2019-11-14T14:49:09-06:00 2018-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2018-01-01 953484589 Adventist Health SystemWest ADVE 9164060000 PO Box 619135 Roseville CA 95661 Bill Wing Chief Financial Officer 9164060000 2019-11-10 1 Tracy S Paglia P00366884 2099556100 2019-11-10 12.129.4.210 2019-11-10 15:29:04 PS P F565611BDA9E00D03FA055086BAA92DB14EC1355 2CA4604677747A1B8287DC7DD1B2F222DAF5CAE3 2018 2020-04-17 16:48:07Z X Adventist Health Scott Reiner PO Box 619135 Roseville CA 95661 403095376 0 1071 X www.adventisthealth.org/ X 1980 CA Living God's love by inspiring health, wholeness and hope. 12 10 2002 0 6626269 1461897 96561 21065390 266072501 245806456 37623779 16485256 1700332 1387050 305493173 284744152 519657 7664910 0 0 173221246 223802819 0 0 0 198402859 144152789 372143762 375620518 -66650589 -90876366 2097917902 1914161010 2146305706 2091389972 -48387804 -177228962 X Living God's love by inspiring health, wholeness and hope. 0 0 110949678 7664910 245806456 See Schedule O 110949678 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 1 1 1 0 0 1 2890 0 1 2002 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X Jay Lipps VP System Controller 9167465932 PO Box 619135 Roseville CA 95661 X Banks David Director 4.00 0.00 X 27620 0 0 Cherry Robert Director 4.00 0.00 X 25126 0 0 Davis Andrew Director 4.00 0.00 X 24002 0 0 Freedman John Director/Vice Chair 4.00 0.00 X 718 0 0 Gabriel Melody Director thru 12/2018 4.00 0.00 X 20464 0 0 Graham Ricardo Director/Chair 4.00 0.00 X 1442 0 0 Heinrich Kerry Director 4.00 0.00 X 20485 0 0 Innocent Larry Director 4.00 0.00 X 31885 0 0 Pedersen James Director thru 07/2018 4.00 0.00 X 3625 0 0 Reiner Richard Director 4.00 0.00 X 27964 0 0 Reiner Scott CEO 50.00 0.00 X X 2458436 0 44472 Rippey Wesley Director thru 05/2018 50.00 0.00 X 623943 0 47568 Salazar Velino Director 4.00 0.00 X 1542 0 0 Wing Bill Director/President 50.00 0.00 X X 1875311 0 49315 Jobe Meredith Secretary 50.00 0.00 X 666615 0 38328 Reppert Joseph CFO/Asst Secr 50.00 0.00 X 953615 0 46846 Wagner Jack CFO/Asst Secr thru 03/2018 50.00 0.00 X 1332908 0 34076 Ashlock Mark SR VP Physician Strategy 50.00 0.00 X 1287879 0 38328 Asmar Hoda SR VP CCO 50.00 0.00 X 966689 0 202 Bancarz Gloria VP/CNO 50.00 0.00 X 733406 0 27770 Beaman John VP Finance/SFO 50.00 0.00 X 870039 0 49956 Beehler Robert VP Mkt Dev, M&A 50.00 0.00 X 727250 0 37750 Church Lowell VP Material Management 50.00 0.00 X 467398 0 38035 Conklin Jeffrey VP/Pres Managed Care 50.00 0.00 X 855173 0 51458 Dickinson Chip VP Business Solutions 50.00 0.00 X 610348 0 41645 Eller Jeff SR VP/Pres, NCR 0.00 50.00 X 1176550 0 38127 Ferch Wayne SR VP/Pres, CCR 0.00 50.00 X 1232626 0 21068 Fink Matthew CIO 50.00 0.00 X 566840 0 41549 Gordon Daniel VP Financial SRVS 50.00 0.00 X 523670 0 1102151 Gustin John VP Facilities, Const, RE 50.00 0.00 X 520317 0 38064 Jakobsen Dag VP/COO, AHPS 0.00 50.00 X 726260 0 27595 Marchuk Robert VP Ancillary Services 50.00 0.00 X 475837 0 46588 Newmyer Joyce SR VP/Pres, PNR 0.00 50.00 X 1166598 0 42409 Olson JoAline SR VP/CHPIO 50.00 0.00 X 1114993 0 40827 Tetz Doris VP Talent & Strategy 50.00 0.00 X 509317 0 37629 Wilson Kathleen VP Benefits Admin 50.00 0.00 X 523329 0 27477 Zachary Beth President, SCR thru 01/2018 0.00 50.00 X 1310580 0 42365 Knittel Monty President, AHFR thru 09/2018 0.00 50.00 X 1914874 0 38363 Nahapetian Arby Region Medical Officer, SCR 0.00 50.00 X 966535 0 51169 Raethel Kathryn President, AHCS 0.00 50.00 X 2528851 0 19042 Raffoul John Former President, WMMC 0.00 50.00 X 842389 0 442687 Chilton Harold Interim Pres, AHFR 0.00 50.00 X 612398 0 38665 Doram Keith Former VP Clin Effectiveness 0.00 0.00 X 247279 0 10334 Erich Kevin Former Interim Executive, AHHM 0.00 0.00 X 1799057 0 0 McKague Kirby Former VP/CFO AHPN 0.00 0.00 X 367672 0 19488 Russell Thomas Former VP POP Hlth Innov 0.00 0.00 X 2074545 0 0 Soderblom Alan Former VP/CIO 0.00 0.00 X 205398 0 12413 36019798 0 2683759 550 1 1 0 Swinerton Builders 15 Business Park Way Suite 101 Sacramento CA 95828 Construction 60943933 Cerner Corporation 2800 Rockcreek Parkway Kansas City MO 64117 IT Solutions Management 35367007 Deloitte Consulting LLP 980 9th Street Suite 1800 Sacramento CA 95814 Healthcare Consulting 8397241 Brown Parker & Damarinis 620 Newport Center Drive Newport Beach CA 92660 Healthcare Marketing 4450891 Quest Media & Supplies Inc 5822 Roseville Road Sacramento CA 95842 Contract Labor 3270252 120 13753838 7311552 21065390 Management fees 900099 224526158 219270926 5255232 Partnership income related progra 541900 19055126 18440620 614506 Other program service rev 900099 2225172 2225172 245806456 2382685 2382685 246772 246772 72000 0 72000 72000 72000 132206474 118350675 13855799 13855799 13855799 5000 0 5000 5000 475 549 -74 -74 Clinical engineering 811000 756531 756531 Miscellaneous revenue 900099 553593 553593 1310124 284744152 239936718 6626269 17115775 X 5279535 5279535 2385375 2385375 22102730 22102730 827704 827704 157300280 35284297 122015983 12086154 5406153 6680001 20914254 5395705 15518549 10571697 2140283 8431414 131339 -3991 135330 6681475 6681475 2371446 2371446 100763 100763 67524415 15731574 51792841 1622779 1622779 7043847 2146985 4896862 19552968 14278906 5274062 15616520 14658428 958092 5918403 1642557 4275846 891714 206274 685440 13372772 13372600 172 24681034 18042877 6638157 323964 321006 2958 Rental/lease costs equi 927153 322251 604902 Income taxes 692878 497227 195651 Quality assurance fee 516 516 Patient care supplies -25745245 -26595980 850735 2444048 -490851 2934899 375620518 110949678 264670840 0 1700 23391 31010593 250105247 12396893 56142 2564720 38199866 9634156 21035061 30188611 35291801 494668765 202705699 221048607 291963066 946091525 1239166048 59471656 4501715 7451447 781007726 30868941 2097917902 1914161010 243669918 261012245 6042 0 1097361144 1159038461 652268429 163555928 153000173 507783338 2146305706 2091389972 X -48461604 -182485199 73800 5256237 -48387804 -177228962 2097917902 1914161010 -90876366 -53578391 15613599 0 X 0 1 X 1 0 X 49080 100 50000 96561 7311552 7507293 279705645 293372514 289039507 263827180 241640379 1367585225 279754725 293372614 289089507 263923741 248951931 1375092518 6349290 4259278 6178041 16786609 0 6349290 4259278 6178041 16786609 1358305909 45621779 50242418 57028162 8329768 2629457 163851584 45621779 50242418 57028162 8329768 2629457 163851584 400179 549535 272887 517858 786186 2526645 2100 1650159 1997795 660599 4310653 325778783 345814726 348388351 272771367 253028173 1545781400 0.87870 0.10600 X Schedule A, Part III, Line 12, Explanation of Other Income: Settlement proceeds Gain on debt refinancing Miscellaneous revenue RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 100763 100763 0 Part II-B, Line 1: Adventist Health engages lobbyists and belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. 