544 Total Students 593 Total Hours 108,333 Sharp Grossmont Hospital Nursing Students 581 Nursing Group Hours 44,428 Nursing Precepted Hours 13,472 Ancillary Students 226 Ancillary Hours 51,324 Total Students 807 Total Hours 109,224 Sharp Mary Birch Hospital for Women & Newborns Nursing Students 194 Nursing Group Hours 14,035 Nursing Precepted Hours 4,991 Ancillary Students 30 Ancillary Hours 7,200 Total Students 224 Total Hours 26,226 Sharp Memorial Hospital Nursing Students 442 Nursing Group Hours 30,680 Nursing Precepted Hours 20,386 Ancillary Students 318 Ancillary Hours 62,074 Total Students 760 Total Hours 113,140 Sharp Mesa Vista Hospital Nursing Students 330 Nursing Group Hours 25,457 Nursing Precepted Hours 3,128 Ancillary Students 34 Ancillary Hours 16,524 Total Students 364 Total Hours 45,109 Sharp HospiceCare Nursing Students 96 Nursing Group Hours 0 Nursing Precepted Hours 768 Ancillary Students 1 Ancillary Hours 80 Total Students 97 Total Hours 848 Sharp HealthCare Nursing Students 368 Nursing Group Hours 0 Nursing Precepted Hours 55,730 Ancillary Students 197 Ancillary Hours 42,531 Total Students 565 Total Hours 98,261 Health Sciences High and Middle College Since 2007, Sharp has been an industry partner with charter school Health Sciences High and Middle College (HSHMC) to provide students broad exposure to health care careers. Through this partnership, HSHMC students connect with Sharp team members through job shadowing to explore real world application of their school-based knowledge and skills. This collaboration prepares high school students to enter health, science and medical technology careers in the following five career pathways: biotechnology research and development, diagnostic services, health informatics, support services and therapeutic services. The HSHMC program began in 2007 with students on the campuses of SGH and SMH, and expanded to include SMV and SMBHWN in 2009, SCHHC in 2010, and SCVMC in 2011. HSHMC students also devote time to various SRS sites in San Diego. New in FY 2014, HSHMC students began their experience with a systemwide orientation to Sharp HealthCare and their upcoming job-shadowing activities. Throughout FY 2014, nearly 400 HSHMC students were supervised for thousands of hours on various Sharp campuses, where they rotated through instructional pods in specialty areas such as nursing, obstetrics and gynecology (OB/GYN), occupational therapy, physical therapy, behavioral health, surgical intensive care unit (SICU), medical intensive care unit (MICU), imaging, rehabilitation, laboratory services, pharmacy, engineering, pulmonary services, cardiac services and operations. The students not only had the opportunity to observe patient care, but also received guidance from Sharp staff on career ladder development as well as job and education requirements. HSHMC students earn high school diplomas, complete college entrance requirements and have opportunities to earn community college credits, degrees or vocational certificates. Even with many of HSHMC students facing financial hardship the free and reduced price meal (FRPM) eligibility rate is higher than the averages for SDC and California the charter school excels in preparing students for high school graduation, college entrance and a future career. In 2014, 91 percent of the HSHMC graduating class went on to attend two- or four-year colleges, while 82 percent of students said they wanted to pursue careers in health care. In addition, HSHMC has a 99 percent graduation rate, higher than California's 80 percent state average, as we”

“Lectures and Continuing Education Sharp contributes to the academic environment of many colleges and universities in San Diego. In FY 2014, Sharp staff provided hundreds of academic hours in lectures, courses and presentations on numerous college and university campuses throughout San Diego. Through the delivery of a variety of guest lectures, including pharmacy practice lectures, health information technology lectures at MC and USD, nutrition lectures at PLNU, and a variety of health administration lectures to public health graduate students at SDSU, Sharp staff remains active and engaged with San Diego's academic health care community. To better serve the health care needs of the San Diego community, Sharp's Continuing Medical Education (CME) department assesses, designs, implements and evaluates educational initiatives for Sharp's affiliated physicians, pharmacists and other non-Sharp health care professionals. In FY 2014, the professionals at Sharp HealthCare CME invested more than 1,850 hours in numerous CME activities open to San Diego health care providers, ranging from conferences around primary care, atrial fibrillation, kidney transplant, compassion cultivation training, binational breast and cervical cancer and presentations on the Kenyan perspective of spine surgery and the power of mindfulness. Research Innovation is critical to the future of health care. Sharp HealthCare Center for Research (Center for Research) supports innovation through its commitment to quality research initiatives that are safe and effective; provide valuable knowledge to the San Diego health care community; and positively impact patients and community members. To date, Sharp HealthCare participates in more than 365 research studies. The Center for Research provides education and guidance for researchers across Sharp, and in the community. Nurses, pharmacy residents and other members of the health care community receive education on various study-specific requirements regarding the protection of human subjects and Health Insurance Portability and Accountability Act compliance. Additionally, the Center for Research hosts quarterly meetings on relevant educational topics to the research community within and outside of Sharp HealthCare. These meetings are open to physicians, psychologists, research nurses, study coordinators and students throughout San Diego. Recent presentations have covered topics such as "Taking the Mystery out of the IRB Process," "Research and the Sunshine Act" and "Riding the Big Data Wave in Health Care." The Center for Research also includes the Sharp HealthCare Institutional Review Board (IRB) and the Sharp HealthCare Outcomes Research Institute (ORI). Sharp HealthCare Institutional Review Board Sharp HealthCare's IRB seeks to promote a culture of safety and respect for those participating in research for the greater good of the community. All proposed entity research studies with human participants are required to be reviewed by the Sharp HealthCare IRB in order to protect participant safety and maintain responsible research conduct. In FY 2014, a dedicated IRB committee of 14 including physicians, psychologists, research nurses and pharmacists devoted hundreds of hours to the review and analysis of both ongoing and new research studies. Research is conducted on all phases of drug and device development, and spans from research with newborns to older adults with Alzheimer's disease. Current studies include regenerative medicine (stem cells), gene therapy and neonatal research. Sharp Outcomes Research Institute The Sharp ORI began in 2010 as a pilot initiative funded by Sharp HealthCare Foundation. The ORI is dedicated to facilitating interdisciplinary research on health care practices for generating the clinical knowledge necessary to improve overall patient-centered health outcomes, as well as promoting the importance of outcomes research and best practices to members of the professional health care community. With b”

