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UKIAH ADVENTIST HOSPITAL: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
UKIAH ADVENTIST HOSPITAL (EIN 94-1639901)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-06
IRS object ID
202523109349302462
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)
Return2025-11-06T11:07:52-06:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Baker Tilly Advisory Group LPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12882 Prospect Park Dr Ste 300AddressLine1Txt
CityRancho CordovaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95670ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN941639901EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Ukiah Adventist HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUKIABusinessNameControlTxt
Phone9164060000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1275 Hospital DriveAddressLine1Txt
CityUkiahCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95482ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRichard RiterPersonNm
Person TitleTreasurerPersonTitleTxt
Phone9164060000PhoneNum
Signature2025-10-25SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLauren A HaverlockPreparerPersonNm
PTINP00545829PTIN
Phone9165038100PhoneNum
Preparation2025-10-25PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health Ukiah ValleyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerParker PridgenPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1275 Hospital DriveAddressLine1Txt
CityUkiahCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95482ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$282,524,932GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.adventisthealth.org/ukiah-valley/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1967FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionLiving God's love by inspiring health, wholeness and hope.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee967TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$79,967TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,253,922PYContributionsGrantsAmt
CY Contributions Grants$6,195,584CYContributionsGrantsAmt
PY Program Service Revenue$255,410,857PYProgramServiceRevenueAmt
CY Program Service Revenue$269,792,705CYProgramServiceRevenueAmt
PY Investment Income$2,822,575PYInvestmentIncomeAmt
CY Investment Income$6,487,853CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$261,487,354PYTotalRevenueAmt
CY Total Revenue$282,476,142CYTotalRevenueAmt
PY Grants And Similar Paid$249,848PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$832,429CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$84,485,456PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$94,355,521CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$92,457CYTotalFundraisingExpenseAmt
PY Other Expenses$171,926,716PYOtherExpensesAmt
CY Other Expenses$180,985,998CYOtherExpensesAmt
PY Total Expenses$256,662,020PYTotalExpensesAmt
CY Total Expenses$276,173,948CYTotalExpensesAmt
PY Revenues Less Expenses$4,825,334PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,302,194CYRevenuesLessExpensesAmt
Total Assets BOY$261,031,343TotalAssetsBOYAmt
Total Assets EOY$269,457,052TotalAssetsEOYAmt
Total Liabilities BOY$105,934,809TotalLiabilitiesBOYAmt
Total Liabilities EOY$109,293,252TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$155,096,534NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$160,163,800NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionLiving God's love by inspiring health, wholeness and hope.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$229,309,550ExpenseAmt
Grant$832,429GrantAmt
Revenue$269,712,738RevenueAmt
DescSee Schedule ODesc
Total Program Service Expenses$229,309,550TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee967EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1John Beaman CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9164060000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 Adventist Health WayAddressLine1Txt
CityRosevilleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95661ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Heinrich Kerry
Dir/Chair/CEO0.0050.00Yes (X)Yes (X)$0$3,974,195$57,975
Hofheins Todd
Dir/Vice Chair/COO0.0050.50Yes (X)Yes (X)$0$2,407,675$65,992
Freedman John
Director0.004.00Yes (X)$0$27,203$0
Newton Bradford
Director0.004.00Yes (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
Wagner Jack
Director0.004.00Yes (X)$0$21,611$0
Woodson Marc
Director0.004.00Yes (X)$0$21,611$0
Salazar Velino
Director thru 09/240.004.00Yes (X)$0$21,181$0
Fehr Joy
Director0.004.00Yes (X)$0$18,680$0
Beckett Ann
Director as of 01/240.004.00Yes (X)$0$17,930$0
Daggett Jonathan
Director as of 01/240.004.00Yes (X)$0$16,180$0
Jutzy Kenneth
Director as of 01/240.004.00Yes (X)$0$16,180$0
Cress John
Director as of 10/240.004.00Yes (X)$0$430$0
Beaman John
CFO/Assistant Secretary0.0050.50Yes (X)$0$1,980,861$79,808
Jobe Meredith
Secretary0.0050.50Yes (X)$0$1,221,104$57,975
Howe Judson - Pres AHUV
Pres, N Coast Ntwk thru 07/248.3041.70Yes (X)$0$830,097$79,497
Mock Jeffrey-TreasAsst Secr
Ops Exec, N Coast Svc Ar as of 09/2410.0040.00Yes (X)$0$568,248$35,835
Stevens Eric-Pres AHUV 0724
Pres, N Coast Svc Ar as of 07/245.0045.50$0$1,886,146$57,975Yes (X)
Eberhart Gregory
Area Medical Officer thru 04/2412.5037.50$0$670,753$73,606Yes (X)
Assadian Hoda
Operations Executive thru 06/2416.7033.30$0$498,153$60,421Yes (X)
Bartolomie Jill
Patient Care Executive thru 04/2450.000.00$0$358,771$38,096Yes (X)
Buckingham Amy - Associate
Patient Care Executive as of 12/2425.0025.00$0$356,296$30,007Yes (X)
Leighton David
Administrator40.000.00$340,838$0$38,034Yes (X)
Winter Carrie
Multi-Site Director Pharmacy40.000.00$300,052$0$50,479Yes (X)
Denoeu Rebecca
Director, Emergency Services40.000.00$279,398$0$53,337Yes (X)
Woodruff Nicole
Director, Perioperative Services40.000.00$272,035$0$36,417Yes (X)
Loi Victor
Pharmacist40.000.00$254,527$0$17,630Yes (X)
Wells Jason
Former President thru 12/200.0050.00$0$1,543,056$79,808Yes (X)
Shepardson Dean - Former
Treas/Asst Secr thru 09/230.0050.00$0$651,222$76,490Yes (X)
Wing Bill - Former Dir
Asst Secr/Vice Chair thru 01/220.000.00$0$273,263$0Yes (X)
Nahapetian Arby - Former Care
Division Medical Officer thru 02/220.0050.00$0$1,759,258$79,808Yes (X)
Jahn Andrew - Former Care
Division President thru 02/220.0050.00$0$693,217$59,411Yes (X)
Spencer Lindsey - Former
Operations Executive thru 05/220.0050.00$0$603,528$79,808Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,446,850TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$20,570,232TotReportableCompRltdOrgAmt
Total Other Compensation$1,208,409TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K254IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Pacific Redwood Medical Group Inc
242 Hospital Drive Suite BUkiahCA95482Medical Services$3,135,125
Anesthesia Management Services of CA In
617 Park BoulevardUkiahCA94582Medical Services$2,957,412
Galen Inpatient Physicians Inc
2100 Powell St Ste 400EmeryvilleCA94608Medical Services$2,953,241
RMG Medical Imaging Consultants
PO Box 86348Los AngelesCA90086Medical Services$2,704,740
CHG Companies Inc
PO Box 972651DallasTX75397Staffing Services$2,170,589
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K46CntrctRcvdGreaterThan100KCnt
Government Grants$5,883,253GovernmentGrantsAmt
All Other Contributions$312,331AllOtherContributionsAmt
Total Contributions$6,195,584TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Patient service revenue621110$210,796,468$210,796,468
Premium revenue900099$43,430,126$43,430,126
340B Pharmacy456110$12,532,678$12,452,711$79,967
Intercompany revenue621990$1,152,486$1,152,486
Incentive and quality revenue621990$1,083,345$1,083,345

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$797,602TotalRevenueColumnAmt
Related Or Exempt Func Income$797,602RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$269,792,705TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,536,643TotalRevenueColumnAmt
Exclusion$6,536,643ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$48,790OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$48,790OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$48,790TotalRevenueColumnAmt
Exclusion-$48,790ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$282,476,142TotalRevenueColumnAmt
Related Or Exempt Func Income$269,712,738RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$79,967UnrelatedBusinessRevenueAmt
Exclusion$6,487,853ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$832,429TotalAmt
Program Services$832,429ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$73,466,045TotalAmt
Program Services$61,616,242ProgramServicesAmt
Management And General$11,793,707ManagementAndGeneralAmt
Fundraising$56,096FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,841,574TotalAmt
Program Services$2,383,239ProgramServicesAmt
Management And General$456,166ManagementAndGeneralAmt
Fundraising$2,169FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$12,712,996TotalAmt
Program Services$10,307,455ProgramServicesAmt
Management And General$2,393,519ManagementAndGeneralAmt
Fundraising$12,022FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,334,906TotalAmt
Program Services$4,608,679ProgramServicesAmt
Management And General$720,987ManagementAndGeneralAmt
Fundraising$5,240FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$16,887,986TotalAmt
Program Services$225ProgramServicesAmt
Management And General$16,887,761ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$240,791TotalAmt
Management And General$240,791ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$18,937TotalAmt
Program Services$18,937ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$73,730,904TotalAmt
Program Services$71,220,173ProgramServicesAmt
Management And General$2,504,021ManagementAndGeneralAmt
Fundraising$6,710FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$87,910TotalAmt
Management And General$87,910ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,799,432TotalAmt
Program Services$1,492,871ProgramServicesAmt
Management And General$305,711ManagementAndGeneralAmt
Fundraising$850FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$11,742,579TotalAmt
Program Services$1,495,556ProgramServicesAmt
Management And General$10,247,023ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,600,623TotalAmt
Program Services$8,931,116ProgramServicesAmt
Management And General$669,507ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$371,003TotalAmt
Program Services$240,253ProgramServicesAmt
Management And General$130,750ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,802TotalAmt
Program Services$24,680ProgramServicesAmt
Management And General$31,122ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,202,879TotalAmt
Program Services$2,202,879ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,717,678TotalAmt
Program Services$8,656,736ProgramServicesAmt
Management And General$60,942ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,346,143TotalAmt
Program Services$1,346,143ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
Patient care supplies$50,228,390$50,219,020$9,370
Quality assurance fees$1,123,309$1,123,309
Rental/lease costs equi$530,524$521,408$9,116
UBI taxes$27,388$27,388

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,273,720TotalAmt
Program Services$2,040,812ProgramServicesAmt
Management And General$232,908ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$276,173,948TotalAmt
Program Services$229,309,550ProgramServicesAmt
Management And General$46,771,941ManagementAndGeneralAmt
Fundraising$92,457FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$11,891BOYAmt
EOY$11,601EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$106,483,965BOYAmt
EOY$102,877,596EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$236,448BOYAmt
EOY$142,282EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,986,359BOYAmt
EOY$31,219,990EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,874,713BOYAmt
EOY$2,819,864EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$225,052BOYAmt
EOY$110,833EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$148,023,951LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$74,567,732LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$70,306,778BOYAmt
EOY$73,456,219EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$28,618BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$500,000BOYAmt
EOY$500,000EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$172,586BOYAmt
EOY$172,586EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$53,204,933BOYAmt
EOY$58,146,081EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$261,031,343BOYAmt
EOY$269,457,052EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,443,679BOYAmt
EOY$20,449,139EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$294,282BOYAmt
EOY$220,960EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$90,196,848BOYAmt
EOY$88,623,153EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$105,934,809BOYAmt
EOY$109,293,252EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$151,257,858BOYAmt
EOY$157,213,006EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,838,676BOYAmt
EOY$2,950,794EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$155,096,534BOYAmt
EOY$160,163,800EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$261,031,343BOYAmt
EOY$269,457,052EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,302,194ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,314,539NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments-$2,549,467PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)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)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$18,937OtherActivitiesAmt
Total Lobbying Expenditures$18,937TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationThe Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to NL Short Public Affairs were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,838,676BeginningYearBalanceAmt
Contributions$584,721ContributionsAmt
Other Expenditures$1,472,603OtherExpendituresAmt
End Year Balance$2,950,794EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,698,375BeginningYearBalanceAmt
Contributions$32,085ContributionsAmt
Other Expenditures$1,891,784OtherExpendituresAmt
End Year Balance$3,838,676EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,320,654BeginningYearBalanceAmt
Contributions$7,225,833ContributionsAmt
Investment Earnings Or Losses-$4,123InvestmentEarningsOrLossesAmt
Other Expenditures$2,843,989OtherExpendituresAmt
End Year Balance$5,698,375EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,291,863BeginningYearBalanceAmt
Contributions$1,023,959ContributionsAmt
Investment Earnings Or Losses$5,118InvestmentEarningsOrLossesAmt
Other Expenditures$1,000,286OtherExpendituresAmt
End Year Balance$1,320,654EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,311,452BeginningYearBalanceAmt
Contributions$822,627ContributionsAmt
Other Expenditures$842,216OtherExpendituresAmt
End Year Balance$1,291,863EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,276,873OtherCostOrOtherBasisAmt
Book Value$1,276,873BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$104,567,027OtherCostOrOtherBasisAmt
Depreciation$45,707,562DepreciationAmt
Book Value$58,859,465BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,548,711OtherCostOrOtherBasisAmt
Depreciation$1,224,698DepreciationAmt
Book Value$1,324,013BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,631,340OtherCostOrOtherBasisAmt
Depreciation$27,635,472DepreciationAmt
Book Value$11,995,868BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$73,456,219TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Receivables from third-party payors$43,259,684
Right-of-use assets$11,426,988
Other receivables$2,921,013
Receivables from related organizations$530,396
Other assets$8,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$58,146,081TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Payables to related organizations$67,046,075
Payables to third party payors$11,777,895
Lease liability$9,799,183
FieldValueIRS element (for citing)
Total Liability$88,623,153TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:Board-designated and temporarily restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.
Part X, Line 2:The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2024 and 2023, no such assets or liabilities were recorded. The System currently files Form 990 (Informational Return of Organizations Exempt From Income Taxes) and Form 990-T (Exempt Organization Business Income Tax Return) 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 (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$853,506TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$853,506NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$853,506TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$853,506NetCommunityBenefitExpnsAmt
Total Expense0.00310TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$951,700TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$73,368DirectOffsettingRevenueAmt
Net Community Benefit Expns$878,332NetCommunityBenefitExpnsAmt
Total Expense0.00320TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,032,281TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,001,163DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,031,118NetCommunityBenefitExpnsAmt
Total Expense0.00740TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43,134,521TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$29,460,836DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,673,685NetCommunityBenefitExpnsAmt
Total Expense0.04950TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$52,747TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$52,747NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$47,171,249TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,535,367DirectOffsettingRevenueAmt
Net Community Benefit Expns$16,635,882NetCommunityBenefitExpnsAmt
Total Expense0.06030TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,024,755TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$30,535,367DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,489,388NetCommunityBenefitExpnsAmt
Total Expense0.06340TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$397,138TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$397,138NetCommunityBenefitExpnsAmt
Total Expense0.00140TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$161,314TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$161,314NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$558,452TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$558,452NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$1,444,305BadDebtExpenseAmt
Bad Debt Expense Attributable$527,839BadDebtExpenseAttributableAmt
Reimbursed By Medicare$51,659,626ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$62,566,834CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,907,208MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

FieldValueIRS element (for citing)
Business Name Line11 Hospital Dr Med Plaza AssnBusinessNameLine1Txt
FieldValueIRS element (for citing)
Primary ActivitiesProperty managementPrimaryActivitiesTxt
Org Profit Or Ownership0.33000OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership0.00000OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership0.67000PhysiciansProfitOrOwnershipPct
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health Ukiah ValleyBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1275 Hospital DriveAddressLine1Txt
CityUkiahCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95482ZIPCd
FieldValueIRS element (for citing)
Website AddressSee Form 990, Pg 1, Item JWebsiteAddressTxt
State License110000095StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Adventist Health Ukiah ValleyBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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 (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)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 (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSee Sch H Part VI - Needs AssessmentStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSch H, Part VI-Patient EducFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSch H, Part VI-Patient EducFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSch H, Part VI-Patient EducFAPSummaryOnWebsiteURLTxt
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 (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
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 (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Adventist Health Ukiah ValleyPart V, Section B, Line 5: The 2022 Community Health Needs Assessment for Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) 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). In total, nine focus groups were conducted with 40 participants, and seven key informant interviews were held. Survey data was gathered from the North Coast region (region name defined by survey administrator, UC Berkeley IGS).The 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 heard. In total, nine focus groups were conducted with 40 participants, and seven key informant interviews were held. Civic government & leadership, community-based organizations focusing on early education, education, low-income, medically underserved, minority populations, older adults, provider, substance use, students, workforce representatives, and unhoused populations were represented in the primary data collection.
Adventist Health Ukiah ValleyPart V, Section B, Line 6a: Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial Hospital (AHHM) and Adventist Health Mendocino Coast (AHMC) worked together to produce the 2022 CHNA.
Adventist Health Ukiah ValleyPart V, Section B, Line 6b: Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) collaborated with Building Bridges, Head Start, Housing Action Team, Mendocino Area Parks Association, Mendocino County Department of Public Health, Mendocino County Office of Education, Mendocino County Probation Department, Mendocino County Farm Bureau, Mendonoma Health Alliance, Rural Communities Housing Development Corporation, and Willits Senior Center.
Adventist Health Ukiah ValleyPart V, Section B, Line 11: Tax Year 2024 was Year Two of the Implementation Strategy for the 2022 Community Health Needs Assessment (CHNA). 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: Access to Care; Financial Stability and Health Risk Behaviors. Priority Need One: Access to Care - Barriers.Goal is to provide medical services to community members with no transportation. Strategy is to provide medical services to the homeless population through street medicine. Tax Year 2024 Community Impact Activities and Outcomes:The Adventist Health Street Medicine Program, a collaboration between the COMPASS Street Medicine Team and the SMART Track Program, continued its vital work in 2024, providing essential services to people experiencing homelessness (PEH) in Mendocino County. Building upon the foundation established in 2023, the program saw significant growth and expansion.Continued Outreach and Care: The program maintained its commitment to providing accessible healthcare, conducting over 100 Street Medicine clinics throughout the year. Over 400 individuals received care, resulting in more than 1,000 encounters, demonstrating the program's significant reach.Multidisciplinary Team: The COMPASS Street Medicine team, consisting of a registered nurse, care coordinator, social worker, nurse practitioner, licensed therapist, and physicians, ensured comprehensive