1146338 7277972 -3327136 2090865 3006309 1131235 96561 18082 94541 4999 1146338 1114944 50000 21830 55539 1131235 1140516 100 26705 52377 1114944 1103082 49080 28237 39883 1140516 0.00000 0.00000 1.00000 0 0 34937638 34937638 8038289 6522130 1516159 2920816 3162646 -241830 316642834 193020923 123621911 132129188 132129188 291963066 Payables to related organizations 376052386 Other liabilities 128789963 Workers' compensation liability 2702033 Payables to third party - HMO/PPO 238956 507783338 Part V, Line 4: A $1M board-designated fund was established to honor a former AH president. The earnings are used to provide funding for paying college student interns and graduate student residents as they participate in tracks such as accounting/finance, human resources, communications and management with the goal of introducing the participants to career options in the integrated health care field. Individuals who participate in the program frequently become employed within the AH system upon completion of their academic studies. Central America and the Caribbean 0 0 Investments in region 150000 Central America and the Caribbean 0 0 Program services Reinsurance 1204763 Central America and the Caribbean 0 0 Investments in region Legal fees 61900 Sub-Saharan Africa 0 0 Program services Mission trip 15000 0 0 0 0 0 0 1431663 0 1431663 1 0 1 0 0 0 1 Adventist Health System (FL) 900 Hope Way Altamonte FL 32714 590724459 501(c)(3) 24890 Materials and labor for NAD healthcare wall Affordable Housing Now 1787 Tribute Road Suite K Sacramento CA 95815 824179512 501(c)(4) 50000 General support AH St Helena Hospital Foundation 10 Woodland Road St Helena CA 94574 201384250 501(c)(3) 2000000 Capital matching Auburn Renewal Center 12225 Rock Creek Road Auburn CA 95602 680260677 501(c)(3) 35000 Grant funds Child Advocates of Placer County 3715 Atherton Road Rocklin CA 95765 770620948 501(c)(3) 45000 CASA grant funds Loma Linda University School Of Religion Centennial Complex 24760 Stewart Street Loma Linda CA 92350 951816009 501(c)(3) 13000 Mission leadership scholarship fund Maranatha Volunteers International Inc 990 Reserve Drive Suite 100 Roseville CA 95678 381945104 501(c)(3) 25050 Project funding National Hispanic Health Foundation 1920 L Street NW Suite 725 Washington DC 20036 260051920 501(c)(3) 10000 National Hispanic Health Professional student scholarship Pacific Union College One Angwin Avenue Angwin CA 94508 770578450 501(c)(3) 5756 Education grant (nursing and health sciences) and student scholarship Rideout Memorial Hospital 989 Plumas Street Yuba City CA 95991 941387866 501(c)(3) 3000000 General support Roseville Area Chamber of Commerce 650 Douglas Boulevard Roseville CA 95678 941079379 501(c)(6) 7789 2018 sponsorship Roseville Joint Union High School District 1750 Cirby Way Roseville CA 95661 Gov't 14000 Community impact grant Sacramento Adventist Academy 5601 Winding Way Carmichael CA 95608 941431179 501(c)(3) 31800 Education grant Seniors First Inc 12183 Locksley Lane Auburn CA 95602 680430154 501(c)(3) 7200 Camp Fire relief grant Yes for Healthcare (PAC) PO Box 42307 Portland OR 97242 503295185 527 10000 Educate the public on a ballot initiative to provide funding to Medicaid to expand health insurance coverage in Oregon 12 3 Camp Fire assistance 519 2385375 Part I, Line 2: Funding provided to other organizations is provided to recipients with the understanding that the funds are being used only for the designated purposes. No monitoring is conducted by AH. X X X X 1 1 X X X X 1 1 0 0 0 0 0 0 0 Reiner Scott CEO 1339257 0 747881 0 371298 0 16682 0 27790 0 2502908 0 289242 0 Rippey Wesley Director thru 05/2018 565539 0 0 0 58404 0 20249 0 27319 0 671511 0 0 0 Wing Bill Director/President 1015353 0 603273 0 256685 0 16682 0 32633 0 1924626 0 191758 0 Jobe Meredith Secretary 419684 0 111013 0 135918 0 16682 0 21646 0 704943 0 59224 0 Reppert Joseph CFO/Asst Secr 686470 0 152446 0 114699 0 16682 0 30164 0 1000461 0 0 0 Wagner Jack CFO/Asst Secr thru 03/2018 180671 0 414342 0 737895 0 11182 0 22894 0 1366984 0 0 0 Ashlock Mark SR VP Physician Strategy 716157 0 375988 0 195734 0 16682 0 21646 0 1326207 0 132855 0 Asmar Hoda SR VP CCO 543617 0 132022 0 291050 0 0 0 202 0 966891 0 0 0 Bancarz Gloria VP/CNO 443451 0 129136 0 160819 0 16682 0 11088 0 761176 0 63339 0 Beaman John VP Finance/SFO 581502 0 192171 0 96366 0 11182 0 38774 0 919995 0 68945 0 Beehler Robert VP Mkt Dev, M&A 456139 0 112269 0 158842 0 16682 0 21068 0 765000 0 61063 0 Church Lowell VP Material Management 320485 0 88412 0 58501 0 16682 0 21353 0 505433 0 0 0 Conklin Jeffrey VP/Pres Managed Care 498012 0 152446 0 204715 0 16682 0 34776 0 906631 0 78186 0 Dickinson Chip VP Business Solutions 415021 0 111058 0 84269 0 18296 0 23349 0 651993 0 32341 0 Eller Jeff SR VP/Pres, NCR 699892 0 344777 0 131881 0 16682 0 21445 0 1214677 0 118827 0 Ferch Wayne SR VP/Pres, CCR 740094 0 327200 0 165332 0 0 0 21068 0 1253694 0 140584 0 Fink Matthew CIO 433358 0 77659 0 55823 0 16682 0 24867 0 608389 0 0 0 Gordon Daniel VP Financial SRVS 64099 0 86363 0 373208 0 1098599 0 3552 0 1625821 0 39298 0 Gustin John VP Facilities, Const, RE 329785 0 88254 0 102278 0 16682 0 21382 0 558381 0 39296 0 Jakobsen Dag VP/COO, AHPS 416068 0 116093 0 194099 0 16682 0 10913 0 753855 0 84066 0 Marchuk Robert VP Ancillary Services 257697 0 81739 0 136401 0 16682 0 29906 0 522425 0 32007 0 Newmyer Joyce SR VP/Pres, PNR 657199 0 294310 0 215089 0 16682 0 25727 0 1209007 0 115201 0 Olson JoAline SR VP/CHPIO 616955 0 311474 0 186564 0 16682 0 24145 0 1155820 0 122565 0 Tetz Doris VP Talent & Strategy 308080 0 81030 0 120207 0 16682 0 20947 0 546946 0 42519 0 Wilson Kathleen VP Benefits Admin 307220 0 84753 0 131356 0 16682 0 10795 0 550806 0 54511 0 Zachary Beth President, SCR thru 01/2018 191195 0 270398 0 848987 0 16682 0 25683 0 1352945 0 155882 0 Knittel Monty President, AHFR thru 09/2018 302514 0 132920 0 1479440 0 16682 0 21681 0 1953237 0 57600 0 Nahapetian Arby Region Medical Officer, SCR 557553 0 165709 0 243273 0 16682 0 34487 0 1017704 0 108840 0 Raethel Kathryn President, AHCS 431687 0 174290 0 1922874 0 16682 0 2360 0 2547893 0 139514 0 Raffoul John Former President, WMMC 469321 0 176246 0 196822 0 419155 0 23532 0 1285076 0 73717 0 Chilton Harold Interim Pres, AHFR 367529 0 71750 0 173119 0 16682 0 21983 0 651063 0 53306 0 Doram Keith Former VP Clin Effectiveness 47046 0 0 0 200233 0 0 0 10334 0 257613 0 0 0 Erich Kevin Former Interim Executive, AHHM 0 0 0 0 1799057 0 0 0 0 0 1799057 0 56592 0 McKague Kirby Former VP/CFO AHPN 28053 0 0 0 339619 0 0 0 19488 0 387160 0 0 0 Russell Thomas Former VP POP Hlth Innov 0 0 0 0 2074545 0 0 0 0 0 2074545 0 149476 0 Soderblom Alan Former VP/CIO 13125 0 0 0 192273 0 0 0 12413 0 217811 0 2489 0 Part I, Line 1a All items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. 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. Doram, Keith - severance payment - $188,825 Gordon, Daniel - severance payment - $248,953 Knittel, Monty - severance payment - $92,646 Marchuk, Robert - severance payment - $47,750 McKague, Kirby - severance payment - $336,631 Soderblom, Alan - severance payment - $157,500 Wagner, Jack - severance payment - $598,810 Zachary, Beth - severance payment - $633,692 The Supplemental Executive Retirement Plan (SERP) is a defined contribution plan designed to encourage the participants continued employment with Adventist Health and is subject to the participants satisfying specified substantial risks of forfeiture. The SERP benefit distribution occurs when the executive achieves 30 years of Adventist health care service, 20 of which are to be as an executive and at least 10 are to be with Adventist Health System/West, and reaches age 60. Until that time, the SERP benefit is at risk to the creditors of Adventist Health. The SERP benefit is designed to help the executive receive employer-provided retirement benefit income equal to 60% of pre-retirement income. The SERP plan was frozen for new participants in 2016. Erich, Kevin - Distribution - $1,742,465 Gordon, Dan - Distribution - $31,450 Gordon, Dan - Funding - $1,088,301 Knittel, Monty - Distribution - $1,257,714 Raethel, Kathryn - Distribution - $1,675,365 Raffoul, John - Funding - $402,473 Russell, Thomas - Distribution - $1,925,069 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. Ashlock, Mark - $132,855 Bancarz, Gloria - $63,339 Beaman, John - $68,945 Beehler, Robert - $61,063 Chilton, Harold - $53,306 Conklin, Jeffrey - $78,186 Dickinson, Charles - $32,341 Doram, Keith - $3,457 Eller, Jeff - $118,827 Erich, Kevin - $56,592 Ferch, Wayne - $140,584 Gordon, Daniel - $39,298 Gustin, John - $39,296 Jakobsen, Dag - $84,066 Jobe, Meredith - $59,224 Knittel, Monty - $57,600 Marchuk, Robert - $32,007 Nahapetian, Arby - $108,840 Newmyer, Joyce - $115,201 Olson, JoAline - $122,565 Raethel, Kathryn - $139,514 Raffoul, John - $73,717 Reiner, Scott - $289,242 Russell, Thomas - $149,476 Soderblom, Alan - $2,489 Tetz, Doris - $42,519 Wilson, Kathleen - $54,511 Wing, Bill - $191,758 Zachary, Beth - $155,882 A CSCDA Series A 2007 680164610 1307957C5 2007-05-08 57500000 See Part VI 0 0 0 B CHFFA Series B 2009 521643828 13033LBC0 2009-05-20 30000000 See Part VI 0 0 0 C CHFFA Series C 2009 521643828 13033F8B9 2009-05-20 56309648 See Part VI 0 0 0 D HFA Multnomah 2009 931266280 62551PBS5 2009-09-30 66147216 See Part VI 0 0 0 A 1425000 57140625 3909625 643910 1409177 50966616 2010 0 0 1 1 B 30000000 299917 29699958 2009 0 0 1 1 C 50495000 61940613 1212236 55750607 2009 1 0 1 1 D 66147216 6094359 886660 59011989 2009 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 0 0 0 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer Name: CHFFA Series B 2009 Date the Rebate Computation was Performed: 07/31/2014 Issuer Name: HFA Multnomah 2009 Date the Rebate Computation was Performed: 11/10/2014 Issuer Name: CHFFA Series C 2011 Date the Rebate Computation was Performed: 07/25/2016 Part I, Column (a) Issuer's Name: CSCDA - California Statewide Communities Development Authority CHFFA - California Health Facilities Financing Authority HFA - The Hospital Facilities Authority of Multnomah County, Oregon Entity 1, Part II, Line 7, Column A: Bond issued on 5/08/2007, CUSIP#1307957C5 - cost of issuance greater than estimated at the time of filing 8038. Schedule K, Part 1, Column (f), Line A: Construct, equip and remodel the following health care facilities: Feather River Hospital, Paradise, CA Hanford Community Hospital, Hanford, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Schedule K, Part 1, Column(f), Line B: Acquire, construct and equip the following health care facilities: Adventist Health Clearlake Hospital Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Schedule K, Part 1, Column (f), Line C: Refund outstanding balance of the following bond issues: 1991 California Health Facilities Financing Authority (AHS/West Series A) bonds issued July 23, 1991 1991 California Health Facilities Financing Authority (AHS/West Series B) bonds issued September 25, 1991 1991 City of Glendale (AHS/West Series A) bonds issued July 23, 1991 Schedule K, Part 1, Column (f), Line D: Refinance a bank loan used to construct, equip and improve: Adventist Medical Center - Portland, Portland, OR Schedule K (2nd), Part 1, Column (f), Line A: Acquire, construct and equip the following health care facilities: Adventist Health Clearlake Hospital Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA Schedule K (2nd), Part 1, Column (f), Line B: Refund outstanding balance of the following bond issues: 2002 California Health Facilities Financing Authority (AHS/West Series A) bonds issued March 20, 2002 2002 California Health Facilities Financing Authority (AHS/West Series B) bonds issued March 20, 2002 2003 California Health Facilities Financing Authority (AHS/West Series A) bonds issued July 1, 2003 Schedule K (2nd), Part 1, Column (f), Line C: Acquire, construct, and equip the following health care facilities: Central Valley General Hospital, Hanford, CA Feather River Hospital, Paradise, CA Hanford Community Hospital, Hanford, CA San Joaquin Community Hospital, Bakersfield, CA Ukiah Valley Hospital, Ukiah, CA Willits Hospital, Inc., Willits, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA Schedule K (2nd), Part 1, Column (f), Line D: Refund outstanding balance of the following bond issue: 2005 California Statewide Communities Development Authority (AHS/West Series A) bonds issued October 18, 2005 Schedule K (3rd), Part 1, Column (f), Line A: Acquire, construct and equip the following health care facilities: Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA Schedule K (3rd), Part 1, Column (f), Line A: 1998 California Health Facilities Financing Authority (AHS/West Series A) bonds issued February 18, 1998 2007 California Statewide Communities Development Authority (AHS/West Series B) bonds issued May 8, 2007 2007 California Statewide Communities Development Authority (Lodi) bonds issued December 13, 2007 2009 California Health Facilities Financing Authority (AHS/West Series A) bonds issued May 20, 2009 A CHFFA Series C 2011 521643828 000000000 2011-06-09 130000000 See Part VI 0 0 0 B CHFFA Series A 2013 521643828 13033LS65 2013-02-14 208420907 See Part VI 0 0 0 C CHFFA Series A 2013 521643828 13033LS57 2013-02-14 100741934 See Part VI 0 0 0 D CSCDA Series A 2015 680164610 13080SJL9 2015-06-30 157990834 See Part VI 0 0 0 A 14535000 130000000 478200 129521800 2015 0 0 1 1 B 9655800 208420907 979927 207440930 2016 1 0 1 1 C 100741934 741934 100000000 2016 1 0 1 1 D 5526300 157990834 1493445 9150 156488239 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 0 1 0 0 0 0 1 D 0 0 0 1 0 0 0 0 1 A 1 B 1 C 1 D 1 A CSCDA Series A 2015 680164610 13080SJM7 2015-06-30 42422999 See Part VI 0 0 0 B CHFFA Series A 2016 521643828 13032UGL6 2016-09-08 309720490 See Part VI 0 0 0 A 1558700 42422999 420423 2576 31404156 10595844 0 0 0 0 B 6975000 309720490 2280369 307440121 2016 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 Ashlock M Key employee Relocation X 118000 116000 0 1 1 Ashlock M Key employee Supplemental retirement CASD X 3469990 3620474 0 1 1 Asmar H Key employee Relocation X 150000 148300 0 1 1 Beaman J Key employee Relocation X 125000 99050 0 1 1 Beaman J Key employee Supplemental retirement CASD X 699888 730233 0 1 1 Beehler B Key employee Relocation X 100000 87300 0 1 1 Chilton H Former key employee Relocation X 100000 92100 0 1 1 Conklin J Key employee Relocation X 125000 32852 0 1 1 Dickinson C Key employee Relocation X 99900 96500 0 1 1 Eller J Key employee Relocation X 300000 290700 0 1 1 Eller J Key employee Supplemental retirement CASD X 4614772 4814901 0 1 1 Ferch W Key employee Relocation X 150000 129800 0 1 1 Ferch W Key employee Supplemental retirement CASD X 650795 679018 0 1 1 Fink M Key employee Relocation X 100000 98650 0 1 1 Gustin J Key employee Relocation X 100000 98800 0 1 1 Jobe M Officer Relocation X 100000 89800 0 1 1 Newmyer J Key employee Relocation X 150000 142600 0 1 1 Newmyer J Key employee Supplemental retirement CASD X 4170066 4350869 0 1 1 Olson J Key employee Relocation X 200000 64500 0 1 1 Olson J Key employee Supplemental retirement CASD X 1735225 1810476 0 1 1 Reiner S Officer Supplemental retirement CASD X 5989288 6248967 0 1 1 Reppert J Officer Relocation X 150000 147300 0 1 1 Reppert J Officer Relocation X 50000 49600 0 1 1 Tetz D Key employee Relocation X 100000 93600 0 1 1 Tetz W Key employee Relocation X 100000 98050 0 1 1 Wagner J Officer Supplemental retirement CASD X 6216544 6486130 0 1 1 Wing B Officer Relocation X 200000 195400 0 1 1 Wing B Officer Supplemental retirement CASD X 5096748 5317729 0 1 1 Zachary B Key employee Supplemental retirement CASD X 1888277 1970167 0 1 1 38199866 Beehler Matthew Family member of Key EE, B. Beehler 278872 Employment 0 Bancarz Michelle Family member of Key EE, G. Bancarz 126556 Employment 0 Bancarz Theodore Family member of Key EE, G. Bancarz 103625 Employment 0 Eller Eric Family member of Key EE, J. Eller 62193 Employment 0 Wagner Brent Family member of Officer, J. Wagner 82281 Employment 0 Dickinson Brett Family member of Key EE, C. Dickinson 41447 Employment 0 Ferch Josiah Family member of Key EE, W. Ferch 42946 Employment 0 Part II, Supplemental Retirement Benefits: The organization provides supplemental retirement benefits through an alternative funding arrangement the IRS calls "collateral assignment split dollar" (CASD). Although the IRS requires reporting in the loan section of Schedule L, CASD is not an actual loanno funds are transferred to the executive. Rather, the "loan" treatment applies because after the executive has received retirement benefits, the organization recovers all outlays plus interest.The recovery right is a key advantage of CASD for the organization. Rather than paying retirement benefits to the executive that would never be recovered, under CASD the organization recovers not only its outlays, but also consideration for the time value of money.CASD works as follows. The organization deposits funds into a cash value life insurance policy on the executive's life. During life, to the extent the executive fulfills service and vesting requirements, the executive can borrow against values in the policy to supplement retirement income. Policy performance is closely monitored. If policy performance lags, the executive's borrowing rights are reduced to protect the organization's recovery rights.At the executive's death, the policy death proceeds are first used to repay the organization its deposits plus compounded interest (at the IRS long-term applicable federal rate). The executive's beneficiary then receives any projected retirement borrowing the executive did not access during life. Any remaining death proceeds were available to be paid to the executive's beneficiary. However, the executives made a gift of the excess proceeds, estimated to total $86.67 million, to the organization to provide additional funding for the organization's charitable activities.Gift of excess proceeds (estimated):Mark Ashlock: $6,730,594. John Beaman: $4,458,001. Jeffrey Eller: $10,707,142. Wayne Ferch: $1,668,090. Joyce Newmyer: $7,742,500. JoAline Olson: $2,082,940. Scott Reiner: $16,495,703. Jack Wagner: $14,529,621. Bill Wing: $18,898,158. Beth Zachary: $3,359,341. Part IV, Page 1, Line 1: Melody Gabriel, an AH director, and her husband are owners and officers of businesses that engage in joint ventures with AH and member hospitals. Other family members with ownership and officer positions in these businesses include her parents, her brother and his wife, and trusts established on behalf of her children. The ventures are organized as LLCs. At the end of 2018 PVHR, LLC had an outstanding balance of $4.2M secured and unsecured market rate interest bearing loans. This LLC is 50% controlled by another LLC of which Ms. Gabriel and her family have a controlling interest. Interest is accrued on these loans, principal and interest at the end of 2018 was $92,392. Principal and interest payments are being made monthly. Form 990, Part III, Line 4a Adventist Health is a faith-based, nonprofit integrated health system serving more than 80 communities on the West Coast and Hawaii. Founded on Seventh-day Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care agencies, hospice agencies and joint-venture retirement centers in both rural and urban communities. Our compassionate and talented team of 35,000 includes associates, medical staff physicians, allied health professionals and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope. Together, we are transforming the American healthcare experience with an innovative, yet timeless, whole-person focus on physical, mental, spiritual and social healing. Mission-driven The healthcare industry continues to experience significant changes. From high and rising costs to regulatory initiatives, these issues are causing hospitals and health systems to re-think who they are and how they want to deliver care. At Adventist Health, we are thriving and growing in the face of this transition by building on our legacy and reestablishing ourselves as the leader in physical, mental, spiritual and social health. We remain committed to "living God's love by inspiring health, wholeness and hope." Our mission represents the heart of our people. It expresses that we know the love of God and consistently reflect that love in our actions, relationships and work. Mission is the reason our organization exists. Community Health Development Words like prevention, wellness and partnerships are more than the latest buzzwords at Adventist Health. Since St. Helena Sanitarium opened its doors in 1878 in California's picturesque Napa Valley, the heritage of the Seventh-day Adventist Church has focused on whole-person health and well-being. Adventist Health not only strives to promote individual health and well-being but also the well-being of healthy families and communities a natural fit in today's population health environment. Adventist Health's mission is coupled with a vision to transform the health experience of our community by improving health and well-being, enhancing interactions and making care more accessible. Building healthy communities requires multiple stakeholders working together with a common purpose. Adventist Health has partnered with over 50 community churches and hundreds of organizations across the system to integrate community benefit programs in their communities. In Northern California, we are reaching out into our communities through the Street Medicine Outreach in Ukiah and Project Restoration in Lake County. In Southern California we partnered with local schools to implement programs aimed at reducing obesity and diabetes among school children through healthy lifestyle education. In our Central California Region, we focused on immunizations, screenings, support groups and outreach to support community health. Adventist Health Portland in the Pacific Northwest Region recognizes that stable housing is critical to the improvement of health outcomes. They joined other area hospitals and health systems to address Portland's health and housing needs through the Housing is Health Initiative. In 2018, Adventist Health improved its strategic goal to transform the health of its communities by engaging in local communities, investing in community wellness and serving the most vulnerable. Community Benefit Provided Amount Free and discounted care $45,189,009 Aid to the poor $98,568,219 Community health improvement $23,731,866 Education and research $29,080,520 Aid to the elderly $259,863,670 Subsidized community healthcare $88,528,206 Total $544,961,490 Population Health Population health is a whole-person, outcomes-based approach that works to improve the health of entire communities. It requires collaboration among researchers, providers, public health entities and policy makers. Population health aligns with Adventist Health's philosophy of care and, as overall health declines in North America, provides unprecedented opportunities. Adventist Health believes that improving the health status of entire populations begins at home. In 2018, Adventist Health entered its sixth year of offering two health plans for employees and their families: The Engaged! Plan and Base Plan. Both plans offer wellness-focused programs and tools, including a wellness website, fitness activities, nutrition guidance, smoking cessation workshops and more. Participants in the Engaged! Premier program (the voluntary wellness component of the Engaged! Plan) complete a free biometric screening and wellness assessment, and those with high-risk conditions take part in a free care management program that provides support and education. Nearly 94 percent of employees signed up for the Engaged! Premier Program! In 2018. Whole-person health involves mind, body and spirit. The health plans empower employees, their families and, by extension, the larger community to take an active role in managing their health so they may live vibrant and productive lives. Care Transformation Care Transformation in Adventist Health reflects our promise to deliver top decile safety and quality performance and top quartile in clinical operations. The transformation focuses on initiatives such as Clinical Leadership Development, High Reliability Organization, Patient Experience, Care Redesign, Population Health and Clinical Workforce. All these efforts focus on effectively blending people, processes and technology and include consistent design, delivery and evaluation of care performance. Our caregivers are working hard every day to achieve the clinical goals and continue to spread our mission. Patient Safety & Quality Adventist Health focuses not only on patient safety and quality patient care, but also provides a quality work environment for its associates. Maintaining a culture of teamwork and safety among clinicians and staff is foundational to Care Transformation. For the past eight years, Adventist Health has participated in the Culture of Safety survey, which provides insight into focused areas where actions can be taken to improve the safety and teamwork climate in clinical departments. Adventist Health hospitals received quality and safety awards from The Joint Commission, The LeapFrog Group, Healthgrades and Malcolm Baldrige. Physician Alignment Adventist Health operates 280 medical offices across the West Coast and Hawaii. These ambulatory care centers include Rural Health Clinics (RHC), hospital-based outpatient clinics (HBOC), employed physician models in Oregon and Hawaii, medical foundation in California and community health clinics. These medical offices offer primary care and more than 50 different specialties in medical offices large and small. We have more than 500 primary care providers and nearly 700 specialists providing services ranging from Addiction Medicine to Wound Care, Audiology to Vascular Surgery. Adventist Health also provides much-needed dental care in six of our rural communities, with plans to expand in the future. The providers in these medical offices are committed to providing best practice, quality-driven care with excellent health outcomes and exceptional patient experience. In each of the past three years we have provided more than 2 million patient visits, about 9,000 visits daily. The excellent experience our physicians and Advanced Practice Providers offer patients results in a patient satisfaction Star Rating of 4.6 out of 5 stars. The success of our medical providers and associates generated 42 percent of the organization's net revenue. Form 990, Part III, Line 4a Rural Health Clinics (RHC) As an extension of our mission, high quality services are provided to small communities where access to care is often significantly less than more urbanized areas. People living in rural or underserved communities are often at a disadvantage when accessing health care. At the end of 2018, we had 65 clinics providing health care to underserved populations throughout Northern and Central California, Hawaii and Oregon. Our system of rural health continues to be the largest network of clinics in the state of California (more than 10 percent of the RHCs in the state are part of Adventist Health). Our RHC network also is one of the largest in the country, representing almost one percent of the nation's RHCs. Adventist Health provides oversight services for all our RHCs to include financial monitoring, program audits, operational support, professional development, advocacy and education regarding new regulations. But the real evidence of success is the patients served - 1,064,573 visits from 310,256 unique individuals in 2018. Thanks to the RHCs, many of these rural communities' most disenfranchised now have access to primary care, dentistry, women's and children's services and health education. Specialty care services are also available at many RHC locations, including 19 behavioral health programs. One example of our excellent rural health care is our clinic located in the heart of Paradise, California - a town which was nearly wiped off the map during the wildfires in late 2018. Our three-story RHC was the first to re-open in Paradise after the fire and remains a comprehensive healthcare option for most people in a 10-mile radius, offering primary care, dental, women's and children's services to a population in dire need of resources. Home Care Services Adventist Health/Home Care Services offers advanced, quality health care in an at-home setting by operating 14 home health agencies and nine hospices. In 2018, care, compassion and quality services were provided with 215,477 home health visits and 93,576 hospice days. Many of the agencies provide specialized programs and treatment plans, such as pediatric, CHF, diabetes and palliative care. In addition to providing treatment or care management, we strive to improve overall quality of life, hasten recovery and positively influence the emotional, physical and spiritual well-being of our home care patients. We are most proud of the following accomplishments in 2018: 1. Purchased hospice license for Bakersfield, CA 2. Reestablished home health and hospice in Yuba City, CA 3. Implemented new EMR (HomeCare HomeBase) in five agencies 4. Centralized OASIS reviews and HIS submissions 5. Feather River home health and hospice continued to see patients the days immediately following the devastating Camp fire. Operational hub was moved to Chico within 5 days. 6. First Hospice Medical Directors meeting Developing a Virtual Care Network The Adventist Health Virtual Care Network allows health care professionals to evaluate, diagnose and treat patients in both remote