999.5(d)(5)(C)

Description of Services to Medi-Cal, County Indigent and Other Classes of Patients

A description of the medical services provided by St. Francis Medical Center to Medi-Cal patients, county indigent patients and other classes of patients is set forth in the Community Health Impact Report, attached to Section (5) (G) of this application, and is incorporated by reference herein. The data and/or information provided by St. Francis Medical Center in response to this section represents its best estimate of the costs of the medical services provided by St. Francis Medical Center to its Medi-Cal, Medicare, managed care, county indigent and other classes of patients. Generally, all types of medically necessary hospitals services are available to these classes of patients.

Relevant excerpts from the Community Health Impact Report are attached hereto.

Profile and Key Services: St. Francis Medical Center, Lynwood, CA

Recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Maternal-Child Health and Trauma, an established network of community clinics and outreach programs, and a vital role in LA Countys Public/Private Health Care Safety Net

2013 Healthcare Leadership Award Hospital Finalist, Los Angeles Business Journal Ranked in top 50 cardiovascular hospitals in 2012 by Thomson Reuters Recognized as a High Performing Hospital in Ear, Nose & Throat, Nephrology, and Urology in

2012 by U.S. News and World Report Honorable Mention Award for top performance in Evidence-Based Care, Mortality and Cost of

Care in 2011 by Premier Website QUEST In 2013, SFMC provided more than $56 million in community benefit programs and services to

the community, as well as more than $8 million in care for the elderly

Key Services Include:

Comprehensive Maternal-Child Health Neonatal Intensive Care Unit Level II Cardiovascular Care Emergency Services/Paramedic Base Station Trauma Services (Level II) STEMI Receiving Center Behavioral Health Services Primary Care and Occupational Health Clinics, Wound Care Center including Hyperbaric

Medicine Community Outreach and Wellness Programs

Cost and Revenue by Payor

SFMC received $99 million and $114 million in net supplemental funding under several programs in FY2012 and FY2013, respectively

o In FY2013, approximately $60 million was received under the statewide Hospital Quality Assurance Fee Program and approximately $4 million as a result of meeting certain Meaningful Use program requirements

o SFMC also received approximately $50 million in Medi-Cal supplemental funding and is the only DCHS hospital to receive such payments

SFMC received a Capitation Premium of $34 million in calendar year 2012 and $41 million in calendar year 2013

Medicare and Medi-Cal participants accounted for more than 76% of all patient days over the past two fiscal years

St Francis Medical CenterCost of Services by Payer Category

FY 2010 - 2014

2010 2011 2012 2013 2014

Operating Expenses $302,794,734 $355,924,881 $363,455,627 $378,087,533 $370,514,513Adjusted Operating Expenses $289,659,611 $307,659,604 $317,893,107 $325,808,020 $348,233,926

Cost of Services by PayerMedicare $56,946,641 $86,889,499 $83,222,582 $91,749,459 $96,563,529Medi-Cal $164,060,752 $180,857,492 $172,120,314 $152,153,788 $168,889,173Third Party $38,285,515 $13,529,276 $28,194,202 $28,896,258 $43,181,084Other $30,366,703 $26,383,337 $34,356,008 $53,008,514 $39,600,139

St Francis Medical CenterNet Patient Revenue by Payer

FY 2010 - 2014

2010 2011 2012 2013 2014

Medicare $85,304,412 $105,616,060 $103,585,904 $99,952,538 $87,698,795Medi-Cal $161,216,342 $238,669,994 $225,084,309 $259,301,882 $165,410,779Third Party $35,214,046 $29,970,218 $31,513,047 $32,041,615 $59,654,989Other $8,992,837 $8,892,118 $10,960,176 $13,523,599 $32,193,210

Total $290,727,637 $383,148,390 $371,143,436 $404,819,633 $344,957,773

Source: OSHPD Disclosure Reports 2010 - 2014

St. Francis Medical Center Actual

YTD FY11 YTD FY12 YTD FY13 YTD FY14 YTD FY15

Jul-Jun Jul-Jun Jul-Jun Jul-Jun Jul-May

PATIENT REVENUE

Inpatient Gross Revenue

Inpatient Medicare 247,016,923$ 234,241,739$ 214,531,699$ 213,956,982$ 165,823,932$

Inpatient Medi-Cal 403,858,302$ 320,153,302$ 357,896,090$ 387,085,863$ 403,084,977$

Inpatient HMO/PPO 60,561,655$ 107,723,550$ 105,646,503$ 133,511,788$ 156,631,995$

Inpatient Self-Pay 77,175,078$ 135,468,352$ 141,857,549$ 161,272,552$ 102,061,268$

Inpatient Capitation 67,885,991$ 64,805,336$ 67,924,084$ 82,411,206$ 91,481,660$

Inpatient Other 2,327,100$ 21,738,134$ 17,594,043$ 18,994,819$ 19,799,403$

Outpatient Gross Revenue

Outpatient Medicare 53,150,075$ 52,727,139$ 56,981,080$ 51,451,087$ 45,811,807$

Outpatient Medi-Cal 170,073,668$ 147,855,732$ 158,044,313$ 180,307,695$ 179,110,168$

Outpatient HMO/PPO 36,946,528$ 59,063,178$ 69,389,087$ 79,047,052$ 79,943,212$

Outpatient Self-Pay 64,488,708$ 73,608,784$ 81,216,117$ 93,325,977$ 79,670,200$

Outpatient Capitation 23,937,344$ 28,521,500$ 33,176,603$ 39,229,481$ 44,107,797$

Outpatient Other 2,434,724$ 8,724,069$ 7,659,071$ 12,328,987$ 9,096,377$

TOTAL PATIENT REVENUES 1,209,856,096$ 1,254,630,815$ 1,311,916,239$ 1,452,923,489$ 1,376,622,796$

Days

Total Medicare Days 29,566 27,355 21,326 19,127 14,608

Total Medi-Cal Days 49,490 43,711 41,325 38,945 41,745

Total HMO/PPO Days 6,040 8,561 10,768 9,812 9,997

Total Self-Pay Days 9,442 8,114 6,567 6,741 1,415

Total Capitation Days 7,453 7,480 6,078 7,089 7,902

Total Other Days 268 2,349 1,880 5,962 6,957

TOTAL DAYS 102,259 97,570 87,944 87,676 82,624

Discharges

Medicare Discharges 4,428 3,738 3,358 2,892 2,409

Medi-Cal Discharges 10,099 9,620 9,626 9,830 10,422

HMO/PPO Discharges 1,539 1,941 2,426 2,288 2,207

Self-Pay Discharges 1,814 1,823 1,546 1,570 308

Capitation Discharges 1,934 1,977 1,736 1,887 1,889

Other Discharges 41 274 265 383 679

TOTAL DISCHARGES 19,855 19,373 18,957 18,850 17,914

Patient Origin

The table below demonstrates that 32 zip codes comprise the service area from which 84.2% of St. Francis Medical Centers inpatient discharges originated in CY 2011. The top seven zip codes account for 54.6% of total discharges.

ZIP Code CommunitySt. Francis Discharges

Percent of Total

Cumulative Percent

Service Area Total Discharges

St. Francis Market Share

90262 Lynwood 2,683 13.4% 13.4% 7,054 38.0%90280 South Gate 1,983 9.9% 23.3% 7,891 25.1%90201 Bell Gardens 1,304 6.5% 29.8% 8,234 15.8%90221 Compton 1,301 6.5% 36.3% 5,791 22.5%90002 Los Angeles 1,178 5.9% 42.2% 6,078 19.4%90059 Los Angeles 1,068 5.3% 47.5% 5,256 20.3%90255 Huntington Park 1,014 5.1% 52.6% 6,954 14.6%90001 Los Angeles 949 4.7% 57.3% 6,395 14.8%90222 Compton 890 4.4% 61.8% 3,816 23.3%90220 Compton 801 4.0% 65.8% 6,270 12.8%90044 Los Angeles 562 2.8% 68.6% 12,027 4.7%90003 Los Angeles 556 2.8% 71.4% 8,233 6.8%90061 Los Angeles 389 1.9% 73.3% 3,679 10.6%90723 Paramount 353 1.8% 75.1% 5,293 6.7%90270 Maywood 276 1.4% 76.4% 2,731 10.1%90706 Bellflower 192 1.0% 77.4% 7,775 2.5%90241 Downey 189 0.9% 78.3% 4,503 4.2%90242 Downey 185 0.9% 79.3% 4,222 4.4%90047 Los Angeles 175 0.9% 80.1% 7,201 2.4%90250 Hawthorne 163 0.8% 81.0% 9,480 1.7%90043 Los Angeles 119 0.6% 81.6% 6,579 1.8%90301 Inglewood 87 0.4% 82.0% 4,512 1.9%90240 Downey 86 0.4% 82.4% 2,299 3.7%90247 Gardena 82 0.4% 82.8% 5,668 1.4%90304 Inglewood 65 0.3% 83.2% 2,334 2.8%90249 Gardena 52 0.3% 83.4% 2,972 1.7%90302 Inglewood 52 0.3% 83.7% 3,013 1.7%90022 Los Angeles 44 0.2% 83.9% 6,904 0.6%90260 Lawndale 30 0.1% 84.0% 3,261 0.9%90040 Los Angeles 24 0.1% 84.2% 1,299 1.8%90248 Gardena 11 0.1% 84.2% 1,181 0.9%90278 Redondo Beach 4 0.0% 84.2% 3,385 0.1%

