WHITE MEMORIAL MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- WHITE MEMORIAL MEDICAL CENTER (EIN 95-2282647)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201603209349316880
- Schema version
- 2015v2.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T16:11:44-08:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clement & Associates CPA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2930 Honolulu Avenue Suite 200 | AddressLine1Txt |
| City | La Crescenta | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952282647 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | White Memorial Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WHIT | BusinessNameControlTxt |
| Phone | 3232685000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 Cesar E Chavez Avenue | AddressLine1Txt |
| City | Los Angeles | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Blin Richards | PersonNm |
| Person Title | CFO/VP Finance | PersonTitleTxt |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | S Clement | PreparerPersonNm |
| PTIN | P01218012 | PTIN |
| Phone | 8182491065 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Raffoul John | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Douglas Blvd | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $427,917,007 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Group Exemption | 1071 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.whitememorial.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1963 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 2034 | TotalEmployeeCnt |
| Total Volunteers | 258 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,458,400 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,683,628 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $382,098,695 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $407,498,952 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,519,771 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,396,430 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,869,998 | PYOtherRevenueAmt |
| CY Other Revenue | $4,337,997 | CYOtherRevenueAmt |
| PY Total Revenue | $401,946,864 | PYTotalRevenueAmt |
| CY Total Revenue | $427,917,007 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,920,143 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $813,263 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $155,104,184 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $165,170,180 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $621,348 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $218,519,511 | PYOtherExpensesAmt |
| CY Other Expenses | $224,160,107 | CYOtherExpensesAmt |
| PY Total Expenses | $375,543,838 | PYTotalExpensesAmt |
| CY Total Expenses | $390,143,550 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $26,403,026 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $37,773,457 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $674,445,699 | TotalAssetsBOYAmt |
| Total Assets EOY | $700,844,744 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $143,273,971 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $135,120,713 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $531,171,728 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $565,724,031 | NetAssetsOrFundBalancesEOYAmt |
| Mission | As a Seventh-day Adventist medical center, we are a family of caring professionals serving our community with: 1) A passion for excellence, 2) A spirit of Christian service, 3) A commitment to medical education. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $351,522,666 | ExpenseAmt |
| Grant | $813,263 | GrantAmt |
| Revenue | $410,384,929 | RevenueAmt |
| Desc | As a Seventh-day Adventist medical center, we are a family of caring professionals serving our community with: 1. A spirit of Christian service 2. A passion for excellence and 3. A commitment to medical education.The White Memorial Medical Center, a member of Adventist Health, provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of the White Memorial Medical Center, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:Providing free care and/or subsidized careProviding care to persons covered by governmental programs at below costProviding health/wellness activities and community education programsNot only does the White Memorial Medical Center provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. The White Memorial Medical Center recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed value of providing care to these patients in 2015 was $10,923,477.Inpatient services in 2015 were provided to 22,062 patients. These services included: 3,773 Newborns 3,698 Babies delivered 3,499 Surgeries performed 1,108 Cardiac catherization patients 478 Skilled nursing patients 277 Rehabilitation patients 762 Neonatal Intensive Care Patients 234 Pediatric Intensive Care Patients 2,146 Psychiatric Care Patients 8,571 Other Medical/Surgical Services Outpatient services in 2015 were provided to 126,535 patients. These services included: 59,191 Emergency room visits 5,304 Outpatient surgeries performed 92,412 Radiology procedures performed 912 Cardiac catheterizations outpatients840,554 Laboratory tests performed 2,089 Cleft Palate visits 4,502 Cancer Center proceduresThe White Memorial Medical Center recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Thanks to support from our community partners, the organization is able to fulfill its mission through the following programs:Diabetes education and glucose testingRainbow Center Child CarePartners for PreventionHealth Fairs - Glucose Screenings for DiabetesPatient Healthcare TransportationWelcome BabyOne of the greatest assets an organization can possess is the trust of its community internal and external. Beyond our role as a leading community health care provider, we are committed to operating as a socially responsible organization meeting the needs of all of our stakeholders our patients, physicians, workforce, neighbors, partners, volunteers and donors. This is why WMMC devotes a significant amount of financial and human resources to maintain its legacy of over 100 years of community-centered service to medically underserved communities in our area. Our goal is to enable people to achieve more than just good health by creating opportunities for growth and development that will make a real, lasting impact on the health of the community.The WMMC is a community-serving, community-engaged academic medical center which serves a community where almost 87% of the residents are Latino. Approximately 34% of the households in our community earn less than $25,000 annually, amounts well below the poverty level. The average median income for the market is $35,757--which is 41% lower than the average income in the United States. As such, we are positioned to provide this historically medically underserved population with highly advanced specialty services, including advanced certifications, specialty care services and state-of-the-art procedures, as well as Latino-focused language programs and education and bilingual doctors and nurses. WMMC has adopted rigorous national quality standards and regularly receives various awards and recognitions. WMMC has adopted rigorous national quality standards and regularly receives various awards and recognitions. The WMMC has been named one of the Healthgrades America's 100 Best Hospitals overall. Being a Top 100 hospital places the WMMC in the Top 2% of hospitals Nationwide. On average, a person seeking treatment at the WMMC has a 26.5% lower risk of dying than if they were treated in a hospital that did not receive this award. WMMCs mission anchors everything we do, extending out to the community in many ways. Collaborative efforts between WMMC, local organizations and donors has created critical programs needed to address the specific health care needs of the more than two million residents living throughout eastern Los Angeles. Together we are changing the outcome of the community's health.For example: The Diabetes Care Center addresses the high prevalence of diabetes within the community and provides full-service diabetes testing, education, peer counseling and follow-up care and runs a successful Healthy Eating & Lifestyle Program (H.E.L.P.). This six-week program is designed to teach children at-risk of developing diabetes the benefits of a well-balanced diet and regular exercise. No insurance is needed to access this bilingual program. Our at-risk newborns, cared for in one of the few Level III Neonatal Intensive Care Units in Los Angeles, are protected by state-of-the-art technology neo blue lights and our newest Giraffe Beds, purchased with donations received through the WMMC Foundation. Nonetheless, a significant portion of the mission-driven assistance WMMC provides its community is intangible or otherwise difficult to quantify. The following story illustrates this:Recently, I ran into Dr. Brian Johnston in the hallway on my way to a Planetree meeting. He does not know me well, but he knows Ive helped him with his homeless projects each year by donating clothes and Ziploc bags of hygiene products. We are always helping adults, he said out of the blue. What about the children who are homeless? The only thing I could think to say is Where are they? He mentioned the Chaplains office. They can help you find them. And find them they did. Thirty-eight homeless children who all attend the 2nd Street Elementary School. Christina Munoz, the school principal, told me that because they are homeless, these children often have problems with head lice and, since their families cannot afford to buy lice shampoo, are kept out of school.I took the leap dont ask me why and declared that I would adopt her 38 children and get them school supplies. I think I shocked her, possibly myself, as she at first could not believe what she was hearing. I assured her that I was good at my word, and we shook hands in agreement. At home, all I could think of were the 38 children. I called my family and we started our campaign that my sister Sylvia named Fill the Backpacks. I went to my Unit-Based Council and informed the Planetree Council of my intentions. As word got around, coworkers, committee members, family and senior citizens donated several items, including a donation of 38 boxes of lice shampoo from the White Memorial pharmacy. On Aug 12, we arrived with our backpacks and school supplies and much else. Principal Munoz was very thankful. Had had we not provided these school supplies for the children they would have nothing at all. She shared with us that when school starts, they would give them a warm breakfast every morning and a lunch. But she was not quite sure what they would have for dinner that evening. But for now they would have backpacks and school supplies and so much else. Stories like Rosemarys are not unusual. We hear them all the time as we walk the halls of the hospital, as we walk to and from the cafeteria, to and from the examination rooms, to and from the doctors offices, to and from the parking lots we are assigned to. People at the WMMC have a great habit of adopting people, causes, homeless women, needy children, the displaced or disposed, people in need of someone to talk to, someone who will talk back. It comes with the territory, perhaps, or the calling, or the culture, were not quite sure what. Doesnt matter. We welcome the habit, for us and for the communities we serve.It takes special people to create change, people with a passion for making a difference in the lives of others and the community at large. Not just because it is the right thing to do, but because the passion to help those less fortunate is in their heart and their hunger for excellence. White Memorial invites you to partner with us in building | Desc |
| Total Program Service Expenses | $351,522,666 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | Yes (true) | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 373 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2034 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Blin Richards CFO | PersonNm |
| Phone | 3232685000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1720 Cesar E Chavez Ave | AddressLine1Txt |
| City | Los Angeles | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 900332443 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Caviness Larry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $6,749 | $0 | ||||
| Dickinson Charles | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $5,456 | $0 | ||||
| Friedstad Christine | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,752 | $0 | ||||
| Gabriel Melody | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,333 | $0 | ||||
| Graham Ricardo | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $4,132 | $0 | ||||
| Heinrich Kerry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $528 | $0 | ||||
| Innocent Larry | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,045 | $0 | ||||
| Jones Helmuth | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $84,278 | $0 | ||||
| Reimche Allan | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,734 | $0 | ||||
| Rippey Wesley | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $126,608 | $0 | ||||
| Salazar Velino | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $1,416 | $0 | ||||
| Torkelsen Max | ||||||||||
| Director | 0.00 | 4.00 | Yes (X) | $0 | $2,801 | $0 | ||||
| Reiner Scott | ||||||||||
| Dir/Chair | 0.00 | 50.00 | Yes (X) | $0 | $1,526,040 | $261,659 | Yes (X) | |||
| Wing Bill | ||||||||||
| Dir/V Chair | 0.00 | 50.00 | Yes (X) | $0 | $1,245,488 | $228,400 | Yes (X) | |||
| Jobe Meredith | ||||||||||
| Secretary | 0.00 | 50.00 | $0 | $537,841 | $93,577 | Yes (X) | ||||
| Wagner Jack | ||||||||||
| Asst Treas | 0.00 | 50.00 | $0 | $1,056,525 | $41,424 | Yes (X) | ||||
| Wehtje Rodney | ||||||||||
| Asst Treas | 0.00 | 50.00 | $0 | $591,283 | $58,716 | Yes (X) | ||||
| Zachary Beth | ||||||||||
| Sr VP/Pres SCR | 0.00 | 50.00 | $0 | $1,013,175 | $439,403 | Yes (X) | ||||
| Raffoul John | ||||||||||
| President & CEO | 0.00 | 50.00 | $0 | $537,117 | $180,441 | Yes (X) | ||||
| Richards Blin | ||||||||||
| VP Finance/CFO | 0.00 | 50.00 | $0 | $271,414 | $47,486 | Yes (X) | ||||
| Armendariz Cesar | ||||||||||
| VP Bus Dev | 0.00 | 50.00 | $0 | $251,312 | $49,888 | Yes (X) | ||||
| Bryant Mara | ||||||||||
| Sr VP Org Perf | 0.00 | 50.00 | $0 | $327,946 | $67,787 | Yes (X) | ||||
| Chern Mary Anne | ||||||||||
| Sr VP Fund Dev/Ex Rel | 0.00 | 50.00 | $0 | $313,315 | $52,784 | Yes (X) | ||||
| Hansberger Karen | ||||||||||