and urban locations using telecommunications technology. Virtual Care is the umbrella term for the group of services and functions that include telemedicine, telepharmacy, teleICU, teleradiology, and telepathology, but which also includes and can support regional health information sharing, patient education and provider networking. Virtual Care provides patients with access to high-quality, affordable specialty care when and where they need it, aiding in rapid diagnosis, treatment and improved patient outcomes. This collaboration supports Adventist Health's mission of bringing high-quality health and healing to the communities it serves, and is consistent with the organization's focus on innovation, strategic growth and population health. During 2018, Virtual Care services continued to develop and grow. Nine hospitals receive telehealth stroke services, six hospitals receive pediatric services, five sites receive infectious disease services and ten sites receive emergency psychiatry assessment services. Under an initiative with Blue Shield of California, funds from a USDA grant and hospital investment, telehealth equipment was provided for medical specialty outpatient care and deployed to 29 sites in California and Oregon including three non-Adventist Health sites. Twenty-four specialties including behavioral health are available for outpatient facilities. Store and forward services for dermatology and diabetic retinopathy screenings were added in 2018, as well as peer-to-peer e-consults. Direct-to-Consumer services for employees under the Adventist Health Plan were implemented with plans to utilize the platform in 2019 for chronic care patients. Adventist Health is a preferred provider for Virtual Care with the California Department of Corrections and Rehabilitation, serving multiple prison locations through the Virtual Care Coordination Center. Strategic Planning To strengthen our ability to deliver optimal health, Adventist Health deployed a robust and aggressive strategic plan in 2013 which continues to evolve and now looks at strategy through 2020 and beyond. Guided by our mission, this plan positions our organization as one of the most significant health systems on the West Coast. By the end of 2020, Adventist Health with our engaged physicians, workforce and community, will transform the health (including experience, outcomes and status) for our defined populations, especially the underserved. We will partner with a fully integrated, affordable value-based network of services to serve one million lives with the ability to manage and leverage information in a full-risk payment environment. Our presence in Western states, including rural markets, where we have an advantageous, competitive position, enables us to expand our mission and double the number of people served. Form 990, Part VI, Section A, line 6 Individuals who represent the Seventh-day Adventist Church and lay people who are in good standing with the Seventh-day Adventist Church serve as members of Adventist Health System/West (the Organization") including the following: (a) the president, treasurer, and other other representative from both the offices of the Pacific Union and the North Pacific Union; (b) one representative from each of the local conferences of the Church in which affiliated health care facilities are located; (c) two representatives selected from among the colleges and universities affiliated with the Church and located in the Pacific Union or North Pacific Union; (d) the CEO and president of the Organization, plus two additional representatives of the management of the Organization; (e) three representatives selected from the presidents of the hospitals affiliated with the Organization; three representatives from the physician members of medical staff of hospitals affiliated with the Organization; (g) up to 16 lay representatives who do not belong to any of the other categories set forth but who otherwise meet the qualifications for membership. Annually, the members meet for the purpose of conducting the business of the membership. Actions are taken as required to enable Adventist Health System/West to continue operating in concert with its Articles and Bylaws. Form 990, Part VI, Section A, line 7a The Organization's Board of Directors consists of the following: (a) The president of the Pacific Union and North Pacific Union of the Seventh-day Adventist Church; (b) two presidents selected from among the local conferences of the Church in which are located affiliated health care institutions; (c) The CEO of the Organization; (d) the president of the Organization; (e) two professional health care providers; and (f) seven lay representatives as elected by the membership. Form 990, Part VI, Section A, line 7b Amendments to the Organization's Bylaws require approval by the membership. 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 Organization's Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, corporate officers, key employees, and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The statements are reviewed by the internal audit staff as part of the annual financial statement audit. For potential conflicts, the CEO or a designee will determine and present all relevant facts to the governing body prior to the decision. After addressing any questions asked by the governing body, the responsible person must leave the meeting during the discussion of the matter that involves a conflict and during any vote on the matter. 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 CEOs and CFOs, 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 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, Section C, line 19 The Organization does not make its governing documents publicly available beyond required filings of Articles of Incorporation with the Secretary of State. The Organization does not make its Conflict of Interest Policy available to the public. Form 990, Part VII: In recognition of the time commitment directors make to serve on the Adventist Health System/West boards and committees, directors receive compensation when their employment agreements with their employers allow such payments. For those whose employers do not allow accepting compensation for board service, the funds are directly distributed to charitable organizations as mandated by their employment agreements. In addition, amounts paid for taxable benefits are also reported. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 124,725. Management and general expenses 285,642. Fundraising expenses 0. Total expenses 410,367. Other medical professional fees : Program service expenses 10,940. Management and general expenses 3,565. Fundraising expenses 0. Total expenses 14,505. Consulting and other management fees: Program service expenses 2,627,718. Management and general expenses 22,268,196. Fundraising expenses 0. Total expenses 24,895,914. Other professional fees non-medical: Program service expenses 357,685. Management and general expenses 786,311. Fundraising expenses 0. Total expenses 1,143,996. Contract labor: Program service expenses 530,901. Management and general expenses 5,397,575. Fundraising expenses 0. Total expenses 5,928,476. Purchased medical services: Program service expenses 0. Management and general expenses 423,942. Fundraising expenses 0. Total expenses 423,942. Repairs and maintenance : Program service expenses 173,780. Management and general expenses 642,531. Fundraising expenses 0. Total expenses 816,311. All other purchased services: Program service expenses 13,027,647. Management and general expenses 19,427,594. Fundraising expenses 0. Total expenses 32,455,241. Revenue cycle fees: Program service expenses -1,121,822. Management and general expenses 2,557,485. Fundraising expenses 0. Total expenses 1,435,663. Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Adventist Health Physicians Network PO Box 619135 Roseville CA 95661 680357690 Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest 1 Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest 1 Feather River Hospital PO Box 619135 Roseville CA 95661 941101228 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Fremont-Rideout Health Group 989 Plumas Street Yuba City CA 95991 942917251 Acute care hospital CA 501(c)(3) Line 12b, II Stone Point Health 1 Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi CA 95240 941044474 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 1 Paradise Valley Hospital PO Box 619135 Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 1 Reedley Community Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Rideout Memorial Hospital 989 Plumas Street Yuba City CA 95991 941387866 Acute care hospital CA 501(c)(3) Line 3 Fremont-Rideout Health Group 1 St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Simi Valley Hospital & Health Care Services 2975 N Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Stone Point Health PO Box 619135 Roseville CA 95661 823763347 Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest 1 Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 United Com-Serve 989 Plumas Street Yuba City CA 95991 943015356 Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Fremont-Rideout Health Group 1 Walla Walla General Hospital PO Box 619135 Roseville CA 95661 910617726 Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest 1 Western Health Resources PO Box 619135 Roseville CA 95661 953867863 Home care CA 501(c)(3) Line 10 Adventist Health SystemWest 1 White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 1 South Coast Medical Center PO Box 619135 Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C 0 AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure captive insurance BD Adventist Health SystemWest C 43971 1241523 0.50000 1 0 1 1 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 Rideout Memorial Hospital B 3000000 Cash transfer amount Walla Walla General Hospital C 13753838 Cash transfer amount Adventist Health Clearlake Hospital Inc L 4142167 FMV Adventist Health Medical Center 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3461435 FMV Hanford Community Hospital O 4816417 FMV Lodi Memorial Hospital Association Inc O 2151006 FMV Northwest Medical Foundation of Tillamook O 965075 FMV Portland Adventist Medical Center O 3154906 FMV Reedley Community Hospital O 368335 FMV San Joaquin Community Hospital O 2400749 FMV Simi Valley Hospital & Health Care Services O 2108669 FMV Sonora Community Hospital O 1698339 FMV St Helena Hospital O 1613396 FMV Ukiah Adventist Hospital O 1511058 FMV Walla Walla General Hospital O 254130 FMV Western Health Resources O 887599 FMV White Memorial Medical Center O 3082950 FMV Willits Hospital Inc O 1298554 FMV Adventist Health Clearlake Hospital Inc Q 262889 FMV Adventist Health Clearlake Hospital Inc Q 4679188 FMV Adventist Health Medical Center Tehachapi Q 779537 FMV Adventist Health Medical Center Tehachapi Q 1376488 FMV Adventist Health Physicians Network Q 61283 FMV Adventist Health Physicians Network Q 3946014 FMV Castle Medical Center Q 272502 FMV Castle Medical Center Q 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11500823 FMV Ukiah Adventist Hospital Q 279300 FMV Ukiah Adventist Hospital Q 6868514 FMV Western Health Resources Q 348897 FMV Western Health Resources Q 1449761 FMV White Memorial Medical Center Q 456022 FMV White Memorial Medical Center Q 16356445 FMV Willits Hospital Inc Q 175072 FMV Willits Hospital Inc Q 3049540 FMV Adventist Health Clearlake Hospital Inc S 9518171 Cash transfer amount Adventist Health Medical Center Tehachapi S 13087011 Cash transfer amount Adventist Health Physicians Network S 12339039 Cash transfer amount Adventist Health Plan S 4718336 Cash transfer amount Castle Medical Center S 5809124 Cash transfer amount Feather River Hospital S 38364579 Cash transfer amount Fremont-Rideout Health Group S 11670649 Cash transfer amount Glendale Adventist Medical Center S 5285235 Cash transfer amount Hanford Community Hospital S 144186176 Cash transfer amount Healthcare Resources Northwest LLC S 776051 Cash transfer amount Lodi Memorial Hospital Association Inc S 52400954 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