2025-11-12T16:28:49-08:00 2024-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2024-01-01 990107330 Castle Medical Center dba Adventist Health Castle CAST 8082635500 640 Ulukahiki St Kailua HI 96734 Johnson Nicolas Treasurer 2025-11-12 false true Steve Clement P01218012 8185475701 X 2024 2025-03-06 01:10:19Z Ashlock Ryan 275085862 false 1071 X www.adventisthealth.org/castle X 1960 HI Living Gods love by inspiring health, wholeness and hope. 15 13 1396 82 33358 1879393 2692334 5848889 232309828 259400243 7466180 7190023 1681737 2571363 244150079 275010518 134297 126110 0 119798292 127655022 0 324621 127309823 137624392 247242412 265405524 -3092333 9604994 274760745 280805611 104024677 101460297 170736068 179345314 Living Gods love by inspiring health, wholeness and hope. false false 219552928 126110 275010518 Castle Medical Center, dba Adventist Health Castle (AHCS), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay.Although, reimbursement for services rendered is critical to the operation and stability of Castle Medical Center, 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 coverage will be considered when individuals who need health care cannot afford to pay: Free care and/or subsidized care Care to persons covered by governmental programs at/or below cost Health/wellness activities and community education programsNot only does Castle Medical Center provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits.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 2024 was $6,600,461.The following Inpatient services were provided to all our patients:922 babies delivered969 surgeries performed26,922 patient days The following Outpatient services were provided to all our patients:36,082 emergency room visits2,179 outpatient surgeries performed74,561 outpatient visits 169,086 clinic visitsAHCS recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2024 was $16,868,073.AHCS' quality and performance awards include: Centers for Medicare and Medicaid Services 5-Star Rating, Top 100 Hospitals by Fortune and Premier's PINC AI, "A" Hospital Safety Grade from The Leapfrogn Group for Spring 2025, Best Places to Work in Hawaii by Hawaii Business Magazine, Healthgrades Quality Achievement Awards Outstanding Patient Experience - 12 Years Running, Beacon Award for Excellence - ICU, Level III Trauma Medical Center verification from the American College of Surgeons Committee on Trauma and the State of Hawaii Department of Health, 5-Star Cleanliness Rating by CMS, and America's Best Maternity Hospitals by Newsweek. 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/ 219552928 true true false true false false false false false true true false false false true true false true false false false false false false true false true true true false true false false false false false false false false false false false false true true false false false true 10 0 true 1396 true true true false false false false false false 0 false false false false false false false X 15 13 false false false false true true true true true false false true true true true true true true true true true HI X John Beaman 9164060000 PO Box 619135 Roseville CA 95661 HeinrichKerry Director/CEO 0.00 50.50 X X 0 3974195 57975 Hofheins Todd COO/Vice Chair 0.00 50.50 X X 0 2407675 65992 Beaman John CFO/Asst Secty 0.00 50.50 X 0 1980861 79808 Stevens Eric Fmr Care Div Ops Exec thru 2/22 0.00 50.50 0 1886146 57975 Nahapetian Arby Former Care Div Med Off thru2/22 0.00 50.00 0 1759258 79808 Ing Albert Physician 40.00 0.00 1352994 0 32665 Jobe Meredith Secretary 0.00 50.50 X 0 1221104 57975 Ashlock Ryan thru 1024 President, AHCS 10.00 40.00 X 0 1092176 74790 Rippey Wesley Frmr Reginal Med Off, PNR thru 3/21 0.00 50.00 0 796263 37321 Welch Donald Frmr Finance Officer, PNR thru 3/21 0.00 50.00 0 706292 57975 Loui William Physician 40.00 0.00 720036 0 38121 Jahn Andrew Former Care Div President thru 2/22 0.00 37.50 0 736769 17097 Witmer Kenneth Physician 40.00 0.00 600542 0 42790 Munir Jamalah Physician 40.00 0.00 599291 0 39460 Younoszai Barak Physician 40.00 0.00 590397 0 42380 Thordarson Heidar Former Treas / Asst Sec thru 3/21 0.00 50.00 0 550840 57975 Johnson Nicolas Treasurer 50.00 0.00 X 0 474082 51692 Smitson Robert Medical Officer 50.00 0.00 0 402919 73331 LeeAdam For Dir Mark&Comm, PNR thru 3/21 0.00 50.00 0 375643 79483 Seibel Jesse Mission and Admin Executive 50.00 0.00 0 317521 63107 Voshell Shane Former Reg HR Dir, PNR thru 3/21 0.00 50.00 0 305087 71269 Anderson Erik Patient Care Exec. thru 10/2024 2.00 48.00 0 291984 30508 Saavedra Garcia Katherine Operations Executive 50.00 0.00 0 259217 45059 Wing Bill Former Dir/A Sec/V Chair thru 01/22 0.00 0.00 0 273263 0 Aalborg Chase eff 1024 President, AHCS 50.00 0.00 X 0 126854 11012 Freedman John Dir/Chair 0.00 4.00 X X 0 27203 0 Newton Bradford Dir/Vice Chair 0.00 4.00 X X 0 26939 0 Davis Andrew Director 0.00 4.00 X 0 26611 0 Cherry Robert Director 0.00 4.00 X 0 26611 0 Innocent Larry Director 0.00 4.00 X 0 26611 0 Reiner Richard Director 0.00 4.00 X 0 26611 0 Wagner Jack Director 0.00 4.00 X 0 21611 0 Woodson Marc Director 0.00 4.00 X 0 21611 0 SalazarVelino thru924 Director 0.00 4.00 X 0 21181 0 Fehr Joy Director 0.00 4.00 X 0 18680 0 Beckett Ann Director 0.00 4.00 X 0 17930 0 Jutsy Kenneth Director 0.00 4.00 X 0 16180 0 Daggett Jonathan Director 0.00 4.00 X 0 16180 0 Cress John eff 1024 Director 0.00 4.00 X 0 430 0 3863260 20232538 1265568 349 true true false Sodexo Inc and Affiliates PO Box 360170 Pittsburgh PA 15251 Staffing 4980632 Pacific Radiology Group Inc 321 N Kuakini St 405 Honolulu HI 96817 Medical services 2541174 Koolau Anesthesia Group LLC 44-668 Kuono Pl Kaneohe HI 96744 Medical services 2002045 Allied Universal Security Services PO Box 31001-2374 Pasadena CA 91110 Security services 1618534 Inpatient Medicine Services PO Box 22562 Honolulu HI 96823 Medical services 1020000 38 48086 2203494 3597309 20000 5848889 Medical Office Rentals 900099 3075028 3075028 Other Program Svc Rev 531120 2127777 2127777 Patient Care Services 238284045 238284045 Pharmacy 340b Revenue 621110 9196673 9196673 Premium Revenue 722514 6716720 6716720 259400243 5218901 5218901 0 0 0 1975442 4320 1975442 -4320 1971122 1971122 140766 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81621356 104024677 101460297 X 165258967 171787756 5477101 7557558 170736068 179345314 274760745 280805611 X 9604994 -995748 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 23391 23391 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. Part IV - Additional Information 8206024 3756566 9255 1676470 10295375 12334199 1620243 10941 5759359 8206024 8740300 4099290 -3388 502003 12334199 3100104 6387961 6519 754284 8740300 1569011 1883540 79856 237214 195089 3100104 0.26590 0.73410 false true true 28803952 28803952 329073 192729156 109240522 83817707 5356019 4732771 623248 46877573 32494555 14383018 6841307 4152271 2689036 130316961 Annuities Payable 872399 Other Liabilities 2681220 Payables to Related Organizations 77727321 Payables to Third-Party Medicare 340416 81621356 X Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X : FIN48 Footnote The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2024 and 2023, no such assets or liabilities were recorded.The System currently files Form 990 (informational return of organizations exempt from income taxes) and form 990-T (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2021 in major tax jurisdictions. X X X X X X X false CA Golf Tournament 188852 48086 140766 58963 188852 48086 140766 58963 58963 81803 true true X true X true X true true true false true true 526583 526583 0.00200 40713158 34639280 6073878 0.02290 41239741 34639280 6600461 0.02490 2690675 2690675 0.01010 395328 395328 0.00150 30610398 16998299 13612099 0.05130 169971 169971 0.00060 33866372 16998299 16868073 0.06350 75106113 51637579 23468534 0.08840 266294 266294 0.00100 266294 266294 0.00100 true 1115558 305214 38106209 37853581 252628 X true true Castle Ambulatory Surgery Outpatient Surgery Center 0.76660 0.23340 The Cancer Center of Hawaii Outpatient Cancer Center 0.25000 0.30000 Hawaii Health Network LLC Managed Care Network 0.51000 0.49000 1 1 Castle Medical Center 640 Ulukahiki St Kailua HI 96734 See Form 990 Question J 120006 X X X false false true X X X X X X X X X 22 true true true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 22 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: - Part V, Section B, Line 5 The CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. Collection of most recently available demographic, socioeconomic and health indicator data. 3. Primary data gathering from community membersThe research team had the opportunity to engage with over 200 people across Hawaii who care deeply about their state. Social workers, teachers, farmers, doctors, policy advocates, mothers and fathers, sons and daughters, survivors, students, and healthcare providers all asked to share their thoughts on and for the communities where they live, the clients they serve, and the people they love. Strategies to collect input included: 82 key informant interviews, 18 community meetings, three expert panel webinars, four small focus groups, a literature review of CHNA reports from various U.S. markets, and a review of publicly available secondary data. The importance of a shared kuleana - responsibility - of healthcare working together with community and government to address social determinants of health was an important theme throughout the process. Vulnerable populations included homeless households, developmentally disabled persons, ALICE families, Kupuna/seniors, persons with mental health needs,and domestic violence survivors. Facility: - Part V, Section B, Line 6a Yes other participating hospitals included: The Queens Medical Center, Kaiser Permanente, Moanalua Medical