WHITE MEMORIAL MEDICAL CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- WHITE MEMORIAL MEDICAL CENTER (EIN 95-2282647)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202223159349307297
- Schema version
- 2021v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T16:24:57-08:00 | ReturnTs |
| Tax Period End | 2021-12-31 | 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 Fl 20 | AddressLine1Txt |
| City | Glendale | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952282647 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | White Memorial Medical Center | BusinessNameLine1Txt |
| Business Name Line2 | dba Adventist Health White Memorial | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WHIT | BusinessNameControlTxt |
| Phone | 3232685000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 East Cesar E Chavez Avenue | AddressLine1Txt |
| City | Los Angeles | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Owens Francis | PersonNm |
| Person Title | Treas Eff 9/22 | PersonTitleTxt |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Owens | PersonFirstNm |
| Person Last | Francis | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
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 | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Raffoul John | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 East Cesar E Chavez Avenue | AddressLine1Txt |
| City | Los Angeles | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 900332443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $497,685,642 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.AdventistHealth.org/White-Memorial | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1963 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Living Gods love by inspiring health, wholeness and hope. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 2389 | TotalEmployeeCnt |
| Total Volunteers | 209 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,844,472 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,132,187 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $455,558,651 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $470,460,550 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,131,347 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,092,905 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $474,534,470 | PYTotalRevenueAmt |
| CY Total Revenue | $497,685,642 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,615,362 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,063,008 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $184,766,119 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $184,921,672 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $610,304 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $300,665,085 | PYOtherExpensesAmt |
| CY Other Expenses | $320,566,367 | CYOtherExpensesAmt |
| PY Total Expenses | $487,046,566 | PYTotalExpensesAmt |
| CY Total Expenses | $506,551,047 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$12,512,096 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,865,405 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $806,317,743 | TotalAssetsBOYAmt |
| Total Assets EOY | $779,737,909 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $120,889,767 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $160,493,565 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $685,427,976 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $619,244,344 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Living Gods love by inspiring health, wholeness and hope. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $409,255,694 | ExpenseAmt |
| Grant | $1,063,008 | GrantAmt |
| Revenue | $497,685,642 | RevenueAmt |
| Desc | White Memorial Medical Center (AHWM) 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 White Memorial Medical Center, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following 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 White Memorial Medical Center 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.AHWM 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 $1,641,576.The following Inpatient services that were provided to all our patients. These services included:3,404 Babies delivered2,873 Surgeries performed79,272 Patient days The following Outpatient services that were provided to all our patients. These services included:50,726 Emergency department visits4,698 Outpatient Surgeries performed69,862 Outpatient visits 26,795 Clinic visitsAHWM 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 2020 was $22,662,235.Adventist Health's mission statement of Living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry as represented by the life of Jesus Christ and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever.The impact on our community by our hospital and medical staff can be illustrated by the following story: For over 65 years, the Hill Family has enjoyed a relationship with White Memorial Medical Center that spans three generations. Our family chose White Memorial because of the consistent quality of care we have received throughout the entire hospital system, said Jaclyn Tilley Hill. White Memorial is so much more than a hospital it is a Community that we are proud to be a part of. As multi-generational Los Angelenos, East Los Angeles has always been in the landscape of the Hill Family. Jaclyns great-grandmother lived in Boyle Heights and growing up in Montebello, Jaclyns neighbors were on the medical staff at White Memorial. In 1956, a lifelong relationship began with White Memorial when Juanita Tilley, Jaclyns mother, delivered her youngest child under the care of legendary Dr. Elisabeth Larsson. Dr. Larsson went on to deliver all four of Jaclyns daughters. In the delivery of her fourth child, Dr. Masao Nakamoto assisted. As one doctor retired, the next generation of physicians picked up the torch, firmly establishing the gold standard of patient care for the Tilley Hill Family. Jaclyn was first introduced to Dr. E. Laurence Spencer-Smith during his