2021-11-10T18:07:21-06:00 2020-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2020-01-01 953867863 Western Health Resources WEST 9164060000 1 Adventist Health Way Roseville CA 956613266 Todd Hofheins Chief Financial Officer 9164060000 2021-10-24 1 Todd Hofheins 999009999 Tracy S Paglia P00366884 2099556100 2021-10-24 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z X Adventist HealthHome Care Melissa Ward 1 Adventist Health Way Roseville CA 956613266 65849923 0 1071 X www.adventisthealth.org/ X 1983 CA Living God's love by inspiring health, wholeness and hope. 5 0 696 35 0 0 127865 10339 56791474 65839584 90086 0 6767 0 57016192 65849923 500 0 0 0 48196166 51091115 0 0 0 16583620 18056608 64780286 69147723 -7764094 -3297800 23049980 29445542 23385588 33078950 -335608 -3633408 X Living God's love by inspiring health, wholeness and hope. 0 0 41032415 0 65839584 See Schedule O 41032415 1 1 0 0 0 0 0 0 0 1 1 0 0 0 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 1 0 0 0 1 0 0 696 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Todd Hofheins CFO 9164060000 PO Box 619135 Roseville CA 95661 Reiner Scott Dir/Chair thru 07/20 0.50 50.00 X X 0 2358378 54819 Wing Bill Dir/CFO thru 09/20 0.50 50.00 X X 0 1760327 59054 Jahn Andrew Dir/Chair as of 09/20 0.50 50.00 X X 0 1365841 59307 El-Asmar Hoda - DirVice Chair/Pres as of 01/20 thru 10/20 0.50 50.00 X X 0 1247499 39498 Beaman John Director 0.50 50.00 X 0 963104 45033 Ashlock Mark Dir/Vice Chair thru 06/20 0.00 50.00 X X 0 963056 44174 Reppert Joseph Former CFO/Asst Secr thru 08/19 0.00 0.00 X 0 813425 41111 Jobe Meredith Dir/Secretary 0.50 50.00 X X 0 769985 43868 Liebowitz Jacalyn Dir/Vice Chair as of 09/20 0.50 50.00 X X 0 679163 44488 Hofheins Todd CFO as of 08/20 0.50 50.00 X 0 469107 13281 Mendoza Sherry CEO thru 01/20 50.00 0.00 X 0 313790 45602 Mock Jeffrey Director as of 01/20 0.50 50.00 X 0 234130 68993 De Pietro Wendy RN 50.00 0.00 X 250790 0 37534 Wagner Jack Dir/Former CFO thru 03/18 0.00 0.00 X 0 269387 13558 Tondreau Mary Director of Home Health thru 10/20 50.00 0.00 X 186228 0 48860 Ainsworth Laura Administrative Director, Operations 50.00 0.00 X 176884 0 46256 Rengiil Evadne Administrative Director, Operations 50.00 0.00 X 191896 0 22122 Kasson Paul Administrative Director, Operations 50.00 0.00 X 183280 0 12763 Ward Melissa Director, President as of 07/20 0.50 50.00 X X 0 130924 11357 989078 12338116 751678 133 1 1 0 AHSA LLC PO Box 670529 Dallas TX 75267 Workforce consulting services 1889627 Nurse Communication After Hours Inc PO Box 16727 Irvine CA 92623 Telephone answering service 775803 Stateserv Network Services 1201 S Alma School Road Mesa AZ 85210 Medical equipment service 392440 Edmund H Lew MD Inc 1505 Wilson Terrace Suite 250 Glendale CA 91206 Medical services 253656 Simione Healthcare Consultants LLC 4130 Whitney Avenue Hamden CT 06518 Consulting services 171708 5 10339 10339 Patient service revenue 621110 63964076 63964076 CARES Act funding 900099 1872544 1872544 Incentive & quality revenue 621990 692 692 2272 2272 65839584 65849923 65839584 0 0 40294363 27740749 12553614 1444084 998010 446074 6292509 4015168 2277341 3060159 2143528 916631 2416629 4400 2412229 14510 14510 6601110 2772511 3828599 3462 3462 1403073 27205 1375868 60514 108 60406 937897 937897 1498297 1237289 261008 20219 2319 17900 895697 895697 542016 497648 44368 110214 38822 71392 Patient care supplies 1917726 1539944 377782 Rental/lease costs equi 559144 14462 544682 Income taxes 1600 1600 1074500 252 1074248 69147723 41032415 28115308 0 19616466 25840876 409758 221732 4778353 2713032 1450668 2065321 850000 850000 723088 467613 23049980 29445542 5836339 5992952 17549249 27085998 23385588 33078950 X -535219 -3821236 199611 187828 -335608 -3633408 23049980 29445542 -3297800 0 X 0 1 X 1 0 X 110499 65624 315174 127865 10339 629501 61742927 57002656 59461015 56791474 65839584 300837656 61853426 57068280 59776189 56919339 65849923 301467157 0 0 0 301467157 25264 16183 112817 90086 244350 25264 16183 112817 90086 244350 61878690 57084463 59889006 57009425 65849923 301711507 0.99920 0.99900 0.00080 0.00100 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 199611 3830 15613 187828 137020 64903 2312 199611 137850 30000 30830 137020 146695 878 9723 137850 161755 15060 146695 0.00000 0.00000 1.00000 0 0 1640458 1108361 532097 245099 230833 14266 2815129 1296171 1518958 77667 77667 0 2065321 Payables to related organizations 26185357 Other liabilities 900641 27085998 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 is 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, 2020 and 2019, 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 2016 in major tax jurisdictions. X X X X 1 1 0 0 0 0 0 0 0 Reiner Scott Dir/Chair thru 07/20 0 1631895 0 352059 0 374424 0 17042 0 37777 0 2413197 0 349200 Wing Bill Dir/CFO thru 09/20 0 1458328 0 279883 0 22116 0 17042 0 42012 0 1819381 0 0 Jahn Andrew Dir/Chair as of 09/20 0 992796 0 210574 0 162471 0 17042 0 42265 0 1425148 0 0 El-Asmar Hoda - DirVice Chair/Pres as of 01/20 thru 10/20 0 719268 0 163690 0 364541 0 17042 0 22456 0 1286997 0 0 Beaman John Director 0 815598 0 130585 0 16921 0 0 0 45033 0 1008137 0 0 Ashlock Mark Dir/Vice Chair thru 06/20 0 720972 0 153655 0 88429 0 14637 0 29537 0 1007230 0 0 Reppert Joseph Former CFO/Asst Secr thru 08/19 0 2779 0 0 0 810646 0 0 0 41111 0 854536 0 0 Jobe Meredith Dir/Secretary 0 575127 0 81637 0 113221 0 13010 0 30858 0 813853 0 0 Liebowitz Jacalyn Dir/Vice Chair as of 09/20 0 467077 0 55070 0 157016 0 5700 0 38788 0 723651 0 0 Hofheins Todd CFO as of 08/20 0 297756 0 66 0 171285 0 0 0 13281 0 482388 0 0 Mendoza Sherry CEO thru 01/20 0 29065 0 0 0 284725 0 11923 0 33679 0 359392 0 0 Mock Jeffrey Director as of 01/20 0 208000 0 21782 0 4348 0 10317 0 58676 0 303123 0 0 De Pietro Wendy RN 103598 0 32 0 147160 0 7644 0 29890 0 288324 0 0 0 Wagner Jack Dir/Former CFO thru 03/18 0 0 0 0 0 269387 0 0 0 13558 0 282945 0 0 Tondreau Mary Director of Home Health thru 10/20 143904 0 15785 0 26539 0 9642 0 39218 0 235088 0 0 0 Ainsworth Laura Administrative Director, Operations 161251 0 14563 0 1070 0 6852 0 39404 0 223140 0 0 0 Rengiil Evadne Administrative Director, Operations 172015 0 18410 0 1471 0 0 0 22122 0 214018 0 0 0 Kasson Paul Administrative Director, Operations 176234 0 6017 0 1029 0 3510 0 9253 0 196043 0 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health Services/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Ashlock, Mark - severance payment - $57,658 De Pietro, Wendy - severance payment - $129,735 El-Asmar, Hoda - severance payment - $197,829 Mendoza, Sherry - severance payment - $284,725 Reppert, Joseph - severance payment - $809,806 Wagner, Jack - severance payment - $269,387 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, Scott Reiner, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Reiner, Scott - $349,200 Form 990, Part III, Line 4a: Adventist Health/Home Care offers advanced, high quality health care in an at-home setting by operating 14 home health agencies and nine hospices. In 2020, care, compassion and high quality services were provided with 204,587 home health visits and 78,641 hospice 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. Accomplishments for 2020: - Implemented Cardinal Health at-Home to provide patient direct supplies - Implemented Forcura to create efficiencies for physician orders and intake - Received regulatory change of ownership approval for Lodi Home Health to move under Western Health Resources - Expanded the Yuba City, CA service area to include the Feather River population - Migrated all contracts to Conga to create system standardization - Prepared for mandatory Electronic Visit Verification in Hawaii for an anticipated go-live of 08/01/2021 - Started HCHB optimization Form 990, Part VI, Section A, line 6 Individuals representing the Seventh-day Adventist Church and its health care operations serve as members of Western Health Resources. Annually, the members meet for the purpose of conducting the business of the membership. Actions are taken as required to enable Western Health Resources to continue operating in concert with its Articles of Incorporation and Bylaws. Form 990, Part VI, Section A, line 7a Annually, the members meet for the purpose of conducting the business of the membership. Actions are taken as required to enable Western Health Resources to continue operating in concert with its Articles of Incorporation and Bylaws. Board appointments are approved by the membership. Form 990, Part VI, Section A, line 7b The membership must approve all amendments to the Organization's 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 Organization'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 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 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. 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 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 PO Box 619135 Roseville CA 95661 680357690 Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Adventist Health SystemWest PO Box 619135 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 Health Foundation PO Box 619135 Roseville CA 95661 680002188 Fundraising for hospital CA 501(c)(3) Line 12a, I N/A 0 Feather River Hospital PO Box 619135 Roseville CA 95661 941101228 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Fremont-Rideout Health Group 989 Plumas Street Yuba City CA 95991 942917251 Acute care hospital CA 501(c)(3) Line 12b, II Stone Point Health 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 PO Box 619135 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 PO Box 619135 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 989 Plumas Street Yuba City CA 95991 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 PO Box 619135 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 989 Plumas Street Yuba City CA 95991 943015356 Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Stone Point Health 0 Walla Walla General Hospital PO Box 619135 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 Zones LLC 323 N Washington Avenue 2nd Floor Minneapolis MN 55401 271603327 Education MN N/A 0 0 PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 260622555 Real property rental OR N/A 0 0 PVHR2 LLC dba Parkview at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 473300170 Real property rental OR N/A 0 0 WWGHR LLC 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 810591221 Rental OR N/A 0 0 Western Physician Services Inc PO Box 619135 Roseville CA 95661 942536300 Inactive CA Western Health Resources C 1.00000 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 PO Box 619135 Roseville CA 95661 952037297 Wind down after sale of hospital CA N/A C 0 Thrive Productions Inc 323 N Washington Avenue Minneapolis CA 55401 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