2021-11-10T16:52:26-06:00 2020-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2020-01-01 930429015 Portland Adventist Medical Center PORT 9164060000 10123 SE Market Street Portland OR 97216 Donald Welch Treasurer 9164060000 2021-11-08 1 Donald Welch 999009999 Tracy S Paglia P00366884 2099556100 2021-11-08 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z Adventist Health Portland Kyle King 10123 SE Market Street Portland OR 97216 340923597 0 1071 X www.adventisthealth.org/portland/ X 1900 OR Living God's love by inspiring health, wholeness and hope. 14 12 2170 194 2060258 1010340 461443 280800 336542428 334935258 9204715 4711144 -21737 917940 346186849 340845142 52432 5550 0 0 168940332 169673393 42321 122434 528871 168292996 167078619 337328081 336879996 8858768 3965146 340125339 378909823 138878702 174634313 201246637 204275510 X Living God's love by inspiring health, wholeness and hope. 0 0 272015955 5550 334935258 See Schedule O 272015955 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 1 1 0 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 1 1 0 0 0 1 0 0 2170 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X Todd Hofheins CFO 9164060000 PO Box 619135 Roseville CA 95661 X Reiner Scott Dir/Chair 0.00 50.00 X X 0 2358378 54819 Wing Bill Dir/Asst Secr/Vice Chair 0.00 50.00 X X 0 1760327 59054 Jahn Andrew President, Care Division 2.00 48.00 X 0 1365841 59307 Boskind Jeffrey Physician 50.00 0.00 X 1021644 0 53672 Tella Mallik Physician 50.00 0.00 X 997014 0 36871 Newmyer Joyce - President PNR thru 08/20; CCO as of 08/20 12.50 37.50 X 0 933247 62067 Spear Eugene Physician 50.00 0.00 X 905592 0 60863 Joo Elliot Physician 50.00 0.00 X 898578 0 58611 Nahapetian Arby - Care Division Chief Medical Officer 2.00 48.00 X 0 868206 54711 Reppert Joseph Former CFO/Asst Secr thru 08/19 0.00 0.00 X 0 813425 41111 Alhumaid Fawaz Physician 50.00 0.00 X 783751 0 64741 Jobe Meredith Secretary 0.00 50.00 X 0 769985 43868 Welch Donald - Interim Treasurer/Finance Officer, PNR 12.50 37.50 X 0 597456 53834 Rippey Wesley Regional Medical Officer, PNR 12.50 37.50 X 0 603356 40956 King Kyle - Network Dev Exec PNR, President as of 10/20 12.50 37.50 X 0 439095 50450 Hofheins Todd CFO as of 08/20 0.00 50.00 X 0 469107 13281 Russell David President thru 05/19 0.00 0.00 X 0 432463 32041 Brower Dorane Physican Services Exec thru 02/20 0.00 50.00 X 0 386961 57556 Nutter Lucinda Patient Care Executive 0.00 50.00 X 0 370743 50229 Leach Judy Strategy & Comm Exec, PNR 0.00 50.00 X 0 358886 39489 Knox Jody Physican Services Exec 0.00 50.00 X 0 319047 21601 Voshell Shane Reg HR Dir, PNR 0.00 50.00 X 0 271024 58224 Wagner Jack Former Asst Secr thru 03/18 0.00 0.00 X 0 269387 13558 Shaker Kamal Medical Officer 0.00 50.00 X 0 216750 1678 Poole Aaron Treas/Asst Secr thru 07/19 0.00 0.00 X 0 175505 9583 Tkachuck Derrik VP Support Services thru 07/19 0.00 0.00 X 0 111023 20558 Freedman John Director 0.00 4.00 X 0 27216 0 Davis Andrew Director 0.00 4.00 X 0 26971 0 Reiner Richard Director 0.00 4.00 X 0 26764 0 Cherry Robert Director 0.00 4.00 X 0 26160 0 Innocent Larry Director 0.00 4.00 X 0 25608 0 Graham Ricardo Director 0.00 4.00 X 0 23359 0 Heinrich Kerry Director 0.00 4.00 X 0 20608 0 Woodson Marc Director 0.00 4.00 X 0 20608 0 Ocampo Lucy Director 0.00 4.00 X 0 20358 0 Banks David Director 0.00 4.00 X 0 15441 0 Salazar Velino Director 0.00 4.00 X 0 6651 0 Fehr Joy Director 0.00 4.00 X 0 108 0 Philip Celeste Director thru 04/20 0.00 4.00 X 0 0 0 4606579 14130064 1112733 341 1 1 0 Mortenson Construction 710 NW 14th Ave Ste 300 Portland OR 97209 Construction Services 6030808 Oregon Anesthesiology Group PC 707 SW Washington St Ste 700 Portland OR 97205 Medical Services 1993228 Fortis Construction Inc 1705 Sw Taylor St Ste 200 Portland OR 97205 Construction Services 1583647 Siemens Medical Solutions Dept LA 21536 Pasadena CA 91185 Medical Services 1379480 Hill Rom Company Inc PO Box 643592 Pittsburgh PA 15264 Construction Services 1127417 43 10000 58413 212387 31301 280800 Patient service revenue 621110 296742072 296742072 CARES Act funding 900099 17396570 17396570 OHSU partnership 900099 10000000 10000000 Premium revenue 900099 3816918 3816918 Related rental income 531120 2250958 2250958 4728740 3596914 1131826 334935258 4707731 4707731 4500 1087 3413 3413 3413 66876 77368 -10492 -10492 Passthrough Income 900099 928432 928432 928432 340845142 333803432 