2010 ANNUAL REPORT - Mission Hospital

ABOUT MISSION HOSPITALMission Hospital has been serving thegreater needs of the south Orange Countycommunity for nearly 40 years, improvingthe quality of life in the communities itserves.Mission Hospital provides access to advanced care andadvanced caring through two convenient locations,Mission Viejo and Laguna Beach. Mission Hospitalin Mission Viejo is an acute care, full-service facilityproviding the most advanced healthcare servicesand diagnostic care to south Orange County. One ofonly three designated trauma centers in the county,the 552-bed hospital offers 24-hour emergency careand specialized services through its Mission ImagingCenter, Mission Heart Center, Mission Stroke Center,Mission Maternity Center and Mission Women’sWellness Center. The hospital also offers the highestlevel of care in orthopedics, rehabilitation, cancer,spine and vascular services. Mission HospitalLaguna Beach’s healthcare services include 24-houremergency, intensive and medical-surgical care as wellas behavioral health including psychiatric servicesand chemical and pain medication dependencytreatment. CHOC Children’s at Mission Hospital, aseparately licensed pediatric hospital on the MissionViejo campus, serves as the only dedicated pediatrichospital in south Orange County.A member of the St. Joseph Health System, MissionHospital is one of 14 not-for-profit hospitals sponsoredby the St. Joseph Health Ministry.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWASPIRE TO CARING - VIDEO TRANSCRIPT“2010 was a milestone year for MissionHospital in regards to our stewardship andour fiscal performance at a time where a lotof institutions and companies were havingvery difficult down turn years.”Through our stewardship, management, philanthropyand program development and working closely theour doctors, we were able to expand. As a result,we were able to perform at a much higher leveland ultimately had probably the best fiscal year inthe history of the hospital. We had an opportunityin building our new tower to invest in the mostadvanced diagnostic equipment possible and replaceall of its infrastructure at one time without building acompletely brand new hospital.With great diagnostic capabilities, you have theability for early diagnosis, early clinical interventionand better clinical outcomes to get you back at home.And we had to do things differently. We had to seeourselves differently in a more innovative manner.It’s not just being innovative in terms of how wecan operationalize what we do more efficiently, butactually looking at the consumer, looking at a personwho needs access to care and making sure that’savailable in the most dynamic efficient manner. It’sreally striving for perfect care. People challengethe goal that we have for providing perfect care,but you know, when you come to a hospital youwant perfect care. So we want to make sure thatwe have all the assets in place to be able to provide,both the technological part as well as the people andprofessionals, to provide that perfect care.Peter F. BastonePresident and Chief Executive OfficerWith the acquisition of our Laguna Beach campusadded two specific programs we’ve never hadbefore that are not only in very big demand but veryunderserved in the Orange County community. Oneis Behavioral Health including Psychiatry and theother is Chemical Dependency.In 2010, we focused our ministry on the charism ofThe Sisters of St. Joseph of Orange, and in terms ofcaring for our dear neighbor we cared for those thatcame to us without the ability to care for themselvesand pay for healthcare. We were there for them andsupported them in a way that we’re charged to dowithin our ministry.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWASPIRE TO GROWTH - VIDEO TRANSCRIPTMission Hospital purchased South CoastMedical Center in order to extend ourministry of the Sisters of St. Joseph ofOrange. We have a deep care for the citizensof the coastal communities in south OrangeCounty.For so many years, the community, the physiciansand employees were unsure whether there was goingto be a hospital. Now there’s an assurance that notonly is there going to be a hospital, it’s going to behere for a long time and the resources are going to beavailable for it to be an excellent hospital.We conducted an extensive community health needsassessment which we focused entirely on the needsof Laguna Beach and listened to their concerns. Inlistening to the community, probably the biggestconcern is the need to be able to access emergencyservices when they need it.Thanks to Mission Hospital being in Laguna Beachnow there’s a lot of comfort in knowing that if there’san emergent need, paramedics can bring the patientto the emergency room to be triaged, for the hospitalto provide for those needs. And if the services are notavailable that are needed, the patient can very quicklybe transported to Mission Hospital in Mission Viejoto provide that patient what they need.Michael BeckVice President Operations, Mission Hospital Laguna