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SAN JOAQUIN COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SAN JOAQUIN COMMUNITY HOSPITAL (EIN 95-2294234)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201143199349309829
Schema version
2010v3.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-15T16:04:47-08:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BROWN ARMSTRONG ACCOUNTANCY CORPORATIONBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14200 TRUXTUN AVE STE 300AddressLine1
CityBAKERSFIELDCity
StateCAState
ZIP Code933090668ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952294234EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1San Joaquin Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSANJNameControl
Phone6613953000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12615 Chester AvenueAddressLine1
CityBakersfieldCity
StateCAState
ZIP Code93301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBrent SoperName
TitleVP FinanceTitle
Date Signed2011-11-15DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameChristina M ThornburghName
Phone6613244971Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts273745011GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number1071GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitesanjoaquinhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTo share God's love with our community by providing physical, mental, and spiritual healing.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees2021TotalNbrEmployees
Total Nbr Volunteers229TotalNbrVolunteers
Total Gross UBI25165TotalGrossUBI
Net Unrelated Business Txbl Income22025NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year879972ContributionsGrantsPriorYear
Contributions Grants Current Year1354738ContributionsGrantsCurrentYear
Program Service Revenue Prior Year217742393ProgramServiceRevenuePriorYear
Program Service Revenue CY265649177ProgramServiceRevenueCY
Investment Income Prior Year926186InvestmentIncomePriorYear
Investment Income Current Year3192516InvestmentIncomeCurrentYear
Other Revenue Prior Year2028907OtherRevenuePriorYear
Other Revenue Current Year2290181OtherRevenueCurrentYear
Total Revenue Prior Year221577458TotalRevenuePriorYear
Total Revenue Current Year272486612TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year105899055SalariesEtcPriorYear
Salaries Etc Current Year123252602SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year96785770OtherExpensePriorYear
Other Expenses Current Year121907870OtherExpensesCurrentYear
Total Expenses Prior Year202684825TotalExpensesPriorYear
Total Expenses Current Year245160472TotalExpensesCurrentYear
Revenues Less Expenses Prior Year18892633RevenuesLessExpensesPriorYear
Revenues Less Expenses CY27326140RevenuesLessExpensesCY
Total Assets BOY195634968TotalAssetsBOY
Total Assets EOY238506359TotalAssetsEOY
Total Liabilities BOY115799934TotalLiabilitiesBOY
Total Liabilities EOY131345185TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY79835034NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY107161174NetAssetsOrFundBalancesEOY
Mission DescriptionTo share God's love with our community by providing physical, mental, and spiritual healing.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense203725605Expense
Revenue265649177Revenue
DescriptionSan Joaquin Community Hospital provides quality medical healthcare 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 San Joaquin Community Hospital, the organization recognizes that not all individuals possess the ability to pay for essential medical services.San Joaquin Community Hospital's vision is that our service will set the standard for customer-centered, quality care. We will 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. Our mission is to carry on the healing ministry of Jesus Christ by providing quality patient care, maintaining a competent, caring, professional staff and responding to community needs. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need healthcare cannot pay: - Providing free care and/or subsidized care - Providing care to persons covered by governmental programs at below cost - Providing health/wellness activities and community education programsNot only does San Joaquin Community Hospital provide low-cost care to individuals covered by government programs and those unable to afford healthcare, but it also helps patients find and access private and governmental resources for healthcare benefits. San Joaquin Community Hospital 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 2010 was $.Inpatient services in 2010 were provided to 19,100 patients. These services included: - Acute care services for medical/surgical, pediatric, obstetric and critical care patients - Baby deliveries totaling 2,509 - Surgery cases performed totaling of which open-heart surgeries totaled We also perform neurosurgery, ophthalmology, oral and maxillofacial surgery, otolaryngology, cosmetic surgery, thoracic and vascular surgery, urology, dental surgery and orthopedic surgery. - Radiology procedures performed - Cardiac catheterizations and other procedures - Laboratory tests performed - TCU/Intermediate care - Rehabilitation servicesOutpatient services in 2010 were provided to 73,634 patients. These services included: - Emergency room visits totaling 49,879 - Outpatient surgery cases performed totaled 23,755 - Radiology procedures performed - Cardiac catherizations and other procedures - Laboratory tests performed - OB ClinicsHome Health Care services in 2010 were provided to 919 unduplicated patients. These services included: - Home health - Private duty - Home medical equipment - Home infusion therapySan Joaquin Community Hospital recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission: - Business Health Network - This program meets the healthcare needs of the local industry. The program features workers' compensation case management, substance abuse screening, physicals, and wellness and educational programs. - Immunization Program - This program educates the community about childhood immunizations and makes vaccines both accessible and affordable to children in Kern County. It offers immunization clinics throughout the city for children two years of age and under. - Buck Owens Wellness Resource Center - This program provides a well-trained culturally competent staff to promote early detection, diabetes education, screening, and referral and follow up services in Bakersfield and the outlying communities.Description
Total Program Service Expense203725605TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096312NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees2021NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBrent SoperNamePerson
Telephone Number6613953000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12615 Chester AvenueAddressLine1
CityBakersfieldCity
StateCAState
ZIP Code93301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Wes Rippey
Director1.00X014470774
Steven Herber
Director1.00X014675474
Scott Reiner
Asst Sec50.000706956142451X
Ruthita Fike
Director1.00X040574
Rodney Wehtje
Asst Treas50.000484703160891X
Robert Carmen
Chairman50.00X01485848256139X
Robert Bradshaw
Director1.00X0132174
Robert Beehler
President / CEO50.00045019094996X
Ricardo Graham
Director1.00X0230974
Mohamad Itani
VP Support Srv50.00020517932310X
Meredith Jobe
Director1.00X01624674
Max Torkelsen
Director1.00X0185474
Martha Samora
VP Ancillary Sr50.00023049131749X
Lynn Creitz
Director1.00X0212374
Larry Dodds
V Chair / Sec50.00X0789424159012X
Larry Caviness
Director1.00X0250574
Kurt Hoekendorf
VP Physician De50.00249829022397X
Jeffrey Jackson
Pharmacist38.00182498042722X
Jarrod McNaughton
VP Mrktg & Dev50.00019500727440X
Fe Tolosa
RN Clinical Nrs49.00194823054993X
Douglas Rebok
Asst Sec50.000701547140807X
Deborah Hankins
VP / CNO50.00024014030540X
Christine Friestad
Director1.00X0131174
Brent Soper
Treas / VP Fin50.00025041221668X
Berry Chupa
RN First Assist34.00193907028143X
Al Reimche
Director1.00X0144074
Agnes Faria
RN Clinical Nrs II47.00189880050919X
Aaron Gates
Pharmacist0.00182233042660X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1193170TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6060872TotalReportableCompFrmRltdOrgs
Total Other Compensation1340651TotalOtherCompensation
Number Individuals GT100 K236NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Valley Anesthesia Associates
PO Box 2029BakersfieldCA93303Medical5072567
Quest Imaging Medical Assoc
PO Box 2447BakersfieldCA933032447Medical5014539
Kaiser Foundation Hospitals
5055 California AvenueBakersfieldCA93309Medical9338457
Houchin Community Blood Bank
5901 Truxtun AvenueBakersfieldCA93309Medical2253983
Crothall Service Group
13029 Collections Center DrChicagoIL60693Maintenance2243638
FieldValueIRS element (for citing)
Number Of Contractors GT100 K52NumberOfContractorsGT100K
Government Grants827246GovernmentGrants
All Other Contributions527492AllOtherContributions
Total Contributions1354738TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Rental-Medical Office531120563279563279
Net Patient Revenue621110265060733265060733
Lab Fees6215002516525165
FieldValueIRS element (for citing)
Total Program Service Revenue265649177TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3211389TotalRevenueColumn
Exclusion$3,211,389ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other8300Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other27173Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-18873Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-18873TotalRevenueColumn
Exclusion-$18,873ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events149649GrossIncomeFundraisingEvents
Fundraising Direct Expenses100197FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column49452TotalRevenueColumn
Exclusion$49,452ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory1131029GrossSalesOfInventory
Cost Of Goods Sold1131029CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Other Services624200892821892821
Education6241005899058990
Dietary72221012889181288918
FieldValueIRS element (for citing)
Total Other Revenue2240729TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column272486612TotalRevenueColumn
Related Or Exempt Function Income267864741RelatedOrExemptFunctionIncome
Unrelated Business Revenue25165UnrelatedBusinessRevenue
Exclusion$3,241,968ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1435007Total
Program Services1162779ProgramServices