| Sr VP Medical Affairs | 0.00 | 50.00 | $0 | $78,229 | $2,430 | Yes (X) | ||||
| Fargo Roland | ||||||||||
| Sr VP Reg Physician Ops | 0.00 | 50.00 | $0 | $462,224 | $83,048 | Yes (X) | ||||
| Milatovich Natasha | ||||||||||
| VP HR | 50.00 | 50.00 | $0 | $286,258 | $50,699 | Yes (X) | ||||
| Miller Elizabeth | ||||||||||
| VP Care Mngt | 50.00 | 50.00 | $0 | $280,863 | $31,691 | Yes (X) | ||||
| Nahapetian Arby | ||||||||||
| Reg CMO | 0.00 | 50.00 | $0 | $660,426 | $133,928 | Yes (X) | ||||
| Stone Patricia | ||||||||||
| Sr VP Nurs/CNE | 0.00 | 50.00 | $0 | $264,646 | $27,647 | Yes (X) | ||||
| Coan Carol | ||||||||||
| CEO, FQHC | 50.00 | 0.00 | $249,023 | $0 | $18,115 | Yes (X) | ||||
| Nguyen Thao | ||||||||||
| Dir. Pharmacy | 60.00 | 0.00 | $230,006 | $0 | $32,411 | Yes (X) | ||||
| Hopper Monica | ||||||||||
| Dir. Finance | 60.00 | 0.00 | $224,922 | $0 | $31,489 | Yes (X) | ||||
| Saad John | ||||||||||
| Dir. Perioperative | 50.00 | 0.00 | $206,743 | $0 | $30,047 | Yes (X) | ||||
| Velazquez Jesus | ||||||||||
| Staff RN | 50.00 | 0.00 | $206,282 | $0 | $12,514 | Yes (X) | ||||
| Carmen Robert | ||||||||||
| Former Dir/Chair | 0.00 | 0.00 | $126,867 | $100,007 | $6,362 | Yes (X) | ||||
| Rebok Douglas | ||||||||||
| Former Asst Sec | 0.00 | 0.00 | $0 | $597,483 | $29,043 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,243,843 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $10,642,424 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,010,989 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 241 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Shiftwise Inc | |||||
| PO Box 70870 | St Paul | MN | 551709705 | Registry Services | $5,755,292 |
| FCS Medical Corporation | |||||
| 5823 York Blvd Suite 1 | Highland Park | CA | 90042 | Medical Services | $1,955,808 |
| White Memorial Medical GRP Inc | |||||
| 1701 Cesar Chavez Ave Suite 510 | Los Angeles | CA | 90033 | Medical Services | $1,687,036 |
| DVA Renal Healthcare Inc | |||||
| PO Box 8500-1607 | Philadelphia | PA | 191781607 | Medical Services | $1,540,479 |
| Faculty Physicians and Surgeon | |||||
| 11175 Campus Street Rm11126 | Loma Linda | CA | 92350 | Medical Services | $1,235,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 58 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $178,335 | RelatedOrganizationsAmt |
| Government Grants | $5,097,219 | GovernmentGrantsAmt |
| All Other Contributions | $408,074 | AllOtherContributionsAmt |
| Total Contributions | $5,683,628 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| Dietary | 722210 | $1,352,434 | $1,352,434 | |
| Other Prog Svc Rev | 900099 | $1,131,868 | $442,313 | $689,555 |
| Parking | 812930 | $717,629 | $717,629 | |
| Patient Svc Revenue | 621110 | $398,479,436 | $398,479,436 | |
| Rental Income-Pgm Svc | 531120 | $5,458,647 | $5,413,811 | $44,836 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $358,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $358,938 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $407,498,952 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,396,430 | TotalRevenueColumnAmt |
| Exclusion | $10,396,430 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Net Assets Rel from Rest | 900099 | $4,228,021 | $4,228,021 |
| Value Change-Net Asset | 900099 | $109,976 | $109,976 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,337,997 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $427,917,007 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $410,384,929 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $11,848,450 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $742,849 | TotalAmt |
| Program Services | $742,849 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,414 | TotalAmt |
| Program Services | $70,414 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,887,233 | TotalAmt |
| Program Services | $120,862,896 | ProgramServicesAmt |
| Management And General | $9,536,030 | ManagementAndGeneralAmt |
| Fundraising | $488,307 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,648,720 | TotalAmt |
| Program Services | $4,648,720 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,098,162 | TotalAmt |
| Program Services | $17,098,548 | ProgramServicesAmt |
| Management And General | $2,905,104 | ManagementAndGeneralAmt |
| Fundraising | $94,510 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,536,065 | TotalAmt |
| Program Services | $8,817,702 | ProgramServicesAmt |
| Management And General | $680,800 | ManagementAndGeneralAmt |
| Fundraising | $37,563 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $645,405 | TotalAmt |
| Management And General | $645,405 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,180,348 | TotalAmt |
| Management And General | $1,180,348 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,934,949 | TotalAmt |
| Program Services | $24,049,512 | ProgramServicesAmt |
| Management And General | $3,885,437 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $975,047 | TotalAmt |
| Management And General | $975,047 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,915,402 | TotalAmt |
| Program Services | $3,500,075 | ProgramServicesAmt |
| Management And General | $1,415,180 | ManagementAndGeneralAmt |
| Fundraising | $147 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,326,884 | TotalAmt |
| Program Services | $17,876,889 | ProgramServicesAmt |
| Management And General | $449,995 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,633,741 | TotalAmt |
| Program Services | $11,613,056 | ProgramServicesAmt |
| Management And General | $20,685 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,571 | TotalAmt |
| Program Services | $192,696 | ProgramServicesAmt |
| Management And General | $179,054 | ManagementAndGeneralAmt |
| Fundraising | $821 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $316,235 | TotalAmt |
| Program Services | $216,627 | ProgramServicesAmt |
| Management And General | $99,608 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,621 | TotalAmt |
| Program Services | $34,621 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,538,705 | TotalAmt |
| Program Services | $18,381,797 | ProgramServicesAmt |
| Management And General | $156,908 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,050,282 | TotalAmt |
| Program Services | $2,050,282 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Pt Care Supplies | $51,832,411 | $51,832,411 | |
| Purchased Services | $39,717,301 | $24,453,128 | $15,264,173 |
| Qual Assur Hosp Fee | $32,870,558 | $32,870,558 | |
| Other Expenses | $10,801,379 | $10,267,718 | $533,661 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,014,268 | TotalAmt |
| Program Services | $1,942,167 | ProgramServicesAmt |
| Management And General | $72,101 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,143,550 | TotalAmt |
| Program Services | $351,522,666 | ProgramServicesAmt |
| Management And General | $37,999,536 | ManagementAndGeneralAmt |
| Fundraising | $621,348 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,497 | BOYAmt |
| EOY | $463,462 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,598,693 | BOYAmt |
| EOY | $428,032,628 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,314,517 | BOYAmt |
| EOY | $188,068 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,058,275 | BOYAmt |
| EOY | $60,623,938 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,977,887 | BOYAmt |
| EOY | $4,708,703 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,102,833 | BOYAmt |
| EOY | $1,377,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $382,867,552 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $208,272,835 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,437,513 | BOYAmt |
| EOY | $174,594,717 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,895,816 | BOYAmt |
| EOY | $4,233,098 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $800,000 | BOYAmt |
| EOY | $1,150,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,054,668 | BOYAmt |
| EOY | $25,472,782 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $674,445,699 | BOYAmt |
| EOY | $700,844,744 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,240,256 | BOYAmt |
| EOY | $43,370,007 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,828,337 | BOYAmt |
| EOY | $57,417,255 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,205,378 | BOYAmt |
| EOY | $34,333,451 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,273,971 | BOYAmt |
| EOY | $135,120,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,451,455 | BOYAmt |
| EOY | $560,229,634 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,720,273 | BOYAmt |
| EOY | $5,494,397 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,171,728 | BOYAmt |
| EOY | $565,724,031 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $674,445,699 | BOYAmt |
| EOY | $700,844,744 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $37,773,457 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,221,154 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Church | Yes (X) | ChurchInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed Section4955 Tax | false | Form4720FiledSection4955TaxInd |
| Correction Made | false | CorrectionMadeInd |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $7,425 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $187,994 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $195,419 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1i - Other Activities Description | FormAndLineReferenceDesc |
| Explanation | Allocation of dues paid to industry and professional organizations and consulting. The industry and professional organizations conduct lobbying activity and a portion of the membership dues is allocated for this purpose.Executives met with state and federal legislators and attended industry organization meet and greet events for the purpose of educating legislators and advocating for the needs of the health care industry. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,720,273 | BeginningYearBalanceAmt |
| Contributions | $4,106,539 | ContributionsAmt |
| Other Expenditures | $4,332,415 | OtherExpendituresAmt |
| End Year Balance | $5,494,397 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $5,297,595 | BeginningYearBalanceAmt |
| Contributions | $3,594,787 | ContributionsAmt |
| Other Expenditures | $3,172,109 | OtherExpendituresAmt |
| End Year Balance | $5,720,273 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,802,349 | BeginningYearBalanceAmt |
| Contributions | $2,703,813 | ContributionsAmt |
| Other Expenditures | $2,208,567 | OtherExpendituresAmt |
| End Year Balance | $5,297,595 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $3,997,249 | BeginningYearBalanceAmt |
| Contributions | $2,992,064 | ContributionsAmt |
| Other Expenditures | $2,186,964 | OtherExpendituresAmt |
| End Year Balance | $4,802,349 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,351,534 | BeginningYearBalanceAmt |
| Contributions | $2,139,353 | ContributionsAmt |
| Other Expenditures | $2,493,638 | OtherExpendituresAmt |
| End Year Balance | $3,997,249 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (true) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (true) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,263,420 | OtherCostOrOtherBasisAmt |
| Book Value | $2,263,420 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $286,449,133 | OtherCostOrOtherBasisAmt |
| Depreciation | $141,008,201 | DepreciationAmt |
| Book Value | $145,440,932 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $82,876,125 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,594,813 | DepreciationAmt |
| Book Value | $20,281,312 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,278,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,669,821 | DepreciationAmt |
| Book Value | $6,609,053 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $174,594,717 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Payables to Related Organizations | $2,877,731 |
| Settlements-Medicare Pay to 3rd Pty | $25,658,722 |
| Workers Comp Payable | $5,796,998 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $34,333,451 | TotalLiabilityAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part V, Line 4: Intended uses of the endowment fund. | FormAndLineReferenceDesc |
| Explanation | Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. | ExplanationTxt |
Schedule F IRS990ScheduleF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants To Org Outside US GrantsToOrgOutsideUSGrp (2 entries)
| RegionRegionTxt | Purpose Of GrantPurposeOfGrantTxt | Non Cash AssistanceNonCashAssistanceAmt | Description Of Non Cash AsstDescriptionOfNonCashAsstTxt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|---|
| East Asia | Mission Trip | $55,679 | Travel/Supplies | Cost |
| Latin America | Mission Trip | $14,735 | Travel/Supplies |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Org | 2 | TotalOtherOrgCnt |
| Transfer To Foreign Corp | false | TransferToForeignCorpInd |
| Interest In Foreign Trust | false | InterestInForeignTrustInd |
| Foreign Corp Ownership | false | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | false | PassiveForeignInvestmestCoInd |
| Foreign Partnership | false | ForeignPartnershipInd |
| Boycott Countries | false | BoycottCountriesInd |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,546,170 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,546,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $213,291,811 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $197,045,838 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,245,973 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04160 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $740,937 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $334,426 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $406,511 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $215,578,918 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $197,380,264 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,198,654 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04660 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,680,349 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,680,349 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00940 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,943,515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,484,562 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,458,953 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02940 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,634,500 