2060258 4700652 X 5550 5550 508249 508249 133713398 130155812 3292276 265310 5337267 5279607 47729 9931 20256097 19765562 455535 35000 9858382 9661307 180034 17041 25181935 830956 24350979 357704 357704 24612 24612 122434 122434 36747484 20295812 16413121 38551 448453 448453 1444368 1438903 5465 10698263 1917914 8780349 9815197 8297903 1493401 23893 334332 279296 51664 3372 208188 185605 16788 5795 2241212 2241212 13946677 13491947 454730 2031179 1899913 131266 Patient care supplies 40470789 40470195 594 Quality assurance hospi 14316628 14316628 Rental/lease costs equi 810386 810101 285 Income taxes 163064 361 162703 0 7838148 138510 7698438 1200 336879996 272015955 64335170 528871 158147672 177642073 40507296 38862425 4320292 4508871 891750 1059678 385485130 240770178 125032666 144714952 3796183 141428 41200 3091050 3091050 4197002 8989574 340125339 378909823 41191750 33674789 978735 930584 96708217 140028940 138878702 174634313 X 196351646 199654849 4894991 4620661 201246637 204275510 340125339 378909823 X 3965146 -7841 -928432 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 24612 24612 0 Part II-B, Line 1: The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. 9141943 269503 -213633 320200 8877613 8864875 493428 185688 402048 9141943 8798496 524630 137502 595753 8864875 8797541 423076 115160 537081 8798496 8000751 861239 450598 515047 8797541 0.47950 0.00000 0.52050 0 0 5079709 5079709 205112588 132667308 72445280 27202869 11274295 15928574 148089964 96828575 51261389 144714952 Payables to related organizations 83664088 Other liabilities 42991177 Payables to third-party payors 13344575 Income taxes payable 29100 140028940 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. X X X X X 1 TSM Donor Engagement Team Inc PO Box 645421 Pittsburgh PA 152645421 Mail solicitations 0 96500 102434 -5934 Patrick SilvergEvent LLC 11815 SW Terra Linda Street Beaverton OR 97005 Golf tournament director 0 0 20000 -20000 96500 122434 -25934 OR 1 1 X 1 X 1 X 1 1 1 0 1 1 2292312 2292312 0.00680 74583203 61809885 12773318 0.03790 76875515 61809885 15065630 0.04470 4953426 24790 4928636 0.01460 262343 63779 198564 0.00060 19685 19685 0.00010 5235454 88569 5146885 0.01530 82110969 61898454 20212515 0.06000 343654 343654 0.00100 343654 343654 0.00100 1 3633039 956882 38475740 37068965 1406775 X 1 1 1 Assn-Unit Owners Plaza Conf Condo association mgmt 0.90000 0.10000 1 1 Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 www.adventisthealth.org/Portland 14-1127 X X X Portland Adventist Medical Center 1 0 0 1 X X X X X X X X X 19 1 0 1 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment X 1 19 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X 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 Part V, Section A: Audiology (1); Imaging (2); Physician Clinics (22); Rehab (PT/OT/Sp) Clinics (9); Urgent Care (2); Wound Care (1) Portland Adventist Medical Center 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. Community data gathering accomplished through provider surveys and listening sessions. Data gathering was accomplished by using a widely-distributed community survey. Adventist Health Portland has chosen two different community surveys to be able to take into account the various groups that need to be represented. To not duplicate responses, Adventist Health Portland has chosen to use the Healthy Columbia Willamette (HCWC) as their main source of primary data for our service area. A second survey ("service provider" survey) was conducted to gather the opinions of the community from various health experts in our community. Additionally, nine listening sessions included the rural community, seniors, veterans, ethnic diversity and those in housing insecurity for a total of 104 participants. Secondary data sources include collected data on key health indicators, morbidity, mortality, and various social determinants of health from the Census, Centers for Disease Control and Prevention, Community Commons, and various other state and federal databases. Portland Adventist Medical Center Part V, Section B, Line 6b: The Healthy Columbia Willamette Collaborative data was utilized in the 2019 CHNA. It is a large public-private collaborative comprised of 14 hospitals and four local public health departments in the four-county region. Members include: Adventist Medical Center, Clackamas County Health Department, Clark County Public Health Department, Kaiser Permanente, Legacy Emanuel Medical Center, Legacy Good Samaritan Medical Center, Legacy Meridian Park Medical Center, Legacy Mount Hood Medical Center, Legacy Salmon Creek, Multnomah County Health Department, Oregon Health & Science University, PeaceHealth Southwest Medical Center, Providence Milwaukie, Providence Portland, Providence St. Vincent, Providence Willamette Falls, Tuality Healthcare and Washington County Health Department. Portland Adventist Medical Center 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 four significant health needs: Chronic Disease, Access to Care, Behavioral Health, and Social Determinants: Food Access/Safety. Priority Need 1 - Chronic Disease - The goal is to work collaboratively to reduce the incidence and impact of chronic diseases like heart disease, cancer, and diabetes through culturally sensitive screening, education and treatment, including the use of lifestyle medicine approaches. Strategy 1 - Community Health Screenings and interactive education activities around certain health conditions (CVD, CA, COVID-19, Diabetes and Obesity) with attention to the benefits/"How to" of moving towards a more whole food, plant-based diet, and other healthy lifestyle practices (e.g. sleep, exercise, and stress management). Activity 1.1 - Targeted Screening & Learning Activities/Events, and Activity 1.2 - Professional Lifestyle Medicine- COVID-19 dramatically impacted planned efforts for 2020. However, a number of community educational sessions were still able to happen prior to the shut-down. Areas included cardiovascular disease, breastfeeding, childbirth, pre-diabetes, cancer, hormonal disorders, weight management and cooking/nutrition. A total of three community sessions were hosted before the shut-down. A seminar titled, "Evidence-based Weight Management had more than 600 attendees and over 40,000 views on YouTube by the end of 2020. The seminar titled, "Hormones and Nutrition" had 300 attendees. The annual Northwest Health & Nutrition Conference had 137 attendees. The annual Pain Management Symposia included 96 participants. Priority Need 2 - Access to Care -The goal is to work with others to improve the access to quality, culturally appropriate health care services in our service area, and to work proactively to increase the numbers of those entering health care careers. Strategy 1 - Provide greater access to culturally responsive medical/dental services for low-income, underserved and immigrant individuals and families through direct services and selected partnerships. Strategy 2 - Provide educational opportunities to improve access to health professionals in the future. Activity 1.1 - Impact Your Health/Compassion Connect clinic events- All community medical, dental and vision clinics were cancelled due to COVID, as well as the Compassion Connect clinics. Activity 1.2 - Project Access Now - Program support continued in 2020. Funding support provided direct patient care for an estimated 1,855 individuals and additional assistance with enrolling in health plans. Activity 1.3 - Slavic Navigator Outreach Program - program was active during 2020. Much of their work was directed towards COVID prevention education and answering community questions. Included media articles/posts, radio interviews and phone-based work with patients, providers, civic leaders, etc. Other planned community events were cancelled due to COVID-19. 11,966 touches were reported specific to Slavic community. Activity 1.4 - Student Healthcare Leaders Program - program was cancelled in 2020 due to school changes, and restricted access to hospital. AHPL was not able to realistically reorient to a virtual format. The current plan is to restart in Fall, 2021. Additional activities involving patient transport - program services were significantly reduced but a total of 22 patients received transportation services with multiple sessions.Priority Need 3 - Behavioral Health & Well-Being - The goal is to support the development of a robust and sustainable behavioral health care system for the Greater Portland Area, and create school support resources that nurture overall well-being.Strategy 1 - Improve access to stable emergency and other more formal behavioral health/addiction recovery services through direct services funded partnerships. Strategy 2 - Provide a variety of addiction, grief, social and spiritual support, and education services. Activity 1.1 - BH/SUD IP/Emergent Care via UNITY Center - Our ongoing partner support of the UNITY Center for Behavioral Health helped enable their professional staff to provide care for an estimated 10,000 adult and adolescent visits. This included emergency, inpatient and outpatient care services helping provide more tailored care than is often available in a typical emergency room. Our funding helps cover uncompensated care expenses. We had a total of 1,524 BH patients seen in our ED, of those 23.95% were transferred out to one of three local facilities for more acute care. UNITY received the highest percentage of those referrals. Activity 1.2 - Enhancing SUD Care via FORA Health partnership - The St. Vincent De Paul partnership and the new facility development continued in 2020. Activity 1.3 - First Friday - Program was cut short due to COVID. A total of three social, emotional, and spiritual inspiration sessions serving approximately 450 individuals were held. Activity 1.4 - Support Groups (Smoking, Grief, Cancer) and virtual Behavioral Health classes - Smoke Free support group had 85 touches, 20 touches in the grief support group, and nine touches in our cancer support group. Support group participation greatly decreased due to COVID-19 and safety protocols. Additional activities included a virtual "Grieving Through the Holidays" session which had a total of 258 views on YouTube and Facebook.Priority Need 4 - Food Insecurity/Access - The goal is to improve access to quality nutrition for food insecure groups and build capacity for greater community nutrition self-support. Strategy 1 - Support community and school gardens for low cost fresh produce, outdoor exercise, community-building, and increased self-sufficiency especially for Black, Indigenous, People of Color (BIPOC)/refugee community. Activity 1.1 - Community Garden - The Market Street Garden continued in 2020 and provided 51 refugee families and four American families with a total of 42,000 square feet of growing space. The partnership with the Oregon Food Bank led to a pair of refugee food pickup events and 180 families were served. In addition, many food boxes were personally delivered to families. The First Friday Soup & Salad Meal - Social Support Program provided a total of 225 meals before activities were halted due to COVID. Finally, the GROW Portland program was postponed and is projected for future involvement. Priority needs not addressed:No hospital can address all the health needs identified in its community. Adventist Health Portland 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 address include the following: 1. Housing - we have made significant investments in this area in the past and will continue to support small projects/facilities as possible. Limited current resources for large projects. 2. Alcohol & Drug Misuse - This is addressed somewhat though our clinics and there are other community organizations taking the lead on this health priority. One is Fora Health who is moving in next door to us. We are looking at partnership possibilities for the future. 3. Liver Disease and Sexually Transmitted Diseases - There are others working in this area and resources are limited in this area outside of our primary care work, and support of community clinics. 4. Transportation - Beyond a limited program for some patients, addressing this need will effectively require more financial resources than we can commit to at this time. Portland Adventist Medical Center Part V, Section B, Line 13h: Income level and family size are considered. Individuals eligible for Medicaid also qualify for financial assistance. 35 1 - AH Medical Group-Gresham Station 831 NW Council Drive Suite 101 125 Gresham OR 97030 Physician Clinic 2 - AH Medical Group-Parkrose Primary CareInt 1350 NE 122nd Avenue 100 Portland OR 97230 Physician Clinic 3 - AH Medical Group-Clackamas 10151 SE Sunnyside Rd 100 Clackamas OR 97015 Physician Clinic 4 - AH Medical Group-Sandy Family Practice 17055 Ruben Lane Sandy OR 97055 Physician Clinic 5 - AH Medical Group-Troutdale Clinic 1700 SW 257th Ave Troutdale OR 97060 Physician Clinic 6 - AH Medical Group-Portland Lung Clinic 10201 SE Main St Suite 11 Portland OR 97216 Physician Clinic 7 - AH Medical Group-Cherry Park FP 10201 SE Main Suite 10 12 Portland OR 97216 Physician Clinic 8 - AH Medical Group-Damascus 14450 SE Royer Road Damascus OR 97089 Physician Clinic 9 - AH Medical Group-Wound Health & Hyperbaric 10201 SE Main St Suite 9 Portland OR 97216 Physician Clinic 10 - AH Medical Group-Rheumatology & Endocrine 10101 SE Main St Suite 2011 Portland OR 97216 Physician Clinic 11 - AH Medical Group-Diabetes Clinic 10101 SE Main Street Suite 2011 Portland OR 97216 Physician Clinic 12 - AH Medical Group-NW Regional Surgical Asso 10000 SE Main St 365 Portland OR 97216 Physician Clinic 13 - AH Medical Group-NW Orthopedic Specialists 10000 SE Main St 224 Portland OR 97216 Physician Clinic 14 - AH Medical Group-Gastroenterology Clinic 10000 SE Main Street Suite 112 Portland OR 97216 Physician Clinic 15 - AH Medical Group-Parkrose Urgent Care 1350 NE 122nd Ave 200 Portland OR 97230 Physician Clinic/Urgent Care 16 - AH Medical Group-NW Reg Heart & Vasc 10000 SE Main Street Suite 60B Portland OR 97216 Physician Clinic 17 - AH Medical Group-Sleep Clinic 10201 SE Main St Suite 29 Portland OR 97216 Physician Clinic 18 - AH Medical Group-Sandy Urgent Care 17055 Ruben Lane Sandy OR 97055 Physician Clinic/Urgent Care 19 - AH Medical Group-NW Reg Heart & Vasc 2700 SW Stratus Ave Ste 406 McMinnville OR 97128 Physician Clinic 20 - AH Medical Group-Multi Spec Surgery Clinic 10000 SE Main St Suite 316 Portland OR 97216 Physician Clinic 21 - AH Medical Group-Infectious Disease Clinic 10201 SE Main St Suite 29 Portland OR 97216 Physician Clinic 22 - AH Physical Therapy-Campus Rehab 10101 SE Main Street LL Portland OR 97216 Physical Therapy Clinic 23 - AH Physical Therapy Vancouver 16096 SE 15th Ave Vancouver WA 98683 Physical Therapy Clinic 24 - AH Physical Therapy Gresham 831 NW Council Dr Suite 200 Gresham OR 97030 Physical Therapy Clinic 25 - AH Physical Therapy Clackamas 10151 SE Sunnyside Rd 100 Clackamas OR 97015 Physical Therapy Clinic 26 - AH Physical Therapy Sandy 37095 SE Hwy 26 Suite 102 Sandy OR 97055 Physical Therapy Clinic 27 - AH Physical Therapy Parkrose 1350 NE 122nd Avenue 200 Portland OR 97230 Physical Therapy Clinic 28 - AH Speech Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Speech Therapy Services 29 - AH Audiology 10201 SE Main Street Suite 1 Portland OR 97216 Audiology Services 30 - AH Occupational Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Occupational Therapy Clinic 31 - AH Speciality Rehab 10201 SE Main St 1 Portland OR 97216 Specialty Rehab Clinic 32 - AH Clackamas Imaging Center 10151 SE Sunnyside Rd 100 Clackamas OR 97015 Imaging Services 33 - AH Gresham Station Imaging Center 831 NW Council Dr Suite 100 Gresham OR 97030 Imaging Services 34 - AH Medical Group-Occupational Med Parkrose 1350 NE 122nd Ave 200 Portland OR 97230 Physician Clinic 35 - AH Wound Healing and Hyperbaric Medicine 10201 SE Main St Suite 9 Portland OR 97216 Wound Care Services-Hospital Outpatient 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 audited combined financial statements. The formula used for computation equals financial statement data labeled as follows for 7a-c:(Total expenses - (Provision for bad debts + Other revenue + Interest income))/Gross patient chargesLines 7f and i are calculated based on specific expenses and revenuesLine 7g uses specific cost to charge ratios for those departments 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. The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information, those accounts would have been reclassified from bad debt expense to charity care. 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 based on 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 healthcare "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 to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care. In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. Our mission is to promote health in the community regardless of a person's ability to pay. We provide care to those with Medicare coverage who present themselves to our facility without consideration that the costs may or may not be fully reimbursed. The Medicare shortfall is a community benefit because care is provided to Medicare beneficiaries who are primarily elderly and disabled individuals on fixed incomes and who usually have no other resources with which to obtain medical care. We are thus relieving a local and federal government burden by caring for these people.Medicare revenue reconciliation from the Medicare cost report to general ledger: Medicare cost report revenue* 38,475,740 Prior year settlements 417,103 Cost report reimbursable bad debts 398,017 Non-cost report revenue 14,760,580 Estimates and accrual variances 356,241 Other (652,363) Total Medicare revenue 53,755,318*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, Portland Adventist Medical Center 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 prime service area for Portland Adventist Medical Center is the following areas of Multnomah and Clackamas Counties: Mid County, East County, and the eastern most portions of Central Eastside and Southeast. Also included would be the areas of Clackamas County that border East County and Southeast Multnomah County and the Sandy region. Total population for the primary service area is 567,931 with a density of 1,238.97 per square mile. Population under 18 years of age is 22.24% as compared to the state average of 21.27%. Population of adults over the age of 65 is 14.14% as compared to the state average of 16.72%. The population of with limited English proficiency is 10.63% which is significantly higher that the state average of 5.83%. People in the service area have a life expectancy of 78.11 years as compared to the state average of 79.22 years. The uninsured rate is also higher than the state average at 7.91% as opposed to 7.27%. Children living in poverty accounts for 20.41% of the service area which is far above the state average of 18.03%. Adventist Health Portland's primary service area also has a lower graduation rate of 77.90% than the state average of 79.4%. 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 are soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively 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 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, Reports Filed With States OR 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.Local Strength Grants from Adventist Health Portland were provided to Portland Rescue Mission-which provided meals for 150 individuals for one week and nursing care for 50 individuals in recovery, Portland Adventist Community Services- allowed for delivery services and approximately 6,000 people were served, Fort Kennedy which provided food, clothing and social support services to local veterans dealing with COVID related challenges, and Meals on Wheels People - provided an additional 676 meals. 1 Employee emergency funds 10 5550 Part I, Line 2: Employee emergency funds are for employees experiencing hardships. No monitoring is conducted by Portland Adventist Medical Center. X X X X 1 1 0 0 0 0 0 0 0 Reiner Scott Dir/Chair 0 1631895 0 352059 0 374424 0 17042 0 37777 0 2413197 0 349200 Wing Bill Dir/Asst Secr/Vice 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 Boskind Jeffrey Physician 1021644 0 0 0 0 0 16596 0 37076 0 1075316 0 0 0 Tella Mallik Physician 969925 0 0 0 27089 0 17042 0 19829 0 1033885 0 0 0 Newmyer Joyce - President PNR thru 08/20; CCO as of 08/20 0 757634 0 155648 0 19965 0 17042 0 45025 0 995314 0 0 Spear Eugene Physician 905592 0 0 0 0 0 17042 0 43821 0 966455 0 0 0 Joo Elliot Physician 898578 0 0 0 0 0 14743 0 43868 0 957189 0 0 0 Nahapetian Arby - Care Division Chief Medical Officer 0 648088 0 107260 0 112858 0 12449 0 42262 0 922917 0 0 Reppert Joseph Former CFO/Asst Secr thru 08/19 0 2779 0 0 0 810646 0 0 0 41111 0 854536 0 0 Alhumaid Fawaz Physician 764746 0 0 0 19005 0 17042 0 47699 0 848492 0 0 0 Jobe Meredith Secretary 0 575127 0 81637 0 113221 0 13010 0 30858 0 813853 0 0 Welch Donald - Interim Treasurer/Finance Officer, PNR 0 437746 0 79504 0 80206 0 17042 0 36792 0 651290 0 0 Rippey Wesley Regional Medical Officer, PNR 0 448162 0 69299 0 85895 0 12673 0 28283 0 644312 0 0 King Kyle - Network Dev Exec PNR, President as of 10/20 0 360067 0 41930 0 37098 0 16964 0 33486 0 489545 0 0 Hofheins Todd CFO as of 08/20 0 297756 0 66 0 171285 0 0 0 13281 0 482388 0 0 Russell David President thru 05/19 0 0 0 0 0 432463 0 0 0 32041 0 464504 0 0 Brower Dorane Physican Services Exec thru 02/20 0 303692 0 45290 0 37979 0 17042 0 40514 0 444517 0 0 Nutter Lucinda Patient Care Executive 0 288250 0 42899 0 39594 0 16512 0 33717 0 420972 0 0 Leach Judy Strategy & Comm Exec, PNR 0 289448 0 34453 0 34985 0 17042 0 22447 0 398375 0 0 Knox Jody Physican Services Exec 0 260962 0 0 0 58085 0 2042 0 19559 0 340648 0 0 Voshell Shane Reg HR Dir, PNR 0 216133 0 32844 0 22047 0 14269 0 43955 0 329248 0 0 Wagner Jack Former Asst Secr thru 03/18 0 0 0 0 0 269387 0 0 0 13558 0 282945 0 0 Shaker Kamal Medical Officer 0 216750 0 0 0 0 0 0 0 1678 0 218428 0 0 Poole Aaron Treas/Asst Secr thru 07/19 0 0 0 0 0 175505 0 0 0 9583 0 185088 0 0 Tkachuck Derrik VP Support Services thru 07/19 0 0 0 0 0 111023 0 0 0 20558 0 131581 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health Services/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Poole, Aaron - severance payment - $174,090 Reppert, Joseph - severance payment - $809,806 Russell, David - severance payment - $431,453 Tkachuck, Derrik - severance payment - $111,023 Wagner, Jack - severance payment - $269,387 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are Joyce Newmyer, Scott Reiner, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Reiner, Scott - $349,200 Brower Charles Family member of Key EE, D. Brower 116721 Employment 0 Henry Linda Family member of Key EE, W. Rippey 68528 Employment 0 Lee Jessica Family member of former Officer, D. Russell 101957 Employment 0 Russell Jennika Family member of former Officer, D. Russell 13528 Employment 0 Russell Kevin Family member of former Officer, D. Russell 166610 Employment 0 Tkachuck Victoria Family member of former Key EE, D. Tkachuck 40906 Employment 0 X 1 31301 FMV 0 0 1 0 Part I, Column (b): The Hospital is reporting the number of contributions in column (b). Form 990, Part III, Line 4a: Portland Adventist Medical Center dba Adventist Health Portland (AHPL) 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 AHPL, 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 AHPL 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. AHPL 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 $15,065,629. The following Inpatient services were provided to all our patients. These services included: - 552 Babies delivered - 1,607 Surgeries performed - 28,492 Patient days The following Outpatient services were provided to all our patients. These services included: - 38,179 Emergency department visits - 3,773 Outpatient Surgeries performed - 145,803 Outpatient visits - 278,466 Clinic visits AHPL 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 $5,146,885. 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 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Section A, line 7a The Hospital's Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, line 7b The sole corporate member, Adventist Health System/West, must approve all changes to the Articles of Incorporation and Bylaws. Form 990, Part VI, Section B, line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the System Controller and Market Finance Officer, and shared by electronic communication with the 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, 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 the 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 Organization'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 professional fees: Program service expenses 5,539,080. Management and general expenses 1,932,405. Fundraising expenses 0. Total expenses 7,471,485. Consulting and other management fees: Program service expenses 66,920. Management and general expenses 250,167. Fundraising expenses 27,840. Total expenses 344,927. Contract labor: Program service expenses 2,146,413. Management and general expenses 100,696. Fundraising expenses 0. Total expenses 2,247,109. Purchased medical services: Program service expenses 2,703,944. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,703,944. Repairs and maintenance: Program service expenses 631,856. Management and general expenses 31,019. Fundraising expenses 0. Total expenses 662,875. Cerner management fee: Program service expenses 0. Management and general expenses 11,112,534. Fundraising expenses 0. Total expenses 11,112,534. All other purchased services: Program service expenses 8,616,758. Management and general expenses 2,970,886. Fundraising expenses 10,711. Total expenses 11,598,355. Other professional medical fees: Program service expenses 0. Management and general expenses 14,164. Fundraising expenses 0. Total expenses 14,164. Other non-medical professional fees: Program service expenses 590,841. Management and general expenses 1,250. Fundraising expenses 0. Total expenses 592,091. Form 990, Part XI, line 9: Passthrough Income -928,432. 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