LODI MEMORIAL HOSPITAL ASSOCIATION INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- LODI MEMORIAL HOSPITAL ASSOCIATION INC (EIN 94-1044474)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-12
- IRS object ID
- 202443179349309654
- 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 | 2024-11-12T20:02:12-06:00 | 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 | 941044474 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lodi Memorial Hospital Association Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LODI | BusinessNameControlTxt |
| Phone | 9164060000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 975 S Fairmont Avenue | AddressLine1Txt |
| City | Lodi | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952405118 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Katherine Delmore | 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 | Yes (1) | 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 Lodi Memorial | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Brooke McCollough | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 975 S Fairmont Avenue | AddressLine1Txt |
| City | Lodi | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952405118 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $296,168,361 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/lodi-memorial/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1945 | 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 | 1568 | TotalEmployeeCnt |
| Total Volunteers | 39 | TotalVolunteersCnt |
| Total Gross UBI | -$27,595 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,685,010 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,996,366 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $254,139,893 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $289,027,188 | CYProgramServiceRevenueAmt |
| PY Investment Income | $322,835 | PYInvestmentIncomeAmt |
| CY Investment Income | $127,088 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$21,383 | PYOtherRevenueAmt |
| CY Other Revenue | -$23,553 | CYOtherRevenueAmt |
| PY Total Revenue | $260,126,355 | PYTotalRevenueAmt |
| CY Total Revenue | $296,127,089 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $249,457 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $383,368 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $101,780,488 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $116,368,883 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $439,471 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $168,703,422 | PYOtherExpensesAmt |
| CY Other Expenses | $182,349,344 | CYOtherExpensesAmt |
| PY Total Expenses | $270,733,367 | PYTotalExpensesAmt |
| CY Total Expenses | $299,101,595 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$10,607,012 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,974,506 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $212,195,615 | TotalAssetsBOYAmt |
| Total Assets EOY | $216,571,314 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $187,368,173 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $195,492,205 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,827,442 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,079,109 | 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 | $250,857,154 | ExpenseAmt |
| Grant | $383,368 | GrantAmt |
| Revenue | $289,054,783 | RevenueAmt |
| Desc | See Schedule O | Desc |
| Total Program Service Expenses | $250,857,154 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| 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 | 1568 | 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 (34 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 | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | 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 | 45.00 | $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) | ||||
| 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 | ||||
| Wolcott Daniel | ||||||||||
| Former President thru 12/20 | 0.00 | 50.00 | $0 | $952,733 | $65,709 | Yes (X) | ||||
| Larsen David - Former | ||||||||||
| Finance Officer, CCR thru 04/19 | 0.00 | 50.00 | $0 | $805,493 | $58,193 | Yes (X) | ||||
| Whitney Jason - Former | ||||||||||
| Treasurer/Asst Secr thru 08/22 | 0.00 | 50.00 | $0 | $598,454 | $26,522 | Yes (X) | ||||
| McCollough Brooke | ||||||||||
| President | 50.00 | 0.00 | Yes (X) | $0 | $572,946 | $38,956 | ||||
| Cornwell Eric | ||||||||||
| Medical Officer thru 03/23 | 50.00 | 0.00 | $0 | $528,342 | $65,755 | Yes (X) | ||||
| Spenst Brett - Former Care | ||||||||||
| Division Finance Officer thru 02/22 | 0.00 | 50.00 | $0 | $520,625 | $45,847 | Yes (X) | ||||
| Delmore Katie | ||||||||||
| Treasurer/Asst Secretary | 50.00 | 0.00 | Yes (X) | $0 | $510,099 | $38,929 | ||||
| Karagounis Timothy | ||||||||||
| Operations Excecutive | 50.00 | 0.00 | $0 | $371,204 | $72,641 | Yes (X) | ||||
| Stewart Donovan | ||||||||||
| Patient Care Executive | 50.00 | 0.00 | $0 | $392,430 | $45,671 | Yes (X) | ||||
| Wairimu Rachel | ||||||||||
| Director, Emergency Services | 40.00 | 0.00 | $267,876 | $0 | $81,992 | Yes (X) | ||||
| Beck Atwater Sandra | ||||||||||
| Director Hospital Pharmacy | 40.00 | 0.00 | $293,306 | $0 | $46,488 | Yes (X) | ||||
| Stump Valerie | ||||||||||
| Director, RN | 40.00 | 0.00 | $266,695 | $0 | $60,991 | Yes (X) | ||||
| Pascua Helen | ||||||||||
| RN, First Assistant | 40.00 | 0.00 | $274,242 | $0 | $52,622 | Yes (X) | ||||
| Reed Shelby | ||||||||||
| Director, RN | 40.00 | 0.00 | $274,994 | $0 | $45,073 | 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 | ||||
| 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 | ||||
| Newton Bradford | ||||||||||
| 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 | $1,377,113 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $19,631,178 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,284,713 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 413 | 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 |
|---|---|---|---|---|---|
| Stability Healthcare Inc | |||||
| PO Box 849358 | Los Angeles | CA | 90084 | Contract labor | $4,194,393 |
| PT Solutions Holdings LLC | |||||
| PO Box 724557 | Atlanta | GA | 31139 | Outpatient PT, ST, and OT services | $3,595,137 |
| CEP America Anesthesia PC | |||||
| 2100 Powell Street Suite 400 | Emeryville | CA | 94608 | Physician professional fees | $3,230,152 |