residency in the White Memorial OB/GYN Residency program managed by Dr. Nakamoto. She had an instant connection with him. Dr. Spencer-Smith deeply cares for his patients. He is in a league of his own because of the impact he has made on so many in the community, said Jaclyn. The legacy of care continued with Dr. Spencer-Smith delivering eight of her grandchildren.The Robert R. and Jaclyn Tilley Hill Family Charitable Giving Trust has generously donated $50,000 to recognize the relationship they have shared with Dr. Spencer-Smith. The E. Laurence Spencer-Smith M.D. OB/GYN Fund will be used to launch a new program, The Art of Caring for Residency and Faculty Education, under his supervision. The purpose of the training program is to enhance the physician-patient relationship for the White Memorial OB/GYN Residency program residents and staff.The Art of Caring program will be used for training future residents, nurses, and staff, so families will have the opportunity to experience the same kind of personal relationships that my family has treasured, explains Jaclyn. According to Dr. Spencer-Smith, because of the way medicine is being done now,what was once the standard of the personal patient relationship has been lost. As a profession I worry that we are losing the Art of Caring. The goal of this gift is to develop an educational program to train OB/GYN physicians and staff to understand more about how important the patient-doctor relationship is, and what it can do for a patients overall physical and mental well-being.Dr. Spencer-Smith believes the greatest joy for me as a doctor has been having a special relationship with patients. This has given me great personal satisfaction. When you have that, medicine isnt a job. Its truly a profession - a lifes passion and you never get tired of it. Separately, the Robert R. and Jaclyn Tilley Hill Family Charitable Giving Trust has donated $25,000 to honor Dr. E. Laurence Spencer- Smith, Dr. Francis Lau, Dr. Suzie Lau, Dr. Kevin Pelton, and (in loving memory of) Dr. Elisabeth Larsson and Dr. Masao Nakamoto for all the wonderful care their family has received for six decades and to encourage other donors to do the same. With these donations, the Tilley Hill Family is honoring White Memorial Medical Center, saluting its physicians, and supporting its unique mission to provide quality medical care to the East Los Angeles community.Our hope with this gift is to encourage others to pay it forward and show appreciation for the incredible care everyone who walks in the doors of White Memorial receives, said Jaclyn. There is magic from the minute you enter the hospital. It never fails to astound me how special White Memorial is.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ | Desc |
| Total Program Service Expenses | $409,255,694 | 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 | Yes (true) | 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| 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 | 2389 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 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 |
|---|---|---|---|---|---|---|---|
| Reiner Scott | |||||||
| CEO thru 12/21 | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,940,088 | $62,418 |
| Wing Bill | |||||||
| Dir/Asst Sec/VC | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $2,459,079 | $76,222 |
| Jahn Andrew | |||||||
| President, Care Division | 2.00 | 48.00 | $0 | $1,848,683 | $72,937 | ||
| Hofheins Todd | |||||||
| CFO | 0.00 | 50.00 | Yes (X) | $0 | $1,319,147 | $59,910 | |
| Nahapetian Arby | |||||||
| Care Division Chief Medical Officer | 2.00 | 48.00 | $0 | $1,058,113 | $78,302 | ||
| Raffoul John | |||||||
| FO, SCR/Pres | 1.00 | 49.00 | Yes (X) | $0 | $986,729 | $56,796 | |
| Jobe Meredith | |||||||
| Secretary | 0.00 | 50.00 | Yes (X) | $0 | $932,705 | $59,821 | |
| Stevens Eric | |||||||
| Care Division Operations Executive | 2.00 | 48.00 | $0 | $884,611 | $49,992 | ||
| Takahashi Patrick | |||||||
| Medical Officer | 50.00 | 0.00 | $0 | $785,190 | $48,929 | ||
| Spenst Brett | |||||||
| Care Division Finance Officer | 2.00 | 48.00 | $0 | $786,101 | $45,300 | ||
| Burke James | |||||||
| Medical Officer, SCR | 10.00 | 40.00 | $0 | $620,023 | $73,327 | ||
| Milatovic Natasa | |||||||
| Reg HR Dir, SCR | 10.00 | 40.00 | $0 | $557,717 | $76,107 | ||
| Bryant Mara | |||||||
| Operations Exec | 50.00 | 0.00 | $0 | $560,665 | $52,852 | ||
| Richards Blin | |||||||
| Treas/A Sec | 4.00 | 46.00 | Yes (X) | $0 | $469,877 | $57,209 | |
| Schwarz Greg | |||||||
| Bus Dev Executive | 50.00 | 0.00 | $0 | $427,028 | $55,578 | ||
| Owens Francis | |||||||
| Treas Eff 9/22 | 0.00 | 50.00 | Yes (X) | $0 | $367,294 | $75,973 | |
| Santiago Brigida | |||||||
| RN | 50.00 | 0.00 | $269,739 | $0 | $91,345 | ||
| Nguyen Thao | |||||||
| Director Pharmacy | 50.00 | 0.00 | $282,030 | $0 | $79,026 | ||
| Velazquez Jesus | |||||||
| RN | 50.00 | 0.00 | $266,987 | $0 | $83,101 | ||
| Vera Esfeamor | |||||||
| RN | 50.00 | 0.00 | $254,068 | $0 | $74,469 | ||
| Tam Pui Yi | |||||||
| Pharmacist | 50.00 | 0.00 | $277,949 | $0 | $49,539 | ||
| Heinrich Kerry - Incoming CEO | |||||||
| Dir/CEO 1/22 | 0.00 | 50.00 | Yes (X) | Yes (X) | $0 | $282,697 | $2,627 |
| Stone Patricia | |||||||
| Patient Care Executive | 50.00 | 0.00 | $0 | $250,116 | $24,815 | ||
| Reppert Joseph | |||||||
| Former CFO/Asst Secr thru 8/19 | 0.00 | 0.00 | $0 | $179,119 | $11,442 | ||
| Freedman John | |||||||
| VC/Chair 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $26,435 | $0 |
| Banks David | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Cherry Robert | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Davis Andrew | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Innocent Larry | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Reiner Richard | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $26,159 | $0 | |
| Graham Ricardo | |||||||
| Chair thru 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $19,545 | $0 |
| Woodson Marc | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $15,909 | $0 | |