Center, Kap'iolani Medical Center for Women & Children, Shriners Hospital for Children Honolulu, Wahiawa General Hospital, Hawai'i State Hospital, Hilo Medical Center, Kona Community Hospital, North Hawai'i Community Hospital, Hale Hoola Hamakua, Kau Hospital, Kohala Hospital, Maui Memorial Medical Center, Kula Hospital, Molokai General Hospital, Lana'i Community Hospital, Kuakini Medical Center, Pali Momi Medical Center, Straub Medical Center, Wilcox Memorial Hospital, Samuel Mahelona Memorial Hospital, Kaua'i Veterans Memorial Hospital, Kona Community Hospital, Hilo Medical Center, Kahuku Medical Center, Sutter Health Kahi Mohala, and West Kaua'i Medical Center (KVMH). Facility: - Part V, Section B, Line 11 Tax year 2024 was Year Two of the Implementation Strategy for the 2022 Community Health Needs Assessment (CHNA). All programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified four areas of significance: Access to Care (trust and equitable access), Financial Stability, Housing and Mental Health. Priority Need One- Access to Care (trust and equitable access): The goal for this need is to collaborate with outpatient healthcare providers to increase access to healthcare for patients with any type of insurance by identifying providers that accept all insurances. In 2023, Castle Medical Center developed an easy-to-use website serving as a hub of resources to assist community members in finding a primary care provider and implemented a phone line to help community members find a primary care provider or specialist. A resource link was added in partnership with the Castle Medical Center Community Outreach team to assist members with insurance, food insecurity, housing and other needs identified by patients as well as providing enrollment assistance through a third-party vendor to assist community members with Medicaid eligibility, high touch customer service and patient advocacy. This website was maintained in 2024 and a directory of primary care physicians accepting new patients has been created and distributed at community events. This directory is updated continuously to reflect changes in provider availability. 2024 saw 13,157 new patients 95,477 primary care and 7,689 specialty). Priority Need Two- Financial Stability: Castle Medical Centers goal is to meet the strategic workforce needs in a dynamic labor market and environment to deliver high quality care and become an integral part of the community as an employer, providing entry points into the workforce, and fostering career and growth opportunities to Hawaii residents. In 2024 Castle Medical Center performed the following activities and programs addressing financial stability. 1). Optimized and improved existing training programs such as Acute Care Nursing Assistants, Medical Assistants, Mental Health Technicians and Surgical Technicians. 2). Continued work on Healthcare Association of Hawai`i and Sector Partnership-Chamber of Commerce Steering Committee and joined the Windward Workforce Development initiative whose main initiative is to increase healthcare career awareness through teacher externships, connecting employers with educational institutions to ensure alignment of provided skills and needs of the employers. 3). 2024 Adventist Health Castle Training Cohorts: Acute Care Nursing Assistants: 3 Cohorts, 13 Graduates; Medical Assistants: 1 Cohort, 3 Graduates; Mental Health Techs: 1 Cohort, 3 Graduates; Surgical Techs: 1 Cohort, 3 Graduates. In 2024, the hospital participated in 11 events that created awareness for career opportunities at Castle Medical Center including: 2/22/24 Kaneohe Marine Base, Career Speaking; 3/5/2024, Kailua High School, Healthcare Association of Hawaii Partnership; 3/28/2024, Key Project, Job Fair; 4/3/2024, Brigham Young University -Hawaii, Career Fair; 4/17/2024, Chaminade University, Career Fair; 5/17/2024, Schofield Barracks, Employment Readiness Program Career Fair; 8/8/20204, Kapiolani Community College, MA Presentation. Priority Need Three-Housing: The goal is to establish partnerships utilizing community healthcare coordinators to connect the homeless and those with housing instability with existing services and programs that lessen financial burden and facilitate available resources between client and organizations through collaboration with community partnerships. In 2024, Adventist Health accomplished the following programs/activities: 1). Implemented online database through KEY Project for Find Help Search and Connect to Social Care and reached 930 community members through 32 outreaches. 2). Collaborated with internal educational training programs promoting both clinical and non-clinical based careers to the community and partnered with the hospital Community Outreach Hui and Education and Training team to implement training for the following cohorts: Acute Care Nursing Assistants: 3 Cohorts, 13 Graduates, Medical Assistants: 1 Cohort, 3 Graduates, Mental Health Techs: 1 Cohort, 3 Graduates and registered with the University of Hawaii system to provide 1 Medical Assistant cohort, and 1 Acute Nursing Assistant cohort for 2025. 3). Provided financial support to interns hired through the Adventist Health Workforce Readiness Program and assisted 8 interns through their internship period. 4). Provided financial, hiring, and community services to 35 community members to assist in obtaining a full-time position at Castle Medical Center. 5). Completed outreaches to promote jobs available, job training, job requirements, job skills, community colleges in development, housing stability services, support services and Workforce Readiness Program and connected with 165 community members through 32 outreaches for a total of 161 community members supported. 6). Collaborated with hospital Case Management with providing social services and supported 10 patients with referrals to food security and housing stability resources. 7). Established quarterly efforts with Hui Mahiai and Weinberg Village providing workforce and social services to residents. 8). Enrolled and graduated a total of 78 community members from employability and technical skill courses hosted, arranged, or referred by hospital Community Outreach Hui through 12 training sessions with Key Project, ERVSAFE Food Handler Training: 2 sessions, HPD Academy Preparation: 1 session, Personal Caregiver Certification: 1 session, CDL 101 Overview: 2 sessions , SLC Public Speaking Training: 6 sessions, hosted 1 Acute Care Nursing Aid Workshop and provided one on one resume building, and application assistance training. Priority Need Four- Mental Health: The goal is to provide access for community and state of Hawaii mental health needs and evaluate additional behavioral health services that are not limited to detoxification and telehealth psychiatric services by increasing and improving access to behavioral health services. In 2024 Castle Medical Center engaged in the following activities: 1). Engaged and created partnerships with Kaiser Permanente Behavioral and Social Work departments to improve patient flow and Emergency Department referrals. 2). Maintained and continued community collaborative meetings with members from key stakeholders in the community such as the state legislature, NAMI, Patient self-help, Poailani, Hina Mauka and former Department of Health. 3). Collaborated with Institute of Human Services to expand mental health services for homeless through meetings with hospital social workers and IHS case managers. 4). Maintained and continued community partnerships with Castle Medical Center Community Outreach through presence at community events. 5). Primary sponsor of the annual Hawaii NAMI conference and participated in annual NAMI Walk where we strengthened our relationship with other mental health entities and hospitals. 6). A report was developed to keep track of provider transfer times from ED intake to BHS unit. The report shows the average amount of time it takes from Psychiatric assessment to In-patient admission is 49 minutes.Identified Needs from CHNA, Not Addressed and Why - No hospital can address all the health needs identified in its community. Castle Medical Center is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Other needs identified in the 2022 Community Health Needs Assessment were to work together for equity and justice; strengthen safe families; prepare for emergencies; build good food systems; community cohesiveness; environment; invest in teenagers and healthy starts; and shift kapuna care away from sick care. These additional needs will be addressed by the entirety of the state of Hawaii through collaboration and partnerships. Facility: - Part V, Section B, Line 13h Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources.The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. Koolau Pharmacy 642 Ulukahiki Street Suite 101 Kailua HI 96734 Retail Pharmacy Kaneohe Laboratory Services 46-001 Kamehameha Highway Suite 104 Kaneohe HI 96744 Laboratory Services Pearl City Urgent Care 1234 Kuala St Pearl City HI 96782 Urgent Care Clinic Kailua Urgent Care 660 Kailua Road Kailua HI 96734 Urgent Care Clinic Castle Primary Care of Laie 55-510 Kamehameha Hwy Suite 5 Suite Laie HI 96762 Rural Health Clinic Castle Performance & Rehabilitation Center-Kaneohe 46-001 Kamehameha Highway Suite 104 Kaneohe HI 96744 Physical Therapy Kapolei Urgent Care 890 Kamokila Blvd Kapolei HI 96707 Urgent Care Clinic Oncology HBOC 642 Ulukahiki Street Suite 104 Kailua HI 96734 Oncology Clinic Kaneohe Radiology 46-001 Kamehameha Highway Suite 104 Kaneohe HI 96744 A department of the hospital Kapolei OBGYN 711 Kamokila Blvd Suite 103 Kailua HI 96734 OB Clinic Waikiki Urgent Care 1860 Ala Moana Blvd Honolulu HI 96815 Urgent Care Clinic Multi Specialty Clinic 642 Ulukahiki Street Suite 103 Kailua HI 96734 Specialty Clinic Complex Care Clinic 46-001 Kamehameha Highway Suite 208 Kaneohe HI 96744 Specialty Clinic OB Clinic 642 Ulukahiki Street Suite 301 Kailua HI 96734 OB Clinic Outpatient Psychiatry 40 Aulike Street Suite 217 Kailua HI 96734 Outpatient Psychiatry Castle Primary Care of Kailua 30 Aulike Street Suite 501 Kailua HI 96734 Urgent Care Castle Primary Care of Kaneohe 46-001 Kamehameha Hwy Suite 401 Kaneohe HI 96744 Urgent Care Central Medical Clinic 321 North Kuakini St Honolulu HI 96815 Medical Clinic Multi Specialty Clinic 46-001 Kamehameha Highway Suite 202 Kaneohe HI 96744 Specialty Clinic AlaMoana Specialty 1441 Kapiolani Blvd Honolulu HI 96814 Specialty Practice Makawao Specialty 30 Kupaoa St Suite 205 Makawao HI 96768 Specialty Practice 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 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. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information please refer to schedule H part III section B. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low 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 Castle Medical Center promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the Year Two Update, FY 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/castle/about-us/community-benefit/.The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2022, 2023 and 2024 Community Health Plan Updates are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, Castle Medical Center supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. In addition to the CHNA, our hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. 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 hospitals website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the hospitals Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdf. 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 Castle Medical Center is situated in the City & County of Honolulu (O'ahu) As would be expected of an urban center, the stresses of long commute times, driving alone on a long commute, and other urban lifestyle indicators are clear in the secondary data. Another example is air quality, which is much worse on O'ahu than on the Neighbor Islands. Insufficient sleep, defined as 7 hours or less per 24-hour period, was much higher on O'ahu (45% of adults, contrasted to 38-40% on Neighbor Islands). Certain health outcomes data, however, are generally better for residents of O'ahu than for those on the Neighbor Islands, likely due to greater access to screening and preventive care. The birth rate, which has fallen on O'ahu and almost everywhere in the past several years, remains the highest in the state, while the teen birth rate is among the lowest. Data for teens show levels of fruit/vegetable consumption and sufficient sleep to be lower on O'ahu than on the Neighbor Islands. However, the percentage of teens reporting being bullied or cyberbullied is lowest on O'ahu, as is the percentage who reported at least one suicide attempt in the 12 months prior to being surveyed (as part of the Hawai'i DOH Youth Risk Behavior Surveillance System). Levels of teen vaping and alcohol use are reportedly lowest on O'ahu, as well. This data may be a reflection of the highest median household income in the state and the proliferation of private schools on the island. Part VI, Line 4 - Community Building Activities The hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options.2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. Blue Zones widens our impact from only reaching our hospitals communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. Part VI, Line 5 - Promotion of Community Health Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the Triple Aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6 - Affilated Health Care System The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report HI Part VI - Additional Information Other Items Inspiring health, wholeness and hope in the communities we serve requires that we provide services that allow everyone to reach their optimal health. Ensuring that everyone in our communities has that opportunity is the definition of health equity. Adventist Health is committing the time and effort to ensuring health equity in all of our markets. A Health Equity Committee has been formed with champions from every market. We are especially sensitive to addressing health equity gaps for the underserved, frail, elderly, and minority populations, says Raul Ayala, MD, MHCM, Adventist Health Ambulatory Medical Officer, Central Valley Network family practitioner, and leader of our Health Equity Committee. We are assessing the gaps in care for these populations and finding ways to close those gaps. The Health Equity Committee is looking at the programs we currently have that successfully meet the needs of underserved groups and are figuring out how we can duplicate these efforts in other markets. Programs such as our technological language support, mobile clinics, ACO nurse navigators, Community Connect, community health workers, and our substance abuse navigators. We know we must also create more access to care and enhance the patient/customer experience. In 2024, screenings for social determinants of health at our hospital reached 92.9% which included screenings for housing instability, food insecurity, utility difficulties and transportation needs. This robust data enabled our hospital to identify key areas of concern and strategically develop and refine programs to better support our communitys health. Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education false American Heart Association AHA ECC Distribution Dallas TX 75284 135613797 501(c)(3) 15000 0 Funds Transfer General Support Kokua Mau PO Box 62155 Honolulu HI 96839 990339201 501(c)(3) 6000 0 Funds Transfer General Support National Alliance on Mental I 770 Kapiolani Blvd Ste 613 Honolulu HI 96813 990272540 501(c)(3) 10000 0 Funds Transfer General Support The Outdoor Circle Lani Kailua Outdoor Circle Kailua HI 96734 990085044 501(c)(3) 6000 0 Funds Transfer General Support 4 0 Additional Supplemental Information Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required.Employees donate to an employee assistance fund which in turn is used to assist employees needing financial assistance. The maximum assistance an employee can request is $500. X X X X true true false false false false false false false Anderson Erik Patient Care Exec. thru 10/2024 214241 53625 24118 13296 17212 322492 Ashlock Ryan thru 1024 President, AHCS 634923 129977 327276 13296 61494 1166966 Beaman John CFO/Asst Secty 1261000 698818 21043 13296 66512 2060669 HeinrichKerry Director/CEO 2342000 1586113 46082 13296 44679 4032170 Hofheins Todd COO/Vice Chair 1474000 888115 45560 13296 52696 2473667 Ing Albert Physician 1345744 7250 13296 19369 1385659 Jahn Andrew Former Care Div President thru 2/22 281190 407001 48578 13296 3801 753866 Jobe Meredith Secretary 796100 281132 143872 13296 44679 1279079 Johnson Nicolas Treasurer 350967 85828 37287 13296 38396 525774 LeeAdam For Dir Mark&Comm, PNR thru 3/21 298456 48371 28816 13296 66187 455126 Loui William Physician 687180 32856 13296 24825 758157 Munir Jamalah Physician 557155 42136 13296 26164 638751 Nahapetian Arby Former Care Div Med Off thru2/22 1111000 458435 189823 13296 66512 1839066 Rippey Wesley Frmr Reginal Med Off, PNR thru 3/21 551182 131994 113087 13296 24025 833584 Saavedra Garcia Katherine Operations Executive 154730 63276 41211 7737 37322 304276 Seibel Jesse Mission and Admin Executive 123693 60305 133523 6185 56922 380628 Smitson Robert Medical Officer 328478 48369 26072 13296 60035 476250 Stevens Eric Fmr Care Div Ops Exec thru 2/22 1196000 495682 194464 13296 44679 1944121 Thordarson Heidar Former Treas / Asst Sec thru 3/21 425591 77747 47502 13296 44679 608815 Voshell Shane Former Reg HR Dir, PNR thru 3/21 234959 46691 23437 11748 59521 376356 Welch Donald Frmr Finance Officer, PNR thru 3/21 465504 150507 90281 13296 44679 764267 Wing Bill Former Dir/A Sec/V Chair thru 01/22 273263 273263 Witmer Kenneth Physician 551356 49186 13296 29494 643332 Younoszai Barak Physician 590397 13296 29084 632777 Form 990, Part VI, Section A, Line 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Section A, Line 7a The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, Line 7b The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. 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 Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, Line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital 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 to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System General Counsel immediately.The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, Line 15a The Hospital's Board of Directors has established a Human Resources 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 at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section B, Line 15b See Line 15a explanation. Form 990, Part VI, Section C, Line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part XI, Line 9 Change in Interest Joint Ventures = -$6514748 Form 990, Part XI, Line 9 Split Interest Agreements-Change in Value = $75924 Form 990, Part XI, Line 9 Transfers from Related Entities = $4219947 Form 990, Part XI, Line 9 Unrealized Gain on Investments = $1223129 Crestview Property LLC 640 Ulukahiki St Kailua HI 96734 050574476 Real propety holding HI N/A Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Delano 1401 Garces Hwy Delano CA 93215 770258013 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Foundation 1 Adventist Health Way Roseville CA 95661 680002188 Charitable Foundation CA 501(c)(3) 7 Adventist Health SystemWest false Adventist Health Med Ctr Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Mendocino Coast 700 River Drive Fort 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