| Aya Healthcare Inc | |||||
| Dept 3519 PO Box 123519 | Dallas | TX | 75312 | Contract labor | $2,540,998 |
| Sound Physicians of California III | |||||
| PO Box 742936 | Los Angeles | CA | 90074 | Physician professional fees | $2,522,562 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 50 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,440,657 | GovernmentGrantsAmt |
| All Other Contributions | $1,555,709 | AllOtherContributionsAmt |
| Total Contributions | $6,996,366 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 621400 | $273,591,758 | $273,591,758 |
| Revenue/subsidy from related orgs | 900099 | $3,233,690 | $3,233,690 |
| Dietary/cafeteria revenue | 722514 | $804,556 | $804,556 |
| Related rental revenue | 532000 | $644,064 | $644,064 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,753,120 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,780,715 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$27,595 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $289,027,188 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119,651 | TotalRevenueColumnAmt |
| Exclusion | $119,651 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,719 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $41,272 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$23,553 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$23,553 | TotalRevenueColumnAmt |
| Exclusion | -$23,553 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,437 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,437 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,437 | TotalRevenueColumnAmt |
| Exclusion | $7,437 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $296,127,089 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $289,054,783 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$27,595 | UnrelatedBusinessRevenueAmt |
| Exclusion | $103,535 | 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 | $383,368 | TotalAmt |
| Program Services | $383,368 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,255,411 | TotalAmt |
| Program Services | $84,077,071 | ProgramServicesAmt |
| Management And General | $10,824,792 | ManagementAndGeneralAmt |
| Fundraising | $353,548 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,716,284 | TotalAmt |
| Program Services | $3,163,688 | ProgramServicesAmt |
| Management And General | $538,781 | ManagementAndGeneralAmt |
| Fundraising | $13,815 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,440,505 | TotalAmt |
| Program Services | $10,216,829 | ProgramServicesAmt |
| Management And General | $178,174 | ManagementAndGeneralAmt |
| Fundraising | $45,502 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,956,683 | TotalAmt |
| Program Services | $6,154,970 | ProgramServicesAmt |
| Management And General | $775,921 | ManagementAndGeneralAmt |
| Fundraising | $25,792 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,481,288 | TotalAmt |
| Management And General | $24,481,288 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,599 | TotalAmt |
| Management And General | $759,599 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,853 | TotalAmt |
| Program Services | $29,853 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,051,473 | TotalAmt |
| Program Services | $51,121,678 | ProgramServicesAmt |
| Management And General | $2,929,795 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,600 | TotalAmt |
| Management And General | $114,600 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,785 | TotalAmt |
| Program Services | $826,476 | ProgramServicesAmt |
| Management And General | $247,495 | ManagementAndGeneralAmt |
| Fundraising | $814 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,810,450 | TotalAmt |
| Program Services | $1,635,559 | ProgramServicesAmt |
| Management And General | $6,174,891 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,832,316 | TotalAmt |
| Program Services | $3,820,261 | ProgramServicesAmt |
| Management And General | $12,055 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,571 | TotalAmt |
| Program Services | $134,705 | ProgramServicesAmt |
| Management And General | $32,866 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,364 | TotalAmt |
| Program Services | $37,929 | ProgramServicesAmt |
| Management And General | $4,435 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,983,899 | TotalAmt |
| Program Services | $4,983,899 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,766,345 | TotalAmt |
| Program Services | $9,666,024 | ProgramServicesAmt |
| Management And General | $100,321 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,470,703 | TotalAmt |
| Program Services | $2,470,203 | ProgramServicesAmt |
| Management And General | $500 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient care supplies | $41,221,550 | $41,221,550 | |
| Quality assurance fee | $14,248,749 | $14,248,749 | |
| Leased equipment expens | $443,036 | $416,973 | $26,063 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,850,763 | TotalAmt |
| Program Services | $16,247,369 | ProgramServicesAmt |
| Management And General | $603,394 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,101,595 | TotalAmt |
| Program Services | $250,857,154 | ProgramServicesAmt |
| Management And General | $47,804,970 | ManagementAndGeneralAmt |
| Fundraising | $439,471 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,374,477 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,112 | BOYAmt |
| EOY | $85,029 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,943,291 | BOYAmt |
| EOY | $43,144,731 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,597,536 | BOYAmt |
| EOY | $3,407,827 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,250 | BOYAmt |
| EOY | $630,310 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $282,051,732 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $177,386,628 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,606,896 | BOYAmt |
| EOY | $104,665,104 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,144,623 | BOYAmt |
| EOY | $4,592,401 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,984,430 | BOYAmt |
| EOY | $60,045,912 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,195,615 | BOYAmt |
| EOY | $216,571,314 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,706,467 | BOYAmt |