BeachThey provide an opportunity for Mission Hospitalto strategically plan so that we can build upon thoseservices both at this campus and at the Mission Viejocampus and look to see who we can partner withwithin our community to make sure that our primaryand secondary service areas have what they need.One of the things that many staff has said over the pastyear is that Mission Hospital’s focus on recognizingsacred encounters really speaks to why they wentinto healthcare. Mission Hospital has brought thewords and also the intent of making every interactionsacred, recognizing that and honoring that.There are core services on the Laguna Beach campusalready: Chemical Dependency, Inpatient Psychiatry,Outpatient Psychiatric Services for adults as well asOutpatient Chemical Dependency programs and theylay a really strong foundation.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWTOP HIGHLIGHTSAn extraordinary year of remarkable care.At Mission Hospital, we aspire to many things.Resting on our laurels isn’t one of them.That being said, a number of landmark achievementsover the past year deserve special mention, such asacquiring a second campus, Mission Hospital LagunaBeach, and opening a new 94,000-square-foot patientcare tower. It has indeed been an extraordinary year ofremarkable care. While there is much to accomplishin the year ahead, there is also much to celebrate aswe look back.• Mission Hospital Laguna Beach (formerly SouthCoast Medical Center) was acquired in July 2009and recently celebrated its one-year anniversaryas part of Mission Hospital--The facility offers 24/7 emergency,intensive and medical-surgical care, alongwith supporting ancillary services--Mission Hospital Laguna Beach expandedour service offerings to include behavioralhealth, with psychiatric and chemicaldependency treatment programs--With the acquisition, Mission Hospital nowboasts:▪▪▪▪▪▪▪▪796 affiliated physicians2,743 employees592 volunteers552 licensed beds• On November 15, 2009 Mission Hospital openedTower 2—a four-story patient care tower thatfeatures a patient-centered design along withnext-generation advancements in healthcaretechnology. This makes Mission Hospital amongthe most technologically advanced hospital in thecountry.• Tower 2 was featured on WorldArchitectureNews.com highlighting the tower’s patient-centereddesign, superior seismic performance and 45-seat chapel and healing garden. It received manyawards, including:--2010 American Institute of Architects (AIA)Design Award for design excellence--Associated General Contractors of America(AGC) Marvin M. Black Excellencein Partnering Award for contractingmanagement and collaboration--Constructech Magazine’s Gold Awardfor use of three-dimensional BuildingInformation Modeling (BIM) to increasedesign and construction productivity• Extraordinarily successful fundraising efforts ledto a total of $8.3M raised for Fiscal Year 2010.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWTOP HIGHLIGHTS• Additional awards include:--U.S. Department of Health & HumanServices Medal of Honor for excellencefor organ donation for the fourth time(December 2009).--HealthGrades: Specialty Excellence –Stroke Care (2010).--Certificate of Excellence for CHARTPerformance: (September 2009, January2010)• We are also proud to highlight:--Access OC and Mission Hospital providedfree surgeries for uninsured patients onSeptember 26, 2009. This outpatient serviceallowed recipients to get back to their livesand remain productive members of ourcommunity.--Mission Viejo Emergency Departmenthas continued its environmental efforts byeliminating paper charting (95% paperless.100% computerized).--FY10 noteworthy statistics include:▪▪Emergency Room Visits (Mission Viejoand Laguna Beach campuses) – 71,420▪▪Trauma Patients – 931▪▪Births – 3,1822010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWLEADERSHIPPeter F. BastonePresident &Chief Executive OfficerMarkie Cowley,MSN, RN, FACEExecutive Vice President &Chief Operating OfficerKenneth McFarlandSenior Vice President &Chief Financial OfficerShirley BarnesSenior Vice President,Human ResourcesLinda Johnson,RN, BSN, MSN, NEA-BCVice President,Patient Care & Chief Nursing OfficerMichael BeckVice President,OperationsMission Hospital Laguna BeachSister Martha Ann FitzpatrickVice President,Advocacy & Ministry FormationWinnie JohnsonSenior Vice President & ChiefDevelopment Officer,FoundationCindy MuellerVice President,Mission IntegrationDennis Haghighat, MDVice President,Medical AffairsPaula SeriosVice President,Marketing & CommunicationsEileen HaublVice President,Financial OperationsLisa WeaverVice President,Business Development & StrategicPlanning2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

