UKIAH ADVENTIST HOSPITAL: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- UKIAH ADVENTIST HOSPITAL (EIN 94-1639901)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-05
- IRS object ID
- 202443109349303094
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-05T14:32:39-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Moss Adams LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 W March Ln Ste 200 | AddressLine1Txt |
| City | Stockton | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952192367 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941639901 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ukiah Adventist Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UKIA | BusinessNameControlTxt |
| Phone | 9164060000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 275 Hospital Drive | AddressLine1Txt |
| City | Ukiah | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95482 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Mock | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 9164060000 | PhoneNum |
| Signature | 2024-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Tracy S Paglia | PreparerPersonNm |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | PhoneNum |
| Preparation | 2024-11-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Ukiah Valley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Judson Howe | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 275 Hospital Drive | AddressLine1Txt |
| City | Ukiah | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $261,487,354 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/ukiah-valley/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Living God's love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 993 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $86,112 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,735,809 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,253,922 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $240,455,100 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $255,410,857 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,480,157 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,822,575 | CYInvestmentIncomeAmt |
| PY Other Revenue | $240 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $257,671,306 | PYTotalRevenueAmt |
| CY Total Revenue | $261,487,354 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $256,957 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $249,848 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $74,760,618 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $84,485,456 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $203,416 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $167,616,571 | PYOtherExpensesAmt |
| CY Other Expenses | $171,926,716 | CYOtherExpensesAmt |
| PY Total Expenses | $242,634,146 | PYTotalExpensesAmt |
| CY Total Expenses | $256,662,020 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $15,037,160 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,825,334 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $244,768,311 | TotalAssetsBOYAmt |
| Total Assets EOY | $261,031,343 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $101,076,076 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $105,934,809 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $143,692,235 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $155,096,534 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | Living God's love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $212,602,177 | ExpenseAmt |
| Grant | $249,848 | GrantAmt |
| Revenue | $255,324,745 | RevenueAmt |
| Desc | See Schedule O | Desc |
| Total Program Service Expenses | $212,602,177 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 993 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | John Beaman CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9164060000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Adventist Health Way | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Heinrich Kerry | ||||||||||
| Dir/Chair/CEO | 0.00 | 50.50 | Yes (X) | Yes (X) | $0 | $3,302,428 | $57,395 | |||
| Hofheins Todd | ||||||||||
| Dir/Vice Chair/COO | 0.00 | 50.50 | Yes (X) | Yes (X) | $0 | $2,272,592 | $76,141 | |||
| Beaman John | ||||||||||
| CFO/Assistant Secretary | 0.00 | 50.50 | Yes (X) | $0 | $1,680,553 | $73,355 | ||||
| Stevens Eric - President | ||||||||||
| Northern CA/HI State Network | 5.00 | 45.50 | $0 | $1,526,293 | $59,552 | Yes (X) | ||||
| Jahn Andrew - Former | ||||||||||
| Care Division President thru 02/22 | 0.00 | 50.00 | $0 | $1,465,906 | $103,785 | Yes (X) | ||||
| Nahapetian Arby - Former Care | ||||||||||
| Division Medical Officer thru 02/22 | 0.00 | 50.00 | $0 | $1,482,294 | $69,613 | Yes (X) | ||||
| Wells Jason | ||||||||||
| Former President thru 12/20 | 0.00 | 50.00 | $0 | $1,470,582 | $37,177 | Yes (X) | ||||
| Wing Bill - Former | ||||||||||
| Dir/Asst Secr/Vice Chair thru 01/22 | 0.00 | 0.00 | $0 | $1,438,460 | $40,073 | Yes (X) | ||||
| Jobe Meredith | ||||||||||
| Secretary | 0.00 | 50.50 | Yes (X) | $0 | $959,488 | $59,410 | ||||
| Howe Judson - President AHUV | ||||||||||
| Pres, North Coast Network thru 03/23 | 8.30 | 41.70 | Yes (X) | $0 | $808,895 | $28,997 | ||||
| Tetz Warren - Former | ||||||||||
| Treas/Asst Secr thru 12/22 | 0.00 | 0.00 | $0 | $560,025 | $58,835 | Yes (X) | ||||
| Spencer Lindsey - Former | ||||||||||
| Operations Executive thru 05/22 | 0.00 | 50.00 | $0 | $564,751 | $51,445 | Yes (X) | ||||
| Eberhart Gregory | ||||||||||
| Area Medical Officer | 12.50 | 37.50 | $0 | $582,946 | $27,959 | Yes (X) | ||||
| Spenst Brett - Former Care | ||||||||||
| Division Finance Officer thru 02/22 | 0.00 | 50.00 | $0 | $520,625 | $45,847 | Yes (X) | ||||
| Van Housen Heather | ||||||||||
| Former Patient Care Exec thru 09/18 | 0.00 | 40.00 | $0 | $478,454 | $71,665 | Yes (X) | ||||
| Mock Jeffrey | ||||||||||
| Treasurer/Asst Secr as of 09/23 | 10.00 | 40.50 | Yes (X) | $0 | $470,391 | $67,797 | ||||
| Shepardson Dean - Treasurer | ||||||||||
| Asst Secr from 03/23 thru 09/23 | 12.50 | 37.50 | Yes (X) | $0 | $461,843 | $55,761 | ||||
| Assadian Hoda | ||||||||||
| Operations Executive | 16.70 | 33.30 | $0 | $460,925 | $52,377 | Yes (X) | ||||
| Bartolomie Jill | ||||||||||
| Patient Care Executive | 50.00 | 0.00 | $0 | $385,649 | $88,778 | Yes (X) | ||||
| Leighton David | ||||||||||
| Administrator | 40.00 | 0.00 | $375,015 | $0 | $27,859 | Yes (X) | ||||
| Winter Carrie | ||||||||||
| Multi-Site Director Pharmacy | 40.00 | 0.00 | $316,233 | $0 | $55,995 | Yes (X) | ||||
| Woodruff Nicole | ||||||||||
| Director, Perioperative Services | 40.00 | 0.00 | $312,439 | $0 | $42,636 | Yes (X) | ||||
| Denoeu Rebecca | ||||||||||
| Director, Emergency Services | 40.00 | 0.00 | $291,427 | $0 | $61,986 | Yes (X) | ||||
| Newman Honalee | ||||||||||
| Director, Diagnostic Imaging | 40.00 | 0.00 | $294,703 | $0 | $22,531 | Yes (X) | ||||
| Byrnes John - Former | ||||||||||
| Medical Officer, NCR thru 02/20 | 0.00 | 0.00 | $0 | $263,659 | $34,955 | Yes (X) | ||||
| Parker Bessant - Former | ||||||||||
| Area Medical Officer thru 03/22 | 0.00 | 0.00 | $0 | $211,890 | $52,366 | Yes (X) | ||||
| Freedman John | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,770 | $0 | ||||
| Cherry Robert | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Davis Andrew | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Innocent Larry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Newton Bradford | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Reiner Richard | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Salazar Velino | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,611 | $0 | ||||
| Banks David | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,181 | $0 | ||||
| Woodson Marc | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $21,611 | $0 | ||||
| Wagner Jack | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $16,180 | $0 | ||||
| Fehr Joy | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $430 | $0 | ||||
| Ocampo Lucy | ||||||||||
| Director thru 08/23 | 0.00 | 4.00 | Yes (X) | $0 | $0 | $0 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,589,817 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $21,619,487 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,424,290 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 224 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Pacific Redwood Medical Group Inc | |||||
| 242 Hospital Drive Suite B | Ukiah | CA | 95482 | Medical services | $3,185,310 |
| Galen Inpatient Physicians Inc | |||||
| 2100 Powell Street Suite 400 | Emeryville | CA | 94608 | Medical services | $2,820,149 |
| RMG Medical Imaging Consultants | |||||
| PO Box 86348 | Los Angeles | CA | 90086 | Medical services | $2,625,364 |
| CHG Companies Inc | |||||
| PO Box 972651 | Dallas | TX | 75397 | Medical services | $2,176,055 |
| Anesthesia Management Services of CA In | |||||
| 617 Park Boulevard | Ukiah | CA | 94582 | Medical services | $1,992,741 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 48 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,054,028 | GovernmentGrantsAmt |
| All Other Contributions | $199,894 | AllOtherContributionsAmt |
| Total Contributions | $3,253,922 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Patient service revenue | 621110 | $193,884,578 | $193,884,578 | |
| Premium revenue | 900099 | $47,625,317 | $47,625,317 | |
| 340B Pharmacy | 456110 | $11,342,349 | $11,256,237 | $86,112 |
| Intercompany revenue | 621990 | $1,229,474 | $1,229,474 | |
| Dietary services | 722210 | $479,476 | $479,476 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $849,663 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $849,663 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $255,410,857 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,822,575 | TotalRevenueColumnAmt |
| Exclusion | $2,822,575 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $261,487,354 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $255,324,745 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $86,112 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,822,575 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,848 | TotalAmt |
| Program Services | $249,848 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,474,164 | TotalAmt |
| Program Services | $55,834,666 | ProgramServicesAmt |
| Management And General | $10,484,925 | ManagementAndGeneralAmt |
| Fundraising | $154,573 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,414,913 | TotalAmt |
| Program Services | $2,016,094 | ProgramServicesAmt |
| Management And General | $393,268 | ManagementAndGeneralAmt |
| Fundraising | $5,551 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,839,850 | TotalAmt |
| Program Services | $9,408,712 | ProgramServicesAmt |
| Management And General | $1,404,788 | ManagementAndGeneralAmt |
| Fundraising | $26,350 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,756,529 | TotalAmt |
| Program Services | $4,084,654 | ProgramServicesAmt |
| Management And General | $660,351 | ManagementAndGeneralAmt |
| Fundraising | $11,524 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,999,617 | TotalAmt |
| Management And General | $20,999,617 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,847 | TotalAmt |
| Management And General | $234,847 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,109 | TotalAmt |
| Management And General | $12,109 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,477 | TotalAmt |
| Program Services | $21,477 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,792,851 | TotalAmt |
| Program Services | $77,550,248 | ProgramServicesAmt |
| Management And General | $2,241,103 | ManagementAndGeneralAmt |
| Fundraising | $1,500 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,608 | TotalAmt |
| Management And General | $26,608 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,312,424 | TotalAmt |
| Program Services | $1,026,951 | ProgramServicesAmt |
| Management And General | $283,011 | ManagementAndGeneralAmt |
| Fundraising | $2,462 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,454,215 | TotalAmt |
| Program Services | $1,067,517 | ProgramServicesAmt |
| Management And General | $5,386,698 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,177,251 | TotalAmt |
| Program Services | $5,502,765 | ProgramServicesAmt |
| Management And General | $674,486 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $526,883 | TotalAmt |
| Program Services | $302,437 | ProgramServicesAmt |
| Management And General | $222,990 | ManagementAndGeneralAmt |
| Fundraising | $1,456 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,007 | TotalAmt |
| Program Services | $26,612 | ProgramServicesAmt |
| Management And General | $44,395 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,920,624 | TotalAmt |
| Program Services | $1,920,624 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,293,895 | TotalAmt |
| Program Services | $8,230,089 | ProgramServicesAmt |
| Management And General | $63,806 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,507,763 | TotalAmt |
| Program Services | $1,507,763 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient care supplies | $41,029,567 | $41,029,567 | |
| Rental/lease costs equi | $555,703 | $484,045 | $71,658 |
| Quality assurance fees | $261,104 | $261,104 | |
| UBI taxes | $15,750 | $15,750 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,713,021 | TotalAmt |
| Program Services | $2,061,254 | ProgramServicesAmt |
| Management And General | $651,767 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256,662,020 | TotalAmt |
| Program Services | $212,602,177 | ProgramServicesAmt |
| Management And General | $43,856,427 | ManagementAndGeneralAmt |
| Fundraising | $203,416 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,789 | BOYAmt |
| EOY | $11,891 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,716,294 | BOYAmt |
| EOY | $106,483,965 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,149 | BOYAmt |
| EOY | $236,448 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,531,086 | BOYAmt |
| EOY | $24,986,359 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,709,497 | BOYAmt |
| EOY | $4,874,713 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,368 | BOYAmt |
| EOY | $225,052 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $139,103,641 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $68,796,863 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,425,360 | BOYAmt |
| EOY | $70,306,778 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,618 | BOYAmt |
| EOY | $28,618 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,000 | BOYAmt |
| EOY | $500,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,586 | BOYAmt |
| EOY | $172,586 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,174,564 | BOYAmt |
| EOY | $53,204,933 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,768,311 | BOYAmt |
| EOY | $261,031,343 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,126,731 | BOYAmt |
| EOY | $15,443,679 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,997 | BOYAmt |
| EOY | $294,282 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,818,348 | BOYAmt |
| EOY | $90,196,848 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,076,076 | BOYAmt |
| EOY | $105,934,809 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,993,791 | BOYAmt |
| EOY | $151,257,858 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,698,444 | BOYAmt |
| EOY | $3,838,676 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,692,235 | BOYAmt |
| EOY | $155,096,534 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,768,311 | BOYAmt |
| EOY | $261,031,343 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,825,334 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,983,965 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$405,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $21,477 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $21,477 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to NL Short Public Affairs were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,698,375 | BeginningYearBalanceAmt |
| Contributions | $32,085 | ContributionsAmt |
| Other Expenditures | $1,891,784 | OtherExpendituresAmt |
| End Year Balance | $3,838,676 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,320,654 | BeginningYearBalanceAmt |
| Contributions | $7,225,833 | ContributionsAmt |
| Investment Earnings Or Losses | -$4,123 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,843,989 | OtherExpendituresAmt |
| End Year Balance | $5,698,375 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,291,863 | BeginningYearBalanceAmt |
| Contributions | $1,023,959 | ContributionsAmt |
| Investment Earnings Or Losses | $5,118 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,000,286 | OtherExpendituresAmt |
| End Year Balance | $1,320,654 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,311,452 | BeginningYearBalanceAmt |
| Contributions | $822,627 | ContributionsAmt |
| Other Expenditures | $842,216 | OtherExpendituresAmt |
| End Year Balance | $1,291,863 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,770,229 | BeginningYearBalanceAmt |
| Contributions | $1,131,568 | ContributionsAmt |
| Investment Earnings Or Losses | $5 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $861,270 | GrantsOrScholarshipsAmt |
| Other Expenditures | $729,080 | OtherExpendituresAmt |
| End Year Balance | $1,311,452 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,276,873 | OtherCostOrOtherBasisAmt |
| Book Value | $1,276,873 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $101,054,115 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,446,483 | DepreciationAmt |
| Book Value | $59,607,632 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,032,722 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,200,519 | DepreciationAmt |
| Book Value | $1,832,203 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,739,931 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,149,861 | DepreciationAmt |
| Book Value | $7,590,070 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $70,306,778 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Receivables from third-party payors | $36,104,164 |
| Right-of-use assets | $13,478,488 |
| Receivables from related organizations | $2,198,470 |
| Other receivables | $1,415,811 |
| Other assets | $8,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $53,204,933 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Payables to related organizations | $67,688,523 |
| Lease liability | $11,788,671 |
| Payables to third party payors | $10,719,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $90,196,848 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Board-designated and temporarily restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. |
| Part X, Line 2: | The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2023 and 2022, no such assets or liabilities were recorded. The System currently files Form 990 (Informational Return of Organizations Exempt From Income Taxes) and Form 990-T (Exempt Organization Business Income Tax Return) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2020 in major tax jurisdictions. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $950,446 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $950,446 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $69,085,231 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,937,852 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $70,035,677 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $103,937,852 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $950,446 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00370 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $934,726 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,400 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $920,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,487,589 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,283,541 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,204,048 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00860 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,162,712 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,395,870 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,766,842 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05360 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,500 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,500 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,599,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $26,693,811 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,905,716 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $113,635,204 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $130,631,663 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $17,856,162 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06960 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $381,324 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $381,324 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $156,640 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $156,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $537,964 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $537,964 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $813,076 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $282,235 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $45,318,764 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $54,957,835 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$9,639,071 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 Hospital Dr Med Plaza Assn | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | Property management | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.33000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.67000 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Ukiah Valley | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 275 Hospital Drive | AddressLine1Txt |
| City | Ukiah | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95482 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | See Form 990, Pg 1, Item J | WebsiteAddressTxt |
| State License | 110000095 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Ukiah Valley | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Sch H Part VI - Needs Assessment | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | See Sch H Part VI - Needs Assessment | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Sch H Part VI - Needs Assessment | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | Sch H, Part VI-Patient Educ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | Sch H, Part VI-Patient Educ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | Sch H, Part VI-Patient Educ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Adventist Health Ukiah Valley | Part V, Section B, Line 5: The 2022 Community Health Needs Assessment for Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS). In total, nine focus groups were conducted with 40 participants, and seven key informant interviews were held. Survey data was gathered from the North Coast region (region name defined by survey administrator, UC Berkeley IGS).The CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations - the voices of those with chronic disease, low incomes, and the underserved - were heard. In total, nine focus groups were conducted with 40 participants, and seven key informant interviews were held. Civic government & leadership, community-based organizations focusing on early education, education, low-income, medically underserved, minority populations, older adults, provider, substance use, students, workforce representatives, and unhoused populations were represented in the primary data collection. |
| Adventist Health Ukiah Valley | Part V, Section B, Line 6a: Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial Hospital (AHHM) and Adventist Health Mendocino Coast (AHMC) worked together to produce the 2022 CHNA. |
| Adventist Health Ukiah Valley | Part V, Section B, Line 6b: Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) collaborated with Building Bridges, Head Start, Housing Action Team, Mendocino Area Parks Association, Mendocino County Department of Public Health, Mendocino County Office of Education, Mendocino County Probation Department, Mendocino County Farm Bureau, Mendonoma Health Alliance, Rural Communities Housing Development Corporation, and Willits Senior Center. |
| Adventist Health Ukiah Valley | Part V, Section B, Line 11: Tax year 2023 was Year One of the Implementation Strategy for the 2022 Community Health Needs Assessment (CHNA). Programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care; Financial Stability and Health Risk Behaviors. Priority Need One: Access to Care - Barriers.Goal is to provide medical services to community members with no transportation. Strategy is to provide medical services to the homeless population through street medicine. FY 2023 Community Impact Activities and Outcomes:Throughout 2023, Adventist Health Street Medicine Program, a collaborative effort of the Adventist Health COMPASS Street Medicine Team and the Adventist Health Family Medicine Residency Street Medicine Active Resident Training (SMART) Track Program, provided and coordinated vital services for people experiencing homelessness (PEH) within Mendocino County. Through collaboration with community partners (Redwood Community Service's Building Bridges Homeless Resource Center, Redwood Gospel Mission's Center for Hope, and the Ukiah Community Food Bank), medical care was provided at over 100 Street Medicine clinics during 2023. Over 400 individuals received care totaling more than 1,000 encounters. The COMPASS Street Medicine team is a multidisciplinary care team with a registered nurse, care coordinator, social worker, physician, nurse practitioner, and licensed therapist. The SMART Track program trains family medicine physicians to competently and compassionately work within a team to provide health care services (including but not limited to MAT, Hepatitis C treatment, and place-based care) to homeless individuals. Three physician residents and multiple resident faculty physicians participated in the program in 2023.The Street Medicine Program also took a new collaborative step forward in 2023 when Mendocino Community Health Clinics' (MCHC) care management staff began integrating into existing clinics. This collaboration has helped improve the quality of care provided via the Street Medicine clinics for patients already established at MCHC for primary care and expanded the primary care access options for person experiencing homelessness (PEH) in Mendocino County.Further amplifying their impact on Street Medicine access in Mendocino County, the COMPASS Team spearheaded the planning for the inaugural Mendocino County Street Medicine Collaborative meeting to be held in February of 2024. This landmark event will convene a diverse group of partner agencies, including MCHC, MCHC's Ryan White Program, MCHC's Community Care Program, MCHC's Medication-Assisted Treatment (MAT) Program, Consolidated Tribal Health Project Outreach, Mendocino Coast Clinic's Street Medicine Program, Mendocino Coast Hospitality Center's Street Medicine Project, AHUV's Family Medicine Residency, Adventist Health's Substance Use Navigation (SUN) program, and Mendocino County AIDS/Viral Hepatitis Network. The goal of this effort is to improve the health and well- being of Mendocino County's PEH via expanded access to physical, mental and social health services through increased community collaboration.After a mid-year needs assessment, the COMPASS Street Medicine team reevaluated its resources and identified better locations to increase the number of PEH being served. This included expanding the amount of time and resources dedicated to outreach to homeless encampments.Priority Need One: Access to Care - Insurance.Goal is to verify/re-verify MediCal eligibility for vulnerable populations.Strategy is to provide education and outreach to medical providers (Registrars, Community Health Workers, Substance Use Navigators) to identify those medically eligible patients and help enroll or re-enroll them in available benefits and direct them to ongoing