2021-11-10T17:18:02-06:00 2020-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2020-01-01 941387866 Rideout Memorial Hospital RIDE 9164060000 989 Plumas Street Yuba City CA 95991 Eduardo Gonzalez Treasurer 9164060000 2021-10-22 1 Eduardo Gonzalez 999009999 Tracy S Paglia P00366884 2099556100 2021-10-22 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Adventist Health and Rideout Richard Rawson 989 Plumas Street Yuba City CA 95991 444920032 0 X www.adventisthealth.org/rideout/ X 1955 CA Living God's love by inspiring health, wholeness, and hope. 3 2 2282 73 3289612 192836 252281 288655 411706204 440383894 830231 1302695 363447 2870545 413152163 444845789 327174 134648 0 0 182671029 185854102 0 0 485398 264735397 301192224 447733600 487180974 -34581437 -42335185 468844298 477359112 199791297 230451873 269053001 246907239 X Living God's love by inspiring health, wholeness, and hope. 0 0 400388467 134648 440383894 See Schedule O 400388467 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 2282 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Todd Hofheins CFO 9164060000 PO Box 619135 Roseville CA 95661 X Wing Bill Director/Chair 0.00 50.00 X X 0 1760327 59054 Jahn Andrew President, Care Division 2.00 48.00 X 0 1365841 59307 Eller Jeff President, NCR thru 06/20 4.00 46.00 X 0 1154747 49411 Reiner Scott Vice Chair 0.00 50.00 X 0 2358378 54819 Nahapetian Arby - Care Division Chief Medical Officer 2.00 48.00 X 0 868206 54711 Rawson Richard President 9.00 41.00 X 0 798315 29537 Jobe Meredith Secretary 0.00 50.00 X 0 769985 43868 Byrnes John Medical Officer, NCR 4.00 46.00 X 0 766859 46424 Sheikh Azad Medical Officer 0.00 40.00 X 0 613897 39931 Gonzalez Eduardo Treasurer/Asst Secr 9.00 41.00 X 0 461243 61165 Gordon Cyndy Patient Care Executive 40.00 0.00 X 0 473419 44365 Chibaya Daniel Operations Manager 0.00 40.00 X 0 393379 60574 Lonto Robert Reg HP Dir, NCR 9.00 41.00 X 0 376950 59047 Arrowsmith Monica Bus Dev Leader 0.00 40.00 X 0 378543 48156 Lang Kevin Finance Officer, NCR 4.00 46.00 X 0 388220 0 Mensch Deborah Patient Care Executive thru 08/20 40.00 0.00 X 0 318227 49483 Minton Krista Director, Clinical Care 40.00 0.00 X 233969 0 71926 Gonzales Jerry Manager, Pharmacy 40.00 0.00 X 253880 0 47974 Swanson Jeffery President, Philanthropy 40.00 0.00 X 237401 0 58400 Hyer Theresa Director, Emergency Services 40.00 0.00 X 230480 0 60241 Kaur Rose RN-Staff 40.00 0.00 X 228529 0 36998 Reiner Richard Director 0.00 4.00 X 0 26764 0 Innocent Larry Director 0.00 4.00 X 0 25608 0 1184259 13298908 1035391 696 0 1 1 Acute Care Surgery Medical Group Inc PO Box 1528 Sacramento CA 95812 Physician services 4902850 Fastaff LLC PO Box 911452 Denver CO 802911452 Contract labor services 3122083 Regents of the University of California PO Box 989062 West Sacramento CA 95691 Physician services 2397410 Total Renal Care Inc PO Box 781607 Philadelphia PA 19178 Dialysis services 2281799 Trustaff Travel Nurses 4675 Comell Road Suite 100 Cincinnati OH 452638231 Contract labor services 1425641 48 106476 182179 288655 Patient service revenue 621400 404442628 401153016 3289612 CARES Act revenue 621990 28054378 28054378 Intercompany revenue 900099 3580257 3580257 340B Pharmacy revenue 621400 1587836 1587836 Related rental revenue 621400 540272 540272 2178523 2178523 440383894 1354289 1354289 19356 70950 -51594 -51594 -51594 2873838 3293 2870545 2870545 444845789 437094282 3289612 4173240 X 134648 134648 148565556 138710597 9538680 316279 5288447 5226210 52910 9327 21613355 20123943 1427397 62015 10386744 9887175 474810 24759 41202689 4930830 36271859 241328 241328 37580 37580 18211 18211 81982855 63537204 18443412 2239 73312 73312 1589609 1076120 486134 27355 19272169 6961607 12283580 26982 6889621 5544749 1344062 810 77982 60419 15686 1877 18343 13330 5013 4089254 3964387 124867 23494285 23198336 295949 782911 779717 3194 Patient care supplies 65915104 65915104 AHPN elimination 26214363 26214363 Hospital Medi-Cal Quali 20815545 20795940 19605 Leased equipment expens 2133817 2090147 43670 6343246 1205430 5127255 10561 487180974 400388467 86307109 485398 9739753 36440607 68505948 59691211 5328667 6145874 8060 1634331 569183813 244082626 336633272 325101187 48628598 48345902 468844298 477359112 45716787 36580902 3350 118361 2997109 1379345 151074051 192373265 199791297 230451873 X 268981001 246830773 72000 76466 269053001 246907239 468844298 477359112 X -42335185 20189423 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 18211 18211 0 Part II-B, Line 1: The Hospital is a member of industry associations. A portion of the membership dues is used for lobbying purposes. 