YEAR IN REVIEWLEADERSHIPBoard of TrusteesPeter. F. BastonePresident and Chief Executive OfficerMission Hospital R. Clifford CarperRetiredSister Karen ClockMarriage Family TherapistSt. Joseph HospitalSister Claudette Des ForgesVice President, Mission IntegrationSt. Jude Medical CenterWilliam EldienBoard ChairPresident and Chief Executive Officer Ketel One Vodka Oscar FloresManager of ChemistrySan Onofre NuclearGenerating StationSister Jayne Helmlinger – SecretaryExecutive Vice President,Mission IntegrationSt. Joseph Health SystemPat KellyChief Operating OfficerAffiliated Research InstituteSister Cecilia MagladryCenter for Spiritual DevelopmentMelinda MassonFounder and Chief Executive OfficerThe MERIT CompaniesSherri MedinaPartnerJourney Health PropertiesBill MurinExecutive Vice President,System ServicesSt. Joseph Health SystemChristopher Nolan, M.D.Chief of Staff and Plastic SurgeonMission HospitalMichele Staunton, M.DInternal Medicine Physician2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONASPIRE TO SERVE - VIDEO TRANSCRIPTMission Integration in my mind is aboutilluminating and animating into ourorganizational culture, the mission andvalues that we’ve inherited from the Sistersof St. Joseph of Orange.We have tons of examples in regards to how weengage our employees, physicians and volunteers infinding personal meaning and connection with ourmission. And one of those, for example, is a programthat we launched this past year called Mission GainsMomentum. This program is six months long andemployees have an opportunity to do a deep dive inregards to, what does our mission really mean? Whatis the tradition of the Sisters of St. Joseph of Orange?What legacy have we inherited from those Sisters?How do we connect that particular legacy with ourwork every single day?Sacred Encounters is actually one of our missionoutcomes or strategic goals in regards to how weenvision getting closer to living out our missionstatement. And our belief is that every interactionshould be experienced as a sacred encounter. Andwe know that there are four attributes that aretypically present in a sacred encounter. That’s thedignity of the person, a sense of caring, making apersonal connection with that person and also being acompassionate presence as well.Cindy MuellerVice President, Mission IntegrationI think something that’s very unique about ourmission is that we not only attend to improving healthhere in the hospital and in the community but also thequality of life of individuals. And we really believeby attending to health and quality of life that we arebringing people to the fullness of their potential inbody, mind and spirit.It starts with understanding ourselves as a ministryand knowing we’re not just a hospital within the fourwalls of a building, we are really here to improve thehealth and quality of life of people in the communitieswe serve. We really believe in attending to thoseuproot causes of health disparities and being in thecommunity and trying to identify those root causesand addressing them.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONASPIRE TO SERVEThrough Mission Integration, we incorporatethe mission and values of the Sisters ofSt. Joseph of Orange into our day-to-dayoperations.Affiliated physicians, nurses and staff provide carebased upon and integrated with the St. Joseph HealthSystem’s core values of Dignity, Service, Excellenceand Justice. As such, caring for our patients goesbeyond treating physical needs; emotional andspiritual needs are of equal importance in the healingprocess. We believe care should be as individualizedas the patients themselves. And on a larger scale,caring goes beyond the hospital walls and into thecommunity, where we seek to extend our healingministry to the poor and vulnerable.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONSACRED ENCOUNTERSWe believe every encounter with our patients,visitors and coworkers should be treated as aSacred Encounter.This is the mindset with which we minister to theneeds of the whole person—body, mind and spirit– through every interaction and every initiative weundertake.Sacred Spaces• A 45-seat chapel and Schumacher Healing Garden– both designed with the family and patient inmind – provide a peaceful setting to relax. Theseare open to all individuals seeking comfort orreflection.Spiritual CareMission Hospital ministers to the needs of the wholeperson through chaplains and volunteers who aretrained to provide holistic spiritual care to persons ofall religious faiths, and those without any religiousaffiliation.• Available for pastoral counseling, crisisintervention, prayer, and bereavement counseling.• Mission Hospital’s NODA (“No One Dies Alone”)outreach program assures that no patient will diewithout the comfort of a compassionate presencewhen a loved one cannot be present. Over the pastthree years, 215 volunteers have spent 607 hoursat the bedside of 33 patients.• Mission Hospital supports each patientin deciding the care they wish to receive,especially when they cannot voice it themselves.Advanced Directives include protocols thatgive seriously ill patients greater dignity thanever before. Through a program known as FiveWishes, patients can decide:--Who makes care decisions for them whenthey can’t--The kind of medical treatment they wish toreceive--How comfortable they want to be--How they want people to treat them--What they want their loved ones to know- - An estimated 5,000 copies of Five Wisheswere distributed to patients in FY102010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONVALUES IN ACTION AWARDSEach year, our Values in Action program allows staff, physicians and volunteers to recognizeindividuals that best exemplified these values.ExcellenceCherie FoxRN, BSN, CCRN-CSCDignityLars GaluppoDirector, Mission ConstructionCherie managed the Cardiac Intensive Care Unit(CICU) in an interim capacity for eight months. Shetook advantage of every training opportunity andlearned new managerial skills that contributed to hersuccess in meeting and exceeding the needs of herpatients, fellow nurses and coworkers.Lars oversaw construction of the four-story, 122-bed patient care tower, interacting with thousands ofstakeholders and approaching every situation withsensitivity to othersJusticeGeorge B. AvilaMURP, Manager HealthyCommunities, Mission IntegrationServiceLong PhamSenior Business Analyst,Information Technology ServicesGeorge is an advocate for two Mission Hospitalinitiatives—the CHEC Family Resource Centerand affordable housing. He tirelessly goes out intothe community to identify the needs of the mostvulnerable to help them have a voice and receive thejustice they deserve.Long is admired for his out of the box IT solutionsto improve patient care and safety. His positiveattitude and commitment to service allows everyoneto do their job more efficiently. Long also won the St.Joseph Health System award for Service.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONSACRED ENCOUNTERSPersonnel Programs• NODS is a service standard for each staff memberto give their Name, Occupation and Duty with aSmile when they enter a patient’s room so theyknow who they are and what they are there for.This program eases the strain of a hospital stayand creates a more positive patient experience• Personnel Orientation--In FY10, 344 employees and 137 contractindividuals went through WelcomeOrientation Week (WOW) to learn aboutthe history, heritage, job-related policiesand functions, and other hospital-relatedinitiatives to ensure ongoing quality of care.This important program ensures each newmember of the Mission Family has the toolsthey need to deliver on our mission in theirdaily workPatient/Family Advisory Councils• Bring together patients, their families andMission Hospital administrators, physicians andstaff to develop new services and programs thatimprove the hospital experience• Draws on the valuable knowledge and experienceof its members to help guide Mission’s Patientand Family Centered Care focus• Two Councils (Critical Care and Maternity)served the Mission Viejo campus in FY10Critical Care Council highlights include:--Collaborated with staff to developdocuments for Traumatic Brain Injury sitterqualifications, transitioning patients moreeffectively between Surgical Intensive CareUnit, Progressive Care and Stroke Unit andAdult Rehabilitation Unit--Developed a list of former patientswilling to help new families with theirillnesses/crisis--Helped offer suggestions on newMission Hospital Web site--Participated in Rapid Improvementevents to improve hospital processesMaternity Council highlights include:--Instituted a perinatal comfort carecommittee for families anticipatinginfant loss--Thoroughly revised infant lossbereavement materials--Revised and updated maternity brochure--Provided guidance for online maternityeducation development--Facilitated change in materials providedto new mother--Provided input on several hospitalmarketing campaignsAvatar / Patient Satisfaction SurveysAvatar surveys help assess the patient experience.The results of these assessments are communicatedto appropriate audiences and improvement plans aredeveloped, implemented, and evaluated to improvethe care we provide.• In the categories of Loyalty and Endorsement,Mission Hospital received its highest scores todate of 93.45. This was well above the targetedgoal of 92.21.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONASPIRE TO PROVIDE - VIDEO TRANSCRIPTThe Sisters in 1650 used the name the DearNeighbor and historically that has alwaysbeen part of our mission, to go out in thecommunity and meet the needs of the dearneighbor.At Mission Hospital, we do acute care very well here,in a very caring and compassionate way. But wealso look beyond the walls to the broader communityand Camino Health Center has been doing that foralmost 28 years now. To date at Camino, we haveserved almost one million men, women and children.To me it’s a safety net for low income people inour community, many of them who have lost theirhealth insurance due to economic cutbacks. For thesecommunity members, Camino has been and continuesto be an important safety net.As a way to reach the community, we have mobilevans that go into high needs areas. Knowingtransportation can be a challenge, the communitycan access primary medical care through the vans.Advocating for children’s access is important. Wewant