Sharp Healthcare

“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 condcted in November/December 2014.”

“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 274,784,753. Management and general expenses 1,644,378. Fundraising expenses 0. Total expenses 276,429,131. Registry: Program service expenses 250,419. Management and general expenses 1,960,029. Fundraising expenses 0. Total expenses 2,210,448. Purchased Services: Program service expenses 118,318,785. Management and general expenses 17,755,174. Fundraising expenses 0. Total expenses 136,073,959.”

“Current Year Other Comprehensive Income -7,684,158. Beneficial Interest in Sharp HealthCare Foundation -547,130. Book/tax difference on partnership interest - MRI 44,905. Book/tax difference on partnership interest - Sharp ACO, LLC 938,696. Book/tax difference on partnership interest - BMT Program -1,316,729.”

“Attachment to 2014 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: 9/30/2015 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 9/30/2015. 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 9/30/2015. 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: $ 4,147,537.23 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 2014 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: 9/30/2015 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 9/30/2015. 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 9/30/2015. 1. Property transferred to the transferee: Contribution of $4,147,537.23 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 2015 Community Benefit Plan and 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; 22 medical centers; five urgent care centers; 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, 2015, Sharp is licensed to operate 2,088 beds and has approximately 2,600 Sharp-affiliated physicians and more than 17,000 employees. FOUR ACUTE CARE HOSPITALS: Sharp Chula Vista Medical Center (343 licensed beds) The largest provider of health care services in San Diego County's rapidly expanding South Bay, Sharp Chula Vista Medical Center (SCVMC) operates the South Bay'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, cancer treatment, women and infants, and the only bloodless medicine and surgery center in SDC. Sharp Coronado Hospital and Healthcare Center (181 licensed beds) Sharp Coronado Hospital and Healthcare Center (SCHHC) provides services that include acute, sub-acute and long-term care, rehabilitation therapies, joint replacement surgery, and hospice and emergency services. Sharp Grossmont Hospital (528 licensed 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 licensed 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 licensed 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 (158 licensed 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 licensed 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. The operations of Sharp HospiceCare are reported within SGH. 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 co”

“Pillars of Excellence In support of Sharp's organizational commitment to transform the health care experience, Sharp's Pillars of Excellence serve as a guide for its team members, providing framework and alignment for everything Sharp does. In 2014, Sharp HealthCare made an important decision regarding these pillars as part of its continued journey toward excellence. Each year, Sharp incorporates cycles of learning into its strategic planning process. In 2014, Sharp's Executive Steering and Board of Directors enhanced Sharp's safety focus, further driving the organization's emphasis on its culture of safety and incorporating the commitment to become a High Reliability Organization (HRO) in all aspects of the organization. At the core of HROs are five key concepts: Sensitivity to operations A reluctance to simplify Preoccupation with failure Deference to expertise Resilience Applying high-reliability concepts in an organization begins when leaders at all levels start thinking about how the care they provide could become better. It begins with a culture of safety. With this learning, Sharp is a seven-pillar organization ? Quality, Safety, Service, People, Finance, Growth and Community. The foundational elements of Sharp's strategic plan have been enhanced to emphasize Sharp's desire to do no harm. This strategic plan continues Sharp's transformation of the health care experience, focusing on safe, high-quality and efficient care provided in a caring, convenient, cost-effective and accessible manner. 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: *Quality - Demonstrate and improve clinical excellence to set industry standards and exceed customer expectations. *Safety - Keep patients, employees and physicians safe and free from harm. *Service - Create exceptional experiences at every touch point for customers, physicians and partners by demonstrating service excellence. *People - Create a values-driven culture that attracts, retains and promotes the best and brightest people, who are committed to Sharp's mission and vision. *Finance - Achieve financial results to ensure Sharp's ability to provide quality health care services, new technology and investment in the organization. *Growth - Achieve consistent net revenue growth to enhance market dominance, sustain infrastructure improvements and support innovative development. *Community - Be an exemplary community citizen by improving the health and well-being of 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 and 2014 World's Most Ethical (WME) Companies by the Ethisphere Institute, the leading business ethics think tank. WME companies are those that truly embrace ethical business practices and demonstrate industry leadership, forcing peers to follow suit or fall behind. Sharp is the only health care company in San Diego recognized in both years. 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," 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 was named "Best Hospital Group" by U-T San Diego readers participating in the paper's 2015 "Best of San Diego" Readers Poll. In 2015, SMBHWN was named "Best Hospital," while SGH and SMH were ranked second and third "Best Hospitals." Sharp Community Medical Group (SCMG) and Sharp R”

“SHP was ranked a top 100 U.S. health plan and a top three California health plan based on the National Committee for Quality Assurance's (NCQA) Private Health Insurance Rankings 2014 2015, which rated health insurance plans based on clinical quality, member satisfaction and NCQA Accreditation Survey results. SHP also received the highest level "Excellent" Accreditation status from the NCQA for the third year in a row (2013 2015). The NCQA awards accreditation status based on compliance with rigorous requirements and performance on Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures. SHP was also rated highest in California among reporting California Health Plans for Rating of the Health Plan, Rating of Health Care, Rating of Personal Doctor, and Rating of Health Promotion and Education in NCQA's 2015 Quality Compass/CAHPS survey, which provides state, regional and national benchmarks as well as individual plan performance. In 2015, Sharp was ranked fourth in the large employers category as one of the "Best Places to Work" for Information Technology (IT) professionals by the International Data Group's (IDG) Computerworld survey. The list is compiled by the following criteria: benefits, training, retention, career development, average salary increases, employee surveys, workplace morale and more. In 2015, SGH and SMBHWN received a 2015 Women's Choice Award -- a symbol of excellence in customer experience awarded by the collective of women. SGH was recognized as one of America's Best Hospitals for Cancer Care and SMBHWN was recognized as one of America's Best Hospitals for Obstetrics. For the third year in a row, and the fourth time in five years, Sharp HealthCare won the top spot in the Mega Employer category in the Rideshare 2015 Challenge. The month-long challenge encouraged the replacement of solo drivers with sustainable carpool, vanpool, bike, walk, or transit commutes. Powered by San Diego Association of Governments (SANDAG) and in cooperation with the 511 transportation information service, iCommute is the Transportation Demand Management program for the San Diego region and encourages use of transportation alternatives to help reduce traffic congestion and greenhouse gas emissions. Patient Access to Care Programs Uninsured patients with no ability to pay and insured patients with inadequate coverage receive financial assistance for medically necessary services through Sharp's Financial Assistance Program. Sharp does not refuse any patient requiring emergency medical care. Sharp provides services to help every unfunded patient received in the 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 2015, Sharp helped guide approximately 85,910 self-pay patients through the maze of government health coverage programs while maintaining the patient's dignity throughout the process. Beginning in 2014 Sharp hospitals implemented an on-site 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 2,198 unfunded patients in the ED during FY 2015. In support of Covered California's annual open enrollment period, 14 members of Sharp's registration staff have become Certified Applicatio”

“In response to the community screenings, Sharp received countless emails and letters expressing heartfelt gratitude from community members, many of whom were inspired to take control of their health after their screening. Through these efforts, Sharp's community health screenings brought helpful and, at times, life-changing health information to the people of San Diego -- truly exemplifying Sharp's commitment to the health of its community. Health Professions Training Internships Students and recent health care graduates are a valuable asset to the community. Sharp demonstrates a deep investment in these potential and newest members of the health care workforce through internships, financial aid and career pipeline programs. In FY 2015, more than 4,600 student interns dedicated nearly 680,000 hours within the Sharp system. Students belonged to a variety of disciplines including nursing, allied health and professional educational programs. Sharp provided education and training programs for nursing students (e.g. critical care, medical/surgical, behavioral health, women's services and wound care) and allied health professions such as rehabilitation therapies (speech, physical, occupational and recreational therapy), pharmacy, respiratory therapy, imaging, cardiovascular, dietetics, lab, radiation therapy, surgical technology, paramedic, social work, psychology, business, health information management and public health. Students came from local community colleges such as Grossmont College, San Diego City College, San Diego Mesa College (MC) and Southwestern College (SWC); local and national university campuses such as Point Loma Nazarene University (PLNU), San Diego State University (SDSU), University of California, San Diego (UCSD), and University of San Diego (USD); and vocational schools such as Kaplan College. Table 1 presents the number of students and student hours at each of the Sharp entities in FY 2015. Table 1: Sharp HealthCare Internships -- FY 2015 Sharp Chula Vista Medical Center Nursing 842 Students 60,662 Group Hours 20,398 Precepted Hours Ancillary 172 Students 37,627 Hours Total 1,014 Students 118,687 Hours Sharp Coronado Hospital and Healthcare Center Nursing 590 Students 92,510 Group Hours 3,024 Precepted Hours Ancillary 77 Students 21,127 Hours Total 667 Students 116,661 Hours Sharp Grossmont Hospital Nursing 732 Students 62,492 Group Hours 16,643 Precepted Hours Ancillary 238 Students 54,200 Hours Total 970 Students 133,335 Hours Sharp Mary Birch Hospital for Women & Newborns Nursing 207 Students 15,204 Group Hours 5,184 Precepted Hours Ancillary 15 Students 4,486 Hours Total 222 Students 24,874 Hours Sharp Memorial Hospital Nursing 404 Students 29,451 Group Hours 18,902 Precepted Hours Ancillary 310 Students 73,998 Hours Total 714 Students 122,351 Hours Sharp Mesa Vista Hospital Nursing 318 Students 22,642 Group Hours 3,524 Precepted Hours Ancillary 38 Students 23,106 Hours Total 356 Students 49,272 Hours Sharp HospiceCare Nursing 74 Students 674 Precepted Hours Total 74 Students 674 Hours Sharp HealthCare Nursing 387 Students 60,843 Precepted Hours Ancillary 223 Students 52,947 Hours Total 610 Students 113,790 Hours Total Nursing 3,554 Students 282,961 Group Hours 129,192 Precepted Hours Ancillary 1,073 Students 267,491 Hours Total 4,627 Students 679,644 Hours”

“Health Sciences High and Middle College Sharp is an industry partner with charter school 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. HSHMC students earn high school diplomas, complete college entrance requirements and have opportunities to earn community college credits, degrees or vocational certificates. 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. Students also devote time to various SRS sites. Students begin their experience with a systemwide orientation to Sharp and their upcoming job-shadowing activities, which consist of two levels of training. Level I of the HSHMC program is the entry level for all students and is conducted over an eight-week period. Through Level I, ninth grade students shadow primarily non-nursing areas of the hospital as well as complete additional coursework in Infection Control and Mental Health Matters at Mesa College. Level II of the HSHMC program is designed for students in grades 10 through 12 and includes enhanced patient interaction, college-level clinical rotation, and hands-on experience. Level II students are placed in a new assignment each semester for a variety of patient care experiences, as well as take additional health-related coursework at Mesa College, including Anatomy, Physiology, Medical Terminology, Health 101, Psychology and Abnormal Psychology. Nearly 500 HSHMC students -- including 143 Level I students and 347 Level II students -- were supervised for approximately 55,000 hours on Sharp campuses in FY 2015. Students rotated through instructional pods in specialty areas, including but not limited to nursing; emergency services; obstetrics and gynecology (OB/GYN); occupational therapy; physical therapy; behavioral health; pediatrics; medical/surgical; imaging; rehabilitation; laboratory services; pharmacy; pathology; radiology; endoscopy; engineering; pulmonary services; cardiac services; and operations. 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. In May 2015, the HSHMC program graduated its fifth full class. Each year, Sharp HealthCare reviews and evaluates the collaboration with HSHMC, including outcomes of students and graduates, to promote long-term sustainability. Although many HSHMC students face 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 2015, 93 percent of the HSHMC graduating class went on to attend two- or four-year colleges, while 85 percent of students said they wanted to pursue careers in health care. In addition, HSHMC has a 100 percent graduation rate, which is higher than California's 80.8 percent state average as well as an Academic Performance Index score of 828, which exceeds the state's goal of 800. The California Department of Education recognizes HSHMC as a 2015 California Gold Ribbon School for its outstanding education programs and practices, and a Title I Academic Achieving school for demonstrating success in significantly reducing the gap between high and low-performing students. HSHMC is also a 2014 U.S. News & World Report Best High Schools bronze award winner, and National School Safety Advocacy Council award winner. Lectures and Continuing Educati”