70704 267654 263189 75169 135652 128479 45013 148414 70704 135652 135652 0.00000 0.00000 1.00000 0 0 14051878 14051878 387689025 114901477 272787548 14664250 6396271 8267979 152778660 122784878 29993782 325101187 Receivables from third-party payors 28243371 Receivables from related organizations 10306761 Other assets 5417095 Other receivables 4378675 48345902 Payables to related organizations 139332921 CARES Act liability 32503828 Payables to third parties 6663924 Workers' compensation liability 5063765 Lease controller liability 3209763 Long-term malpractice liability 3566163 457b Deferred compensation liability 1695021 Asbestos liability 337880 192373265 X Part V, Line 4: Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X, Line 2: The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2020 and 2019, 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 2016 in major tax jurisdictions. 1 1 X 1 X 1 X 1 1 1 0 1 1 2386386 2386386 0.00490 155540156 111976488 43563668 0.08940 157926542 111976488 45950054 0.09430 1928334 4800 1923534 0.00390 1488920 1488920 0.00310 3417254 4800 3412454 0.00700 161343796 111981288 49362508 0.10130 947 947 0.00000 531853 531853 0.00110 532800 532800 0.00110 1 5370426 1605029 118581434 160890776 -42309342 X 1 1 1 1 Rideout Memorial Hospital 726 4th Street Marysville CA 95901 https://www.adventisthealth.org/rideou 230000126 X X X Rideout Memorial Hospital 0 0 1 X X X X X X X X X 19 1 1 0 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment 1 19 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X X X X X X 1 X 0 X X X X 1 X 0 0 Rideout Memorial Hospital 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; and3. Data gathering from community members. Community input was provided by a broad range of community members using key informant interviews and focus groups. Individuals with the knowledge, information, and expertise relevant to the health needs of the community were consulted. These individuals included representatives from local governmental and public health agencies as well as leaders, representatives, or members of underserved, low-income, and minority populations. Primary data included 13 interviews with 35 community health experts as well as four focus groups conducted with a total of 53 community residents that included seniors, people experiencing homelessness, Hmong community members and Latino community members.Focusing on social determinants of health to identify and organize secondary data, datasets included measures to describe mortality and morbidity and social and economic factors such as income, educational attainment, and employment. Further, the measures also included indicators to describe health behaviors, clinical care (both quality and access), and the physical environment. Data sources include but are not limited to the California Department of Public Health, US Census Bureau, American Community Survey, Robert Wood Johnson Foundation County Health and Roadmaps and the Community Health Vulnerability Index which is a healthcare disparity index based largely on the Community Need Index developed by Barsi and Roth. Rideout Memorial Hospital Part V, Section B, Line 6a: Hospitals that participated in the 2019 CHNA process included Sutter Surgical Hospital North Valley. Rideout Memorial Hospital 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 to 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: access to mental/behavioral/substance abuse services, access to basic needs such as housing, jobs and food, and access to quality primary care health services. Priority Need 1 - Access to Mental/Behavioral/Substance Abuse Services - The goal is to raise awareness and improve access to substance use and mental health services in the emergency department. Strategy 1 - Expand Emergency Department substance use disorders and behavioral health initiatives. Activity 1.1 - Continue Behavioral Health Collaborative in Rideout ER - Although the program has components that are covered by grants, community benefit expenses include parts of the tele-psychiatry services and the Community Well-Being staff time. Within 2020, AHRO's emergency department saw 2,396 patients with behavioral health complaints. Case management is provided and due to the collaborative partnership with community organizations, close to 