| EOY | $23,515,833 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,919 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $12,361,980 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $164,661,706 | BOYAmt |
| EOY | $159,609,473 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,368,173 | BOYAmt |
| EOY | $195,492,205 | 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 | $24,183,189 | BOYAmt |
| EOY | $19,194,078 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $644,253 | BOYAmt |
| EOY | $1,885,031 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,827,442 | BOYAmt |
| EOY | $21,079,109 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,195,615 | BOYAmt |
| EOY | $216,571,314 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,974,506 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $257,291 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$476,000 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$555,118 | 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 | $29,853 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $29,853 | 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 | $644,253 | BeginningYearBalanceAmt |
| Contributions | $1,615,521 | ContributionsAmt |
| Investment Earnings Or Losses | $7 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $374,750 | AdministrativeExpensesAmt |
| End Year Balance | $1,885,031 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,338,107 | BeginningYearBalanceAmt |
| Contributions | $1,066,286 | ContributionsAmt |
| Investment Earnings Or Losses | -$1,374 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,758,766 | OtherExpendituresAmt |
| End Year Balance | $644,253 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,230,274 | BeginningYearBalanceAmt |
| Contributions | $747,274 | ContributionsAmt |
| Investment Earnings Or Losses | $1,706 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $641,147 | OtherExpendituresAmt |
| End Year Balance | $3,338,107 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,171,700 | BeginningYearBalanceAmt |
| Contributions | $2,663,248 | ContributionsAmt |
| Other Expenditures | $2,604,674 | OtherExpendituresAmt |
| End Year Balance | $3,230,274 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $541,320 | BeginningYearBalanceAmt |
| Contributions | $2,659,952 | ContributionsAmt |
| Other Expenditures | $29,572 | OtherExpendituresAmt |
| End Year Balance | $3,171,700 | 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 | $9,973,938 | OtherCostOrOtherBasisAmt |
| Book Value | $9,973,938 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $194,747,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $116,060,796 | DepreciationAmt |
| Book Value | $78,686,258 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,218,380 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,031,373 | DepreciationAmt |
| Book Value | $187,007 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,961,041 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,152,730 | DepreciationAmt |
| Book Value | $8,808,311 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,151,319 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,141,729 | DepreciationAmt |
| Book Value | $7,009,590 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $104,665,104 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Receivables from third-party payors | $36,302,267 |
| Receivables from related organizations | $19,370,921 |
| Right-of-use assets | $3,876,593 |
| State Board of Pharmacy receivable | $370,174 |
| Other assets | $125,957 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $60,045,912 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Payable to related organizations | $155,479,506 |
| Other liabilities | $4,129,967 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $159,609,473 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | Board-designated, temporary and permanently 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 | $625,187 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $625,187 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $90,482,422 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $56,672,942 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $33,809,480 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,107,609 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $56,672,942 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $34,434,667 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11510 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $657,584 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $657,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $737,714 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $737,714 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00250 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,781,262 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,614,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $22,167,228 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07410 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $109,752 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $109,752 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,286,312 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,614,034 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,672,278 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07920 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $119,393,921 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $61,286,976 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $58,106,945 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19430 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $890 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $890 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $29,689 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $29,689 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $799 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $799 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,378 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,378 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $786,627 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $108,946 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $61,419,908 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $57,960,006 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,459,902 | 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 |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | Facility Reporting GroupFacilityReportingGroupCd | Address Line2USAddress/AddressLine2Txt | OtherOtherDesc |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lodi Memorial Hospital Association Inc DBA AHLM | ||||||||||||