“Sharp Outcomes Research Institute The Sharp Outcomes Research Institute (ORI) began in 2010 as a pilot initiative funded by the Sharp HealthCare Foundation. The ORI facilitates interdisciplinary research on health care practices in order to identify and promote quality patient care across the health care community. The ORI collaborates with Sharp team members by facilitating the design of patient-centered outcomes research projects; assisting with database development as well as data collection and analysis; exploring funding mechanisms for research projects; and facilitating IRB application submissions. A priority for the ORI is to seek guidance and expertise from the local and national academic community on how to effectively conduct outcomes research in order to improve patient and community health. This networking has resulted in collaborative research partnerships with investigators at SDSU and National University (NU). The ORI has also developed educational presentations for the greater health care research community that foster awareness of the importance of research for improving health outcomes. This includes presentations of peer-reviewed abstracts of research study results and training on research designs. Evidence-Based Practice Institute Sharp participates in the Evidence-Based Practice Institute (EBPI), which prepares teams of staff fellows (inter-professional 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 for 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, UCSD Health System, U.S. Department of Veterans Affairs (VA) San Diego Healthcare System, Elizabeth Hospice, PLNU, SDSU, APU and USD. The Naval Medical Center San Diego (NMCSD) is expected to join in FY 2016. 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 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 2015, 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. Thirty-four fellows graduated from the EBPI program in FY 2015 and completed projects that addressed the following issues in clinical practice and patient care: health literacy for patients; structured debriefing for critical incidents in the intensive care setting; nurse-driven protocol for urinary catheter removal; charge nurse rounding in the ED; cue-based feedings in the neonatal intensive care unit (NICU); and noise reduction in the progressive care setting. Volunteer Service Sharp Lends a Hand In FY 2015, 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 be completed by September 30, 2015. Eleven projects were selected: San Diego Blood Bank, Holiday Mail for Heroes, San Die”

“Founded in 2001, the San Diego River Park Foundation is a grassroots nonprofit organization that works to protect the greenbelt from the mountains to the ocean along the 52-mile San Diego River. Approximately 40 SLAH volunteers joined the San Diego River Park Foundation to care for California native plants and trees at the Point Loma Native Plant Garden in March and the San Diego River Garden in Mission Valley in May. Activities included trail maintenance, watering, pruning and other light gardening projects. In July, SLAH volunteers joined the foundation once again for the Coastal Habitat Restoration event in Ocean Beach to help save and restore one of the last remaining coastal dune and wetland habitats in San Diego. Twenty volunteers helped remove invasive plants, watered and cared for recent plantings, and provided trail maintenance and litter removal. Sharp Humanitarian Service Program In FY 2015, the Sharp Humanitarian Service Program funded more than 50 Sharp employees in service programs that provide health care or other supportive services to underserved or adversely affected populations in Haiti, Guatemala, Peru, southern Africa and other vulnerable areas. Through the program, a Sharp pharmacist participated in a two-week medical mission trip to the impoverished villages of Ayacucho, Peru, located in the central Andes Mountains. Sponsored by the Peruvian American Medical Society, the mission team consisted of approximately 50 professionals -- including physicians, a pharmacist, nurses, translators, case workers and general volunteers -- who provided medical examinations and medications for approximately 75 to 100 patients each day. In May, a Sharp nurse traveled to Zimbabwe with Operation of Hope, a nonprofit volunteer surgical team that provides free surgeries to children in developing countries who are born with or suffering from facial deformities. For approximately two weeks, the team member worked alongside surgeons, anesthesiologists and other staff who surgically repaired the cleft lips and palates of approximately 75 patients. The team also received assistance from staff at a Zimbabwe hospital and from the local rotary club. In addition, the team educated community members about cleft lip and palates on a local radio station in an effort to reduce the social stigma associated with the malformation. In April, another Sharp nurse served in the operating room (OR) on Africa Mercy. As the world's largest civilian hospital ship, Africa Mercy is operated by Mercy Ships, a global charity that brings lifesaving surgeries, hope and healing to people living in the world's poorest regions. During their two-week mission, the team member assisted with multiple surgical procedures for approximately 60 citizens of Madagascar, including the removal of large tumors on backs and necks as well as hernia repairs. International Medical Relief (IMR) is a nonprofit organization that treats underserved patients by providing medical services, medication, supplies, training and education to communities all over the globe with help from medical volunteers. For 10 days, a Sharp team member joined IMR to help treat those lacking medical services in the remote villages of Uganda. Alongside other foreign staff -- such as physicians, nurse practitioners, nurses, respiratory therapists and various other nonmedical professionals -- the team member provided health assessments, medications, antibiotics and wellness exams to thousands of people in need. Haitian parents without a job are often at risk of sending their children to an orphanage because they are unable to feed them. The I'mME organization empowers and sustains the structure of family to the orphans of the world through care, education, prevention and stewardship. In FY 2015, one Sharp team member participated in a trip to Haiti with I'mME, where she provided assistance to an orphanage and a feeding program that serves meals to 150 children and youth twice a week, who would otherwise”

“Sharp volunteers spend their time within hospitals, in the community, and in support of the foundations. On average, more than 1,920 individuals actively volunteered at Sharp each month in FY 2015, contributing a total of more than 270,000 hours of service to Sharp and its initiatives throughout the year. This included more than 1,900 auxiliary members and thousands of individual volunteers from the San Diego community, including volunteers for Sharp's various foundations. These community members dedicated more than 9,600 hours to activities such as delivering meals to homebound seniors and assisting with health fairs and events. Table 2 details the average number of active volunteers per month as well as the total number of volunteer service hours provided to each Sharp entity, specifically for patient and community support. Table 2: Sharp Volunteers and Volunteer Hours FY 2015 Sharp Chula Vista Medical Center 390 Average Active Volunteers per Month 53,136 Volunteer Hours Sharp Coronado Hospital and Healthcare Center 78 Average Active Volunteers per Month 8,226 Volunteer Hours Sharp Grossmont Hospital 729 Average Active Volunteers per Month 111,342 Volunteer Hours Sharp HospiceCare 77 Average Active Volunteers per Month 6,634 Volunteer Hours Sharp Metropolitan Medical Campus 649 Average Active Volunteers per Month 90,934 Volunteer Hours TOTAL 1,923 Average Active Volunteers per Month 270,272 Volunteer Hours In support of Sharp's foundations -- including the Sharp HealthCare Foundation, Grossmont Hospital Foundation and Coronado Hospital Foundation -- volunteers dedicated hours of support to various events, such as annual golf tournaments and galas. In addition, Sharp offers a systemwide Junior Volunteer Program for high school students interested in giving back to their communities and exploring future health care careers. Program requirements vary, however all require high grade point averages and long-term commitments of at least 100 hours. Junior volunteers serve in a wide range of roles throughout Sharp. They enhance patient-centered care through hospitality, such as greeting and escorting patients and families, answering questions, and creating a welcoming and relaxing environment for guests. Through volunteering in the gift shops and thrift store, they learn about merchandising, fundraising and retail sales. And on the inpatient units, they are exposed to clinical experiences that provide a glimpse into future careers. In FY 2015, more than 480 high school students contributed a total of 58,100 hours to the Junior Volunteer Program. This included 85 juniors who provided more than 6,500 hours of service at SMH and SMBHWN; 144 juniors who dedicated approximately 16,600 hours of service at SCVMC; and nearly 257 juniors who contributed nearly 35,000 hours of service at SGH. Volunteers on Sharp's various entity boards provide program oversight, administration and decision making regarding financial resources. In FY 2015, nearly 120 volunteers contributed their time to Sharp's boards. Sharp employees also donate time as volunteers for the Sharp organization, including service on 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. This section describes the achievements of various Sharp volunteer programs in FY 2015. Sharp HospiceCare Volunteer Programs Sharp HospiceCare provided a variety of volunteer training opportunities in FY 2015. Hospice volunteers are often working towards a career in the medical field, and can gain valuable knowledge and experience through volunteering. Volunteers provide valuable services to the hospice organization and those they serve, including companionship to those near the end-of-life, support for families and caregivers and help with community outreach. Fifty-one new hospice volunteers were trained in FY 2015. Volunteers complete an extensive 32-hour training”

“Sharp HospiceCare offers the Memory Bear Program to support community members who have lost a loved one. Through the program, volunteers create 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 2015, volunteers devoted nearly 3,600 hours to handcraft approximately 900 bears for nearly 350 families. Sharp HospiceCare offers a monthly support group to enhance volunteers' education and training. Volunteers are also recognized for their valuable contribution during National Volunteer Week in April and National Hospice and Palliative Care Month in November. Sharp Metropolitan Medical Campus (SMH, SMBHWN, SMV) Volunteer Programs SMH created the Community Care Partner (CCP) program to serve and comfort patients without family or friends to support them during their hospital stay. 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, spend time together in conversation, read to patients, write letters, take walks and play games. Since February 2010, the Cushman Wellness Center Community Health Library and the SMH Volunteer Department have offered the Health Information Ambassador Program to bring the library's services directly to patients and their families, and empower them to become involved in their own health care. The Health Information Ambassadors are hospital volunteers who receive additional training through the Community Health Library. Once trained, the volunteers visit patients at SMH, the SMH Rehabilitation Center and the perinatal special care unit at SMBHWN, and ask if they or their family members would like to receive additional resources on their diagnosis. The volunteers bring requests back to the consumer health librarian who then prints consumer-oriented information from quality websites. The volunteers deliver the health information back to the patients as requested. Patients or family members who have already conducted their own research are offered a website bookmark from www.medlineplus.gov in order to guide them towards using trustworthy websites in the future. Patients and families are welcome to keep in touch with the library after discharge to ensure they have access to reliable health information at home. In FY 2015, the Health Information Ambassadors visited more than 3,000 patient rooms and filled approximately 780 information requests. At SMMC, the volunteer-run Arts for Healing Program uses art therapy to reduce feelings of fear, stress, pain and isolation among patients facing significant medical challenges and their loved ones. Arts for Healing brings a variety of activities to patients at their bedside -- such as painting, beading, creative writing, card-making, scrapbooking, quilting and music to help improve their emotional and spiritual health, and promote a faster recovery. The program also engages visitors and community members during hospital and community events. Funded completely by donations, Arts for Healing is led by Sharp's Spiritual Care Department and is implemented with help from licensed music and art therapists as well as a team of trained volunteers who serve as the primary providers of the program. The Arts for Healing program is offered across the SMMC, including at SMH, SMH OPP, SMBHWN, SMV and SMC. At SMH, Arts for Healing typically serves patients who are recovering from stroke; receiving treatment for cancer; facing life with newly acquired disabilities following catastrophic events; recovering from surgery; waiting for organ transplant; or receiving palliative care. At SMBHWN, Arts for Healing support”

“SGH furthered 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 -- who has been vetted and referred by local service agencies -- and dedicated personal time to making the holidays the best they can be for each family. Special holiday gifts, including grocery gift cards, clothing, toiletries, household items, movie tickets, bicycles, children's toys, and a holiday meal, are purchased for the families by hospital staff using primarily their personal resources and through occasional fundraisers. The SGH Engineering Department also participated in the SDFB Food 4 Kids Backpack program in FY 2015. The program provides a backpack full of child-friendly, shelf-stable food for elementary school children who receive a free meal at school, but are suffering from hunger over the weekends when little or no food is available. Food 4 Kids strives to alleviate hunger, improve school performance, improve health and provide additional information to parents about available local community services. Between January and April, 2015, the team filled approximately 50 backpacks with roughly 600 pounds of food per week for chronically hungry elementary school students. Similarly, the Labor and Delivery Department at SMBHWN is committed to the fight against hunger through participation in the International Relief Team's (IRT) Feeding San Diego's Kids project. Based in San Diego, IRT is a relief organization providing worldwide support that combines both short-term relief efforts and long-term programs to save and change lives. Through Feeding San Diego's Kids, nutritious food is provided to children in the Linda Vista Elementary School nutrition club, a group specifically for children who have been identified as homeless by the school nurse. Every week, labor and delivery team members stuff backpacks with nonperishable, nutritious food that can feed a family of four for the weekend. The backpacks are also stuffed with weekly nutrition-related prizes to encourage students and families to learn and participate in their own nutrition as well as with occasional holiday-related gifts. Since the start of the program in May 2013, the team has dedicated more than 125 weeks of service to filling 2,800 backpacks for approximately 25 children and their families per school year. More than 475,000 people in San Diego County face the threat of hunger every day. The SDFB distributes emergency food to approximately 400,000 children and families, active duty military and fixed income seniors living in poverty every month. During the 2015 holiday season, Sharp demonstrated its commitment to fighting hunger by hosting a food drive to support the SDFB. Through the food drive, team members donated nearly 1,600 pounds of food, which supplied more than 1,300 meals to those in need. All Ways Green Initiative As San Diego's largest private employer, Sharp is committed to improving the health of the environment and therefore the communities we serve. Sharp recognizes that a healthy environment influences individual well-being, and is dedicated to minimizing any adverse impact on the environment by creating healthy green practices for employees, physicians and patients to transfer from the health care environment to home. Sharp promotes a culture of environmental responsibility through education, outreach, and collaboration with San Diego earth-friendly businesses to help identify best practices, reduce the costs of green practices and facilitate implementation of sustainable initiatives. In 2009, Sharp created the All Ways Green logo to brand its environmental activities and communicate sustainability throughout Sharp and the San Diego community. Sharp's systemwide All Ways Green committee is charged with identifying, creating and evaluating opportunities and best practices in seven distinct areas: (1) energy efficiency, (2) alternative energy”

“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. Certified ES buildings 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, 2013 and 2015. In addition, Sharp's SRS Downtown medical office building meets Leadership in Energy and Environmental Design (LEED) silver certification specifications, one of the first medical office buildings in San Diego of its kind. Water Conservation 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 650,000 gallons of water. Of this, approximately 25 percent is used for domestic purposes such as sinks, toilets and showers, while the remaining 75 percent is used to cool Sharp's buildings, sterilize equipment, prepare food and water the landscape. In an effort to conserve water, Sharp has researched and implemented numerous infrastructure changes and best practices to ensure its facilities are optimally operated while monitoring and measuring water consumption. These changes include installation of motion-sensing faucets and toilets in public restrooms; low-flow showerheads and toilets in patient rooms and locker rooms; mist eliminators; microfiber mops; water-saving devices and equipment; high-efficiency, low-water-use dishwashers; installation of water-efficient chillers; water monitoring and control systems; water practice and utilization evaluations; regular rounding to identify leaks; installation of low water sterile processing equipment; and landscape improvements including reduced watering times, drip irrigation systems, xeriscaping, hardscaping and planting succulents and other drought tolerant plants. To comply with the mandatory water restrictions for California issued on April 1, 2015, Sharp modified irrigation schedules, properly sized sprinkler heads, installed water-sensing equipment and reduced watering times and frequency at all sites. Over eight million pounds of textiles, such as sheets, towels, scrubs and patient gowns, are used at Sharp each year. The significant amount of laundry generated by Sharp prompted the selection of Emerald Textiles, an environmentally-friendly laundry and linen provider that demonstrates strong investment in sustainability practices. Emerald Textiles, operates a state-of-the-art plant that has been efficiently designed to reduce utility consumption and preserve natural resources. Sharp saves an estimated 50 million gallons of water per year (50 percent of total usage) through the use of a state-of-the-art water filtration system, more than 71,000 kWh of electricity through the use of energy efficient lighting, and more than 750,000 therms of gas through the use of energy-efficient laundry equipment. Waste Minimization According to Practice Greenhealth's Healthier Hospitals Initiative (HHI), hospitals generate an average of 26 pounds of waste per staffed bed each day. To significantly reduce waste at each entity and extend the lifespan of local landfills, Sharp has created a comprehensive waste minimization program, including a systemwide, multidisciplinary Waste Management committee. The committee's purpose is to provide oversight of Sharp's waste management initiatives, including proper waste segregation and enhancing recycling efforts to divert w”

“Sustainable Food Practices 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. In 2015, Sharp implemented the Food and Nutrition Best Health Committee -- a component of Sharp's larger Best Health employee wellness program -- to standardize, facilitate and promote its food sustainability efforts throughout the system. 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. Implemented in collaboration with Sodexo, Sharp's food service vendor, Sharp's Mindful Food program includes Meatless Mondays; wellness menus; Community Supported Agriculture (CSA); fresh and organic produce; food composting; increasing recycling activities; the promotion of sugarless beverages; the use of postconsumer recycled packaging solutions; and increasing local, organic and sustainable food purchases. In addition, Sharp participates in HHI's Healthier Food program by committing to the purchase of local and sustainable foods. In FY 2015, Sharp purchased more than 285,000 pounds of local produce, representing an increase of 5.1 percent in local purchases from FY 2014. In addition, Sharp increased its purchase of animal protein from local, sustainable sources, a 16.8 percent increase since FY 2014. Sharp expects to further increase the purchase of local, sustainable food as new, safe sources of food items are identified and credentialed. Furthering its sustainable food practices, 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. These organic gardens produce an average of 22 pounds of produce per week. 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. SMV joined this effort in 2014, and SCHHC, SCVMC and SGH plan to participate in 2016. Through the program, EDCO, a solid waste vendor, transports food waste to the Miramar Greenery -- a 74-acre facility located at the Miramar Landfill in Kearny Mesa. The food waste is processed into a rich compost product and sold to commercial landscapers, non-city residents, and to city residents at no charge for volumes of up to two cubic yards. The compost offers several benefits including improving the health and fertility of soil, reducing the need to purchase commercial fertilizers, increasing the soil's ability to retain water and helping the environment by recycling valuable organic materials. According to the City of San Diego, such waste diversion programs contribute to the landfill's lifespan being extended from 2012 to at least 2022. In 2015, Sharp received the San Diego Recycling and Composting Award and continues to work with the City to expand food waste composting to other Sharp entities. Additional sustainable food practices at Sharp include: 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 addition, beginning in April 2014, Sodexo expanded purchases of paper products made from recycled, compostable and chlorine-free renewable materials in place of the traditional foam, plastic and aluminum packaging commonly used in food service. Commuter Solutions Sharp supports ride sharing, public transit programs and other transportation efforts to reduce transportation emissions generated by Sharp and its employees. Sharp replaced higher fuel-consuming cargo vans w”

“* Sharp partnered with the U.S. Drug Enforcement Administration on National Drug Take Back Day to provide a safe, convenient and responsible means of drug disposal and to educate the general public about the potential for prescription medication abuse. * Sharp continued participation in San Diego's Gathering of Green Teams with other San Diego business leaders to identify and discuss sustainable best practices, which can be emulated across industries. * Sharp participates in San Diego County's Hazmat (Hazardous Materials) Stakeholder meetings to discuss best practices for medical waste management with other hospital leaders in SDC Sharp's All Ways Green initiative remains committed to creating sustainable practices for employees, physicians and the community to improve the health of the environment and ultimately the health of the populations that it serves. Table 4 highlights the All Ways Green efforts at Sharp entities. Table 4: All Ways Green Initiatives by Sharp Entity - FY 2015 SCHHC -Energy Efficiency * Energy audits * Air Handler projects * HVAC projects * Lighting retrofits * LED lighting * New energy-efficient appliances in the cafe * New building management system to optimize energy usage for the cooling system -Water Conservation * Water-efficient dishwashing system * 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 award * HVAC projects * Lighting retrofits * Energy-efficient dishwasher * Elevator upgrades -Water Conservation * Drip irrigation * Drought-tolerant plants and bark-covered ground * Electronic and low-flow faucets * Evaluation of water utilization practices * Hardscaping * Landscape water reduction systems * Mist eliminators * Replacement of 3.5gpf toilets with 1.28 gpf toilets * Cooling tower replacement (40% less water used) -Waste Minimization * Blue-wrap recycling * Compactor renovation * Electronic cafe menus * Single-stream recycling * Surgical instrument reprocessing * Reusable sharps containers * Clean Business designation by City of Chula Vista * Replacement of bottled water with spa water -Education and Outreach * America Recycles Day * Earth Week activities * Environmental policy * Green Team * No smoking policy * Organic farmer's market * Recycling education * Ride share promotion SGH -Energy Efficiency * Energy audits * ES participation * HVAC projects * Lighting retrofits * Retro-commissioning * Elevator modernization * High efficiency LED fixtures -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 * Valve and sprinkle head replacement * Water fountains off * Water-efficient cleaning chemical dispensing machines * Plumbing projects to address water leaks * GMP Weekly Fire Pump Chum Test -Waste Minimization * Blue wrap recycling * Electronic cafe menus * Single-serve paper napkin and plastic cutlery dispensers * Single-stream recycling * Surgical instrument reprocessing * Recycle bins distribution * Reusable sharps containers -Education and Outreach * Earth Week activities * Environmental policy * Green Team * No smoking policy * Organic farmer's market * Recycling education * Ride share promotion Sharp System Services -Energy Efficiency * EVCs * Energy audits * Energy efficient chillers/motors * ES participation * HVAC projects * LED Light”

“SHP -Energy Efficiency * Energy audits * HVAC projects * Lighting retrofits * Occupancy sensors -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 * Water dispensers to replace bottled water -Waste Minimization * Recycle bin distribution * Recycled paper * Single-serve paper napkin and plastic cutlery dispensers * Single-stream recycling * Spring cleaning events -Education and Outreach * Earth Week activities * Environmental policy * Green Team * No smoking policy * Recycling education * Ride share promotion SMH/ SMBHWN -Energy Efficiency * EVCs * Energy audits * Energy-efficient chillers/motors * ES participation * HVAC projects * LED lighting * Lighting retrofits * Occupancy sensors * Pipe insulations * Piping cross bridges * Steam trap repairs -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 * Water-efficient sterile department processing cart washer -Waste Minimization * Blue wrap recycling * Composting * Electronic cafe menus * Food waste composting * Peroxide based cleaning products * 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 * Air handler replacement * 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 * Composting * 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 contributes to the health and safety of the San Diego community through essential emergency and disaster planning activities and services. Throughout FY 2015, Sharp provided education to staff, community members, and community health professionals on emergency and disaster preparedness. Sharp's disaster preparedness team offered several disaster education courses to first responders, health care providers and community members across SDC. The Hospital-Based First Receiver Awareness Course and First Receiver Operations Course were offered as a two-part series to educate and prepare hospital staff for a decontamination event. Course topics included decontamination principles and best practices; basic hazards; utilization of appropriate Personal Protective Equipment; response concepts; containment; decontamination; and recovery. A standardiz”

“Employee Wellness: Sharp Best Health Sharp recognizes that improving the health of its team members benefits the health of the broader community. In 2010, the Sharp Best Health Employee Wellness Program was established 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 offers team members tools, information and resources to help them stay fit and healthy. Through the Sharp Best Health Web Portal, the program's comprehensive and interactive website, employees can access a variety of digital tools to support their health improvement efforts, including a personal health assessment, meal and exercise planners, food and physical activity logs, healthy recipes and tips, nutrition for sports athletes, wellness or diet-specific dietary eating plans, a progress tracker and a health library. The web portal also provides information on available wellness workshops, health coaching, training plans, 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. The web portal also provides information on the Best Health HealthyNow mobile app, an on-the-go complement to the web portal that is a convenient collection of mobile tools, allowing for easy access and engagement from a mobile device. Sharp Best Health hosts a variety of employee wellness activities throughout the year. Team members are encouraged to participate in on-site fitness classes, meditation workshops, micro-stretch breaks, relaxation and stress management workshops, mindfulness classes, walking and running clubs, and events such as bike-to-work days, wellness days and take-the-stairs days. Sharp Best Health hosted activities, such as Fit for the Holidays and "Caught in the Act" of being healthy at work (i.e., taking the stairs, walking outside, etc.) to encourage healthy habits. In May, Sharp Best Health collaborated with SANDAG to recognize National Bike to Work Day and promote a healthier alternative for commuting to work. During the event, Sharp Best Health provided six pit stops for new and experienced riders to enjoy a fun rest break, snacks and encouragement. Sharp Best Health also participated in community health events throughout the year, including the American Cancer Society (ACS) Great American Smoke Out, National Nutrition Month, the ADA Tour de Cure bike ride and National Walking Day. Each Sharp hospital as well as SRS has a dedicated Best Health committee that works to promote wellness at their individual work sites. For instance, in February, approximately 460 employees and their spouses and kids participated in 5K the Sharp Way and Kid's Run at Tidelands Park in Coronado, hosted by thee Best Health Committee at SGH. In addition, committees at each Sharp hospital and most SRS locations hosted Employee Wellness Fairs throughout the summer months, reaching more than 1,000 Sharp team members. The fairs provided education and resources on a variety of topics, such as employee safety, cancer awareness, physical therapy, weight management and health coaching, as well as offered bone density screenings and a nutrition booth with healthy food samples. Sharp Best Health included healthy vending machine options on all hospital campuses as well as healthy food items in each cafeteria and retail area. In FY 2015, Sharp Best Health implemented a new initiative called "Go, Make the Healthier Choice." This initiative color-codes the food options sold in vending machines and food service areas to help employees, visitors, and guests easily discern the nutritional value of each item. According to the color-code, green-labeled items are the healthiest options and can be consumed often; yellow-labeled items are moderately hea”

“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) 2015 (October 1, 2014, through September 30, 2015). In addition, the summary reports the economic value of community benefit provided by Sharp, according to the framework specifically identified in Senate Bill (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 2015 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 navigation 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 and support for the community Highlights of Community Benefit Provided by Sharp in FY 2015 The following are examples of community benefit programs and services provided by Sharp hospitals and entities in FY 2015. * 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 U.S. Department of Veterans Affairs (CHAMPVA), and TRICARE -- the regionally managed health care program for active-duty, 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 and the San Diego Food Bank (SDFB); 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 and made i”

“Section 3 - Community Benefit Planning Process For the past 19 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 (SDC) 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 community members across the county, with a particular focus on vulnerable populations. Additionally, the process aimed to highlight health issues that hospitals could impact through programs, services and collaboration. In this endeavor, Sharp collaborated with the Hospital Association of San Diego and Imperial Counties (HASD&IC), the Institute for Public Health (IPH) at San Diego State University (SDSU) and SDC hospital systems, including Kaiser Foundation Hospital, San Diego, Palomar Health, Rady Children's Hospital, Scripps Health, Tri-City Medical Center and UC San Diego Health System. The complete report of this collaborative process -- the HASD&IC 2013 CHNA -- is available for public viewing at http://www.hasdic.org. The results of this collaborative process significantly informed the 2013 CHNAs for each Sharp hospital and individual hospital assessments were further supported by additional data collection and analysis and community outreach specific to the primary communities served by each Sharp hospital. Additionally, in accordance with federal regulations, the Sharp Memorial Hospital (SMH) 2013 CHNA also includes needs identified for communities served by Sharp Mary Birch Hospital for Women & Newborns (SMBHWN), as the two hospitals share a license, and report all utilization and financial data as a single entity to the Office of Statewide Health Planning and Development (OSHPD). As such, the SMH 2013 CHNA summarizes the processes and findings for communities served by both hospital entities. The 2013 CHNAs for each Sharp hospital help inform current and future community benefit programs and services, especially for high-need community members. This section describes the general methodology employed for Sharp HealthCare's 2013 CHNAs. Data Collection and Analysis As the study area for both the collaborative HASD&IC 2013 CHNA and the Sharp 2013 CHNAs cover SDC, the HASD&IC 2013 CHNA process and findings significantly informed Sharp's CHNA process and, as such, are described as applicable throughout the various CHNA reports. For complete details on the HASD&IC 2013 CHNA process, please visit the HASD&IC website at http://www.hasdic.org or contact Lindsey Wade, Vice President, Public Policy at HASD&IC at [email protected]. For the HASD&IC 2013 CHNA process, the IPH employed a rigorous methodology using both community input (primary data sources) and quantitative analysis (secondary data sources) to identify and prioritize the top health conditions in SDC. These health needs were prioritized based on the following criteria: * Has a significant prevalence in the community * Contributes significantly to the morbidity and mortality in SDC * Disproportionately impa”

“Sharp is committed to the health and well-being of the community, and the findings of Sharp's 2013 CHNAs will help to inform the activities and services provided by Sharp to improve the health of the community members it serves. The 2013 CHNA process also generated a list of currently existing resources in SDC, an asset map, that address the health needs identified through the CHNA process. While not an exhaustive list of the available resources in San Diego, this map will serve as a resource for Sharp to help continue, refine and create programs that meet the needs of their most vulnerable community members. With the challenging and uncertain future of health care, there are many factors to consider in the development of programs to best serve members of the San Diego community. The health conditions and health issues identified in this CHNA, including, but not limited to, health care and insurance access and education and information for all community members will not be resolved with a quick fix. On the contrary, these resolutions will be a journey requiring time, persistence, collaboration and innovation. It is a journey that the entire Sharp system is committed to making, and Sharp remains steadfastly dedicated to the care and improvement of health and well-being for all San Diegans. The 2013 CHNAs for each Sharp hospital are available online at http://www.sharp.com/about/community/community-health-needs-assessments or by contacting Sharp HealthCare Community Benefit at [email protected]. Determination of Priority Community Needs: Sharp HealthCare Sharp entities reviewed their 2013 CHNAs and used these assessments to help determine priority needs for the communities served by their hospitals. In identifying these priorities, Sharp entities also considered the expertise and mission of its programs and services in addition to the needs of the unique, ever-changing demographics and health topics that comprise Sharp's service area and region. Steps Completed to Prepare an Annual Community Benefit Report On an annual basis, each Sharp hospital performs the following steps in preparation of its Community Benefit Report: * Establishes and/or reviews hospital-specific objectives taking into account results of the entity CHNA and evaluation of the entity's service area and expertise/services provided to the community * Verifies the need for an ongoing focus on identified community needs or adds new identified community needs * Reports on activities conducted in the prior fiscal year -- FY 2015 Report of Activities * Develops a plan for the upcoming fiscal year, including specific steps to be undertaken -- FY 2016 Plan * Reports and categorizes the economic value of community benefit provided in FY 2015, according to the framework specifically identified in SB 697 * Reviews and approves a Community Benefit Plan * Distributes the Community Benefit Plan and Report to members of the Sharp board of directors and each of the Sharp hospital boards of directors, highlighting activities provided in the prior fiscal year as well as specific action steps to be undertaken in the upcoming fiscal year Ongoing Commitment to 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 San Diegans for Healthcare Coverage, the San Diego Food System Alliance, Hunger Advocacy Network, 2-1-1 San Diego 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 2015. Community organizations are listed a”

“* MRI Joint Venture Board * National Active and Retired Federal Employees Association * National Alliance on Mental Illness * National Association of Neonatal Nurses * National Association of Hispanic Nurses, San Diego Chapter * National Hospice and Palliative Care Organization * National Institute for Children's Health Quality * National Kidney Foundation * National University * Neighborhood Healthcare Community Clinic * North County Health Project * Peninsula Shepherd Senior Center * Perinatal Safety Collaborative * Perinatal Social Work Cluster * Planetree Board of Directors * Professional Oncology Network * Public Health Nurse Advisory Board * Recovery Innovations California * Regional Perinatal System * Residential Care Council * Rotary Club of Chula Vista * Rotary Club of Coronado * Safety Net Connect * San Diego Community Action Network * San Diegans for Healthcare Coverage * San Diego Association of Diabetes Educators * San Diego Association of Directors of Volunteer Services * San Diego Association of Governments Public Health Stakeholder Group * San Diego Black Nurses Association * San Diego Blood Bank * San Diego Brain Injury Foundation * San Diego Coalition of Mental Health * San Diego Council on Suicide Prevention * San Diego County Breastfeeding Coalition Advisory Board * San Diego County Coalition for Improving End-of-Life Care * San Diego County Council on Aging * San Diego County Emergency Medical Care Committee * San Diego County Health and Human Services Agency * San Diego County Hospice-Veteran Partnership * San Diego County Older Adult Behavioral Health System of Care Council * San Diego County Perinatal Care Network * San Diego County Social Services Advisory Board * San Diego County Stroke Consortium * San Diego County Suicide Prevention Council * San Diego County Taxpayers Association * San Diego Covered California Collaborative * San Diego Dietetic Association Board * San Diego East County Chamber of Commerce Health Committee * San Diego Emergency Medical Care Committee * San Diego Eye Bank Nurses Advisory Board * San Diego Food Bank * San Diego Food System Alliance, Healthy Food Access Committee * San Diego Half Marathon * San Diego Health Information Association * San Diego Healthcare Disaster Council * San Diego Hospice and Palliative Nurses Association * San Diego Housing Commission * San Diego Hunger Coalition * San Diego Imperial Council of Hospital Volunteers * San Diego Lesbian, Gay, Bisexual, and Transgender Community Center, Inc. * San Diego Mental Health Coalition * San Diego Mesa College * San Diego Military Family Collaborative * San Diego North Chamber of Commerce * San Diego Older Adult Council * San Diego Organization of Healthcare Leaders, a local ACHE Chapter * San Diego Patient Safety Consortium * San Diego Physician Orders for Life-Sustaining Treatment Coalition * San Diego Regional Home Care Council * San Diego Rescue Mission * San Diego River Park Foundation * San Diego-Imperial Council of Hospital Volunteers * San Diego Regional Chamber of Commerce * San Diego Rescue Mission * San Diego Science Alliance * San Diego State University * San Ysidro High School * Santee Chamber of Commerce * SAY San Diego * Second Chance * Serving Seniors * Sigma Theta Tau International Honor Society of Nursing * Society of Trauma Nurses * South Bay Community Services * South County Action Network * South County Economic Development Council * Southern California Association of Neonatal Nurses * Southern California Earthquake Alliance * Southern Caregiver Resource Center * Special Olympics * St. Paul's Retirement Homes Foundation * St. Vincent de Paul Village * Susan G. Komen Breast Cancer Foundation * Sweetwater Union High School District * The Meeting Place * Third Avenue Charitable Organization * Trauma Center Association of America * United Service Organizations Council of San Diego * University of California, San Diego * University of San Diego * VA San Diego Healthcare System * Veterans Home of C”