| Salazar Velino | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $6,058 | $0 | |
| Ocampo Lucy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $159 | $0 | |
| Fehr Joy | |||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $114 | $0 | |
| Newton Bradford | |||||||
| Dir/VChair 8/21 | 0.00 | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,350,773 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $17,913,997 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,418,037 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 518 | 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 |
|---|---|---|---|---|---|
| Aya Healthcare Inc | |||||
| 5930 Cornerstone Court West Suite 3 | San Diego | CA | 92121 | Registry Services | $5,031,893 |
| Consultants of Anesthesia and Management of | |||||
| 521 Caruso Avenue | Glendale | CA | 91210 | Medical Services | $3,114,529 |
| Fastaff LLC | |||||
| 5700 South Quebec Street Suite 300 | Greenwood Village | CO | 80111 | Registry Services | $3,091,834 |
| DVA Renal Healthcare Inc | |||||
| 601 Hawaii Street | El Segundo | CA | 90245 | Medical Services | $2,671,720 |
| White Memorial Medical Group Inc | |||||
| 1701 Cesar Chavez Ave | Los Angeles | CA | 90033 | Medical Services | $2,345,788 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,349,628 | RelatedOrganizationsAmt |
| Government Grants | $1,875,447 | GovernmentGrantsAmt |
| All Other Contributions | $1,907,112 | AllOtherContributionsAmt |
| Total Contributions | $6,132,187 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | BusinessBusinessCd |
|---|---|---|---|
| Dietary | $1,717,824 | $1,717,824 | |
| Patient Care Services | $412,236,956 | $412,236,956 | 900099 |
| Premium Revenue | $45,361,283 | $45,361,283 | 722514 |
| Rental Income-Program Svc | $7,754,578 | $7,754,578 | 900099 |
| Revenue fr Subsidiaries | $1,205,882 | $1,205,882 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,184,027 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,184,027 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $470,460,550 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,092,475 | TotalRevenueColumnAmt |
| Exclusion | $21,092,475 | 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 |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $430 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $430 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $430 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $430 | RelatedOrExemptFuncIncomeAmt |
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 | $497,685,642 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $470,460,980 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $21,092,475 | 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 | $1,063,008 | TotalAmt |
| Program Services | $1,063,008 | 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 | $151,066,772 | TotalAmt |
| Program Services | $137,267,767 | ProgramServicesAmt |
| Management And General | $13,321,762 | ManagementAndGeneralAmt |
| Fundraising | $477,243 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,350,391 | TotalAmt |
| Program Services | $5,767,236 | ProgramServicesAmt |
| Management And General | $562,687 | ManagementAndGeneralAmt |
| Fundraising | $20,468 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,346,929 | TotalAmt |
| Program Services | $15,665,810 | ProgramServicesAmt |
| Management And General | $1,611,912 | ManagementAndGeneralAmt |
| Fundraising | $69,207 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,157,580 | TotalAmt |
| Program Services | $9,371,097 | ProgramServicesAmt |
| Management And General | $750,662 | ManagementAndGeneralAmt |
| Fundraising | $35,821 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,811,492 | TotalAmt |
| Management And General | $57,811,492 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $627,504 | TotalAmt |
| Management And General | $627,504 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,946 | TotalAmt |
| Management And General | $43,946 | 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 | $93,862,590 | TotalAmt |
| Program Services | $89,259,742 | ProgramServicesAmt |
| Management And General | $4,602,848 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,444 | TotalAmt |
| Management And General | $12,444 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,477,234 | TotalAmt |
| Program Services | $1,741,550 | ProgramServicesAmt |
| Management And General | $731,528 | ManagementAndGeneralAmt |
| Fundraising | $4,156 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,936,114 | TotalAmt |
| Program Services | $2,790,056 | ProgramServicesAmt |
| Management And General | $12,146,058 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,078,377 | TotalAmt |
| Program Services | $17,160,832 | ProgramServicesAmt |
| Management And General | $915,846 | ManagementAndGeneralAmt |
| Fundraising | $1,699 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,097 | TotalAmt |
| Program Services | $133,662 | ProgramServicesAmt |
| Management And General | $84,435 | 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 | $44,816 | TotalAmt |
| Program Services | $31,165 | ProgramServicesAmt |
| Management And General | $12,561 | ManagementAndGeneralAmt |
| Fundraising | $1,090 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,593,519 | TotalAmt |
| Program Services | $1,593,519 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,756,533 | TotalAmt |
| Program Services | $15,592,503 | ProgramServicesAmt |
| Management And General | $164,030 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,198,828 | TotalAmt |
| Program Services | $2,198,828 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Patient Care Supplies | $69,816,941 | $69,484,192 | $332,129 | $620 |
| Quality Assurance | $35,865,904 | $35,865,904 | ||
| Other expenses | $5,229,417 | $2,283,387 | $2,946,030 | |
| Equipment Rental | $1,992,611 | $1,985,436 | $7,175 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $506,551,047 | TotalAmt |
| Program Services | $409,255,694 | ProgramServicesAmt |
| Management And General | $96,685,049 | ManagementAndGeneralAmt |
| Fundraising | $610,304 | 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) |
|---|---|---|
| BOY | $525,539,833 | BOYAmt |
| EOY | $526,153,574 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $664,136 | BOYAmt |
| EOY | $444,837 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,623,398 | BOYAmt |
| EOY | $49,449,952 | 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 | $7,901,828 | BOYAmt |
| EOY | $8,403,300 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,718,890 | BOYAmt |
| EOY | $1,408,654 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $427,061,802 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $309,204,210 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,004,381 | BOYAmt |
| EOY | $117,857,592 | 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 | $350,000 | BOYAmt |
| EOY | $350,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,515,277 | BOYAmt |
| EOY | $75,670,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,317,743 | BOYAmt |
| EOY | $779,737,909 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,011,306 | BOYAmt |
| EOY | $39,188,386 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $241,989 | BOYAmt |
| EOY | $99,664 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,636,472 | BOYAmt |
| EOY | $121,205,515 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,889,767 | BOYAmt |
| EOY | $160,493,565 | 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 | $678,396,296 | BOYAmt |
| EOY | $612,834,026 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,031,680 | BOYAmt |
| EOY | $6,410,318 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $685,427,976 | BOYAmt |
| EOY | $619,244,344 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $806,317,743 | BOYAmt |
| EOY | $779,737,909 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$8,865,405 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$56,739,998 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$578,229 | OtherChangesInNetAssetsAmt |
| 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 | $121,090 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $121,090 | 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. Expenditures to Noteware and Holland & Knight were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare.Executives met with state and federal legislators and attended industry organization meet and greet events for the purpose of educating legislators and advocating for the needs of the health care industry. |
| Part IV - Additional Information |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,109,043 | BeginningYearBalanceAmt |
| Contributions | $2,933,485 | ContributionsAmt |
| Investment Earnings Or Losses | $3,812 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,585,254 | OtherExpendituresAmt |
| End Year Balance | $7,461,086 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,807,348 | BeginningYearBalanceAmt |
| Contributions | $3,313,944 | ContributionsAmt |
| Investment Earnings Or Losses | $3,534 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $2,154,688 | GrantsOrScholarshipsAmt |
| Other Expenditures | $861,095 | OtherExpendituresAmt |
| End Year Balance | $8,109,043 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $6,766,420 | BeginningYearBalanceAmt |
| Contributions | $4,902,834 | ContributionsAmt |
| Investment Earnings Or Losses | $111 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,006,718 | GrantsOrScholarshipsAmt |
| Other Expenditures | $855,299 | OtherExpendituresAmt |
| End Year Balance | $7,807,348 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,919,763 | BeginningYearBalanceAmt |
| Contributions | $6,252,523 | ContributionsAmt |
| Investment Earnings Or Losses | $177,086 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,582,952 | OtherExpendituresAmt |
| End Year Balance | $6,766,420 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,161,470 | BeginningYearBalanceAmt |
| Contributions | $4,418,182 | ContributionsAmt |
| Investment Earnings Or Losses | $209 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,660,098 | OtherExpendituresAmt |
| End Year Balance | $3,919,763 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.14080 | BoardDesignatedBalanceEOYPct |
| Term Endowment Balance EOY | 0.85920 | 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 | $2,627,471 | OtherCostOrOtherBasisAmt |
| Book Value | $2,627,471 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $299,150,051 | OtherCostOrOtherBasisAmt |
| Depreciation | $208,264,726 | DepreciationAmt |
| Book Value | $90,885,325 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,057,701 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,571 | DepreciationAmt |
| Book Value | $995,130 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $114,497,174 | OtherCostOrOtherBasisAmt |
| Depreciation | $94,662,142 | DepreciationAmt |
| Book Value | $19,835,032 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,729,405 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,214,771 | DepreciationAmt |
| Book Value | $3,514,634 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $117,857,592 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Interest in Consolidated Organizations | $7,409,907 |
| Other Assets | $654,000 |
| Other Receivables | $2,737,535 |
| Receivables from Related Organizations | $5,386,174 |
| Receivables from Third Parties | $59,482,384 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $75,670,000 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Other Liabilities | $9,011,450 |
| Payables to Related Organizations | $90,969,162 |
| Payables to Third Parties | $21,224,903 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $121,205,515 | 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, 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. |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants To Org Outside US GrantsToOrgOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | Latin America | RegionTxt |
| Purpose Of Grant | Community Projects | PurposeOfGrantTxt |
| Cash Grant | $14,500 | CashGrantAmt |
| Manner Of Cash Disbursement | Check | MannerOfCashDisbursementTxt |
| Valuation Method Used | Cost | ValuationMethodUsedDesc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Org | 1 | TotalOtherOrgCnt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
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 | $1,641,576 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,641,576 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,641,576 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,641,576 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,470,328 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,470,328 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00290 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,219,214 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,145,906 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,073,308 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02380 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,161,537 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,123,633 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,037,904 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $85,298 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $85,298 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,936,377 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,269,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $23,666,838 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04670 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,577,953 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,269,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $25,308,414 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04990 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $56,877 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $56,877 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,432 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,432 | NetCommunityBenefitExpnsAmt |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $117,478 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $117,478 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $176,787 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $176,787 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $690,186 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $463,507 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $47,014,476 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $49,240,878 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,226,402 | 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 | Adv Health White Memorial | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 Cesar E Chavez Avenue | AddressLine1Txt |
| City | Los Angeles | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Acute,Rehab,Psychiatric,Skilled Nursing | OtherDesc |
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 | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | 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 | 19 | 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 |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | See Sch H Part VI-Patient Education | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | See Sch H Part VI-Patient Education | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | See 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 | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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.From February 4, 2019 to May 7, 2019, focus groups, key informant interviews and surveys were administered within AHWMs PSA. Approximately 156 people were surveyed to obtain input from the community in the form of 8 focus groups (with a total of 76 focus group participants), 16 key informant interviews and 64 people responded to the online survey (51 in English and 13 Spanish). Community Survey: Survey participants lived in areas similar to that of focus group participants and key informants. Ninety percent of the survey respondents lived in Los Angeles County most living in 90033 (Arroyo Seco) and 90023 (Boyle Heights) zip codes.Community Focus Group: Focus group participants were end-users of programs and services provided by AHWM. Populations represented by focus group members included seniors, low-income, homeless, parents, and college students in the medical field and other sectors. The majority of focus group participants live in Boyle Heights. Several of the respondents mentioned living in shelters in the Boyle Heights area.Key Informant Interview: Key informant interviews consisted of key leaders in our community from an array of agencies, including those that connect financial and social resources to area populations, educational, and health care services. Additionally, key informant interviews were conducted with representatives from the non-profit, educational, homeless, law enforcement, and faith-based sectors. The majority of the people interviewed serve residents in Boyle Heights, East Los Angeles, and throughout Los Angeles County. Most key informants hold titles such as Director or Executive Director, President or Vice President, Chief Medical Officer, and Monsignor.Secondary sources include publicly available state and nationally recognized data sources available at the zip code, county and state level. Health indicators for social and economic factors, health system, public health and prevention, and physical environment are incorporated. A significant portion of the data for this assessment was collected through reports generated through CARES Engagement Network CHNA (https://engagementnetwork.org/assessment/).Other sources include Los Angeles County Department of Public Health, California Department of Public Health, County Health Rankings & Roadmaps, and California Environmental Protection Agencys Office of Environmental Health Hazard Assessment. When feasible, health metrics have been further compared to estimates for the state or national benchmarks, such as the Healthy People 2020 objectives. Adventist Health White Memorial identified relevant key informants and topical focus groups to gather more insightful data and aid in describing the community. Key informants and focus groups were purposefully chosen to represent medically under-served, low-income, or minority populations in our community, to better direct our investments and form partnerships. |
| 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 three areas of significant need: Chronic Disease, Mental Health, and Access to Health Care and Resources. Priority Need 1- Chronic Disease- The goal is to improve health outcomes in patients and community members with chronic disease. Strategy 1- Mobilize patients and community members through education and tools to manage chronic disease. Activity 1.1- Diabetes Center- Due to the impact of COVID-19, we needed to adjust and pivot our methods of delivering education to the community. With virtual sessions offered to the community, we were able to engage with community members in hopes to inspire them to live healthier lifestyles. Even though our numbers for 2021 were reduced the impact included the following: Virtual HELP classes from May- November 2021; A total of 64 people participated in the Diabetes Self-Management Education (DSME) Classes with 70.3% of participants were checking their blood at least 1 time per day, 81% of participants met their target goal of lowering their A1c level, and 79% had a reduction in their weight; A total of 105 participants participated I the HELP program.Activity 1.2- Vive Bien! Senior- The AHWM senior well program provides wellness classes, health screenings, exercise and strengthening classes, computer education, caregiver support, and special assistance for senior within the community. It also provides local older Hispanic adults with access to resources. Due to the impact of COVID-19, many of the sessions in early 2021 were held virtually or through conference calls. In Mid-July, there was a soft reopening. Services that were offered between January through October consisted of primarily of health education classes and physical activity classes were re-introduced in November: A total of 17 participants participated in the exercise classes; A total of 204 participants participated in the health education classes.Additional activities include our Blue Zones Project work. We are currently in the beginning phases and have completed community listening meetings. Priority Need 2- Mental Health- The goal is appropriate mental and behavioral health services. Strategy 1- Assess and refer vulnerable populations to appropriate mental and behavioral health services. Activity 1.1- Welcome Baby Program (Community Program)- The Welcome Baby Program is an outreach program provided for expectant mothers in our community to educate, support, provide home wellness visits, and connections to resources in the community. The total of mental health assessments in pregnant women: 72, postpartum mental health education/support tools provided: 2,763, and total number of referrals to mental health sources: 181. Activity 1.2- Community Information Center Virtual Referral and resource site. Due to the COVID-19 pandemic, the Community Information Center remained closed until July 2021. When it reopened, there was limited capacity, affecting the number of referrals for mental health services. A total of 3 people were referred to wellness and mental health services. Priority Need 3- Access to Health Care and Resources- The goal is to provide a hub of health care resources and referrals to services to improve access. Strategy 1- Engage local stakeholders to refer to the Community Information Center through the implementation of a referral application in addition to normal duties and responsibilities of the center. Activity 1.1- Community Information Center- The Community Information Center provides enrollment assistance and support for individuals on understanding and using health care coverage. It includes counseling sessions on health care coverage options that include Medicare, Covered California, and Medi-Cal. In 2021, Services and resources referred via Referral Pad. Number of services and resources referred & coordinated: 460. Of the 460, 181 were referred through UNITE US, 279 went through the AHWM process. Collectively, a total of 309 were successful at getting the resources and services they needed. Additionally, a total of 81 people were enrolled into the Wellness Program and were provided health education opportunities. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 - Explanation of Costing Methodology | The hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of Californias 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 | Adventist Health White Memorial (AHWM) service areas can be defined in three ways, as Los Angeles County, Primary Service Area, or zip code. Primary, Secondary Service Areas and Tertiary Service Areas (PSA, SSA and TSA, respectively) are comprised of zip codes that are defined by the volume of patients discharges. PSA is comprised of 18 zip codes that makes-up 63% of the total impatient discharges for AHWM. Those zip codes include Boyle Heights, East Los Angeles, City Terrace, Downtown Los Angeles, Huntington Park, Bell Gardens, Montebello, El Sereno, Lincoln Heights, South Gate, Pico Rivera, Maywood and Chinatown. Residents of the primary service areas are 49.6% male and 50.4% female, while majority of the population is Hispanic (85.1%). Of the 10,105,722 people living in LA County, 1,161,693 are residents of the PSA. The average household income in the PSA is $52,596 as compared to $89,855 in LA County. For every 10,000 children, there are 31.7 Head Start Facilities in AHWMs PSA. This rate is higher than the estimate for Los Angeles County (6.4 per 10,000 children) and the state (5.9 per 10,000 children). When looking at adult educational attainment by race/ethnicity in Los Angeles County, one finds that Latinos fare worse than other ethnicities in earning a high school degree at 42.2% followed by African Americans at 11.3%. Whites have the highest percentage for attaining college or postgraduate degrees at 45.5%, while Latinos have the lowest at 9.8%. When looking at percent of adults who are employed, AHWMs PSA has a lower percent (52.9%) as compared to Los Angeles County (57.5%) and the nation (56.4%). AHWMs PSA has a lower percentage of total population and children under age 18 living under the 100% federal poverty level at 38.5% and 27.0% as compared to zip code 90033. However, the estimates are higher than Los Angeles County and California. Within the homeless population in Los Angeles County, youth experiencing homelessness showed the greatest increase (32.5%) in comparison to other groups from 2018 to 2019. Chronically homeless populations showed the second greatest growth at 10%. When looking at occupational trends across the total service area, service occupations (44.2% manufacturing occupations (15.4%), and retail trade occupations (12%) emerged as the most common type of employment for the overall population.The population for the hospital service area is 1,165,691 and projected to grow about 2.3 percent in 5 years. The population is young with a median age of 30 and almost 46 percent of the female population is of childbearing age.The population is 44 percent Caucasian, 6 percent African American, 4 percent Asian/Pacific Islander and 55 percent Other which includes those choosing more than one race. As the population becomes blended and the US Census Bureau reporting methodologies change, the segment of the population that identifies as Hispanic is about 87 percent and could be included in any of the race/ethnicity categories. Spanish and English are the most commonly spoken languages in the primary service area. 13% of people, on average, aged 18-64 years reported speaking only English, with the greatest concentration residing within the 90039 zip code (Los Angeles). An average of 47% of persons aged 18-64 years reported speaking Spanish, with the greatest concentration residing within the 90255 zip code (Huntington Park).The community served by the hospital has an at-risk, vulnerable population. This is evidenced by low education rates as about 31 percent of adults aged 25 years and older have less than a 9th grade education and another 18 percent have some high school, but did not receive a high school diploma. The Federal Poverty Level guidelines for 2018 indicate the FPL for a family of 4 is $25,100. In the AHWM service area, 32 percent of the households are living below the FPL earning $25,000 or less each year.The unemployment rate in the primary service area is substantially higher in some neighborhoods according the the Community Health Needs Assement prepared in 2016. The highest rate is 26.7% in the area surrounding the hospital. As a result of high levels of unemployment and poverty, access to health care can be limited. In the service area, 29.3% of adults, ages 18-64, lack health insurance. |
| 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 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 White Memorial (AHWM) 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. Due to the magnitude of the three selected priority needs and the capacity of AHWM, the following areas will not be addressed: Homelessness and Poverty and Access to Healthy Foods. These priorities are being met through collaboration of community partners. Other Items In FY 2021, Adventist Health White Memorial continues the following actions in response to the needs created or exacerbated by COVID-19: Continuted virtual healthcare visits to keep community members safe and healthy; continued their online symptom tracker; and participated in a community wide effort to vaccinate eligible community members. Additionally, the hospital took the following actions: Reopened the Community Resource Center in mid-July; Continued a food distribution program at AHWM Community Garden until April 2021; In partnership with the YMCA, we provided food deliveries for the local senior population. Tackling food insecurity due to the COVID-19 impact; Maintained a community COVID-19 vaccination clinic on campus and mobile clinic to reach vulnerable communities.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 | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| CA Hlth Fund and Trust | ||||||||
| 1215 K St Ste 800 | Sacramento | CA | 95814 | 941498697 | $882,533 | $0 | Funds Transfer | Uninsured/Underinsured Patients |
| California Community Foundati | ||||||||
| 221 S Figueroa Street 400 | Los Angeles | CA | 90012 | 953510055 | $25,000 | $0 | Funds Transfer | Sponsorship |
| Eastmont Community Center | ||||||||
| 701 Hoefner Ave | Los Angeles | CA | 90022 | 956221642 | $6,000 | $0 | Funds Transfer | Sponsorship |
| Inter American Division Inc | ||||||||
| 8100 SW 117 Avenue | Miami | FL | 33183 | 352570801 | $7,000 | $0 | Funds Transfer | Sponsorship |
| LA Best | ||||||||
| 200 No Spring St | Los Angeles | CA | 90012 | 954311058 | $9,000 | $0 | Funds Transfer | Sponsorship |
| The Long Term Partners LLC | ||||||||
| 220 1/2 Reeves Dr | Beverly Hills | CA | 90212 | 822940355 | $37,475 | $0 | Funds Transfer | Sponsorship |
| University of Laverne | ||||||||
| 1950 3rd St | La Verne | CA | 91750 | 951644026 | $10,000 | $0 | Funds Transfer | Sponsorship |
| Weingart East Los Angeles YMC | ||||||||
| 2900 Whittier Blvd | Los Angeles | CA | 90023 | 951644052 | $10,000 | $0 | Funds Transfer | Sponsorship |
| White Memorial Adventist Sch | ||||||||
| 1605 New Jersy Street | Los Angeles | CA | 90033 | 954349770 | $10,000 | $0 | Funds Transfer | Sponsorship |
| White Memorial SDA Church | ||||||||
| 401 North State St | Los Angeles | CA | 90033 | 951994597 | $44,000 | $0 | Funds Transfer | Sponsorship |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 9 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Grantmaker's Description of How Grants are Used | FormAndLineReferenceDesc |
| Explanation | Grants are donations made to US tax exempt organizations who present a valid purpose for their donation request. It is anticipated that no further monitoring is required. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (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 (24 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Bryant Mara | ||||||||||||
| Operations Exec | $400,448 | $102,524 | $57,693 | $12,112 | $40,740 | $613,517 | ||||||
| Burke James | ||||||||||||
| Medical Officer, SCR | $461,501 | $76,438 | $82,084 | $11,644 | $61,683 | $693,350 | ||||||
| Heinrich Kerry - Incoming CEO | ||||||||||||
| Dir/CEO 1/22 | $138,538 | $123,000 | $21,159 | $2,627 | $285,324 | |||||||
| Hofheins Todd | ||||||||||||
| CFO | $999,600 | $116,549 | $202,998 | $11,644 | $48,266 | $1,379,057 | ||||||
| Jahn Andrew | ||||||||||||
| President, Care Division | $1,044,420 | $600,285 | $203,978 | $11,644 | $61,293 | $1,921,620 | ||||||
| Jobe Meredith | ||||||||||||
| Secretary | $616,324 | $169,142 | $147,239 | $14,609 | $45,212 | $992,526 | ||||||
| Milatovic Natasa | ||||||||||||
| Reg HR Dir, SCR | $405,008 | $103,859 | $48,850 | $11,835 | $64,272 | $633,824 | ||||||
| Nahapetian Arby | ||||||||||||
| Care Division Chief Medical Officer | $700,000 | $222,478 | $135,635 | $11,644 | $66,658 | $1,136,415 | ||||||
| Nguyen Thao | ||||||||||||
| Director Pharmacy | $244,318 | $24,737 | $12,975 | $11,830 | $67,196 | $361,056 | ||||||
| Owens Francis | ||||||||||||
| Treas Eff 9/22 | $272,340 | $65,941 | $29,013 | $12,420 | $63,553 | $443,267 | ||||||
| Raffoul John | ||||||||||||
| FO, SCR/Pres | $598,791 | $254,842 | $133,096 | $11,644 | $45,152 | $1,043,525 | ||||||
| Reiner Scott | ||||||||||||
| CEO thru 12/21 | $1,801,000 | $1,112,062 | $27,026 | $11,644 | $50,774 | $3,002,506 | ||||||
| Reppert Joseph | ||||||||||||
| Former CFO/Asst Secr thru 8/19 | $179,119 | $11,442 | $190,561 | |||||||||
| Richards Blin | ||||||||||||
| Treas/A Sec | $332,486 | $82,937 | $54,454 | $12,225 | $44,984 | $527,086 | ||||||
| Santiago Brigida | ||||||||||||
| RN | $269,739 | $10,614 | $80,731 | $361,084 | ||||||||
| Schwarz Greg | ||||||||||||
| Bus Dev Executive | $314,000 | $74,199 | $38,829 | $11,644 | $43,934 | $482,606 | ||||||
| Spenst Brett | ||||||||||||
| Care Division Finance Officer | $734,400 | $38,124 | $13,577 | $11,644 | $33,656 | $831,401 | ||||||
| Stevens Eric | ||||||||||||
| Care Division Operations Executive | $749,000 | $76 | $135,535 | $16,336 | $33,656 | $934,603 | ||||||
| Stone Patricia | ||||||||||||
| Patient Care Executive | $149,846 | $85,107 | $15,163 | $24,815 | $274,931 | |||||||
| Takahashi Patrick | ||||||||||||
| Medical Officer | $495,519 | $177,452 | $112,219 | $11,644 | $37,285 | $834,119 | ||||||
| Tam Pui Yi | ||||||||||||
| Pharmacist | $272,010 | $750 | $5,189 | $13,893 | $35,646 | $327,488 | ||||||
| Velazquez Jesus | ||||||||||||
| RN | $266,237 | $750 | $11,549 | $71,552 | $350,088 | |||||||
| Vera Esfeamor | ||||||||||||
| RN | $254,068 | $11,038 | $63,431 | $328,537 | ||||||||
| Wing Bill | ||||||||||||
| Dir/Asst Sec/VC | $1,440,800 | $991,833 | $26,446 | $11,644 | $64,578 | $2,535,301 | ||||||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | See Sch L p2 |
| 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 | Change in interest-Foundation = -$563297 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Net Assets Released = -$14932 |
| 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 (29 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 Hlth Medical Ctr Tehachapi | ||||||||||
| 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 | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Feather River Hospital | ||||||||||
| PO Box 619135 | Glendale | CA | 95661 | 941101228 | Hospital | HI | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| The Fremont- Rideout Health Group | ||||||||||
| 898 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 | 95370 | 453220509 | Hospital | CA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Rideout Memorial Hospital | ||||||||||
| 989 Plumas Street | Yuba City | CA | 93065 | 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 Care | CA | 501(c)(3) | 12b2 | Fremont Rideout Health Group | false |
| Walla Walla General Hospital | ||||||||||
| PO Box 61935 | Roseville | CA | 95661 | 910617726 | Hospital | WA | 501(c)(3) | 3 | Adventist Health SystemWest | false |
| Western Health Resources | ||||||||||
| PO Box 61935 | Roseville | CA | 95661 | 953867863 | Home Care | CA | 501(C)(3) | 10 | Adventist Health SystemWest | false |
| White Memorial Med Cntr Charitable Fdtn | ||||||||||
| 1720 East Cesar E Chavez Avenue | Los Angeles | CA | 900332443 | 953760201 | Hospital | CA | 501(C)(3) | 3 | Adventist Health SystemWest | Yes (true) |
| Willits Hospital Inc | ||||||||||
| 1 Marcela Drive | Willits | CA | 95490 | 680108919 | Fundraising for 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 | Western Health Resources | 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Coast Medical Center | BusinessNameLine1Txt |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952037291 | EIN |
| Primary Activities | Wind down after sale of hospital | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AHSWest | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C-Corp | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| 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 | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | 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 (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Adventist Health SystemWest | ||
| e | $90,969,162 | Notes Payable |
| Adventist Health SystemWest | ||
| m | $70,819,255 | Operating Exp |
| Adventist Health SystemWest | ||
| o | $1,763,078 | Compensation |
| Adventist Health SystemWest | ||
| r | $526,153,573 | Cash Mgt Funds |
| White Memorial Med Cntr Charitable Fdtn | ||
| m | $916,843 | Compensation |
| White Memorial Med Cntr Charitable Fdtn | ||
| s | $2,349,628 | Funds Transfer |