ADVENTIST HEALTH TULARE: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ADVENTIST HEALTH TULARE (EIN 83-2351753)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-08
- IRS object ID
- 202303129349304345
- Schema version
- 2022v5.0
- 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 | 2023-11-08T14:23:56-08:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 800519547 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ACCOUNTANCY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 N BRAND BLVD STE 1930 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 832351753 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Tulare | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADVE | BusinessNameControlTxt |
| Phone | 5596880821 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 869 N Cherry St | AddressLine1Txt |
| City | Tulare | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93274 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Haydock Timothy | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Signature | 2023-11-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Haydock | PersonFirstNm |
| Person Last | Timothy | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | S Clement | PreparerPersonNm |
| PTIN | P01218012 | PTIN |
| Phone | 8185475701 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kofl Andrea | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 869 N Cherry St | AddressLine1Txt |
| City | Tulare | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93274 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $52,064,031 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.adventisthealth.org/tulare | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Living Gods love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 432 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $124,092 | PYContributionsGrantsAmt |
| CY Contributions Grants | $902,647 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $35,198,021 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $51,043,492 | CYProgramServiceRevenueAmt |
| PY Investment Income | $97,880 | PYInvestmentIncomeAmt |
| CY Investment Income | $117,892 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $35,419,993 | PYTotalRevenueAmt |
| CY Total Revenue | $52,064,031 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $50,650 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $181,212 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,258,530 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,708,832 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $156,255 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $53,752,669 | PYOtherExpensesAmt |
| CY Other Expenses | $57,925,589 | CYOtherExpensesAmt |
| PY Total Expenses | $82,061,849 | PYTotalExpensesAmt |
| CY Total Expenses | $89,815,633 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$46,641,856 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$37,751,602 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $47,090,498 | TotalAssetsBOYAmt |
| Total Assets EOY | $40,512,216 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $103,377,904 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $136,253,224 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$56,287,406 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$95,741,008 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Living Gods love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $70,884,185 | ExpenseAmt |
| Grant | $181,212 | GrantAmt |
| Revenue | $52,064,031 | RevenueAmt |
| Desc | Adventist Health Tulare (AHTR) 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 Adventist Health Tulare, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths 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 programsNot only does Adventist Health Tulare 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.AHTR 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 2022 was $24,668,558.The following Inpatient services were provided to all our patients:244 babies delivered466 surgeries performed9,091 patient days The following Outpatient services were provided to all our patients:32,047 emergency department visits2,301 outpatient surgeries performed16,884 outpatient visits AHTR 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 2022 was $83,190.Adventist Healths mission statement of living Gods 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 Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.The following story illustrates how Adventist Health Tulare is able to provide quality care for our community in an extraordinary way:Angela Gutierrez, a medical assistant on Adventist Healths mobile care unit, was putting materials away after an event when a woman approached. Excuse me, maam, would you be able to take my blood pressure? the woman asked. Im not feeling well. She was shaking and said she felt dizzy.Angela immediately grabbed her blood pressure cuff to check her and read the numbers out loud. 280 over 180. Thats within the range of having a stroke. Angela helped the patient get to the closest emergency department, where she was admitted and treated.That was a close one, Angela says. If we hadnt been there, Id hate to think what wouldve happened to her. Once she was discharged, the woman returned to the Mobile Care unit with hugs and snacks. She knew we had saved her life and was so grateful we were there. For many of our community members who face transportation barriers, getting to the doctors office isnt always easy. Our mobile unit allows us to meet our community where they are and provide care physically and mentally. This program is entirely funded by donors and grants, and we need your help to keep it rolling. Were taking the best of what we have in our hospitals and our clinics, and we have equipped this mobile unit to go out into the areas that have not been seen before, explains Raul Ayala, MD, Ambulatory Medical Officer at Adventist Health Central Valley Network . We have towns that are less than 500 people or 1,000 people, and the next healthcare provider is maybe 30, 50 or even 100 miles away . The mobile unit is one part of our vision to bring healthcare including a growing number of medical specialties to clinics and sites throughout the region. This vision also includes the family medicine residency program at Adventist Health in the Central Valley and clinic rotations for medical assistant, physician assistant and nurse practitioner students from over 50 schools.Dr. Joseph Maddela, a third-year resident at Adventist Health, is grateful for the opportunity to serve in the mobile clinic. Having grown up in a rural community, its been my dream to give back to the people who raised me. Dr. Maddela and his colleagues provide care at clinics throughout the area and on the mobile unit, which travels across a 200-mile area and is fully equipped with the exam rooms, equipment and technology needed to provide care. I enjoyed getting to know the patients, learning what gives them hope, what makes them happy, and seeing their improvement through our care, he says. The mobile clinic also has increased the number of experiences and opportunities for students to learn more about Adventist Health, to learn more about the community, to learn more about how they can make a difference, says Dr. Ayala.Our mobile care unit visits schools, farms, homeless shelters and churches. This will allow us to find those patients that are in need, who dont visit a doctor, dont have access to good health care. and we will be that bridge that brings them from the community, into a medical home, because I know we provide the best health care in this Valley. God has given us this calling, and we need the community's support, says Dr. Ayala. Our dream is to have a mobile unit traveling north, east, south and west, serving our hard-to-reach communities. We have one unit, and it is doing incredible things and we are planning to add more units as the funds allow.Compassionate, high-quality patient care; life-saving and life-preserving medical and surgical services; advanced treatments in a community-based hospital; essential emergency services-these are the reasons we are in our community.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ | Desc |
| Total Program Service Expenses | $70,884,185 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 432 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | John Beaman | PersonNm |
| Phone | 9164060000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 619135 | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (38 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| Wing Bill - Departed 122 | |||||||
| Dir/VC/Asst Sec | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,511,347 | $53,289 |
| Heinrich Kerry | |||||||
| Director/CEO | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,131,444 | $48,069 |
| Hofheins Todd | |||||||
| COO Eff 1/22 | 0.00 | 50.00 | Yes (X) | $0 | $1,971,652 | $55,964 | |
| Jahn Andrew-Care Div Pres thru 222 | |||||||
| President, Southern CA Network | 0.00 | 50.00 | $0 | $1,409,539 | $60,092 | ||
| Beaman John | |||||||
| CFO/Secretary | 0.00 | 50.00 | Yes (X) | $0 | $1,361,096 | $61,075 | |
| Nahapetian Arby-Care Div Med Off th | |||||||
| Chief Clinical Officer | 0.00 | 50.00 | $0 | $1,334,111 | $60,780 | ||
| Spenst Brett-Care Div Fin Off thru | |||||||
| Sr. Finance Officer & CIO | 0.00 | 50.00 | $0 | $1,322,824 | $40,922 | ||
| Stevens Eric-Care Div Ops Exec thru | |||||||
| President, No Cal/HI State Network | 0.00 | 50.00 | $0 | $1,315,314 | $46,881 | ||
| Reiner Scott | |||||||
| Former Dir/Chair/CEO thru 12/21 | 0.00 | 50.00 | $0 | $1,222,073 | $25,188 | ||
| Kofl Andrea | |||||||
| Ctrl Vally Pres | 10.00 | 40.00 | Yes (X) | $0 | $1,136,791 | $47,967 | |
| Jobe Meredith | |||||||
| Secretary | 0.00 | 50.00 | Yes (X) | $0 | $930,036 | $49,067 | |
| Ayala Raul-CVN Clinics | |||||||
| Medical Officer | 0.00 | 50.00 | Yes (X) | $0 | $756,718 | $32,319 | |
| Kaur Gurvinder | |||||||
| Medical Officer, CVN | 10.00 | 40.00 | $0 | $692,810 | $32,124 | ||
| Haydock Timothy | |||||||
| Treas/Asst Sec | 10.00 | 40.00 | Yes (X) | $0 | $589,178 | $60,824 | |
| Reyna Sonja | |||||||
| Operations Executive | 10.00 | 40.00 | $0 | $504,348 | $33,291 | ||
| Taggart Laurie | |||||||
| Patient Care Executive | 10.00 | 40.00 | $0 | $473,349 | $48,172 | ||
| Day Lauren | |||||||
| Foundation Executive | 0.00 | 50.00 | $0 | $350,763 | $57,016 | ||
| Pickering Christine-Departed 422 | |||||||
| Communication Dir, CCR | 10.00 | 40.00 | $0 | $343,094 | $39,906 | ||
| Ammon Edward | |||||||
| Former Fdtn Exec thru 1/21 | 0.00 | 50.00 | $0 | $321,724 | $47,612 | ||
| Garcia Rosa | |||||||
| RN, Nurse Lead | 40.00 | 0.00 | $257,632 | $0 | $57,038 | ||
| Pereira Sheri | |||||||
| Associate Patient Care Executive | 50.00 | 0.00 | $252,390 | $0 | $51,465 | ||
| McGowan John | |||||||
| Associate Patient Care | 10.00 | 40.00 | $0 | $233,681 | $41,183 | ||
| Ng Mankwong | |||||||
| Pharmacist | 40.00 | 0.00 | $188,794 | $0 | $47,149 | ||
| Boggess Marjorie | |||||||
| RN, House Supervis | 40.00 | 0.00 | $188,483 | $0 | $39,658 | ||
| Martin Cassi | |||||||
| Director RN | 40.00 | 0.00 | $186,515 | $0 | $39,620 | ||
| Aflague Stefanie | |||||||
| Charge Pharmacist | 40.00 | 0.00 | $190,479 | $0 | $19,605 | ||
| Chen Steven-Departed 322 | |||||||
| Fmr Finance Off | 0.00 | 0.00 | Yes (X) | $0 | $127,975 | $15,047 | |
| Freedman John | |||||||
| Dir/Chair | 0.00 | 4.00 | Yes (X) | $0 | $26,858 | $0 | |
| Woodson Marc | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,728 | $0 | |
| Banks David | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,478 | $0 | |
| Cherry Robert | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,478 | $0 | |
| Davis Andrew | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,478 | $0 | |
| Innocent Larry | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,478 | $0 | |
| Reiner Richard | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,478 | $0 | |
| Newton Bradford | |||||||
| Dir/Vice Chair | 0.00 | 4.00 | Yes (X) | $0 | $25,180 | $0 | |
| Salazar Velino | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $21,478 | $0 | |
| Fehr Joy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $430 | $0 | |
| Ocampo Lucy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $430 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,264,293 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $21,273,361 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,211,323 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 80 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Emergency Medical Services Authority | |||||
| 10901 Gold Center Dr Ste 400 | Rancho Cordova | CA | 95670 | Medical Staffing | $3,565,609 |
| Comfort Anesthesia Associates Inc | |||||
| 11704 Nantwick Ct | Bakersfield | CA | 93311 | Physician Services | $2,483,460 |
| Galen Inpatient Physicians Inc | |||||
| 2100 Powell St Suite 400 | Emeryville | CA | 94608 | Physician Services | $1,722,463 |
| Aya Healthcare Inc | |||||
| Dept 3519 PO Box 123519 | Dallas | TX | 75312 | Medical Staffing | $1,193,217 |
| Rmg Medical Imaging Consultants | |||||
| PO Box 86348 | Los Angeles | CA | 90086 | Physician Services | $1,170,019 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $657,543 | GovernmentGrantsAmt |
| All Other Contributions | $245,104 | AllOtherContributionsAmt |
| Total Contributions | $902,647 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CARES Act Income | 722514 | $115,352 | $115,352 |
| Dietary/Cafeteria Revenue | $321,436 | $321,436 | |
| Other Program Services | 900099 | $734,014 | $734,014 |
| Patient Care Services | 900099 | $49,615,388 | $49,615,388 |
| Revenue from Related Orgs | $257,114 | $257,114 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $188 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $51,043,492 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $117,892 | TotalRevenueColumnAmt |
| Exclusion | $117,892 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $52,064,031 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $51,043,492 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $117,892 | 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 | $181,212 | TotalAmt |
| Program Services | $181,212 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,272,477 | TotalAmt |
| Program Services | $23,229,374 | ProgramServicesAmt |
| Management And General | $1,927,471 | ManagementAndGeneralAmt |
| Fundraising | $115,632 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,132 | TotalAmt |
| Program Services | $803,051 | ProgramServicesAmt |
| Management And General | $70,080 | ManagementAndGeneralAmt |
| Fundraising | $5,001 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,747,835 | TotalAmt |
| Program Services | $3,293,306 | ProgramServicesAmt |
| Management And General | $439,393 | ManagementAndGeneralAmt |
| Fundraising | $15,136 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,810,388 | TotalAmt |
| Program Services | $1,682,298 | ProgramServicesAmt |
| Management And General | $119,010 | ManagementAndGeneralAmt |
| Fundraising | $9,080 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,720,857 | TotalAmt |
| Management And General | $9,720,857 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,582 | TotalAmt |
| Management And General | $37,582 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,219 | TotalAmt |
| Management And General | $3,219 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,319,068 | TotalAmt |
| Program Services | $17,866,407 | ProgramServicesAmt |
| Management And General | $451,607 | ManagementAndGeneralAmt |
| Fundraising | $1,054 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $516,453 | TotalAmt |
| Program Services | $397,971 | ProgramServicesAmt |
| Management And General | $118,482 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,256,323 | TotalAmt |
| Program Services | $651,883 | ProgramServicesAmt |
| Management And General | $604,440 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,823,693 | TotalAmt |
| Program Services | $2,421,010 | ProgramServicesAmt |
| Management And General | $2,392,376 | ManagementAndGeneralAmt |
| Fundraising | $10,307 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,750 | TotalAmt |
| Program Services | $114,591 | ProgramServicesAmt |
| Management And General | $5,159 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,818 | TotalAmt |
| Program Services | $2,268 | ProgramServicesAmt |
| Management And General | $1,550 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,897,088 | TotalAmt |
| Program Services | $3,897,088 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,800,190 | TotalAmt |
| Program Services | $3,731,662 | ProgramServicesAmt |
| Management And General | $68,528 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,026 | TotalAmt |
| Program Services | $461,026 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Patient Care Supplies | $9,656,601 | $9,647,102 | $9,454 | $45 |
| Other Expenses | $2,924,235 | $118,250 | $2,805,985 | |
| Quality Assurance | $1,796,769 | $1,796,769 | ||
| Equipment Rentals | $588,917 | $588,917 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,815,633 | TotalAmt |
| Program Services | $70,884,185 | ProgramServicesAmt |
| Management And General | $18,775,193 | ManagementAndGeneralAmt |
| Fundraising | $156,255 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,905,377 | BOYAmt |
| EOY | $16,212,713 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,839,878 | BOYAmt |
| EOY | $1,912,259 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,169 | BOYAmt |
| EOY | $193,341 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $26,943,552 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,980,355 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,326,954 | BOYAmt |
| EOY | $11,963,197 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,000 | BOYAmt |
| EOY | $303,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,597,120 | BOYAmt |
| EOY | $9,927,706 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,090,498 | BOYAmt |
| EOY | $40,512,216 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,457,609 | BOYAmt |
| EOY | $9,374,427 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,335 | BOYAmt |
| EOY | $725,112 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,775,960 | BOYAmt |
| EOY | $126,153,685 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,377,904 | BOYAmt |
| EOY | $136,253,224 | 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 | -$56,293,406 | BOYAmt |
| EOY | -$95,964,735 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,000 | BOYAmt |
| EOY | $223,727 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$56,287,406 | BOYAmt |
| EOY | -$95,741,008 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,090,498 | BOYAmt |
| EOY | $40,512,216 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$37,751,602 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$1,702,000 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $40,102 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $40,102 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part II-B, Line 1i - Other Activities Description | The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. |
| Part IV - Additional Information |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,000 | BeginningYearBalanceAmt |
| Contributions | $217,727 | ContributionsAmt |
| End Year Balance | $223,727 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $124,092 | ContributionsAmt |
| Other Expenditures | $118,092 | OtherExpendituresAmt |
| End Year Balance | $6,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,425 | BeginningYearBalanceAmt |
| Contributions | $191,583 | ContributionsAmt |
| Other Expenditures | $202,008 | OtherExpendituresAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributions | $11,673 | ContributionsAmt |
| Grants Or Scholarships | $1,248 | GrantsOrScholarshipsAmt |
| End Year Balance | $10,425 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,591,487 | OtherCostOrOtherBasisAmt |
| Book Value | $2,591,487 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,005,746 | OtherCostOrOtherBasisAmt |
| Depreciation | $170,192 | DepreciationAmt |
| Book Value | $835,554 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,346,319 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,810,163 | DepreciationAmt |
| Book Value | $8,536,156 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,963,197 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Receivables | $1,320,056 |
| Receivables from Related Organizations | $177,610 |
| Receivables from Third Parties | $8,430,040 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $9,927,706 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Cash Overdraft | $77,625,822 |
| Other Liabilities | $2,044,473 |
| Payables to Related Organizations | $46,483,390 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $126,153,685 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: Intended uses of the endowment fund. | 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 : FIN48 Footnote | 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, 2022 and 2021, 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 (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2018 in major tax jurisdictions. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $590,435 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $590,435 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00660 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,607,940 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,529,817 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,078,123 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.26810 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,198,375 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,529,817 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,668,558 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.27470 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,190 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,190 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,190 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,190 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $44,281,565 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,529,817 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,751,748 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.27560 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94,797 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $94,797 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $94,797 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $94,797 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,351,717 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $389,150 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $10,506,177 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $13,461,127 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,954,950 | 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 (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Adventist Health Tulare | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 869 North Cherry Street | AddressLine1Txt |
| City | Tulare | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93274 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| State License | 106540816 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | 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 (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | 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 (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See Sch H Part VI - Needs Assessment | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| 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 (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | 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 (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | Sch H Part VI - Patient Education | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | Sch H Part VI - Patient Education | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | Sch H Part VI - Patient Education | 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 (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Facility: - Part V, Section B, Line 5 | The 2022 CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations the voices of those with chronic disease, low incomes and the underserved were heardAging, civic government and leadership, community-based organizations focusing on healthcare consumer, law enforcement, low-income, medically underserved, minority populations, substance abuse, transportation and unhoused population participated in seven focus groups with fifty-two individuals participating as well as eight key informant interviews. Represented race/ethnicities were Black, Hispanic, Multi-Race and White. The 2022 Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS Survey data was gathered from the Central Valley region (region name defined by survey administrator, UC Berkeley IGS). |
| Facility: - Part V, Section B, Line 6a | Adventist Health Central Valley network consisting of Reedley Community Hospital, Adventist Health Tulare and Adventist Health Hanford & Selma participated in the 2022 CHNA process. |
| Facility: - Part V, Section B, Line 11 | The COVID-19 global pandemic has caused extraordinary challenges for Adventist Health hospitals and health care systems across the world including keeping front line workers safe, shortages of protective equipment, limited ICU bed space and developing testing protocols. They have also focused on helping patients and families deal with the isolation needed to stop the spread of the virus, and more recently vaccine roll out efforts. Adventist Health, like other health care systems, had to pivot its focus to meet the most urgent healthcare needs of its community during the pandemic, as well as reassess the ability to continue with some community health strategies due public health guidelines for social distancing. Adjustments have been made to continue community health improvement efforts as possible, while ensuring the health and safety of those participating. Tax year 2022 was year three of the Implementation Strategy for the 2019 CHNA. All programs and activities provided to the community were in response to the priority health needs identified in the 2019 CHNA. Our 2019 CHNA identified five areas of significant need: Access to Care, Obesity/ Healthy Eating Active Living (HEAL)/ Diabetes, Mental Health, Economic Security/Homelessness, Maternal & Infant Health. Our overall goal is to improve the health and wellness of our communities through provision of services, community collaboration and innovation. Priority Need 1- Access to Care- The goal is to improve the overall health and wellness of our communities through provisions of services, community collaboration and innovation. Strategy 1- Improving access to care through increased health awareness and access to needed services. Activity 1.1- Transportation to clinic appointments. Adventist Health contracts with transportation vendors to provide round trip transportation to our clinics for patients that do not have transportation and would otherwise not be able to attend their necessary medical appointments. The rides help prevent appointment no-shows and increase access to care for our patients. Additionally, with the use of telehealth, patients were able to receive care in their own homes, and not worry about transportation. Number of Community Members Served: 625. Activity 1.2- Provider Recruitment. Access to care is limited in our region due to a shortage of healthcare providers, including physicians, nurse practitioners and physician assistants. Recruitment of providers and specialists is critical to meeting the healthcare needs of our patients and rural communities. Number of Providers Added: 27 physicians, nurse practitioners and physician assistants to the area. Additional Activities: 1. In July of 2022, an additional Mobile Care Clinic was obtained. The Mobile Care Clinics provide high-quality, primary care services for the entire family in low-income neighborhoods. In 2022, the Mobile Care Clinics recorded serving communities such as Laton, Alpaugh, Tulare, Hanford, Earlimart, Avenal, Five Points, Selma and Reedley, and provided care to over 300 patients. Overall, 1,567 COVID-19 vaccines, 420 flu vaccines, 180 sports physicals, and 764 point of care testings were completed in 2022. 2. Adventist Health provided free medical screenings and back to school immunizations to over 200 school aged children in Orange Cove, Tulare, and Reedley during Health & Wellness Fairs in 2022. We also provided health education about mental wellness and access to care at various locations and events throughout the community including school fairs, baseball games, and run/walk events which ultimately reached 5,000 community members across three counties.Priority Need 2- Obesity/ Healthy Eating Active Living (HEAL)/Diabetes- The goal is to create healthy communities through expansion of preventative programs and chronic disease support. Strategy 1- Through a focus on educational activities, work to empower communities to understand the importance of healthy eating and exercise to live a healthier life. Activity 1.1- Diabetes self-management classes. Due to staffing shortages and the continuation of COVID-19 fluctuations, all diabetes self-management education classes were placed on hold. However, we believed it was still necessary to provide community members with services and education surrounding diabetes management, healthy eating and active living. Mobile Care Clinics were able to provide A1C testing, educational materials, and support to very vulnerable populations. In October 2020, Adventist Health partnered with Nurtrible, a food program aimed at providing nutritional meals for patients who meet the requirements. This program has seen great success and we are looking at expanding the program to other clinics in 2023. Additional Activities: Adventist Health partnered with Hanford Joint High Schools and Tulare Joint High Schools to provide free school physicals. We were able to provide physicals to over 1,200 students over the course of two months. During these physicals students received counseling and educational materials about hydration and healthy eating, specifically while participating in sports.Priority Need 3- Mental Health- The goal is to increase access to behavioral health services for vulnerable populations. Strategy 1- to enhance provider and community partners knowledge of factors influencing behavioral health to support referrals to appropriate behavioral health resources. Activity 1.1- Provide mental health education to external Adventist Health partner organizations and community members. 1. Adventist Health partnered with the Tulare County Behavioral Health Department to create a behavioral health collaborative. The collaborative also includes Fresno and Kings County. Meetings are scheduled into 2023 and focus on developing strategies to address the mental health crisis all three counties are experiencing. 2. Virtual Mental Health visits were also made available in 2022. Patients were able to experience faster access to care and decreased wait times when using the virtual option. 3. In 2022, Adventist Health began employing community health workers with funding provided by a literacy grant. The community health workers are used to educate the community on available resources. Many of our community health workers are predominantly located in communities with language barriers. The community health workers act as a translator and connector to available services that individuals were unaware of due to the language barrierPriority Need 4- Economic Security/ Homelessness- The goal is to address social needs and social determinants of health, to allow for a healthy foundation for communities to build a healthy life. Strategy 1- Partner with county and local programs to have a greater impact on creating access to shelter and housing. Activity 1.1- Recuperative Board and Care (Kings Gospel Mission) In 2022, Adventist Health continued the work with Kings Gospel Mission to provide recuperative room and board to homeless individuals who present to emergency departments. Due to continued COVID-19 efforts California provided, like Project Room Key & Project Home Key, the number of homeless individuals looking for temporary housing declined. The total number of individuals who utilized Kings Gospel Mission services was 12 Additional Activities: 1. In 2022, Adventist Health joined the Kings County Homeless Collaborative, which aims to address and provide support and resources to the homeless community in Kings County, while also discussing and implementing resources to address the crisis. As part of the collaboration, Adventist Health used our Mobile Care Clinic to provide monthly medical screenings to the homeless in Kings County. The Individuals who had access to the monthly mobile care clinic decreased the need for emergency care, thus decreasing wait times and crowding in our emergency departments. Similarly, Adventist Health also partnered with the City of Tulare to provide medical care to the homeless population in the city. Care was provided twice a month with the intent to help rehabilitate and revive the encampments within the city. 2. In 2022, Adventist Health also provided support to individuals experiencing economic insecurity through the Inspire Hope Program. The Inspire Hope Program aims to provide needed items such as home goods, appliances, furniture, personal hygiene items, shelf stable foods, and more to community members in need. The program partners 250 non-profit organizations and allows for these organizations to identify families and the basic needs that are needed. The program was able to donate items to over 3,500 families in the hospital service area.Priority Need 5- Maternal and Infant Health- The goal is to increase overall health and wellness. Strategy 1- Provide educational materials and host educational sessions. Activity 1.1- Provide free car safety seat checks to the community. Although program participation was reduced or limited due to COVID-19, our |
| Facility: - 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. |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tulare Toxicology Lab | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 E Merritt Avenue Suite 107 | AddressLine1Txt |
| City | Tulare | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93274 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Reference Lab-Toxicology | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | 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 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | 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. 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 - Bad Debt Expense | The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | The Medicare cost report apportions the hospitals 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 evolving 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 too 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 - Provisions On Collection Practices For Qualified Patients | 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 incomeX 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 - Needs Assessment | The hospital's 2022 CHNA, the 2023 community health implementation strategy approved in FY 2023, and the 2022 Community Health Plan (CHP) Update for fiscal year 2022 are posted on the hospital's website at https://www.adventisthealth.org/about-central-valley/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2020, 2021 and 2022 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. |
| Part VI, Line 3 - Patient Education of Eligibility for Assistance | 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:1.https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ 2.https://www.adventisthealth.org/documents/financial-assistance/13863-Self-Pay-Billing-and-Collection-Policy.pdfThese documents are available in multiple languages.At 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 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 - Community Information | The Central Valley Network (CVN) is comprised of four cities: Hanford, Tulare, Reedley and Selma. The CVN is home to a total population of 530,375 residents with the majority age group being children (5-17), making up 22.2% of the population. Centrally located between northern and southern California, CVNs geographic region is one of its biggest assets benefiting farmland businesses as well as residents pursuing recreational activities such as a short road trip to Yosemite National Park or the cool coastlines of Monterey Bay and Big Sur. This young population is vibrant with festivals, events and small businesses. Of the population, 64.68% are Hispanic. The median household income is $60,367 of which 59.22% is spent on housing and transportation. Among this population, 27.23% of children live in poverty and 2.70% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. The following zip codes represent Adventist Health Central Valley Networks primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The Adventist Health Central Valley Network CHNA market has a total population of 537,932 (based on the 2020 Decennial Census). The largest city in the service area is Tulare, with population of 59,312. The service area is comprised of the following zip codes: 93219, 93648, 93625, 93646, 93609, 93647, 93631, 93657, 93245, 93234, 93239, 93654, 93204, 93618, 93230, 93615, 93662, 93212, 93630, 93619, 93210, 93656, 93274. 57.31% of the population own their home and 42.69% are renters. Currently 8.57% of the Central Valley population does not have health insurance. The labor force participation rate (57.62%) is lower than that of California (63.29%) and the United States (62.97%). The unemployment rate is at 8.42% and is higher than both the state and the nation. Unemployment creates financial instability and barriers to access including insurance coverage, health services and education, healthy food, and other necessities that impact health status. The rate is higher for people of multiple races (11.27%) and people who chose some other race (10.49%). The childhood poverty rate is extremely high at 27.23%, higher than that of California (16.8%) and US (17.48%). Racial disparity in childhood poverty is evident, with 67.13% of Native Hawaiian or Pacific Islander children aged 0-17, 26.76% of Black children, and 28.23% of Native American or Alaska Native children living in households with income below the federal poverty level. The median household income is $60,367, which is below both the California rate and that of the nation, and poses a significant problem given the exceedingly high cost of living and housing costs in the area. The percent of the Central Valley population living in poverty is extremely high (19.22%) and is considerably higher than the rate of poverty in California (12.58%) and in the US (12.84%). The percentage of students eligible for the free or reduced-price school food program represents 75.84% of public-school students, which is higher than the state average of 59.18% and the nations average of 42.16%. Access to mental health (MH) providers in the Central Valley is extremely limited. The rate of mental health providers is 43.82 per 100k people, as compared to 150.31 in California and 132.27 in the United States. The percentage of adults with poor mental health is higher in the Central Valley (16.1%) than in California (12.5%) and in the US (13.6%). Deaths of despair, which include any deaths due to intentional self-harm, alcohol related disease, and drug overdose are at 43.4 per 100k people and are elevated than the rate in the rest of the state of California (37.1). |
| Part VI, Line 4 - 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, and as we enter 2022 these projects are active. 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. These activities are not included elsewhere on Schedule H. |
| Part VI, Line 5 - Promotion of Community Health | Our hospitals mission is, Living Gods 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 todays state of health, where cost and heartache are 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 healthyeven 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; and 3) 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, and 3) 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 - Affilated Health Care System | 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 telepharmacy 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 - States Filing of Community Benefit Report | CA |
| Part VI - Additional Information | Identified Needs from CHNA, Not Addressed and Why (Based on FY 2022) CHP Update -No hospital can address all the health needs identified in its community. Adventist Health Hanford & Selma 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. Climate Change: We feel that this is not our area of expertise and while we are willing to partner with organization who are engaging in activities to address Climate Change, this is not a top priority at this time. Substance Abuse/Tobacco- will be addressed through Mental Health, Access to Care, and Healthy Eating Active Living (HEAL). Oral Health- will be addressed through Access to Care. Asthma- will be addressed through Access to Care. CVD/Stroke- will be addressed through Access to Care and HEAL. HIV/AIDS/STIs- will be addressed through Access to Care and Maternal/Infant Health. Cancer- will be address through Access to Care and HEAL. Violence/Injury Prevention- will be address through Economic Security/Homelessness, Access to Care and Maternal/Infant Health. Other Items: Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CA Hlth Fund & Trust | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1215 K St Ste 800 | AddressLine1Txt |
| City | Sacramento | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 941498697 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $179,045 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Valuation Method Used | Funds Transfer | ValuationMethodUsedDesc |
| Purpose Of Grant | Uninsured/Underinsured Patients | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 0 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
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 (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (26 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Aflague Stefanie | ||||||||||||
| Charge Pharmacist | $189,574 | $74 | $831 | $9,138 | $10,467 | $210,084 | ||||||
| Ammon Edward | ||||||||||||
| Former Fdtn Exec thru 1/21 | $241,457 | $52,220 | $28,047 | $11,970 | $35,642 | $369,336 | ||||||
| Ayala Raul-CVN Clinics | ||||||||||||
| Medical Officer | $499,610 | $106,568 | $150,540 | $12,310 | $20,009 | $789,037 | ||||||
| Beaman John | ||||||||||||
| CFO/Secretary | $1,047,636 | $298,600 | $14,860 | $12,310 | $48,765 | $1,422,171 | ||||||
| Boggess Marjorie | ||||||||||||
| RN, House Supervis | $188,408 | $75 | $9,328 | $30,330 | $228,141 | |||||||
| Day Lauren | ||||||||||||
| Foundation Executive | $235,012 | $76 | $115,675 | $11,738 | $45,278 | $407,779 | ||||||
| Garcia Rosa | ||||||||||||
| RN, Nurse Lead | $257,581 | $51 | $12,310 | $44,728 | $314,670 | |||||||
| Haydock Timothy | ||||||||||||
| Treas/Asst Sec | $426,006 | $110,862 | $52,310 | $12,310 | $48,514 | $650,002 | ||||||
| Heinrich Kerry | ||||||||||||
| Director/CEO | $1,817,710 | $76 | $313,658 | $12,310 | $35,759 | $2,179,513 | ||||||
| Hofheins Todd | ||||||||||||
| COO Eff 1/22 | $1,358,421 | $376,216 | $237,015 | $12,310 | $43,654 | $2,027,616 | ||||||
| Jahn Andrew-Care Div Pres thru 222 | ||||||||||||
| President, Southern CA Network | $1,047,840 | $349,414 | $12,285 | $12,310 | $47,782 | $1,469,631 | ||||||
| Jobe Meredith | ||||||||||||
| Secretary | $639,741 | $154,687 | $135,608 | $12,310 | $36,757 | $979,103 | ||||||
| Kaur Gurvinder | ||||||||||||
| Medical Officer, CVN | $495,993 | $121,649 | $75,168 | $12,310 | $19,814 | $724,934 | ||||||
| Kofl Andrea | ||||||||||||
| Ctrl Vally Pres | $761,722 | $233,427 | $141,642 | $12,310 | $35,657 | $1,184,758 | ||||||
| Martin Cassi | ||||||||||||
| Director RN | $169,866 | $16,138 | $511 | $8,493 | $31,127 | $226,135 | ||||||
| McGowan John | ||||||||||||
| Associate Patient Care | $186,649 | $44,256 | $2,776 | $9,332 | $31,851 | $274,864 | ||||||
| Nahapetian Arby-Care Div Med Off th | ||||||||||||
| Chief Clinical Officer | $927,049 | $234,212 | $172,850 | $12,310 | $48,470 | $1,394,891 | ||||||
| Ng Mankwong | ||||||||||||
| Pharmacist | $188,720 | $74 | $9,377 | $37,772 | $235,943 | |||||||
| Pereira Sheri | ||||||||||||
| Associate Patient Care Executive | $212,711 | $38,114 | $1,565 | $10,306 | $41,159 | $303,855 | ||||||
| Pickering Christine-Departed 422 | ||||||||||||
| Communication Dir, CCR | $85,004 | $74,747 | $183,343 | $3,766 | $36,140 | $383,000 | ||||||
| Reiner Scott | ||||||||||||
| Former Dir/Chair/CEO thru 12/21 | $348,458 | $870,709 | $2,906 | $12,310 | $12,878 | $1,247,261 | ||||||
| Reyna Sonja | ||||||||||||
| Operations Executive | $362,002 | $89,368 | $52,978 | $12,310 | $20,981 | $537,639 | ||||||
| Spenst Brett-Care Div Fin Off thru | ||||||||||||
| Sr. Finance Officer & CIO | $817,612 | $416,845 | $88,367 | $12,310 | $28,612 | $1,363,746 | ||||||
| Stevens Eric-Care Div Ops Exec thru | ||||||||||||
| President, No Cal/HI State Network | $896,507 | $250,602 | $168,205 | $12,310 | $34,571 | $1,362,195 | ||||||
| Taggart Laurie | ||||||||||||
| Patient Care Executive | $344,509 | $88,523 | $40,317 | $12,310 | $35,862 | $521,521 | ||||||
| Wing Bill - Departed 122 | ||||||||||||
| Dir/VC/Asst Sec | $263,334 | $662,638 | $1,585,375 | $12,310 | $40,979 | $2,564,636 | ||||||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 6 | The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. |
| Form 990, Part VI, Section A, Line 7a | The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. |
| Form 990, Part VI, Section A, Line 7b | The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. |
| 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 System Controller and market Finance 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. Copies for the officers and key employees' COIs are kept in their personnel files. 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 15a | The Organization'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 B, Line 15b | See Line 15a explanation. |
| 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. |
| Prior Period Adjustments | Prior Period adjustments were a result of cash balance correction and clean up of books due to prior period activities including debt service, capital expenditures, and other items. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health SystemWest | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 953484589 | Integrated Health System | CA | 501(c)(3) | 10 | Adventist Health SystemWest | false |
| Adventist Health Clearlake Hospital Inc | ||||||||||
| 15630 18th Avenue | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Medical Center-Tehachap | ||||||||||
| 1100 Magellan Drive | Tehachapi | CA | 93561 | 812240617 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Physicians Network | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 680357690 | Medical Foundation | CA | 501(c)(3) | 12b2 | Adventist Health SystemWest | false |
| Castle Medical Center | ||||||||||
| 640 Ulukahiki Street | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Feather River Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 941101228 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Fremont-Rideout Health Group | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 942917251 | Hospital | CA | 501(c)(3) | 12b2 | Stone Point Health | false |
| Glendale Adventist Medical Center | ||||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 951816017 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Hanford Community Hospital | ||||||||||
| 115 Mall Drive | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Lodi Memorial Hospital Association Inc | ||||||||||
| 975 S Fairmont Avenue | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Northwest Medical Fdtn of Tillamook | ||||||||||
| 1000 Third Street | Tillamook | OR | 97141 | 930622075 | Hospital | OR | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Paradise Valley Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 951816034 | Discontinued Operations | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Portland Adventist Medical Center | ||||||||||
| 10123 SE Market Street | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Reedley Community Hospital | ||||||||||
| 372 Cypress Avenue | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Rideout Memorial Hospital | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 941387866 | Hospital | CA | 501(c)(3) | 3 | Fremont-Rideout Health Group | false |
| St Helena Hospital | ||||||||||
| 10 Woodland Road | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| San Joaquin Community Hospital | ||||||||||
| 2615 Chester Avenue | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Simi Valley Hospital and Health Care Ser | ||||||||||
| 2975 N Sycamore Drive | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Sonora Community Hospital | ||||||||||
| 1000 Greenley Road | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Stone Point Health | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 823763347 | Supporting organization | CA | 501(c)(3) | 12b2 | Adventist Health SystemWest | false |
| Ukiah Adventist Hospital | ||||||||||
| 275 Hospital Drive | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| United Com-Serve | ||||||||||
| 989 Plumas Street | Yuba City | CA | 95991 | 943015356 | Skilled nursing/asstd living/home health | CA | 501(c)(3) | 12b2 | Fremont-Rideout Health Group | false |
| Walla Walla General Hospital | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 910617726 | Hospital | WA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Western Health Resources | ||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 953867863 | Home care | CA | 501(c)(3) | 10 | Adventist Health SystemWest | false |
| White Memorial Medical Center | ||||||||||
| 1720 Cesar E Chavez Avenue | Los Angeles | CA | 90033 | 952282647 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Willits Hospital Inc | ||||||||||
| 1 Marcela Drive | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Delano | ||||||||||
| PO Box 460 | Delano | CA | 93216 | 770258013 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Adventist Health Mendocino Coast | ||||||||||
| 700 River Drive | Fort Bragg | CA | 95437 | 845174585 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| Blue Legacy Ventures LLC | |||||||||
| 1010 NE 2nd Avenue | Miami | FL | 33132 | 871254649 | Real Property Rental | FL | AHSWest | false | false |
| Blue Zones LLC | |||||||||
| 200 Southdale Center | Edina | MN | 55435 | 271603327 | Education | MN | AHSWest | false | false |
| PAR LLC dba CherryWood Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackamas | OR | 97015 | 931262371 | Senior Housing | OR | AHSWest | false | false |
| PVHR LLC dba Paradise Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackamas | OR | 97015 | 260622555 | Senior Housing | OR | AHSWest | false | false |
| PVHR2 LLC dba Parkview Memory Care | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackamas | OR | 97015 | 473300170 | Senior Housing | OR | AHSWest | false | false |
| WWGHR LLC dba Wheatland Village | |||||||||
| 8440 SE Sunnybrook Blvd Suite 100 | Clackamas | OR | 97015 | 810591221 | Senior Housing | OR | AHSWest | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| South Coast Medical Center | ||||||||||||||
| PO Box 619135 | Roseville | CA | 95661 | 952037291 | Wind down after sale of hospital | CA | AHSWest | C-Corp | false | |||||
| Adventist Health Plan Inc | ||||||||||||||
| 1 Adventist Health Way | Roseville | CA | 95661 | 463833261 | Health Insurance | CA | AHSWest | C-Corp | false | |||||
| Thrive Productions Inc | ||||||||||||||
| 200 Southdale Center | Edina | MN | 55435 | 453369049 | Production Company | MN | AHSWest | C-Corp | false | |||||
| AdHealth Limited | ||||||||||||||
| Pure Captive Insurance | AHSWest | C-Corp | false | PO Box HM 2062 | Hamilton | BD | HM HX | BD | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Adventist Health SystemWest | ||
| e | $46,483,390 | Notes Payable |
| Adventist Health SystemWest | ||
| m | $10,503,364 | Operating Exp |
| Adventist Health SystemWest | ||
| r | $33,351,434 | Cash Mgt Funds |