54% of patients seen have been safely discharged back into the community. Activity 1.2 - Implement ED Bridge Program - Adventist Health and Rideout applied and was awarded $175,000 to start the California Bridge Program. Additional funds were awarded in the middle of the year. Although most program costs were covered by the grant, community benefit expenses include staff time in securing, processing, and coordinating program requirements. Through this program, in 2020 a total of 723 unique individuals were served. Priority Need 2 - Expand screening and partner with community organizations to increase access to food resources - The goal is to improve access to food resources in the community. Strategy 1 - Expand screening with community organizations to increase food resources. Activity 1 - Expand Food Security Program - To address this need, AHRO initiated a food security program, which begins with a screening process for all patients that are seen by Adventist Health and Rideout. If a patient is identified as food insecure, a referral is submitted to the Patient Care Coordinator who then follows up with the patient and provides person specific community resources, a connection to a local food pantry, and food upon discharge. In 2020, Adventist Health and Rideout identified 301 patients as food insecure. This number includes the patient population at The Rideout Cancer Center, which this program was expanded into in 2020. Of these individuals, 54% were considered homeless, 25% of the individuals who were identified as food insecure are 55 years of age or older and 20% are 65 years of age or older. All individuals served in the Food Security program are vulnerable, lack the resources necessary to obtain food or proper nutrition, and are underserved. Adventist Health and Rideout's Medical Staff donated $10,000 to our partner, The Yuba-Sutter Food Bank. The Rideout Foundation donated $22,000 in matching funds to provide Christmas dinner to 3,500 individuals in the Yuba-Sutter community. During the early months of the COVID-19 pandemic Adventist Health donated $10,000 in Community Strength grant funding to the Yuba-Sutter Food Bank. The funding was used to help serve over 3,881 families directly from the Food Bank. Food was also purchased and then distributed throughout the Yuba and Sutter Counties and support services were provided to our partner agencies to serve 5,517 households with approximately 10,654 people within Yuba County and 936 households with approximately 2,422 people in Sutter County. With the assistance of Adventist Health and Rideout and the partnership between the Food Security Program and The Yuba-Sutter Food Bank, The Yuba-Sutter Food Bank was able to increase the number of individuals served, ensure the needs of high-risk individuals were met, and add more resources to the Yuba-Sutter Community. Although most of the program costs were covered by grants. Community benefit expenses include staff time and expenses that were not covered by the grant to make these events possible. Priority Need 3 - Access to Quality Primary Care Health Services - The goal is to improve access to primary care services for the community. Strategy 1 - Street Nursing Program. Activity 1 - Establish and expand street nursing program - Adventist Health and Rideout initiated a street nursing program in response to the growing population experiencing homelessness. In 2020 The Adventist Health Street Nurse Team saw 324 new patients out in the field. Total encounters for the Street Nurse Team in 2020 including new patients, follow visits, and outreach, was 3,174. In 2020 the program showed significant growth in staff, in days per week, and in outreach locations made possible by several different awarded grant dollars. The Street Nurse Team now functions five days per week with one nurse, two social workers, and several nursing interns. Program outcomes include the following: 62 clients established care with a primary care doctor, 133 individuals were given food and food resources, 109 prescriptions were provided with 31 being paid in full by the street nursing team, 95 individuals moved from homelessness and were entered into temporary housing such as a shelter, nine individuals were moved from homelessness and were entered into permanent housing,136 were seen by a tele medicine doctor out in the field, and 105 were referred to the substance use navigator for resources and referrals.Priority needs not addressed:No