2023-11-08T15:41:27-08:00 2022-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2022-01-01 956064971 Simi Valley Hosp and Hlth Care Services dba Adventist Health Simi Valley SIMI 8059556000 2975 N Sycamore Dr Simi Valley CA 93065 Combis Theodore Treas Eff 9/22 2023-11-08 true Combis Theodore 999009999 true S Clement P01218012 8185475701 X 2 AAL1 IAL1 FAL1 2022 2023-04-26 12:10:37Z Jennifer Swenson 203551528 false 1071 X www.adventisthealth.org/simi-valley X 1960 CA Living Gods love by inspiring health, wholeness and hope. 13 12 1296 334517 146320 865126 3408919 195319972 199512063 2817211 -957171 285473 83813 199287782 202047624 60450 205406 0 79028793 91468392 0 167530 126854548 132682693 205943791 224356491 -6656009 -22308867 175592149 174224266 156192407 181938159 19399742 -7713893 Living Gods love by inspiring health, wholeness and hope. false false 170948870 205406 202047624 Simi Valley Hosp and Hlth Care Services, dba Adventist Health Simi Valley (AHSV), 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 Simi Valley Hosp and Hlth Care Services, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a 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 programsNot only does Simi Valley Hosp and Hlth Care Services 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.AHSV 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 2022 was $19,439,725.The following Inpatient services were provided to all our patients:461 babies delivered1,032 surgeries performed31,948 patient days The following Outpatient services were provided to all our patients:42,732 emergency department visits3,281 outpatient surgeries performed38,033 outpatient visits 59,621 clinic visitsAHSV 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 2022 was $12,351,585.Adventist Healths mission statement of living Gods 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 Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.The following story illustrates how Adventist Health Simi Valley works to provide quality care for our community:Recounting the details of a traumatic event is never easy. Many of us have experienced close calls and losses that have caused us to feel fear, shock and grief.I had been experiencing the warning signs of heart disease,but I thought it was a panic attack. A week later, a stabbing pain hit my chest. I needed to get to the emergency room. My wife drove me to the nearest hospital, Adventist HealthSimi Valley, where doctors confirmed I was having a heart attack.Looking back on that day, I am reminded that if my heart attack had happened a week or two sooner, I may not be here to tell my story. The cardiac catheterization lab had just opened weeks prior to my event, and I was its first major save. If the cath lab werent there, I would have been transferred to a neighboring hospital and might have died enroute. Adventist Health Simi Valley now has two Cath Labs. More operating rooms means more lives saved, and more health issues addressed to elevate our communitys quality of life.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 170948870 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 0 0 true 1296 true true true false false false false false false 0 false false false false false false false X 13 12 true false false false true true true true true false false true true true true true true true true true true CA X John Beaman 9164060000 PO Box 619135 Roseville CA 95661 Wing Bill - Departed 122 Dir/VC/Asst Sec 0.00 50.00 X X 0 2511347 53289 Heinrich Kerry Director/CEO 0.00 50.00 X X 0 2131444 48069 Hofheins Todd COO Eff 1/22 0.00 50.00 X 0 1971652 55964 Burke James Medical Officer, SCR 10.00 40.00 0 1620690 59640 JahnAndrew-Care Div Pres thru 222 President, Southern CA Network 10.00 40.00 0 1409539 60092 Beaman John CFO Secretary 0.00 50.00 X 0 1361096 61075 Nahapetian Arby-Care Div Med Off th Chief Clinical Officer 0.00 50.00 0 1334111 60780 Spenst Brett-Care Div Fin Off thru Sr. Finance Officer & CIO 0.00 50.00 0 1322824 40922 Stevens Eric-Care Div Ops Exec thru President, No Cal/HI State Network 0.00 50.00 0 1315314 46881 Reiner Scott Former Dir/Chair/CEO thru 12/21 0.00 50.00 0 1222073 25188 Jobe Meredith Secretary 0.00 50.00 X 0 930036 49067 Raffoul John Finance Officer, SCR 0.00 50.00 0 911284 48284 Swenson Jennifer President, AHSV 50.00 0.00 X 0 705956 61948 Milatovic Natasa Reg HR Dir, SCR 10.00 40.00 0 574613 53910 Owens Francis-Departed 822 Treas/Asst Sec 50.00 0.00 X 0 399366 63436 Ferrier Corbett Bus Dev Exec 50.00 0.00 0 341700 40627 Riddell Stella Patient Care Executive 50.00 0.00 0 312274 53509 Nguyen Truong RN 40.00 0.00 282248 0 56005 Retan Wendi RN Nurse Lead 40.00 0.00 272795 0 41109 Feliz Virginia RN 40.00 0.00 266471 0 36424 Deamer Carol Director, Pharmacy 40.00 0.00 239430 0 37369 Maurer Jeanine Dir Perioperative 40.00 0.00 245715 0 13412 Combis Theodore Eff 922 Treas/Asst Sec 50.00 0.00 X 0 219130 26457 Dingilian John Medical Officer 50.00 0.00 0 198297 19765 Gaffney Esparza Caroline COO/CNO 50.00 0.00 0 180421 17569 Freedman John Dir/Chair 0.00 4.00 X 0 26858 0 Woodson Marc Director 0.00 4.00 X 0 26728 0 Banks David Director 0.00 4.00 X 0 26478 0 Cherry Robert Director 0.00 4.00 X 0 26478 0 Davis Andrew Director 0.00 4.00 X 0 26478 0 Innocent Larry Director 0.00 4.00 X 0 26478 0 Reiner Richard Director 0.00 4.00 X 0 26478 0 Newton Bradford Dir/Vice Chair 0.00 4.00 X 0 25180 0 Salazar Velino Director 0.00 4.00 X 0 21478 0 Fehr Joy Director 0.00 4.00 X 0 430 0 Ocampo Lucy Director 0.00 4.00 X 0 430 0 1306659 21206661 1130791 221 true true false Menalam Health Services PC 2975 North Sycamore Drive Simi Valley CA 93065 Physician Services 1931644 Radnet Management Inc 1687 Erringer Rd 210 Simi Valley CA 93065 Medical 1751712 Sodexo Inc and Affiliates 9801 Washingtonian Blvd Gaithersburg MD 20878 Food and Facilities Mgmt 1173412 Aya Healthcare Inc 5930 Cornerstone Court West Ste 300 San Diego CA 92121 Staffing Registry 1052696 Fastaff LLC 5700 South Quebec Street Suite 300 Greenwood Village CO 80111 Staffing Registry 913006 30 2958718 450201 3408919 CARES Act Income 900099 566314 566314 Dietary 722514 233596 233596 Medical Office Rentals 531120 1453882 1453882 Other Program Services 398980 398980 Patient Care Services 900099 196742843 196408326 334517 116448 116448 199512063 106664 106664 0 0 0 434745 1498580 -1498580 434745 -1063835 -1063835 0 0 89137 5324 83813 83813 0 202047624 198197524 334517 106664 X 205406 205406 0 0 0 0 0 75496694 69257644 6120368 118682 2540027 2311055 223282 5690 8072413 7423650 640777 7986 5359258 5024627 323085 11546 22225963 22225963 569473 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false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to Noteware were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. Part IV - Additional Information 465156 596208 505390 555974 762186 129269 426299 465156 760455 302549 70000 230818 762186 815425 229369 35000 249339 760455 934825 216897 -6401 329896 815425 0.13200 0.86800 false true true 8393945 8393945 176718347 87412125 89306222 2052478 2051147 1331 57446275 40424574 17021701 7524540 4957810 2566730 117289929 Investment in ASV 2001845 Investment in Fdtn 837920 Other Receivables 3669236 Receivables from Related Organizations 3484183 Receivables from Third Parties 8798732 18791916 Cash Overdraft 39871088 Other Liabilities 7989122 Payable Third Party -13258 Payables to Related Organizations 118705604 166552556 X Part V, Line 4: Intended uses of the endowment fund. 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 : FIN48 Footnote 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 2018 in major tax jurisdictions. true true X true X true X true true true false true true 445694 445694 0.00200 47793129 28799098 18994031 0.08470 48238823 28799098 19439725 0.08670 1208945 1208945 0.00540 307242 307242 0.00140 14539793 4292244 10247549 0.04570 587850 1 587849 0.00260 16643830 4292245 12351585 0.05510 64882653 33091343 31791310 0.14180 20530 20530 0.00010 22750 22750 0.00010 43280 43280 0.00020 true 1382191 51586 47231801 58325438 -11093637 X true true Aspen Surgery Venture LLC Ambulatory surgery center 0.72500 0.27500 1 1 Simi Valley Hospital 2975 N Sycamore Dr Simi Valley CA 93065 050000216 X X X false false true X X X X X X X X X 22 true true true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 22 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X X X true true X X X X true X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The 2022 CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. collection of most recently available demographic, socioeconomic and health indicator data; 3. Data gathering from community members. The CHNA findings result from the extensive analysis of primary and secondary data sources. The main source for the secondary data, or data that have been previously collected, is the community indicator database maintained by Conduent Healthy Communities Institute. The following is list of both local and national sources used in Ventura Countys Community Health Needs Assessment: Ventura County, American Community Survey, American Lung Association, California Department of Education, California Department of Health Care Access and Information, California Department of Justice, California Department of Public Health , California Department of Public Health, Immunization Branch, California Department of Public Health, STD Control Branch, California Health Interview Survey, California Health Interview Survey, Neighborhood Edition , California Healthy Kids Survey, California Opioid Overdose Surveillance Dashboard, California Secretary of State, California State Highway Patrol, CDC PLACES, Centers for Disease Control and Prevention 118, Centers for Medicare & Medicaid Services, Child Welfare Dynamic Report System, Claritas Pop-Facts, Claritas Consumer Profiles, Controlled Substance Utilization Review and Evaluation System, County Health Rankings, Feeding America, Healthy Communities Institute, Lucile Packard Foundation for Children's Health, National Cancer Institute, National Center for Education Statistics, National Environmental Public Health Tracking Network, U.S. Bureau of Labor Statistics, U.S. Census - County Business Patterns, U.S. Department of Agriculture - Food Environment Atlas, U.S. Environmental Protection Agency and United For ALICE. Secondary data used for this assessment were collected and analyzed from HCIs community indicator database. This database, maintained by researchers and analysts at HCI, includes over 241 community indicators from at least 32 state and national data sources. HCI carefully evaluates sources based on the following three criteria: the source has a validated methodology for data collection and analysis; the source has scheduled, regular publication of findings; and the source has data values for small geographic areas or populations. Secondary Data Scoring HCIs Data Scoring Tool was used to systematically summarize multiple comparisons in order to rank indicators based on highest need. For each indicator, the community value was compared to a distribution of California and US counties, state and national values, Healthy People 2030, and significant trends were noted. These comparison scores range from 0-3, where 0 indicates the best outcome and 3 the worst. Availability of each type of comparison varies by indicator and is dependent upon the data source, comparability with data collected for other communities and changes in methodology over time. The comparison scores were summarized for each indicator, and indicators were then grouped into topic areas for a systematic ranking of community health needs. Primary data methods and analysis included surveys, focus groups and focus group profiles. The Community Health Assessment Survey (2022) was designed and disseminated by the Ventura County Community Health Needs Assessment Collaborative (VCCHIC). Furthermore, VCCHIC participated in a Centers for Disease Control and Prevention health equity pilot which required the inclusion of survey questions on racial trauma and discrimination. The community survey was distributed online through Qualtrics from February 9th through March 30th of 2022. The survey was made available in both English and Spanish. Paper surveys were also made available and answers to the paper survey were entered into Qualtrics. A total of 3,066 responses were collected. One of the key objectives of this assessment was to engage the community, including socially marginalized populations, and other stakeholders to share their perceptions on the health needs for Ventura County residents. Eighteen focus groups were conducted in February and March 2022. The groups were organized and facilitated by members of VCCHIC and partners from California State Channel Islands University and Pacifica High School. Participants were recruited using multiple modes: direct recruitment by partner community-based organizations, email invitations, flyers, newspaper and social media postings. The following groups, who are more likely to be socially marginalized, were recruited for participation in the focus groups: persons from the black community, monolingual Hispanic or Latino Spanish speakers, older adults, LGBTQIA+ persons, students, and those accessing mental health and substance use treatment services among others. In collaboration with California State Channel Islands University and Pacifica High School in Oxnard, CA, VCCHIC was also able to receive input from local high school and college students about the issues impacting them. Each focus group included both a facilitator and a note taker from to capture the conversation verbatim. The focus group transcripts and notes were analyzed qualitatively to code the transcripts according to a list of major health and quality of life topics. Facility: - Part V, Section B, Line 6a The Ventura County Community Health Improvement Collaborative (VCCHIC) is a formal, charter-bound partnership of seven health agencies that came together in June 2018 to participate in the development of a joint CHNA exercise and report. They have continued their successful partnership through the 2022 CHNA assessment period. The agencies that constitute the VCCHIC are Adventist Health Simi Valley, Camarillo Health Care District, Clinicas Del Camino Real, Inc., Community Memorial Health System and St. Johns regional Medical Center, Dignity Health. Facility: - Part V, Section B, Line 11 The COVID-19 global pandemic has caused extraordinary challenges for Adventist Health hospitals and health care systems across the world including keeping front line workers safe, shortages of protective equipment, limited ICU bed space and developing testing protocols. They have also focused on helping patients and families deal with the isolation needed to stop the spread of the virus, and more recently vaccine roll out efforts. Adventist Health, like other health care systems, had to pivot its focus to meet the most urgent healthcare needs of its community during the pandemic, as well as reassess the ability to continue with some community health strategies due public health guidelines for social distancing. Adjustments have been made to continue community health improvement efforts as possible, while ensuring the health and safety of those participating. Tax year 2022 was year three of the Implementation Strategy for the 2019 CHNA. All programs and activities provided to the community were in response to the priority health needs identified in the 2019 CHNA. Our 2019 CHNA in conjunction with the Ventura County Community Health Improvement Collaborative (VCCHIC) identified four areas of significant need: Aligning Cross-Sectoral Partnerships for Population Health Impact, Improve Access to Health Services, Address Social Needs through Food Access Interventions, and Improve the Health and Wellbeing of Older Adults. Priority Need 1- Aligning Cross-Sectoral Partnership for Population Health Impact. The goal is to develop a sustainable collaborative structure of hospital and community partnerships for long term implementation of chosen community health and population health strategies. Strategy 1 Build Governance Structure. In 2022 the Community Information exchange governance was established with the outlining and defining stakeholders, roles, responsibilities with a formalized project scope and structure and coordinated goals and efforts. Strategy 2 Cross-Sector Prevention Model. In 2022 Adventist Health Simi Valley participated in the Ventura County Collaborative to design, plan and complete the 2022 CHNA. Strategy 3 Develop Financing Plan. Funding was secured through Ventura County Public Health or a full-time associate to manage the Ventura County Community Health Improvement Collaborative. The creation of a Backbone organization selection framework, criteria and governance was implemented in 2022. Strategy 4- Build a health information exchange in Ventura County. Despite the significant impact of Covid-19, the Ventura County Community Health Improvement Collaborate was able to accomplish getting Manifest MedEx selected as our Health Information Exchange (HIE) provider. Gold Coast Health Plan, Ventura County Public Health and Adventist Health all signed the agreement and are working independently to get their interoperability functionality established. Other VCCHIC partners are in the process of evaluating Manifest MedEX. The HIE has to go through each organizations IT/Security clearance process and also go through various executive approvals. We anticipate the functionality of the HIE to improve how the health care providers, including clinics and physician offices, can better manage the care of their shared patients. Strategy 5- Develop Performance Management Evaluation. Activity 5.1- Create performance feedback loops. Anticipated to occur in 2023 after HIE launch. Priority Need 2- Improve Access to Health Services. The goal is to improve access to health services by addressing social needs of high risk/high need clients to reduce presentable emergency room and hospital utilization. Strategy 1- From 2019 to 2022, VCCHIC will build a Community Information Exchange (CIE) which can be adopted by participating hospitals and other community-based organizations to increase intra- and inter-agency referrals and tracking of high risk/high need clients. Activities 1.1- Identify non-traditional partners through asset mapping exercises, Activity 1.2 Identification of appropriate SDoH screening tool, Activity 1.3- SDoH Screen Tool Deployment, Activity 1.4- Workflow modifications as needed per provider practices and CBOs needs, Activity 1.5- Staff training on screening and service referrals, Activity 1.6- Facilitate Community Information Exchange (CIE). Though delayed by impact of the pandemic, the VCCHIC was able to convene multiple virtual meetings in Q3 and Q4 of 2020 to evaluate the functionality of UniteUs as a CIE platform. The collaborative made significant progress in 2022: 1. Established charter for membership of Ventura County Community Information Exchange board 2. Established bylaws 3. Secured over 4 million dollars in startup funding 4. Hired technology assessment consultant 5. Interviewed a variety of CIE leaders from counties and cities across the United States 6. Established technology committee 7. Established governance committee 8. Established CBO outreach planning team. The collaborative has escalated this project due to a funding opportunity and expect to make significant progress in 2022Additional activities include the following: Access to Care for Underserved Populations- Free Clinic of Simi Valley: lab and radiology services provided to all Free Clinic referrals. A total of 461 people served with a cash value t $153,665. Other support included financial contributions and PPE supplies. Westminster Free Clinic: More than 400 people served, support included financial contributions and PPE supplies. Community Health and Wellness Programs: A total of 12,150 people served valued at $805,588. Access to Care- Health Professions- Nursing student clinical rotations: A total of 159 students served. Other health profession rotations: A total of 75 students served. Health Professions Scholarships: A total of 20 students served valued at $25,000. Priority Need 3- Address Social Needs through a Food Access Intervention- the goal is to address food insecurity and reduce hospitalizations and health care costs in medically complex populations by increasing access to appropriate nutrition. Strategy 1- From 2019 to 2022, the VCCHIC will reduce food insecurity by 2% from baseline (pre-COVID-19 data) by screening for food insecurity at provider practices and hospitals and referring high need/high risk clients to food and nutrition access programs, resources and professionals. Activity 1.1- Select uniform screening tool for providers, practices and hospitals Huger Vital signs was selected s the screening tool. Activity 1.2- Business agreement template for screening partnerships, Activity 1.3- Client referral program, Activity 1.4- Clinical dietary counseling referrals for chronic disease and prevention, Activity 1.5- Clinical care plan template for tailored care plans, Activity 1.6- Connect screening and referrals to federal and state food assistance programs, CBO resources. Although most of the activities selected were placed on hold due to COVID-19, this portion of our CHIS is delayed due to Covid-19 but we made progress on the selection of the screening tool and will address our need to adjust our metrics to include the new landscape and data points after Covid-19. We anticipate building this into our CIE project as it is built and deployed.Additional activities include the following: Adventist Health Simi Valley provided population health interventions with a focus on youth. 1. Moorpark College program. Athletic Training and Medical Oversight Program, Sports medicine physician provides oversight, Athletic trainers funded by the hospital for 5 high schools, Creation of SDoH interventions and care navigation for student athletes. 2. Healthy Kids Fun Zones at 10 community events that served over 20,000 visitors. 3. Every 15 Minutes Committee Planning for 2022 Event. 4. Family Education Classes: Childbirth, breastfeeding, siblings. 5. Simi Valley Education Foundation Enhancement Grant funding. 6. Moorpark Education Foundation program grant funding. 7. Boys & Girls Club of Simi Valley and Moorpark funding of food access program. 8. Funding for concussion prevention and education. Population Health Interventions/upstream prevention with a focus on youth: Empathy training programs funded at SVUSD and MPUSD; Athletic Training and Medical Oversight Program- sports medicine physician provides oversight, athletic trainers funded by the hospital for 5 high schools, creation of SDoH interventions and care navigation for student athletes; Healthy Kids Fun Zones at 2 community events serving over 20,000 visitors; Every 15 Minutes Committee planning for 2022 event; Family education classes (childbirth, breastfeeding, siblings); Simi Valley Education Foundation Enhancement Grant funding, Moorpark Education Foundation program grant funding; Boys & Girls Club of Simi Valley and Moorpark funding of food access program; funding for concussion prevention and education. Population Health Interventions with a focus substance use and mental health: 1. Appli Facility: - 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. Aspen Outpatient Center 2750 N Sycamore Dr Simi Valley CA 93065 Outpatient Imaging & Surgery Child Development Center 1900 E Los Angeles Ave Simi Valley CA 93065 Outpatient Pediatric Therapy Nancy Reagan Breast Center 2750 N Sycamore Dr Simi Valley CA 93065 Outpatient Women's Imaging Part I, Line 7 - Explanation of Costing Methodology 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 charges Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense 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 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit 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. 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 - Bad Debt Expense The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too 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 - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low incomeX 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 - Needs Assessment The hospital's 2022 CHNA, the 2023 community health implementation strategy approved in FY 2023, and the 2022 Community Health Plan (CHP) Update for fiscal year 2022 are posted on the hospital's website at https://www.adventisthealth.org/simi-valley/about-us/community-benefit/The two most recent Community Health Needs Assessments, two most recent Implementation Strategy reports and the 2022, 2021 and 2020 Community Health Plan Updates are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/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 - Patient Education of Eligibility for Assistance 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:1.https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ 2.https://www.adventisthealth.org/documents/financial-assistance/13863-Self-Pay-Billing-and-Collection-Policy.pdfThese documents are available in multiple languages.At 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 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 - Community Information Located in Southern California, Ventura County has a land area of 1,843.1 square miles which encompasses 10 cities, 23 census-designated places, and 15 other unincorporated communities. In 2022, Ventura Countys population had a median age of 39.3 and a median household income of $101,407. Additionally, 50.5% of the population is female, 5.7% are below five years of age, 22.1% are below 18 years and 17.3% are 65 years and above and 38.6% of the people in Ventura County speak a non-English language at home. (Claritas Pop-Facts, 2022) The homeownership rate is 59.4%, households with an internet subscription is 89.8%, and among county residents, 5.8% have veteran status and 21.3% are foreign born (American Community Survey, 2016-2020). In 2021, the percent of households with a computer is 89.6% (Claritas Consumer Profiles, 2021).According to 2022 Claritas Pop-Facts, Ventura County has a population of 842,465 and is the 13th largest county in terms of population. Figure 5 illustrates the population size in Ventura County by zip code. The most populated zip codes are 93033 (Oxnard), 93065 (Simi Valley), 93030 (Oxnard), and 93063 (Simi Valley) with population totals of 82,273; 74,289; 60,815; and 55,685. In Ventura County, 44.66% of residents identify as Hispanic/Latino (of any race) and 55.34% identify as Non-Hispanic/Latino. Compared to California, Ventura County has a larger White population (65.13%) and smaller Black or African American and Asian populations (2.07% and 7.62%, respectively). Ventura has a median household income above the state value and the national values. Ventura County has an estimated median household income of approximately $101,407, which was $11,926 higher than the median household income of California ($89,481) and $36,413 higher than the national value of $64,994 (American Community Survey 2016- 2020). Ventura County has lower rates of poverty compared to the state and national poverty rates. Ventura County has a poverty rate of 8.9%, while state and national rates of poverty are 12.6% and 12.8%, respectively. According to the American Community Survey, for the 2016-2020 period, 12.2% of children in Ventura County were living below the federal poverty level. This is lower than the percentage of children living below the poverty level in California (16.8%) and the United States (17.5%). Examining this by race, American Indian/Alaska Native children and Hispanic/Latino children had the highest disparity, with 43.3% of American Indian/Alaska Native children living in poverty. The next highest populations are those identifying as Some Other Race (20%) and Hispanic or Latino (17.1%). Ventura County has a lower food insecurity rate in 2019 (7.8%) compared to the state (10.2) and the nation (10.9). Part VI, Line 4 - 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, and as we enter 2022 these projects are active. 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. These activities are not included elsewhere on Schedule H.Additional Community Benefit ActivitiesOther Activities: 1. Heart Health: American Heart & Stroke Association- Happiness In The Park /Heart Walk. Blood pressure awareness education. Heart disease prevention education. Hands-Only CPR training. 2. Cancer Support: CSC Support groups virtualized during pandemic. Genetic Testing Program. Lung Cancer Screening. Cancer care navigation program- Hired two navigators in late 2021 and currently rebuilding program for 2022. Festival of Trees grants for local cancer patients. Part VI, Line 5 - Promotion of Community Health Our hospitals mission is, Living Gods 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 todays 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 healthyeven 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; and 3) 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, and 3) 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 - Affilated Health Care System The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report CA Part VI - Additional Information Describe how the hospital has addressed the significant needs identified in the 2022 Community Health Needs Assessment (CHNA)continued -Priority Need 4- Improve the health and wellbeing of older adults. The goal is to implement a multi-hospital-based intervention with the assistance of CBOS that will establish a continuum of care and reduce readmissions for high-risk Medicare beneficiaries. Strategy 1- From 2019 to 2022, VCCHIC will implement a Community Based Care Transition Program per Section 3026 of the Affordable Care Act to support medically fragile 65+ year old adults and their caregivers after an acute care hospitalization to reduce hospital readmissions and improve the provision of value-based services. Activity 1.1- Caregiver Assessments and Care Planning, Activity 1.2- Community Partner Identification, Activity 1.3- Education for Caregivers, Activity 1.4- Integration into Health Systems. Adventist Health Simi Valley hired a care transition's nurse to build the care transitions team that includes the caregiver support navigator. AHSV has three staff who share the work of navigating caregivers and connecting them with appropriate resources. The program was severely impacted when Covid-19 caused the hospital to restrict all visitation and eliminate any non-clinically necessary in person visits with care management and care navigators. The dramatic impact of our response to the pandemic has delayed our program but we created a new workplan for 2022 with adjusted metrics based on the impact of the pandemic.Additional activities include the following: Accomplished in 2022: 1. VCCF Caregiver Support Program Grant awardees include Adventist Health Simi Valley, Dignity Health St. Johns and Community Memorial Hospital & Health System 2. Awarded grant from UniHealth Foundation to augment the program 3. California State University Channel Islands mid-term evaluation completed. 4. Simi Valley Hospital revived the caregiver support program. 5. Participated in collaborative committee meetings. 6. Funded Powerful Tools for Caregivers within collaborative. 7. Adventist Health provided a focus on seniors through the Senior Center collaborations with Senior Wellness Expo where 300+ seniors were screened for blood pressure and advanced directives. 8. Parks & Recreations collaboration with funding provided for Senior Games with 500 seniors served. Identified Needs from CHNA, Not Addressed and Why (Based on FY 2022) CHP Update - No hospital can address all the health needs identified in its community. Simi Valley Hospital (AHSV) 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. The following significant health needs that will not be addressed include the following: reduce the impact of behavioral health issues and reduce the burden of chronic disease. Our Adventist Health Simi Valley and the Ventura County Community Health Improvement Collaborative (VCCHIC) has identified other community stakeholders who actively lead programs to address these needs. Other Items Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education true Boys and Girls Club Moorpark 2850 Lemon Driv Simi Valley CA 93063 770112701 501(c)(3) 10000 0 Funds Transfer Event Sponsorship CA Health Fund & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 6787 0 Funds Transfer Hlth srvs uninsured/underinsured pt Kiwanis Club of Simi Valley PO Box 477 Simi Valley CA 93062 753114651 501(c)(4) 10000 0 Funds Transfer Sponorsorship Moorpark Chamber of Commerce 18 High Street Moorpark CA 93021 956102218 501(c)(6) 7500 0 Funds Transfer Event Sponsorship Moorpark College Foundation 7075 Campus Road Moorpark CA 93021 953533986 501(c)(3) 45000 0 Funds Transfer Nursing Scholarship National Health Foundation 515 S Figueroa Street 1300 Los Angeles CA 90071 237314808 501(c)(3) 7000 0 Funds Transfer General Support New Beginnings Christian Fell 2816 Sycamore Drive Simi Valley CA 93065 202688919 501(c)(3) 10000 0 Funds Transfer Event Sponsorship Rotary Club of Moorpark PO Box 172 Moorpark CA 93020 952114272 501(c)(4) 5500 0 Funds Transfer Sponsorship Simi Valley Chamber of Commer 40 W Cochran St Suite 100 Simi Valley CA 93065 952215253 501(c)(6) 6200 0 Funds Transfer Event Sponsorship Simi Valley Education Fdtn PO Box 1439 Simi Valley CA 93062 770299495 501(c)(3) 10000 0 Funds Transfer Enhancement Grant 6 4 Additional Supplemental Information Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X X X X true true false false false false false false false Beaman John CFO Secretary 1047636 298600 14860 12310 48765 1422171 Burke James Medical Officer, SCR 1169177 192892 258621 12310 47330 1680330 Combis Theodore Eff 922 Treas/Asst Sec 178143 14680 26307 8907 17550 245587 Deamer Carol Director, Pharmacy 210187 22515 6728 10509 26860 276799 Dingilian John Medical Officer 120369 60916 17012 5963 13802 218062 Feliz Virginia RN 207871 58600 10439 25985 302895 Ferrier Corbett Bus Dev Exec 270087 45147 26466 12310 28317 382327 Gaffney Esparza Caroline COO/CNO 106790 53284 20347 5215 12354 197990 Heinrich Kerry Director/CEO 1817710 76 313658 12310 35759 2179513 Hofheins Todd COO Eff 1/22 1358421 376216 237015 12310 43654 2027616 JahnAndrew-Care Div Pres thru 222 President, Southern CA Network 1047840 349414 12285 12310 47782 1469631 Jobe Meredith Secretary 639741 154687 135608 12310 36757 979103 Maurer Jeanine Dir Perioperative 65824 179891 3291 10121 259127 Milatovic Natasa Reg HR Dir, SCR 420759 101677 52177 12310 41600 628523 Nahapetian Arby-Care Div Med Off th Chief Clinical Officer 927049 234212 172850 12310 48470 1394891 Nguyen Truong RN 226048 56200 11458 44547 338253 Owens Francis-Departed 822 Treas/Asst Sec 321242 48157 29967 12310 51126 462802 Raffoul John Finance Officer, SCR 640537 138425 132322 12310 35974 959568 Reiner Scott Former Dir/Chair/CEO thru 12/21 348458 870709 2906 12310 12878 1247261 Retan Wendi RN Nurse Lead 210145 62650 10470 30639 313904 Riddell Stella Patient Care Executive 247271 27876 37127 12310 41199 365783 Spenst Brett-Care Div Fin Off thru Sr. Finance Officer & CIO 817612 416845 88367 12310 28612 1363746 Stevens Eric-Care Div Ops Exec thru President, No Cal/HI State Network 896507 250602 168205 12310 34571 1362195 Swenson Jennifer President, AHSV 521251 93801 90904 12310 49638 767904 Wing Bill - Departed 122 Dir/VC/Asst Sec 263334 662638 1585375 12310 40979 2564636 Form 990, Part VI, Section A, Line 2 See Sch L p2 Form 990, Part VI, Section A, Line 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. 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, 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 sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. 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 System Controller and market Finance 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 immediately.The System 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 General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Copies for the officers and key employees' COIs are kept in their personnel files. 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 15a The Organization's Board of Directors has established a Human Performance 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 B, Line 15b See Line 15a explanation. 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 XI, Line 9 Change in interest-Foundation = -$3076 Form 990, Part XI, Line 9 Change in interest-Joint Venture = -$54692 Prior Period Adjustments Prior Period adjustments were a result of cash balance correction and clean up of books due to prior period activities including debt service, capital expenditures, and other items. 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Surgery Center CA Simi Valley Hospital false true 0.69000 Blue Legacy Ventures LLC 1010 NE 2nd Avenue Miami FL 33132 871254649 Real Property Rental FL AHSWest false false Blue Zones LLC 200 Southdale Center Edina MN 55435 271603327 Education MN AHSWest false false PAR LLC dba CherryWood Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 931262371 Senior Housing OR AHSWest false false PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 260622555 Senior Housing OR AHSWest false false PVHR2 LLC dba Parkview Memory Care 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 473300170 Senior Housing OR AHSWest false false WWGHR LLC dba Wheatland Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 810591221 Senior Housing OR AHSWest false false South Coast Medical Center PO Box 619135 Roseville CA 95661 952037291 Wind down after sale of hospital CA AHSWest C-Corp false Adventist Health Plan Inc 1 Adventist Health Way Roseville CA 95661 463833261 Health Insurance CA AHSWest C-Corp false Thrive Productions Inc 200 Southdale Center Edina MN 55435 453369049 Production Company MN AHSWest C-Corp false AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure Captive Insurance BD AHSWest C-Corp false false false false false true false false false false false false true true true true true true true true Adventist Health SystemWest e 118705604 Notes Payable Adventist Health SystemWest m 27685048 Operating Exp Adventist Health SystemWest o 1641059 Compensation Adventist Health SystemWest r 33361739 Cash Mgt Funds