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ADVENTIST HEALTH TULARE: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
ADVENTIST HEALTH TULARE (EIN 83-2351753)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-12
IRS object ID
202533169349309808
Schema version
2024v5.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-11-12T20:14:32-08:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt
Disaster ReliefLos Angeles Wildfires and WindstormsDisasterReliefTxt

Preparer Firm PreparerFirmGrp

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Preparer Firm Name PreparerFirmName

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Business Name Line1THE ACCOUNTANCY LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

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Address Line1500 N BRAND BLVD STE 1930AddressLine1Txt
CityGLENDALECityNm
State AbbreviationCAStateAbbreviationCd
ZIP91203ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

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EIN832351753EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health TulareBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlADVEBusinessNameControlTxt
Phone5596880821PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1869 N Cherry StAddressLine1Txt
CityTulareCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93274ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonThordarson HeidarPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2025-11-12SignatureDt
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FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSteve ClementPreparerPersonNm
PTINP01218012PTIN
Phone8185475701PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKofl AndreaPrincipalOfficerNm
Gross Receipts$84,122,659GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.adventisthealth.org/tulareWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2018FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionLiving Gods love by inspiring health, wholeness and hope.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee521TotalEmployeeCnt
Total Volunteers3TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$5,958,611PYContributionsGrantsAmt
CY Contributions Grants$4,935,138CYContributionsGrantsAmt
PY Program Service Revenue$61,121,870PYProgramServiceRevenueAmt
CY Program Service Revenue$79,151,211CYProgramServiceRevenueAmt
PY Investment Income$117,411PYInvestmentIncomeAmt
CY Investment Income$36,310CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$67,197,892PYTotalRevenueAmt
CY Total Revenue$84,122,659CYTotalRevenueAmt
PY Grants And Similar Paid$2,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$50,176CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$37,475,733PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$42,829,330CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$6,910CYTotalFundraisingExpenseAmt
PY Other Expenses$54,872,198PYOtherExpensesAmt
CY Other Expenses$62,745,955CYOtherExpensesAmt
PY Total Expenses$92,350,431PYTotalExpensesAmt
CY Total Expenses$105,625,461CYTotalExpensesAmt
PY Revenues Less Expenses-$25,152,539PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$21,502,802CYRevenuesLessExpensesAmt
Total Assets BOY$42,777,136TotalAssetsBOYAmt
Total Assets EOY$61,434,436TotalAssetsEOYAmt
Total Liabilities BOY$163,807,444TotalLiabilitiesBOYAmt
Total Liabilities EOY$205,014,563TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$121,030,308NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$143,580,127NetAssetsOrFundBalancesEOYAmt
MissionLiving Gods love by inspiring health, wholeness and hope.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$88,226,110ExpenseAmt
Grant$50,176GrantAmt
Revenue$84,122,659RevenueAmt
DescAdventist Health Tulare (AHTR) provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHTR is part of the Adventist Health Central California Network, a non-profit, faith-based organization operating eight hospitals - including Bakersfield, Specialty Bakersfield, Delano, Hanford, Selma, Reedley, Tehachapi and Tulare - and over 130 clinics throughout the Central Valley.Although reimbursement for services rendered is critical to the operation and stability of Adventist Health Tulare, 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 Adventist Health Tulare 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.AHTR 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 $22,713,007.The following Inpatient services were provided to all our patients:36 babies delivered306 surgeries performed7,330 patient days The following Outpatient services were provided to all our patients:34,666 emergency department visits2,549 outpatient surgeries performed18,447 outpatient visits 118 clinic visitsAHTR 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 $3,069,051.AHTRs quality and performance awards include: "A" in patient safety by The Leapfrog Group, Stroke Silver Plus Award by the American Heart Association Get with the Guidelines, Primary Stroke Center accredited by The Joint Commission, and Geriatric Emergency Department accredited by the American College of Emergency Physicians.Adventist Healths mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever.As part of Adventist Healths ongoing mission to care for underserved communities and address pressing public health challenges, our Tulare Family Medicine Residency Program is leading the way in providing compassionate care for individuals affected by substance use disorders in Californias Central Valley. The rise in opioid-related emergency room visits and overdoses across California has become a serious public health challengeand the situation is especially urgent in the states Central Valley. At Adventist Health, we are committed to addressing this crisis by expanding access to whole-person care for vulnerable and underserved populations. One key initiative driving this effort is the Tulare Family Medicine Residency Program, which plays a vital role in extending healthcare to communities that often go without it. We have a large population of medically underserved people in the Central Valley, says Dr. Muhammad Nausherwan Khan, director of the Tulare Family Medicine Residency. Being a good family doctor means we need to be able to provide whole-person care. That includes excellent primary care for patients with substance use disorders. With support from the California Residency Program Collaborative (CRPC), Adventist Healths Tulare and Hanford residency programs have received grant funding to train residents in substance use disorder (SUD) care. This training is now a core part of the residency curriculum, ensuring future physicians are well-equipped to provide nonjudgmental, high-quality care for patients affected by addiction.Last summer, residents, faculty, and staff underwent comprehensive education and partnered with addiction specialists to build stronger referral networks. In January, the Tulare residency clinic began accepting referrals from local emergency departments for patients presenting with symptoms of substance useextending a continuum of care where its needed most. This effort aligns closely with CA Bridge, a statewide initiative adopted by 19 Adventist Health hospitals. CA Bridge uses substance use navigators to engage patients in the emergency room and, if desired, connect them with further care. Thanks to their specialized training, Tulare residents can now serve as primary care providers for these patientsmany of whom would otherwise go without ongoing support. The impact goes beyond immediate care. Residents also serve on a mobile clinic van, bringing primary care directly to rural communities with little or no healthcare accessanother example of Adventist Healths mission in action.This work not only fulfills the training requirements of the ACGME [Accreditation Council for Graduate Medical Education], Dr. Khan explains, but it fulfills our mission to care for those who need us most. Through training, innovation, and heart, Adventist Health is building a stronger future for rural healthcareone where no patient is left behind.The following story illustrates how Adventist Health Hanford provides quality care for our community in a caring manner:As a retired surgical tech in the operating department of a local hospital, Ray Moreno knew plenty of doctors and thought he knew all the options when it came time to choosing where he would have his own surgical procedure performed.Until his wife, Merideth, made a suggestion he hadnt considered: Why not try Tulare?A nurse, Merideth had previously worked at the Tulare hospital before it became part of the Adventist Health family and knew many of the people there. She told him he would be in good hands. He decided to take her recommendation.He asked Dr. Tu-Hi Hong to schedule his procedure at the Tulare hospital.Dr. Hong was familiar with both of us, Ray said, and I had cared for his patients. I knew his work.When it was all over, Ray said his wife could not have been more correct.From the time I walked in the front door for my pre-op work ? including registration, labs, the EKG everyone was very welcoming, he said. They were just really on the ball. I think I was done within an hour.Not only that, when he left the hospital after the surgery, he said he felt great, like he hadnt been through surgery at all. Which, to him, meant the anesthesia had been administered expertly.I couldnt believe how good I felt! he said. And, the outcome was good, with everything going according to plan.He said he appreciated the one-on-one-connections with the staff who he said took such good care of him while he was there.Im just thankful this hospital was open because I had such a good experience.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/Desc
Total Program Service Expenses$88,226,110TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
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Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
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Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
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PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
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Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
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Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee521EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
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Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
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Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJohn BeamanPersonNm
Phone9164060000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 619135AddressLine1Txt
CityRosevilleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95661ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (43 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Heinrich Kerry
Director/CEO0.0050.50Yes (X)Yes (X)$0$3,974,195$57,975
Hofheins Todd
COO/Vice Chair0.0050.50Yes (X)Yes (X)$0$2,407,675$65,992
Beaman John
CFO/ Asst Sec0.0050.50Yes (X)$0$1,980,861$79,808
Stevens Eric eff 724
President0.0050.50Yes (X)$0$1,886,146$57,975
Nahapetian Arby
Frmr Care Div Med Off thru 02/220.0050.00$0$1,759,258$79,808
Wells Jason
President CCN10.0040.00Yes (X)$0$1,543,056$79,808
Jobe Meredith
Secretary0.0050.50Yes (X)$0$1,221,104$57,975
Kofl Andrea thru 124
Ctrl Vally Pres12.5037.50Yes (X)$0$1,085,827$54,194
Jamaleddine Ghassan
Medical Officer Eff 07/01/238.3041.70$0$882,388$79,808
Ayala Raul
Ambulatory Medical Officer, CVN8.3041.70$0$820,554$36,137
Haydock Timothy eff 724
Ops Exec CCN8.3041.70Yes (X)$0$727,318$79,808
Cox Shane thru 724
Treasurer16.7033.30Yes (X)$0$739,632$56,832
Jahn Andrew
Frmr Care Div Pres thru 02/220.0050.00$0$736,769$17,097
Reyna Sonja
Ambulatory Executive8.3041.70$0$628,786$40,807
Van Housen Heather
Patient Care Executive40.000.00$0$589,725$63,003
Tomono Olga
Business Development Exec eff 11/248.3041.70$0$521,544$14,186
Tomono Christopher
Partnership Executive8.3041.70$0$448,461$79,636
Taggart Laurie
Patient Care Exec40.000.00$0$483,635$44,381
Day Lauren
Philanthropy Executive, CVN12.5037.50$0$356,253$84,253
Albano Maureen
RN40.000.00$349,919$0$24,289
Jones Larry
Admin Direc, Ancillary Serv, CVN12.5037.50$0$245,345$44,212
Ammon Edward
Form. Foundation Exec thru 01/2112.5037.50$0$239,238$43,938
Garcia Rosa
RN House Supervisr40.000.00$233,069$0$48,568
Wing Bill
Former Dir/Asst Sec/VChair thru1/220.000.00$0$273,263$0
Gamboa Pedro
RN40.000.00$224,867$0$45,267
Martin Cassi
Director RN40.000.00$234,186$0$21,744
Ng Mankwong
Pharmacist40.000.00$207,302$0$43,928
Pereira Sheri
Assoc Patient Care Exec thru 2/2450.000.00$0$226,989$24,136
Freedman John
Dir/Chair0.004.00Yes (X)$0$27,203$0
Newton Bradford
Dir/Vice Chair0.004.00Yes (X)$0$26,939$0
Cherry Robert
Director0.004.00Yes (X)$0$26,611$0
Davis Andrew
Director0.004.00Yes (X)$0$26,611$0
Innocent Larry
Director0.004.00Yes (X)$0$26,611$0
Reiner Richard
Director0.004.00Yes (X)$0$26,611$0
WagnerJack
Director0.004.00Yes (X)$0$21,611$0
Woodson Marc
Director0.004.00Yes (X)$0$21,611$0
SalazarVelino thru924
Director0.004.00Yes (X)$0$21,181$0
Fehr Joy
Director0.004.00Yes (X)$0$18,680$0
Beckett Ann
Director0.004.00Yes (X)$0$17,930$0
Justy Kenneth
Director0.004.00Yes (X)$0$16,180$0
Daggett Jonathan
Director0.004.00Yes (X)$0$16,180$0
Cress John eff 1024
Director0.004.00Yes (X)$0$430$0
Thordarson Heidar
Treasurer0.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,249,343TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$24,072,411TotReportableCompRltdOrgAmt
Total Other Compensation$1,425,565TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K98IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Comfort Anesthesia Associates Inc
2635 G St Ste 101BakersfieldCA93301Medical services$2,828,718
Galen Inpatient Physicians Inc
2100 Powell St Ste 400EmeryvilleCA94608Medical services$1,615,034
RMG Medical Imaging Consultants
PO Box 86348Los AngelesCA90086Medical services$1,555,788
Sodexo Inc and Affiliates
PO Box 360170PittsburghPA15251Staffing$1,511,185
CEP America California
2100 Powell St Ste 400EmeryvilleCA94608Medical services$870,343
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K24CntrctRcvdGreaterThan100KCnt
Government Grants$3,213,173GovernmentGrantsAmt
All Other Contributions$1,721,965AllOtherContributionsAmt
Total Contributions$4,935,138TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtBusinessBusinessCd
Dietary/Cafeteria Revenue$276,872$276,872
Incentive & Quality Rev$2,083$2,083
Other Program Services$1,059,847$1,059,847900099
Patient Care Services$76,075,744$76,075,744900099
Revenue from Related Orgs$1,736,665$1,736,665
FieldValueIRS element (for citing)
Total Program Service Revenue$79,151,211TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$36,305TotalRevenueColumnAmt
Exclusion$36,305ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$5OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$5OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5TotalRevenueColumnAmt
Related Or Exempt Func Income$5RelatedOrExemptFuncIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$84,122,659TotalRevenueColumnAmt
Related Or Exempt Func Income$79,151,216RelatedOrExemptFuncIncomeAmt
Exclusion$36,305ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$50,176TotalAmt
Program Services$50,176ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,916,423TotalAmt
Program Services$30,228,708ProgramServicesAmt
Management And General$3,687,715ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,153,902TotalAmt
Program Services$1,028,439ProgramServicesAmt
Management And General$125,463ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,226,312TotalAmt
Program Services$4,564,372ProgramServicesAmt
Management And General$661,940ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,532,693TotalAmt
Program Services$2,310,364ProgramServicesAmt
Management And General$222,329ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$7,691,980TotalAmt
Management And General$7,691,980ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$125,895TotalAmt
Management And General$125,895ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$15,528,672TotalAmt
Program Services$14,112,127ProgramServicesAmt
Management And General$1,416,475ManagementAndGeneralAmt
Fundraising$70FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$46,202TotalAmt
Management And General$46,202ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$625,641TotalAmt
Program Services$524,950ProgramServicesAmt
Management And General$100,691ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$4,269,413TotalAmt
Program Services$1,481,590ProgramServicesAmt
Management And General$2,787,323ManagementAndGeneralAmt
Fundraising$500FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,428,631TotalAmt
Program Services$5,417,248ProgramServicesAmt
Management And General$5,043ManagementAndGeneralAmt
Fundraising$6,340FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$266,703TotalAmt
Program Services$257,736ProgramServicesAmt
Management And General$8,967ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19,902TotalAmt
Program Services$17,812ProgramServicesAmt
Management And General$2,090ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$8,242,815TotalAmt
Program Services$8,242,815ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,670,791TotalAmt
Program Services$4,624,565ProgramServicesAmt
Management And General$46,226ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$884,702TotalAmt
Program Services$884,702ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Patient Care Supplies$12,076,818$12,001,063$75,755
Quality Assurance$1,925,410$1,925,410
Other Expenses$615,821$228,006$387,815
Equipment Rentals$326,559$326,027$532

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$105,625,461TotalAmt
Program Services$88,226,110ProgramServicesAmt
Management And General$17,392,441ManagementAndGeneralAmt
Fundraising$6,910FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,891,708BOYAmt
EOY$11,258,147EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,865,819BOYAmt
EOY$2,172,813EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$171,758BOYAmt
EOY$416,483EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$37,523,116LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$13,162,496LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,442,671BOYAmt
EOY$24,360,620EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$303,000BOYAmt
EOY$303,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$15,102,180BOYAmt
EOY$22,923,373EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$42,777,136BOYAmt
EOY$61,434,436EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$7,321,595BOYAmt
EOY$9,040,728EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$122,417BOYAmt
EOY$113,879EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$156,363,432BOYAmt
EOY$195,859,956EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$163,807,444BOYAmt
EOY$205,014,563EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$121,423,989BOYAmt
EOY-$144,353,281EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$393,681BOYAmt
EOY$773,154EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$121,030,308BOYAmt
EOY-$143,580,127EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$42,777,136BOYAmt
EOY$61,434,436EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$21,502,802ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$1,047,017OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed Section4955 TaxfalseForm4720FiledSection4955TaxInd
Correction MadefalseCorrectionMadeInd
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$16,894OtherActivitiesAmt
Total Lobbying Expenditures$16,894TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part II-B, Line 1i - Other Activities DescriptionThe organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities.
Part IV - Additional Information

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$393,680BeginningYearBalanceAmt
Contributions$1,711,368ContributionsAmt
Other Expenditures$1,331,895OtherExpendituresAmt
End Year Balance$773,153EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$223,727BeginningYearBalanceAmt
Contributions$1,941,233ContributionsAmt
Other Expenditures$1,771,280OtherExpendituresAmt
End Year Balance$393,680EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,000BeginningYearBalanceAmt
Contributions$217,727ContributionsAmt
End Year Balance$223,727EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Contributions$124,092ContributionsAmt
Other Expenditures$118,092OtherExpendituresAmt
End Year Balance$6,000EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$10,425BeginningYearBalanceAmt
Contributions$191,583ContributionsAmt
Other Expenditures$202,008OtherExpendituresAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (true)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (true)RelatedOrgListSchRInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,844,118OtherCostOrOtherBasisAmt
Depreciation$520,319DepreciationAmt
Book Value$3,323,799BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$33,678,998OtherCostOrOtherBasisAmt
Depreciation$12,642,177DepreciationAmt
Book Value$21,036,821BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,360,620TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Other Receivables$1,506,184
Receivables from Related Organizations$934,538
Receivables from Third Parties$20,482,651
FieldValueIRS element (for citing)
Total Book Value Other Assets$22,923,373TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Cash Overdraft$63,457,331
Other Liabilities$9,152,050
Payables to Related Organizations$123,250,575
FieldValueIRS element (for citing)
Total Liability$195,859,956TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 FootnoteThe 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.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$378,880TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$378,880NetCommunityBenefitExpnsAmt
Total Expense0.00360TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,878,952TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$26,544,825DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,334,127NetCommunityBenefitExpnsAmt
Total Expense0.21140TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$49,257,832TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$26,544,825DirectOffsettingRevenueAmt
Net Community Benefit Expns$22,713,007NetCommunityBenefitExpnsAmt
Total Expense0.21500TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$147,399TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$147,399NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,651,739TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$229,193DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,422,546NetCommunityBenefitExpnsAmt
Total Expense0.02290TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$720,066TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$220,960DirectOffsettingRevenueAmt
Net Community Benefit Expns$499,106NetCommunityBenefitExpnsAmt
Total Expense0.00470TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,519,204TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$450,153DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,069,051NetCommunityBenefitExpnsAmt
Total Expense0.02900TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$52,777,036TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$26,994,978DirectOffsettingRevenueAmt
Net Community Benefit Expns$25,782,058NetCommunityBenefitExpnsAmt
Total Expense0.24400TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$703,731BadDebtExpenseAmt
Bad Debt Expense Attributable$263,899BadDebtExpenseAttributableAmt
Reimbursed By Medicare$13,957,812ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$16,779,979CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,822,167MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health TulareBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1869 North Cherry StreetAddressLine1Txt
CityTulareCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93274ZIPCd
FieldValueIRS element (for citing)
Website AddressSee Form 990 Question JWebsiteAddressTxt
State License106540816StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Sch H Part VI - Needs AssessmentOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Sch H Part VI - Needs AssessmentOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Sch H Part VI - Needs AssessmentStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.0000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Sch H Part VI - Patient EducationFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Sch H Part VI - Patient EducationFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Sch H Part VI - Patient EducationFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Facility: - Part V, Section B, Line 5The 2022 CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations the voices of those with chronic disease, low incomes, and the underserved were heardAging, civic government and leadership, community-based organizations focusing on healthcare consumer, law enforcement, low-income, medically underserved, minority populations, substance abuse, transportation and unhoused population participated in seven focus groups with fifty-two individuals participating as well as eight key informant interviews. Represented race/ethnicities were Black, Hispanic, Multi-Race and White. The 2022 Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS Survey data was gathered from the Central Valley region (region name defined by survey administrator, UC Berkeley IGS).
Facility: - Part V, Section B, Line 6aOther hospitals that participated in the 2022 Community Health Needs Assessment included Reedley Community Hospital and Adventist Health Tulare.
Facility: - Part V, Section B, Line 11Tax 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 three areas of significant need: Financial Stability, Food Security and Mental Health. Priority Need One-Financial Stability. The goal is to advocate for and collaborate with internal and external partners to identify community members experiencing poverty and connect them to support services to lessen financial burden. This will be accomplished through the partnerships with external and internal stakeholders to provide financial literacy programs. In August 2024, Adventist Health Tulare held a Back-to-School Wellness Fair at a Tulare clinic and provided several community resources including financial literacy documents, free medical and dental exams and provided each student with a free backpack and haircut. Over 200 participants attended to receive these services. Student athletes in Tulare County were offered free sports physicals at three events organized by Adventist Health Tulare. Schools require a sports physical for student athletes of all ages in order to determine a students medical eligibility to play on a sports team. Sports physicals include a basic medical screening that checks a students height and weight, blood pressure and vision. Physicals usually take 30-45 minutes, and each student received a swag bag that included a water bottle and school supplies. These free sports physicals address issues with access to care in Tulare where 61.12% live in a population affected by a health professional shortage area as well as the childhood poverty rate at 22.61% as compared to the national childhood poverty rate of 16.66%. Adventist Health Tulare collaborated with Salt & Light, a community-based organization that addresses homelessness in Tulare County. Salt & Light provide case management services, permanent housing in a 75-home neighborhood built specifically for their neighbors, and other resources to help transition back into the workforce. Adventist Health Tulare provided medical care via monthly Mobile Care clinics. Associates donated presents to the neighbors in our yearly adopt a family program, providing 52 families with gifts they wouldnt be able to afford on their own. Other strategies included a partnership with Parallon to assist community members in the enrollment and approval process for individual or family medical insurance coverage. Priority Need Two- Food Security. The goal is to give access to current food distribution programs to the community identified by clinical screenings by building relationships with external partner who already have an established distribution program. In 2024, Adventist Health Tulare provided a list of food outreach resources in our emergency department and available at our clinics. In 2024, the Central Valley Network Care Coordination team at Adventist Health Tulare focused on identifying patients entering through the Emergency Department or admitted as inpatients who required social services support. Community Health Workers were assigned to these patients to assist with care follow up and connect them to essential resources the support overall well-being. These resources included food assistance, transportation, referral coordination and help overcoming access to care barriers.Priority Need Three- Mental Health. The goal is to provide mental health awareness and access to our communities by working with external and internal stakeholders to provide educational awareness. In 2024, Adventist Health Tulare continued to participate in the quarterly Behavioral Health Collaborative meetings where concerns over access to care and recruitment of mental health providers are addressed. Adventist Health Tulare substance abuse navigators and community health workers work closely with the Champions Recovery case management team to align their services with our patients and focus on substance abuse and mental health. Substance abuse navigators are active in the community, providing education on prevention of abuse and resources for additional help.
Facility: - Part V, Section B, Line 13hPatients 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.

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Tulare Toxicology LabBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 E Merritt Avenue Suite 107AddressLine1Txt
CityTulareCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93274ZIPCd
FieldValueIRS element (for citing)
FacilityReference Lab-ToxicologyFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseUncollected 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 BenefitThe 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 ExpenseThe system-wide combined audited financial statements do not contain a footnote describing bad debt expense.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe 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 PatientsWhen a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest
Part VI, Line 2 - Needs AssessmentAdventist Health Tulare 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/central-valley/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, Adventist Health 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, the 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 AssistanceThe 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.pdfAt 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 InformationThe Central Valley Network (CVN) is comprised of four cities: Hanford, Tulare, Reedley, and Selma. The CVN is home to a total population of 530,375 residents with the majority age group being children (5-17), making up 22.2% of the population. Centrally located between northern and southern California, CVNs geographic region is one of its biggest assets benefiting farmland businesses as well as residents pursuing recreational activities such as a short road trip to Yosemite National Park or the cool coastlines of Monterey Bay and Big Sur. This young population is vibrant with festivals, events, and small businesses. Of the population, 64.68% are Hispanic. The median household income is $60,367 of which 59.22% is spent on housing and transportation. Among this population, 27.23% of children live in poverty and 2.70% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. The following zip codes represent Adventist Health Central Valley Networks primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The Adventist Health Central Valley Network CHNA market has a total population of 537,932 (based on the 2020 Decennial Census). The largest city in the service area is Tulare, with population of 59,312. The service area is comprised of the following zip codes: 93219, 93648, 93625, 93646, 93609, 93647, 93631, 93657, 93245, 93234, 93239, 93654, 93204, 93618, 93230, 93615, 93662, 93212, 93630, 93619, 93210, 93656, 93274. 57.31% of the population own their home and 42.69% are renters. Currently 8.57% of the Central Valley population does not have health insurance. The labor force participation rate (57.62%) is lower than that of California (63.29%) and the United States (62.97%). The unemployment rate is at 8.42% and is higher than both the State and the Nation. Unemployment creates financial instability and barriers to access including insurance coverage, health services and education, healthy food, and other necessities that impact health status. The rate is higher for people of multiple races (11.27%) and people who chose some other race (10.49%). The childhood poverty rate is extremely high at 27.23%, higher than that of California (16.8%) and US (17.48%). Racial disparity in childhood poverty is evident, with 67.13% of Native Hawaiian or Pacific Islander children aged 0-17, 26.76% of African American children, and 28.23% of Native American or Alaska Native children living in households with income below the federal poverty level. The median household income is $60,367, which is below both the California rate and that of the Nation, and poses a significant problem given the exceedingly high cost of living and housing costs in the area. The percent of the Central Valley population living in poverty is extremely high (19.22%) and is considerably higher than the rate of poverty in California (12.58%) and in the US (12.84%). The percentage of students eligible for the free or reduced-price school food program represents 75.84% of public-school students, which is higher than the state average of 59.18% and the Nations average of 42.16%. Access to mental health (MH) providers in the Central Valley is extremely limited. The rate of mental health providers is 43.82 per 100k people, as compared to 150.31 in California and 132.27 in the United States. The percentage of adults with poor mental health is higher in the Central Valley (16.1%) than in California (12.5%) and in the US (13.6%). Deaths of despair, which include any deaths due to intentional self-harm, alcohol related disease, and drug overdose are at 43.4 per 100k people and are elevated than the rate in the rest of the state of California (37.1).
Part VI, Line 4 - Community Building ActivitiesThe 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 HealthOur 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 are soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively 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 SystemThe 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 ReportCA
Part VI - Additional InformationListing of Organizations that Particpated in the Hospital's CHNA -Organizations that participated in the 2022 CHNA included: Champions Recovery, City of Hanford, City of Reedley, Family Healthcare Network, Fresno County Department of Public Health, Kings Area Regional Transit, Kings County, Kings County Commission on Aging, Kings County Department of Public Health, Kings Partnership for Prevention, Kings County Sheriffs Department, Kings Tulare Homeless Alliance, National Association for the Advancement of Colored People (NAACP) and Tulare County Department of Public Health. Identified Needs from CHNA, Not Addressed and Why -No hospital can address all the health needs identified in its community. Adventist Health Tulare committed to serving the community by adhering to its mission, and using its skills, expertise, and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed but fulfilled by other community organizations include housing, health risk behaviors, health conditions, access to care, environment & infrastructure, inclusion & equity, COVID, education, community vitality and community safety. While these significant health needs are not address directly, they are likely to benefit from collective efforts of our community partnerships. Other Items: Adventist Health Tulare addressed access to care issues through the Tulare Internal Medicine Residency program that was launched in April 2023 and continues in 2024 with a class of four scheduled for graduation in 2026. The Internal Medicine Residency program is a three-year program and follows a 4+2 block rotation schedule (four weeks inpatient and two weeks outpatient), designed to comply with all ACGME Internal Medicine Review Committee requirements. Each year has 24, two-week blocks of inpatient/outpatient/specialty/elective rotations, with longitudinal experiences throughout the training. The residency continuity clinic is a part of the longitudinal experience across three years of training. In addition, the Tulare Family Medicine Residency was continued in 2024 and graduated 6 residents of which three stayed within the Adventist Health California Central Valley Network. This is a commitment to educate and train competent and compassionate family physicians who can provide evidence-based and value-based full-spectrum patient care. Its philosophy of family medicine is one that addresses the physical, mental, and spiritual aspects of our patients health to promote and maintain overall wellness for our patients and their families. The residents believe that they have been given a special opportunity to make a meaningful and lasting impact to the populations served, especially the vulnerable and underserved communities. To further this, the program is expanding efforts to contribute to community events, performing sports physicals at local high schools and using the Adventist Health mobile van to reach the less fortunate.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 84.9% 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

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CA Hlth Fund & TrustBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K St Ste 800AddressLine1Txt
CitySacramentoCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd
FieldValueIRS element (for citing)
Recipient EIN941498697RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$50,176CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedFunds TransferValuationMethodUsedDesc
Purpose Of GrantUninsured/Underinsured PatientsPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (28 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
Albano Maureen
RN$337,594$12,325$13,296$10,993$374,208
Ammon Edward
Form. Foundation Exec thru 01/21$239,238$43,938$283,176
Ayala Raul
Ambulatory Medical Officer, CVN$59,246$22,841$856,691$602,279$159,029$13,296
Beaman John
CFO/ Asst Sec$21,043$66,512$2,060,669$1,261,000$698,818$13,296
Cox Shane thru 724
Treasurer$71,378$43,536$796,464$517,317$150,937$13,296
Day Lauren
Philanthropy Executive, CVN$21,184$71,197$440,506$261,124$73,945$13,056
Gamboa Pedro
RN$222,350$2,517$11,430$33,837$270,134
Garcia Rosa
RN House Supervisr$230,178$2,891$11,662$36,906$281,637
Haydock Timothy eff 724
Ops Exec CCN$56,651$66,512$807,126$492,108$178,559$13,296
Heinrich Kerry
Director/CEO$46,082$44,679$4,032,170$2,342,000$1,586,113$13,296
Hofheins Todd
COO/Vice Chair$45,560$52,696$2,473,667$1,474,000$888,115$13,296
Jahn Andrew
Frmr Care Div Pres thru 02/22$48,578$3,801$753,866$281,190$407,001$13,296
Jamaleddine Ghassan
Medical Officer Eff 07/01/23$65,371$66,512$962,196$632,373$184,644$13,296
Jobe Meredith
Secretary$143,872$44,679$1,279,079$796,100$281,132$13,296
Jones Larry
Admin Direc, Ancillary Serv, CVN$422$33,907$289,557$206,093$38,830$10,305
Kofl Andrea thru 124
Ctrl Vally Pres$597,436$44,008$1,140,021$203,715$284,676$10,186
Martin Cassi
Director RN$213,516$20,355$10,676$11,068$255,930$315
Nahapetian Arby
Frmr Care Div Med Off thru 02/22$189,823$66,512$1,839,066$1,111,000$458,435$13,296
Ng Mankwong
Pharmacist$203,386$3,916$10,461$33,467$251,230
Pereira Sheri
Assoc Patient Care Exec thru 2/24$196,470$22,610$251,125$30,519$1,526
Reyna Sonja
Ambulatory Executive$164,851$27,511$669,593$287,169$176,766$13,296
Stevens Eric eff 724
President$194,464$44,679$1,944,121$1,196,000$495,682$13,296
Taggart Laurie
Patient Care Exec$368,530$43,946$528,016$8,700$106,405$435
Tomono Christopher
Partnership Executive$36,221$66,340$528,097$323,323$88,917$13,296
Tomono Olga
Business Development Exec eff 11/24$31,812$890$535,730$395,901$93,831$13,296
Van Housen Heather
Patient Care Executive$47,097$49,707$652,728$429,414$113,214$13,296
Wells Jason
President CCN$151,735$66,512$1,622,864$968,000$423,321$13,296
Wing Bill
Former Dir/Asst Sec/VChair thru1/22$273,263$273,263

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, Line 6The 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 7aThe Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors.
Form 990, Part VI, Section A, Line 7bThe 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 11bThis 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 12cDuring 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 15aThe 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 15bSee Line 15a explanation.
Form 990, Part VI, Section C, Line 19The 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 9Transfer to Other Funds = -$0
Form 990, Part XI, Line 9Transfer to Related Entities = -$1047017

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Adventist Health Clearlake Hospital Inc
15630 18th AvenueClearlakeCA95422680395149HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Adventist Health Delano
1401 Garces HwyDelanoCA93215770258013HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Adventist Health Foundation
1 Adventist Health WayRosevilleCA95661680002188Charitable FoundationCA501(c)(3)7Adventist Health SystemWestfalse
Adventist Health Med Ctr Tehachapi
1100 Magellan DriveTehachapiCA93561812240617HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Adventist Health Mendocino Coast
700 River DriveFort BraggCA95437845174585HospitalCA501(c)(3)3Stone Point Healthfalse
Adventist Health Physicians Network
1 Adventist Health WayRosevilleCA95661680357690Medical FoundationCA501(c)(3)12b2Adventist Health SystemWestfalse
Adventist Health SystemWest
1 Adventist Health WayRosevilleCA95661953484589Integrated Health SystemCA501(c)(3)10NAfalse
Castle Medical Center
640 Ulukahiki StreetKailuaHI96734990107330HospitalHI501(c)(3)3Adventist Health SystemWestfalse
Feather River Hospital
1 Adventist Health WayRosevilleCA95661941101228HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Glendale Adventist Medical Center
1509 Wilson TerraceGlendaleCA91206951816017HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Hanford Community Hospital
115 Mall DriveHanfordCA93230940535360HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Lodi Memorial Hospital Association
975 S Fairmont AvenueLodiCA95240941044474HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Mid-Columbia Medical Center
1700 E 19th StreetThe DallesOR97058930386936HospitalOR501(c)(3)3Stone Point Healthfalse
Northwest Medical Fdtn of Tillamook
1000 Third StreetTillamookOR97141930622075HospitalOR501(c)(3)3Adventist Health SystemWestfalse
Portland Adventist Medical Center
10123 SE Market StreetPortlandOR97216930429015HospitalOR501(c)(3)3Adventist Health SystemWestfalse
Reedley Community Hospital
372 Cypress AvenueReedleyCA93654453220509HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Rideout Memorial Hospital
726 Fourth StreetMarysvilleCA95901941387866HospitalCA501(c)(3)3Stone Point Healthfalse
St Helena Hospital
10 Woodland RoadSt HelenaCA94574941279779HospitalCA501(c)(3)3Adventist Health SystemWestfalse
San Joaquin Community Hospital
2615 Chester AvenueBakersfieldCA93301952294234HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Sierra Vista Hospital Inc
1010 Murray AvenueSan Luis ObispoCA93405952588614HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Simi Valley Hospital and Health Care Svc
2975 N Sycamore DriveSimi ValleyCA93065956064971HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Sonora Community Hospital
1000 Greenley RoadSonoraCA95370941415069HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Stone Point Health
1 Adventist Health WayRosevilleCA95661823763347Supporting OrganizationCA501(c)(3)12b2Adventist Health SystemWestfalse
Twin Cities Community Hospital Inc
1100 Las Tablas RoadTempletonCA93465752918765HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Ukiah Adventist Hospital
275 Hospital DriveUkiahCA95482941639901HospitalCA501(c)(3)3Adventist Health SystemWestfalse
United Com-Serve
726 Fourth StreetMarysvilleCA95901943015356Skilled Nursing/Assisted Living/Hm HlthCA501(c)(3)12b2Stone Point Healthfalse
Western Health Resources
1 Adventist Health WayRosevilleCA95661953867863Home CareCA501(c)(3)10Adventist Health SystemWestfalse
White Memorial Medical Center
1720 E Cesar E Chavez AvenueLos AngelesCA90033952282647HospitalCA501(c)(3)3Adventist Health SystemWestfalse
Willits Hospital Inc
1 Marcela DriveWillitsCA95490680108919HospitalCA501(c)(3)3Adventist Health SystemWestfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Blue Legacy Ventures LLC
1010 NE 2nd AvenueMiamiFL33132871254649Real Property RentalFLAHSWestfalsefalse
Blue Zones LLC
200 Southdale CenterEdinaMN55435271603327EducationMNAHSWestfalsefalse
PAR LLC dba CherryWood Village
8440 SE Sunnybrook Blvd Suite 100ClackamasOR97015931262371Senior HousingORAHSWestfalsefalse
PVHR LLC dba Paradise Village
8440 SE Sunnybrook Blvd Suite 100ClackamasOR97015260622555Senior HousingORAHSWestfalsefalse
PVHR2 LLC dba Parkview Memory Care
8440 SE Sunnybrook Blvd Suite 100ClackamasOR97015473300170Senior HousingORAHSWestfalsefalse
WWGHR LLC dba Wheatland Village
8440 SE Sunnybrook Blvd Suite 100ClackamasOR97015810591221Senior HousingORAHSWestfalsefalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCd
Thrive Productions Inc
200 Southdale CenterEdinaMN55435453369049Production CompanyMNAHSWestC-Corpfalse
AdHealth Limited
Pure Captive InsuranceAHSWestC-CorpfalsePO Box HM 2062HamiltonBDHM HX
Adventist Health Plan Inc
463833261Health InsuranceAHSWestC-Corpfalse1 Adventist Health WayRosevilleBD
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Adventist Health SystemWest
e$123,250,575Notes Payable
Adventist Health SystemWest
m$10,479,303Operating Exp
Adventist Health SystemWest
o$1,453,231Compensation
Adventist Health SystemWest
s$30,432,325Cash Mgt Funds