Management And General272228ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total94692067Total
Program Services90305357ProgramServices
Management And General4386710ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2529737Total
Program Services2351805ProgramServices
Management And General177932ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total17675974Total
Program Services16811544ProgramServices
Management And General864430ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6919817Total
Program Services6638623ProgramServices
Management And General281194ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total521959Total
Management And General521959ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total112469Total
Management And General112469ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total78000Total
Management And General78000ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9553953Total
Program Services5945800ProgramServices
Management And General3608153ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1201227Total
Management And General1201227ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2940722Total
Program Services2476242ProgramServices
Management And General464480ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4928416Total
Program Services4928416ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4232671Total
Program Services3679166ProgramServices
Management And General553505ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total1060819Total
Program Services704809ProgramServices
Management And General356010ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total3297765Total
Program Services3297765ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8579512Total
Program Services8508920ProgramServices
Management And General70592ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1820432Total
Program Services1820432ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Rental/Lease Costs Equip9490719477761295
Purchased Services20164442107787979385645
Pt Care Supplies4290969042909690
Other Expenses1955672245768419099038

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total245160472Total
Program Services203725605ProgramServices
Management And General41434867ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY982762BOY
EOY343375EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY45407011BOY
EOY73389254EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY48199EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY42011255BOY
EOY34030861EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3822468BOY
EOY5826136EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY208753BOY
EOY898730EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis163207658LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec59679202LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY93989524BOY
EOY103528456EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY11062458EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9213195BOY
EOY9378890EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY195634968BOY
EOY238506359EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15372288BOY
EOY17217032EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY20255BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY78497724BOY
EOY93503605EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21909667BOY
EOY20624548EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY115799934BOY
EOY131345185EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY78515362BOY
EOY106137824EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1319672BOY
EOY1023350EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY79835034BOY
EOY107161174EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY195634968BOY
EOY238506359EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses27326140ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Church170b1 AiXChurch170b1Ai

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$78,000OtherActivitiesAmount
Total Lobbying Expenditures IIB78000TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationLobbying expenses are an allocated portion of industry association membership dues as defined by the association.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3796968OtherCostOrOtherBasis
Book Value3796968BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis109258663OtherCostOrOtherBasis
Depreciation29822164Depreciation
Book Value79436499BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis481658OtherCostOrOtherBasis
Depreciation181938Depreciation
Book Value299720BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis49670369OtherCostOrOtherBasis
Depreciation29675100Depreciation
Book Value19995269BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings103528456TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Workers Comp Payable$2,027,056
Payables to Third Party Payors$17,284,866
Payables to Related Organizations$1,312,626
FieldValueIRS element (for citing)
Total Of Amounts20624548TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XIdentifier
Return ReferencePart X : FIN48 FootnoteReturnReference
ExplanationThe hospital, a member of a group that issues combined audited financial statements, does not have a FIN 48 disclosure in the combined audited financial statement. The combined audited financial statements report that there is no material effect for FIN 48 on the combined financial statements.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Grand Affair of the HeartNameOfEvent1
Gross Receipts Event1149649GrossReceiptsEvent1
Gross Revenue Event1149649GrossRevenueEvent1
Rent Facility Costs Event145027RentFacilityCostsEvent1
Food And Beverage Event123201FoodAndBeverageEvent1
Entertainment Event11150EntertainmentEvent1
Other Direct Expenses Event130819OtherDirectExpensesEvent1
Gross Receipts Total149649GrossReceiptsTotal
Gross Revenue Total Events149649GrossRevenueTotalEvents
Rent Facility Costs Total Events45027RentFacilityCostsTotalEvents
Food And Beverage Total Events23201FoodAndBeverageTotalEvents
Entertainment Total Events1150EntertainmentTotalEvents
Other Direct Expenses Total Events30819OtherDirectExpensesTotalEvents
Direct Expense Summary Events100197DirectExpenseSummaryEvents
Net Income Summary49452NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CarefalseAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3251628TotalCommunityBenefitExpense
Direct Offsetting Revenue18960DirectOffsettingRevenue
Net Community Benefit Expense3232668NetCommunityBenefitExpense
Percent Of Total Expense0.01320PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense34876376TotalCommunityBenefitExpense
Direct Offsetting Revenue24249161DirectOffsettingRevenue
Net Community Benefit Expense10627215NetCommunityBenefitExpense
Percent Of Total Expense0.04330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense38128004TotalCommunityBenefitExpense
Direct Offsetting Revenue24268121DirectOffsettingRevenue
Net Community Benefit Expense13859883NetCommunityBenefitExpense
Percent Of Total Expense0.05650PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense464375TotalCommunityBenefitExpense
Net Community Benefit Expense464375NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense11305TotalCommunityBenefitExpense
Net Community Benefit Expense11305NetCommunityBenefitExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense908507TotalCommunityBenefitExpense
Direct Offsetting Revenue332673DirectOffsettingRevenue
Net Community Benefit Expense575834NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense671378TotalCommunityBenefitExpense
Net Community Benefit Expense671378NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2055565TotalCommunityBenefitExpense
Direct Offsetting Revenue332673DirectOffsettingRevenue
Net Community Benefit Expense1722892NetCommunityBenefitExpense
Percent Of Total Expense0.00690PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense40183569TotalCommunityBenefitExpense
Direct Offsetting Revenue24600794DirectOffsettingRevenue
Net Community Benefit Expense15582775NetCommunityBenefitExpense
Percent Of Total Expense0.06340PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense3908TotalCommunityBuildingExpense
Net Community Building Expense3908NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense3908TotalCommunityBuildingExpense
Net Community Building Expense3908NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,541,618BadDebtExpenseAmount
Amount Attributable To1550387AmountAttributableTo
Amount Reimbursed By Medicare62782000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare63587664CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-805664MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1San Joaquin Community HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12615 Chester AvenueAddressLine1
CityBakersfieldCity
StateCAState
ZIP Code93301ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1San Joaquin Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedfalseEligibilityCriteriaExplained
Uses FPG FreefalseUsesFPGFree
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasisfalseExplainsBasis
Explains Application MethodfalseExplainsApplicationMethod
Includes Publicity MeasuresfalseIncludesPublicityMeasures
Actions On NonpaymentfalseActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part VI - Additional InformationSchedule H, Part V, Section B is optional for the reporting organization as the tax year began prior to March 23, 2010. Further, IRS Announcement 2011-37 states the entire Part V, Section B is optional for the 2010 Form 990. Lacerte software has not provided a tool for an organization to indicate that it is opting not to complete Part V, Section B. In addition, the software has been programmed so that it populates responses when the organization chooses to provide no data inputs. Part V, Section B should be blank as the reporting organization opts to not complete it.
Part VI - Affilated Health Care System Roles and PromotionThe hospital is a member of a larger health care system, which provides services in diversified areas of the Western United States. The hospital shares some services with other hospitals in its geographic area. Using today's technology, hospitals outside the geographic area are able to support the hospital by providing remote services such as telepharmacy and robotics surgery. The Corporate Office provides support for the rural health clinics, quality of care, and other clinical needs.
Part VI - Community Building ActivitiesOur hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. Furthermore, we work with neighborhood programs, including schools, work sites, and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.
Part VI - Community InformationThe hospital is one of the largest healthcare systems in the area serving Kern County and surrounding areas. The service area includes a small city and surrounding suburbs, small towns and rural agricultural areas. The diverse population includes Caucasian and a large minority population, both Hispanic and African-American.
Part VI - Patient Education of Eligibility for AssistanceAt the time of registration, patients who do not possess third party coverage are counseled on how to apply for assistance via government programs. In many Adventist Health facilities, outside vendors are hired to assist in this area. Patients also are informed of their right to request charity assistance at the time of registration and via signs and other communiqus posted and displayed throughout the hospitals. System facilities also provide brochures at the time of registration that explain hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance.
Part VI - Needs AssessmentThe health system retains outside research firms to assess changes in the market and community perception. Data is collected through a variety of vehicles, including phone surveys, paper surveys, and focus groups. Questions were added to the survey to help assess the impact of our community benefit activities and residents' barriers to access for health care services as well as unmet community needs.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsWhen a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. 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 General Ledger Revenue Received* Medicare Cost Report Revenue 61,364,300 Prior Year Settlements -Cost Report Reimbursable Bad Debts 1,400,560 Estimated and Accrual Variances (4,186,047)Medicare Revenue Not on Cost Report 394,242 Other 3,808,945 Total Medicare Revenue 62,782,000* Note: The medicare Cost Report revenue does no 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 accounted for in the co-pay and deductible amounts.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgstrueCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Scott Reiner
5105801353326104412232320128849407
Rodney Wehtje
32443071576886971448271606464559454524
Robert Carmen
920840235921329087235392207471741987211163
Robert Beehler
35060084678149127891616080545186
Mohamad Itani
15758029563180361231319997237489
Martha Samora
18319529216180801375317996262240
Larry Dodds
5889301528914760314291216100948436
Kurt Hoekendorf
2470982731875513642272226
Jeffrey Jackson
18249842722225220
Jarrod McNaughton
1597202956357241147515965222447
Fe Tolosa
19482354993249816
Douglas Rebok
5127801377825098512248818319842354
Deborah Hankins
19602032208119121455315987270680
Brent Soper
2102063568445221131410354272080
Berry Chupa
19390728143222050
Agnes Faria
18988050919240799
Aaron Gates
18223342660224893

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 6bIdentifier
Return ReferencePart I, Line 6b: Explanation of organization compensation contingent on net earnings from related orReturnReference
ExplanationAn incentive plan is included as part of the board-approved compensation plan for hospital executives. The hospital has a similar plan for department directors. The purpose of these plans is to provide incentives to hospital management to accomplish the financial, operational, quality, and mission objectives of the hospital during each fiscal year. Each member of the management team is evaluated against pre-determined objectives to arrive at the incentive amount, if any, for the fiscal year. The hospital must achieve a specific financial goal before any incentives can be earned. See Schedule O for additional detail.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Itani Design ConceptsBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipContractorRelationship
Amount Of Transaction139230AmountOfTransaction
Description Of TransactionBuilding RemodelingDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VII, Line 1a - Board CompThe directors serve on the Board without compensation. Amounts reported generally are for taxable benefits. Further explanation for those directors who receive compensation for services rendered in their professional capacity follows. Steven Herber, MD is the Chief Medical Officer for St. Helena Hospital. The hospital paid Dr. Herber $144,001 for his services. The CMO services were provided under contract approved by the Board Compliance Committee.Jobe & Stoterau, a law practice with which Meredith Jobe is affiliated, provided legal services regarding real estate matters to White Memorial Medical Center in the amount of $13,791. Wes Rippey, MD is the Chief Medical Officer for Portland Adventist Medical Center. The hospital paid Dr. Rippey $57,600 for his services. Additionally, Healthcare Specialists NW, the medical group of which Dr. Rippey is a member, provides vascular study interpretations and on call coverage for patients of the hospital. The medical group received $85,818 for these professional services. These services were provided under contract approved by the Board Compliance Committee.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe 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 VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Adventist Health System/West 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 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsDuring 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 review these questionnaires and disclose each year during the audit process.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe completed Form 990 is shared with members of the hospital's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board after their review but prior to filing.Form 990, Part VI, Line 11
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe 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 operates as an affiliate of Adventist Health System/West.Form 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Premier MSO LLC
2615 Chester AveBakersfieldCA93301271977963BILLING AND SCHEDULING FOR PREMIER IPACA9418231938543SAN JOAQUIN COMMUNITY HOSPITAL
Itani Investments LLC
2615 Chester AveBakersfieldCA93301800531044PROPERTY ACQUISITIONSCA24250172SAN JOAQUIN COMMUNITY HOSPITAL

Form990 Schedule R Part II Form990ScheduleRPartII (19 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Willits Hospital Inc
1 Madrone StreetWillitsCA95490680108919HospitalCA501(c)(3)1N/Afalse
White Memorial Medical Center
1720 Cesar E Chavez AvenueLos AngelesCA90033952282647HospitalCA501(c)(3)1N/Afalse
Walla Walla General Hospital
1025 South Second AvenueWalla WallaWA99362910617726HospitalWA501(c)(3)1N/Afalse
Ukiah Adventist Hospital
275 Hospital DriveUkiahCA95482941639901HospitalCA501(c)(3)1N/Afalse
St Helena Hospital
10 Woodland RoadSt HelenaCA94574941279779HospitalCA501(c)(3)1N/Afalse
South Coast Medical Center
2100 Douglas BlvdRosevilleCA95661952037291WIND DOWN AFTER SALE OF HOSPITAL FACILITIESCA501(c)(3)3N/Afalse
Sonora Community Hospital
1000 Greenley RoadSonoraCA95370941415069HospitalCA501(c)(3)1N/Afalse
Simi Valley Hospital & Health Care Svcs
2975 North Sycamore DriveSimi ValleyCA93065956064971HospitalCA501(c)(3)1N/Afalse
Selma Community Hospital Inc
1141 Rose AvenueSelmaCA93662770509133Supporting Hanford Community HospitalCA501(c)(3)11c, Type 3 - F1N/Afalse
Portland Adventist Medical Center
10123 SE Market StreetPortlandOR97216930429015HospitalOR501(c)(3)1N/Afalse
Paradise Valley Hospital
2100 Douglas BlvdRosevilleCA95661951816034Wind Down After Sale of Hospital FacilitiesCA501(c)(3)1N/Afalse
Northwest Medical Foundation - Tillamook
1000 Third StreetTillamookOR97141930622075HospitalOR501(c)(3)1N/Afalse
Hanford Community Hospital
115 Mall DrHanfordCA93230940535360HospitalCA501(c)(3)1N/Afalse
Glendale Adventist Medical Center
1509 Wilson TerraceGlendaleCA91206951816017HospitalCA501(c)(3)1N/Afalse
Feather River Hospital
5974 Pentz RoadParadiseCA95969941101228HospitalCA501(c)(3)1N/Afalse
Central Valley General Hopital
1025 N Douty StreetHanfordCA93230770324630HospitalCA501(c)(3)1N/Afalse
Castle Medical Center
640 Ulukahiki StreetKailuaHI96734990107330HospitalHI501(c)(3)1N/Afalse
Adventist Health Clearlake Hospital Inc
15630 18th AveClearlakeCA95422680395149HospitalCA501(c)(3)3N/Afalse
Adventist Health SystemsWest
2100 Douglas BoulevardRosevilleCA95661953484589Support and Manage System-Wide ActivitiesCA501(c)(3)1N/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg