2025-11-06T11:31:03-06:00 2024-12-31 390859910 Baker Tilly Advisory Group LP 2882 Prospect Park Dr Ste 300 Rancho Cordova CA 95670 990 2024-01-01 941279779 St Helena Hospital STHE 9164060000 10 Woodland Road St Helena CA 94574 Richard Riter Treasurer 9164060000 2025-10-25 1 1 Lauren A Haverlock P00545829 9165038100 2025-10-25 2024 2025-03-06 01:10:19Z Adventist Health St Helena Steven Herber 10 Woodland Road St Helena CA 94574 308838663 0 1071 X www.adventisthealth.org/st-helena/ X 1898 CA Living God's love by inspiring health, wholeness and hope. 14 13 1266 46 49936 1239 4720671 5985608 293121306 302599935 195730 253120 0 0 298037707 308838663 103898 103338 0 0 102256072 111436153 0 0 958613 212007909 222897492 314367879 334436983 -16330172 -25598320 205326410 219832151 224822773 268270765 -19496363 -48438614 X Living God's love by inspiring health, wholeness and hope. 0 0 278551331 103338 302549999 See Schedule O 278551331 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 1266 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X John Beaman CFO 9164060000 1 Adventist Health Way Roseville CA 95661 X Heinrich Kerry Dir/Chair/CEO 0.00 50.00 X X 0 3974195 57975 Hofheins Todd Dir/Vice Chair/COO 0.00 50.50 X X 0 2407675 65992 Beaman John CFO/Assistant Secretary 0.00 50.50 X 0 1980861 79808 Stevens Eric Pres, Northern California Network 5.00 45.50 X 0 1886146 57975 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0.00 50.00 X 0 1759258 79808 Jobe Meredith Secretary 0.00 50.50 X 0 1221104 57975 Howe Judson Pres, North Coast Network thru 07/24 8.30 41.70 X 0 830097 79497 Herber Steven President 50.00 0.00 X 0 783802 57975 Jahn Andrew - Former Care Division President thru 02/22 0.00 50.00 X 0 693217 59411 Mock Jeffrey Treasurer/Asst Secr 10.00 40.00 X 0 568248 35835 Mensch Deborah Patient Care Executive 50.00 0.00 X 0 392101 57499 Tomlinson Sean Director, Pharmacy 40.00 0.00 X 322187 0 40233 Hasso Ruth RN 40.00 0.00 X 305305 0 25350 Nonescan Cindy RN 40.00 0.00 X 272454 0 50454 Smith Lorinda RN 40.00 0.00 X 270910 0 43458 Snyder Retha RN 40.00 0.00 X 264499 0 24282 Wing Bill - Former Dir Asst Secr/Vice Chair thru 01/22 0.00 0.00 X 0 273263 0 Vichi Julie Finance Officer 50.00 0.00 X 0 210778 21400 Lyons Timothy Former Medical Officer thru 12/22 0.00 0.00 X 0 131000 0 Freedman John Director 0.00 4.00 X 0 27203 0 Newton Bradford Director 0.00 4.00 X 0 26939 0 Cherry Robert Director 0.00 4.00 X 0 26611 0 Davis Andrew Director 0.00 4.00 X 0 26611 0 Innocent Larry Director 0.00 4.00 X 0 26611 0 Reiner Richard Director 0.00 4.00 X 0 26611 0 Wagner Jack Director 0.00 4.00 X 0 21611 0 Woodson Marc Director 0.00 4.00 X 0 21611 0 Salazar Velino Director thru 09/24 0.00 4.00 X 0 21181 0 Fehr Joy Director 0.00 4.00 X 0 18680 0 Beckett Ann Director as of 01/24 0.00 4.00 X 0 17930 0 Daggett Jonathan Director as of 01/24 0.00 4.00 X 0 16180 0 Jutzy Kenneth Director as of 01/24 0.00 4.00 X 0 16180 0 Cress John Director as of 10/24 0.00 4.00 X 0 430 0 1435355 17406134 894927 345 1 1 0 Crothall Healthcare Inc 13028 Collections Center Dr Chicago IL 60693 Patient support 4213645 Galen Inpatient Physicians Inc 2100 Powell St Ste 400 Emeryville CA 94608 Medical services 2774315 PT Solutions Holdings LLC PO Box 724557 Atlanta GA 31139 Medical and Mgmt services 2042895 Napa Valley Oncology Group 389 Blue Jay Way Napa CA 94558 Medical services 1704472 Allied Universal Security Services PO Box 31001-2374 Pasadena CA 91110 Security services 1663326 72 1273167 4712441 5985608 Patient service revenue 621110 262756197 262706261 49936 Premium revenue 531120 24351997 24351997 340B Pharmacy 456110 6702779 6702779 Related rental revenue 532000 1586323 1586323 Cafeteria revenue 722514 667310 667310 6535329 6535329 302599935 57238 57238 195882 0 195882 195882 195882 308838663 302549999 49936 253120 X 103338 103338 88554547 74805902 13191719 556926 3797714 3208095 565735 23884 12617591 9476369 3045154 96068 6466301 5552225 876257 37819 21385049 726360 20658689 82256 82256 15716 15716 34000 34000 59457327 57264008 2110530 82789 74739 74739 1178178 752338 314515 111325 14517548 1865835 12641633 10080 10278263 10233802 43258 1203 155464 77764 62071 15629 41119 20779 10849 9491 10748155 10748155 10686026 10591627 94399 1714327 1203419 510908 Patient care supplies 65455194 65447539 7655 Quality assurance fees 13051261 13051261 Rental/lease costs 945933 943065 2868 UBI taxes 784 784 13076153 12444666 628611 2876 334436983 278551331 54927039 958613 34190703 44162927 6930547 8646667 970963 1050850 297558015 198175959 101637927 99382056 61596270 66589651 205326410 219832151 132732005 178291078 92090768 89979687 224822773 268270765 X -45952409 -72891474 26456046 24452860 -19496363 -48438614 205326410 219832151 X -25598320 102974 -3211458 -235447 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 34000 34000 0 Part II-B, Line 1: The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to NL Short Public Affairs were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. 40734330 2767605 984010 5526364 38959581 39224435 2176115 1336765 2002985 40734330 39609878 5174604 -2054872 3505175 39224435 23344620 16012718 4064487 3811947 39609878 21759518 1247814 1116727 779439 23344620 0.37235 0.00000 0.62765 0 1 1 425124 425124 187601889 112323973 75277916 25192686 18231863 6960823 84338316 67620123 16718193 99382056 Interest in Foundation 38576103 Receivables from related organizations 15614598 Right-of-use assets 4903729 Receivables from third-party payors 3881130 Other receivables 2166990 Johnson Trust assets 1355290 Other assets 91811 66589651 Payables to related organizations 79932297 Payables to third-party payors 5619973 Other liabilities 4328690 Annuity payable 98727 89979687 X Part V, Line 4: Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X, Line 2: The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2024 and 2023, no such assets or liabilities were recorded. The System currently files Form 990 (Informational Return of Organizations Exempt From Income Taxes) and Form 990-T (Exempt Organization Business Income Tax Return) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2021 in major tax jurisdictions. 1 1 X 1 X 1 X 1 1 1 0 1 1 516950 516950 0.00150 516950 516950 0.00150 1470817 1470817 0.00440 61254 61254 0.00020 47853462 22118681 25734781 0.07690 18272 18272 0.00010 179746 179746 0.00050 49583551 22118681 27464870 0.08210 50100501 22118681 27981820 0.08360 632850 632850 0.00190 10750 10750 0.00000 643600 643600 0.00190 1 657775 88619 83770180 90785502 -7015322 X 1 1 2 1 St Helena Hospital 10 Woodland Road St Helena CA 94574 www.adventisthealth.org/sthelena 110000073 X X X A 2 Adventist Health Vallejo 525 Oregon Street Vallejo CA 94590 www.adventisthealth.org/sthelena 110000042 X Acute Psychiatric Hospital A Facility Reporting Group - A 0 0 1 X X X X X X X X X 22 1 0 1 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment X 1 22 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility Reporting Group A Facility Reporting Group A consists of: - Facility 1: St. Helena Hospital, - Facility 2: Adventist Health Vallejo Facility Reporting Group - A Part V, Section B, line 5: The CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations - the voices of those with chronic disease, low incomes, and the underserved - were heard. Agricultural workers, civic government, community-based healthcare workers focusing on behavioral health, education, first responders, health & human services, providers, law enforcement, low-income, medically underserved, minority populations, older adults, public health, students, and the unhoused populations. In total, 12 focus groups were conducted with 78 participants, and 16 key informant interviews were held.This Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS). Survey data was gathered from the Bay Area region (region name defined by survey administrator, UC Berkeley IGS). Facility Reporting Group - A Part V, Section B, line 6b: American Canyon Police Department, Calistoga Fire Department, Calistoga Joint Unified School District, Catholic Charities' Nightingale Center, Chateau Calistoga Mobile Home Park, City of Calistoga, Mentis, Molly's Angels, Napa County Department of Health & Human Services, Napa County Department of Public Health, Napa Valley Grape Growers Foundation, Napa Valley Transportation Authority, Partnership Health Plan of California and Up Valley Family Center participated in the 2022 CHNA process. Facility Reporting Group - A Part V, Section B, line 11: Tax Year 2024 was Year Two of the Implementation Strategy for the 2022 CHNA. Programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care, Health Conditions-Physical and Mental Health.Priority Need One - Access to Care.The goal is to reduce transportation barriers by informing the community of resources available and increasing mobile van medical services. To address access to care, the Hospital offered a shuttle service for cancer patients who live in Lake County to get to their cancer treatment appointments at Adventist Health St. Helena (AHSH). The AHSH Cancer Center is the closest one in this rural area where 48% of our patients live. Many patients fall under the poverty line and one of the barriers to accessing appropriate care is the lack of transportation. Our shuttle service alleviates this issue and provides two trips per day Monday through Friday. St. Helena Hospital Foundation's Mobile Health - affectionately named Mobi - and team serve our community's adults, families and most vulnerable residents, including older adults and students. This versatile team provides preventative screenings which include height, weight, BMI, A1C, total cholesterol panel (including education on results), help with medications, education on chronic disease management, and sports physicals for students. The Mobile Health team has also eliminated barriers such as cost, transportation, language, and technology in order to provide COVID-19 vaccines, flu vaccines, and Tdap vaccines. More than one quarter of the population in the AHSH primary and secondary service area are deemed to be living in a health professional shortage area. In addition, only 8.36% of the population live within one mile to the nearest hospital with an emergency room. The Hospital committed in 2024 to recruit physicians to the area and was successful in recruiting physicians in in occupational medicine, cardiology, radiation oncology, general surgery, and breast surgery. In addition, AHSH recruited multiple Advanced Practice Providers in various specialties.Priority Need Two - Health Conditions/Physical Health.The goal is to reduce barriers that lead to chronic health conditions by creating an environment that discourages commercial tobacco and nicotine use, provides healthy tobacco-free spaces and places, supports prevention, cessation, and enforcement efforts, and limits/regulates the retail of tobacco products. To encourage behaviors that reduce preventable diseases and provide chronic disease and cancer screenings, AHSH committed to addressing behaviors that can lead to chronic illness in 2024 by directing contributions and programming in the community. These included donations to UpValley Family Centers (UVFC) to allow them to encourage healthy behaviors and reduce preventable diseases through their Promotoras and Senior Lunch and Learn programs. The Promotoras are a group of community health workers who are trained lay people and have a strong capacity for grassroots community engagement, like spreading key wellness information to the Spanish speaking members of the community. The Lunch and Learns at UVFC are aimed at the older adults of the community to help keep them informed of helpful resources when it comes to their health and well-being. Some workshops have covered topics from emergency preparedness to housing rights to Medi-Cal expansion. It also provided the opportunity to socialize with others to alleviate the loneliness that many older adults face. The Hospital provided contributions for the Run/Walk event for Zero Prostate Cancer event. The organization's goal is to help create Generation ZERO - the first generation free from prostate cancer. Contributions to their Run/Walk event help them keep their fundraising costs low and ensure that more money goes towards saving lives and keeping families together. The Hospital continued to offer free mammograms to those who are at risk and cannot afford the screening. Educational seminars were provided to the public to share information on the latest breakthroughs in treatment for orthopedic issues. This is a population health initiative that allows us to help community members feel more comfortable attaining services that enhance their overall well-being and improve their ability to perform everyday activities. Free monthly Diabetes and Self-Education Classes were offered to the public. The purpose of the class is to provide education and support to people and their loved ones/caregivers who are living with diabetes. The class allows community members to meet one on one with a registered dietician where they focus on nutrition, physical activity, medications, and mental health with the goal of lowering participants hemoglobin A1c and improving quality of life. The Hospital Substance Use Navigator served as a public educator bringing to light the harmful effects fentanyl has on the individual, community and environment. The Substance Use Navigator attended Farmer's Markets in Saint Helena and Napa to educate the public as well as distribute free Narcan kits. Fentanyl test strips are also offered to community members who come into contact with opioids and other illicit drugs. Cooking demonstration on 5/24/24 at the local Farmers Market and at an event at our local movie theater, Cameo Cinema. The goal of this event was to share healthy recipes and practices inspire by the Blue Zones Project, to encourage healthy habits for community members. The events were open for everyone to attend and food/hours were donated for the cooking demos.Utilization of the mobile health van in 2024 addressed more than access to care issues. It also addressed food insecurity issues by providing 53,365 pounds of fresh produce (equivalent to approximate $81,100 in value). The mobile van was available at three sites per month (Calistoga, Saint Helena, Napa). It provided food to 100 families per site for a total of almost 500 individuals each month. It provided a total of 1,043 health assessments that included blood pressure, height, weight, A1c, total cholesterol panels and health education on the results. It administered over 2,000 vaccines in 2024, including Monovalent COVID-19 vaccine (1,175 doses), regular flu season (700 doses), high dose flu season (497 doses) and RSV (77 doses).Throughout this cycle, AHSH has also collaborated with community partners to advance tobacco prevention and control initiatives, including updating school district substance use policies with non-punitive approaches, strengthening smoke-free spaces and events, advocating for smoke-free multi-unit housing policies, and implementing a tobacco retail licensing ordinance. Community education campaigns, youth engagement efforts like poster contests, and retailer outreach on the statewide flavor ban further supported these efforts. These initiatives spanned St. Helena, Calistoga, and Yountville, fostering healthier environments through ongoing comprehensive tobacco policy work.Priority Need Three - Mental Health.The goal is to work with mental health partners to provide additional treatment and programs to our service area while stimulating an environment that increases mental well-being. This will be accomplished through the connection of the people of Upper Napa Valley to opportunities that impact individual well-being through engagement, education, and inspiration. Part V, Section B, Line 11, continuation: In 2024, contributions were provided to Napa Valley Grapegrowers, a community of wine industry leaders committed to working together to advance the heritage and reputation of the Napa Valley appellation by providing valuable educational opportunities that elevate the lives of grape growers, farmworkers, and the community at-large. This local organization supports farmworkers by providing opportunities and preserving land. AHSH supported their Harvest STOMP event, which since 2008 has connected Napa Valley Grapegrowers. (NVG) and the Napa Valley Farmworker Foundation (FWF) with individuals passionate about preserving agricultural land and providing opportunity to farmworkers and their families. Adventist Health Vallejo participated in coalition building through the attendance at the Solano County Behavioral Health LPS/PED bi-monthly meetings. This meeting is a county wide consortium comprised of entities, both public and private, that care for the uninsured, underinsured, homeless, disabled and persons living with mental illness. It is a collaborative group whose main focus is to strategize on a multi-system approach to the above-mentioned groups for their betterment and care. They also participated in the Napa County Behavioral Health bi-monthly meetings to address mental health care in Napa Valley. Contributions were made to Mentis, a nonprofit organization Adventist Health St. Helena has partnered with to address mental health needs in the community. Mentis provides bilingual and affordable mental health services to people of every age and income level. Our donations help Mentis provide services from early intervention to outpatient treatment to residential treatment.Significant needs not met:No hospital can address all the health needs identified in its community. AHSH is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Significant needs that will not be directly addressed include financial stability, health risk behaviors, housing, food security, environment and infrastructure, homelessness, COVID-19, education, inclusion and equity, community safety and community vitality. While these significant health needs are not addressed directly, they are likely to benefit from collective efforts of our community partnerships. Part V, Section B, Line 13h: Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. 5 1 - AH St Helena - Martin O'Neil Cancer Cente 10 Woodland Road St Helena CA 94574 Cancer treatment 2 - Mental Health 913 Washington Street Calistoga CA 94558 Psych/mental health 3 - AH St Helena - Coon Joint Replacement Ins 6 Woodland Road St Helena CA 94574 Orthopedics 4 - AH St Helena - Cardiology 999 Adams Street St Helena CA 94574 Outpatient clinic 5 - Occupational Medicine 10 Woodland Road St Helena CA 94574 Job care - occupational medicine Part I, Line 7: The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. Part II, Community Building Activities: The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. Part III, Line 2: Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3: The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4: The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8: The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B. Part III, Line 9b: When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income, and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2: Adventist Health St. Helena promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in Tax Year 2023, and the Year Two Update, Tax Year 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/st-helena/about-us/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2022, 2023, and 2024 Community Health Plan Updates are also available on the Adventist Health Corporate website at:https://www.adventisthealth.org/about-us/community-benefit/ The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, the Hospital supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. In addition to the CHNA, our Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our Hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Part VI, Line 3: The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital's billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. Part VI, Line 4: The AHSH service area exemplifies diversity and is known for beautiful vineyards, a culinary scene with renowned dining, and a popular tourist destination that brings visitors from across the country. Just over 196,000 residents call our service area home now, and the growth continues as the tranquility of this beautiful place becomes known. Total population of 196,116 is based on the 2020 decennial census. Approximately 65.40% of the population owns their home and 34.60% rents their home. Household income levels are slightly higher than the California average, with 54% of annual income going towards housing and transportation. Age ranges are consistent, with children ages 0 to 4 being the smallest population group at 5.3%, to age 65, the largest community group by age is those 65 and older, 19.7% of the population. The largest groups by population are Caucasian, followed by LatinX and Black.Nearly 30% of the St. Helena population is obese, and cancer risk (7.3%) and cancer mortality rates (152 per 100,000) are higher than in California and the United States. In the AHSH service area, 13.5% of adults report having poor mental health and 30% of Medicare beneficiaries have mental health and substance use conditions. Among Medicare recipients, 4.6% have a substance use disorder, while 17.6% of the overall adult population binge drink. Unemployment and high cost of living contributes to increased stress by creating financial instability and barriers to basic needs like health services, food and housing. The suicide rate in our community (14.8 per 100,000) is higher than in California overall (10.5 per 100,000). Part VI, Line 5: Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low-income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy - even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population, 2. Factors that cause the present outcomes distribution, and3. Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to:1. Increase the prevalence of evidence-based preventive health services and preventive health behaviors,2. Improve care quality and patient safety, and3. Advance care coordination across the health care continuum.We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6: The Hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as tele-pharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7, Reports Filed With States CA Part VI: Other Information: In August of 2024, Upper Napa Valley was designated a certified Blue Zones Community, recognizing the community's measurable well-being transformation through the successful implementation of Blue Zones Project, which was sponsored and powered by AHSH, and its culminating impact across the community. Final well-being improvement measurement indicated that the community's overall well-being score increased by 3.9 points from their baseline in 2021. The community well-being score increased from 69.3 (baseline in 2021) to 76.3 (2024). Social well-being scores increased by 5.9 points from their baseline in 2021 and physical well-being increased by 3.9 points. Purpose well-being decreased from 69.2 to 68.8. Financial well-being increased by 8.6. points overall. The following initiatives were accomplished in 2024. Under the PEOPLE pillar the Blue Zones Upper Napa Valley team engaged with 699 new individuals in 2024. The Upper Napa Valley Blue Zones Team hosted numerous cooking demonstrations, story speeches, moais, purpose workshops and volunteer events, attracting attendance of 680 participants (some attending more than one event). Blue Zones activities on the AHSH campus attracted an additional 302 attendees. A breakdown of events included: 326 attendees at cooking demonstrations, 181 at the Blue Zones Story, 124 attendees at Blue Zones potluck, 12 attendees at purpose workshops, nine volunteers and 28 participants in engagement activities. Under the PLACES pillar, the Blue Zones Upper Napa Valley team certified four restaurants (Nova Terra, Bon Appetit, Ray Ray's Tacos, Clif Family Food Truck); eight workplaces (City of Calistoga, Clif Family Winery and Farm, Pacific Union College, Grove 45, Twomey Winery, City of St. Helena, Town of Yountville, Silver Oak Wine Cellars LLC); two schools (Calistoga Elementary School, Calistoga Junior Senior High School); and two grocery stores (Howell Mountain Market, Cal Mart). Under the POLICY pillar, the Blue Zones Project Upper Napa Valley team alongside local partners, supported the development, adoption, or implementation of 23 built environment initiatives that included the development of 40 walking routes across the region that would meet the needs of the community. Work to enhance pedestrian and bicycle safety was furthered by Safe Routes to School (SRTS) and demonstration projects in Calistoga and St. Helena. New community engagement with the Napa County Park Rx Coalition led to the launch of OuterSpacialan app that challenged residents to visit local parks and provided walking maps to reintroduce residents to their neighborhoods. And the local Blue Zones Project team supported capacity building for important efforts like affordable housing and support for an 8.2-mile expansion of the Vine Trail. Blue Zones Project established a Food Policy Committee that united regional partners to strategize around food systems policy. The committee, in partnership with the St. Helena Hospital Foundation, created a comprehensive resource for community members experiencing food insecurity, highlighting local food access points. Additionally, Blue Zones Project launched a Farm to School working group in collaboration with Innovative Health Solutions and three Napa County school districts. The group designed a pilot program featuring a "Harvest of the Month" initiative, supporting school gardens, and offering gardening skills and food education. Calistoga schools continued advancing farm-to-school efforts with the Project's support. In a landmark effort, Blue Zones Project worked alongside local stakeholders to draft a Napa County food policy resolution aimed at increasing access to healthy food options. The resolution committed city councils to address food insecurity by making nutritious foods available for pick-up at various locations, implementing food market regulations, promoting health food in restaurants, and supporting best practices for food retail. This resolution served as a vital policy experience for all involved, guiding the development of initiatives to improve access to balanced and affordable food in under-served neighborhoods. Blue Zones Project's Tobacco Policy Committee led a Community Education Campaign in Calistoga and St. Helena to educate the community on tobacco issues in the community. A goal of the campaign was to collect community signatures to support future city policies that will prevent tobacco use and limit exposure to tobacco smoke. Additionally, Blue Zones Project's Tobacco Policy committee created a flavor ban infographic, distributed to local tobacco retailers and Chambers of Commerce, to support California's statewide ban and educate retailers, with the assistance of Napa County Public Health and UpValley Family Centers.With support from Blue Zones Project, the Upper Napa Valley community has advanced many tobacco-free ordinances. In Calistoga, the Project supported the inclusion of a smoke-free multi-unit housing ordinance in the city's 2023-2031 Housing Element (set for implementation by December 2026) through letters, sample ordinance documents, and meetings with local officials, while also gathering personal stories from residents affected by secondhand smoke to strengthen future advocacy. In Yountville, Blue Zones Project collaborated with the town to update its Special Event Permit in late 2023, requiring smoke-free policies for events on public property and encouraging similar practices on private land.Blue Zones Project collaborated with school districts in St. Helena and Calistoga to hold student anti-smoking poster contests. The winning designs, judged by the Project's Tobacco Policy Committee, were displayed in schools and around town, promoting anti-tobacco messages to the community. Additionally, the Project worked with both school districts to create non-punitive tobacco protocols that guide staff on how to handle students caught with tobacco products. The protocols aim to provide support and cessation resources rather than focusing on punishment. A bilingual resource list was also created to provide information about tobacco cessation and ways for youth to get involved in prevention efforts. These protocols were adopted by school boards and shared with staff for implementation. These initiatives will continue to positively influence the rate of tobacco use across the Upper Napa Valley, which sits at a low 2.5% down from 5.1% at the start of the Blue Zones project in 2021. 1 California Health Fund & Trust 1215 K Street Suite 800 Sacramento CA 95814 941498697 501(c)(3) 15389 0 Hlth srvs uninsured/underinsured pt Zero Prostate Cancer Run 515 King Street Suite 420 Alexandria VA 22314 593400922 501(c)(3) 10000 0 Sponsorship UpValley Family Centers of Napa County 1440 Spring Street St Helena CA 94574 800023012 501(c)(3) 30038 0 Promotoras (health care workers) Mentis Sponsorship 709 Franklin Street Napa CA 94559 941236934 501(c)(3) 10000 0 Sponsorship Napa Valley Vine Trail Coalition 3299 Claremont Way Suite 5 Napa CA 94558 233426758 501(c)(3) 8000 0 Sponsorship 5 0 Part I, Line 2: Grants are made to public charities. No formal monitoring of the grants is completed. X X X X 1 1 0 0 0 0 0 0 0 Heinrich Kerry Dir/Chair/CEO 0 2342000 0 1586113 0 46082 0 13296 0 44679 0 4032170 0 0 Hofheins Todd Dir/Vice Chair/COO 0 1474000 0 888115 0 45560 0 13296 0 52696 0 2473667 0 0 Beaman John CFO/Assistant Secretary 0 1261000 0 698818 0 21043 0 13296 0 66512 0 2060669 0 0 Stevens Eric Pres, Northern California Network 0 1196000 0 495682 0 194464 0 13296 0 44679 0 1944121 0 0 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0 1111000 0 458435 0 189823 0 13296 0 66512 0 1839066 0 0 Jobe Meredith Secretary 0 796100 0 281132 0 143872 0 13296 0 44679 0 1279079 0 0 Howe Judson Pres, North Coast Network thru 07/24 0 326174 0 206444 0 297479 0 13296 0 66201 0 909594 0 0 Herber Steven President 0 559000 0 121819 0 102983 0 13296 0 44679 0 841777 0 0 Jahn Andrew - Former Care Division President thru 02/22 0 281190 0 407001 0 5026 0 55610 0 3801 0 752628 0 0 Mock Jeffrey Treasurer/Asst Secr 0 414258 0 90747 0 63243 0 13296 0 22539 0 604083 0 0 Mensch Deborah Patient Care Executive 0 295275 0 48346 0 48480 0 13296 0 44203 0 449600 0 0 Tomlinson Sean Director, Pharmacy 274233 0 47954 0 0 0 0 0 40233 0 362420 0 0 0 Hasso Ruth RN 301264 0 3554 0 487 0 13296 0 12054 0 330655 0 0 0 Nonescan Cindy RN 268902 0 3552 0 0 0 13296 0 37158 0 322908 0 0 0 Smith Lorinda RN 267358 0 3552 0 0 0 13296 0 30162 0 314368 0 0 0 Snyder Retha RN 242912 0 18106 0 3481 0 12146 0 12136 0 288781 0 0 0 Wing Bill - Former Dir Asst Secr/Vice Chair thru 01/22 0 0 0 0 0 273263 0 0 0 0 0 273263 0 0 Vichi Julie Finance Officer 0 191883 0 12108 0 6787 0 9594 0 11806 0 232178 0 0 Lyons Timothy Former Medical Officer thru 12/22 0 0 0 0 0 131000 0 0 0 0 0 131000 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Howe, Judson - severance payment - $258,685 Jahn, Andrew - severance payment - $15,065 Wing, Bill - severance payment - $271,535 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2024 Form 990, Part III, Line 4a: St. Helena Hospital, DBA Adventist Health St. Helena (AHSH), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHSH, located in Napa County, offers a full spectrum of services including cancer care, diabetes management, emergency care, heart and vascular services, stroke care, inpatient and outpatient surgery, behavioral health, orthopedics, women's health, and primary care. The Hospital is home to 193 credentialed providers and 117 telehealth partners across 31 medical specialties, supported by 1,071 associates and 95 volunteers. Although reimbursement for services rendered is critical to the operation and stability of AHSH, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHSH provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHSH recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2024 was $516,950. The following Inpatient services were provided to all our patients: - 78,048 clinic visits - 5,832 discharges - 7,289 emergency room visits - 1,095 inpatient surgeries - 48,842 outpatient hospital visits - 5,708 outpatient surgeries - 39,602 patient days AHSH recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2024 was $25,734,780. AHSH's quality and performance awards include: Joint Commission Certification, Advanced Total Hip and Knee Replacement, Advanced Primary Stroke Center, CoC-Accredited Cancer Program, 2025 Women's Choice Award. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Form 990, Part VI, Section A, line 7a The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, line 7b The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. Form 990, Part VI, Section B, line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System Chief Legal Officer/General Counsel immediately. The System Chief Legal Officer/General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System Chief Legal Officer/General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System Chief Legal Officer/General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, line 15 The Adventist Health Board of Directors has established an Executive Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 40 percent spread from minimum to maximum. Form 990, Part VI, Section C, line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part VII: Board compensation is for Adventist Health System/West Board of Directors only - not hospital Board of Directors. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 23,258,456. Management and general expenses 350,200. Fundraising expenses 0. Total expenses 23,608,656. Purchased medical services: Program service expenses 17,950,112. Management and general expenses 521,905. Fundraising expenses 0. Total expenses 18,472,017. All other purchased services: Program service expenses 3,750,712. Management and general expenses 644,380. Fundraising expenses 50,493. Total expenses 4,445,585. Contract labor: Program service expenses 3,789,476. Management and general expenses 71,563. Fundraising expenses 0. Total expenses 3,861,039. Other medical professional fees: Program service expenses 3,403,921. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,403,921. Repairs and maintenance: Program service expenses 4,728,852. Management and general expenses 0. Fundraising expenses 11,067. Total expenses 4,739,919. Consulting and other management fees: Program service expenses 299,653. Management and general expenses 422,796. Fundraising expenses 21,194. Total expenses 743,643. Other professional fees non-medical: Program service expenses 82,826. Management and general expenses 99,686. Fundraising expenses 35. Total expenses 182,547. Form 990, Part XI, line 9: Change in interest in Foundation -264,084. Split-interest agreements - change in value 28,637. Form 990, Part XI, Line 8: Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items. 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