care delivery. The SMART Track program continued to train two family medicine residents, equipping them with the skills to serve PEH effectively. All six first year residents spent time with the team as part of their community medicine rotation.Enhanced Collaboration: The program strengthened its partnership with Mendocino Community Health Clinics (MCHC), integrating MCHC's care management staff into Street Medicine clinics. The inaugural Mendocino County Street Medicine Collaborative meeting, held in February 2024, fostered greater collaboration among various community agencies. Meetings continued quarterly throughout the year. On September 26, 2024, Adventist Health, in partnership with various community organizations, hosted a training session focused on improving care for individuals experiencing homelessness. The event, led by experts from USC Keck School of Medicine, aimed to equip healthcare providers and community workers with the knowledge and skills necessary to effectively address the unique needs of this vulnerable population.Expanded Outreach: In late 2024, the COMPASS Street Medicine team initiated bi-weekly outreach clinics to an encampment in southern Ukiah, providing direct medical care and care coordination. Due to positive reception and need, encampment outreach frequency will increase to weekly in early 2025, and additional outreach sites are being identified.Enhanced Service Delivery: A collaborative "medication backpack" project, in partnership with the AHUV pharmacy team, will be implemented in Q1 2025, enabling the team to address a wider range of medical conditions on-site. A point-of-care testing program, bringing essential diagnostic tests directly to PEH, is anticipated to be operational in Q1 and Q2 of 2025.Priority Need One: Access to Care - Insurance.Goal is to verify/re-verify Medi-Cal eligibility for vulnerable populations.Strategy is to provide education and outreach to medical providers (Registrars, Community Health Workers, Substance Use Navigators) to identify those medically eligible patients and help enroll or re-enroll them in available benefits and direct them to ongoing services. In 2024, AHMC continued its proactive efforts to mitigate disruptions in healthcare access for Medi-Cal members in Mendocino County, building upon the foundation laid in 2023 during the unwinding of the Pandemic Era Medicaid Continuous Coverage Requirement. The focus remained on ensuring smooth transitions for individuals facing Medi-Cal renewal or needing to explore alternative coverage options.Tax Year 2024 Community Impact Activities and Outcomes:Building on 2023 Efforts: Adventist Health continued the multi-faceted strategy established in 2023, which involved collaboration with community agencies, targeted marketing campaigns, and staff training. The organization maintained its commitment to providing support for individuals needing assistance with Medi-Cal renewal or applications for other coverage.Targeted Outreach and Communication: In early 2024, Adventist Health leveraged data analysis to create a mailing list of over 3,000 Mendocino County households that had lost Medi-Cal coverage in 2023. A letter campaign was launched to provide these households with up-to-date resources for renewal or alternative insurance. Updated Medi-Cal navigation resources from the California Department of Health Care Services were incorporated into new banners, posters, and flyers distributed throughout Adventist Health's facilities. A social media campaign was implemented in October. In November of 2024, a mailer was deployed to over 7,000 households in Mendocino County, providing Medi-Cal enrollment and re-enrollment guidance in both English and Spanish.Expanded Support and Navigation: Front-line Adventist Health associates received ongoing training to guide patients through Medi-Cal renewal and Covered California options. Collaboration with our revenue cycle management partner continued to expand the scope of the insurance navigation program. Adventist Health associates worked with community agencies to provide navigation support for high-risk individuals facing procedural barriers.Community Collaboration: Adventist Health continued to collaborate with community partners to identify opportunities for enrollment events within the communities most impacted by the reenrollment process. Our Hospital's commitment to providing clear and accessible information ensured that Mendocino County residents were equipped to navigate the complexities of healthcare coverage.Priority Need Two: Financial Stability.Goal is to identify vulnerable, unstably housed community members and connect with Community Health Workers for Support services through CalAIM funding.Strategy is to utilize the COMPASS Street Medicine team identify unstably housed clients and connect them with services within the county that afford financial assistance.Tax Year 2024 Community Impact Activities and Outcomes:CalAIM and Holistic Healthcare through Enhanced Care Management (ECM): ECM is an essential component of California Advancing and Innovating Medi-Cal (CalAIM). ECM is a Medi-Cal managed care benefit providing community-based care management for individuals experiencing homelessness, behavioral health needs, substance use, children involved in child welfare, and individuals transitioning from incarceration. Lead Care Managers work individually with enrolled patients to provide up to one year or more of case management services, linking them to community resources such as but not limited to, transportation to medical appointments, food support, access to medical and mental health services, and other to improve health outcomes and overall well-being. AHUV, AHHM and AHMC remained dedicated to the CalAIM program's goals of integrating medical care with essential social services to address the social determinants of health through dedicated Adventist Health staff. The organization recognized the critical role of Enhanced Care Management (ECM), and Community Supports (CS) in providing comprehensive care for high-need individuals. In 2024, 25 members were enrolled. COMPASS Team's Core Functions: The COMPASS team continued to serve as a vital navigation resource for PEH, connecting them with services across various healthcare providers in Mendocino County, including Adventist Health facilities, Mendocino Community Health Clinics, Anchor Health Management, Redwood Community Services, and others. The team actively participated in collaborative meetings with community agencies, including the Mendocino County Homeless Service Continuum of Care, the Mendocino County CalAIM Collaborative, and Mendocino County Adult Protective Services.Enhanced Collaboration and Service Integration: The collaboration with the MCHC Connections to Care team at clinics held at Redwood Gospel Mission's Center for Hope and the Ukiah Community Food Bank was strengthened, increasing navigation capacity. The COMPASS team expanded staffing support for weekly clinics at the Building Bridges Shelter, resulting in improved connections to housing, social security, food stamps, and other vital resources. In 2024, the COMPASS team provided care management services to 480 people experiencing homelessness, with significant proportions facing medical complexity, mental health diagnoses, and substance use disorders.