hospital can address all the health needs identified in its community. Adventist Health and Rideout is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed include the following: Prevention of Disease and Injury through Knowledge, Action, and Access to Resources; Adventist Health and Rideout focuses on wellness and prevention through health education classes and programs. AHRO will continue providing classes and programs to the community. Access and Functional Needs: Access to transportation services is a large need in the primary service area. AHRO currently addresses this need by offering free transportation to and from the hospital, Cancer Center and clinics. In addition to this transportation service, we also provided bus passes, gas cards and food cards to low-income patients to help with travel needs. Access to Specialty and Extended Care: Adventist Health and Rideout is consistently recruiting specialty providers to increase access for the community. We plan to continue these efforts. Active Living and Healthy Eating: Adventist Health and Rideout currently offers free classes on diabetes and other health issues in addition to encouraging healthy lifestyles. Safe and Violence-Free Environment: Adventist Health and Rideout agrees that this is a huge need throughout the community, but at this time, we feel addressing this need will require dedicated effort from many other community organizations. We cannot tackle this community need on our own. At this time, we believe we can focus efforts and resources on the other prioritized health needs to make a larger impact. 3 1 - Rideout Women's Imaging Center 945 Shasta Street Yuba City CA 95991 Radiology 2 - AHPN Yuba City - Occupational Medicine 1531 Plumas Court B Yuba City CA 95991 Occupational Medicine 3 - Rideout Drug Testing Services 1531 Plumas Street Yuba City CA 95991 Occupational Medicine Part I, Line 7: The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)/Gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. Part II, Community Building Activities: The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities that we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020 Adventist Health completed the acquisition of Blue Zones as the first step toward reaching this goal. By partnering with Blue Zones, we are able to gain ground in shifting the balance from healthcare - treating people once they are ill - to transformative well-being - changing the way communities live, work and play. 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 III, Line 2: Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3: The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4: The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8: The Medicare cost report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology. Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Since the 1997 Balanced Budget Act, 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 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. Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL:*Medicare Cost Report Revenue 118,581,434Prior Year Settlements 2,443,888 Cost Report Reimbursable Bad Debts 227,216 Estimates and Accrual Variances 11,793,421 Other 20,613,120 Total Medicare Revenue 153,564,685 *Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. Part III, Line 9b: When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2: The Hospital's 2019 CHNA, the 2021 Community Health Plan (CHP) Update for fiscal year 2020, and the 2020 Implementation Strategy adopted in 2020 are posted on the Hospital's website at:https://www.adventisthealth.org/about-us/community-benefit/ The two most recent Community Health Needs Assessment, two most recent Implementation Strategy reports and the most recent Community Health Plan Updates are also available on the Adventist Health Corporate website at:https://www.adventisthealth.org/about-us/community-benefit/The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, Rideout Memorial Hospital supports local partners to augment our own efforts and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. Part VI, Line 3: 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: The definition of the community served was the primary service area jointly shared by Rideout Memorial Health and SSHNV. This area was defined by five ZIP Codes: 95901, 95953, 95961, 95991, and 95993. This service area was designated because the majority of patients served by both RMH and SSHNV resided in these ZIP Codes. RMH is located in Marysville, CA, and SSHNV is located in Yuba City, CA. Separated by the Feather River, these cities are located adjacent to one another and are part of the Yuba City Metropolitan Statistical Area as designated by the US Office of Management and Budget. The service area is home to over 147,000 community residents, and encompassed portions of both Sutter and Yuba Counties. The rural community is rich in diversity along a number of dimensions.Population characteristics for Sutter County include a median age of 35.6, a poverty rate of 17.5%, a 13.2% uninsured rate, a 52.0% minority rate, a 13.5% disability rate and 37% of residents living with high housing costs. Sutter County has a median income of $52,943.Population characteristics for Yuba County include a median age of 32.2, a poverty rate of 20.8%, a 12.2% uninsured rate, a 43.0% minority rate, a 16.9% disability rate and 41% of residents living with high housing costs. Yuba County has a median income of $48,739. Part VI, Line 5: Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "triple aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population; 2. Factors that cause the present outcomes distribution; 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: 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 can 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, Reports Filed With States CA Part VI, Other Information: In 2020, Adventist Health as a system took the following actions in response to the needs created or exacerbated by COVID-19: Adventist Health as a system directed "Community Strength Fund grants" to each hospital to support community partners' immediate response to COVID-19; Adventist Health as a system directed "Community Integration Catalyst" funds to each hospital to support internal new or expanded community well-being programming and innovation as an immediate response to COVID-19; began offering more virtual health care visits to keep community members safe and healthy; developed an online symptom tracker to help community members determine if they may have COVID-19 or some other flu type illness and what steps to take; partnered with MaskUp, a collaboration of 100 leading health systems representing thousands of hospitals across the U.S. joining to create messages for the betterment of the communities they serve. 1 CA Health Fund & Trust 1215 K Street Suite 800 Sacramento CA 95814 941498697 501(c)(3) 94718 Hlth srvs un/underinsured pt Yuba Sutter Chamber Of Commerce 1300 Franklin Road Yuba City CA 95993 941731239 501(c)(6) 6000 2020 Gala Puttin On The Ritz 1 1 Part I, Line 2: Grantees are provided support based on the program for which they are soliciting funds. Our expectation is that the monies will be used accordingly, and reporting from the recipient is not required. X X X X 0 1 0 0 0 0 0 0 0 Reiner Scott Vice Chair 0 1631895 0 352059 0 374424 0 17042 0 37777 0 2413197 0 349200 Wing Bill Director/Chair 0 1458328 0 279883 0 22116 0 17042 0 42012 0 1819381 0 0 Jahn Andrew President, Care Division 0 992796 0 210574 0 162471 0 17042 0 42265 0 1425148 0 0 Eller Jeff President, NCR thru 06/20 0 926131 0 197976 0 30640 0 17042 0 32369 0 1204158 0 0 Nahapetian Arby - Care Division Chief Medical Officer 0 648088 0 107260 0 112858 0 12449 0 42262 0 922917 0 0 Rawson Richard President 0 585738 0 115611 0 96966 0 0 0 29537 0 827852 0 0 Jobe Meredith Secretary 0 575127 0 81637 0 113221 0 13010 0 30858 0 813853 0 0 Byrnes John Medical Officer, NCR 0 578510 0 98480 0 89869 0 17042 0 29382 0 813283 0 0 Sheikh Azad Medical Officer 0 452538 0 76727 0 84632 0 17042 0 22889 0 653828 0 0 Gonzalez Eduardo Treasurer/Asst Secr 0 295577 0 47982 0 117684 0 17042 0 44123 0 522408 0 0 Gordon Cyndy Patient Care Executive 0 356374 0 60443 0 56602 0 15030 0 29335 0 517784 0 0 Chibaya Daniel Operations Manager 0 305463 0 51819 0 36097 0 17042 0 43532 0 453953 0 0 Lonto Robert Reg HP Dir, NCR 0 294752 0 46824 0 35374 0 17042 0 42005 0 435997 0 0 Arrowsmith Monica Bus Dev Leader 0 288493 0 48941 0 41109 0 17042 0 31114 0 426699 0 0 Lang Kevin Finance Officer, NCR 0 0 0 0 0 388220 0 0 0 0 0 388220 0 0 Mensch Deborah Patient Care Executive thru 08/20 0 232016 0 42948 0 43263 0 11995 0 37488 0 367710 0 0 Minton Krista Director, Clinical Care 214021 0 12417 0 7531 0 12597 0 59329 0 305895 0 0 0 Gonzales Jerry Manager, Pharmacy 231206 0 14208 0 8466 0 14031 0 33943 0 301854 0 0 0 Swanson Jeffery President, Philanthropy 233288 0 78 0 4035 0 11045 0 47355 0 295801 0 0 0 Hyer Theresa Director, Emergency Services 215458 0 12302 0 2720 0 11983 0 48258 0 290721 0 0 0 Kaur Rose RN-Staff 228458 0 71 0 0 0 9218 0 27780 0 265527 0 0 0 Part I, Line 4b Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life participants are Jeff Eller, Scott Reiner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated amount equivalent to 41 percent of their base compensation, less the value employees meeting certain criteria. The participants are provided with an of their corporate provided benefits. The balance is set aside for non-vested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Reiner, Scott - $349,200 Part II: Kevin Lang, Finance Officer, NCR was paid through an unrelated organization KJL, Inc. that was reported on Form 1099. Compensation paid is reported in Form 990, Part VII, Section A and Schedule J, Part II. Form 990, Part III, Line 4a: Rideout Memorial Hospital (AHRO) 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 of AHRO, 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 afford to pay: - providing free care and/or subsidized care - providing care to persons covered by governmental programs at below cost - providing health/wellness activities and community education programs Not only does AHRO 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. AHRO 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 2020 was $45,950,054. The following Inpatient services were provided to all our patients. These services included: - 1,740 Babies delivered - 1,691 Surgeries performed - 55,226 Patient days The following Outpatient services were provided to all our patients. These services included: - 60,530 Emergency department visits - 1,668 Outpatient Surgeries performed - 94,379 Outpatient visits - 136,216 Clinic visits AHRO 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 $3,412,454. Adventist Health's mission statement of Living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry as represented by the life of Jesus Christ and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Form 990, Part VI, Section A, line 4 The Hospital amended its Bylaws to change the sole member from Fremont-Rideout Health Group to Stone Point Health. Form 990, Part VI, Section A, line 6 The sole member of the organization is Stone Point Health, a California nonprofit public benefit corporation. Form 990, Part VI, Section A, line 7a Each individual who is a director of the board of Stone Point Health shall automatically be a director of Rideout Memorial Hospital, and shall serve as a director of Rideout Memorial Hospital until such time as that person is no longer a director of Stone Point Health. Form 990, Part VI, Section A, line 7b Stone Point Health shall exercise its membership rights through its Board of Directors, which may, by resolution, authorize one or more of its officers to exercise its vote on any matter to come before the membership of Rideout Memorial Hospital. Request for action by Stone Point Health may be made by the Chair of the Stone Point Health's board or any other person designated in writing by Stone Point Health. Form 990, Part VI, Section B, line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the System Controller and Market Finance Officer, and shared by electronic communication with the Hospital's Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, corporate officers, key employees, and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president immediately. The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Copies for the officers and key employees' COIs are kept in their personnel files. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, line 15 The Hospital's Board of Directors has established a Compensation 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 Presidents and 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, Section C, line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part VII: In recognition of the time commitment directors make to serve on the Adventist Health System/West boards and committees, directors have the option to receive compensation when their employment agreements with their employers allow such payments. In addition, amounts paid for taxable benefits are also reported. Form 990, Part IX, line 11g Physician fees: Program service expenses 36,540,228. Management and general expenses 343,735. Fundraising expenses 0. Total