2019-11-12T10:56:21-08:00 2018-12-31 800519547 THE ACCOUNTANCY LLP 330 N BRAND BLVD STE 200 GLENDALE CA 912032361 990 2018-01-01 951816017 Glendale Adventist Medical Center GLEN 8184098000 1509 Wilson Terrace Glendale CA 91206 Krueger Eric Treasurer 2019-11-12 true S Clement P01218012 8185475701 X 2018 2020-04-17 16:48:07Z Issai Alice 1509 Wilson Terrace Glendale CA 91206 483634135 false false 1071 X www.AdventistHealth.org/Glendale X 1905 CA The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all. 12 10 3035 395 0 748456 2101645 32290165 447493539 448616260 1365957 1700590 2574513 1021384 453535654 483628399 27500 793638 0 200433280 195999427 0 0 259758621 259672198 460219401 456465263 -6683747 27163136 375928464 389252059 247077849 234630283 128850615 154621776 Living Gods love by inspiring health, wholeness and hope. false false 372348652 793638 449532209 Glendale Adventist Medical Center (AHGL) provides quality medical health care 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 Glendale Adventist Medical Center, 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 will be considered when individuals who need health care cannot pay:providing free care and/or subsidized careproviding care to persons covered by governmental programs at below costproviding health/wellness activities and community education programsNot only does Glendale Adventist Medical Center 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.AHGL 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 2018 was $23,046,576.The following Inpatient services that were provided to all our patients. These services included:1,769 Babies delivered3,321 Surgeries performed100,533 Patient days The following Outpatient services that were provided to all our patients. These services included:58,614 Emergency department visits2,983 Outpatient Surgeries performed142,652 Outpatient visits 112,349 Clinic visitsAHGL recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2018 was $22,800,676.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.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 372348652 true true false true false false false false false true true false false true true false false true false false false true false false false false true true true false true false false false false false false false false false false false false false false false false true false false false true 0 0 true 3035 true true true false false false false false false 0 false false false false false false false false false false false false X 12 10 false false false false true true true true true false false true true true true true true true true true true CA X Jay Lipps 9164061092 PO Box 619135 Roseville CA 95661 X Banks David Director 0.00 4.00 X 0 27620 0 Cherry Robert Director 0.00 4.00 X 0 25126 0 Davis Andrew Director 0.00 4.00 X 0 24002 0 Freedman John Director 0.00 4.00 X 0 718 0 Gabriel Melody Dir Thru 12/18 0.00 4.00 X 0 20464 0 Graham Ricardo Director 0.00 4.00 X 0 1442 0 Heinrich Kerry Director 0.00 4.00 X 0 20485 0 Innocent Larry Director 0.00 4.00 X 0 31885 0 Pedersen James Dir Thru 7/18 0.00 4.00 X 0 3625 0 Reiner Richard Director 0.00 4.00 X 0 27694 0 Rippey Wesley Dir Thru 5/18 0.00 50.00 X 0 623943 47568 Salazar Velino Director 0.00 4.00 X 0 1542 0 Reiner Scott Dir/Chair 0.00 50.00 X X 0 2458436 44472 Wing Bill Dir/V Chair 0.00 50.00 X X 0 1875310 49315 Jobe Meredith Secretary 0.00 50.00 X 0 666615 38328 Roberts Kevin President & CEO 50.00 0.00 X 0 528122 17907 Issai Alice President 50.00 0.00 X 0 378946 18607 Krueger Eric Treasurer 50.00 0.00 X 0 424292 47078 Wagner Jack A Sec Thru 3/18 0.00 50.00 X 0 1332907 34076 Wehtje Ronald SCR CFO 12.50 37.50 X 0 833628 37770 Zachary Beth SCR CEO 12.50 37.50 X 0 1310581 42365 Jahn Andrew SCR CEO 12.50 37.50 X 0 1116118 59339 Nahapetian Arby SCR Medical Officer 12.50 37.50 X 0 966535 51169 Burke James SCR Medical Officer 12.50 37.50 X 0 314198 22044 Melidonian Serineh Medical Officer 50.00 0.00 X 0 94350 0 Repert Joseph CFO 0.00 50.00 X 0 953615 46846 Nguyen Jinhee Patient Care Executive 50.00 0.00 X 0 284503 42660 Markarian Ramella Bus Dev/Phys Rel Officer 50.00 0.00 X 0 285527 44983 Bourdon Irene Presiden, Healthcare FND 50.00 0.00 X 0 337704 37865 Brandt-Mayo Karen Operations Officer 50.00 0.00 X 0 330848 34111 Cochran Elizabeth Operations Officer 50.00 0.00 X 0 53774 73 Milatovich Natasha Human Resource Officer