2023-11-01T12:39:57-05:00 2022-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2022-01-01 953867863 Western Health Resources WEST 9164060000 1 Adventist Health Way Roseville CA 956613266 John Beaman Chief Financial Officer 9164060000 2023-10-26 1 John Beaman 999009999 1 Tracy S Paglia P00366884 2099556100 2023-10-27 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Adventist HealthHome Care Melissa Ward 1 Adventist Health Way Roseville CA 956613266 66929324 0 1071 X www.adventisthealth.org/ X 1983 CA Living God's love by inspiring health, wholeness and hope. 7 0 661 43 0 0 31250 28674 66030760 66900650 195 0 0 0 66062205 66929324 0 0 0 0 48697746 51692254 0 0 0 16512314 15522193 65210060 67214447 852145 -285123 15390414 12052928 29710328 28089965 -14319914 -16037037 X Living God's love by inspiring health, wholeness and hope. 0 0 42765031 0 66900650 See Schedule O 42765031 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 661 1 0 0 0 0 0 0 0 0 0 0 0 0 X 7 0 0 0 1 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 Hofheins Todd Chief Operating Officer as of 01/22 0.50 50.00 X 0 1971652 72279 Jahn Andrew Dir/Chair thru 02/22 0.50 50.00 X X 0 1409539 74100 Beaman John Director 0.50 50.00 X 0 1361096 58476 Stevens Eric Dir/Chair as of 03/22 0.50 50.00 X X 0 1315314 62845 Spenst Brett CFO as of 03/22 0.00 50.00 X 0 1322824 36101 Jobe Meredith Dir/Secretary 0.50 50.00 X X 0 930036 39184 Liebowitz Jacalyn Dir/Vice Chair 0.50 50.00 X X 0 801693 57117 El-Asmar Hoda - Former Dir/Vice Chair/Pres thru 10/20 0.00 0.00 X 0 661321 64633 Mock Jeffrey Director 0.50 50.00 X 0 422487 97833 Ward Melissa Dir/President 0.50 50.00 X X 0 432208 51301 Ashlock Mark Former Dir/Vice Chair thru 06/20 0.00 0.00 X 0 385805 32805 Dingilian John Director 0.50 40.00 X 0 198297 66683 Ainsworth Laura Administrative Director, Operations 40.00 0.00 X 209826 0 55145 Kasson Paul Administrative Director, Operations 40.00 0.00 X 212172 0 47614 Summers Jacob Administrative Director, Operations 40.00 0.00 X 216247 0 39569 Johnson Joycelyn Administrative Director, Operations 40.00 0.00 X 174820 0 59654 Alario Suzanne Administrative Director, Operations 40.00 0.00 X 166303 0 53094 979368 11212272 968433 133 1 1 0 McBee Associates Inc PO Box 713519 Philadelphia PA 19171 Home health and hospice coding 1231898 Nurse Communication After Hours Inc PO Box 16727 Irvine CA 92623 After hours nursing service 757985 Stateserv Network Services 1201 S Alma School Rd Mesa AZ 85210 Durable medical equipment 470397 SimiTree Healthcare Consulting 4130 Whitney Ave Hamden CT 06518 Reporting prep & recruiting agency 417474 AMN Healthcare Inc 2735 Collections Center Dr Chicago IL 60693 Medical service 239329 10 28674 28674 Patient service revenue 621110 65850648 65850648 CARES Act funding 900099 609221 609221 440781 440781 66900650 66929324 66900650 0 0 40772931 29741730 11031201 1496097 1093800 402297 6423039 4517438 1905601 3000187 2225542 774645 2817182 6100 2811082 1234 1234 4474852 1039850 3435002 4050 4050 1078404 7922 1070482 692666 20 692646 462669 6181 456488 1724218 1506788 217430 28174 1690 26484 703818 703818 468155 444096 24059 170174 29389 140785 Patient care supplies 2178429 2126397 52032 Rental/lease costs equi 537348 537348 180820 18088 162732 67214447 42765031 24449416 0 9614626 9498534 170655 187346 2742651 2086865 1844520 655786 850000 850000 2910613 861262 15390414 12052928 6477424 5852571 23232904 22237394 29710328 28089965 X -14555781 -16284342 235867 247305 -14319914 -16037037 15390414 12052928 X -285123 -1432000 0 X 0 1 X 1 1 1 X 315174 127865 10339 31250 28674 513302 59461015 56791474 65839584 66030760 66900650 315023483 59776189 56919339 65849923 66062010 66929324 315536785 0 0 0 315536785 112817 90086 195 203098 112817 90086 195 203098 59889006 57009425 65849923 66062205 66929324 315739883 0.99940 0.99930 0.00060 0.00070 X 235867 11438 247305 187828 48854 815 235867 199611 3830 15613 187828 137020 64903 2312 199611 137850 30000 30830 137020 0.00000 0.00000 1.00000 0 0 1640458 1237343 403115 245099 242164 2935 779427 529691 249736 77667 77667 0 655786 Right-of-use assets 746070 Receivables from related organizations 114972 Other receivables 220 861262 Payables to related organizations 21669583 Other liabilities 567811 22237394 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, 2022 and 2021, 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 (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2019 in major tax jurisdictions. X X X X 1 1 0 0 0 0 0 0 0 Hofheins Todd Chief Operating Officer as of 01/22 0 1358421 0 376216 0 237015 0 12220 0 60059 0 2043931 0 0 Jahn Andrew Dir/Chair thru 02/22 0 1047840 0 349414 0 12285 0 12220 0 61880 0 1483639 0 0 Beaman John Director 0 1047636 0 298600 0 14860 0 12220 0 46256 0 1419572 0 0 Stevens Eric Dir/Chair as of 03/22 0 896507 0 250602 0 168205 0 12220 0 50625 0 1378159 0 0 Spenst Brett CFO as of 03/22 0 817612 0 416845 0 88367 0 12220 0 23881 0 1358925 0 0 Jobe Meredith Dir/Secretary 0 639741 0 154687 0 135608 0 12220 0 26964 0 969220 0 0 Liebowitz Jacalyn Dir/Vice Chair 0 551237 0 169658 0 80798 0 12220 0 44897 0 858810 0 0 El-Asmar Hoda - Former Dir/Vice Chair/Pres thru 10/20 0 0 0 0 0 661321 0 12220 0 52413 0 725954 0 0 Mock Jeffrey Director 0 286124 0 75485 0 60878 0 12220 0 85613 0 520320 0 0 Ward Melissa Dir/President 0 310695 0 71722 0 49791 0 12220 0 39081 0 483509 0 0 Ashlock Mark Former Dir/Vice Chair thru 06/20 0 69 0 0 0 385736 0 11574 0 21231 0 418610 0 0 Dingilian John Director 0 120369 0 60916 0 17012 0 5949 0 60734 0 264980 0 0 Ainsworth Laura Administrative Director, Operations 182901 0 26176 0 749 0 6295 0 48850 0 264971 0 0 0 Kasson Paul Administrative Director, Operations 184202 0 26326 0 1644 0 6365 0 41249 0 259786 0 0 0 Summers Jacob Administrative Director, Operations 186622 0 29147 0 478 0 6487 0 33082 0 255816 0 0 0 Johnson Joycelyn Administrative Director, Operations 150696 0 21973 0 2151 0 5245 0 54409 0 234474 0 0 0 Alario Suzanne Administrative Director, Operations 156540 0 9763 0 0 0 4989 0 48105 0 219397 0 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. Ashlock, Mark - severance payment - $386,312 El-Asmar, Hoda - severance payment - $659,431 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life participants are Mark Ashlock, John Beaman, Todd Hofheins, Andrew Jahn, and Brett Spenst. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an of their corporate provided benefits. The balance is set aside for forfeiture and is at risk to the creditors of Adventist Health. Payouts substantial risks of forfeiture have lapsed. The plan was frozen for new amount equivalent to 41 percent of their base compensation, less the value nonvested deferred compensation that is subject to substantial risk of occur according to the participants' payment elections after all non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2022 Form 990, Part III, Line 4a: Adventist Health Home Care offers advanced, high quality health care in an at-home setting by operating 13 home health agencies and eight hospices. In 2022, care, compassion and high-quality services were provided with 199,653 home health visits and 74,239 hospice patient days. Many of the agencies provide specialized programs and treatment plans, such as, wound care, CHF and diabetes management. Our home health mission is to help patients recover, regain independence and become as self-sufficient as possible in the comfort of their home. Our hospice mission is to provide whole-person care that envelopes the body, comforts the mind and nurtures the spirit. We are most proud of the following accomplishments in 2022: - Partnered with IntellaTriage to improve the patient and clinician experience after-hours - Launched the Elsevier platform to provide industry leading, evidence-based education for both the clinician and patient - Developed a standardized orientation program for all new hires - Implemented Forcura Circle for increased orders management efficiencies - Provided telehealth/remote patient monitoring for diabetes patients - Granted CHAP accreditation for 8 locations - Expanded EVV to all California locations - Received regulatory change of ownership approvals for Sonora Hospice, Sonora Home Health, Simi Valley Home Health and Mendocino Coast Home Health Form 990, Part VI, Section A, line 4 Open for redlined copy of the amendments made to the WHR Bylaws. Form 990, Part VI, Section A, line 7a The Organization's Board of Directors consists of the following ex-officio positions: the Chief Executive Officer from Adventist Health System/West, a related tax-exempt organization and the President and Treasurer from Western Health Resources. The Board of Directors of Adventist Health System/West designates the directors of Western Health Resources. Form 990, Part VI, Section A, line 7b Amendments to the Articles of Incorporation or Bylaws may only be made if adopted by Adventist Health System/West. 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, hospital officers, key employees and department directors are asked to complete an online annual conflict of interest questionnaire. The questionnaire includes an explanation of what constitutes potential conflicts and reminds the recipient that if a perceived conflict should arise before the next annual questionnaire, that person is to notify the Office of General Counsel immediately. Disclosures are reviewed by General Counsel, and potential conflicts are taken to the Board of Directors for review. If present during a Board review, the individual with the potential conflict must recuse themselves during any vote on the transaction. All proceedings are documented in the meeting minutes of the Board of Directors. Form 990, Part VI, Section B, line 15 The Organization's Board of Directors has established a Human Resources 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 Presidents and Finance Officers, 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 executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section C, line 19 The Organization does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Organization does not make its Conflict of Interest Policy publicly available. 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. Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Delano 1401 Garces Highway Delano CA 93215 770258013 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Foundation fka Feather River Health Foundation 1 Adventist Health Way Roseville CA 95661 680002188 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Mendocino Coast 700 River Drive Fort Bragg CA 95437 845174585 Hospital CA 501(c)(3) Line 3 Stone Point Health 0 Adventist Health Physicians Network 1 Adventist Health Way Roseville CA 95661 680357690 Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Adventist Health SystemWest 1 Adventist Health Way Roseville CA 95661 953484589 Integrated health system CA 501(c)(3) Line 10 N/A 0 Adventist Health Tulare 869 North Cherry Street Tulare CA 93274 832351753 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest 0 Central Valley Health Foundation 1021 N Douty Street Hanford CA 93232 770578450 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Feather River Hospital 1 Adventist Health Way Roseville CA 95661 941101228 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Glendale Adventist Medical Center Foundation 1509 Wilson Terrace Glendale CA 91206 953899682 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi CA 95240 941044474 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 North America Community Benefit Corporation 1 Adventist Health Way Roseville CA 95661 113698591 Supporting charitable activities of WHR CA 501(c)(3) Line 12c, III-FI N/A 0 Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Paradise Valley Hospital 1 Adventist Health Way Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) Line 1 Adventist Health SystemWest 0 Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Reedley Community Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Rideout Memorial Hospital 726 Fourth Street Marysville CA 95901 941387866 Acute care hospital CA 501(c)(3) Line 3 Stone Point Health 0 San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Simi Valley Hospital and Health Care Services 2975 N Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Simi Valley Hospital Foundation 2975 N Sycamore Drive Simi Valley CA 93065 912135595 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Stone Point Health 1 Adventist Health Way Roseville CA 95661 823763347 Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 United Com-Serve 726 Fourth Street Marysville CA 95901 943015356 Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Stone Point Health 0 Walla Walla General Hospital 1 Adventist Health Way Roseville CA 95661 910617726 Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest 0 White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 White Memorial Medical Center Charitable Foundation 1720 Cesar E Chavez Avenue Los Angeles CA 90033 953760201 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Blue Legacy Ventures LLC 1010 NE 2nd Avenue Miami FL 33132 871254649 Real property rental FL N/A 0 0 Blue Zones LLC 200 Southdale Center Edina MN 55435 271603327 Education MN N/A 0 0 PAR LLC dba CherryWood Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 931262371 Senior housing OR N/A 0 0 PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 260622555 Senior housing OR N/A 0 0 PVHR2 LLC dba Parkview Memory Care at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 473300170 Senior housing OR N/A 0 0 WWGHR LLC dba Wheatland Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 810591221 Senior housing OR N/A 0 0 AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure captive insurance BD N/A C 0 Adventist Health Plan Inc 1 Adventist Health Way Roseville CA 95661 463833261 Health insurance CA N/A C 0 South Coast Medical Center 1 Adventist Health Way Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C 0 Thrive Productions Inc 200 Southdale Center Edina MN 55435 453369049 Production company MN N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1