| 1 | 975 S Fairmont Ave | Lodi | CA | 95240 | www.adventisthealth.org/lodi-memorial/ | 030000056 | Yes (X) | Yes (X) | Yes (X) | A | ||
| Lodi Memorial Hospital - West DBA AHLM | ||||||||||||
| 2 | 800 Lower Sacramento Road Acute | Lodi | CA | 95242 | www.adventisthealth.org/lodi-memorial/ | 030000056 | Yes (X) | Yes (X) | A | Phys | Outpatient departments at this campus | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Facility Reporting Group - A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Section B | Facility Reporting Group A |
| Facility Reporting Group A consists of: | - Facility 1: Lodi Memorial Hospital Association, Inc. DBA A, - Facility 2: Lodi Memorial Hospital - West DBA AHLM |
| Facility Reporting Group - A Part V, Section B, line 5: | The San Joaquin County 2022 Community Health Needs Assessment (CHNA) presents a comprehensive picture of community health that encompasses the conditions that impact health in the County. From data collection and analysis to the identification of prioritized needs, the development of the 2022 CHNA report has been an inclusive and comprehensive process guided by a Core Team planning group and broadly representative Steering Committee, with input from hundreds of community residents. The process in 2022 included interviews with ten key informants, 29 focus group discussions with 291 diverse community residents. These individuals included representatives from local governmental and public health agencies, community-based organizations, and leaders, representatives, or members of underserved, low-income, and racial/ethnic populations. Secondary data analyses of over 100 indicators, created a robust picture of the issues affecting people's health where they live, work, and play. The 2022 CHNA utilized a mixed-methods approach. San Joaquin County Public Health Services epidemiologists compiled a comprehensive set of secondary data from national, statewide, and local sources to provide a multi-faceted picture of health in San Joaquin County. These data were compared to benchmark data and analyzed to identify potential areas of need. In addition, Ad Lucem Consulting, in concert with the Core Team, collected primary data via key informant interviews and focus groups that offered a wide range of opinions about issues that most impact the health of the community, as well as examples of existing resources that work to address those needs, and suggestions for continued progress in improving these issues. The data used for this CHNA follows the health needs organization and indicators found in the Kaiser Permanente (KP) Community Health Data Platform. The most up-to-date data were included and data by race/ethnicity were also compiled, as well as a number of additional demographic indicators. The analyzed quantitative and qualitative data were triangulated to identify the top health needs in the County. |
| Facility Reporting Group - A Part V, Section B, line 6a: | Adventist Health Lodi Memorial participated with Dameron Hospital, Dignity Health-St. Joseph's Medical Center and Behavioral Health Center, Kaiser Permanente, and San Joaquin County Clinics/San Joaquin General Hospital in the 2022 CHNA. |
| Facility Reporting Group - A Part V, Section B, line 6b: | Core team members that participated in the 2022 CHNA included: Community Foundation of San Joaquin, Community Medical Centers, First 5 San Joaquin, Health Net, Health Plan of San Joaquin, San Joaquin County Office of Education, San Joaquin County Public Health Services, Sutter Health Valley Area and University of the Pacific. Steering Committee members included: 211 San Joaquin, Amelia Adams Whole Life Center, Asian Pacific Self-Development and Residential Association (APSARA), Boys and Girls Club, Catholic Charities Stockton Diocese, Child Abuse Prevention Council, City of Stockton, Office of the Mayor, Office of Violence Prevention, Data Co-op, Interim Director, Delta Health Care, Department of Health and Human Services, Region 9, El Concilio, Emergency Food Bank, Little Manila Rising, LOVE Inc. Manteca, Mary Magdalene Community Services Public Health Advocates, Reinvent South Stockton Coalition, San Joaquin PRIDE Center, Sierra Vista Homes, Residents Council, SJC Behavioral Health Services, SJC Children's Alliance, SJC Clinics, SJC Council of Governments, Early Childhood Education, Comprehensive Health Programs. SJC Health Care Services Agency and Whole Person Care Program, SJC Human Services Agency: Aging and Community Services, St. Mary's Dining Room, Stocktonians Taking Action to Neutralize Drugs (STAND), Faith in the Valley, Health Force Partners, Hispanic Chamber of Commerce, Stockton NAACP, Third City Coalition, Visionary Home Builders and Women's Center and Youth Services Agency. |
| Facility Reporting Group - A Part V, Section B, line 11: | Tax year 2023 was Year One of the Implementation Strategy for the 2022 Community Health Needs Assessment. All 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 Mental Health. Priority Need One - Access to Care. The goal was to explore the feasibility of expanding primary care services to the aging populations through using Lodi Memorial's Adult Daycare Services program. In 2023, Adventist Health Lodi Memorial (AHLM) performed a review of the current facility footprint for the Lodi Adult Daycare Center at Hutchins Street Square. It was confirmed that it can only accommodate its current client capacity based on mandated staffing ratios and operational square footage. This will not allow us to accept additional foot traffic that would be generated by offering additional basic health services for the 75-plus population. Additionally, there are also general security concerns with opening public access to these offices while providing client services. Continued analysis determined that AHLM will consider partnering with existing senior centers, schools or health centers in the area that would provide opportunities for increase access to care that would benefit all age groups.Other activities to increase access to care included a discussion with the city of Lodi to develop a new 210 bed community center for the homeless and underserved populations. AHLM has been in discussion with the City of Lodi throughout 2023 for a target date of completion in Fall 2025. The Salvation Army has been awarded the opening contract for facility management and is planning on offering: 1. Client Resources: A life skills learning center for clients and include trades training for at-risk youth. Will also include city, county, and state agency services. 2. Health: An office for preventative care for their clients. They are also planning for an 8-10 bed "recuperative care/quiet zone," which is designed for indigent patients that only require minimal medical monitoring/intervention beds. These patients might be supported by home health services and transported for follow-up outpatient appointments. Once their medical course of care concludes, these patients could remain as clients for shelter, rehabilitation, or vocational training, etc. 3. Potential Partnership: The recuperative facility could receive appropriate patient discharged from our hospital that require minimal medical intervention. Discussions between our home health services and key access center stakeholders are being scheduled to explore opportunities. In addition, AHLM was able to hire 12 providers to address access to care issues in 2023. The AHLM service area has 92,818 people living in a health professional shortage area which represents 30.60% of the population. There are 75.98 medical providers per 100,000 residents which is well below the national average of 111.42 providers per 100,000 residents. Of those providers, three were primary care physicians, one primary care nurse practitioner, four specialty physician assistants and five specialty physicians. Priority Need Two - Financial Stability.The goal is to provide supportive environment for members of vulnerable populations to gain exposure and skills for employability in allied health professions through internships, externships, and apprenticeship opportunities in medical and allied health professions. Opportunities in 2023 included: 1. Partnerships with educational institutions to offer internships and residency opportunities to their students in the areas of nursing, diagnostic imaging, rehabilitation services, laboratory, and pharmacy. In 2023, staff time spent in direct support of these programs included more than 8,000 hours for nursing, 250 hours for rehabilitation services, 440 hours for medical assistant and 96 hours for physician assistant residencies, internships, and training. 2. Continuation of the HOPE Nursing Program. The current cohort (Cohort #4) has 11 incumbent workers at AHLM, Dameron Hospital and Community Medical Centers. Cohort #3 graduated in 2023 and a total of 11 out of the 12 students passed their licensing examination and are transitioning over to the workforce. In Cohort #3, 11 out of the 12 graduates were from Lodi Memorial Hospital or Dameron Hospital. 3. Certified Nursing Program. The program began development with an anticipated implementation date of 2024 pending approval by the California Department of Public Health. This program is a 14-week guided study for participants to become certified nursing assistants. It is geared towards the working adult so they can continue to support themselves and their family so the program will be held nights and weekends. Additional programs to assist with addressing financial stability included: 1. Collaboration with partners to connect community members with support services and education to reduce financial burden such as Medi-CAL/CalAIM and provide childcare service referrals for single parents pursuing their education or employment to provide relief from full-time childcare responsibilities. The Hospital established a partnership with a third-party service provider to connect Medi-Cal patients who have complex health needs, are unhoused, or are high emergency room utilizers, with additional support and services. The program provides a whole-person approach to care and addresses clinical and non-clinical needs of enrollees.2. The continued use and improved functionality of the Unite Us platform to integrate social needs referrals directly into the electronic medical record. These allowed streamlined workflows and the coordination of communication and implementation of process to provide referrals and track outcomes for vulnerable populations. Priority Need Three - Mental Health: The goal is to collaborate with community partners in addressing workplace related stress as well as mental health concerns that employees may have in the workplace through workplace symposiums addressing burnout prevention and available resources. Activities in 2023 included: 1. Completed first webinar "Happy Half Hour" on zoom featuring medical experts providing tips and information on practicing healthy habits that help maintain physical and mental well-being. More than 18 employer organizations and over 1,000 people attended. 2. Utilized the existing partnership with the American Heart Association to present educational outreach to the San Joaquin County workforce via their employers. 3. Conducted an employer onsite learning seminar on substance abuse that reached more than 1,000 employees. 4. Sponsored the San Joaquin Way's Power of One community leadership gathering in November to convey the need for expanded mental health support services.5. Continued work with the San Joaquin County CHIP Committee on the community improvement project within the county, targeting public park enhancement to support community usage, family, and physical activity as ways to support physical and mental well-being. 6. Continued participation on the San Joaquin County Community Health Leadership Council, comprised of executive leadership from health care, government agencies and community organizations, collaborating on efforts to address youth mental health needs through a series of meetings to identify existing mental health resources and resource gaps, that may reveal duplicative services or support taking a more holistic approach. AHLM has continued to utilize the funds from the Behavioral Health Pilot Project (BHPP) to support a substance use navigator (SUN) in the emergency department (ED). In 2023, the SUN at the Hospital provided services to 356 patients in the emergency department /inpatient care between January and December. Of these, 177 patients accepted referrals to medicated assisted treatment (MAT) treatment, substance use treatment and behavioral health with scheduled appointments as the patients were discharged from the emergency department or inpatient hospital setting. Out of the 177 patients that accepted referral, 123 patients were MAT referrals for opiates and alcohol. Out of 123 patients, 88 patients attended their MAT Program scheduled appointments. In 2023, a total of 103 Buprenorphine prescriptions were administered or written in the ED or inpatient settings. A total of 137 patients received a drug overdose diagnosis. Also, 226 patients were diagnosed with opiate use disorder. Additionally, the SUN coordinated the direct transfer of at least eight patients directly from the hospital inpatient setting to community residential treatment programs for a seamless course of care for their conditions. |
