2019-11-12T10:55:14-08:00 2018-12-31 800519547 THE ACCOUNTANCY LLP 330 N BRAND BLVD STE 200 GLENDALE CA 912032361 990 2018-01-01 990107330 Castle Medical Center dba Adventist Health Castle CAST 8082635500 640 Ulukahiki St Kailua HI 96734 Heidar Thordarson Treasurer 2019-11-12 true S Clement P01218012 8185475701 X 2018 2020-03-31 21:24:44Z Raethel Kathryn 640 Ulukahiki St Kailua HI 96734 179537745 false false 1071 X www.adventisthealth.org/castle X 1960 HI Living Gods love by inspiring health, wholeness and hope. 12 10 1229 118 0 1374117 376819 1004860 169761238 174487124 2637655 3929441 1063027 -1852 173838739 179419573 119612 69112 0 79997447 79167465 0 0 82637579 93059346 162754638 172295923 11084101 7123650 275748039 287745337 98715547 102687709 177032492 185057628 Living Gods love by inspiring health, wholeness and hope. false false 141557210 69112 176013113 Castle Medical Center dba Adventist Health Castle (AHCS) 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 Castle Medical Center dba Adventist Health Castle, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Castle Medical Center dba Adventist Health Castle 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.AHCS 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 2018 was $8,250,142.The following Inpatient services that were provided to all our patients. These services included:1,104 Babies delivered1,463 Surgeries performed31,396 Patient days The following Outpatient services that were provided to all our patients. These services included:34,277 Emergency department visits1,221 Outpatient Surgeries performed61,540 Outpatient visits 23,252, Clinic visitsAHCS 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 2018 was $2,175,026.Adventist Healths mission statement of Living Gods love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry as represented by the life of Jesus Christ and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs and inner cities we serve, we continue our journey to provide quality healthcare until every person made in Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 141557210 true true false true false false false false false true true false false true true false false true false false false false false false true false true true false false true false false false false false false false false false false false false false false false true true false false false true 0 0 true 1229 true true true false false false false true true false 0 false false false false false false false false false false false false X 12 10 false false false false true true true true true false false true true true true true true true true true true HI X Jay Lipps 9164061092 PO Box 619135 Roseville CA 95661 X Banks David Director 0.00 4.00 X 0 27160 0 Cherry Robert Director 0.00 4.00 X 0 25126 0 Davis Andrew Director 0.00 4.00 X 0 24002 0 Freedman John Director 0.00 4.00 X 0 718 0 Gabriel Melody Dir Thru 12/18 0.00 4.00 X 0 20464 0 Graham Ricardo Director 0.00 4.00 X 0 1442 0 Heinrich Kerry Director 0.00 4.00 X 0 20485 0 Innocent Larry Director 0.00 4.00 X 0 31885 0 Pedersen James Dir Thru 7/18 0.00 4.00 X 0 3625 0 Reiner Richard Director 0.00 4.00 X 0 27964 0 Rippey Wesley Dir Thru 5/18 0.00 50.00 X 0 623943 47568 Salazar Velino Director 0.00 4.00 X 0 1542 0 Reiner Scott Dir/Chair 0.00 50.00 X X 0 2458436 44472 Wing Bill Dir/VCh/AsstSec 0.00 50.00 X X 0 1875310 49315 Jobe Meredith Secretary 0.00 50.00 X 0 666515 38328 Wagner Jack A Sec Thru 3/18 0.00 50.00 X 0 1332907 34076 Raethel Kathryn President 50.00 0.00 X 0 2528850 19042 Thordarson Heidar Treasurer 50.00 0.00 X 0 285313 16375 Newmeyer Joyce President, PNR 12.50 37.50 X 0 1166598 42409 Welch Donald Finance Officer, PNR 12.50 37.50 X 0 671125 44290 Cheung Alan VP Medical Affairs 50.00 0.00 X 0 251126 0 Reppert Joseph CFO 0.00 50.00 X 0 953615 46846 Westphal Laura Patient Care Exec 50.00 0.00 X 0 318742 17935 Clegg Travis VP Operations 50.00 0.00 X 0 329771 17894 Tsai Joseph Physician 50.00 0.00 X 291885 0 372 Yong Clara Physician 50.00 0.00 X 284316 0 15967 Keller Howard Physician 50.00 0.00 X 268939 0 16060 Schlacter Marc Physician 50.00 0.00 X 227906 0 13768 Wilson Maria Physician 50.00 0.00 X 219413 0 8393 Roney Benjamin Former MD 0.00 50.00 X 0 210194 12078 1292459 13856858 485188 5 true true false Hawaiian Dredging Constr PO Box 4088 Honolulu HI 96812 Construction Svces 2991438 Inpatient Medicine Services PO BOX 22562 Honolulu HI 96823 Physican Services 1509504 Glenn PK Akiona DBA GAAS LLC 301 