SCR 8.33 41.67 X 0 398746 29727 Patana Suvanna RN 50.00 0.00 X 273808 0 17846 Brown Robert RN Lead 50.00 0.00 X 351963 0 28337 Eskandarian Romic Director Pharmacy 50.00 0.00 X 243069 0 36856 Philip Ajitha Supervisor, RN 50.00 0.00 X 213878 0 20112 Kanne Claudia Reg Dir Compliance 50.00 0.00 X 206637 0 35273 Tetz Warren Former Asst Sec/SR VP 0.00 50.00 X 0 929360 135928 Correa Sharon Former Information Officer 0.00 50.00 X 0 345922 37660 Kayichian Despina Former Med Affairs/Quality Office 0.00 50.00 X 0 445435 42291 1289355 17474018 1100606 489 true true false Family Practice of Glendale Glendale Med Gp 801 S Chevy Chase 201 Glendale CA 91205 Medical Services 3412288 Consultants for Anesthesia PO Box 8254 Pasadena CA 91109 Medical Services 1399194 Glendale Hospital Medical Group 898 N Pacific Coast Hwy Ste 600 El Segundo CA 90245 Medical Services 1749635 Faculty Physicians & Surgeon 11175 Campus St 11120 Loma Linda CA 92350 Medical Services 2038763 ShiftwiseOrigin PO Box 70870 St Paul MN 55170 Nurse Staffing 3080745 64 817404 29485123 1987638 32290165 Dependent Care 624410 728700 728700 Dietary 722210 2618111 2618111 Patient Svc Revenue 621110 442507907 442507907 Program Service Revenue 621110 105435 105435 Rental Income - Prog 531120 2656107 2656107 448616260 1697298 1697298 8428 8428 0 0 600 5736 -5136 -5136 -5136 0 0 0 Chg In Fdtn/JV Net Asset 900099 Mgmt Fees-Unrelated Orgs 541900 Other Non-Operating Inc 900099 1021384 1021384 1021384 483628399 449532209 1806025 793638 793638 0 0 0 0 0 156697471 143900488 12796983 5687945 5252806 435139 22135740 20690026 1445714 11478271 10658588 819683 22194143 774653 21419490 393993 393993 3620 3620 0 0 0 25750781 23403492 2347289 1018671 1018671 1098393 899079 199314 17589858 2997429 14592429 0 19652969 16223448 3429521 245835 146584 99251 0 253971 225056 28915 5162612 5162612 0 15551495 15033283 518212 98770 75266 23504 Patient care supplies 59869152 59615160 253992 QA Fee 44036585 44036585 Revenue Cycle Fees 19137821 19137821 Other purchased services 15547735 13857668 1690067 12065794 8602791 3463003 456465263 372348652 84116611 0 -177050 0 63631016 57091562 467428 193093 58058170 69271413 0 0 0 5598650 5428153 1181886 1199101 484653593 294544059 195684096 190109534 4100279 4418324 0 0 6196542 6033048 41187447 55507831 375928464 389252059 35817821 43205889 29386935 51748 181873093 191372646 247077849 234630283 X 120565466 147509065 8004290 6831856 280859 280855 128850615 154621776 375928464 389252059 X 27163136 -1391975 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 50652 50652 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. 8285149 6733712 -212386 4162991 10643484 7961660 1771084 5073 1452668 8285149 4562426 5247910 5257 1853933 7961660 4623999 1170607 6219 1238399 4562426 5496022 1682931 6334 2561288 53981 0.33000 0.03000 0.64000 false true true 3726115 3726115 375204871 220086427 155118444 13724773 3727927 9996846 81925503 68499659 13425844 10072331 2230046 7842285 190109534 Interest in Fdtn/JV's 4410935 Other Assets 2337671 Other Receivables 2050874 Receivables from Related Organizations 19584987 Receivables from Third-Party Payors 27123364 55507831 Payables to Related Organizations 181490354 Workers Compensation Liability 9882292 191372646 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. true Armenia Mission Trip 251488 Travel/Supplies Cost 1 false false false false false false true true X true X true X true true true false true true 2115600 2115600 0.00460 145432457 124501481 20930976 0.04590 147548057 124501481 23046576 0.05050 1323430 285320 1038110 0.00230 8919962 2233857 6686105 0.01460 19282096 4510434 14771662 0.03240 521578 460942 60636 0.00010 244163 244163 0.00050 30291229 7490553 22800676 0.04990 177839286 131992034 45847252 0.10040 19243 19243 12354 12354 267171 810 266361 0.00060 298768 810 297958 0.00060 true 142966329 142323382 642947 X true true 1 1 Adventist Health Glendale 1509 Wilson Terrace Glendale CA 91206 X X X X Acute Psychatric & Skilled Nursing Adventist Health Glendale 1 false false true X X X X X X X X X 16 true true false true X See Form 990, Pg 1, Item J X See Sch H Part VI - Needs Assessment X X true 18 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X true true X X X X true X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X See Sch H Part VI-Patient Education X X X X X true X false X X X X true X false false Facility: Adventist Health Glendale - Part V, Section B, Line 5 Focus GroupsMeetings with Community LeadersDiscussions with Area Hospitals Facility: Adventist Health Glendale - Part V, Section B, Line 6a Glendale Memorial Hospital & Health CenterVerdugo Hills Hospital Facility: Adventist Health Glendale - Part V, Section B, Line 7d The Community Benefit Plan for Adventist Health Glendale can be found at https://www.adventisthealth.org/pages/about-us/community-health-needs-assessments.aspx Facility: Adventist Health Glendale - Part V, Section B, Line 11 1. Schedule H, Part V, Section B, Line 11Please describe how the hospital is addressing the significant needs identified in the most recent Community Health Needs Assessment (CHNA).The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and analysis of data, including input from community stakeholders that is used to inform the development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. In 2017, Adventist Health Glendale (AHGL) Community Health Plan focused on these four priority areas: Cardiovascular Health-Integrate Patient Education into Cardiovascular Services, Improve Stroke Education and Support, Population Health for Chronic Diseases, and Wellness and Support for Patients Diagnosed with Cancer as the priority areas. To accomplish these goals, the following activities took place:Need: Cardiovascular Health-Integrate Patient Education into Cardiovascular ServicesObjective: Expand community education and early symptom identification.Outcomes: 1) AHGL conducts a wide variety of cardiovascular health education events for the community that includes cholesterol screenings, and Heart Healthy MD seminar talks; 2) Introduction of the Transcatheter Aortic Valve Replacement (TAVR) and education on the TVAR and Surgical Aortic Valve Replacement (SAVR) programs at the hospital, including highlighting that 90.5% of TAVR patients have improved Quality of Life Outcomes at 30 days post TAVR; 3) Serving uninsured and un-reimbursed patients in the STEMI Center; and 4) Incorporating and tracking responses to web-based health interventions and participation in the Transcatheter Valve Therapy comprehensive database program. Need: Improve Stroke Education and Support Objective: Expand community-based stroke prevention and education activities through additional community access points and network formulation.Outcomes: 1) AHGL conducts a wide variety of stroke health education events for the community that included stroke risk assessment and blood pressure screenings, a monthly stroke support group, Community Mobility Program and stroke awareness presentations; 2) Support of the Free Stroke Medication Management & Education Clinics by the AH Neuroscience Instute to encourage patients to review and discuss adjustments to medication dosage with a pharmacist; 3) Incorporating and tracking responses to web-based health interventions; and 4) Working with local partners to incorporate community health navigators to assist patients with aftercare and reduce utilization of specialists.Need: Population Health for Chronic DiseaseObjectives: 1) Reduce diabetes risk in community members who live, work and play in Glendale; 2) Implement a targeted diabesity risk reduction program, including programs specifically supporting children 0-5; 3) Develop & implement a diabetes management education and training program for mid-level clinicians at six FQHC Safety Net clinics and other primary care providers; 4) Implement the project's community engagement strategy with bilingual community partners conducting the diabetes self-management program; 5) Increase the knowledge of healthy eating active living as it relates to the 0-5 population and their families through community based participatory relationships that collaborate to improve the lives of young children.Outcomes: 1) AHGL has become the primary steward of the Champions for Change program in concert with the LA County Department of Public Health in the Glendale area. This is a statewide movement to inspire familites to make health lifestyle changes; 2) Conducted 232 Direct Education Classes, 20 Physical Activity Classes delivering yoga and Latinc dance classes to community members, 11 community events such as Glendale Cruise Night and multiple school events; 3) Established 4 edible gardens at three school sites with community partners, such as the Kiwanis Club, where students are allowed to take ownership and get involved in growing and maintaining fruit and vegetables by planting seeds and watering their gardens. The results are proving that by involving the children in these gardens, the parents are stating that their children are choosing to eat more fruits and vegetables and telling us that their children are loosing weight.Need: Wellness and Support for Patients Diagnosed with Cancer.Objective: By 2018, screen 80% of adults ages 50 and older for colorectal cancer by collaborating with the American Cancer Society and other area providers who have also committed to this objective.Outcomes: 1) Hosting colorectal screening programs for the community; 2) Hosting a physician-led educational session amongst primary care physicians of the services offered at AHGL; 3) Developing a smoothly functioning system of care to facilitate screening tests to include both patient and physician reminders around screening; 4) Monitoring the quality of screening and reports out of the National Cancer Data Base. Eagle Rock Therapy & Wellness Center 2560 Colorado Blvd Los Angeles CA 90041 Physical Therapy GAMC Alcohol & Drug Rehab 335 Mission Road Glendale CA 91206 Alcohol & Drug Rehabilitation Services Occmed 600 604 South Glendale Ave Glendale CA 91205 Occupational Medicine Heart & Vascular Clinic 1500 Chevy Chase Dr Glendale CA 91206 Heart & Vascular Medicine Spine & Ortho Clinic 1500 Chevy Chase Dr Glendale CA 91206 Spine & Orthopaedic Medicine 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 described for Part I, Line 7 is multiplied times the hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3 - 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. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide combined audited 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. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL: Revenue Rec. *Medicare Cost Report Revenue $142,966,329 Prior Year Settlements 9,045,922 Cost Report Reimbursable Bad Debts 3,173,657 Non-Cost Report Revenue Estimates and Accrual Variances 294,395 Other (9,365,871) ___________ Total Medicare Revenue $146,114,432*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. 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 income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part V - Explanation of Number of Facility Type The hospital provides outpatient services in multiple locations within its service area. Part VI, Line 2 - Needs Assessment For the 2016 CHNA, three Glendale hospitalsAHGL, Glendale Memorial Hospital and Health Center, and Verdugo Hills Hospitalcollaborated, as they have in the past, to work with the Center for Nonprofit Management consulting team in conducting the CHNA. During the initial phase of the CHNA process, community input was collected during a focus group with key stakeholders, including health care professionals, government officials, social service providers, community residents, leaders, and other relevant individuals. Previous CHNAs were reviewed to identify trends. Participants completed an online questionnaire about health needs, drivers, and resources, and ranked each health need according to several criteria including severity, change over time, resources available to address the need or driver. Part VI, Line 3 - Patient Education of Eligibility for Assistance For scheduled cases, hospital staff run patients eligibility and informs patients of their benefits and financial responsibility. If a patient is insured under a government program, staff informs them about any financial responsibility they have, and ask whether the patient has further questions about their government benefits. If a patient is uninsured, staff provides education about government programs that may be available, and including appointment-setting with the on-site state Medi-Cal worker. If a patient is uninsured and unable to meet any portion of their financial responsibility, staff connects them with government programs, and if appropriate, helps them apply for AHGLs hospital assistance program. AHGL communicates to the public through the website, application form and plain language, the FAP, application form and plain language summary (PLS) are available free of charge in registration areas. Notices about financial assistance are posted in high traffic registration areas. Part VI, Line 4 - Community Information AHGL serves greater Glendale and Northeast Los Angeles including Highland Park, Glassell Park, and Eagle Rock. The area includes an medically underserved area as well as a health profession shortage area. Based on the Community Health Needs Assessment prepared in 2016, the population served (about 325,000) is 35.5% Latino, 44.7% Caucasian (including the largest population of Armenians outside of Russia/Armenia), 15.5% Asian (Korean and Filipino), 1.6% African-American, and 2.7% Other. AHGL serves a large immigrant, low-income and uninsured population whose ability to access health services is impacted by barriers such as immigration status, educational attainment, employment status and level of poverty. Overall, 54% of residents are foreign born. Approximately 21% of the households were estimated to earn below the Federal Poverty Level (FPL) which was identified as $23,850 in 2014 for a family of four and $11,670 for a family of one and almost half of the households live below an amount equal to twice the FPL. Part VI Promotion of community health. GAMC has a civic advisory board that meets quarterly to establish or maintain a dialogue with the community. The hospitals mission expresses itself as caring for the whole community by initiating many community collaborative projects, including the development of the Glendale Healthier Community Coalition (GHCC) and Glendale Healthy Kids, obtaining the California Healthy City designation for Glendale. GHCC is the vehicle GAMC uses to coordinate its efforts with the community, including Care Transition, Consortium of Safety Net Providers, and We Own the Health of Our Community. Part VI, Line 4 - Community Building Activities Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. Part VI, Line 5 - Promotion of Community Health The hospital has an operating board composed of community members who advise the president/CEO regarding the needs of the community. Based on their advice, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include cardiac, neuro, spine, cancer, emergency, outpatient services, minimally invasive surgery (robotics and no scar surgery), ortho, behavioral medicine, and rehabilitative medicine, as well as a family medicine residency program. The hospital cooperates with area physicians to offer both family medicine and obstetrics clinics. AHGL has also established a Department of Clinical Research to help our communities gain access to cutting edge clinical advancements. 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 communites served. Part VI, Line 7 - States Filing of Community Benefit Report CA true Armenian American Medical Soc PO Box 32 Glendale CA 91209 954108352 501(c)(3) 7500 0 Sponsorship Armenian Bone Marrow Donor Re 347 W Stocker Ste 208 Glendale CA 91202 050573780 501(c)(3) 10000 0 Sponsorship Armenian Educational Fdtn 600 W Broadway Glendale CA 91209 952000503 501(c)(3) 10000 0 Sponsorship CA Hlth Fund & Trust 1215 K St Ste 800 Sacramento CA 95814 953928295 501(c)(3) 433781 0 Health Svcs Un/Underinsured Pt Glendale Chamber of Commerce 701 N Brand Blvd 120 Glendale CA 91205 950775310 501(c)(6) 17285 0 Sponsorship Glendale College Foundation 1500 N Verdugo Rd Glendale CA 91206 953876072 501(c)(3) 6650 0 Sponsorship Glendale Fire Department 421 Oak Street Glendale CA 91204 956000714 Government Org 60000 0 Sponsorship Glendale Kiwanis Fdtn PO Box 10545 Glendale CA 91209 956225168 501(c)(3) 15000 0 Sponsorship Western Diocese of Armenia 3325 N Glenoaks Blvd Burbank CA 91504 956081942 501(c)(3) 11250 0 Sponsorship YMCA of Glendale 140 N Louise St Glendale CA 91206 951661118 501(c)(3) 6500 0 Sponsorship YMCA of Los Angeles 325 S New Hampshire Ave Los Angeles CA 90005 951644052 501(c)(3) 6000 0 Sponsorship 10 1 Grantmaker's Description of How Grants are Used 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 true true X X X X true true false false false false false false false false Bourdon Irene Presiden, Healthcare FND 271188 34191 32325 16682 21183 375569 Brandt-Mayo Karen Operations Officer 210454 33281 87113 34111 364959 Brown Robert RN Lead 331838 20125 19132 9205 380300 Burke James SCR Medical Officer 273216 40982 18504 3540 336242 Correa Sharon Former Information Officer 213347 69487 63088 16682 20978 383582 Eskandarian Romic Director Pharmacy 28167 8499 206403 14317 22539 279925 Issai Alice President 275000 75000 28946 8223 10384 397553 Jahn Andrew SCR CEO 672558 157741 285819 16682 42657 1175457 Jobe Meredith Secretary 419684 111013 135918 16682 21646 704943 Kanne Claudia Reg Dir Compliance 180757 338 25542 11812 23461 241910 Kayichian Despina Former Med Affairs/Quality Office 328915 45355 71165 16682 25609 487726 Krueger Eric Treasurer 360475 6167 57650 16682 30396 471370 Markarian Ramella Bus Dev/Phys Rel Officer 230746 29097 25684 15320 29663 330510 Milatovich Natasha Human Resource Officer SCR 291273 300 107173 29727 428473 Nahapetian Arby SCR Medical Officer 557553 165709 243273 16682 34487 1017704 Nguyen Jinhee Patient Care Executive 248342 15422 20739 15668 26992 327163 Patana Suvanna RN 273708 100 16540 1306 291654 Philip Ajitha Supervisor, RN 204619 6000 3259 10628 9484 233990 Reiner Scott Dir/Chair 1339257 747881 371298 16682 27790 2502908 Repert Joseph CFO 686470 152446 114699 16682 30164 1000461 Rippey Wesley Dir Thru 5/18 565539 58404 20249 27319 671511 Roberts Kevin President & CEO 35709 492413 17907 546029 Tetz Warren Former Asst Sec/SR VP 555867 150147 223346 33364 102564 1065288 Wagner Jack A Sec Thru 3/18 180671 414342 737894 11182 22894 1366983 Wehtje Ronald SCR CFO 525772 154336 153520 16682 21088 871398 Wing Bill Dir/V Chair 1015353 603273 256685 16682 32633 1924626 Zachary Beth SCR CEO 191196 270398 848987 16682 25683 1352946 Part I, Line 1a: Relevant information in regards to selections on 1a. John Roberts Officer-Brother 149241 Employment false Linda Henry Key EE Sister 59434 Employment false Brent Wagner Son of Officer 82281 Employment false Cambria Wehtje-Sim Dghtr-Fmr Ofcr 89784 Employment false Doris Tetz Dghtr-Key EE 464679 Employment false Carol Jobe Officer's Spouse 4429 Employment false Anette Bedford Officer's sister 158943 Employment false Schedule L, Part V Supplemental Information Additional information regarding interested persons listed above:1. John Roberts is the brother of former AH Glendale President, Kevin Roberts.2. Linda Henry is the daughter of Adventist Health board member, Wesley Rippey.3. Brent Wagner is the son of former Adventist Health CFO, Jack Wagner.4. Cambria Wehtje-Sim is the daughter of former officer Rodney Wehtje.5. Doris Tetz is the daughter of former key employee, Warrent Tetz.6. Carol Jobe is the wife of Meredith Jobe, an officer of Adventist Health.7. Anette Bedford is the sister of AH Glendale President, Alice Issai. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit public charity. The hospital bylaws define its board of directors to be the same individuals who are members of Adventist Health System/West board of directors. Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body 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. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 11b: Form 990 Review Process 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, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaireis sent to board members, hospital officers, key employees and department directorsfor completion and signature. The questionnaire is accompanied by a letter ofexplanation, to illustrate examples of a conflict and to remind the recipient thatif any perceived conflict should arise before the next annual questionnaire, he/sheis to notify the CEO immediately.The Corporate General Counsel distributes, collects, and reviews for signatures theCOIs for all applicable Corporate employees and the board. In addition, thehospitals administration is responsible for keeping record to ensure allhospital-based individuals with director and above positions have submitted theirCOIs. The Corporate General Counsel reviews all the disclosures on the board andCorporate employees COIs. Corporate General Counsel retains the COIs for the boardmembers. 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, Line 15a: Compensation Review & Approval Process - CEO, Top Management See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to overseethe executive compensation program. This committee is composed of independentdirectors with no conflicts of interest. The committee performs the followingfunctions: recommends a total compensation philosophy to the board; assurescompliance with the board-approved philosophy; meets annually to reviewcomparability data from outside consultants; recommends any adjustments to currentexecutive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annualgoals; recommends appropriate incentive awards to the board for approval; follows adiligent process that meets regulatory requirements for a rebuttable presumption ofreasonableness; records committee deliberations and decisions in timely minutes;selects, engages and supervises any consultant hired to advise and providecomparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. A hospital CEO has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital. (Incentive potential is industry norm) Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available 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. Other Changes In Net Assets Or Fund Balances - Other Increases Change in Value = $68372 Other Changes In Net Assets Or Fund Balances - Other Decreases Prior Year Adjustments = -$1187462 Other Changes In Net Assets Or Fund Balances - Other Decreases Tr to JV = -$272885 Adventist Health SystemWest PO Box 619135 Roseville CA 95661 953484589 Integrated Health System CA 501(c)(3) 10 NA false Adventist Health Clearlake Hospital Inc Avenue 18 at Highway 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Hlth Medical Ctr Tehachapi 115 W E St Techapi CA 93561 812240617 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Physicians Ntwk PO Box 619135 Roseville CA 95661 680357690 Hospital CA 501(c)(3) 12b2 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) 3 Adventist Health SystemWest false Feather River Hospital PO Box 619135 Sacramento CA 95661 941101228 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Fremont- Rideout Health Group 898 Plumas Street Yuba City CA 95991 942917251 Acute Care Hospital CA 501(c)(3) 12b2 Adventist Health SystemWest false Glendale Adventist Medical Center Fdtn 1509 Wilson Terrace Glendale CA 91206 953899682 Fundraising for Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Lodi Memorial Hospital Assn Inc 975 So Fairmont Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Northwest Medical Fdtn of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Foundation OR 501(c)(3) 3 Adventist Health SystemWest false Paradise Valley Hospital PO Box 619135 Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) 1 Adventist Health SystemWest false Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) 3 Adventist Health SystemWest false Reedley Community Hospital 372 Cypress Ave Reedley CA 95370 453220509 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Rideout Memorial Hospital 989 Plumas Street Yuba City CA 95991 941387866 Acute Care Hospital CA 501(c)(3) 3 Adventist Health SystemWest false St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Simi Valley Hospital & Health Care Svc 2975 No Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Stone Point Health PO Box 619135 Roseville CA 95661 823763347 Supporting Organization CA 501(c)(3) 12b2 Adventist Health SystemWest false Ukiah Adventist HospitalAdventist Health 275 Hospital Drive Yuba City CA 95482 941639901 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false United Com-Serve 989 Plumas Street Yuba City CA 95991 943015356 Skilled Nursing/Assisted Living/Hm Care CA 501(c)(3) 12b2 Fremont Rideout Health Group false Walla Walla General Hospital PO Box 619135 Roseville CA 95661 910617726 Hospital WA 501(C)(3) 3 Adventist Health SystemWest false Western Health Resources PO Box 619135 Roseville CA 95661 953867863 Home Care CA 501(C)(3) 10 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(C)(3) 3 Adventist Health SystemWest false Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(C)(3) 3 Adventist Health SystemWest false Adventist Health So CA Medical Fdtn PO Box 619135 Roseville CA 95661 954424391 Discontinued Operations CA 501(c)(3) 12b2 Adventist Health SystemWest false Physician Medical Terrace LP 1509 Wilson Terrace Glendale CA 91206 954277400 Med Ofc Bld CA N/A false true 0.63686 Glendale Adventist Medical Building LP 1509 Wilson Terrace Glendale CA 91206 953752800 Med Ofc Bld CA N/A false true 0.54613 Physicians Surgery Center at GAMC 1500 E Chevy Chase Dr Ste 101 Glendale CA 91206 464085815 Ambulatory Surgical Center CA N/A false true 0.58549 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA C-Corp false false false false true true false false false false true true true true true true true true true true Glendale Adventist Medical Center Fdtn l 833351 Actual Cost Glendale Adventist Medical Center Fdtn o 1083707 Actual Cost Glendale Adventist Medical Center Fdtn s 2212900 Funds Transfer