| Part V, Section B, Line 11 continuation: | Significant needs not met:No hospital can address all the health needs identified in its community. AHLM is 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. Significant health needs that will not be directly addressed include the following: housing, chronic disease and healthy eating, community safety, family and social support, education, and transportation. While these significant health needs are not address directly, they are likely to benefit from collective efforts of our community partnerships.Community impact activities not included elsewhere included Lodi Farmers Market Outreach and Education efforts in 2023. The Adventist Health Lodi Memorial Emergency Department team provided four community outreach events at the Lodi Farmers Market during the months of June and July. They offered the public education on stroke, heart disease and hands-only CPR training at these events. They also provided this community service at the Festa Italiana Community Event that was held in June at the Lodi Grape Festival Grounds. More than 700 event attendees are estimated to have received information and/or training at these public outreach events.The Hospital supported Lawrence Elementary School with a significant number of lice treatment kits for their students and families. They explained that they have frequent breakouts of lice infestations that occur at student's homes, which results in high levels of student absenteeism. The kits allow the families to effective treatment for the condition (especially those lacking healthcare coverage or transportation) and maintain school attendance. |
| 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 | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - AHLM Wound & Hyperbaric Care | ||||
| 2415 W Vine Street Suite 106 | Lodi | CA | 95242 | Outpatient clinic - hyperbaric & wound care |
| 2 - Lodi Outpatient Surgical Center | ||||
| 521 S Ham Lane Suite F | Lodi | CA | 95242 | Ambulatory surgical center |
| 3 - Urgent Care Clinic | ||||
| 1235 W Vine Street Suite 20 | Lodi | CA | 95240 | Outpatient clinic - urgent care services |
| 4 - Advanced Imaging Center at AHLM | ||||
| 1031 S Fairmont Avenue | Lodi | CA | 95240 | Outpatient diagnostic imaging |
| 5 - Galt Family and Specialty Care | ||||
| 387 Civic Drive | Galt | CA | 95632 | Outpatient clinic - family medicine |
| 6 - AHLM West Pharmacy | ||||
| 2415 W Vine Street Suite 104 B | Lodi | CA | 95240 | Retail pharmacy |
| 7 - Ham Lane Clinic - Fairmont Ave | ||||
| 845 S Fairmont Avenue Suite 8 | Lodi | CA | 95240 | Outpatient clinic - cardiology & pulmonology |
| 8 - AHLM Occupational Medicine | ||||
| 800 S Lower Sacramento Road | Lodi | CA | 95242 | Outpatient clinic - occupational medicine |
| 9 - AHLM Prenatal Care | ||||
| 2415 W Vine Street Suite 103 | Lodi | CA | 95242 | Outpatient clinic - prenatal care |
| 10 - AHLM Adult Day Services | ||||
| 125 Hutchins Street Suite A | Lodi | CA | 95240 | Adult/senior care day services |
Supplemental Information Detail SupplementalInformationDetail (13 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 Lodi Memorial Hospital promotes 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/lodi-memorial/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, our 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: | Near San Joaquin County, in the Central Valley of California, is roughly 60 miles east of San Francisco and 35 miles south of Sacramento, with a total population of 742,603 (2019). Historically, agriculture has been a strong driver of our economy and many migrants and immigrants have settled here to work in the fields and help with agricultural processing or shipping. The County is mostly rural, with one large urban core (Stockton) and seven smaller cities, as well as many ranching and farming communities scattered across the County. San Joaquin County is home to a high concentration of residents at elevated risk for COVID-19 and who have experienced enormous impacts from the pandemic. A quarter of residents are foreign-born. Overall, 14.5% of residents live in poverty. Residents aged 65 years and older have a poverty rate of 9.9%. The educational attainment of San Joaquin County residents is much lower than California residents. Only 18.8% of County residents aged 25 and older have a bachelor's degree or higher, compared to 33.9% of Californians aged 25 and older that have a bachelor's degree or higher. Many residents of San Joaquin County speak languages other than English at home. Over one quarter of San Joaquin County residents communicate at home in Spanish, which is less than the overall rate for California, and fewer County residents speak Chinese languages than California as a whole. A higher percentage of County residents speak Tagalog, Punjabi and Khmer as compared to California overall. San Joaquin County had higher (risk adjusted) rates of adult hospitalization for heart failure, COPD/asthma (ages 40-plus), asthma (ages 18-39) and hypertension in 2020 than California overall. Many of these hospitalizations could potentially be avoidable through access to high quality outpatient care. In San Joaquin County, the top five causes of death are heart disease, cancer, COVID-19, stroke and lung disease. According to 2021 County Health Profiles, out of 58 counties, SJC had the 14th highest death rate from diabetes, 26th highest coronary heart disease death rate, and the fifth highest stroke death rate in the state. The top five causes of death differ by race/ethnicity. Heart disease and cancer are among the top five causes of death for all racial/ethnic groups; diabetes is among the top five causes of death for Asian and Native Hawaiian/Pacific Islander residents, and unintentional injuries appears in the top five causes of death for Black/African American, Latinx (Hispanic), Native Hawaiian/Pacific Islander and multiethnic residents. COVID-19 was the number one cause of death for Asian and Latinx (Hispanic) residents. |
| 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 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| CA Health Fund & Trust | ||||||||
| 1215 K Street Suite 800 | Sacramento | CA | 95814 | 941498697 | 501(c)(3) | $200,556 | $0 | Health services uninsured/underinsured |
| American Heart Association Inc | ||||||||
| 7272 Greenville Avenue | Dallas | TX | 752314596 | 135613797 | 501(c)(3) | $50,000 | $0 | Healthy for Good sponsorship |
| Lodi Memorial Hospital Foundation | ||||||||
| 845 S Fairmont Avenue Suite 3 | Lodi | CA | 952405140 | 942719880 | 501(c)(3) | $44,390 | $0 | General support to cover part of payroll |
| United Way of San Joaquin County | ||||||||
| 777 N Pershing Avenue Suite B | Stockton | CA | 95203 | 941279805 | 501(c)(3) | $40,000 | $0 | General support |
| Lodi District Chamber of Commerce | ||||||||
| 35 S School Street | Lodi | CA | 95240 | 940636200 | 501(c)(6) | $28,170 | $0 | Grow in Lodi sponsorship, two other minor voluntary donations |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Through the use of temporarily restricted accounts, we track and monitor the incoming receipts from grants and the utilization of grant funds. Each grant is tracked separately. Should the grantor agency require specific reports, we comply with their reporting requirements. The grants we monitor are specific to the grantor's needs and requests. | 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 (22 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 |
| 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 |
| Wolcott Daniel | ||||||||||||||
| Former President thru 12/20 | $0 | $190,804 | $0 | $217,108 | $0 | $544,821 | $0 | $13,296 | $0 | $52,413 | $0 | $1,018,442 | $0 | $0 |
| Larsen David - Former | ||||||||||||||
| Finance Officer, CCR thru 04/19 | $0 | $174,498 | $0 | $152,018 | $0 | $478,977 | $0 | $13,296 | $0 | $44,897 | $0 | $863,686 | $0 | $0 |
| Whitney Jason - Former | ||||||||||||||
| Treasurer/Asst Secr thru 08/22 | $0 | $385,962 | $0 | $63,129 | $0 | $149,363 | $0 | $13,296 | $0 | $13,226 | $0 | $624,976 | $0 | $0 |
| McCollough Brooke | ||||||||||||||
| President | $0 | $439,713 | $0 | $85,147 | $0 | $48,086 | $0 | $13,296 | $0 | $25,660 | $0 | $611,902 | $0 | $0 |
| Cornwell Eric | ||||||||||||||
| Medical Officer thru 03/23 | $0 | $102,784 | $0 | $11,634 | $0 | $413,924 | $0 | $13,296 | $0 | $52,459 | $0 | $594,097 | $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 |
| Delmore Katie | ||||||||||||||
| Treasurer/Asst Secretary | $0 | $308,769 | $0 | $66,530 | $0 | $134,800 | $0 | $13,296 | $0 | $25,633 | $0 | $549,028 | $0 | $0 |
| Karagounis Timothy | ||||||||||||||
| Operations Excecutive | $0 | $277,892 | $0 | $74,770 | $0 | $18,542 | $0 | $13,296 | $0 | $59,345 | $0 | $443,845 | $0 | $0 |
| Stewart Donovan | ||||||||||||||
| Patient Care Executive | $0 | $336,600 | $0 | $49,940 | $0 | $5,890 | $0 | $13,296 | $0 | $32,375 | $0 | $438,101 | $0 | $0 |
| Wairimu Rachel | ||||||||||||||
| Director, Emergency Services | $205,194 | $0 | $36,746 | $0 | $25,936 | $0 | $8,983 | $0 | $73,009 | $0 | $349,868 | $0 | $0 | $0 |
| Beck Atwater Sandra | ||||||||||||||
| Director Hospital Pharmacy | $253,240 | $0 | $31,284 | $0 | $8,782 | $0 | $12,138 | $0 | $34,350 | $0 | $339,794 | $0 | $0 | $0 |
| Stump Valerie | ||||||||||||||
| Director, RN | $217,387 | $0 | $15,639 | $0 | $33,669 | $0 | $9,207 | $0 | $51,784 | $0 | $327,686 | $0 | $0 | $0 |
| Pascua Helen | ||||||||||||||
| RN, First Assistant | $263,485 | $0 | $7,946 | $0 | $2,811 | $0 | $7,077 | $0 | $45,545 | $0 | $326,864 | $0 | $0 | $0 |
| Reed Shelby | ||||||||||||||
| Director, RN | $226,659 | $0 | $15,215 | $0 | $33,120 | $0 | $9,616 | $0 | $35,457 | $0 | $320,067 | $0 | $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. Cornwell, Eric - severance payment - $401,441 Larsen, David - severance payment - $392,620 Wing, Bill - severance payment - $1,440,800 Wolcott, Daniel - severance payment - $517,896 The Supplemental Executive Retirement Plan (SERP) is a defined contribution plan designed to encourage the participants continued employment with Adventist Health and is subject to the participants satisfying specified substantial risks of forfeiture. The SERP benefit distribution occurs when the executive achieves 30 years of Adventist health care service, 20 of which are to be as an executive and at least 10 are to be with Adventist Health System/West, and reaches age 60. Until that time, the SERP benefit is at risk to the creditors of Adventist Health. The SERP benefit is designed to help the executive receive employer-provided retirement benefit income equal to 60% of pre-retirement income. The SERP plan was frozen for new participants in 2016. Larsen, David - participant, no activity in 2023 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 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 (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a: | Lodi Memorial Hospital Association, Inc., DBA Adventist Health Lodi Memorial (AHLM), 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 AHLM, 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 AHLM 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. AHLM 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 $34,434,667. The following Inpatient services were provided to all our patients: - 768 babies delivered - 1,271 surgeries performed - 34,813 patient days The following Outpatient services were provided to all our patients: - 59,446 emergency department visits - 4,658 outpatient surgeries performed - 83,447 outpatient visits - 195,922 clinic visits AHLM 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 $23,672,279. 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/ Briefs: New program supports local caregivers printed July 6, 2023 on www.lodinews.com A new program aimed at providing peace of mind for caregivers has been launched in Lodi. The RED Alert program is being implemented at AHLM in collaboration with the Lodi Senior Commission, Lodi Fire Department, and the Lodi Police Department. Those enrolled in the program will be given a RED Alert magnet to be displayed on one's refrigerator door, alongside a sheet detailing the individual's medical information and specific needs. The magnet is designed to notify first responders that an individual requires constant supervision and cannot be left unattended in the event that their caregiver requires emergency care. To ensure efficient communication, caregivers are encouraged to add their emergency contact's name and phone number at the bottom of the magnet. This information will enable first responders to promptly notify the appropriate contact person in case of an emergency. The RED Alert magnets and medical information sheets will be available to the public at various locations, including the LOEL Senior Center, Lodi Fire and Police departments, and Hutchins Street Square. Additionally, the program will soon extend its reach to Adventist Health primary care offices in the area. |
| 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's 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 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 Performance 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 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 50th 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 fees: Program service expenses 17,584,351. Management and general expenses 1,350,287. Fundraising expenses 0. Total expenses 18,934,638. Contract labor: Program service expenses 15,818,103. Management and general expenses 627,472. Fundraising expenses 0. Total expenses 16,445,575. All other purchased services: Program service expenses 7,605,618. Management and general expenses 551,245. Fundraising expenses 0. Total expenses 8,156,863. Purchased medical services: Program service expenses 5,325,650. Management and general expenses 66,455. Fundraising expenses 0. Total expenses 5,392,105. Consulting fees: Program service expenses 1,218,105. Management and general expenses 262,994. Fundraising expenses 0. Total expenses 1,481,099. Repairs and maintenance: Program service expenses 3,563,014. Management and general expenses 60,824. Fundraising expenses 0. Total expenses 3,623,838. Other professional fees non-medical: Program service expenses 6,837. Management and general expenses 10,518. Fundraising expenses 0. Total expenses 17,355. |
| Form 990, Part XI, line 9: | Change in investment in subsidiaries -552,223. Asset cost adjustment -2,895. |
| 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 Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| Artel LLC (DBA Lodi Outpatient Surgery Center) | |||||||||
| 521 S Ham Lane Suite F | Lodi | CA | 95242 | 263513966 | Ambulatory surgical center | CA | $2,681,935 | $1,647,168 | Lodi Memorial Hospital Association Inc |
| Endoscopy Center of Lodi LLC | |||||||||
| 521 S Ham Lane Suite F | Lodi | CA | 95242 | 261243362 | Medical services | CA | $0 | $0 | Artel LLC |
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 | |
| 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 | |
| Ukiah Adventist Hospital | |||||||||||
| 275 Hospital Drive | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(c)(3) | Line 3 | 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 10 | 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 (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Advanced Imaging Center at Lodi Memorial Hospital LLC (AIC) | ||||||||||||||
| 1001 S Fairmont Avenue | Lodi | CA | 95240 | 943407786 | Diagnostic imaging / MRI outpatient treatment center | CA | Lodi Memorial Hospital Association Inc | Related | $110,196 | $2,219,635 | 0 | 0 | 1.00000 | |
| Blue Legacy Ventures LLC | ||||||||||||||
| 1010 NE 2nd Avenue | Miami | FL | 33132 | 871254649 | Real property rental | FL | 0 | 0 | N/A | |||||
| Blue Zones LLC | ||||||||||||||
| 200 Southdale Center | Edina | MN | 55435 | 271603327 | Education | MN | 0 | 0 | N/A | |||||
| PAR LLC DBA CherryWood Village | ||||||||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 931262371 | Senior housing | OR | 0 | 0 | N/A | |||||
| PVHR LLC DBA Paradise Village | ||||||||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 260622555 | Senior housing | OR | 0 | 0 | N/A | |||||
| PVHR2 LLC DBA Parkview Memory Care at Paradise Village | ||||||||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 473300170 | Senior housing | OR | 0 | 0 | N/A | |||||
| WWGHR LLC DBA Wheatland Village | ||||||||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackmas | OR | 97015 | 810591221 | Senior housing | OR | 0 | 0 | N/A | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Delta Radiology Inc | ||||||||||||||||||
| 975 S Fairmont Avenue | Lodi | CA | 95240 | 941715690 | Radiology services | CA | Lodi Regional Health Systems Inc | C | $4,790,317 | $1,008,907 | 1.00000 | Yes (1) | ||||||
| Lodi Regional Health Systems Inc | ||||||||||||||||||
| 975 S Fairmont Avenue | Lodi | CA | 95240 | 680398894 | Physician management and medical office building development & management | CA | Lodi Memorial Hospital Association Inc | C | $6,087,321 | $11,054,184 | 1.00000 | Yes (1) | ||||||
| AdHealth Limited | ||||||||||||||||||
| Pure captive insurance | C | 0 | PO Box HM 2062 | Hamilton | BD | HM HX | BD | N/A | ||||||||||
| Adventist Health Plan Inc | ||||||||||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 463833261 | Health insurance | CA | C | 0 | N/A | |||||||||
| South Coast Medical Center | ||||||||||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 952037291 | Wind down after sale of hospital | CA | C | 0 | N/A | |||||||||
| Thrive Productions Inc | ||||||||||||||||||
| 200 Southdale Center | Edina | MN | 55435 | 453369049 | Production company | MN | C | 0 | N/A | |||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | Yes (1) | 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 | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Advanced Imaging Center at Lodi Memorial Hospital LLC (AIC) | ||
| A | $9,521 | FMV |
| Advanced Imaging Center at Lodi Memorial Hospital LLC (AIC) | ||
| O | $789,430 | FMV |
| Lodi Regional Health Systems Inc | ||
| O | $247,163 | FMV |
| Delta Rediology Inc | ||
| P | $996,511 | FMV |