“Evidence-Based Practice Institute Sharp participates in the Evidence-Based Practice Institute (EBPI), which prepares teams of staff fellows (interprofessional staff) and mentors to change and improve clinical practice and patient care. This evolution in practice and care occurs through identifying a care problem, developing a plan to solve it and then incorporating this new knowledge into practice. The EBPI is part of the Consortium of Nursing Excellence, San Diego, which promotes evidence-based practice in the nursing community. The consortium is a partnership between SCVMC, SGH, SMBHWN, SMH, Scripps Health, Palomar Health, Rady Children's Hospital San Diego, UC San Diego Health System, VA San Diego Healthcare System and Elizabeth Hospice, as well as PLNU, SDSU, Azusa Pacific University (APU) and USD. Sharp actively supports the EBPI by providing instructors and mentors, as well as administrative coordination. The San Diego EBPI includes six full-day class sessions featuring group activities, self-directed learning programs outside of the classroom and structured mentorship provided throughout the program. The EBPI fellows partner with their mentors and participate in a variety of learning strategies. Mentors facilitate the process of conducting an evidence-based practice change and navigating the hospital system to support the fellows through the process of evidence-based practice. Mentors also assist the fellows in working collaboratively with other key hospital leadership personnel. In FY 2014, the EBPI consisted of a nine-month program culminating with a community conference and graduation ceremony in November, where the project results of all EBPI fellows were shared. Forty-one fellows graduated from the EBPI program in FY 2014, and completed projects that addressed the following issues in clinical practice and patient care: managing electrocardiographic nuisance alarms; bedside shift reports; the effect of teach-back on patient satisfaction; reducing catheter-associated urinary tract infections; hand massage in older adults to reduce pain and anxiety; and strategies for clinicians to combat fatigue on the night shift. Volunteer Service Sharp Lends a Hand In FY 2014, Sharp continued its systemwide community service program, Sharp Lends a Hand (SLAH). In October, Sharp team members suggested project ideas that would: improve the health and well-being of San Diego in a broad, positive way; rely on Sharp for volunteer labor only; support existing nonprofit initiatives, community activities or other programs that serve SDC; and could be completed by September 30, 2014. Eleven projects were selected: Stand Down for Homeless Veterans, San Diego Food Bank, San Diego Half Marathon, San Diego Center for Children Spring Garden Project, Life Rolls On They Will Surf Again, San Diego River Park Foundation Point Loma Native Plant Garden, San Diego River Park Foundation Creek Cleanup at Forester Creek in Santee, Habitat for Humanity, USS Midway Foreign Object Damage Walk-Down, Special Olympics and Electronic and Pharmaceutical Waste Collection. More than 1,770 Sharp employees, family members and friends volunteered nearly 6,200 hours in support of these projects. During ten days in June and July, more than 500 volunteers joined the Veterans Village of San Diego in Stand Down for Homeless Veterans, a community-based intervention program designed to help the nation's estimated 200,000 homeless veterans endure life on the streets. Volunteers sorted and organized clothing donations and provided onsite support, medical services and companionship to hundreds of San Diego's homeless veterans. The San Diego Food Bank feeds people in need and advocates and educates the public about hunger-related issues. Across 14 days in January, February, March, April, May, August and September, more than 840 SLAH volunteers inspected and sorted donated food, assembled boxes and cleaned the San Diego Food Bank warehouse. In March, 75 SLAH volunteers provided”

“In May 2014, a Sharp team member led a three-week medical mission trip to Haiti. The team included 12 nursing and pre-med students with PLNU's LoveWorks program, which conducts mission trips across the world. The team also collaborated with Heart to Heart International, a nonprofit organization committed to improving global health with initiatives that connect people and resources to communities in need. The team worked in mobile clinics in 11 different rural mountain villages in Southeast Haiti, as well as a downtown Port-au-Prince clinic, where clinic visits are typically twice per month. Over the three weeks, the team triaged thousands of community members ranging from infants to the elderly. The team assessed patients for health conditions, dispensed prescribed medication and provided education regarding medication management and diet. The experience was not only special and rewarding for the Sharp team member, but also for the students, as it further enhanced their skills, confidence and passion for the health care field. Through Sharp's Humanitarian Service Program, another Sharp team member took a medical mission trip to Peru serving as a nurse in several of the shanty towns outside of Lima. Health care providers set up tents to treat people of all ages who were without access to health care. Because several community members were treated for parasites, the team also provided significant amounts of education on hand hygiene. The team consisted of three medical providers and six college students, and treated approximately 175 patients each day. The medical team also mentored the attending students, teaching them to perform health assessments, obtain vital signs and perform blood glucose tests. In December 2013, another Sharp team member traveled to India, treating wounded patients and teaching wound care to students. The trip was organized by Health Volunteers Overseas, a nonprofit organization that sends health care workers all over the globe. At a 300-bed hospital in Raxaul near the border of Nepal the Sharp team member joined with other foreign medical staff and learned how local health care workers treated wound care patients. In addition, Sharp donated medical supplies to the hospital, including much-needed suture material. Over nine days, the medical team taught local health care professionals and students various types of wound dressings, performed student rounds and provided lectures on wound care. In FY 2014, Sharp team members once again participated in multiple weeklong medical/surgical mission trips to the northwest mountains of Guatemala. This included teams of 60 to 100 Sharp-affiliated physicians, surgeons, anesthesiologists, nurses, technical staff, therapists, students, chaplains, and many others. Teams participated in partnership with the Ioamai Medical Ministries and Helps International. Over the course of each 10-day trip the teams provided surgeries under different specialties including general surgery, OB/GYN, plastics, otolaryngology, cleft palate repair, and urology. Basic clinic and dentistry services were also available. A team also built stoves in rural houses to keep fires off the floor and reduce burns and smoke inhalation exposure, while other teams provided a water purification unit. In the time provided as a functioning temporary hospital, teams performed an average of 100 surgeries and treated approximately 1,500 patients in clinic. The teams served rural and urban populations surrounding the sites at no cost, and in some cases, members of the impoverished mountain community traveled many hours to receive care. Sharp also donated numerous supplies and equipment to this life-changing experience for both patients and participants. Community Walks For the past 19 years, Sharp has proudly supported the American Heart Association (AHA) annual San Diego Heart & Stroke Walk. In September 2014, more than 800 walkers represented Sharp at the 2014 San Diego Heart & Stroke Walk held at Balboa Park.”