Subtotal 16,867 84.2%

All Other 3,157 15.8% 100.0%

Total 20,024 100.0%

Source: OSHPD 2011 Inpatient DatabaseNote: Excludes normal newborns

St. Francis Medical Center Service Area Map

Daughters of Charity Health System

St. Francis Med. Ctr.

Primary Service Area

Secondary Service Area

Area Hospitals

1. Bellflower Med. Ctr. 2. Centinela Hospital Med. Ctr. 3. Comm. & Mission Hosp. of Huntington

Park 4. PIH Health Downey 5. Kaiser Hospital Downey 6. Memorial Hospital of Gardena

Service Area Population and Demographic Profile

The total population in St. Francis Medical Centers service area is expected to growth at a rate of 0.7% annually through CY 2019, with the fastest growth occurring in the 65+ age cohort.

Estimated 2014 Projected 2019Cumulativ

e

Age Cohort PopulationPercent of Total Population

Percent of Total CAGR

Change 2014-2019

Service Area0-17 476,092 29.2% 471,032 27.9% -0.2% -1.1%18-44 657,749 40.3% 663,060 39.3% 0.2% 0.8%45-64 357,446 21.9% 384,678 22.8% 1.5% 7.6%65+ 141,467 8.7% 168,218 10.0% 3.5% 18.9%

Total 1,632,754 100.0% 1,686,988 100.0% 0.7% 3.3%

California0-17 9,313,067 24.2% 9,388,558 23.3% 0.2% 0.8%18-44 14,639,527 38.0% 14,892,503 37.0% 0.3% 1.7%45-64 9,786,617 25.4% 10,244,346 25.4% 0.9% 4.7%65+ 4,810,836 12.5% 5,734,627 14.2% 3.6% 19.2%

Total 38,550,047 100.0% 40,260,034 100.0% 0.9% 4.4%

Source: Claritas 2014 Database

The service area households are less affluent compared to the state of California overall, with a median household income of $40,684 compared to the state median of $54,015.

Socioeconomic Indicator Estimated 2014 Projected 2019 CAGRCumulative Change

2014-2019

Service AreaPopulation 1,632,754 1,686,988 0.7% 3.3%

Households 450,142 465,384 0.7% 3.4%

Average Household Size 3.6 3.6 0.0% -0.1%

Median Household Income $40,684 $42,733 1.0% 5.0%

Average Household Income $54,986 $58,372 1.2% 6.2%

Income DistributionUnder $25,000 31.2% 29.6% -0.4% -1.9%$25,000-$49,999 28.4% 27.9% 0.3% 1.6%$50,000-$99,999 27.8% 28.0% 0.8% 4.2%$100,000 + 12.6% 14.5% 3.5% 18.9%

CaliforniaPopulation 38,550,047 40,260,034 0.9% 4.4%

Households 13,003,529 13,592,743 0.9% 4.5%

Average Household Size 2.9 2.9 0.0% 0.0%

Median Household Income $54,015 $56,929 1.1% 5.4%

Average Household Income $81,689 $87,810 1.5% 7.5%

Income DistributionUnder $25,000 21.9% 20.5% -0.5% -2.4%$25,000-$49,999 22.3% 21.4% 0.1% 0.6%$50,000-$99,999 29.2% 28.6% 0.5% 2.4%$100,000 + 26.6% 29.5% 3.0% 15.8%