services.FY 2023 Community Impact Activities and Outcomes:During 2023, AHUV, AHHM and AHMC collaborated with multiple community agencies and organizations to mitigate the potential disruption in healthcare access for Medi-Cal members during the unwinding of the Pandemic Era Medicaid Continuous Coverage Requirement. The restart of Medicaid (Medi-Cal) renewals necessitated a proactive approach to ensure smooth access to healthcare services for individuals with lapsed Medi-Cal coverage needing assistance with the renewal process, as well as those needing assistance applying for other coverage if found to be ineligible for Medi-Cal.A multi-faceted strategy was implemented. A marketing campaign was launched across multiple media platforms, both internally for Adventist Health associates as well as a public media campaign which included social media blasts and educational materials in the form of banners, posters, flyers, and handouts posted and made available in the three hospitals and many ambulatory care clinics run by AHMC. Front-line Adventist Health associates working in patient registration, scheduling and insurance verification were provided training to help navigate patients toward Medi-Cal renewal or to Covered California for other coverage options. Adventist Health collaborated with its revenue cycle management partner to expand the population scope for its insurance navigation program. When appropriate, Adventist Health associates collaborated with other agencies to provide navigation support to patients at high risk of losing their Medi-Cal coverage for procedural reasons (change in address, homelessness, disability, language barrier, etc).Additional programs/activities not included in the 2023 Community Health Implementation Strategy that promote access to care that were provided by AHUV, AHHM, and AHMC included physician recruitment efforts.Almost 77% of the population of Mendocino County live in an area affected by a shortage of primary care providers. This shortage contributes to access to care and health status issues within the community. In an effort to combat a shortage of providers, AHUV, AHHM, and AHMC has strived to recruit and retain primary care, dental and mental health professionals. In 2023, AHUV onboarded four primary care advanced practice providers; two primary care physicians; one ophthalmologist; one advanced practice provider specializing in hematology/oncology and one advanced practice provider specializing in psychiatry. AHMC onboarded two primary care advanced practice providers; two advanced practice providers of which one is an orthopedic specialty and the other is a psychologist. AHHM onboarded one primary care advanced practice provider: one advanced practice provider in orthopedics and two general surgeons. In addition, the Incubate Program which is a collaborative effort between the three Hospitals and the community was commenced in 2023. Its goals extended beyond immediate support for physicians to create a long-term vision of a sustainable healthcare environment in Ukiah Valley. Key factors identified during the quarterly summits included the need to foster collaboration between various stakeholders, including healthcare providers and public health organizations; a focus on diversity, equity, and inclusion; and the priority of physician wellness by ensuring they have the support they need to thrive in their community as well as in their work.Priority Need Two: Financial Stability.Goal is to identify vulnerable, unstably housed community members and connect with Community Health Workers for Support services through CalAIM funding.Strategy is to utilize the COMPASS Street Medicine team identify unstably housed clients and connect them with services within the county that afford financial assistance.FY 2023 Community Impact Activities and Outcomes:With more than a dozen contracted CalAIM provider organizations in Mendocino County, AHUV, AHHM, and AHMC identified the need for increased navigation support for people experiencing homelessness (PEH) who are desperately in need of the services provided through CalAIM. The COMPASS team provided care coordination to PEH accessing services across multiple healthcare providers; including Adventist Health Hospitals, primary care and specialty clinics, Mendocino Community Health Clinics, Consolidated Tribal Health Project, Round Valley Health Center, and Mendocino Coast Clinics.The COMPASS team participates in multiple monthly meetings with other community agencies and organizations where the delivery of services is coordinated and planned, including the Mendocino County Homeless Service Continuum of Care (a collaborative of over 31 agencies throughout Mendocino County), the Mendocino County CalAIM Collaborative, and Mendocino County Adult Protective Services. |
| Part V, Section B, Line 11, continuation: | In 2023, the COMPASS team provided ongoing care management services to 320 people experiencing homelessness. Of those served, 57% were medically complex with a severe mental health diagnosis and 81% were medically complex with substance use disorder. The population served had a 36% reduction in hospitalizations, 64% reduction in emergency room visits, and a 27% increase in primary care visits.In 2023, the COMPASS team received and provided specialized palliative care and advanced care planning training for marginalized populations. COMPASS provided these trainings to multiple organizations serving PEH, including Hospitality House Homeless Shelter, Consolidated Tribal Health Project, Redwood Community Services' Building Bridges Homeless Resource Center, Mendocino County Adult Protective Services, and Mendocino Community Health Clinic and their Ryan White Program. The COMPASS team also formed the Mendocino County Hospice and Palliative Care Collaborative, which brought together multiple hospice and palliative care providers to discuss care collaboration instead of competition. VyncaCare, Hospice of Ukiah, Madrone Care Network, and RCMS Community Healthcare all attended these quarterly meetings in 2023.Further amplifying their impact, the COMPASS team spearheaded the inaugural Mendocino County Street Medicine Collaborative meeting to be held in February of 2024. This landmark event will convene a diverse group of partner agencies, including Mendocino Community Health Clinic, the MCHC Ryan White Program, MCHC Community Care, MCHC Medication-Assisted Treatment (MAT) Program, Consolidated Tribal Health Project Outreach, Mendocino Coast Clinics Street Medicine Program, Mendocino Coast Hospitality Center's Street Medicine Project, Adventist Health Ukiah Valley Family Medicine Residency, Adventist Health COMPASS Street Medicine and Substance Use Navigation (SUN) program, and Mendocino County AIDS/Viral Hepatitis Network. This collaborative effort will be dedicated to improving the health and well-being of Mendocino County's PEH through community collaboration.All three Adventist Health Hospitals work with the COPE Health Scholar program to provide educational opportunities for individuals interested in making a difference in health care by working together to advance their careers through firsthand experience in clinical and administrative health care settings to become an integral part of the care delivery team. Cope Scholars assist with basic care for patients alongside nurses, physicians and other members of the care delivery team, and have opportunities to learn the "business" of health care, preparing them for a health care career and helping earn volunteer hours for medical school, nursing school, and other graduate programs while positioning students well for entry-level positions in healthcare.Priority Need Three: Health Risk Behaviors - Diet.Goal is to reduce the obesity rate among teens and adults through targeted food and diet education.Strategy is to improve health food and beverage access.FY 2023 Community Impact and Activities: Working closely with the Blue Zones Project Mendocino County team, the City of Ukiah Update Plan included the implementation of three food policy initiatives: 1. Adopted Healthy food and beverage standards and wellness policies at all city facilities. 2. Adopted institutional wellness policies that reduce and/or eliminate sugar-sweetened beverages in out-of-school programs, as well as parks and recreation sites and programs. 