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,718,344 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,916,156 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01260 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,203 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,203 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,108,369 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,108,369 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,390,936 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,202,906 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,188,030 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05430 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $240,969,854 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $201,583,170 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $39,386,684 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10090 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $216,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $216,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $216,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $216,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,527,806 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $2,114,004 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $68,997,239 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $52,183,961 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $16,813,278 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | White Memorial Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | Acute,Rehab,Psychiatric,Skilled Nursing | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | false | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | See webb address in 7 d above | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.adventisthealth.org/white-me | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Selling Debt | Yes (X) | PermitSellingDebtInd |
| Collection Activities | Yes (true) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 5 - Account Input from Persons Who Represent the Community | White Memorial Medical Center (WMMC) conducted multiple focus groups, key informant interviews, and asked community partners to participate in an online survey. The focus groups and key informant interviews were asked three central questions, which were: What is your vision of a healthy community? What is your perception of our hospital in general and of specific programs and services? What can we do to improve the health and quality of life in the community?Key informants interviews were comprised of key leaders from an array of agencies accross Los Angeles County, ranging from not-for-profits, faith-based organizations, policy groups, elected officials and their staff, to educational institutions and local businesses. These were conducted through email, phone, or in person.The community organization survey was emailed to organizations to collaborate with WMMC and was available online. The survey addressed: which community the organization serves, what is healthy in their community, what is not healthy in their community, and what their community needs to be healthy. In addition, the survey asked about perceived barriers to treatment.WMMC reviewed all the information given, found common themes and summariezed key points within the Needs Assessment. By identifying the common themes WMMC can address the needs of the entire community. |
| Part V, Line 7d - Description of Making Needs Assessment Widely Available | The Community Benefit plan of the White Memorial Medical Center can be found at https://www.adventisthealth.org/pages/about-us/community-health-needs-assessments.aspx |
| Part V, Line 22d - Other Billing Determination of Individuals Without Insurance | The hospital's financial assistance policy has three income ranges for patients who received emergency medical care, which provides a discount based on Medicare rates. There are also three income ranges for patients who received non-emergency medical care; the two lower income ranges provide a discount based on Medicare rates. The higher income range provides a discount from the balance due after the uninsured discount, that is available to all uninsured patients without regard to income. Only five of the six income ranges are discounted based on Medicare rates. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7 - Explanation of Costing Methodology | The 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 Californias regulations and policies and the approval of the federal government. |
| Part III, Line 8 - Explanation Of Shortfall As Community Benefit | The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL Revenue Rec. *Medicare Cost Report Revenue $66,165,984 Prior Year Settlements 13,028,031 Cost Report Reimbursable Bad Debts 677,196 Less Amts included in Part 1, lines g & f (2,060,489) Estimates and Accrual Variances (1,356,801) Other (6,456,682) ___________ Subtotal - Amount reported in Pt III line 5 $68,997,239 Amount included in Part 1, lines g and f 2,060,489 ___________ Total Medicare Revenue $71,057,728*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest |
| Part VI - Needs Assessment | WMMC is devoted to our mission of providing care for the whole person, mind, body and spirit, to people of all faiths with the goal of extending good health and wellness to our community regardless of their ability to pay. We work in partnership with our patients, neighbors, workforce, community, physicians; volunteers; community groups, educational institutions; and the Los Angeles County Department of Health Services to continually assess the health care needs of our community. Adventist Healths vision is to enhance the health of the communities where we live and serve, by engaging our communities and our patients in a partnership for personal community health. |
| Part VI - Patient Education of Eligibility for Assistance | WMMC provides inpatient, outpatient, emergency, diagnostic care, and community education providing over 148,000 patient visits annually. As a Seventh-day Adventist medical center, we are a family of caring professionals serving our community with: A spirit of Christian service; a passion for excellence and a commitment to medical education. White Memorial Medical Center provides quality medical health care regardless of race, creed, sex national origin, handicap, age or ability pay. Although reimbursement for services rendered is critical to the operation and stability of White Memorial, the organization recognizes that not all individuals possess the ability to pay the essential medical services. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay; providing free care and/or subsidized care; providing care to persons covered by governmental programs at below cost; providing health/wellness activities, community education programs and workshops. Not only does the White Memorial Medical Center provide low-cost care to individuals covered by government programs and those unable to afford health care, it also helps patients find and access private and governmental resources for health care benefits. White Memorial Medical Center recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community.White Memorial uses various vehicles to inform patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs. The Registration team is the first point of contact for the patient and there are a number of ways the patient is notified of their ability to apply for insurance coverage through state and federal avenues. WMMCs admissions packet contains documents that highlight patient financial services: The "Your Patient Account" trifold denotes we can "help you figure out your insurance coverage apply for government aid or make interest fee payment arrangements." This is also addressed in our "Welcome to Our Family" packet under Patient Financial Services. Financial assistance information is also provided in each of the Registration booths. WMMC statements sent to the patient has a section titled "Financial Assistance" where it indicates "If you can't pay part of your bill, please contact our Customer Service Department." More importantly White Memorials mission is to provide compassionate, quality care regardless of their ability to pay. The unreimbursed value of providing care to patients in 2015 was $10,923,477.Our on-campus White Memorial Community Information Center provides access to health care programs, senior wellness programs, on-site enrollment services for state-funded insurance plans including Medicare, Covered California and MediCal available at no charge. |
| Part VI - Community Information | The White Memorial Medical Centers service area is primarily comprised of three Service Planning Areas (SPAs) in Los Angeles County as designated by the Los Angeles County Department of Public Health. WMMCs Primary Service and Secondary Service areas are comprised of SPA 4 (Metropolitan Los Angeles), SPA 6 (South Los Angeles), and SPA 7 (East Los Angeles). The primary service area consists of 13 zip codes surrounding the medical center and includes the cities of Boyle Heights, Los Angeles, East Los Angeles, Huntington Park, El Sereno, Lincoln Heights, Florence, Bell Gardens and Montebello. The demographics of the WMMC service area population is 88% Hispanic/Latino; 4% Asian; 3% Caucasian and 4% African American. The age of the WMMC service area population is 30% are younger than 17; 27% are between the ages of 18 34; 26% are 35 54, 8% are 55 64 and 8% are over age 65. In addition, WMMC market share can be characterized as low-income with the median household income at $35,757; 33% of households earn less than $25,000 each year; more than half of the population age 25+ did not complete high school, only 22% of the population has completed high school and 9% have a college degree. According to a recent report from the Los Angeles County Department of Health Services, East Los Angeles (ELA) residents experience a significant chronic disease burden, affected by Diabetes, Arthritis, Depression, and untreated Cardio-vascular Disease and Hypertension and 31% of children are obese. Part VI Promotion of community health. White Memorial Medical Center continually invests in building partnerships with local community organizations that share our vision and dreams for a healthy community. WMMC has partnerships with more than 70 community groups and more than 182 highs schools and educational institutions whose students participate in WMMC Workforce Development programs, our volunteer program and complete career pathway internships. WMMC launched Tu Mundo Hoy a one-hour daily Spanish Language TV program addressing issues of health, finance and features issues that impact the Hispanic community; and an English version Your World Today airs weekly; both shows provide viewers information on a variety of health issues featuring WMMC doctors, nurses, and staff and help our community make informed choices that encourage wellness in our community. WMMC produces a Health and Wellness Community Calendar listing all of free educational and fitness classes and shares this message: Caring for our community doesnt start once people come to see us, nor should it end after theyve left. We understand that being healthy isnt just about the body. And that a healthy life is a journey, not a destination. We dont just care for the body. Rather, we enrich lives and nourish souls. This is our calling. This is who we are and it is what we ultimately do. |
| Part VI - Community Building Activities | The hospital is involved in numerious community building activities which promote the health of the communities we serve. Numerous community concerns are addressed, including health and prevention education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. We work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.The hospital serves a community where 33% of families fall below the federal poverty line and whose residents are predominantly Latino. WMMC is positioned to provide this historically medically underserved population with Latino-focused in-language programs and education, including Spanish bilingual doctors and nurses and is dedicated to providing all its patients with the same level of high quality health care. This care includes highly advanced specialty services including advanced certifications, specialty care services and state-of-the-art procedures. WMMC has adopted rigorous national quality standards and has won four Eureka Awards for Performance Excellence from the California Council on Excellence. WMMC mission anchors everything we do and extends out to the community in many ways. Collaborative efforts between WMMC, local organizations and donors has created critical programs needed to address the specific health care needs of the more than 2 million residents living throughout eastern Los Angeles. Together we can change the outcome of our community's health. |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | The hospital has a governing board composed of community members who advise the president/CEO regarding the healthcare needs of the community. At the direction of the governing board, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include Cardiac, Cancer, Women's Services, Ortho, Neuro, Behavioral Medicine, Rehabilitative Medicine, Emergency, and Home Care services, as well as a residency program. The hospital cooperates with area physicians to offer both family practice and obstetrics clinics. |
| Part VI - Affilated Health Care System Roles and Promotion | The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served |
| Part VI - States Where Community Benefit Report Filed | CA |
| Part V - Explanation of Number of Facility Type | The hospital provides outpatient services in multiple locations within its service area. |
| Part VI - Additional Information | Additional Information:White Memorial Medical Center (WMMC) is a full service 353-bed, faith-based, community-serving, comunity-engaged academic medical center which provides a full range of inpatient, outpatient, emergency and diagnostic services and is located just minutes from downtown Los Angeles. One of the greatest assets an organization can possess is the trust of its community --both internal and external. WMMC devotes a significant amount of financial and human resources to carry on its legacy of close to 100 years of community-centered service to medically underserved communities in our area. Beyond our role as one of the leading providers of health care in our community, we are committed to operating as a socially responsible organization as we meet the needs of our different stakeholders--our patients, physicians, workforce, neighbors, partners and donors. Our goal is to enable people to achieve more than just good health; it is to create opportunities for growth and development that will make a real, lasting impact on the health of our community.WMMC serves a community whose residents are predominantly Latino and where approximately 34% of the households have an annual income of less than $25,000 and 9% of families earn under $10,000, which is well below the federal poverty level. WMMC is positioned to provide this historically medically underserved population with Latino-focused language programs and education, including Spanish bilingual doctors and nurses and is dedicated to providing all its patients with the same level of high quality health care. This care includes highly advanced specialty services including advanced certifications, specialty care services and state-of-the-art procedures. WMMC has adopted rigorous national quality standards and has won four Eureka Awards for Performance Excellence from the California Council on Excellence.WMMC mission anchors everything we do and extends out to the community in many ways. Collaborative efforts between WMMC, local organizations and donors has created critical programs needed to address the specific health care needs of the more than 2 million residents living throughout eastern Los Angeles. Together we can change the outcome of our community's health. For example, the Cecilia Gonzalez De La Hoya Cancer Center, named for the late mother of champion boxer and philanthropist, Oscar De La Hoya, helps address the area's high incidence of breast cancer. The Cancer Center features sophisticated diagnostic and treatment equipment, bilingual breast cancer support groups, a community resource center and free breast exams and mammograms to women who are uninsured or underinsured.The Diabetes Care Center at WMMC addresses the high prevalence of diabetes within the community and provides full-service diabetes testing, education, peer counseling and follow-up care and runs a successful Healthy Eating & Lifestyle Program (H.E.L.P.); a six-week program designed to teach children, at-risk of developing diabetes, the benefits of a well-balanced diet and regular exercise. No insurance is needed to access this bilingual program. Our at-risk newborns, cared for in one of the few Level III Neonatal Intensive Care Units in Los Angeles, are protected by state-of-the-art technology neo blue lights and our Giraffe Beds, purchased with donations received through the WMMC Foundation. Babies are now safer and have a better chance of flourishing because our friends contributed to this successful fundraising effort. The Center for Limb Preservation & Advanced Wound Care offers a unique multidisciplinary approach to limb care and limb preservation and provides advanced outpatient therapy/treatment for wounds consistent with specific needs of the patients. The best thing is that all these services are available under one roof. The primary goal of the Center is to provide vital services to the population at risk of limb threatening condition, including patients of multiple and differing socioeconomic and cultural backgrounds. Limb amputation can be a major complication for patients who have diabetes, peripheral artery disease, kidney problems or another complex condition that impairs circulation. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| Adventist Dev & Relief Agenc | ||||||||
| 12501 Old Columbia Pike | Silver Springs | MD | 20904 | 521314847 | 501(c )(3) | $5,252 | $0 | Hospital matching for Nepal Relief |
| Adventist Health Intl | ||||||||
| 11060 Anderson Street | Loma Linda | CA | 92350 | 330940020 | 501(c )(3) | $10,000 | $0 | Sponsorship |
| Familia Unida Living With MS | ||||||||
| 4716 E Cesar E Chavez Avenue | Los Angeles | CA | 90022 | 911898199 | 501(c )(3) | $7,000 | $0 | Sponsorship |
| General Conference of SDA | ||||||||
| 12501 Ol Columbia Pike | Silver Springs | MD | 20904 | 203164300 | 501(c )(3) | $8,710 | $0 | Mission Trip |
| Glendale Adventist Medical | ||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 951816017 | 501(c )(3) | $6,200 | $0 | Sponsorship |
| Hollenbeck Palms | ||||||||
| 573 S Boyle Ave | Los Angeles | CA | 90033 | 710876594 | 501(c )(3) | $5,300 | $0 | Sponsorship |
| Homeboy Industries | ||||||||
| 1848 E First Street | Los Angeles | CA | 90033 | 954800735 | 501(c )(3) | $10,500 | $0 | Sponsorship |
| Lamajak Inc | ||||||||
| 2125 Chenault Ste 100 | Carrollton | TX | 75006 | 752217016 | N/A | $10,507 | $0 | Volunteer Vouchers |
| Mexican American Opportunity | ||||||||
| 401 N Garfield Avenue | Montebello | CA | 90640 | 952594166 | 501(c )(3) | $84,300 | $0 | Sponsorship |
| Oscar De La Hoya Foundation | ||||||||
| 626 Wilshire Blvd | Los Angeles | CA | 90017 | 954586767 | 501(c )(3) | $12,000 | $0 | Sponsorship |
| Simi Valley Hospital Fndtn | ||||||||
| 2975 No Sycamore Drive | Simi Valley | CA | 93065 | 912135595 | 501(c )(3) | $11,000 | $0 | Sponsorship |
| Telacu Education Foundation | ||||||||
| 5400 E Olympic Blvd | Los Angeles | CA | 90022 | 954384333 | 501(c )(3) | $10,000 | $0 | Sponsorship |
| Womencertified Inc | ||||||||
| 3325 Hollywood Blvd | Hollywood | FL | 33021 | 270721343 | N/A | $17,750 | $0 | Women's Choice Award partner |
| Young Mens Christian Assoc | ||||||||
| 2900 Whitter Blvd | Los Angeles | CA | 90023 | 951644052 | 501(c )(3) | $100,250 | $0 | Sponsorship |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 12 | Total501c3OrgCnt |
| Total Other Org | 2 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Armendariz Cesar | |||||||||||||
| VP Bus Dev | $188,064 | $44,612 | $18,636 | $15,389 | $34,499 | $301,200 | |||||||
| Bryant Mara | |||||||||||||
| Sr VP Org Perf | $239,647 | $54,532 | $33,767 | $33,678 | $34,109 | $395,733 | $28,600 | ||||||
| Carmen Robert | |||||||||||||
| Former Dir/Chair | $92,686 | $7,321 | $6,362 | $106,369 | $126,867 | $126,867 | $126,867 | ||||||
| Chern Mary Anne | |||||||||||||
| Sr VP Fund Dev/Ex Rel | $225,088 | $51,245 | $36,982 | $41,126 | $11,658 | $366,099 | $28,931 | ||||||
| Coan Carol | |||||||||||||
| CEO, FQHC | $237,153 | $267,138 | $8,962 | $2,908 | $18,115 | ||||||||
| Fargo Roland | |||||||||||||
| Sr VP Reg Physician Ops | $321,668 | $71,505 | $69,051 | $52,728 | $30,320 | $545,272 | $42,116 | ||||||
| Hopper Monica | |||||||||||||
| Dir. Finance | $203,549 | $256,411 | $18,866 | $2,507 | $18,115 | $13,374 | |||||||
| Jobe Meredith | |||||||||||||
| Secretary | $355,393 | $98,178 | $84,270 | $74,975 | $18,602 | $631,418 | $53,771 | ||||||
| Milatovich Natasha | |||||||||||||
| VP HR | $220,622 | $47,782 | $17,854 | $16,180 | $34,519 | $336,957 | |||||||
| Miller Elizabeth | |||||||||||||
| VP Care Mngt | $224,616 | $47,840 | $8,407 | $16,180 | $15,511 | $312,554 | |||||||
| Nahapetian Arby | |||||||||||||
| Reg CMO | $479,606 | $78,052 | $102,768 | $95,604 | $38,324 | $794,354 | $55,337 | ||||||
| Nguyen Thao | |||||||||||||
| Dir. Pharmacy | $202,873 | $262,417 | $21,443 | $5,690 | $18,115 | $14,296 | |||||||
| Raffoul John | |||||||||||||
| President & CEO | $381,119 | $75,899 | $80,099 | $149,137 | $31,304 | $717,558 | $49,848 | ||||||
| Rebok Douglas | |||||||||||||
| Former Asst Sec | $206,161 | $198,734 | $192,588 | $16,180 | $12,863 | $626,526 | $150,311 | ||||||
| Reiner Scott | |||||||||||||
| Dir/Chair | $962,984 | $298,366 | $264,690 | $227,469 | $34,190 | $1,787,699 | $182,145 | ||||||
| Richards Blin | |||||||||||||
| VP Finance/CFO | $216,710 | $37,852 | $16,852 | $16,270 | $31,216 | $318,900 | |||||||
| Saad John | |||||||||||||
| Dir. Perioperative | $182,661 | $236,790 | $14,539 | $9,543 | $18,115 | $11,932 | |||||||
| Stone Patricia | |||||||||||||
| Sr VP Nurs/CNE | $244,572 | $11,704 | $8,370 | $15,749 | $11,898 | $292,293 | |||||||
| Velazquez Jesus | |||||||||||||
| Staff RN | $205,816 | $218,796 | $466 | $12,514 | |||||||||
| Wagner Jack | |||||||||||||
| Asst Treas | $775,339 | $146,404 | $134,782 | $16,384 | $25,040 | $1,097,949 | |||||||
| Wehtje Rodney | |||||||||||||
| Asst Treas | $380,562 | $109,398 | $101,323 | $34,588 | $24,128 | $649,999 | $69,093 | ||||||
| Wing Bill | |||||||||||||
| Dir/V Chair | $814,628 | $250,491 | $180,369 | $192,782 | $35,618 | $1,473,888 | $130,871 | ||||||
| Zachary Beth | |||||||||||||
| Sr VP/Pres SCR | $669,124 | $205,059 | $138,992 | $421,689 | $17,714 | $1,452,578 | $90,519 | ||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a: Relevant information in regards to selections on 1a. | FormAndLineReferenceDesc |
| Explanation | Part I, Line 1BAny items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital bylaws define its board of directors to be the same individuals who are members of Adventist Health System/West board of directors. |
| Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders | The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | The completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A telephone board meeting is held to review the 990 highlights. Specific questions related to the filing organization may be asked by any board member prior to filing the return. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff reviews these questionnaires and disclosures each year during the audit process. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Donated property and equip 168.11 - Zero = $0 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Net Assets Released fr Restrictions - 168.30 = -$3099672 |
| Other Changes In Net Assets Or Fund Balances - Other Increases | Restricted Gifts & Grants 169.30/.60 = $4106539 |
| Other Changes In Net Assets Or Fund Balances - Other Decreases | Transfers to Affliated Organizations - 169.20 = -$4228021 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Adventist Health SystemWest | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 953484589 | Support and Manage System-wide Activities | CA | 501(c)(3) | 1 | N/A | false | |
| Adventist Health Clearlake Hospital Inc | |||||||||||
| Ave 18 at Hwy 53 | Clearlake | CA | 95422 | 680395149 | Hospital | CA | 501(c)(3) | 3 | false | Adventist Health SystemWest | |
| Adventist Health Physicians Network | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 95661 | 680357690 | Hospital | CA | 501(c)(3) | 11b, II | false | Adventist Health SystemWest | |
| Castle Medical Center | |||||||||||
| 640 Ulukahiki Street | Kailua | HI | 96734 | 990107330 | Hospital | HI | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Central Valley General Hospital | |||||||||||
| 1025 N Douty Street | Hanford | CA | 93230 | 770324630 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Feather River Hospital | |||||||||||
| 5974 Pentz Road | Paradise | CA | 95969 | 941101228 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Glendale Adventist Medical Center | |||||||||||
| 1509 Wilson Terrace | Glendale | CA | 91206 | 953899682 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Hanford Community Hospital | |||||||||||
| 450 Greenfield Avenue | Hanford | CA | 93230 | 940535360 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Lodi Memorial Hospital Association Inc | |||||||||||
| 975 Fairmount Ave | Lodi | CA | 95240 | 941044474 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Northwest Medical Fdtn of Tillamook | |||||||||||
| 1000 Third Street | Tillamook | OR | 97141 | 930622075 | Hospital | OR | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Paradise Valley Hospital | |||||||||||
| 2100 Douglas Blvd | Roseville | CA | 97216 | 951816034 | Wind Down After Sale of Hospital Facilit | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Portland Adventist Medical Center | |||||||||||
| 10123 SE Market Street | Portland | OR | 97216 | 930429015 | Hospital | OR | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Reedley Community Hospital | |||||||||||
| 372 W Cypress Avenue | Reedley | CA | 93654 | 453220509 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| St Helena Hospital | |||||||||||
| 10 Woodland Road | St Helena | CA | 94574 | 941279779 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| San Joaquin Community Hospital | |||||||||||
| 2615 Chester Avenue | Bakersfield | CA | 93301 | 952294234 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Simi Valley Hospital & Health Care Svcs | |||||||||||
| 2975 N Sycamore Drive | Simi Valley | CA | 93065 | 956064971 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Sonora Community Hospital | |||||||||||
| 1000 Greenley Road | Sonora | CA | 95370 | 941415069 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Ukiah Adventist Hospital | |||||||||||
| 275 Hospital Drive | Ukiah | CA | 95482 | 941639901 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| Walla Walla General Hospital | |||||||||||
| 1025 S Second Avenue | Walla Walla | WA | 99362 | 910617726 | Hospital | WA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
| White Memorial Medical Center Fdtn | |||||||||||
| 1720 Cesar E Chavez Avenue | Los Angeles | CA | 90033 | 952282647 | Fundraising for Hospital | CA | 501(c)(3) | 11, Type 1 | false | Adventist Health SystemWest | |
| Willits Hospital Inc | |||||||||||
| 1 Marcela Dr | Willits | CA | 95490 | 680108919 | Hospital | CA | 501(c)(3) | 1 | false | Adventist Health SystemWest | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Coast Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2100 Douglas Blvd | AddressLine1Txt |
| City | Roseville | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95661 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952037291 | EIN |
| Primary Activities | Wind Down After Sale of Hospital | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C-Corp | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (11 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Adventist Health SystemWest | ||
| e | $300,223 | Cost |
| Adventist Health SystemWest | ||
| m | $19,392,526 | Cost |
| Adventist Health SystemWest | ||
| q | $112,843 | Cost |
| Adventist Health SystemWest | ||
| r | $3,099,671 | Funds Transfer |
| Adventist Health Physicians Network | ||
| m | $6,000,486 | Cost |
| Glendale Adventist Medical Center | ||
| l | $409,540 | |
| Glendale Adventist Medical Center | ||
| m | $327,279 | |
| Glendale Adventist Medical Center | ||
| o | $658,235 | |
| Glendale Adventist Medical Center | ||
| p | $403,638 | |
| Glendale Adventist Medical Center | ||
| q | $514,999 | |
| Simi Valley Hospital & Health Care Svcs | ||
| l | $206,421 | |