them to have a place to go for care, for ongoingmedical care, immunizations, check-ups, all of thethings that go to help create a healthy child.Sister Martha Ann FitzpatrickVice President, Ministry Formation and AdvocacyIf we think of ourselves as a hospital without walls,we have individuals who are constantly in need andour mission is to reach out and to care for those in ourcommunity whether it be medical, spiritual, emotionalor educational. Our mission is very broadly based andall these programs in one way or another help us tocarry out that mission.The Family Resource Center, with two locationsserves the needs of low income people. Therepeople come in and they want to have their childrenenrolled in Healthy Families. Perhaps there arefamily problems, so we have short term counselingavailable or financial assistance. These are just a fewof the kinds of resources that are available throughthe Family Resource Center.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONADVOCACYOur Advocacy initiatives ensure the mostvulnerable and disadvantaged have accessto health and quality-of-life issues includingfood, shelter and adequate healthcare.Mission Hospital sponsors Camino Health Centerwhich has cared for nearly one million men, womenand children over the past 28 years.As its sole sponsor, Mission Hospital supports thevital work that Camino Health Center does, bothwithin its doors and in the community, to increaseaccess to care through:• Women, Infants and Children (WIC)program• Pediatric Dental Clinic• Mobile Diabetes ClinicTotal patients served in FY10: 108,840• medical visits: 22,241• dental visits: 3,005• mobile unit visits: 1,432• WIC: 82,162Mission Hospital’s Community Health EnrichmentCollaborative (CHEC) Family Resource Centerand South Orange County Family Resource Center(SOCFRC) provide programs that offer education,support and resources that help families grow andthrive. These programs assist with everyday issuessuch as:• Health insurance and education• Education assistance• Women’s support groups• Parenting classes• Guidance and mental health support• Senior services• Youth leadership programs• Financial assistance for basic needs2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONASPIRE TO OUTREACH - VIDEO TRANSCRIPTThe Sisters of St. Joseph of Orange havebeen working in these communities fornearly a century. Our efforts are extendingthe work that they’re doing by going out andmeeting with the dear neighbor, serving thecommunities at hand, especially those thatare most vulnerable.We had five core priorities in FY10. The first wasaround Access to Primary Healthcare Services whichwe served through Camino Health Center. We usea variety of different strategies to meet the needs ofthe community. One of those ways was through thePlay More. Eat Better program. That’s a really neatprogram because we go out into the communities ofSan Juan Capistrano and San Clemente and we holdneighborhood block parties which are focused aroundproviding tools for families to create incrementalchanges around eating healthy and getting morephysical activity. And of all the kids who haveparticipated, over six percent have decreased theirbody mass index.Christy CornwallDirector, Community Benefitbeing out in the community, we are able to serve themost vulnerable and those who don’t have accessto regular care. Providing medical care inside thehospital walls is absolutely crucial but providing thatpreventative care on the outside and serving thosewho have fewer resources and maybe less accessis equally important. It’s what I think all togethercreates a healthy community.While we might not be able to build homes as ahospital, we have mobilized a great number ofcommunity agencies that are now working together toaddress having affordable homes in the community.We’re educating consumers and we’re educatinglocal policy officials about what affordable homesmean, who lives there and why are they important.We work closely with our local employers throughproviding education and screenings to provide ahealthier and productive work force. We extend someof those offerings into the broader community wherewe work to keep the community healthy. Throughextending the mission of the Sisters of St. Joseph by2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONHEALTHIEST COMMUNITIESWe actively identify quality of health needsin underserved communities to ensure themost vulnerable and disadvantaged haveaccess to basic health and quality-of-lifeneeds, including food, shelter and adequatehealthcare.Current economic conditions have increased the needfor community-based programs. Our CommunityBenefit commitment totaled $32.7 million in FY10.Initiatives under taken to improve the health andquality of life of the communities we serve were:Increasing access to primary care services• Camino Health Center had over 108,000 visitsand served 3,557 unduplicated residents fromSan Juan Capistrano, San Clemente and DanaPoint (and increase of 8% over FY09)• Provided needed primary medical and dental carethrough the clinic and mobile units• Supported mothers and their children withnutritional substance through the WIC programReducing the prevalence of childhood obesity• In FY10, our child obesity initiative providedover 22,000 encounters for residents of southOrange County• Play More. Eat Better. block parties held in thecommunities of San Juan Capistrano and SanClemente focused on providing education onincremental changes families can make to stayhealthy and active• Of the children who were overweight and obese,we measured 6% decrease in body mass indexIncreasing access to services for depression• The South Orange County Family ResourceCenter saw an increase in mental health clientsof 23% in FY10• The collaborative efforts of the South OrangeCounty Depression Coalition resulted in a 36%increase in recruitment of mental health providerswilling to provide sliding scale services for localresidents2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

MISSION INTEGRATIONHEALTHIEST COMMUNITIESEmployer RelationsMission Hospital works closely with local employersto help their staff improve and maintain healthylifestyle habits. Among the activities (which resultedin 76 new patients) provided were:• Free on-site total cholesterol and glucosescreenings and education• Health risk assessments• Flu vaccine clinics• Mammogram lunch program included 56participantsBreast Marketing CampaignA large-scale marketing campaign was launched inFebruary 2010 to raise awareness about the need forregular screening mammograms. Results included180 new patient encounters and one known positivediagnosis (early stage).2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

ASPIREASPIRE TO ADVANCE - VIDEO TRANSCRIPTAspire to Mission Hospital has meant ourability to take a great stride in the area ofinnovation and technology to support thepractice of medicine in this region.We’ve been able to bring the best technology, the bestdiagnostic capability in the world to south OrangeCounty. Along with it, we’ve been able to support ouraffiliated physicians in our Centers of Excellence withthe best clinical backup and diagnostic capability forthem to do the type of work that is world renowned.We identified the needs of all our Centers ofExcellence and the challenge was to work with ourphysicians and our clinical nurse specialists to makesure that not only our protocol, not only the staff butthat our technologies are also available to do earlydiagnosis, early clinical intervention provide the bestclinical outcome possible.This combination has lead us to be able to advancethe levels of our Centers of Excellence to a degreewhere we’re nationally recognized in terms of clinicaloutcomes. Our technology and our commitment totechnology is at the forefront. We want to be the betasite, we want to be the most advanced, we want tobe the most innovative on all fronts and in doing so,we’re able to bring better quality outcomes to ourpatient population in this region.The milestones that we hit in 2010 were prettyextraordinary. First, was the addition of our newpatient tower. The tower includes a brand newdiagnostic division for the medical center whichis by far the best in the country. Second, is a newSurgical ICU that supports our trauma programand our traumatic brain injury program, and thirdis our Progressive Care Unit which is our strokeunit on the fourth floor and is very unique. Theadvancement that we’ve made becoming one of thefirst Stroke Receiving hospitals in the region has beenextraordinary.Peter F. BastonePresident and Chief Executive OfficerThis year was also a landmark for us in regards tothe 30th Anniversary of Trauma Services at MissionHospital. Mission Hospital was one of the firsttrauma centers in the county and is one of onlythree left. We’re the only regional trauma center insouth Orange County, and the American College ofSurgeons has designated us as the top communitybased trauma center in the country.Having the ability to innovate and use technology anduse that flame of charism for our dear neighbor thatthe Sisters of St. Joseph of Orange brought forwardover 360 years ago is something that differentiatesus as a ministry. If the original Sisters were here Ithink they’d be astounded by the numbers of peoplewe’re able to reach, that we’ve invested in caringfor a broad population, that we are committed tocommunity health and community service andwe still define ourselves as a ministry. We defineourselves as a caring neighbor making sure that themost vulnerable in our community receive care. Takea look at the close to 3,000 employees that we havehere at Mission Hospital -that charism and that spiritis carried forward by all of us as part of the ministry.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

ASPIRETOWER 2 OPENINGAspire to advance.We aspire to provide caring service with advancedtechnology that treats the whole person—mind,body and spirit. In fact, the opening of Tower 2this year makes Mission Hospital among the mosttechnologically advanced hospitals in the country,with internationally recognized, award-winningdesign and nationally-recognized expertise in a widerange of specialties.Access to the world’s best imaging and diagnosticcapabilities and award-winning, life-saving protocols.• Convenient access to technologies such asPET/CT, a dual-source CT scanner, bi-planeangiography, a state-of-the-art 3-Tesla Verio MRIand the software that connects them all, meansfaster, more accurate, integrated diagnosis andtimely treatmentThe Swenson Family Linear Accelerator Suiteprovides patient access to the latest cancer treatmentin Orange County.• Helps destroy cancer cells more effectively whilepreserving surrounding healthy tissue24-bed Progressive Care and Stroke Unit designed tomeet the needs patients requiring more than medicalsurgicalcare, but less than critical care.• Ensures patients and families are involved in thetreatment process from start to finish• Designated Stroke-Neurology Receiving CenterZimmer Neuroscience Wing provides care fortraumatic and critical injuries in our 20-bed SurgicalIntensive Care Unit.• Our team of nurses and specialists isinternationally recognized for developing andimplementing lifesaving treatment protocols• Rooms contain moveable power columns thatextend from the ceiling and carry all diagnosticequipment needed to care for the patient2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

ASPIRETRAUMA 30 TH ANNIVERSARYMission Hospital Regional Trauma Centercelebrated its 30th Anniversary in FY10.The trauma care program, a Center of Excellence,was originally championed by Dr. Tom Shaver in1980. Five hospitals were initially designated as“official trauma centers” – Mission Hospital is one ofthree that remain. At the forefront, through state-ofthe-artprotocols and the most advanced diagnostictechnologies available, today the trauma care programis as strong as ever.• Six surgeons and a group of highly specializednurses form the core of the Trauma Team• Mission Hospital Trauma Services received the2010 Spirit of Volunteerism Award from OneOCfor their accomplishment with Youthful Drugand Alcohol Deterrent Program, Safe Rides andongoing prevention efforts• The legacy of care continues with Dr. TomShaver’s son, Dr. John Shaver who is now theTrauma Medical Director• In FY10, 931 Trauma Patients were provided care2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

ASPIREPERFECT CAREPerfect Care is a long-term strategic initiativedesigned to improve the quality and safetyof patient care through innovation andimproved processes.Mission Hospital has partnered with technologypartners to leverage electronic medical records(EMR) technology that provide easier, more efficientaccess to medical information.Improving Performance – The Mission Way• A system that engages employees and cliniciansin redesigning processes to improve workflowand reduce redundancy/waste, adding value totheir work environment and improving patientexperience--Number of Rapid Improvement Events(RIE) & Values Stream Analysis’ (VSA): 24--New Certified Green Belts: 15*--Return on Mission (ROM):▪▪183 employees participated, 20 in morethan one RIE▪▪Soft Savings; $694,832▪▪Return on Investment (ROI) hardsavings: $937,668Quality and Regulatory Highlights• Completion in July of a successful recertificationof the Joint Commission inpatient primary strokeprogram with praise and no recommendations forimprovement• Mission Hospital Laguna Beach was successfullysurveyed by the Joint Commission, and is now apart of the Mission Hospital Joint CommissionAccreditation• No wrong site surgeries for more than 5 years ina row• Pacific Ambulance is Mission Hospital’s newambulance service provider*Mission Hospital’s Improving Performance program, is based onLean Methodology, follows the martial arts format of having coloredbelts (Green and Black) based on your level of expertise. Green is thefirst level of excellence and indicates a mastery of Lean basics. Blackindicates a complete mastery of process improvement and the ability tocoach individuals or an organization through improving performanceactivities.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

ASPIREADVANCED CAREMission Hospital leads the way in providingthe most advanced diagnostic care in theworld with advanced caring to treat thewhole person - body, mind and spirit.Some of the technologies and protocols that bestexemplify this level of advanced care and advancedcaring include:• Traumatic Brain Injury - The Licox ® BrainTissue Monitoring System is a state-of-the-artsystem that ensures a trauma victim’s braincontinues to receive the oxygen needed toremain healthy• Aortic Dissection - Access to options andexpertise like the Aortic Arch Replacement– a delicate procedure that repairs the largestvessel from the heart, the aorta. It’s performedby the only surgeon in Orange County who’smade it his life’s work• Trauma – The Arctic Sun allows a team ofdoctors to cool a trauma patient’s core bodytemperature. It virtually freezes the body intime in order to preserve brain function for afull recovery• Rapid Response Team - Any unusualsymptom will result in a Rapid Response Nurseat your bedside with additional expertise in amatter of seconds• daVinci S. Surgical Robotic System - Allowshighly skilled surgeons to operate through tinyincisions with pinpoint accuracy, resulting inless pain, less scarring, and a shorter hospitalstay2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

FINANCIALSTOP HIGHLIGHTSAspire to provide.Maintaining the highest standards of integrity isintegral to our goal of providing the best care forour patients and the community at large. As wecontinue to gain momentum in providing advancedcare with advanced caring, we also aspire to be aleader in financial stewardship, transparency andaccountability. By continually striving to better ouroperations we can deliver on our mission to care forthe underserved and meet our goals as a ministry.We are grateful for the hard work and sacrifice fromso many that makes our work possible. And in thisdifficult economy, we are more thankful than everfor the many contributions we have received over thepast year.• Consolidated Net Income of $57.6M or12.3% Profit Margin – a 122.5% improvementover budget• Salaries and benefits for employees whoprovide our services - $201M• Cost of services provided for patients whocouldn’t afford to pay for the care theyreceived (Charity Care): $26M• Other patient service charges for which wedid not receive payment (Bad Debt): $29M• Capital invested to build/improve facilitiesand to enhance patient care: $89M• $18M “turn-around” of our July 1, 2009,Laguna Beach Hospital Acquisition (Formerlyknown as South Coast Medical Center) whichhistorically has been losing over $1M permonth, achieving an Overall Profit Margin of7.6%• Provided over $4.3M in support of“Community Health & Healthy Communities”Programs and ServicesPhilanthropy Highlights:Total giving (raised) amounted to 8.3M, whichincludes:• Camino Health Center Auxiliary FashionShow raised $370,000• Golf benefit raises $360,000 for MissionHospital• Mission Hospital’s ‘Employee Giving’campaign raised $112,000• Annual Holiday Gala raised $900,000• Valiant Women Luncheon raised $125,000for Mission Hospital women’s services2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

FINANCIALSFINANCIAL CHARTSMission HospitalFISCAL YEAR 2010Payor Mix (Insurance)PercentageDischargesCommerical(e.g. PPO, HMO, POS)42%9,541Medicare30%6,859Medi-Cal11%2,565Other17%3,85822,823Discharges - Acute21,492Discharges - Non-Acute1,33122,8232010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

FINANCIALSFINANCIAL CHARTSMission HospitalFISCAL YEAR 2010ExpendituresSalaries & Employee CostsPercentage47%Dollars(in thousands)$200,690Purchased Services12%$49,192Supplies17%$73,652Capital Costs5%$21,161Other19%$80,925$425,6242010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009

FINANCIALSASPIRE TO GIVING - VIDEO TRANSCRIPTWe had our second best year ever in 2010.We had a total giving of $8.3 million which isphenomenal in this time of uncertainty when a lotof people are not giving as large of gifts, but manypeople come forth. And I believe it’s because withinmost of us there is a natural need to help and to giveback. And we’re just very fortunate to have so manydoctors and nurses take good care of their patients,and donors who had great experiences here and havethe means to make the kinds of contributions thatmake Mission the kind of hospital it is.The Spirit of Giving of our board and all of themembers of our community who got behind our$50 million campaign was phenomenal. It reallygalvanized our community to get behind our visionfor the future of this hospital and, the health of thiscommunity. It was really amazing. We were told itcouldn’t be done and we said, just watch us. Jimand Sue Swenson contributed millions of dollarsin support of our Linear Accelerator. They gavebecause of what they see as the best hospital theyhave been to. Our Auxiliary decided some years agothat they wanted to support the building of the chapel.And we also have a wonderful donor in MargaretSchumacher who supported the Healing Garden.Together Margaret Schumacher and the MissionHospital Auxiliary made the difference.Winnie JohnsonExecutive Vice President, FoundationIt’s really important to me to appreciate whateverybody can give. And for me to see peoplecoming together so that we have the healthcare wewant in our community, the quality of life we have,just means so much to who I am because that’s whatI like to see, people coming together.Without our volunteers we would not have the worldclasshospital we have, because they are our partners.Our donors come with expertise, time to devote toactivities and they also make financial contributionsthat really make a difference in what we’re able toprovide for the community. And it’s in their interestthat we have the best hospital that we possibly canso they want to be involved to make sure that that isavailable to them and their friends and neighbors.2010 Mission Hospital Annual ReportReporting on Fiscal Year Ending June 30, 2009