Malaai Rd Hilo HI 96820 Anesthesiology Svcs 1094126 Fresenius Medical Care PO Box 749959 Los Angeles CA 90074 Hemodialysis Service 875161 Diagnostic Laboratory Services 99-859 Iwaiwa St Aiea HI 96744 Lab Services 785203 214 55500 10000 939360 1004860 Child care 624410 568157 568157 Dietary 900099 471388 471388 Other revenue 900099 889282 889282 Patient service revenue 621110 168420373 168420373 Rental income 531190 4047924 4047924 90000 90000 174487124 2403452 2403452 0 0 0 1525989 1525989 1525989 1525989 52660 55500 25621 27039 27039 0 63660 92551 -28891 -28891 0 179419573 176013113 2401600 69112 69112 0 0 0 0 0 62686326 59029446 3656880 2418770 2303528 115242 9490574 8794830 695744 4571795 4361254 210541 8166170 101035 8065135 98434 98434 506 506 0 0 0 9342907 8411041 931866 604927 604927 1298544 862754 435790 7460722 1638845 5821877 0 7411057 6766235 644822 392025 198094 193931 0 66814 60776 6038 1250441 1059373 191068 0 6834516 6823630 10886 92465 92465 Pt Care Supplies 31078406 31020569 57837 Revenue Cycle Fees 8091356 -65513 8156869 Quality Assurance 4485516 4485516 Purchased Services 3296960 2675096 621864 3087580 2869124 218456 172295923 141557210 30738713 0 202018 21851 99555700 104883987 69143 137721 23511875 22485276 0 0 0 3319149 2738746 489843 581064 224736032 111166209 115032863 113569823 10380630 12460040 0 6850086 6320192 0 16336732 24546637 275748039 287745337 18085879 16254978 145554 24224 80484114 86408507 98715547 102687709 X 171595005 182396019 5437487 2661609 177032492 185057628 275748039 287745337 X 7123650 901486 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 8993 8993 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures were also paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. 5519910 1047178 336258 5040289 1863057 7222255 231143 158762 2092250 5519910 6631562 1172425 95798 677530 7222255 4501763 2615477 -148137 337541 6631562 4350738 974793 1265906 2089674 4501763 0.03000 0.97000 false false false 27840806 27840806 329073 131170089 80427637 51071525 7000 924248 521370 409878 33194632 26462184 6732448 31270184 3755018 27515166 113569823 Castle ASC 725440 C Cancer Center LLC 6363839 C Castle Health Group -43647 C Interest in consolidated orgs 1496416 Other Assets 396912 Other receivables 229308 Receivable from 3rd party 746665 Receivable from related orgs 21677336 24546637 Annuities Payable 1476203 Deferred Workers Comp 1344626 Other Liabilities 1256797 Payable to Rel Orgs 82330881 86408507 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. X X X X X false Golf Tournament 108160 55500 52660 8125 7496 10000 108160 55500 52660 8125 7496 10000 25621 27039 true true X true X true X true true true false true true 1804082 1804082 0.01050 35789546 29343486 6446060 0.03740 37593628 29343486 8250142 0.04790 732485 28360 704125 0.00410 362046 362046 0.00210 2916694 1814269 1102425 0.00640 6430 6430 4017655 1842629 2175026 0.01260 41611283 31186115 10425168 0.06050 true 32084135 31019749 1064386 X true true Castle Ambulatory Surgery Outpatient surgery center 0.66415 0.33585 The Cancer Center of Hawaii Outpatient cancer center 0.25000 0.30000 1 1 Castle Medical Center 640 Ulukahiki St Kailua HI 96734 adventisthealth.org/castle 120006 X X X 1 Castle Medical Center 1 false false true X X X X X X X X X 16 true true true true X See Sch H Part VI - Needs Assessment X true 18 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X true true X X X X true X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X X X X X X true X false X X X X true X false false Facility: Castle Medical Center - Part V, Section B, Line 5 The 2016 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.Quantitative data gathering relied on secondary data, or data that has previously been collected. The main source for the secondary data is Hawaii Health Matters, a publicly available data platform that is maintained by the Hawaii Department of Health, the Hawaii Health Data Warehouse, and Healthy Communities Institute. As of March 31, 2015, when the data was queried, there were over 500 health and health-related indicators on the Hawaii Health Matters dashboard, and 429 of those were available for this analysis for the state. In addition to indicators available on Hawaii Health Matters, indicators of preventable hospitalization rates were provided by Hawaii Health Information Corporation (HHIC). These Prevention Quality Indicators (PQI), defined by the Agency for Healthcare Research and Quality (AHRQ) to assess the quality of