“Sharp volunteers spend their time within hospitals, in the community, and in support of the Sharp HealthCare Foundation, Grossmont Hospital Foundation and Coronado Hospital Foundation. Sharp employees also donate time as volunteers for the Sharp organization. Sharp employees also volunteer their time for the Cabrillo Credit Union Sharp Division Board, the Sharp and Children's MRI Board, the UCSD Medical Center/Sharp Bone Marrow Transplant Program Board, and the Grossmont Imaging LLC Board. Volunteers on Sharp's auxiliary boards and the various Sharp entity boards volunteer to provide program oversight, administration and decision making regarding financial resources. In FY 2014, 125 community members contributed their time to Sharp's boards. This section describes various Sharp volunteer programs, as well as their achievements in FY 2014. Sharp HospiceCare Volunteer Programs In FY 2014, Sharp HospiceCare provided extensive training for nearly 70 new volunteers. Because volunteers are often considering a career in the medical field, they gain important knowledge and experience. They learn how to provide valuable services to the hospice organizations, including companionship to those near the end-of-life, support for families and caregivers and help with community outreach. Before being with patients and providing administrative support activities, hospice volunteers go through an extensive, 32-hour training program to confirm their understanding of and commitment to hospice care. In FY 2014, Sharp HospiceCare also trained five teenagers through its Teen Volunteer Program. Through the program, teens are assigned special projects in the office or patient assignments at Sharp HospiceCare's LakeView and ParkView homes. The teens provide simple acts of kindness such as sitting with patients, listening to their stories, providing grooming and hygiene tasks and being a comforting presence by just holding their hand. Three nursing students from PLNU also volunteered at Sharp HospiceCare in FY 2014, offering assistance to family caregivers in private homes. The Sharp HospiceCare Memory Bear Program supports community members who have lost a loved one. Through the program, volunteers created teddy bears out of the garments from those who have passed on. The bears serve as special keepsakes and permanent reminders of the grieving family member's loved one. In FY 2014, Sharp HospiceCare volunteers devoted approximately 3,200 hours to handcraft more than 800 bears for approximately 400 families. Sharp HospiceCare recognized its volunteers by providing a monthly support group to enhance their education and training as volunteers, and by acknowledging their valuable contribution during National Volunteer Month and National Hospice Month. Sharp HospiceCare furthers its volunteer efforts through the 11th Hour Program, a special program to ensure that no patient dies alone. Through this program, patients at the end-of-life without family members by their side are accompanied by a Sharp HospiceCare volunteer. During their final moments, the volunteer sits with and comforts the patient by holding their hand, reading softly to them and simply being present. In addition, families who are present with their dying loved one may prefer the company of a volunteer to help them feel comfortable as their loved one passes away. Sharp Metropolitan Medical Campus (SMH, SMBHWN, SMV) Volunteer Programs To help serve and comfort patients without family or friends to support them during their hospital stay, SMH created the Community Care Partner (CCP) program. This unique program hand-selects and trains hospital volunteers to become Community Care Partners (CCPs). The CCPs act as companions to provide comfort and help keep patients safe by notifying medical staff as needed a task that is usually performed by a family member or friend, but often overlooked for patients who lack a companion. The CCPs provide patients with company and support, share common interests”

“In FY 2014, SMH and SMBHWN brought the Junior Volunteer Program to high school students interested in future health care careers. The program is open to 10th through 12th grade students, ages 15 years or older who maintain a minimum grade point average (GPA) of 3.25 for two full semesters. New volunteers are placed either as guest ambassadors at the concierge desk or in the upscale gift shop or boutiques. The junior volunteers enhance the patient-centered services of staff by greeting and escorting patients and families, answering visitors' questions and baking cookies to create aromatherapy and a relaxing environment for patients and visitors. Through volunteering in the gift shop or boutiques, junior volunteers learn about merchandizing and retail sales while also helping to raise funds for the SMH Auxiliary. After completing a six-month, 100-hour commitment, 11th and 12th grade volunteers have the opportunity to earn promotions into clinical units based on their good attendance, professional communication and high level of productivity. In FY 2014, 110 junior volunteers provided more than 7,800 hours of service to the program. In FY 2015, SMH and SMBHWN plan to continue expanding opportunities for the Junior Volunteer Program. Other Sharp Volunteer Efforts In FY 2014, Sharp staff donated their time and passion to a number of unique initiatives, underscoring Sharp's commitment to the health and welfare of San Diegans. Below are just a few examples of how Sharp employees participated in the community. SGH's Engineering Department volunteered in a number of initiatives in FY 2014, including This Bud's for You, a program that delivers flowers hand-picked from the campus' abundant gardens to unsuspecting patients and their loved ones. The SGH landscape team grows, cuts, bundles and delivers colorful bouquets each week, bringing an element of natural beauty to patients and visitors of both the hospital and Sharp's hospice homes. The team also regularly offers single-stem roses in a small bud vase to passers-by. In FY 2014, the team delivered a daily average of eight to 10 vases of flowers to patient rooms, with as many as 20 vases or more during peak flower season and upon additional requests. In its fourth year, This Bud's for You has become a natural part of the landscape team's day, an act that is simply part of what they do to enhance the experience of visitors to the hospital. The Engineering Department further extends the spirit of caring through Sodexo Cares Cheers Bouquets. During their work day, the engineers keep an eye out for patients or visitors that appear to need encouragement or cheer. With help from Sodexo, the hospital's food service, housekeeping and engineering vendor, a bouquet of balloons, ribbon, a teddy bear or Sodexo football, plus an inspirational quote are quickly assembled. The gift is delivered to bring the patient or visitor comfort and joy while at the hospital. The SGH Engineering Department, landscape team, SGH Auxiliary and local businesses collaborated to bring The Shirt Off Our Backs program to San Diego's needy population during the 2013 holiday season. During the holidays, this program collects, prepares and donates a variety of items to homeless or low-income community members ranging from small children to adults helping to meet their basic needs and bring them holiday joy. Volunteers for The Shirt Off Our Backs program personally collected and filled three trucks with food and other essential items, including hand-made sandwiches, water bottles, clothing, socks, shoes, toiletries, pet food, children's toys, towels, blankets and other household items. In its fourth year, The Shirt Off Our Backs program is committed to bringing comfort and hope to all who express need. The hospital furthers its efforts to provide for those in need during the holidays through its annual Santa's Korner giving event. For more than 30 years, various hospital departments have adopted a family referred by local se”

“According to the U.S. EPA, health care ranks as the country's second most energy intensive industry. Furthermore, the U.S. Department of Energy Information Agency states that hospitals and health care facilities account for more than eight percent of the nation's annual energy consumption and generate nearly eight percent of the country's carbon dioxide (CO2) emissions. Unlike other industries, hospitals must operate 24 hours a day, seven days a week, and must provide service during power outages, natural disasters and other emergencies. The EPA estimates that 30 percent of the health care sector's current energy use could be reduced without sacrificing quality of care through a shift toward energy efficiency and use of renewable energy sources. Sharp has responded to the need for hospitals to conserve energy and reduce carbon emissions by implementing numerous green initiatives. Some of those include: retro-commissioning of heating, ventilation and air conditioning (HVAC) systems; lighting retrofits; pipe insulations; infrastructure control initiatives; occupancy sensor installation; energy audits; and energy-efficient motor and pump replacements. In addition, in 2013 Sharp implemented a computer power management program which enables computers and monitors to go into a low-power sleep mode after a period of inactivity. Since its implementation, the program has been installed on 14,500 computers and has resulted in annual energy savings of 1.2 million kilowatt-hours (kWh). The initiative earned Sharp a Certificate of Recognition from the EPA in 2013. Sharp's energy-saving initiatives are driven by its Energy Conservation Guideline to help manage energy utilization practices throughout the system. Since 2009, these initiatives have reduced the system's energy consumption by more than 17 million kWh and 200,440 natural gas therms (unit of heat energy). As a result of its lighting retrofits alone, Sharp has saved approximately 3.9 million kWh, resulting in annual energy costs savings of more than $500,000. In total, Sharp's energy initiatives have reduced the system's carbon footprint equal to the removal of almost 17,000 metric tons of CO2 each year. In May, Sharp was named as San Diego's HealthCare 2014 Energy Champion by SDG&E in recognition of its commitment to the innovative programs it has implemented to reduce its carbon footprint. Furthering its dedication to energy efficiency, Sharp HealthCare participates in SDG&E's Major Customer Advisory Panel, a group of SDG&E's largest customers who meet quarterly to receive energy updates from SDG&E and provide feedback on important regional energy issues. All Sharp entities participate in the EPA's ES database and monitor their ES scores on a monthly basis. ES is an international standard for energy efficiency created by the EPA. Buildings that are certified by ES must earn a 75 or higher on the EPA's energy performance scale, indicating that the building performs better than at least 75 percent of similar buildings nationwide without sacrifices in comfort or quality. According to the EPA, buildings that qualify for the ES typically use 35 percent or less energy than buildings of similar size and function. As a result of Sharp's commitment to superior energy performance and responsible use of natural resources, SCHHC first earned the ES certification in 2007, and then again each year from 2010 through 2013, while SCVMC received ES certification in 2009, 2010, 2011 and 2013. In addition, Sharp's SRS Downtown medical office building was built to Leadership in Energy and Environmental Design (LEED) gold-certification specifications, one of the first medical office buildings in San Diego of its kind. According to the EPA, hospital water use constitutes seven percent of the total water used in commercial and institutional buildings in the U.S. On any given day, Sharp uses an average of 575,000 gallons of water. Of this, approximately 25 percent is used for domestic purposes such as si”

“The impact of Sharp's waste reduction programs has been significant. In FY 2014, Sharp facilities diverted over 7.5 million pounds of waste from local landfills, which equates to an overall recycling rate of 37 percent. This included, but was not limited to 111,608 pounds of waste diverted through utilization of reusable sharps and pharmaceutical waste containers at SCHHC and SMMC, as well as systemwide recycling of 270,464 pounds of hazardous and universal waste (e.g., batteries, solvents and fluorescent light bulbs), and 39,784 pounds of waste diverted through surgical device reprocessing. In the coming year, Sharp has a system goal of diverting 7.6 million pounds of waste from local landfills. Table 3 presents the waste diversion rates at Sharp HealthCare in FY 2014. Table 3: Sharp HealthCare Waste Diversion FY 2014 Sharp Chula Vista Medical Center Recycled Waste Per Year (lbs.) 773,131 Total Waste Per Year (lbs.) 2,665,343 Percent Recycled 29% Sharp Coronado Hospital and Healthcare Center Recycled Waste Per Year (lbs.) 252,848 Total Waste Per Year (lbs.) 1,335,244 Percent Recycled 18% Sharp Grossmont Hospital Recycled Waste Per Year (lbs.) 1,761,515 Total Waste Per Year (lbs.) 4,703,949 Percent Recycled 37% Sharp Memorial Hospital and Sharp Mary Birch Hospital for Women and Newborns Recycled Waste Per Year (lbs.) 2,006,597 Total Waste Per Year (lbs.) 6,450,334 Percent Recycled 34% Sharp Mesa Vista Hospital Recycled Waste Per Year (lbs.) 257,739 Total Waste Per Year (lbs.) 555,811 Percent Recycled 46% Sharp Rees-Stealy Medical Centers Recycled Waste Per Year (lbs.) 1,158,209 Total Waste Per Year (lbs.) 2,743,139 Percent Recycled 42% Sharp Corporate Sites Recycled Waste Per Year (lbs.) 1,329,075 Total Waste Per Year (lbs.) 2,154,748 Percent Recycled 92% Total Sharp HealthCare Recycled Waste Per Year (lbs.) 7,539,114 Total Waste Per Year (lbs.) 20,608,568 Percent Recycled 37% According to the Intergovernmental Panel on Climate Change, agriculture is responsible for 13.5 percent of greenhouse gas emissions worldwide. Sharp is committed to making eco-friendly food choices to minimize its environmental footprint. This includes a systemwide focus on its sustainable Mindful food program to provide education and healthy food options designed to improve the health of Sharp's patients, staff, community and environment. In collaboration with Sodexo, Sharp's food service vendor, Sharp's Mindful program includes Meatless Mondays, Wellness Menus, Community Supported Agriculture (CSA) fresh produce, food composting, increased recycling activities, the promotion of sugarless beverages, the use of post-consumer recycled packaging solutions and increased local and organic food purchases which are approaching 65 percent at some entities. In addition, SMH, SMV, and SCHHC created the first county-approved organic gardens and use the produce from these gardens in the meals served at the hospital cafes. Sharp has implemented many other sustainable food practices including the use of green-label kitchen soaps and cleansers; electronic cafe' menus; recycling of all cardboard, cans and grease from cafes; organic markets at each hospital and corporate office; purchasing of hormone-free milk; and partnering with vendors who are committed to reducing product packaging. In April 2014, Sodexo began replacing the traditional foam, plastic and aluminum packaging commonly used in food service, and expanded purchases of paper products made from recycled, compostable and chlorine-free renewable materials. If recycled, these paper napkins, cups, bowls and take-out containers will divert 3,220 pounds of waste from the local landfill each month. In 2012, Sharp partnered with the City of San Diego to implement a Food Waste Composting Program in the kitchen that services SMH and SMBHWN, making Sharp the first San Diego health care organization to join the city's initiative. In FY 2014, SMV joined this effort and SCHHC plans to participate in 2015. Through the prog”

“In partnership with the San Diego Association of Governments (SANDAG), Sharp offers a vanpool and carpool match-up to help employees find convenient ride share partners. Sharp employees also utilize SANDAG's online iCommute TripTracker tool to monitor the cost and carbon savings of their alternate methods of commuting. In 2014, for the second year in a row and for the third time in four years, Sharp was awarded the top spot in the Mega Employer Category in the iCommute Rideshare Corporate Challenge. Throughout the month of October, 51 organizations representing more than 102,000 employees participated in the challenge in which employees earned points for replacing their solo drive with a sustainable commute choice, such as biking, walking, carpooling, vanpooling and public transit. Through the challenge, more than 750 Sharp employees reported nearly 25,000 alternative commute trips, saving more than 16,600 gallons of gasoline and approximately 341,000 pounds of carbon dioxide. To further reduce the number of cars on the road Sharp's Commuter Solutions Sub-Committee continuously works to develop new programs and marketing campaigns to educate employees on the benefits of ride sharing. The committee has overseen the implementation of bike racks and designated car pool spots, as well as adding a Bicycle Commuter Benefit, which each year gives employees who bike to work up to $20 per month to use for qualified costs associated with bicycle purchase, improvement, repair and storage. Sharp furthered its support of green transportation through several bike to work initiatives in FY 2014. This included two Bike to Work Day events during which Sharp employees opted to ride their bike to work in place of driving. Sharp also participated in the fifth annual iCommute Bike to Work 2014 Corporate Challenge for the entire month of May (National Bike Month), competing with similar-sized organizations for the highest percentage of bike ridership for the month. In June, Sharp promoted National Dump the Pump Day to employees by sharing special promotions from iCommute, such as vanpool discounts and gift card drawings, for individuals who pledged to "Dump the Pump" and make greener transportation choices. Furthering the commitment to better commuting solutions for its employees, Sharp supplies and supports the hardware and software for more than 200 employees so that they are able to efficiently and effectively telecommute to work. These employees work in areas that do not require an onsite presence, such as information technology support, transcription and human resources. Table 4 highlights the All Ways Green efforts at Sharp entities. Going forward, Sharp remains committed to the All Ways Green initiative and will continue to investigate opportunities to reduce its carbon footprint. Sharp's All Ways Green Committee continues to work with system employees, physicians and corporate partners to develop new and creative ways to reduce its impact on the environment and meet the goal of being an outstanding community citizen through environmental responsibility. Table 4: All Ways Green Initiatives by Sharp Entity FY 2014 SCHHC *Energy Efficiency - Update elevators/ chillers - Energy audits - Energy-efficient chillers/motors - ES Award HVAC projects - Lighting retrofits *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Reusable sharps containers - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No smoking policy - Organic farmer's market - Organic gardens - Recycling education - Ride share promotion SCVMC *Energy Efficiency - Energy audits - Energy-efficient chillers/motors - ES participation and award elig”

“SMH/SMBHWN *Energy Efficiency - EVCs - Energy audits - Energy-efficient chillers/motors - ES participation - HVAC projects - Lighting retrofits - Occupancy sensors - Pipe insulations *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Electronic cafe menus - Food waste composting - Single-serve paper napkin and plastic cutlery dispensers - Reusable sharp waste containers - Single-stream recycling - Surgical instrument reprocessing *Education and Outreach - Drought tolerant rooftop garden - Earth Week activities - Environmental policy - Green Team - No smoking policy - Organic farmer's market - Organic gardens - Recycling education - Ride share promotion SMV/SMC *Energy Efficiency - Energy audits - ES participation - HVAC projects - Lighting retrofits - Motor and pump replacements *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Single-stream recycling - Styrofoam elimination - Surgical instrument reprocessing *Education and Outreach - Earth Week activities - Environmental policy - Green Team - No smoking policy - Organic farmer's market - Recycling education - Ride share promotion SRS *Energy Efficiency - Energy audits - ES participation - Lighting retrofits *Water Conservation - Drip irrigation - Drought-tolerant plants and bark-covered ground - Electronic faucets - Evaluation of water utilization practices - Hardscaping - Landscape water reduction systems - Low-flow systems - Mist eliminators *Waste Minimization - Single-serve paper napkin and plastic cutlery dispensers - Recycling of exam paper - Single-stream recycling - Styrofoam elimination *Education and Outreach - Contractor education - Earth Week activities - Environmental policy - Green Team - No smoking policy - Recycling education - Ride share promotion Emergency and Disaster Preparedness Sharp protects the San Diego community through essential emergency and disaster planning activities and services. Throughout FY 2014, Sharp provided education and training to community members, staff and other health care professionals on emergency and disaster preparedness. Sharp's disaster preparedness team offered disaster trainings to first responder and health care providers across SDC. This included a standardized, on-scene federal emergency management training for hospital management entitled, NIMS (National Incident Management System)/ ICS (Incident Command System)/ HICS (Hospital Incident Command System), and a START (Simple Triage and Rapid Treatment) Triage/ Jump START Triage class to train emergency responders at all levels to triage a large volume of trauma victims within a short period of time. In March, Sharp's disaster team participated in the 2014 Mass Rescue Operations Exercise (MRO) at the San Diego Mission Bay Lifeguard Headquarters. During the exercise, the San Diego Lifeguards, U.S. Coast Guard, American Red Cross (ARC), multiple response agencies, UC San Diego Health System, Palomar Health and Sharp HealthCare engaged in a maritime emergency simulation designed to practice and improve communication, water rescue, helicopter support and Emergency Medical Services (EMS) handoff of victims. In July, Sharp hosted the 5th Annual Disaster Partnership Conference at its Spectrum office location. The conference was attended by approximately 100 health care providers, county emergency personnel, Sharp HealthCare employees and community members and included speakers from SDC hospitals plus a review of lessons learned during an active shooter response exercise. In September, Sharp's disaster leadership presented to more than 900 Cal”

“Employee Wellness: Sharp Best Health Recognizing the importance of improving the health of its team members as part of impacting the health of the broader community, Sharp HealthCare established the Sharp Best Health employee wellness program in 2010. With a goal to improve the overall health, happiness and productivity of Sharp's workforce, Sharp Best Health encourages team members to incorporate healthy habits into their lifestyles and supports them on their journey to attain their personal health goals. Sharp Best Health provides team members with the tools, information and resources for them to get fit and stay healthy. The program includes a comprehensive and interactive website the Sharp Best Health Web Portal - that Sharp team members can access any time of day to support their health improvement efforts. The Sharp Best Health Web Portal offers team members a variety of digital health tools, including a personal health assessment, meal and exercise planners, food and physical activity logs, healthy recipes and tips, a progress tracker and health library. The web portal also provides information and resources on available support groups, classes and events, wellness workshops, health coaching, and discounts on thousands of health and wellness products including dinner delivery, gym memberships, wellness centers, training clubs, footwear, weight management, golf packages, yoga, massage and more. Through Sharp Best Health, employees can participate in a variety of health and wellness events throughout the year. Sharp team members are encouraged to take advantage of onsite fitness classes, walking and running clubs and events such as bike to work days, wellness days and take the stairs days. In May, Sharp Best Health collaborated with SANDAG to recognize National Bike to Work Day and promote a healthier alternative for commuting to work. Sharp Best Health also participated in community health events throughout the year, including the American Cancer Society (ACS) Great American Smoke Out, the AHA Go Red for Women, National Nutrition Month, the American Diabetes Association (ADA) Tour de Cure Bike Ride, National Walking Day, Fit for the Holidays and "Caught in the Act" of being healthy at work (i.e. taking the stairs, walking outside, etc.). In addition, each Sharp hospital as well as SRS has a dedicated Best Health committee, which works to promote employee wellness in different ways for their team members. For instance, in FY 2014, more than 700 Sharp team members attended the annual Wellness Fair at SCVMC. Organized by SCVMC's Best Health committee, the event provided an inviting atmosphere for employees to improve wellness of the mind, body and spirit. Educational resources included employee safety, cancer awareness, physical therapy and weight management, as well as bone density screenings and a nutrition booth that offered healthy food samples. At SMH, the Best Health committee provided a Best Health wellness cart, led by members of the committee and a physical therapist. The cart navigated throughout the SMH campus and provided team members with healthy food and wellness tips, such as how to perform stretch breaks and other healthy ideas. Sharp Best Health added healthy vending machine options on all hospital campuses, as well as healthy food items in each cafeteria and retail area. Sharp Best Health also conducts a semi-annual food and nutrition survey at each Sharp hospital and corporate office location to assess employee satisfaction of the organization's cafeteria food and customer service, including requests for feedback and suggestions for improvement. Additionally, in September, Sharp Best Health supported Fresh Fruit and Vegetable Month through the Five-A-Day Challenge, a 21-day initiative designed to motivate Sharp team members to increase their daily consumption of fruits and vegetables. In collaboration with Sodexo and Specialty Produce, Sharp Best Health offers the Green Grocers Delivered to You program at”

“Section 2 Executive Summary This Executive Summary provides an overview of community benefit planning at Sharp HealthCare (Sharp), a listing of community needs addressed in this Community Benefit Report, and a summary of community benefit programs and services provided by Sharp in Fiscal Year (FY) 2014 (October 1, 2013, through September 30, 2014). In addition, the summary reports the economic value of community benefit provided by Sharp, according to the framework specifically identified in SB 697, for the following entities: * Sharp Chula Vista Medical Center * Sharp Coronado Hospital and Healthcare Center * Sharp Grossmont Hospital * Sharp Mary Birch Hospital for Women & Newborns * Sharp Memorial Hospital * Sharp Mesa Vista Hospital and Sharp McDonald Center * Sharp Health Plan Community Benefit Planning at Sharp HealthCare Sharp bases its community benefit planning on its triennial community health needs assessments (CHNA) combined with the expertise in programs and services of each Sharp hospital. Listing of Community Needs Addressed in the Sharp HealthCare Community Benefit Plan and Report, FY 2014 The following community needs are addressed by one or more Sharp hospitals in this Community Benefit Report: * Access to care for individuals without a medical provider, and support for high-risk, underserved and underfunded patients * Education and screening programs on health conditions such as heart and vascular disease, stroke, cancer, diabetes, preterm delivery, unintentional injuries and behavioral health * Health education, support and screening activities for seniors * Welfare of seniors and disabled people * Special support services for hospice patients and their loved ones, and for the community * Support of community nonprofit health organizations * Education and training of community health care professionals * Student and intern supervision and support * Collaboration with local schools to promote interest in health care careers * Cancer education, patient navigator services, and participation in clinical trials * Women's and prenatal health services and education * Meeting the needs of new mothers and their loved ones * Mental health and substance abuse education for the community Highlights of Community Benefit Provided by Sharp in FY 2014 The following are examples of community benefit programs and services provided by Sharp hospitals and entities in FY 2014. * Unreimbursed Medical Care Services included uncompensated care for patients who are unable to pay for services, and the unreimbursed costs of public programs such as Medi-Cal, Medicare, San Diego County Indigent Medical Services, Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA), and TRICARE the regionally managed health care program for active-duty and service members, National Guard and Reserve members, retirees, their loved ones and survivors; and unreimbursed costs of workers' compensation programs. This also included financial support for on-site workers to process Medi-Cal eligibility forms. * Other Benefits for Vulnerable Populations included van transportation for patients to and from medical appointments; flu vaccinations and services for seniors; financial and other support to community clinics to assist in providing and improving access to health services; Project HELP; Project CARE; Meals on Wheels; contribution of time to Stand Down for Homeless Veterans, the San Diego Food Bank and Habitat for Humanity; financial and other support to the Sharp Humanitarian Service Program; and other assistance for vulnerable and high-risk community members. * Other Benefits for the Broader Community included health education and information, and participation in community health fairs and events addressing the unique needs of the community, as well as providing flu vaccinations, health screenings and support groups to the community. Sharp collaborated with local schools to promote interest in health care careers; made Sharp”

“Table 3 includes a summary of unreimbursed costs for each Sharp entity based on the categories specifically identified in SB 697. In FY 2013, Sharp led the community in unreimbursed medical care services among San Diego County's SB 697 hospitals and health care systems. Table 3: FY 2014 Detailed Economic Value of Community Benefit at Sharp HealthCare Entities Based on Senate Bill 697 Categories Sharp Chula Vista Medical Center *Medical Care Services - $64,918,400 *Other Benefits for Vulnerable Populations - $310,178 *Other Benefits for the Broader Community - $225,236 *Health Research, Education and Training Programs - $910,397 *Estimated FY 2014 Unreimbursed Costs - $66,364,211 Sharp Coronado Hospital and Healthcare Center *Medical Care Services - $14,858,765 *Other Benefits for Vulnerable Populations - $22,021 *Other Benefits for the Broader Community - $160,405 *Health Research, Education and Training Programs - $714,446 *Estimated FY 2014 Unreimbursed Costs - $15,755,637 Sharp Grossmont Hospital *Medical Care Services - $114,172,426 *Other Benefits for Vulnerable Populations - $721,474 *Other Benefits for the Broader Community - $590,239 *Health Research, Education and Training Programs - $1,103,214 *Estimated FY 2014 Unreimbursed Costs - $116,587,353 Sharp Mary Birch Hospital for Women & Newborns *Medical Care Services - $16,613,741 *Other Benefits for Vulnerable Populations - $45,880 *Other Benefits for the Broader Community - $162,516 *Health Research, Education and Training Programs - $247,149 *Estimated FY 2014 Unreimbursed Costs - $17,069,286 Sharp Memorial Hospital *Medical Care Services - $123,785,739 *Other Benefits for Vulnerable Populations - $711,595 *Other Benefits for the Broader Community - $530,820 *Health Research, Education and Training Programs - $1,620,333 *Estimated FY 2014 Unreimbursed Costs - $126,648,487 Sharp Mesa Vista Hospital and Sharp McDonald Center *Medical Care Services - $10,681,321 *Other Benefits for Vulnerable Populations - $511,787 *Other Benefits for the Broader Community - $311,288 *Health Research, Education and Training Programs - $209,915 *Estimated FY 2014 Unreimbursed Costs - $11,714,311 Sharp Health Plan *Medical Care Services - $0 *Other Benefits for Vulnerable Populations - $17,200 *Other Benefits for the Broader Community - $109,974 *Health Research, Education and Training Programs - $5,000 *Estimated FY 2014 Unreimbursed Costs - $132,174 ALL ENTITIES *Medical Care Services - $345,030,392 *Other Benefits for Vulnerable Populations - $2,340,135 *Other Benefits for the Broader Community - $2,090,478 *Health Research, Education and Training Programs - $4,810,454 *Estimated FY 2014 Unreimbursed Costs - $354,271,459 Section 3 Community Benefit Planning Process For the past 18 years, Sharp HealthCare has based its community benefit planning on findings from a triennial Community Health Needs Assessment (CHNA) process, as well as from the combination of expertise in programs and services of each Sharp hospital and knowledge of the populations and communities served by those hospitals. Methodology to Conduct the 2013 Sharp HealthCare Community Health Needs Assessments Since 1995, Sharp has participated in a countywide collaboration that includes a broad range of hospitals, health care organizations, and community agencies to conduct a triennial CHNA. Findings from the CHNA, the program and services expertise of each Sharp hospital, and knowledge of the populations and communities served by those hospitals combine to provide a foundation for community benefit planning and program implementation. To address the new requirements under Section 501(r) within Section 9007 of the Affordable Care Act, and IRS Form 990, Schedule H for not-for-profit hospitals, San Diego County hospitals engaged in a new, collaborative CHNA process. This process gathered both salient hospital data and the perspectives of health leaders and residents in order to identify and prioritize health needs for communit”

“Quantitative data (secondary sources) for both the HASD&IC 2013 CHNA and the individual Sharp hospital CHNAs included 2011 calendar year hospital discharge data at the ZIP code level, health statistics from the San Diego County Health and Human Services Agency (HHSA), the U.S. Census Bureau, the Centers for Disease Control and Prevention and others. The variables analyzed are included in Table 1 below, and were analyzed at the ZIP code level wherever possible: Table 1: Variables Analyzed in the HASD&IC and Sharp HealthCare 2013 CHNAs *Secondary Data Variables - Inpatient Hospitalizations by Cause - Emergency Department Visits by Cause - Demographic Data (socio-economic indicators) - Mortality Data - Regional Disease-Specific Health Data (County HHSA) - Self-Reported Health Data (California Health Interview Survey) - Specialized Health Data /Reports (various) Recognizing that health needs differ across the region and that socioeconomic factors impact health outcomes, both HASD&IC's 2013 CHNA and Sharp's 2013 CHNA processes utilized the Dignity Health/Truven Community Need Index (CNI) to identify communities in SDC with the highest level of health disparities and needs. Residents in five of these high-need neighborhoods across SDC were asked to provide input in a community forum setting. For the HASD&IC 2013 CHNA, IPH conducted primary data collection through three methods: an online community health leader/health expert survey, key informant interviews and community forums. The community health leader/health expert survey was completed by 89 members of the health care community, including health care and social service providers, academics, community-based organizations assisting the underserved and other public health experts. Over the winter and spring of 2013, five community forums were held in communities of high need across SDC, reaching a total of 106 community residents. In addition, IPH conducted five key informant interviews with individuals chosen by virtue of their professional discipline and knowledge of health issues in SDC. Key informants included county public health officers, health care and social service providers and members of community-based organizations. Following consultation with the CHNA Planning Teams at each Sharp hospital, additional, specific feedback from additional key informants and community residents was also collected. Community members were asked for open-ended feedback on the health issues of greatest importance to them, as well as any significant barriers they face in maintaining health and well-being. Findings Through the combined analyses of the results for all of the data and information gathered, the following conditions were identified as priority health needs for the primary communities served by Sharp hospitals (listed in alphabetical order): * Behavioral Health (Mental Health) * Cancer * Cardiovascular Disease * Diabetes, Type 2 * High-Risk Pregnancy * Obesity * Orthopedics * Senior Health (including end-of-life care) As the CHNAs were hospital-specific, not all of Sharp's hospitals identified all of the above priority health needs through their CHNA process, given the specific services the individual hospitals provide to the community. For instance, Sharp Mesa Vista Hospital, the largest provider of mental health, chemical dependency and substance abuse treatment in SDC, identified behavioral health as a priority health need for the community members it serves, however it did not identify other needs such as cancer, high-risk pregnancy, etc. In addition, as part of the collaborative CHNA process, the IPH conducted a content analysis of all qualitative feedback collected through the HASD&IC 2013 CHNA process key informants, online survey respondents and community members and found that the input fell into one of the following five categories: * Access to Care or Insurance * Care Management * Education * Screening Services * Collaboration Sharp is committed to the health and well-be”

“Ongoing Commitment to Collaboration In support of its ongoing commitment to working with others on addressing community health priorities to improve the health status of SDC residents, Sharp executive leadership, operational experts and other staff are actively engaged in the national American Hospital Association, statewide California Hospital Association, HASD&IC, and other local collaboratives such as Combined Health Agencies and the Community Health Improvement Partners Behavioral Health Work Team. Appendix A Sharp HealthCare Involvement in Community Organizations The list below shows the involvement of Sharp executive leadership and other staff in community organizations and coalitions in Fiscal Year 2014. Community organizations are listed alphabetically. * 2-1-1 San Diego Board * A New PATH (Parents for Addiction, Treatment and Healing) * Adult Protective Services * Aging and Independence Services (AIS) * Alzheimer's Association * American Association of Colleges of Nursing (AACN) * American Association of Critical Care Nurses, San Diego Chapter (AACCN) * American Cancer Society (ACS) * American College of Healthcare Executives (ACHE) * American Diabetes Association (ADA) * American Foundation for Suicide Prevention * American Health Information Management Association * American Heart Association (AHA) * American Hospital Association (AhA) * American Psychiatric Nurses Association * American Red Cross of San Diego (ARC) * Arc of San Diego * Asian Business Association * Association for Ambulatory Behavioral Healthcare * Association for Clinical Pastoral Education (ACPE) * Association of California Nurse Leaders (ACNL) * Association of periOperative Registered Nurses (AORN) * Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) * Azusa Pacific University (APU) * Beacon Council's Patient Safety Collaborative * Boys and Girls Club of San Diego * Bonita Business and Professional Organization * California Association of Health Plans * California Association of Hospitals and Health Systems * California Association of Marriage and Family Therapists * California Association of Physician Groups * California Board of Behavioral Health Sciences * California College, San Diego * California Council for Excellence * California Department of Public Health * California Dietetic Association, Executive Board * California HealthCare Foundation * California Health Information Association * California Hospice and Palliative Care Association (CHAPCA) * California Hospital Association Center for Behavioral Health * California Library Association * California State University San Marcos (CSUSM) * California Teratogen Information Service * Caregiver Coalition of San Diego * Caregiver Coalition of San Diego Caregiver Education Committee * Caring Hearts Medical Clinic * Centers for Community Solutions * Chelsea's Light Foundation * Chicano Federation of San Diego County * Community Health Improvement Partners (CHIP) Behavioral Health Work Team * CHIP Board * CHIP Health Literacy Task Force * CHIP Suicide Prevention Work Team * CHIP Independent Living Association (ILA) Advisory Board and Peer Review Advisory Team * Chula Vista Chamber of Commerce * Chula Vista Community Collaborative * Chula Vista Family Health Center * Chula Vista Rotary * City of Chula Vista Wellness Program * Coalition to Transform Advanced Care (CTAC) * Combined Health Agencies * Community Emergency Response Team (CERT) * Consortium for Nursing Excellence, San Diego * Coronado Chapter of Rotary International * Coronado Fire Department * Council of Women's and Infants' Specialty Hospitals (CWISH) * Cycle EastLake * Downtown San Diego Partnership * East County Senior Service Providers (ECSSP) * El Cajon Fire Department * Emergency Nurses Association, San Diego Chapter * Employee Assistance Professionals Association * EMSTA College * Family Health Centers of San Diego (FHCSD) * Gardner Group * Gary and Mary West Senior Wellness Center * Girl Scouts of San Diego Im”

“* South Bay Community Services * South County Economic Development Council * Southern California Association of Neonatal Nurses * Southern Caregiver Resource Center (SCRC) * Special Olympics * St. Paul's Retirement Homes Foundation * St. Vincent de Paul Village * Susan G. Komen Breast Cancer Foundation * Sweetwater Union High School District (SUHSD) * The Meeting Place * Third Avenue Charitable Organization (TACO) * Trauma Center Association of America * United Service Organizations Council of San Diego * University of California, San Diego (UCSD) * University of San Diego (USD) * VA San Diego Healthcare System * Veterans Home of California, Chula Vista * Veterans Village of San Diego * Vista Hill ParentCare * Walk San Diego * Women, Infants and Children Program (WIC) * YMCA * YWCA Becky's House * YWCA Board of Directors * YWCA Executive Committee * YWCA In the Company of Women Event”