expenses 36,883,963. Consulting fees: Program service expenses 42,337. Management and general expenses 387,296. Fundraising expenses 0. Total expenses 429,633. Contract labor: Program service expenses 7,307,355. Management and general expenses 307,266. Fundraising expenses 0. Total expenses 7,614,621. Repairs and maintenance: Program service expenses 1,066,712. Management and general expenses 262,028. Fundraising expenses 80. Total expenses 1,328,820. Purchased medical services: Program service expenses 4,804,023. Management and general expenses 451,375. Fundraising expenses 0. Total expenses 5,255,398. Other medical professional fees: Program service expenses 0. Management and general expenses 10,546. Fundraising expenses 0. Total expenses 10,546. Other non-medical professional fees: Program service expenses 575,492. Management and general expenses 146,922. Fundraising expenses 0. Total expenses 722,414. Other purchased services: Program service expenses 13,201,057. Management and general expenses 1,129,490. Fundraising expenses 2,159. Total expenses 14,332,706. Cerner management fees: Program service expenses 0. Management and general expenses 15,404,754. Fundraising expenses 0. Total expenses 15,404,754. Form 990, Part XI, line 9: Net Assets from Fremont Rideout Health Group 20,189,423. Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Delano 1401 Garces Highway Delano CA 93215 770258013 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Mendocino Coast 700 River Drive Fort Bragg CA 95437 845174585 Hospital CA 501(c)(3) Line 3 Stone Point Health 0 Adventist Health Physicians Network PO Box 619135 Roseville CA 95661 680357690 Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Adventist Health SystemWest PO Box 619135 Roseville CA 95661 953484589 Integrated health system CA 501(c)(3) Line 10 N/A 0 Adventist Health Tulare 869 North Cherry Street Tulare CA 93274 832351753 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest 0 Feather River Hospital PO Box 619135 Roseville CA 95661 941101228 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Fremont-Rideout Health Group 989 Plumas Street Yuba City CA 95991 942917251 Acute care hospital CA 501(c)(3) Line 12b, II Stone Point Health 0 Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi CA 95240 941044474 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Paradise Valley Hospital PO Box 619135 Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) Line 1 Adventist Health SystemWest 0 Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Reedley Community Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Simi Valley Hospital and Health Care Services 2975 N Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Stone Point Health PO Box 619135 Roseville CA 95661 823763347 Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 United Com-Serve 989 Plumas Street Yuba City CA 95991 943015356 Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Stone Point Health 0 Walla Walla General Hospital PO Box 619135 Roseville CA 95661 910617726 Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest 0 Western Health Resources PO Box 619135 Roseville CA 95661 953867863 Home care CA 501(c)(3) Line 10 Adventist Health SystemWest 0 White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 FRD Management Company LLC PO Box 2128 Marysville CA 95901 943335136 Operation of cancer center CA Rideout Memorial Hospital RELATED -903670 16265512 0 1 0.51000 Blue Zones LLC 323 N Washington Avenue 2nd Floor Minneapolis MN 55401 271603327 Education MN N/A 0 0 PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 260622555 Real property rental OR N/A 0 0 PVHR2 LLC dba Parkview at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 473300170 Real property rental OR N/A 0 0 WWGHR LLC 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 810591221 Rental OR N/A 0 0 Fremont-Rideout Management Services Organization Inc 989 Plumas Street Yuba City CA 95991 271350379 DME sales CA Rideout Memorial Hospital C 1.00000 0 AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure captive insurance BD N/A C 0 Adventist Health Plan Inc 1 Adventist Health Way Roseville CA 95661 463833261 Health insurance CA N/A C 0 South Coast Medical Center PO Box 619135 Roseville CA 95661 952037297 Wind down after sale of hospital CA N/A C 0 Thrive Productions Inc 323 N Washington Avenue Minneapolis CA 55401 453369049 Production company MN N/A C 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 1