outpatient care, were included in secondary data scoring and provide further insight on the rate of preventable hospitalizations at a sub-county level. Unadjusted rates of admission due to any mental health condition are also presented as an assessment of the relative utilization of services among subpopulations. Finally, several health topic areas were supplemented with quantitative data collected from previously published reports. This additional content was not incorporated in secondary data scoring due to the limited number of comparisons possible, but is included in the narrative of our CHNA for context.Qualitative data gathering was accomplished by conducting key informant interviews. Fifteen key informants were interviewed for their knowledge about community health needs, barriers, strengths, and opportunities (including the needs for vulnerable and underserved populations as required by IRS regulations). In many cases, the vulnerable populations are defined by race/ethnic groups, and this assessment will place a special emphasis on these findings. Interview topics were not restricted to the health area for which a key informant was nominated. These key informants were individuals recognized for their knowledge of community health in one or more health areas, and were nominated and selected by the HAH Advisory Committee in September 2014. Facility: Castle Medical Center - Part V, Section B, Line 6a Fifteen Hawaii hospitals, located on all islands, participated in the CHNA project. These hospitals are:1-Castle Medical Center 2-Kahi Mohala Behavioral Health 3-Kaiser Permanente Medical Center 4-Kapi`olani Medical Center for Women & Children 5-Kuakini Medical Center 6-Molokai General Hospital 7-North Hawaii Community Hospital 8-Pali Momi Medical Center 9-Rehabilitation Hospital of the Pacific 10-Shriners Hospitals for Children - Honolulu 11-Straub Clinic & Hospital 12-The Queens Medical Center 13-The Queens Medical Center West Oahu 14-Wahiawa General Hospital 15-Wilcox Memorial Hospital Facility: Castle Medical Center - Part V, Section B, Line 11 Adventist Health Castle Medical Center identified the following areas of significant needs in the 2016 CHNA: diabetes and access to health care. The main goal was to improve the overall health and wellness of our communities through provision of services, community collaboration and innovation. Priority Need 1 - Diabetes - According to the Centers for Disease Control, by 2023 we will have 86,000 more people diagnosed with diabetes in Hawaii. This trend poses a tremendous economic burden on our state and community. Hawaiis greatest challenge continues to be the cultural perception that diabetes is an unchangeable, hereditary disease. A contributor to our problem is the wide misconception that medication will treat diabetes without the addition of lifestyle changes. The epidemic of pre-diabetes and diabetes in Hawaii now effects nearly 600,000 people or every 1 out of 3 people. Interventions:1. The Castle 5-week Self-Management Education Diabetes Program is continually evaluated, identifying opportunities to bring greater success to participants and the community in the fight against diabetes. In 2017, outreach efforts expanded to rural areas of North Shore Oahu in Laie and the addition of a nurse practitioner who is a certified diabetes educator serving as the inpatient liaison to help bridge the gap from inpatient to outpatient care. This bridge helps to prevent diabetes complications and readmissions. Community partners include an endocrinologist, patient advocate, and primary care physicians of Castle Health Group. Overall, our patients experience an average of a 15% improvement in A1C in 3 to 6 months. Number of community members served 1,180.2. Inpatient diabetes consultations were added to identify and build rapport with hospitalized patients with diabetes. The objective is to encourage outpatient education and healthy lifestyle behavior changes. Additionally, this serves as an opportunity to prevent diabetes complications and readmissions. As of December 2017, a Certified Diabetes Educator Nurse Practitioner was added to the program and she also services patients who are pre-diabetic. Number of community members served 68 visits per month.3. During 2017 the Wellness and Lifestyle Medicine Center provided inspiration, and behavior change skills to help participants build a healthy body, mind, and spirit through programs including tobacco cessation, fitness classes, nutrition counseling, cooking classes, and therapeutic massage. Number of community members served 1,359.4.Eight different types of fitness classes were offered throughout the year. Number of community members served 7,139.5.Ten Eat Well for Life wellness cooking classes were held. Number of community members served 238.Priority Need 2 - Access to Care - In 2017, Castle Medical Center employed 3 additional primary care providers, totaling 10 primary care providers to expand access of care on the Windward side which contributed to reaching 1,600 new patients. In addition, Castle Health Group has expanded from 32 to 43 primary care providers and has extended its hours of service to include week day evenings and weekend hours. Castle Health Group has become the top performer in the state of Hawaii in quality outcome metrics, based on HEDIS (Health Effectiveness Data and Information) measures and community standards. Number of community members served 65,000.Priority Areas Not Addressed:The following 20 areas were identified as top health priority needs in our 2016 CHNA: access to health services, cancer, diabetes, disabilities, economy, education, environment, exercise, nutrition & weight, family planning, heart disease & stroke, immunizations & infectious diseases, injury prevention & safety, maternal, fetal & infant health, mental health & mental disorders, older adults & aging, oral health, respiratory diseases, social environment, substance abuse & lifestyle, and transportation.After investigating the twenty topic areas identified in the report, the CHNA committee followed an iterative process in which the focus was narrowed to increasingly fewer topics, each of which was investigated further to determine its fit with selection criteria. After internal discussion and consultation with community stakeholders, our CHNA committee chose diabetes and access to health care as our top community needs.Other Community Benefits:Substance Abuse was also identified as a health priority need in the 2016 CHNA. Although Castle Medical Center chose to concentrate on the above listed needs, we recognize the importance of smoking on the health of our community. Through a Hawaii Community Foundation Gran, outpatient tobacco counseling was provided to primarily low income, low education or unemployed community members. These are vulnerable groups who have a higher tobacco use prevalence and may face additional barriers to quitting tobacco. As appropriate, these people were provided with grant-funded treatment medications. Additionally, a tobacco support group was created and 71 encounters were provided. Number of community members served: 162Castle Health Group Primary Care Physicians also screened every patient to ask about their smoking status during visits. Smokers were identified and referred to smoking cessation counseling. Number of community members served: 65,000. Castle Professional Center Surgical Weight Loss Institute Ch 46-001 Kamehameha Highway Kaneohe HI 96744 Surgical Weight Loss Institute Child Development Center Kaneohe Radiology 46-001 Kamehameha Highway Suite 104 Kaneohe HI 96744 Radiology Laboratory Services 46-001 Kamehameha Highway Suite 104 Kaneohe HI 96744 Laboratory Services Castle Performance & Rehabilitation Center-Kaneohe 46-001 Kamehameha Highway Suite 301 Kaneohe HI 96744 Physical Therapy Castle Professional Center Pharmacy 46-001 Kamehameha Highway Suite 108 Kaneohe HI 96744 Pharmacy Castle Primary Care of Kaneohe 46-001 Kamehameha Hwy Suite 301 Kaneohe HI 96744 Primary Care Koolau Pharmacy 642 Ulukahiki Street Suite 101 Kailua HI 96734 Retail Pharmacy Wellness and Lifestyle Medicine 642 Ulukahiki Street Suite 105 Kailua HI 96734 Wellness Center Windward Surgery Center 642 Ulukahiki Street Suite 200 Kailua HI 96734 Out Patient Surgery Center Castle Primary Care of Kailua 30 Aulike Street Suite 501 Kailua HI 96734 Primary Care Castle Primary Care of Laie 55-510 Kamehameha Hwy Laie HI 96762 Rural Health Clinic Castle Primary Care of Kailua-2 30 Auliki St Ste 303 Kailua HI 96734 Primary Care Castle Performance & Rehabilitation Center-Kailua 640 Ulukahiki St Kailua HI 96734 Physical Therapy Part I, Line 7 - Explanation of Costing Methodology The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide 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 charges Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. 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 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.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue $32,084,135Prior Year Settlements 70,227Cost Report Reimbursable Bad Debts 113,383Estimates and Accrual Variances 81,641Other (2,023,425) ___________Total Medicare Revenue $30,325,961*Note: The Medicare Cost Report Revenue includes the patient co-pay and deductible amounts, but not the bad-debt reimbursement. Adding the bad-debt reimbursement would have duplicated the revenue and deductible amounts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency: 1. They may not report the patient to a credit bureau 2. They may not file a lawsuit to recover the outstanding liability 3. They may not charge interest Part VI, Line 2 - Needs Assessment The hospital's 2016 CHNA, the 2017 Community Health Plan (CHP) Update/Annual Report, and the 2016 Implementation Strategy (adopted in May 2017), known as the 2017 Community Health Plan (Implementation Strategy) & 2016 Update/Annual Report, are posted on the hospital's website at https://www.adventisthealth.org/castle/about-us/community-benefit/. The CHNA, Implementation Strategy, and the CHPs are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.Hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Committee/Board Participation includes: Aloha Care, Aloha United Way, Boys and Girls Club of Hawaii, Care Resource Hawaii, Hawaii Nutrition and Physical Activity Coalition, Hawaii Independent Physicians Association, Hawaii Medical Service Association, Hawaii Primary Care Association, Healthy Hawaii Initiative, Tobacco Settlement Project, Mental Health America of Hawaii, Parkinsons Disease Foundation, and University of Hawaii Cancer Center. Part VI, Line 3 - Patient Education of Eligibility for Assistance The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospital's website at https://www.adventisthealth.org/castle/patient-resources/financial-assistance. These documents are available in multiple languages.At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. Part VI, Line 4 - Community Information The demographics of a community significantly impact its health profile. Different race/ethnic, age, and socioeconomic groups may have unique needs and require varied approaches to health improvement efforts. In 2016, Hawaiis population was approximately 1.4 million. As measured by the decennial Census,7 the population density in the state is much higher than the U.S. overall. Between 2010 and 2013, population growth was higher across all counties in Hawaii compared to the rest of the states. The race/ethnicity breakdown of Hawaii is also significantly different from the rest of the country. Almost one in four residents identifies as two or more races, which is much more than in the U.S. overall. Within Hawaii in 2013, 25.7% of the population identified as any part Native Hawaiian or Pacific Islander, 55.8% as any part Asian, and 42.5% as any part White. The population reporting as White only made up 25.6% of the population, compared to 73.7% of the nation. Black/African American, Hispanic/Latino, and Other race/ethnicity groups are also much smaller than the U.S. overall.The population of Windward Oahu is 131,886, and comprises households with very diverse income levels. While there is low anticipated growth in the primary service area, the median age of the population is predicted to rise (current median age is 37.2). There are two large centers of Native Hawaiian populations with unique social and health needs. Health issues for this population include higher incidence rates for digestive and lung/liver cancers, higher prevalence of obesity, diabetes and heart disease. Kailua (50,746) and Kaneohe (54,247) are the primary population centers, with smaller centers spread throughout the Primary Service Area. The more distant areas of Waimanalo and Koolauloa (northern Windward Oahu) include a higher percentage of Native Hawaiians. The areas of Kailua, Kaneohe, and Kaaawa have a high median income, whereas Waimanalo and most of Koolauloa have a significantly lower median income. Part VI, Line 4 - Community Building Activities The hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. 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. Health education, diet and lifestyle are keys to community health. CMC works to improve access to and understanding of all three. Our community wellness center offers a variety of free seminars and paid classes in cooking, nutrition, exercise, diabetes and more. Our Bistro offers a healthy vegetarian diet and is rated highly on Yelp and a place to go for lunch. CMC sponsors healthy living for its employees and the community with activities, community fairs and community outreach. In addition, CMC provided $15.8 Million for community development through free and low cost care, community events and donations. These activities are not included elsewhere on Schedule H. Part VI, Line 5 - Promotion of Community Health Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the triple aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6 - Affilated Health Care System The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area 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. X true true X X X X true true false false false false false false false false Cheung Alan VP Medical Affairs 251126 251126 Clegg Travis VP Operations 263393 51702 14676 16682 1212 347665 Jobe Meredith Secretary 419684 111013 135918 16682 21646 704943 Keller Howard Physician 232681 36258 16041 19 284999 Newmeyer Joyce President, PNR 657199 294310 215089 16682 25727 1209007 Raethel Kathryn President 431687 174290 1922874 16682 2360 2547893 Reiner Scott Dir/Chair 1339257 747881 371298 16682 27790 2502908 Reppert Joseph CFO 686470 152446 114699 16682 30164 1000461 Rippey Wesley Dir Thru 5/18 565539 58404 20249 27319 671511 Roney Benjamin Former MD 206722 525 2947 12059 19 222272 Schlacter Marc Physician 198441 525 28940 13396 372 241674 Thordarson Heidar Treasurer 243317 19245 22752 15432 943 301689 Tsai Joseph Physician 223232 525 68128 372 292257 Wagner Jack A Sec Thru 3/18 180671 414342 737894 11182 22894 1366983 Welch Donald Finance Officer, PNR 398127 97502 175496 16682 27608 715415 Westphal Laura Patient Care Exec 241785 50989 25968 16682 1253 336677 Wilson Maria Physician 209080 525 9808 8374 19 227806 Wing Bill Dir/VCh/AsstSec 1015353 603273 256685 16682 32633 1924626 Yong Clara Physician 215417 63872 5027 15948 19 300283 Part I, Line 1a: Relevant information in regards to selections on 1a. Linda Henry Key EE Sister 59434 Employment false Brent Wagner Son of Officer 82281 Employment false Cambria Wehtje-Sim Dghtr-Fmr Ofcr 89784 Employment false Carol Jobe Officer's Spouse 4429 Employment false Schedule L, Part V Supplemental Information Additional information regarding interested persons listed above:1. Linda Henry is the daughter of Adventist Health board member, Wesley Rippey.2. Brent Wagner is the son of former Adventist Health CFO, Jack Wagner.3. Cambria Wehtje-Sim is the daughter of former officer Rodney Wehtje.4. Carol Jobe is the wife of Meredith Jobe, an officer of Adventist Health. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit public charity. The hospital bylaws define its board of directors to be the same individuals who are members of Adventist Health System/West board of directors. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body The hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors.Part VI, Line 7bThe sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 11b: Form 990 Review Process This Form 990, including all supporting schedules, was prepared by a public accounting firm, reviewed by the System Controller and market Finance Officer, and shared by electronic communication with the corporation's Board of Directors prior to filing. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaireis sent to board members, hospital officers, key employees and department directorsfor completion and signature. The questionnaire is accompanied by a letter ofexplanation, to illustrate examples of a conflict and to remind the recipient thatif any perceived conflict should arise before the next annual questionnaire, he/sheis to notify the CEO immediately.The Corporate General Counsel distributes, collects, and reviews for signatures theCOIs for all applicable Corporate employees and the board. In addition, thehospitals administration is responsible for keeping record to ensure allhospital-based individuals with director and above positions have submitted theirCOIs. The Corporate General Counsel reviews all the disclosures on the board andCorporate employees COIs. Corporate General Counsel retains the COIs for the boardmembers. The officers and key employees COIs are kept in their personnel files.Further inquiries on any potential significant conflicts are made as needed.Conflicts are documented and reviewed with the Board. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to overseethe executive compensation program. This committee is composed of independentdirectors with no conflicts of interest. The committee performs the followingfunctions: recommends a total compensation philosophy to the board; assurescompliance with the board-approved philosophy; meets annually to reviewcomparability data from outside consultants; recommends any adjustments to currentexecutive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annualgoals; recommends appropriate incentive awards to the board for approval; follows adiligent process that meets regulatory requirements for a rebuttable presumption ofreasonableness; records committee deliberations and decisions in timely minutes;selects, engages and supervises any consultant hired to advise and providecomparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs 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 CEO has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital. (Incentive potential is industry norm) Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy publicly available. The hospital files annual summary financial reports with the state health-planning agency. Other Changes In Net Assets Or Fund Balances - Other Decreases Beginning of Year NA Adj = -$511044 Other Changes In Net Assets Or Fund Balances - Other Increases Change in Value JV adj = $92166 Other Changes In Net Assets Or Fund Balances - Other Increases Change in Value JV = $411932 Other Changes In Net Assets Or Fund Balances - Other Increases Change in Value of Planned Giving = $336258 Other Changes In Net Assets Or Fund Balances - Other Increases Unrealized Gain on Investments = $572174 Crestview Property LLC 640 Ulukahiki St Kailua HI 96734 050574476 Real propety holding HI N/A Adventist Health SystemWest PO Box 619135 Roseville CA 95661 953484589 Integrated Health System CA 501(c)(3) 10 NA false Adventist Health Clearlake Hospital Inc 15630 18th Ave Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventish Health Medical Center-Tehachap 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Physicians Network PO Box 619135 Roseville CA 95661 680357690 Hospital CA 501(c)(3) 12b2 Adventist Health SystemWest false Adventist Health So CA Medical Fdtn PO Box 619135 Roseville CA 95661 954424391 Discontinued Operations CA 501(c)(3) 12b2 Adventist Health SystemWest false Feather River Hospital PO Box 619135 Roseville CA 95661 941101228 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Fremont- Rideout Health Group 898 Plumas Street Yuba City CA 95991 942917251 Acute Care Hospital CA 501(c)(3) 12b2 Adventist Health SystemWest false Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Lodi Memorial Hospital Assn Inc 975 So Fairmont Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Northwest Medical Fdtn of Tillamook 1000 Third Street Tillamook OR 97141 956064971 93-0622075 OR 501(c)(3) 3 Adventist Health SystemWest false Paradise Valley Hospital PO Box 619135 Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) 1 Adventist Health SystemWest false Reedley Community Hospital 372 Cypress Ave Reedley CA 95370 453220509 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Rideout Memorial Hospital 989 Plumas Street Yuba City CA 95991 941387866 Acute Care Hospital CA 501(c)(3) 3 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Simi Valley Hospital & Health Care Svc 2975 No Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Stone Point Health PO Box 619135 Roseville CA 95661 823763347 Supporting Organization CA 501(c)(3) 12b2 Adventist Health SystemWest false Ukiah Adventist HospitalAdventist Health 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false United Com-Serve 989 Plumas Street Yuba City CA 95991 943015356 Skilled Nursing/Assisted Living/Hm Care CA 501(c)(3) 12b2 Adventist Health SystemWest false Western Health Resources PO Box 619135 Roseville CA 95661 953867863 Home Care CA 501(c)(3) 10 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(C)(3) 3 Adventist Health SystemWest false Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(C)(3) 3 Adventist Health SystemWest false Walla Walla General Hospital PO Box 619135 Roseville CA 95661 910617726 Hospital WA 501(c)(3) 3 Advenstist Health System West false Castle Ambulatory Surgery Center 640 Ulukahiki St Kailua HI 96734 261390010 OP Surg Cnt HI NA 227079 1147943 false false 0.66415 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037297 Wind down after sale of hospital CA N/A C Corp false false false false false true false false false false false false false false false false true true false false