Part V, Section B, Line 11, continuation:Palliative Care and Training: Building on 2023's specialized palliative care and advanced care planning training, the COMPASS team continued to share expertise with organizations serving PEH. The Mendocino County Hospice and Palliative Care Collaborative, formed by the COMPASS team, fostered collaboration among hospice and palliative care providers.Expanded Assistance: The strategies used to help with Medi-Cal renewal and enrollment also helped patients apply for CalFresh, and other cash aid programs, due to the shared state portal.Priority Need Three: Health Risk Behaviors - Diet.Goal is to reduce the obesity rate among teens and adults through targeted food and diet education.Strategy is to improve health food and beverage access.Tax Year 2024 Community Impact and Activities: AHUV, AHHM, and AHMC, local organizations and the Blue Zones Project worked closely on the implementation of two food policy initiatives. The City of Willits Land Use Element policy included incentivizing landowners to allow community-based agriculture on their nonproductive property and amending zoning regulations to reduce prevalence and accessibility of fast-food restaurants. They also achieved the following: 1. Fort Bragg Unified School District adopted an updated Wellness Policy. 2. The architecture design for commercial kitchen for North Coast Opportunities' Caring Kitchen Project. 3. A business plan for North Coast Opportunities' Mendo Lake Food Hub, a dual county initiative with BZP Lake. Priority Need Three: Health Risk Behaviors - Illicit Drugs.Goal is to increase access to treatment in a community with high substance use and overdose rates.Strategy is to create policies and spaces for the treatment of substance use disorders and reduce harm to people who use substances.Tax Year 2024 Community Impact and Activities: In 2024, AHUV, AHHM, and AHMC continued the CA Bridge model of care for addiction treatment, the Substance Use Navigator provides brief screening and intervention for people with substance use and behavioral health needs in the emergency department, inpatient setting and community members in need. In Q1 of 2024, the SUN team integrated with the COMPASS team increasing collaboration. All three Adventist Health Hospitals in Mendocino County participate in the SafeRx Mendocino program and the Naloxone Distribution Project. Mendocino County's SafeRx program tackles the opioid crisis through a two-pronged approach: prescriber education and harm reduction. For medical professionals, SafeRx offers training on safe opioid prescribing practices, encouraging the use of the CURES 2.0 prescription monitoring database to prevent overprescribing. The program also focuses on patient education, providing resources to help people understand their opioid prescriptions and navigate conversations with their doctors. Additionally, SafeRx works on harm reduction by facilitating access to naloxone (Narcan), a medication that can reverse opioid overdoses. Through these efforts, Mendocino County's SafeRx program aims to prevent opioid misuse and addiction while equipping the community to respond to potential overdoses. In 2024, Dr. Cara Eberhart joined AHUV as a Family Medicine physician specializing in addition medicine and actively collaborated with the SUN team, providing addiction consultation services and joined the COMPASS Street Medicine team offering outpatient addiction medicine services. CDC data shows a 31.51% decrease in provisional drug overdose deaths for the 12-month period ending in June 2024 compared to the peak 12-month period in 2021.Priority Need Three: Health Risk Behaviors - Tobacco Use.Strategy One: Decrease youth tobacco use and availability of cigarettes, e-cigarettes, and all flavored tobacco products.Strategy Two: Create systems and supports that target tobacco use prevention and cessation.Tax Year 2024 Community Impact and Activities:AHUV, AHHM, and AHMC, local organizations and the Blue Zones Project worked closely to create the Mendocino County Tobacco Policy Platform which was adopted by the Mendocino County Tobacco Prevention Coalition (County-wide: Willits, Fort Bragg, and Ukiah). The Mendocino County Tobacco Policy Platform was established to address the significant health risks associated with tobacco use and exposure to secondhand smoke. The policy platform focuses on several key areas:Tobacco Prevention and Youth Education: Initiatives aimed at reducing tobacco use among youth through educational programs and community outreach. These efforts are designed to inform young people about the dangers of tobacco use and to prevent the initiation of smoking and vaping.Secondhand Smoke Reduction: Measures to protect the public from the harmful effects of secondhand smoke. This includes the implementation of smoke-free policies in public spaces and workplaces, as well as educational campaigns to raise awareness about the risks of secondhand smoke exposure.Tobacco Use Education: Programs that provide information and resources to help individuals quit smoking and reduce their dependence on tobacco products. These programs often include support groups, counseling services, and access to nicotine replacement therapies.Significant needs not met:No hospital can address all the health needs identified in its community. AHUV, AHHM and AHMC are 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. Areas of significant health needs that will not be directly addressed at this time include housing, mental health, food security, environment & infrastructure, inclusion & equity, COVID-19, education, community vitality and community safety. While these health needs are not addressed directly, they will likely benefit from the collective efforts of our community partnerships.
Part V, Section B, Line 13h:Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets.
FieldValueIRS element (for citing)
Facility29FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (29 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Outpatient Clinics Hematology and O
260 Hospital Drive Suite 207UkiahCA95482Oncology
2 - Outpatient Clinics Wound Care Clini
415 Hospital DriveUkiahCA95482Wound care center
3 - Outpatient Clinics Ambulatory Surge
245 Hospital DriveUkiahCA95482Outpatient surgery
4 - Outpatient Clinics Radiology or Imagin
245 Hospital Drive Suite 100UkiahCA95482Radiology
5 - Outpatient Clinics Radiology or Imagin
245 Hospital Drive Suite 100UkiahCA95482Radiology/MRI
6 - Outpatient Clinics Radiology or Imagin
245 Hospital Drive Suite 100UkiahCA95482Radiology/ultrasound
7 - Outpatient Clinics
415A Hospital DriveUkiahCA95482Pre-op clinic
8 - Retail Pharmacy (AHHM)
3 Marcela Drive Suite BWillitsCA95490Retail pharmacy
9 - Outpatient Clinics Radiology or Imagin
1165 S Dora Street Suite D-1UkiahCA95482Mendo radiology
10 - Outpatient Clinics Rehab Clinic Phys
271 Observatory AvenueUkiahCA95482Physical therapy
11 - Outpatient Clinics Cardiology Clinic
115 Hospital DriveUkiahCA95482Cardiology
12 - Outpatient Clinics Rural Health Clin
1050 N State StreetUkiahCA95482Family practice
13 - Outpatient Clinics Surgical Clinic
246 Hospital DriveUkiahCA95482General surgery
14 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 209UkiahCA95482Family practice
15 - Outpatient Clinics Ophthalmology Clin
248 B Hospital DriveUkiahCA95482Ophthalmology
16 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 102UkiahCA95482Pain management
17 - Outpatient Clinics Radiology or Imagin
245 Hospital Drive Suite 100UkiahCA95482Radiology/mammography
18 - Outpatient Clinics Nephrology or Urolo
260 Hospital Drive Suite 201UkiahCA95482Urology
19 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 107UkiahCA95482Orthopedics
20 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 204UkiahCA95482Pediatrics
21 - Outpatient Clinics Rehab Clinic Phys
3101 South State StreetUkiahCA95482Physical therapy
22 - Outpatient Clinics Gastroenterology Cl
234 Hospital Drive Suite A BUkiahCA95482HBOC-GI
23 - Outpatient Clinics Rural Health Clinic
850 Sequoia CircleFort BraggCA954375490Family medicine
24 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 101UkiahCA95482Behavioral clinic
25 - Outpatient Clinics Rehab Clinic Phys
271 Observatory AvenueUkiahCA95482Speech therapy
26 - Outpatient Clinics Rheumatology
260 Hospital Drive Suite 207UkiahCA95482Rheumatology
27 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 101UkiahCA95482Live well
28 - Outpatient Clinics Central Office
238 Hospital Drive Suite AUkiahCA95482Billing - clinics
29 - Outpatient Clinics Rural Health Clinic
260 Hospital Drive Suite 103UkiahCA95482Internal medicine

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7:The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government.
Part II, Community Building Activities:The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease.
Part III, Line 2:Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2.
Part III, Line 3:The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.
Part III, Line 4:The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense.
Part III, Line 8:The Medicare Cost Report apportions the Hospital's 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 involving 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 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. For further information, please refer to Schedule H, Part III, Section B.
Part III, Line 9b: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, Line 2:Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM) and Adventist Health Mendocino Coast (AHMC) promote access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in Tax Year 2023, and the Year Two Update, Tax Year 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/ukiah-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:The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's 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's 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:From spectacular ocean views, redwood forests, and picturesque towns, the CHNA service area for Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM), and Adventist Health Mendocino Coast (AHMC) is a breathtaking community with a total population of 116,095. Throughout the County people enjoy activities such as the Mendocino Art Center, Theatre Company, and music and film festivals. The median household income is $56,401. The largest segment of the population (37.2%) is made up of residents aged over age 55. The community is known as a location focused on the well-being of its residents with support in the built environment, grocery stores and access to care while also implementing a Blue Zones Project. Among this population, 59.95% of an individual's income is spent on housing and transportation, while 20.66% of children live in poverty and 6.67% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. Approximately 15.9% of the population smoke tobacco, which is a higher rate than in California (11.5%). The teen birth rate is 21.4 per 1,000 females, which is greater than the state's teen birth rate of 15.6 and the national rate of 19.3. The percentage of infants with low birth weight is significantly greater, with Mendocino's rate at 15.1% compared to the state at 6.9%.The AHUV, AHHM, and AHMC CHNA market has a total population of 116,095 (based on the 2020 Decennial Census). The largest city in the service area is Ukiah, with a population of 16,075. The service area is comprised of the following zip codes: 95415, 95463, 95410, 95445, 95460, 95428, 95488, 95449, 95437, 95425, 95453, 95589, 95427, 95456, 95469, 95459, 95468, 95432, 95490, 95429, 95417, 95482, 95587, 95466, 95470, 95494, 95420, 95454, 95585. Approximately 62.33% of the population owns their home and 37.67% of the population rent their home. Total Population by age groups: Age 0-4: 5.8%, Age 5-17:14.9%, Age 18-24: 7.4%, Age 25-34: 11.1%, Age 35-44: 11.7%, Age 45-54: 11.9%, Age 55-64: 14.6%, Age 65+: 22.6%.
Part VI, Line 5:Our Hospital's mission is, "Living God's 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 today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy - even 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, and3. 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, and3. 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: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 tele-pharmacy 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, Reports Filed With StatesCA
Part VI: Other Information:Adventist Health Ukiah Valley (AHUV), Adventist Health Howard Memorial (AHHM), and Adventist Mendocino Coast (AHMC) are proud sponsors of Blue Zones. From May through December 2021, the Blue Zones Project Mendocino County (BZPMC) team assessed Mendocino County's readiness to undertake the community well-being transformation initiative where the healthy option becomes the easy option through permanent changes in environment, policy, and social networks. The Blue Zones Project team conducted a comprehensive analysis of the current state of well-being and met with local leaders and stakeholders across all sectors to learn about the strengths, challenges, and opportunities for improving well-being in Mendocino County and summarized their findings in the Blue Zones Project Discovery Report. The findings in that report were coupled with expert-led discovery meetings in the policy areas of built environment, tobacco, and food policy to inform the Blueprint for Blue Zones Project implementation in Mendocino County. Here is a summary of progress outcomes for 2024 for the three main pillars of engagement of people, places, and policy. PEOPLE: 2,700 unique individuals aged 15 years or older participated in Blue Zones Project activities in 2024, with 8,488 over the Project period. A total of 852 individuals completed the RealAge Test, our Community Wellbeing Survey. Engagement Committee representation geographically and demographically included inland and coast representation, Native American, Latino, older adults, parents, and people with disabilities. Community outreach events with the Tribal and Latino community included: 1. Brush Meadows (housing for migrant farm workers) purpose moai and Zumba Muevete por tu Salud2. Annual Dia del Nino, Dia Del Reyes, Dia De Los Muertos, and Hispanic Heritage events 3. Wellbriety (recovery group) walking moai4. Cooking demo/series with tribal youth camp, Redwood Valley Rancheria, Consolidated Tribal Health Project 5. Blue Zones Story Speech at the Sherwood Valley Band of Pomo Indians Big Time Event, Pinoleville Band of Pomo Indians Health Fair, Cahto Tribe Health and Wellness Fair and Coyote Valley Band of Pomo Indians Earth DaySignature Blue Zone Project Event Breakdown 2024: 1. Blue Zones Story Speech: 33 events, serving 1402. Walking Moais: six events, serving 763. Purpose Moais: two events, serving 28 4. Innovative Moais: four events, serving 116 5. Purpose Workshops: five events, serving 996. Cooking Demos/Classes: 22 events, serving 1,1147. Volunteers: six events, 239 individualsPLACES: Three schools achieved Blue Zones Project approval status in 2024: Fort Bragg Unified School District/Redwood Elementary School, Willits Unified School District/Blosser Lane Elementary School, and Ukiah Unified School District/Instilling Goodness Divine Virtue School. Seven restaurants achieved Blue Zones status: Cucina Verona/Fort Bragg, Harbor View Bistro & Bar/Fort Bragg, Jyun Kang Vegetarian Restaurant/Ukiah, Oco Timr/Ukiah, Patrona's/Ukiah, Princess Seafood/Fort Bragg and Ukiah Natural Foods Cafe/Ukiah. Seven worksites became Blue Zones status: AHMC/Fort Bragg, Blosser Lane Elementary School/Willits, Brookside Elementary School/Willits, County of Mendocino in Willits and Fort Bragg, Fort Bragg Unified School District/Fort Bragg, Mendocino College Ukiah/County-wide and Savings Bank of Mendocino County/Ukiah. POLICY: Policy work around built environment accomplished in 2024: 1. Complete Streets Policy codified in Willits Land Use Element, General Plan (Willits) 2. Commercial Street Improvement Plan reflected complete streets principles and practices (Willits) 3. Plans and policies to increase access to, and ridership of, public transportation codified in Willits Land Use Element, General Plan (Willits)4. Plans and policies to increase access to, and ridership of, public transportation codified in Willits Land Use Element, General Plan (Willits)5. Chief Celeri Drive improvement designs reflected complete streets principles and practices (Fort Bragg)6. Plans and policies to advance placemaking efforts to improve downtowns and other public spaces codified in Willits Land Use Element, General Plan (Willits)