3. Adopted policy to incentivize landowners to allow community-based agriculture on their nonproductive property. In addition, work was done in 2023 to plan and host the reinstitution of the North Coast Farmers' Convergence, an annual gathering of producers and consumers to strengthen long-term capacity and collaboration across food systems-focused organizations and initiatives.Priority Need Three: Health Risk Behaviors - Illicit Drugs.Goal is to increase access to treatment in a community with high substance use and overdose rates.Strategy is to create policies and spaces for the treatment of substance use disorders and reduce harm to people who use substances.FY 2023 Community Impact and Activities: In 2023, AHUV, AHHM, and AHMC continued the CA Bridge model of care for addiction treatment, the Substance Use Navigator provides brief screening and intervention for people with substance use and behavioral health needs in the emergency department, inpatient setting and community members in need. The SUN team provided navigation 1,282 times, which resulted in 385 referrals to treatment: 137 into MAT treatment, 77 to Behavioral Health services, and 171 to residential treatment. SUN navigators also participate in Mendocino County Jail discharge planning and meet weekly to coordinate reentry directly to MAT and residential treatment services.All three Adventist Health Hospitals in Mendocino County participate in the SafeRx Mendocino program and the Naloxone Distribution Project. Mendocino County's SafeRx program tackles the opioid crisis through a two-pronged approach: prescriber education and harm reduction. For medical professionals, SafeRx offers training on safe opioid prescribing practices, encouraging the use of the CURES 2.0 prescription monitoring database to prevent overprescribing. The program also focuses on patient education, providing resources to help people understand their opioid prescriptions and navigate conversations with their doctors. Additionally, SafeRx works on harm reduction by facilitating access to naloxone (Narcan), a medication that can reverse opioid overdoses. Through these efforts, Mendocino County's SafeRx program aims to prevent opioid misuse and addiction while equipping the community to respond to potential overdoses. In 2021, Mendocino County had the highest fatal overdose rate of any county in California, at 54.7 per 100,000 residents. Data through the third quarter of 2023 shows that rate had dropped to 44.0 per 100,000 residents.Priority Need Three: Health Risk Behaviors - Tobacco Use.Strategy One: Decrease youth tobacco use and availability of cigarettes, e-cigarettes, and all flavored tobacco products.Strategy Two: Create systems and supports that target tobacco use prevention and cessation.FY 2023 Community Impact and Activities:AHUV, AHHM, and AHMC and the Blue Zones Project worked closely with the City of Ukiah to adopt policies pertaining tobacco use in Mendocino County. One policy was to provide a smoke-free multi-unit housing policy to include individual units, balconies, patios, and common indoor and outdoor areas and the adoption of outdoor policies that eliminate secondhand smoke and aerosol exposure including dining areas, entryways, public events, recreation areas, service areas, sidewalks, and outdoor worksites. The City of Ukiah adopted a Tobacco Retail License (TRL) that includes ending the sale of flavored tobacco products including fruit, candy, mint, and menthol flavors and eliminate possession, use and purchase (PUP) penalties.The City of Willits adopted a Tobacco Retail License (TRL) that includes ending the sale of flavored tobacco products including fruit, candy, mint, and menthol flavors and eliminate possession, use and purchase (PUP) penalties. Significant needs not met:No hospital can address all the health needs identified in its community. AHUV, AHHM and AHMC are committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Areas of significant health needs that will not be directly addressed at this time include housing, mental health, food security, environment & infrastructure, inclusion & equity, COVID, education, community vitality and community safety. While these health needs are not addressed directly, they will likely benefit from the collective efforts of our community partnerships. |
| Part V, Section B, Line 13h: | Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 30 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - Outpatient Clinics Hematology and Onco | ||||
| 260 Hospital Drive Suite 207 | Ukiah | CA | 95482 | Oncology |
| 2 - Outpatient Clinics Wound Care Clinic | ||||
| 415 Hospital Drive | Ukiah | CA | 95482 | Wound care center |
| 3 - Outpatient Clinics Ambulatory Surgery | ||||
| 245 Hospital Drive | Ukiah | CA | 95482 | Outpatient surgery |
| 4 - Outpatient Clinics Radiology or Imagin | ||||
| 245 Hospital Drive Suite 100 | Ukiah | CA | 95482 | Radiology |
| 5 - Outpatient Clinics Radiology or Imagin | ||||
| 245 Hospital Drive Suite 100 | Ukiah | CA | 95482 | Radiology/MRI |
| 6 - Outpatient Clinics Radiology or Imagin | ||||
| 245 Hospital Drive Suite 100 | Ukiah | CA | 95482 | Radiology/ultrasound |
| 7 - Retail Pharmacy (AHHM) | ||||
| 3 Marcela Drive Suite B | Willits | CA | 95490 | Retail pharmacy |
| 8 - Outpatient Clinics Radiology or Imagin | ||||
| 1165 S Dora Street Suite D-1 | Ukiah | CA | 95482 | Mendo radiology |
| 9 - Outpatient Clinics Rural Health Clinic | ||||
| 1050 North State Street | Ukiah | CA | 95482 | Family practice |
| 10 - Outpatient Clinics | ||||
| 415A Hospital Drive | Ukiah | CA | 95482 | Pre-op clinic |
| 11 - Outpatient Clinics Rehab Clinic | ||||
| 271 Observatory Avenue | Ukiah | CA | 95482 | PT |
| 12 - Outpatient Clinics Cardiology Clinic | ||||
| 115 Hospital Drive | Ukiah | CA | 95482 | Cardiology |
| 13 - Outpatient Clinics Surgical Clinic | ||||
| 246 Hospital Drive | Ukiah | CA | 95482 | General surgery |
| 14 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 209 | Ukiah | CA | 95482 | Family practice |
| 15 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 204 | Ukiah | CA | 95482 | Pediatricians |
| 16 - Outpatient Clinics Radiology or Imagin | ||||
| 245 Hospital Drive Suite 100 | Ukiah | CA | 95482 | Radiology/mammography |
| 17 - Outpatient Clinics Ophthalmology Clini | ||||
| 248 B Hospital Drive | Ukiah | CA | 95482 | Ophthalmology |
| 18 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 102 | Ukiah | CA | 95482 | Pain management |
| 19 - Outpatient Clinics Nephrology or Urolo | ||||
| 260 Hospital Drive Suite 201 | Ukiah | CA | 95482 | Urology |
| 20 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 107 | Ukiah | CA | 95482 | Orthopedics |
| 21 - Outpatient Clinics Gastroenterology | ||||
| 234 Hospital Drive Suite A B | Ukiah | CA | 95482 | HBOC-GI |
| 22 - Outpatient Clinics Rehab Clinic | ||||
| 3101 South State Street | Ukiah | CA | 95482 | Redwood PT |
| 23 - Outpatient Clinics Rural Health Clinic | ||||
| 850 Sequoia Circle | Fort Bragg | CA | 95437 | Family medicine |
| 24 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 103 | Ukiah | CA | 95482 | Internal medicine |
| 25 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 101 | Ukiah | CA | 95482 | Behavioral health |
| 26 - Outpatient Clinics Rehab Clinic | ||||
| 271 Observatory Avenue | Ukiah | CA | 95482 | Speech therapy |
| 27 - Outpatient Clinics Central Office | ||||
| 238 Hospital Drive Suite A | Ukiah | CA | 95482 | Billing - clinics |
| 28 - Outpatient Clinics Rural Health Clinic | ||||
| 260 Hospital Drive Suite 101 | Ukiah | CA | 95472 | Live well |
| 29 - Outpatient Clinics Otolaryngology Clinic | ||||
| 1165 S Dora Street Suite C-2 | Ukiah | CA | 95482 | ENT |
| 30 - Outpatient Clinics Rheumatology | ||||
| 260 Hospital Drive Suite 207 | Ukiah | CA | 95482 | Rheumatology |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. |
| Part II, Community Building Activities: | The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. |
| Part III, Line 2: | Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. |
| Part III, Line 3: | The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. |
| Part III, Line 4: | The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense. |
| Part III, Line 8: | The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B. |
| Part III, Line 9b: | When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income, and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest |
| Part VI, Line 2: | Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) promote access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the Year One Update, FY 2023 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/ukiah-valley/about-us/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2021, 2022 and 2023 Community Health Plan Updates are also available on the Adventist Health Corporate website at: https://www.adventisthealth.org/about-us/community-benefit/The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, Adventist Health supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community.In addition to the CHNA, the Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. |
| Part VI, Line 3: | The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's Self-Pay Billing and Collection Policy is posted at:https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital's billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. |
| Part VI, Line 4: | From spectacular ocean views, redwood forests, and picturesque towns, the CHNA service area for Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) is a breathtaking community with a total population of 116,095. Throughout the County people enjoy activities such as the Mendocino Art Center, Theatre Company, and music and film festivals. The median household income is $56,401. The largest segment of the population (37.2%) is made up of residents aged over age 55. The community is known as a location focused on the well-being of its residents with support in the built environment, grocery stores and access to care while also implementing a Blue Zones Project. Among this population, 59.95% of an individual's income is spent on housing and transportation, while 20.66% of children live in poverty and 6.67% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. 15.9% of the population smoke tobacco, which is a higher rate than in California (11.5%). The teen birth rate is 21.4 per 1,000 females, which is greater than the state's teen birth rate of 15.6 and the national rate of 19.3. The percentage of infants with low birth weight is significantly greater, with Mendocino's rate at 15.1% compared to the state at 6.9%.The AHUV, AHHM, and AHMC CHNA market has a total population of 116,095 (based on the 2020 Decennial Census). The largest city in the service area is Ukiah, with a population of 16,075. The service area is comprised of the following zip codes: 95415, 95463, 95410, 95445, 95460, 95428, 95488, 95449, 95437, 95425, 95453, 95589, 95427, 95456, 95469, 95459, 95468, 95432, 95490, 95429, 95417, 95482, 95587, 95466, 95470, 95494, 95420, 95454, 95585. 62.33% of the population owns their home and 37.67% of the population rent their home. Total Population by age groups: Age 0-4: 5.8%, Age 5-17:14.9%, Age 18-24: 7.4%, Age 25-34: 11.1%, Age 35-44: 11.7%, Age 45-54: 11.9%, Age 55-64: 14.6%, Age 65+: 22.6%. |
| Part VI, Line 5: | Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low-income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy - even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population, 2. Factors that cause the present outcomes distribution, and3. Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to:1. Increase the prevalence of evidence-based preventive health services and preventive health behaviors,2. Improve care quality and patient safety, and3. Advance care coordination across the health care continuum.We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. |
| Part VI, Line 6: | The Hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as tele-pharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. |
| Part VI, Line 7, Reports Filed With States | CA |
| Part VI: Other Information: | Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM), and Adventist Mendocino Coast (AHMC) are proud sponsors of Blue Zones. From May through December 2021, the Blue Zones Project Mendocino County (BZPMC) team assessed Mendocino County's readiness to undertake the community well-being transformation initiative where the healthy option becomes the easy option through permanent changes in environment, policy, and social networks. The Blue Zones Project team conducted a comprehensive analysis of the current state of well-being and met with local leaders and stakeholders across all sectors to learn about the strengths, challenges, and opportunities for improving well-being in Mendocino County and summarized their findings in the Blue Zones Project Discovery Report. The findings in that report were coupled with expert-led discovery meetings in the policy areas of built environment, tobacco, and food policy to inform the Blueprint for Blue Zones Project implementation in Mendocino County. Here is a summary of progress outcomes for 2023 for the three main pillars of engagement of people, places, and policy. PEOPLEIn 2023 over 3,600 unique individuals 15 years or older participated in Blue Zones Project (BZP) activities. Those activities are as follows: - 1,582 individuals completed the RealAge Test, our Community Wellbeing Survey. The local team advocated for paper surveys to reach community members with no access to internet/email. Because of this, we were able to reach a more diverse population than we did in our baseline year when we didn't have the option of paper surveys.- 14% of people engaged have participated in multiple BZP activities.- The Engagement Committee has broad representation geographically and demographically including inland and Coastal representation consisting of Indigenous, Latino, older adults, parent, and people with disabilities. - Partnerships with Tribal, Latino and the Recovery communities to include participation in purpose moais at Brush Meadows housing complex for migrant farm workers; Zumba Muevete por tu Salud; Annual Dia del Nino and Hispanic Heritage events; Spirit Walkers (recovery group) walking moais and purpose workshops; Round Valley Earth Day Celebration; Redwood Valley Little River Band of Pomo Indians Spirit run; Pinoleville Pomo Nation BZP story speech; and attending walking moais, a health fair and the Gathering of Native Americans with the Coyote Valley Band of Pomo Indians. - Partnership with Mendocino Community College (MCC) to include participation at the Dia de Los Muertos; Latino student retreat; cooking demonstrations with MCC CalFresh food distribution program in partnership with Mendocino County CalFresh Healthy Living Program; MCC walking moais (inland and Coast); Native American Heritage Celebration; and the Healthy Body/Healthy Mind educational series.- Facilitated the second largest Purpose Workshop with 180 staff members for all North Coast Opportunities (NCO) employees in partnership with Blue Zones Project Lake County. - Alternative Education High School Engagement with: Big Picture Ukiah Blue Zones Story Speech, Big Picture Fort Bragg cooking demonstrations series, Sanhedrin High School Willits purpose workshop, and Willits High School Community Learning Center (adults with disabilities).- Signature Blue Zones Project events in 2023 included attendance at: Blue Zones story speeches with 6,140 individuals; 11 walking moais with 120 individuals; six purpose workshops with 78 individuals; 28 cooking demonstration/classes with 90 individuals; five volunteer events with 186 individuals and 25 people downloading the Sharecare digital platform. PLACESSchools: Dana Gray Elementary School and Big Picture Alternative High School in Fort Bragg Unified School District achieved BZP Approval status in 2023 and one is in progress for approval early in 2024.Brookside Elementary School and Sanhedrin Alternative High School in Willits Unified School District achieved BZP Approval status in 2023 and one is in progress for approval early in 2024. The BZPMC team is working to set up a planning meeting to create an implementation plan for 2024 in the Ukiah Unified School District.Restaurants: Brickhouse Coffee in Willits, Cafe One in Fort Bragg and Roots Cafe AHHM all achieved Blue Zones Approval status in 2023. Three more are registered, actively engaged in the pledge process, and nearing approval in early 2024.Grocery Stores: Harvest Market in Fort Bragg became Blue Zones approved in October 2023, and the team is actively seeking engagement from two additional grocery stores.Worksites: North Coast Opportunities became Blue Zones Approved in July 2023. Six additional employers are actively working through the pledge process with four approvals expected in early 2024.POLICY Built Environment: Worked with the City of Ukiah General Plan Update to include three built environment policy Initiatives: 1. Active Transportation Plan, 2. Great Redwood Trail connectivity and expansion, and 3. Complete Streets Policy Also, the City of Ukiah requested technical assistance from the BZPMC team in the form of conceptual design for the Perkins and Gobbi Gateway Project, a project that focuses on safety for all modes of transportation and placemaking elements.Capacity Building: Hosted three Complete Streets Workshops for the City of Fort Bragg, the City of Willits, and Mendocino County; joined the Technical Advisory Committee for Mendocino Council of Governments' (MCOG) Mobility Solutions Feasibility Study to define challenges and find solutions for unincorporated Mendocino County communities with no access to public transportation; and worked with the City of Ukiah Clara Avenue Construction Project for a remodel of existing throughfares to include bicycle and pedestrian infrastructure for Complete Streets implementation. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Mendocino County Soccer Academy | ||||||||
| PO Box 1137 | Ukiah | CA | 95482 | 465292113 | 501(c)(3) | $25,000 | $0 | General support - Sponsorship |
| Ukiah Seventh Day Adventist Church | ||||||||
| 1390 Laurel Avenue | Ukiah | CA | 95482 | 942488848 | 501(c)(3) | $6,000 | $0 | General support for Covid Vaccine Clinic |
| CA Health Fund & Trust | ||||||||
| 1215 K Street Suite 800 | Sacramento | CA | 95814 | 941498697 | 501(c)(3) | $97,663 | $0 | Hlth srvs un/underinsured pt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 3 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Charitable support and assistance is provided with no reporting required by recipient. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (26 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Heinrich Kerry | ||||||||||||||
| Dir/Chair/CEO | $0 | $2,017,000 | $0 | $1,208,880 | $0 | $76,548 | $0 | $13,296 | $0 | $44,099 | $0 | $3,359,823 | $0 | $0 |
| Hofheins Todd | ||||||||||||||
| Dir/Vice Chair/COO | $0 | $1,389,462 | $0 | $735,265 | $0 | $147,865 | $0 | $13,296 | $0 | $62,845 | $0 | $2,348,733 | $0 | $0 |
| Beaman John | ||||||||||||||
| CFO/Assistant Secretary | $0 | $1,091,769 | $0 | $569,149 | $0 | $19,635 | $0 | $13,296 | $0 | $60,059 | $0 | $1,753,908 | $0 | $0 |
| Stevens Eric - President | ||||||||||||||
| Northern CA/HI State Network | $0 | $1,045,616 | $0 | $319,995 | $0 | $160,682 | $0 | $13,296 | $0 | $46,256 | $0 | $1,585,845 | $0 | $0 |
| Jahn Andrew - Former | ||||||||||||||
| Care Division President thru 02/22 | $0 | $1,044,420 | $0 | $406,990 | $0 | $14,496 | $0 | $53,160 | $0 | $50,625 | $0 | $1,569,691 | $0 | $0 |
| Nahapetian Arby - Former Care | ||||||||||||||
| Division Medical Officer thru 02/22 | $0 | $967,385 | $0 | $329,621 | $0 | $185,288 | $0 | $13,296 | $0 | $56,317 | $0 | $1,551,907 | $0 | $0 |
| Wells Jason | ||||||||||||||
| Former President thru 12/20 | $0 | $892,808 | $0 | $337,640 | $0 | $240,134 | $0 | $13,296 | $0 | $23,881 | $0 | $1,507,759 | $0 | $0 |
| Wing Bill - Former | ||||||||||||||
| Dir/Asst Secr/Vice Chair thru 01/22 | $0 | $0 | $0 | $0 | $0 | $1,438,460 | $0 | $13,296 | $0 | $26,777 | $0 | $1,478,533 | $0 | $0 |
| Jobe Meredith | ||||||||||||||
| Secretary | $0 | $660,525 | $0 | $168,715 | $0 | $130,248 | $0 | $13,296 | $0 | $46,114 | $0 | $1,018,898 | $0 | $0 |
| Howe Judson - President AHUV | ||||||||||||||
| Pres, North Coast Network thru 03/23 | $0 | $538,154 | $0 | $186,337 | $0 | $84,404 | $0 | $13,296 | $0 | $15,701 | $0 | $837,892 | $0 | $0 |
| Tetz Warren - Former | ||||||||||||||
| Treas/Asst Secr thru 12/22 | $0 | $17,731 | $0 | $125,629 | $0 | $416,665 | $0 | $13,296 | $0 | $45,539 | $0 | $618,860 | $0 | $0 |
| Spencer Lindsey - Former | ||||||||||||||
| Operations Executive thru 05/22 | $0 | $450,442 | $0 | $59,341 | $0 | $54,968 | $0 | $13,296 | $0 | $38,149 | $0 | $616,196 | $0 | $0 |
| Eberhart Gregory | ||||||||||||||
| Area Medical Officer | $0 | $516,674 | $0 | $19,931 | $0 | $46,341 | $0 | $13,296 | $0 | $14,663 | $0 | $610,905 | $0 | $0 |
| Spenst Brett - Former Care | ||||||||||||||
| Division Finance Officer thru 02/22 | $0 | $259,692 | $0 | $250,809 | $0 | $10,124 | $0 | $13,296 | $0 | $32,551 | $0 | $566,472 | $0 | $0 |
| Van Housen Heather | ||||||||||||||
| Former Patient Care Exec thru 09/18 | $0 | $361,260 | $0 | $70,116 | $0 | $47,078 | $0 | $13,296 | $0 | $58,369 | $0 | $550,119 | $0 | $0 |
| Mock Jeffrey | ||||||||||||||
| Treasurer/Asst Secr as of 09/23 | $0 | $344,451 | $0 | $53,131 | $0 | $72,809 | $0 | $13,296 | $0 | $54,501 | $0 | $538,188 | $0 | $0 |
| Shepardson Dean - Treasurer | ||||||||||||||
| Asst Secr from 03/23 thru 09/23 | $0 | $307,500 | $0 | $25,000 | $0 | $129,343 | $0 | $13,296 | $0 | $42,465 | $0 | $517,604 | $0 | $0 |
| Assadian Hoda | ||||||||||||||
| Operations Executive | $0 | $329,595 | $0 | $101,331 | $0 | $29,999 | $0 | $13,296 | $0 | $39,081 | $0 | $513,302 | $0 | $0 |
| Bartolomie Jill | ||||||||||||||
| Patient Care Executive | $0 | $284,196 | $0 | $41,572 | $0 | $59,881 | $0 | $13,296 | $0 | $75,482 | $0 | $474,427 | $0 | $0 |
| Leighton David | ||||||||||||||
| Administrator | $233,126 | $0 | $109,400 | $0 | $32,489 | $0 | $14,819 | $0 | $13,040 | $0 | $402,874 | $0 | $0 | $0 |
| Winter Carrie | ||||||||||||||
| Multi-Site Director Pharmacy | $258,413 | $0 | $25,150 | $0 | $32,670 | $0 | $11,644 | $0 | $44,351 | $0 | $372,228 | $0 | $0 | $0 |
| Woodruff Nicole | ||||||||||||||
| Director, Perioperative Services | $237,554 | $0 | $42,735 | $0 | $32,150 | $0 | $10,884 | $0 | $31,752 | $0 | $355,075 | $0 | $0 | $0 |
| Denoeu Rebecca | ||||||||||||||
| Director, Emergency Services | $239,710 | $0 | $21,454 | $0 | $30,263 | $0 | $10,084 | $0 | $51,902 | $0 | $353,413 | $0 | $0 | $0 |
| Newman Honalee | ||||||||||||||
| Director, Diagnostic Imaging | $196,865 | $0 | $73,277 | $0 | $24,561 | $0 | $9,180 | $0 | $13,351 | $0 | $317,234 | $0 | $0 | $0 |
| Byrnes John - Former | ||||||||||||||
| Medical Officer, NCR thru 02/20 | $0 | $0 | $0 | $0 | $0 | $263,659 | $0 | $13,183 | $0 | $21,772 | $0 | $298,614 | $0 | $0 |
| Parker Bessant - Former | ||||||||||||||
| Area Medical Officer thru 03/22 | $0 | $0 | $0 | $0 | $0 | $211,890 | $0 | $10,594 | $0 | $41,772 | $0 | $264,256 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Lines 4a-b | FormAndLineReferenceDesc |
| Explanation | Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Byrnes, John - severance payment - $262,731 Parker, Bessant - severance payment - $212,500 Tetz, Warren - severance payment - $416,673 Wing, Bill - severance payment - $1,440,800 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Brett Spenst, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2023 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a: | Ukiah Adventist Hospital, DBA Adventist Health Ukiah Valley (AHUV), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of AHUV, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHUV provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHUV recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2023 was $950,446. The following Inpatient services were provided to all our patients: - 704 babies delivered - 527 surgeries performed - 12,142 patient days The following Outpatient services were provided to all our patients: - 30,130 emergency department visits - 3,294 outpatient surgeries performed - 98,171 outpatient visits - 124,523 clinic visits AHUV recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2023 was $16,905,716. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ A conversation with Judson Howe By Karen Rifkin for The Ukiah Daily Journal reported May 5, 2023: According to the Soil Test Report, commissioned by Adventist Health last December, to determine the viability of the community to recruit and sustain primary care doctors, "...Ukiah is home to 19,000 residents... known for its beautiful views, great climate, recreational activities, and wineries. Despite these attributes, AHUV struggles with provider recruitment and retention national report revealed that nearly one in five health care workers have left their jobs during the COVID-19 pandemic, citing environmental strains related to the pandemic, poor pay, and burnout as primary reasons." Judson Howe is the President of Adventist Health's North Coast Network that includes six facilities operating in burnout and loss of purpose which is causing us to question why we make the sacrifices we make every day; and it's especially challenging under these circumstances to find and recruit physicians. With the needs being greater than what physicians can provide, creating human suffering that cannot be solved or cured, he is seeking solutions for breaking out of this cycle, a situation not unique to Mendocino County but of national import. According to an article from the Press Democrat dated March 6, 2021, Lake County had the highest rate of fatal overdoses statewide in 2019 with more than 60 deaths per 100,000 people, more than triple the statewide average rate of 19.6. Mendocino County came second on the list with an overdose death rate of just over 40 fatalities per 100,000, followed by San Francisco County. Howe adds to these statistics: the county is burdened with severe impairments in the social determinants of health; adverse childhood experiences four times the national norm; alcohol use two times the national norm; and severe mental illness that is worsening. He estimates there are 50 primary care providers in the county with a need for 25 more and he is looking for a way for the hospital and community to come together to break out of this impasse and develop a viable method of recruiting and retaining physicians, to support, appreciate and acknowledge what they do and to build capacity for them to preserve themselves for tomorrow. The Soil Test Report identifies that some of the biggest challenges are stability of physician workforce, call/practice coverage, mental health, spousal satisfaction and specialist availability. Corporate medicine is identified as a problem. "We're seeing a loss of empathy and kindness in the medical space; at AHUV we often fail to put a human face to our business," he says. The report points out the importance of doctors having access to specialists, allowing them to practice full spectrum medicine - the way doctors practiced in an earlier era, with a broader spectrum of practice as opposed to hyper-specialization. "The idea that health care is a relationship between the patient and the provider and to build that continuity within the same visit are what full spectrum residencies are going for. We're a full spectrum program, cradle to the grave." But that is not their present reality. "It can take weeks or months to see a doctor and there are not enough. Our current health inequities are massive to the point where senior citizens cannot get in to see a provider." Howe is currently working with Benjamin Anderson, formerly the CEO of Kearney County Hospital in rural, western Kansas, who developed a successful model for medical provider recruitment. Anderson says they developed a culture that allowed them to recruit medical staff - everything from a sustainable on-call structure to building a sense of trust between medical providers and administration. He says by way of providing support, he and his wife babysat a physician's two-year-old daughter; and that most important is communicating that they care about their team members and their families. Howe says, "Everyone needs to stop competing and create access for health care together - not just Adventist Health but Mendocino Community Health Clinic and other stakeholders and providers, as well. We need to be willing to be accessible and humble, to create a safe vulnerable space so we can have a conversation about the collective health needs of the community. "Recruiting on wine, Redwoods and the coast is not sufficient; we have to recruit differently to missional providers, those who realize there's a problem and want to be a part of the solution; we need to initiate a community-led approach to health care with community resources augmenting the physician. That's what we're doing with the Incubate Program." The Incubate Program is a county-wide, collaborative task force sponsored by Mendocino County Health Clinic; Adventist Health; Ukiah Valley Residency Program; North Coast Opportunities; and the Mendocino County Public Health Department to cultivate a supportive training environment for full-scope family medicine in Ukiah, connecting provider and community well-being. Its volunteer members meet twice a quarter with the intention of uniting diverse stakeholders and constructing a supportive environment for physician residents and their families. Their goals include summarizing the current state of workforce challenges, implementing collaborative solutions and developing multi-year strategies. "We need to have housing - viable, sticky neighborhoods where physicians can stay, help connect them to our community, appreciate them and...we need to support local medicine. Every time a patient leaves the community, it takes away a local job. "I want to gather people who want to be part of the conversation, who want to be part of the solution." |
| Form 990, Part VI, Section A, line 4 | The Hospital's Articles of Incorporation were amended for the following: 1. Article III was updated to allow for the Board of Directors of the Hospital to have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital has no members within the meaning of Section 5056 of the California Corporations Code. The Hospital's Bylaws were amended for the following: 1. Article 2 was removed and the Hospital has no members. All sections relating to the membership were removed. 2. Article 5 was revised to indicate that only directors may serve as the chair of the Board and that the vice chair of the Board is designated by the Chief Executive Officer of Adventist Health System/West. |
| Form 990, Part VI, Section A, line 7a | The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. |
| Form 990, Part VI, Section A, line 7b | The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. |
| Form 990, Part VI, Section B, line 11b | This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing. |
| Form 990, Part VI, Section B, line 12c | During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System General Counsel immediately. The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. |
| Form 990, Part VI, Section B, line 15 | The Hospital's Board of Directors has established a Human Resources Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. |
| Form 990, Part VI, Section C, line 19 | The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. |
| Form 990, Part VII: | Board compensation is for Adventist Health System/West Board of Directors only - not Hospital Board of Directors. |
| Form 990, Part IX, line 11g | Physician professional fees: Program service expenses 35,392,629. Management and general expenses 155,451. Fundraising expenses 0. Total expenses 35,548,080. Purchased medical services: Program service expenses 26,652,946. Management and general expenses 6,673. Fundraising expenses 0. Total expenses 26,659,619. All other purchased services: Program service expenses 5,820,165. Management and general expenses 843,178. Fundraising expenses 1,500. Total expenses 6,664,843. Contract labor: Program service expenses 7,503,903. Management and general expenses 275,285. Fundraising expenses 0. Total expenses 7,779,188. Consulting and other management fees: Program service expenses 113,535. Management and general expenses 517,672. Fundraising expenses 0. Total expenses 631,207. Repair and maintenance: Program service expenses 1,904,832. Management and general expenses 9,951. Fundraising expenses 0. Total expenses 1,914,783. Other professional fees non-medical: Program service expenses 92,861. Management and general expenses 401,517. Fundraising expenses 0. Total expenses 494,378. Other professional fees medical: Program service expenses 69,377. Management and general expenses 31,376. Fundraising expenses 0. Total expenses 100,753. |
| Form 990, Part XI, Line 8: | Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health Clearlake Hospital Inc | |||||||||||
| 15630 18th Avenue | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Adventist Health Delano | |||||||||||
| 1401 Garces Hwy | Delano | CA | 93215 | 770258013 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Adventist Health Foundation | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 680002188 | Charitable foundation | CA | 501(c)(3) | Line 7 | Adventist Health SystemWest | 0 | |
| Adventist Health Medical Center Tehachapi | |||||||||||
| 1100 Magellan Drive | Tehachapi | CA | 93561 | 812240617 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Adventist Health Mendocino Coast | |||||||||||
| 700 River Drive | Fort Bragg | CA | 95437 | 845174585 | Hospital | CA | 501(c)(3) | Line 3 | Stone Point Health | 0 | |
| Adventist Health Physicians Network | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 680357690 | Medical foundation | CA | 501(c)(3) | Line 12b, II | Adventist Health SystemWest | 0 | |
| Adventist Health SystemWest | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 953484589 | Integrated health system | CA | 501(c)(3) | Line 10 | 0 | N/A | |
| Adventist Health Tulare | |||||||||||
| 869 North Cherry Street | Tulare | CA | 93274 | 832351753 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Castle Medical Center | |||||||||||
| 640 Ulukahiki Street | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Feather River Hospital | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 941101228 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Glendale Adventist Medical Center | |||||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 951816017 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Hanford Community Hospital | |||||||||||
| 115 Mall Drive | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Lodi Memorial Hospital Association Inc | |||||||||||
| 975 S Fairmont Avenue | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Mid-Columbia Medical Center | |||||||||||
| 1700 E 19th Street | The Dalles | OR | 97058 | 930386936 | Hospital | OR | 501(c)(3) | Line 3 | Stone Point Health | 0 | |
| Northwest Medical Foundation of Tillamook | |||||||||||
| 1000 Third Street | Tillamook | OR | 97141 | 930622075 | Hospital | OR | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Paradise Valley Hospital | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 951816034 | Discontinued Operations | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Portland Adventist Medical Center | |||||||||||
| 10123 SE Market Street | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Reedley Community Hospital | |||||||||||
| 372 Cypress Avenue | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Rideout Memorial Hospital | |||||||||||
| 726 Fourth Street | Marysville | CA | 95901 | 941387866 | Acute care hospital | CA | 501(c)(3) | Line 3 | Stone Point Health | 0 | |
| St Helena Hospital | |||||||||||
| 10 Woodland Road | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| San Joaquin Community Hospital | |||||||||||
| 2615 Chester Avenue | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Simi Valley Hospital and Health Care Services | |||||||||||
| 2975 N Sycamore Drive | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Sonora Community Hospital | |||||||||||
| 1000 Greenley Road | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Stone Point Health | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 823763347 | Supporting organization | CA | 501(c)(3) | Line 12b, II | Adventist Health SystemWest | 0 | |
| United Com-Serve | |||||||||||
| 726 Fourth Street | Marysville | CA | 95901 | 943015356 | Skilled nursing/assisted living/home health | CA | 501(c)(3) | Line 12b, II | Stone Point Health | 0 | |
| Walla Walla General Hospital | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 910617726 | Hospital - closed July 2017 | WA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Western Health Resources | |||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 953867863 | Home care | CA | 501(c)(3) | Line 10 | Adventist Health SystemWest | 0 | |
| White Memorial Medical Center | |||||||||||
| 1720 E Cesar E Chavez Avenue | Los Angeles | CA | 90033 | 952282647 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
| Willits Hospital Inc | |||||||||||
| 1 Marcela Drive | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(c)(3) | Line 3 | Adventist Health SystemWest | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Blue Legacy Ventures LLC | |||||||||
| 1010 NE 2nd Avenue | Miami | FL | 33132 | 871254649 | Real property rental | FL | N/A | 0 | 0 |
| Blue Zones LLC | |||||||||
| 200 Southdale Center | Edina | MN | 55435 | 271603327 | Education | MN | N/A | 0 | 0 |
| PAR LLC DBA CherryWood Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 931262371 | Senior housing | OR | N/A | 0 | 0 |
| PVHR LLC DBA Paradise Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 260622555 | Senior housing | OR | N/A | 0 | 0 |
| PVHR2 LLC DBA Parkview Memory Care at Paradise Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 473300170 | Senior housing | OR | N/A | 0 | 0 |
| WWGHR LLC DBA Wheatland Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 810591221 | Senior housing | OR | N/A | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AdHealth Limited | ||||||||||||||
| PO Box HM 2062 | Hamilton | BD | HM HX | Pure captive insurance | BD | N/A | C | 0 | ||||||
| Adventist Health Plan Inc | ||||||||||||||
| Health insurance | N/A | C | 0 | 1 Adventist Health Way | Roseville | CA | 95661 | 463833261 | CA | |||||
| South Coast Medical Center | ||||||||||||||
| Wind down after sale of hospital | N/A | C | 0 | 1 Adventist Health Way | Roseville | CA | 95661 | 952037291 | CA | |||||
| Thrive Productions Inc | ||||||||||||||
| Production company | N/A | C | 0 | 200 Southdale Center | Edina | MN | 55435 | 453369049 | MN | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |