2022-11-11T16:03:44-08:00 2021-12-31 800519547 THE ACCOUNTANCY LLP 500 N Brand Blvd Fl 20 Glendale CA 91203 990 2021-01-01 812240617 Adventist Health Medical Ctr Tehachapi dba Adventist Health Tehachapi Valley ADVE 6618233000 1100 Magellan Dr Tehachapi CA 93561 Shane Cox Finance Officer 2022-11-11 false Shane Cox 999009999 S Clement P01218012 8185475701 X 2 AAL1 IAL1 FAL1 2021 2022-09-23 18:48:47Z Wolcott Daniel 1100 Magellan Dr Tehachapi CA 935611380 59863269 false 1071 X www.adventisthealth.org/tehachapi-valley X 2016 CA Living Gods love by inspiring health, wholeness and hope. 14 11 345 11 0 724939 1236672 47774654 58083801 298028 542796 0 48797621 59863269 76983 50650 0 18101246 21251844 0 197385 24997516 30680579 43175745 51983073 5621876 7880196 66701688 73073972 70263102 73329590 -3561414 -255618 Living Gods love by inspiring health, wholeness and hope. false false 39739698 50650 59863269 Adventist Health Medical Ctr Tehachapi (AHTV) provides quality medical health care 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 Adventist Health Medical Ctr Tehachapi, 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 will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Adventist Health Medical Ctr Tehachapi 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.AHTV 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 2021 was $3,783,542.The following Inpatient services that were provided to all our patients. These services included:87 Surgeries performed6,017 Patient days The following Outpatient services that were provided to all our patients. These services included:19,014 Emergency department visits243 Outpatient surgeries performed13,185 Outpatient visits 16,989 Clinic visitsAHTV recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2021 was $403,502.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.Website for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 39739698 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 0 0 true 345 true false false false false false false false 0 false false false false false false false X 14 11 true false false false true true true true true false false true true true true true true true true false CA X John Beaman 9164061092 PO Box 619135 Roseville CA 95661 X Reiner Scott CEO thru 12/21 0.00 50.00 X X 0 2940088 62418 Wing Bill Dir/Asst Sec/VC 0.00 50.00 X X 0 2459079 76222 Jahn Andrew President, Care Division 2.00 48.00 0 1848683 72937 Hofheins Todd CFO 0.00 50.00 X 0 1319147 59910 Nahapetian Arby Care Division Chief Medical Officer 2.00 48.00 0 1058113 78302 Eller Jeff Vice Chair/AHTV 0.00 50.00 0 1100138 22996 Wolcott Daniel Pres thru 3/21 0.00 50.00 X 0 932279 72937 Jobe Meredith Secretary 0.00 50.00 X 0 932705 59761 Larsen David Finance Officer, CCR thru 4/19 0.00 50.00 0 876757 67250 Stevens Eric Care Division Operations Executive 2.00 48.00 0 884611 49992 Chen Steven Former Finance Officer, CCR 2/20 0.00 50.00 0 779689 73789 Spenst Brett Care Division Finance Officer 2.00 48.00 0 786101 45300 Butler David Pres eff 3/21 15.00 35.00 X 0 680823 72937 Ferch Wayne Former President, CCR thru 2/20 0.00 0.00 0 586112 18351 Cox Shane Treas/A Sec 15.00 35.00 X 0 504779 83596 Briggs Sharlet President thru 08/20 0.00 0.00 0 548135 32738 Cantrell Misty Patient Care Executive 50.00 0.00 0 401495 97156 Reynoso Hernandez R Former Medical Officer, CCR 0.00 0.00 0 386566 26849 Badders Brett Manager, RN 50.00 0.00 351880 0 5570 Heinrich Kerry-CEO Elect1121 Director 0.00 50.00 X X 0 282697 2627 Lorenz Alida Director, RN 50.00 0.00 187444 0 45074 Guirguis Yehia Pharmacist 50.00 0.00 186002 0 15922 Malas Nisreen Supvsr, Pharmacy 50.00 0.00 178920 0 20048 Waterhouse Karla RN, House Supvsr 50.00 0.00 187849 0 9771 Reppert Joseph Former CFO/Asst Secr thru 8/19 0.00 0.00 0 179119 11442 Jamaleddine Ghassan Medical Officer as of 08/21 50.00 0.00 0 182605 3746 Freedman John VC/Chair 8/21 0.00 4.00 X X 0 26435 0 Banks David Director 0.00 4.00 X 0 26159 0 Cherry Robert Director 0.00 4.00 X 0 26159 0 Davis Andrew Director 0.00 4.00 X 0 26159 0 Innocent Larry Director 0.00 4.00 X 0 26159 0 Reiner Richard Director 0.00 4.00 X 0 26159 0 Graham Ricardo Chair thru 8/21 0.00 4.00 X X 0 19545 0 Woodson Marc Director 0.00 4.00 X 0 15909 0 Salazar Velino Director 0.00 4.00 X 0 6058 0 Ocampo Lucy Director 0.00 4.00 X 0 159 0 Fehr Joy Director 0.00 4.00 X 0 114 0 Newton Bradford Dir/VChair 8/21 0.00 4.00 X X 0 0 0 1092095 19868736 1187641 601 true true false Healthcare Construction Company Inc 1125 Camino Del Mar Ste G Del Mar CA 92014 Design Services 1069997 Sound Physicians of California III PO Box 742936 Los Angeles CA 90074 Physician Services 838817 GE Precision Healthcare LLC PO Box 96483 Chicago IL 60693 Physician Services 777600 Fastaff LLC PO Box 911452 Denver CO 80291 Physician Services 742009 John R Garcia MD Inc 8311 Brimhall Rd Bldg 1900 Ste 1901 Bakersfield CA 93390 Medical Services 740215 18 1236672 1236672 CARES Act Income 900099 5154032 5154032 Dietary/Cafeteria Revenue 97719 97719 Other Program Services 506710 506710 Patient Care Services 900099 52137759 52137759 Pharmacy Revence 99809 99809 87772 87772 58083801 542796 542796 0 0 0 0 0 0 0 0 59863269 58626597 X 50650 50650 0 0 0 0 0 17497386 14797121 2574872 125393 512332 444898 63550 3884 2132576 1678644 435291 18641 1109550 1012257 88134 9159 5398199 9523 5388676 182014 182014 0 0 0 0 10807200 9021483 1756346 29371 24832 24832 316166 209542 99872 6752 1689740 556107 1133633 0 1294438 1256446 37992 173563 162170 8461 2932 0 7946 4148 3504 294 1784423 1784423 0 2142877 2114055 28822 153309 153309 Patient Care Supplies 5382730 5372418 10235 77 Other Expenses 587910 377272 209756 882 Quality Assurance 486267 486267 Equipment Rentals 248965 248965 0 51983073 39739698 12045990 197385 0 10394076 18568952 31477 142935 12230801 5992822 0 0 0 863957 1056671 123126 60850 48496998 6290273 40088813 42206725 0 0 0 20400 111836 2949038 4933181 66701688 73073972 3937142 6016577 2903 531504 66323057 66781509 70263102 73329590 X -5056595 -2312542 1495181 2056924 -3561414 -255618 66701688 73073972 X 7880196 -4469501 -104899 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 4553 4553 false false 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 1505161 1536692 5118 980048 2066923 850442 724919 16851 53349 1505161 478293 725438 353289 850442 225090 253203 478293 100125 124965 225090 1.00000 false true true 114300 114300 41252314 4113751 37138563 72675 72675 7057709 2176522 4881187 42206725 Other Assets 41660 Other Receivables 909145 Receivables from related organizations 70990 Receivables from Third Parties 3911386 4933181 Other Liabilities 590971 Payables to 3rd Parties Medicare 2634866 Payables to Related Organizations 63555672 66781509 X 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, 2021 and 2020, 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 2017 in major tax jurisdictions. true true X true X true X true true true false true true 141145 141145 0.00270 15629584 11987187 3642397 0.07010 15770729 11987187 3783542 0.07280 71203 71203 0.00140 324612 324612 0.00620 7687 7687 0.00010 403502 403502 0.00770 16174231 11987187 4187044 0.08050 8000 8000 0.00020 8000 8000 0.00020 true 1118295 126440 10761545 19796074 -9034529 X true true 1 1 Adv Hlth Med Ctr Tehachapi 1100 Magellan Dr Tehachapi CA 93561 See Form 990, Pg 1, Item J 120000188 X X X X false false true X X X X X X X X X 19 true true false true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 19 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X true true X X X X true X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The 2019 CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. collection of most recently available demographic, socioeconomic and health indicator data; 3. Data gathering from community members. Community Survey: The Kern County Community Benefit Collaborative hospital representatives developed a plan for distribution of a survey to engage community residents. The survey was available in an electronic format through a Survey Monkey link, and in a paper copy format. The electronic and paper surveys were available in English and Spanish. The surveys were available from November 2018 to January 2019 and during this time, 1,114 usable surveys were collected. The hospitals distributed the surveys to their clients, in hospital waiting rooms and service sites, and through social media, including posting the survey link on hospital Facebook pages. The survey was also distributed to community partners who made them available to their clients. A written introduction to the survey questions explained the purpose of the survey and assured participants the survey was voluntary, and that they would remain anonymous. For community members who were illiterate, an agency staff member read the survey introduction and questions to the client in his/her preferred language and marked his/her responses on the survey. The survey included the following: demographics, biggest health issues in the community, greatest needs facing children and families, where residents and their families receive routine health care services, problems faced accessing health care, mental health care, dental care or supportive services, what would make it easier to obtain care, types of support or services needed in the community, and safety concerns in the community.Targeted Interviews: Interviews were used to gather information and opinions, by phone, from persons who represent the community served by the hospital. Interview participants were asked to share their perspectives on a number of topics related to the identified preliminary health needs in the community area. Given shared community areas, the Kern County Community Benefit Adventist Health Bakersfield 14 Collaborative hospitals worked together to conduct the interviews. Forty-one (41) interviews were completed from October 2018 through March 2019. Secondary data were collected from a variety of local, county and state sources to present a community profile, social determinants of health, health care access, birth indicators, leading causes of death, acute and chronic disease, health behaviors, mental health, substance use and misuse, and preventive practices. When available, data sets are presented in the context of Kern County and California to help frame the scope of an issue, as it relates to the broader community. Sources of data include: the U.S. Census American Community Survey, California Department of Public Health, California Health Interview Survey, Kern County Public Health Department, Healthy Kern County, County Health Rankings, California Department of Education, California Office of Statewide Health Planning and Development and California Department of Justice, among others. Facility: - Part V, Section B, Line 6a The Kern County Community Benefit Collaborative convened area hospitals and included these partners:Adventist Health Bakersfield and Adventist Health Tehachapi Valley Hospitals, Delano Regional Medical Center, Dignity Health Bakersfield, Mercy and Memorial Hospitals, Kaiser Permanente Kern County, Kern Medical, and Valley Children's Healthcare. 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. Our 2019 CHNA identified six areas of significant need: Chronic Diseases, Food Insecurity, Preventative Practices, Violence and Injury, Housing and Homelessness, and Economic Insecurity. Priority Need 1- Chronic Diseases- The goal is to reduce the impact of chronic diseases in at-risk communities, increase prevention and awareness. Strategy 1- Increase prevention and awareness activities in targeted zip codes. Activity 1.1- Provide screening for cholesterol, blood glucose, BMI, blood pressure at various health fairs, including a senior health and wellness fair on the AH Tehachapi campus and at the Tehachapi Downtown Farmers Markets & Activity 1.2- Provide cancer-related screening and preventative practice information at a variety of health fairs and community events. Our collective community impact includes the following: screened over 90 children in Mojave and California City by providing sport physicals and health screening assessments; collaborated with the Tehachapi Farmers Market by providing vaccines, screenings, behavioral health and healthy eating habit education to over 5,000 community members; provided both cancer screenings and colon cancer testing kits to over 100 community members, as well as provided breast cancer education for home and on-going preventive care; provided over 200 cholesterol screenings; provided over 100 encounters with information regarding healthcare prevention and behavioral health resources; provided 75 community members with information discussing substance abuse and addiction therapy reduction strategies, as well as information on key drivers of mental health conditions and substance abuse. Priority Need 2- Food Insecurity- The goal is to reduce surplus food waste and improve distribution to those in need. Strategy 1- Partner with Kern Public Health Waste Hunger Not Food to take edible, surplus food to distribute to those in need. Activity 1.1- Partner with Kern Public Health Waste Hunger Not Food to recover leftover hospital caf food and transport/redirect to local churches for distribution- Through 2021, we continued to collaborate and build relationships to provide resources to food insecure community members. Activities included food boxes for senior citizens, information and education to local sourcing programs, and partnered with College Community Services and Community Action Partnership of Kern County to provide free food disbursement and enrollment assistance to participants who identified as food insecure. Priority Need 3- Preventative Practices- The goal is to reduce the rate of unvaccinated and under vaccinated kids ages 0-5 and decrease the risk for outbreaks of vaccine-preventable diseases throughout the community. Strategy 1- Utilize grant funding to provide free flu and childhood immunizations to Kern County residents through a specially equipped mobile unit and provide COVID and Flu vaccinations to Kern County residents through a specially equipped mobile van. Activity 1.1- Mobile Unit- Our mobile unit launched in 2021 and provided primary care services in Tehachapi. Due to outreach and increase of access to care services were provided to rural areas within the county. The pediatric immunization program provided vaccine services to elementary school children. Additionally, the COVID mobile vaccine program provided over 5,000 vaccines. Priority Need 4- Violence and Injury- The goal is to implement research-informed communication efforts designed to prevent suicide by changing knowledge, attitudes, and behaviors. Strategy 1- Hold Question, Persuade, refer (QPR) Training to provide common suicide myths and facts; warning signs of suicide, tips for asking the suicide question, methods for persuading suicidal individuals to get help, and how to refer at-risk people for help. Activity 1.1- Behavioral Health Integration Incentive Program- We enrolled over one-hundred and fifty patients into the behavioral health program addressing mental health and substance abuse disorders. Throughout the year, we hosted 10 behavioral health presentations throughout East Kern County, with 15% of people enrolled seeing an increase in overall wellness.Priority Need 5- Housing and Homelessness- The goal is to work hand-in-hand with community partners to deliver a metric-driven strategy to reduce chronic homelessness across the county. Strategy 1- Partner with existing organizations in Kern County to support accurate homeless counts, data sharing and grant funding opportunities. Activity 1.1- Adventist Health to provide financial and volunteer support for the annual Point-In-Time (PIT) Count, Activity 1.2- Participation in Kern County Homeless Task Force, with an Adventist Health Bakersfield focus on sharing data and metrics- The Bakersfield-Kern Regional Homeless Collaborative (BKRHC) in partnership with Adventist Health sponsoring the Point in time count, also known as the Bakersfield/Kern County Continuum of Care (COC) CA-604, completed the annual 2021 Point-in-Time Count following guidance from the U.S. Department of Housing and Urban Development (HUD) for those who are sheltered and unsheltered. There was a total of 2,150 unduplicated persons sleeping in shelters and unsheltered on January 27, 2021. The PIT Count resulted in 569 persons who were sleeping in shelters and 1,581 who were unsheltered. Adventist Health launched the homeless prevention and homeless ESG grant program in the fall of 2021. The program screened patients, aligned patients with rapid re-housing and hotel stays to vulnerable patients. The program offers case management services to assist in the process of finding permeant housing solutions along with emergent housing.Priority Need 6- Economic Insecurity- The goal is to improve the social and physical well-being of its residents by decreasing barriers to employment. Strategy 1- Support efforts to reduce barriers to employment for those recently released from incarceration. Strategy 2- Align community work to include well-being related to economic security. Activity 1.1- Provide administrative and volunteer staff for a medical tattoo removal program with Garden Pathways- Adventist Health Tehachapi partnered with Garden Pathways to align recently released inmates to job retraining programs. Over 150 were seen in the tattoo removal program to remove employment barriers and sigmatisms around tattoos. Adventist Health Community Care-California City 9350 North Loop Blvd California City CA 93505 Rural Health Clinic Adventist Health Community Care-Mojave 2041 Belshaw Street Mojave CA 93501 Rural Health Clinic Adventist Health Community Care-Tehachapi 105 West E Street Tehachapi CA 93561 Rural Health Clinic Adventist Health Outpatient Physical Therapy 116 W F St Tehachapi CA 93561 Outpatient Physical Therapy Part I, Line 7 - Explanation of Costing Methodology The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)/Gross patient chargesAdventist Health Tehachapi is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. Part 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. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - 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 2019 CHNA, the 2022 Community Health Plan (CHP) Update for fiscal year 2021, and the 2020 Implementation Strategy adopted in 2020 are posted on the hospital's website at Community Benefit | Roseville, California | Adventist Health. The two most recent Community Health Needs Assessment, two most recent Implementation Strategy reports and the most recent Community Health Plan Update are also available on the Adventist Health Corporate website at Community Benefit | Roseville, California | Adventist Health. 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, our hospitals support 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 the regions we serve. 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 https://www.adventisthealth.org/documents/financial-assistance/ENG_PFS-112_Financial-Assistance-Policy.pdf. These 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 Tehachapi Valley community is located in the mountains of Eastern Kern County, California. The areas of service for Adventist Health Tehachapi Valley include: Tehachapi, Bear Valley, Golden Hills, Alpine, California City, Mojave, Rosamond, Boron and Edwards. The population of the Adventist Health Tehachapi Valley (AHTV) service area is 56,177. Population density is 93.76 people per square mile, compared to 107.15 persons per square mile in Kern County. Of the area population, 55.9% are male and 44.1% are female. Children and youth, ages 0-17, make up 23.1% of the population, 62.8% are adults, ages 18-64, and 14.1% of the population are seniors, 65 and over. The service area has a higher percentage of adults, ages 45-84, than the county.In the service area, 58.5% of the population is White, 26.9% are Hispanic/Latino, 8.8% are Black/African American, 2.2% are Asian, and the remaining 3.7% are American Indian/Alaskan Native, Native Hawaiian/Pacific Islander, other race/ethnicity, or multiple races. There is a higher percentage of White Adventist Health Tehachapi Valley and Blacks/African Americans, and a lower percentage of Hispanic/Latinos and Asians in the service area than in the county. The languages spoken at home by area residents largely mirror the racial/ethnic make-up of the service area communities. While 26.9% of the area population is Hispanic or Latino, only 16.4% of the population speaks Spanish in the home. English is spoken at home by 80.5% of the population, and 2% of the population speaks an Asian or Pacific Islander language. 0.7% of the population speaks an Indo- European language in the home. In the service area, 9.5% of the population is foreign-born. Of the foreign-born, 55.5% are not citizens. 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 completed the acquisition of Blue Zones as the first step toward reaching this goal. By partnering with Blue Zones, we are 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 is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively 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 2020 (FY 2019) CHP Update) No hospital can address all the health needs identified in its community. Adventist Health Tehachapi Valley is committed to serving the community by adhering to its mission, and using its skills, expertise, and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed include the following: Mental health-need being addressed by others. Access to health care-need being addressed by others. Substance use and misuse-hospital does not have expertise to effectively address the need. Environmental pollution-hospital does not have expertise to effectively address the need. Sexually transmitted infections-needs being addressed by others. Unintentional injury-hospital does not have expertise to effectively address the need. Dental care/oral health-need being addressed by others. Birth indicators-insufficient resources (financial and personnel) to address the need. Alzheimers disease-need being addressed by others. Overweight and obesity-need being addressed by others. Other Items:In FY2021, Adventist Health Tehachapi Valley continued to take the following actions in response to the needs created or exacerbated by COVID-19: Continued to offer virtual health care visits to keep community members safe and healthy; continued with the online COVID symptom tracker; participated in communitywide efforts to vaccinate eligible community members. Additionally, Adventist Health Tehachapi Valley partnered with Kern County Public Health to provide free COVID-19 testing to the community, donated over 23,000 face masks to local and rural community-based organizations, senior centers, and social districts, initiated a COVID-19 vaccination program and expanded effort within the community. 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 true CA Hlth Fund & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 50650 0 Funds Transfer Uninsured/Underinsured Patients 0 1 Additional Supplemental Information Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X X X X true true false false false false false false false Badders Brett Manager, RN 351805 75 5570 357450 Briggs Sharlet President thru 08/20 548135 32738 580873 Butler David Pres eff 3/21 444092 165028 71703 11644 61293 753760 Cantrell Misty Patient Care Executive 316697 57037 27761 14241 82915 498651 Chen Steven Former Finance Officer, CCR 2/20 515000 183275 81414 11644 62145 853478 Cox Shane Treas/A Sec 364154 85853 54772 12958 70638 588375 Eller Jeff Vice Chair/AHTV 531828 547897 20413 22996 1123134 Ferch Wayne Former President, CCR thru 2/20 585289 823 18351 604463 Guirguis Yehia Pharmacist 186002 6453 9469 201924 Heinrich Kerry-CEO Elect1121 Director 138538 123000 21159 2627 285324 Hofheins Todd CFO 999600 116549 202998 11644 48266 1379057 Jahn Andrew President, Care Division 1044420 600285 203978 11644 61293 1921620 Jamaleddine Ghassan Medical Officer as of 08/21 116077 66528 387 3359 186351 Jobe Meredith Secretary 616324 169142 147239 14609 45152 992466 Larsen David Finance Officer, CCR thru 4/19 567118 201820 107819 11644 55606 944007 Lorenz Alida Director, RN 163980 15600 7864 7835 37239 232518 Malas Nisreen Supvsr, Pharmacy 178696 224 8612 11436 198968 Nahapetian Arby Care Division Chief Medical Officer 700000 222478 135635 11644 66658 1136415 Reiner Scott CEO thru 12/21 1801000 1112062 27026 11644 50774 3002506 Reppert Joseph Former CFO/Asst Secr thru 8/19 179119 11442 190561 Reynoso Hernandez R Former Medical Officer, CCR 229177 125560 31829 26849 413415 Spenst Brett Care Division Finance Officer 734400 38124 13577 11644 33656 831401 Stevens Eric Care Division Operations Executive 749000 76 135535 16336 33656 934603 Waterhouse Karla RN, House Supvsr 180754 1000 6095 6248 3523 197620 Wing Bill Dir/Asst Sec/VC 1440800 991833 26446 11644 64578 2535301 Wolcott Daniel Pres thru 3/21 601280 226669 104330 11644 61293 1005216 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder 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, Line 7a: How Members or Shareholders Elect Governing Body 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, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 11b: Form 990 Review Process 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, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital 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, Line 15a: Compensation Review & Approval Process - CEO, Top Management 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. A hospital president has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital. (Incentive potential is industry norm) Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees See Line 15a explanation. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available 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. Other Changes In Net Assets Or Fund Balances - Other Decreases Net Assets Released = -$104899 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. Adventist Health SystemWest PO Box 619135 Roseville CA 95661 953484589 Integrated Health System CA 501(C)(3) 10 NA 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 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 The 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 Assn Inc 975 So Fairmont Ave 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) 1 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 Ave 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 & Health Care Svc 2975 No 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/Assisted Living/Hm Hlth 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 Advenstist Health SystemWest false Western Health Resources PO Box 61935 Roseville CA 95661 953867863 Home Care CA 501(c)(3) 10 Advenstist 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 Tulare 869 North Cherry Street Tulare CA 93274 832351753 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 South Coast Medical Center PO Box 619135 Roseville CA 95661 952037291 Wind down after sale of hospital CA AHSWest C-Corp false false false false false true false false false false false false false true false true true true true true Adventist Health SystemWest e 63555672 Notes Payable Adventist Health SystemWest m 6660761 Operating Exp Adventist Health SystemWest o 58457 Compensation Adventist Health SystemWest r 18568952 Cash Mgt Funds