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxtRecipient EINRecipientEIN
City of Ukiah
411 W Clay StreetUkiahCA95482Government$10,000$0Sponsorship
Greater Ukiah Business and Tourism Alliance
200 S School StreetUkiahCA95482501(c)(6)$10,000$0Membership940940846
Mendocino College
1000 Hensley Creek RoadUkiahCA95482501(c)(3)$130,500$0Funding for Nursing Program680040876
The One Project
8931 Eureka Grove CircleGranite BayCA95746501(c)(3)$10,000$0Sponsorship475638974
Ukiah Valley Trail Group
759 S State Street NBR 25UkiahCA95482501(c)(3)$25,000$0Sponsorship201098878
Ukiah Seventh - Day Adventist Church
1390 Laurel AvenueUkiahCA95482501(c)(3)$6,000$0Donation946003975
California Health Fund & Trust
1215 K Street Suite 800SacramentoCA95814501(c)(3)$640,929$0Health services un/underinsured patients941498697
FieldValueIRS element (for citing)
Total501c3 Org6Total501c3OrgCnt
Total Other Org1TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationCharitable support and assistance is provided with no reporting required by recipient.ExplanationTxt

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 (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (22 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Heinrich Kerry
Dir/Chair/CEO$0$2,342,000$0$1,586,113$0$46,082$0$13,296$0$44,679$0$4,032,170$0$0
Hofheins Todd
Dir/Vice Chair/COO$0$1,474,000$0$888,115$0$45,560$0$13,296$0$52,696$0$2,473,667$0$0
Beaman John
CFO/Assistant Secretary$0$1,261,000$0$698,818$0$21,043$0$13,296$0$66,512$0$2,060,669$0$0
Stevens Eric-Pres AHUV 0724
Pres, N Coast Svc Ar as of 07/24$0$1,196,000$0$495,682$0$194,464$0$13,296$0$44,679$0$1,944,121$0$0
Nahapetian Arby - Former Care
Division Medical Officer thru 02/22$0$1,111,000$0$458,435$0$189,823$0$13,296$0$66,512$0$1,839,066$0$0
Wells Jason
Former President thru 12/20$0$968,000$0$423,321$0$151,735$0$13,296$0$66,512$0$1,622,864$0$0
Jobe Meredith
Secretary$0$796,100$0$281,132$0$143,872$0$13,296$0$44,679$0$1,279,079$0$0
Howe Judson - Pres AHUV
Pres, N Coast Ntwk thru 07/24$0$326,174$0$206,444$0$297,479$0$13,296$0$66,201$0$909,594$0$0
Jahn Andrew - Former Care
Division President thru 02/22$0$281,190$0$407,001$0$5,026$0$55,610$0$3,801$0$752,628$0$0
Eberhart Gregory
Area Medical Officer thru 04/24$0$152,608$0$136,017$0$382,128$0$7,630$0$65,976$0$744,359$0$0
Shepardson Dean - Former
Treas/Asst Secr thru 09/23$0$414,258$0$116,611$0$120,353$0$13,296$0$63,194$0$727,712$0$0
Spencer Lindsey - Former
Operations Executive thru 05/22$0$459,988$0$88,601$0$54,939$0$13,296$0$66,512$0$683,336$0$0
Mock Jeffrey-TreasAsst Secr
Ops Exec, N Coast Svc Ar as of 09/24$0$414,258$0$90,747$0$63,243$0$13,296$0$22,539$0$604,083$0$0
Assadian Hoda
Operations Executive thru 06/24$0$190,000$0$88,964$0$219,189$0$9,500$0$50,921$0$558,574$0$0
Bartolomie Jill
Patient Care Executive thru 04/24$0$83,942$0$62,890$0$211,939$0$4,197$0$33,899$0$396,867$0$0
Buckingham Amy - Associate
Patient Care Executive as of 12/24$0$247,494$0$105,568$0$3,234$0$12,375$0$17,632$0$386,303$0$0
Leighton David
Administrator$302,947$0$33,912$0$3,979$0$13,296$0$24,738$0$378,872$0$0$0
Winter Carrie
Multi-Site Director Pharmacy$276,763$0$22,622$0$667$0$13,296$0$37,183$0$350,531$0$0$0
Denoeu Rebecca
Director, Emergency Services$260,120$0$19,278$0$0$0$13,104$0$40,233$0$332,735$0$0$0
Woodruff Nicole
Director, Perioperative Services$245,872$0$25,023$0$1,140$0$12,294$0$24,123$0$308,452$0$0$0
Wing Bill - Former Dir
Asst Secr/Vice Chair thru 01/22$0$0$0$0$0$273,263$0$0$0$0$0$273,263$0$0
Loi Victor
Pharmacist$249,527$0$5,000$0$0$0$12,496$0$5,134$0$272,157$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Lines 4a-bFormAndLineReferenceDesc
ExplanationSeverance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Assadian, Hoda - severance payment - $190,000 Bartolomie, Jill - severance payment - $203,228 Eberhart, Gregory - severance payment - $369,472 Howe, Judson - severance payment - $258,685 Jahn, Andrew - severance payment - $15,065 Wing, Bill - severance payment - $271,535 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Jack Wagner, Jason Wells, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2024ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part III, Line 4a:Ukiah Adventist Hospital, DBA Adventist Health Ukiah Valley (AHUV), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHUV is a faith-based, not-for-profit health and wellbeing organization located in the county seat of Mendocino County. It is operated as a 68-bed hospital with 642 associates, 513 medical staff members, and 17 affiliated clinics offering both specialty and primary care services to Mendocino County and surrounding Lake County communities. Although reimbursement for services rendered is critical to the operation and stability of AHUV, 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 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 programs Not only does AHUV 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. AHUV 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 $853,506. The following services were provided to all our patients: - 126,909 clinic visits - 714 deliveries - 3,194 discharges - 31,530 emergency room visits - 462 inpatient surgeries - 99,734 outpatient hospital visits - 3,542 outpatient surgeries - 11,500 patient days AHUV 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 $13,673,685. AHUV's quality and performance awards include: Five-star rating from Centers for Medicare/Medicaid Services 2024, Leapfrog "Grade A" Spring 2024 and Fall 2024 Hospital Safety Score, Opioid Care Honor Roll by Cal Hospital Compare, Get with the Guidelines Rural Stroke - Bronze, and Gold Plus Quality Achievement Award, Geriatric Emergency Department accreditation, Primary Stroke Center accreditation from Joint Commission, Ranked #4 in the nation for social responsibility and #1 in California from Lown Institute for 2024. Adventist Health's 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. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/
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 Chief Legal Officer/General Counsel immediately. The System Chief Legal Officer/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 Chief Legal Officer/General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System Chief Legal Officer/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 15The Adventist Health Board of Directors has established a Executive 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 at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation; 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 40 percent spread from minimum to maximum.
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 VII:Board compensation is for Adventist Health System/West Board of Directors only - not Hospital Board of Directors.
Form 990, Part IX, line 11gPhysician professional fees: Program service expenses 37,649,176. Management and general expenses 268,020. Fundraising expenses 0. Total expenses 37,917,196. Purchased medical services: Program service expenses 25,844,084. Management and general expenses 42,734. Fundraising expenses 0. Total expenses 25,886,818. All other purchased services: Program service expenses 1,291,497. Management and general expenses 714,392. Fundraising expenses 6,710. Total expenses 2,012,599. Contract labor: Program service expenses 4,107,688. Management and general expenses 148,929. Fundraising expenses 0. Total expenses 4,256,617. Consulting and other management fees: Program service expenses 297,127. Management and general expenses 443,598. Fundraising expenses 0. Total expenses 740,725. Repair and maintenance: Program service expenses 1,799,845. Management and general expenses 527,225. Fundraising expenses 0. Total expenses 2,327,070. Other professional fees non-medical: Program service expenses 9,588. Management and general expenses 356,623. Fundraising expenses 0. Total expenses 366,211. Other professional fees medical: Program service expenses 221,168. Management and general expenses 2,500. Fundraising expenses 0. Total expenses 223,668.
Form 990, Part XI, Line 8:Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
Adventist Health Clearlake Hospital Inc
15630 18th AvenueClearlakeCA95422680395149HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Adventist Health Delano
1401 Garces HwyDelanoCA93215770258013HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Adventist Health Foundation
1 Adventist Health WayRosevilleCA95661680002188Charitable foundationCA501(c)(3)Line 7Adventist Health SystemWest0
Adventist Health Medical Center Tehachapi
1100 Magellan DriveTehachapiCA93561812240617HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Adventist Health Mendocino Coast
700 River DriveFort BraggCA95437845174585HospitalCA501(c)(3)Line 3Stone Point Health0
Adventist Health Physicians Network
1 Adventist Health WayRosevilleCA95661680357690Medical foundationCA501(c)(3)Line 12b, IIAdventist Health SystemWest0
Adventist Health SystemWest
1 Adventist Health WayRosevilleCA95661953484589Integrated health systemCA501(c)(3)Line 100N/A
Adventist Health Tulare
869 North Cherry StreetTulareCA93274832351753HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Castle Medical Center
640 Ulukahiki StreetKailuaHI96734990107330HospitalHI501(c)(3)Line 3Adventist Health SystemWest0
Feather River Hospital
1 Adventist Health WayRosevilleCA95661941101228HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Glendale Adventist Medical Center
1509 Wilson TerraceGlendaleCA91206951816017HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Hanford Community Hospital
115 Mall DriveHanfordCA93230940535360HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Lodi Memorial Hospital Association Inc
975 S Fairmont AvenueLodiCA95240941044474HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Mid-Columbia Medical Center
1700 E 19th StreetThe DallesOR97058930386936HospitalOR501(c)(3)Line 3Stone Point Health0
Mid-Columbia Health Foundation
1700 E 19th StreetThe DallesOR97058930854433Charitable foundationOR501(c)(3)Line 7Mid-Columbia Medical Center0
Northwest Medical Foundation of Tillamook
1000 Third StreetTillamookOR97141930622075HospitalOR501(c)(3)Line 3Adventist Health SystemWest0
Portland Adventist Medical Center
10123 SE Market StreetPortlandOR97216930429015HospitalOR501(c)(3)Line 3Adventist Health SystemWest0
Reedley Community Hospital
372 Cypress AvenueReedleyCA93654453220509HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Rideout Memorial Hospital
726 Fourth StreetMarysvilleCA95901941387866HospitalCA501(c)(3)Line 3Stone Point Health0
St Helena Hospital
10 Woodland RoadSt HelenaCA94574941279779HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
San Joaquin Community Hospital
2615 Chester AvenueBakersfieldCA93301952294234HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Sierra Vista Hospital Inc
1010 Murray AvenueSan Luis ObispoCA93405952588614HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Simi Valley Hospital and Health Care Services
2975 N Sycamore DriveSimi ValleyCA93065956064971HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Sonora Community Hospital
1000 Greenley RoadSonoraCA95370941415069HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Stone Point Health
1 Adventist Health WayRosevilleCA95661823763347Supporting organizationCA501(c)(3)Line 12b, IIAdventist Health SystemWest0
Twin Cities Community Hospital Inc
1100 Las Tablas RoadTempletonCA93465752918765HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
United Com-Serve
726 Fourth StreetMarysvilleCA95901943015356Skilled nursing/assisted living/home healthCA501(c)(3)Line 12b, IIStone Point Health0
Western Health Resources
1 Adventist Health WayRosevilleCA95661953867863Home careCA501(c)(3)Line 10Adventist Health SystemWest0
White Memorial Medical Center
1720 E Cesar E Chavez AvenueLos AngelesCA90033952282647HospitalCA501(c)(3)Line 3Adventist Health SystemWest0
Willits Hospital Inc
1 Marcela DriveWillitsCA95490680108919HospitalCA501(c)(3)Line 3Adventist Health SystemWest0

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
Blue Legacy Ventures LLC
1010 NE 2nd AvenueMiamiFL33132871254649Real property rentalFLN/A00
Blue Zones LLC
200 Southdale CenterEdinaMN55435271603327EducationMNN/A00
PAR LLC DBA CherryWood Village
8440 SE Sunnybrook Blvd Suite 100ClackmasOR97015931262371Senior housingORN/A00
PVHR LLC DBA Paradise Village
8440 SE Sunnybrook Blvd Suite 100ClackmasOR97015260622555Senior housingORN/A00
PVHR2 LLC DBA Parkview Memory Care at Paradise Village
8440 SE Sunnybrook Blvd Suite 100ClackmasOR97015473300170Senior housingORN/A00
WWGHR LLC DBA Wheatland Village
8440 SE Sunnybrook Blvd Suite 100ClackmasOR97015810591221Senior housingORN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
AdHealth Limited
PO Box HM 2062HamiltonBDHM HXPure captive insuranceBDN/AC0
Adventist Health Plan Inc
Health insuranceN/AC01 Adventist Health WayRosevilleCA95661463833261CA
South Coast Medical Center
Wind down after sale of hospitalN/AC01 Adventist Health WayRosevilleCA95661952037291CA
Thrive Productions Inc
Production companyN/AC0200 Southdale CenterEdinaMN55435453369049MN
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd