2017-11-15T16:38:15-08:00 2016-12-31 SADD VELAZQUEZ HIGASHI & SHAMMAA LLP 330 N BRAND BLVD STE 200 GLENDALE CA 912032361 990 2016-01-01 951816017 Glendale Adventist Medical Center GLEN 8184098000 1509 Wilson Terrace Glendale CA 91206 Kreuger Eric Asst Sec/CFO 2017-11-15 true S Clement P01218012 8185475701 X 2016 2017-02-10 21:41:12Z Roberts Kevin 2100 Douglas Blvd Roseville CA 95661 463600933 false false 1071 X www.glendaleadventist.com X 1905 CA The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all. 11 7 2679 1023 2090282 514526 1579802 1617339 400425088 459227965 1725798 1602367 647610 1153262 404378298 463600933 580071 -241757 0 192076977 196145553 0 1581952 223514534 259258105 416171582 455161901 -11793284 8439032 369413805 381520459 232489614 235584295 136924191 145936164 Living Gods love by inspiring health, wholeness and hope. false false 392973881 463600933 Glendale Adventist Medical Center (GAMC) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Glendale Adventist Medical Center the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay: Providing free care and/or subsidized care Providing care to persons covered by governmental programs at below cost Providing health/wellness activities and community education programsNot only does Glendale Adventist MedicalCenter provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. Glendale Adventist MedicalCenter 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 2016 was $17,227,821.Inpatient services in 2016 were provided to 21118 patients. These services included: 2,413 Babies delivered 4,103 Surgeries performed 46,942 Radiology procedures performed 27,788 Cardiac catheterizations and other procedures 525,884 Laboratory tests performed 574 Rehabilitation patients 1,576 Mental health patientsOutpatient services in 2016 were provided to 292.504 patients. These services included: 60,011 Emergency room visits 4,458 Outpatient surgeries performed 73,588 Radiology procedures performed 21,291 Cardiac catheterizations and other procedures 369,141 Laboratory tests performedGlendale Adventist MedicalCenter recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission:Children's Health Outreach InitiativeCenter to Increase Community OrganizationCommunity support groupsCommunity health education classesHQ Newsletter for health promotionParamedic base stationTobacco Control ProgramCancer Survivor DayBeyond Loss Bereavement ProgramMental health support groupsBreast Cancer Awareness MonthCancer screeningsCancer Fitness ProgramGAMCs mission anchors everything we do, extending out to the community in many ways. Collaborative efforts between GAMC, local organizations and donors has created critical programs needed to address the specific health care needs of the more than residents living throughout our service area. Together we are changing the outcome of the community's health.Glendale Adventist Medical Center is accreditated as a Chest Pain Center and has been designated as a STEMI receiving center (SRC) by the Los Angeles County Emergency Services. When emergency medical personnel confirm a heart attack/STEMI diagnosis, they bring a patient directly to the GAMC emergency department for treatment. STEMI is a medical term that means heart attack (ST Evaluation MI).During 2016, GAMC was recognized by the County as a Top Performer and a leading program in Los Angeles County for its exceptional treatment times and mortality rate, well under the benchmark goal of being under 10%. GAMC was identified as having the lowest door-to-balloon time out of 34 Los Angeles County hospitals designated as STEMI receiving centers. Door-to-balloon time is the amount of time between the heart attack patient arriving at the doors of the emergency department and the opening of the clogged cardiac artery in the cardiac catheterization lab. The more quickly the artery is opened, the more quickly blood flow and oxygen can be delivered to the heart muscle. Quicker time means heart muscle is saved.Strokes are another area the hospital has received high recognition. Stroke patients who receive tPA (tissue plasminogen activator) intravenously within the first three hours after the start of stroke symptoms show a significant reversal of the effect of a stroke and it reduces permanent disability. The Neuroscience Institute at GAMC is home to one of the few Advanced Primary Stroke Centers in Los Angeles County and became the first hospital in California to receive Comprehensive Stroke Center accreditation from DNV-GL Healthcare USA, the highest certification that a hospital can receive.Glendale Adventist Medical Center is the only hospital in Los Angeles County to be certified as both a Stroke and Chest Pain Center. Both of these designations come about with close cooperation with the local emergency medical system and the physicians who perform the medical procedures and follow up with the patients after their discharge from the hospital. This emphasis on Stroke and Chest Pain along with the focus of all departments in the hospital has enabled it to reduce deaths significantly. GAMC was ranked #5 in the nation as having the 5th lowest risk-adjusted mortality rate according to the Centers for Medicare & Medicaid Services based on deaths occurring within 30 days following discharge based on the 2009-2012 time period.The Centers for Medicare & Medicaid Services (CMS) recently released its Star rating with thousands of hospitals across America rated on a one-to-five star scale. GAMC received an impressive four out of five stars, which was given to only ten hospitals out of 57 rated hospitals within a 25 mile radius of GAMC. The score, four out of five stars, places GAMC in the top 20 percent of hospitals in our region.GAMC has been given five consecutive "A" grades for safest hospital. Our physicians, nurses and associates make patient care, safety and outcomes a priority. Our Comprehensive Community Cancer Program, AHGL Cancer Services is a proud recipient of the Outstanding Achievement Award by the American College of Surgeons for excellence in cancer care. The Cancer Center was also named a Pink Ribbon Facility for providing excellence in breast health paired with exceptional support.GAMC has been voted as the Best Hospital and having the best nurses in the Glendale area for several years by the readers of a local newspaper and more than 100 of the GAMC physicians were nominated by the medical community for Pasadena Magazine's Top Docs.A significant portion of the mission-driven assistance GAMC provides its community is intangible or otherwise difficult to quantify. The following story illustrates this: On Tuesday, Aug. 8, at 9:48 a.m., Glendale Fire paramedics wheeled Silvana Shirvanian, 60, into the Emergency Dept. at Adventist Health Glendale. Silvanas left side was weak. One side of her face was drooping. Her speech was slurred. She had suffered a stroke. On Thursday, Aug. 10, at about 2 p.m., Silvana got dressed and received her discharge information. And later in the day, she literally walked out of the hospital and returned to her everyday life just like nothing ever happened!Not every stroke patient experiences such an incredible outcome, but scenarios like Silvanas are becoming more commonplace at Adventist Health Glendale a credit to the 21st century advanced skills of neuro-interventional surgeons Yaser Badr, MD, and Mikayel Grigorian, MD, and an extraordinary stroke support team that activates when a patient enters the hospital.Compassionate, high-quality patient care; life-saving and life-preserving medical and surgical services; advanced treatments in a community-based hospital; essential emergency services- these are the reasons our donors choose Glendale Adventist Medical Center as their charity of choice.For more information on the work that we do, visit us at www.glendaleadventist.com. 392973881 true true false true false false false false false false true false false true true false false false false false false true false false false false true true true false true false false false false false false false false false true false false false false false false true true false false false true 508 0 true 2679 true true true false false false false false false 0 false false false false false false false false false false X 11 7 false false false false true false true true true false false true true true true true true true true true true CA X Eric Krueger CFO 8184098000 1509 Wilson Terrace Glendale CA 91206 X Dickinson Charles Director 0.00 4.00 X 0 217464 54172 Freedman John Director 0.00 4.00 X 0 300 0 Friestad Christine Director 0.00 4.00 X 0 968 0 Gabriel Melody Director 0.00 4.00 X 0 2269 0 Giese Jonathan CFO/Asst Sec/VP 0.00 50.00 X 0 329599 55765 Graham Ricardo Director 0.00 4.00 X 0 4246 0 Heinrich Kerry Director 0.00 4.00 X 0 683 0 Innocent Larry Director 0.00 4.00 X 0 1503 0 Jobe Meredith Secretary 0.00 50.00 X 0 552085 99823 Reimche Allan Director 0.00 4.00 X 0 4407 0 Reiner Scott Dir/Chair 0.00 50.00 X 0 1711534 283273 Rippey Wesley Director 0.00 4.00 X 0 129770 0 Roberts Kevin President/CEO 0.00 50.00 X X 0 657337 128432 Salazar Velino Dir/V Chair 0.00 4.00 X X 0 3915 0 Torkelsen Max Director 0.00 4.00 X 0 4102 0 Tetz Warren Asst Sec/Sr VP/ 0.00 50.00 X 0 426055 91109 Wagner Jack Asst Sec 0.00 50.00 X 0 1117705 41826 Wing Bill Dir/V Chair/Ass 0.00 50.00 X 0 1319055 238355 Brandt-Mayo Karen VP Clin Svcs/CNO 0.00 50.00 X 0 266193 43282 Correa Sharon VP/CIO 0.00 50.00 X 0 279880 36371 Fargo Roland Sr VP Reg Physician Ops 0.00 50.00 X 0 456293 97883 Markarian Ramella VP Bus Dev/Phys Rel 0.00 50.00 X 0 222643 42112 Nahapetian Arby VP Med Affairs 0.00 50.00 X 0 631536 141957 Zachary Beth Reg President & CEO 0.00 50.00 X 0 1031265 201025 Bourdon Irene President, Healthcare Fnd 0.00 50.00 X 0 281956 40639 Kayichian Despina VP Med Affairs/Quality 0.00 50.00 X 0 210687 12267 Wehtje Ronald CFO SCR 0.00 50.00 X 0 501328 27873 Brown Robert Registered Nurse 55.00 0.00 X 249131 0 22178 Eskandarian Romic Pharmacy Director 50.00 0.00 X 225395 0 13138 Patana Suvanna Registered Nurse 50.00 0.00 X 207601 0 24872 Watson Marion Director, RN 50.00 0.00 X 195853 0 14857 Varghese Punnoose Director, RN 50.00 0.00 X 195297 0 9581 Carmen Robert Former Dir/Chair 0.00 0.00 X 0 358716 7952 Wehtje Rodney Former Asst Treas 0.00 0.00 X 0 388431 41835 1073277 11111925 1770577 504 true true false ShiftwiseOrigin PO Box 7080 St Paul MN 55170 Nurse Staffing 3934036 Family Practice of Glendale Glendale Med Gp 801 S Chevy Chase 201 Glendale CA 91205 Residency Teaching 2956987 Sound Physicians PO Box 742936 Los Angeles CA 90074 Medical Services 2663484 Faculty Physicians & Surgeon 11175 Campus St 11120 Loma Linda CA 92350 Medical Services 2527727 Mak Albert CMD Inc 707 S Garfield Ave Ste B002 Alhambra CA 91801 Medical Services 1785000 43 9483 1477038 130818 1617339 Dietary 722210 1188439 1185967 2472 Other Prog Serv Rev 900099 1535985 1535985 Patient Svc Revenue 621110 451939657 449879847 2059810 Program Service Revenue 621110 1989144 1989144 Rental Income - Prog 531120 1875159 1875159 699581 591493 108088 459227965 1597645 1597645 0 0 0 4722 4722 4722 4722 0 0 0 Accounting Service Rev 21000 21000 Mgmt Fees-Unrelated Orgs 541900 14406 7406 7000 Net Assets Rel from Rest 900099 1839661 1839661 -721805 -721805 1153262 463600933 456193713 2090282 3699599 -241757 -241757 0 0 0 0 0 155294214 141341512 12575302 1377400 6077722 6077722 23600789 19766226 3834563 11172828 10242185 930643 22858565 20984513 1874052 1225841 1225841 15000 15000 0 0 0 0 1234188 1228682 5506 4304925 2812525 1454989 37411 19446483 19406788 39695 0 10689136 10645279 20301 23556 383904 182524 179812 21568 0 307606 237286 70320 4989552 4989552 0 17922224 17918541 3683 1555954 1555954 Purchased Services 60479521 23440814 36937196 101511 Pt Care Supplies 54818707 54818707 Qual Assur Hosp Fee 47396497 47396497 Other Expenses 10249971 10051823 198148 1380031 1347190 32841 455161901 392973881 60606068 1581952 88496 54718 34693297 31330723 0 79985389 69921634 0 0 0 5167784 5390430 2605137 2305690 469012988 262826309 216027459 206186679 1123298 2239950 0 0 6903396 6549969 22819549 57540666 369413805 381520459 32739376 38764795 31801946 30611637 167948292 166207863 232489614 235584295 X 132361765 137974504 4254485 7648463 307941 313197 136924191 145936164 369413805 381520459 X 8439032 572941 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 32809 32809 false false Part II-B, Line 1i - Other Activities Description Allocation of dues paid to industry and professional organizations. 3726115 3726115 375285026 197217204 178067822 6278651 3004106 3274545 77998777 60564467 17434310 5724419 2040532 3683887 206186679 Other Assets 6489337 Other Receivables 608142 Receivables from Related Organizations 28056895 Receivables from Third-Party Payors 22386292 57540666 Other Liabilities 23701 Payables to Related Organizations 149744711 Payble to third-party payors 6771187 Workers Compensation Liability 9668264 166207863 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. true Russia-Armenia Mission Trip 156273 Travel/Supplies Cost 1 false false false false false false true true X true X 300.000000000 true X 450.000000000 true true false false true true 7711930 7711930 0.01690 149667842 106649976 43017866 0.09450 33504 6081 27423 0.00010 157413276 106656057 50757219 0.11150 3962449 728305 3234144 0.00710 5591677 5591677 0.01230 469272 469272 0.00100 10023398 728305 9295093 0.02040 167436674 107384362 60052312 0.13190 3797232 3797232 0.00830 3797232 3797232 0.00830 true 1207743 397565 164329029 127690188 36638841 X true true 1 1 Glendale Adventist Med Center X X X X Acute, Psychiatric & Skilled Nursing false false true X X X X X X X X X 16 true true false true X X true 16 true See webb address in 7 d above true false true X 300.0000 450.0000 X X X true true X X X true X https://www.adventisthealth.org/glendale X X X X X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community Focus GroupsMeetings with Community LeadersDiscussions with Area Hospitals Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Glendale Memorial Hospital & Health CenterVerdugo Hills Hospital Part V, Line 7d - Description of Making Needs Assessment Widely Available The Community Benefit Plan for Glendale Adventist Medical Center can be found at https://www.adventisthealth.org/pages/about-us/community-health-needs-assessments.aspx Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why The CHNA seeks to identify every health need in the community. We have prioritized those needs and matched them up with service lines that we have and developed strategies around those. The primary areas we are focused on are cardiovascular disease, stroke care and prevention, diabetes, and cancer. In other areas that were identified we do not have the resources or expertise to address those needs, so are rely on other partners in the community with expertise in those areas. GAMC Alcohol & Drug Rehab 335 Mission Road Glendale CA 91206 Alcohol & Drug Rehabilitation Services Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide combined audited financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL: Revenue Rec. *Medicare Cost Report Revenue $136,290,904 Prior Year Settlements 3,036,872 Cost Report Reimbursable Bad Debts 1,019,570 Less Amts included in Part 1, lines g & f (1,779,416) Non-Cost Report Revenue 9,767,235 Estimates and Accrual Variances ( 537 835) Other 16,531,699 ___________ Subtotal - Amount reported in Pt III, line 5 164,329,029 Amount included in Part 1, lines g and f 1,779,416 ___________ Total Medicare Revenue $166,108,445*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI - Needs Assessment For the 2016 CHNA, three Glendale hospitalsGAMC, Glendale Memorial Hospital and Health Center, and Verdugo Hills Hospitalcollaborated, as they have in the past, to work with the Center for Nonprofit Management consulting team in conducting the CHNA. During the initial phase of the CHNA process, community input was collected during a focus group with key stakeholders, including health care professionals, government officials, social service providers, community residents, leaders, and other relevant individuals. Previous CHNAs were reviewed to identify trends. Participants completed an online questionnaire about health needs, drivers, and resources, and ranked each health need according to several criteria including severity, change over time, resources available to address the need or driver. Part VI - Patient Education of Eligibility for Assistance For scheduled cases, hospital staff run patients eligibility and informs patients of their benefits and financial responsibility. If a patient is insured under a government program, staff informs them about any financial responsibility they have, and ask whether the patient has further questions about their government benefits. If a patient is uninsured, staff provides education about government programs that may be available, and including appointment-setting with the on-site state Medi-Cal worker. If a patient is uninsured and unable to meet any portion of their financial responsibility, staff connects them with government programs, and if appropriate, helps them apply for GAMCs hospital assistance program. GAMC communicates to the public through the website, application form and plain language, the FAP, application form and plain language summary (PLS) are available free of charge in registration areas. Notices about financial assistance are posted in high traffic registration areas. Part VI - Community Information GAMC serves greater Glendale and Northeast Los Angeles including Highland Park, Glassell Park, and Eagle Rock. The area includes an medically underserved area as well as a health profession shortage area. The population served (about 325,000) is 35.5% Latino, 44.7% Caucasian (including the largest population of Armenians outside of Russia/Armenia), 15.5% Asian (Korean and Filipino), 1.6% African-American, and 2.7% Other. GAMC serves a large immigrant, low-income and uninsured population whose ability to access health services is impacted by barriers such as immigration status, educational attainment, employment status and level of poverty. Overall, 54% of residents are foreign born. Approximately 21% of the households were estimated to earn below the Federal Poverty Level (FPL) which was identified as $23,850 in 2014 for a family of four and $11,670 for a family of one and almost half of the households live below an amount equal to twice the FPL. Part VI Promotion of community health. GAMC has a civic advisory board that meets quarterly to establish or maintain a dialogue with the community. The hospitals mission expresses itself as caring for the whole community by initiating many community collaborative projects, including the development of the Glendale Healthier Community Coalition (GHCC) and Glendale Healthy Kids, obtaining the California Healthy City designation for Glendale. GHCC is the vehicle GAMC uses to coordinate its efforts with the community, including Care Transition, Consortium of Safety Net Providers, and We Own the Health of Our Community. Part VI - Community Building Activities Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The hospital has an operating board composed of community members who advise the president/CEO regarding the needs of the community. Based on their advice, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include cardiac, neuro, spine, cancer, emergency, outpatient services, minimally invasive surgery (robotics and no scar surgery), ortho, behavioral medicine, and rehabilitative medicine, as well as a family medicine residency program. The hospital cooperates with area physicians to offer both family medicine and obstetrics clinics. Glendale Adventist has also established a Department of Clinical Research to help our communities gain access to cutting edge clinical advancements. Part VI - Affilated Health Care System Roles and Promotion The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served. Part VI - States Where Community Benefit Report Filed CA Part V - Explanation of Number of Facility Type The hospital provides outpatient services in multiple locations within its service area. true Armenian American Medical Soc PO Box 32 Glendale CA 91209 954108352 501(c)(3) 12500 0 Sponsorship Armenian Bone Marrow Donor Re 347 W Stocker St 208 Glendale CA 91202 050573780 501(c)(3) 10600 0 Sponsorship Armenian Educational Fdtn 600 W Broadway Glendale CA 91209 952000503 501(c)(3) 10000 0 Sponsorship Glendale Arts 116 W California Ave Glendale CA 91203 954416336 501(c)(3) 10000 0 Sponsorship Glendale Communitas Initiativ 610 E California Ave Glendale CA 91206 463366897 501(c)(3) 7500 0 Sponsorship Gods Soldier Ministries 1535 E Chevy Chase Dr Glendale CA 91206 473732610 501(c)(3) 10000 0 Sponsorship Homenetmen Gelendale Ararat 3347 N San Fernando Rd Los Angeles CA 90065 237062425 501(c)(3) 6050 0 Sponsorship White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 501(c)(3) 6000 0 Sponsorship YMCA of Glendale 140 N Louise St Glendale CA 91206 951661118 501(c)(3) 7500 0 Sponsorship YMCA of the Foothills 1930 Foothill Blvd La Canada CA 91011 951976183 501(c)(3) 10000 0 Sponsorship 10 1 Grantmaker's Description of How Grants are Used Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X true true X X X X false true false false false false false false false false Bourdon Irene President, Healthcare Fnd 236095 21112 24749 16180 24459 322595 Brandt-Mayo Karen VP Clin Svcs/CNO 234279 20043 11871 16180 27102 309475 Brown Robert Registered Nurse 123179 6743 119209 20891 1287 271309 Carmen Robert Former Dir/Chair 358716 7952 366668 Correa Sharon VP/CIO 252873 18814 8193 16240 20131 316251 Dickinson Charles Director 184932 32532 37740 16432 271636 Eskandarian Romic Pharmacy Director 205753 19642 8440 4698 238533 Fargo Roland Sr VP Reg Physician Ops 332464 59878 63951 65541 32342 554176 Giese Jonathan CFO/Asst Sec/VP 282710 24934 21955 45764 10001 385364 Jobe Meredith Secretary 364469 95028 92588 74172 25651 651908 Kayichian Despina VP Med Affairs/Quality 206250 4437 12068 199 222954 Markarian Ramella VP Bus Dev/Phys Rel 194451 17313 10879 13345 28767 264755 Nahapetian Arby VP Med Affairs 495897 88816 46823 108751 33206 773493 Patana Suvanna Registered Nurse 114244 3924 89433 24000 872 232473 Reiner Scott Dir/Chair 1018912 299575 393047 249575 33698 1994807 Roberts Kevin President/CEO 491623 61280 104434 108222 20210 785769 Tetz Warren Asst Sec/Sr VP/ 335855 29962 60238 66590 24519 517164 Varghese Punnoose Director, RN 179109 16188 7272 2309 204878 Wagner Jack Asst Sec 698200 200386 219119 16384 25442 1159531 Watson Marion Director, RN 175594 20259 7638 7219 210710 Wehtje Rodney Former Asst Treas 380418 8013 16393 25442 430266 Wehtje Ronald CFO SCR 335653 80000 85675 10880 16993 529201 Wing Bill Dir/V Chair/Ass 855884 253689 209482 203961 34394 1557410 Zachary Beth Reg President & CEO 696556 171232 163477 168659 32366 1232290 Part I, Line 1a: Relevant information in regards to selections on 1a. Part I, Line 1BAny items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. Kevin Roberts Brother 127299 Employment false Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital bylaws define its board of directors to be the same individuals who are members of Adventist Health System/West board of directors. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 11b: Form 990 Review Process The completed Form 990 is shared with members of the corporation's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board prior to filing. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff reviews these questionnaires and disclosures each year during the audit process. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Other Changes In Net Assets Or Fund Balances - Other Decreases Net Assets Released fr Restrictions 169.20 = -$1839661 Other Changes In Net Assets Or Fund Balances - Other Increases Net Assets Released from Restr-Cap Addtn 168.10 = $0 Other Changes In Net Assets Or Fund Balances - Other Increases Net Realized gains/losses on Perm Restr investments 170.40 = $5257 Other Changes In Net Assets Or Fund Balances - Other Increases Restricted Gifts & Grants 169.30-60 = $5247910 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfers to Affliated Organizations = -$2840565 Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 N/A true Adventist Health Clearlake Hospital Inc Avenue 18 at Highway 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Hlth Medical Ctr Tehachapi 115 W E St Techapi CA 93561 812240617 Hospital CA 501(c)(3) 11b,II Adventist Health SystemWest false Adventist Health Physicians Ntwk 2100 Douglas Blvd Roseville CA 95661 680357690 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua CA 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Road Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Glendale Adventist Medical Center Fdtn 1509 Wilson Terrace Glendale CA 91206 953899682 Fundraising for Hospital CA 501(c)(3) 11, Type 1 Adventist Health SystemWest false Hanford Community Hospital 450 Greenfield Avenue Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Lodi Memorial Hospital Association Inc 975 Fairmount Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Fdtn of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilit CA 501(c)(3) 1 Adventist Health SystemWest false Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Reedley Community Hospital 372 W Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital & Health Care Svcs 2975 N Sycamore Drive Bakersfield CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital WA 501(c)(3) 1 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Willits Hospital Inc 1 Marcela Dr Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Physician Medical Terrace LP 1509 Wilson Terrace Glendale CA 91206 954277400 Med Ofc Bld CA N/A -29764 false true 0.63686 Glendale Adventist Medical Building LP 1509 Wilson Terrace Glendale CA 91206 953752800 Med Ofc Bld CA N/A 335812 false true 0.54613 Physicians Surgery Center at GAMC 1500 E Chevy Chase Dr Ste 101 Glendale CA 91206 464085815 Ambulatory Surgical Center CA N/A -934509 false true 0.58549 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA C-Corp false true false false true true false false false false true true true true false true true true true true Glendale Adventist Medical Center Fdtn l 204552 Cost Glendale Adventist Medical Center Fdtn o 1377400 Cost