ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI (EIN 81-2240617)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-11-12
IRS object ID: 201943169349303764
Schema version: 2018v3.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-11-12T10:59:49-08:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	800519547	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	THE ACCOUNTANCY LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	330 N BRAND BLVD STE 200	AddressLine1Txt
City	GLENDALE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	912032361	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	812240617	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Adventist Health Medical Ctr Tehachapi	BusinessNameLine1Txt
Business Name Line2	dba Adventist Health Tehachapi Valley	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	ADVE	BusinessNameControlTxt
Phone	6618233000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1100 Magellan Dr	AddressLine1Txt
City	Tehachapi	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93561	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Steve Chen	PersonNm
Person Title	CFO/Treasurer	PersonTitleTxt
Signature	2019-11-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	S Clement	PreparerPersonNm
PTIN	P01218012	PTIN
Phone	8185475701	PhoneNum
Self Employed	Yes (X)	SelfEmployedInd

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	Lingerfelt Jeffrey	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1100 Magellan Dr	AddressLine1Txt
City	Tehachapi	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	935611380	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$21,243,169	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
All Affiliates Included	false	AllAffiliatesIncludedInd
Group Exemption	1071	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.adventisthealth.org/tehachapi-valley	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2016	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	Living Gods love by inspiring health, wholeness and hope.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	261	TotalEmployeeCnt
Total Volunteers	25	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$125,000	PYContributionsGrantsAmt
CY Contributions Grants	$263,203	CYContributionsGrantsAmt
PY Program Service Revenue	$22,598,758	PYProgramServiceRevenueAmt
CY Program Service Revenue	$20,942,087	CYProgramServiceRevenueAmt
PY Investment Income	$59,300	PYInvestmentIncomeAmt
CY Investment Income	$37,879	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$22,783,058	PYTotalRevenueAmt
CY Total Revenue	$21,243,169	CYTotalRevenueAmt
PY Grants And Similar Paid	$25,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$16,192	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$12,793,073	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$14,244,371	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$162,570	CYTotalFundraisingExpenseAmt
PY Other Expenses	$10,875,229	PYOtherExpensesAmt
CY Other Expenses	$12,594,741	CYOtherExpensesAmt
PY Total Expenses	$23,693,302	PYTotalExpensesAmt
CY Total Expenses	$26,855,304	CYTotalExpensesAmt
PY Revenues Less Expenses	-$910,244	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$5,612,135	CYRevenuesLessExpensesAmt
Total Assets BOY	$45,546,060	TotalAssetsBOYAmt
Total Assets EOY	$56,614,928	TotalAssetsEOYAmt
Total Liabilities BOY	$46,710,492	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$63,391,495	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	-$1,164,432	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$6,776,567	NetAssetsOrFundBalancesEOYAmt
Mission	Living Gods love by inspiring health, wholeness and hope.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$19,849,099	ExpenseAmt
Grant	$16,192	GrantAmt
Revenue	$20,942,087	RevenueAmt
Desc	Adventist Health Medical Ctr Tehachapi (AHTV) 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 Adventist Health Medical Ctr Tehachapi, 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 Adventist Health Medical Ctr Tehachapi 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.AHTV 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 $6,574,098.The following Inpatient services that were provided to all our patients. These services included:35,211 Patient days The following Outpatient services that were provided to all our patients. These services included:12,470 Emergency department visits7,251 Outpatient visits 14,472 Clinic visitsAHTV 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 $2,641,947Adventist 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/	Desc
Total Program Service Expenses	$19,849,099	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	261	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Form990 T Filed	false	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
DAF Excess Business Holdings	false	DAFExcessBusinessHoldingsInd
Taxable Distributions	false	TaxableDistributionsInd
Distribution To Donor	false	DistributionToDonorInd
Org Filed In Lieu Of Form1041	false	OrgFiledInLieuOfForm1041Ind
Licensed More Than One State	false	LicensedMoreThanOneStateInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Jay Lipps	PersonNm
Phone	9164061092	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 619135	AddressLine1Txt
City	Roseville	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95661	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (39 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Banks David
Director	0.00	4.00	Yes (X)	$0	$27,620	$0
Cherry Robert
Director	0.00	4.00	Yes (X)	$0	$25,126	$0
Davis Andrew
Director	0.00	4.00	Yes (X)	$0	$24,002	$0
Freedman John
Director	0.00	4.00	Yes (X)	$0	$718	$0
Gabriel Melody
Dir Thru 12/18	0.00	4.00	Yes (X)	$0	$20,464	$0
Graham Ricardo
Director	0.00	4.00	Yes (X)	$0	$1,442	$0
Heinrich Kerry
Director	0.00	4.00	Yes (X)	$0	$20,485	$0
Innocent Larry
Director	0.00	4.00	Yes (X)	$0	$31,885	$0
Pedersen James
Dir Thru 7/18	0.00	4.00	Yes (X)	$0	$3,625	$0
Reiner Richard
Director	0.00	4.00	Yes (X)	$0	$27,964	$0
Rippey Wesley
Dir Thru 5/18	0.00	4.00	Yes (X)	$0	$623,943	$47,568
Salazar Velino
Director	0.00	4.00	Yes (X)	$0	$1,542	$0
Reiner Scott
Dir/Chair	0.00	50.00	Yes (X)	$0	$2,458,436	$44,472	Yes (X)
Wing Bill
Dir/Vice Chair	0.00	50.00	Yes (X)	$0	$1,875,310	$49,315	Yes (X)
Jobe Meredith
Secretary	0.00	50.00		$0	$666,615	$38,328	Yes (X)
Lingerfelt Jeffrey
President	50.00	0.00		$0	$320,194	$41,483	Yes (X)
Chen Steven
Treas/Asst Sec	12.50	37.50		$0	$432,417	$59,921	Yes (X)
Wagner Jack
A Sec Thru 3/18	0.00	50.00		$0	$1,332,907	$34,076	Yes (X)
Reppert Joseph
CFO	0.00	50.00		$0	$953,615	$46,846		Yes (X)
Ferch Wayne
President, CCR	8.33	41.67		$0	$1,232,626	$21,068		Yes (X)
Larsen David
Finance Officer, CCR	8.33	41.67		$0	$667,033	$351,055		Yes (X)
Adalberto Renteria
Medical Officer, CCR	8.33	41.67		$0	$445,200	$35,040		Yes (X)
Tetz Warren
Construction Executive	50.00	0.00		$0	$464,679	$67,964		Yes (X)
Cantrel Misty
CNO	50.00	0.00		$199,775	$0	$42,801		Yes (X)
Briggs Sharlet
President	12.50	37.50		$0	$595,552	$27,623		Yes (X)
Wehtje Ronald
SCR CFO	8.33	41.67		$0	$833,628	$37,770		Yes (X)
Roberts George
RN Supervisor	50.00	0.00		$184,941	$0	$26,633			Yes (X)
Bhakta Dixit
Manager, Pharmacy	50.00	0.00		$179,655	$0	$39,212			Yes (X)
Badders Brett
RN House Superviso	50.00	0.00		$174,958	$0	$38,374			Yes (X)
Haworth Scott
Pharmacist	50.00	0.00		$180,440	$0	$11,633			Yes (X)
Harwick Donald
Physician Assist	50.00	0.00		$142,326	$0	$6,022			Yes (X)
Zachary Beth
Former Int President	0.00	50.00		$0	$1,310,581	$42,365				Yes (X)
Wehtje Ronald
Former Finance Officer SCR	0.00	50.00		$0	$833,628	$37,770				Yes (X)
Nahapetian Arby
Former Reg CMO SCR	0.00	50.00		$0	$966,535	$51,169				Yes (X)
Fargo Roland
Former SVP Reg Phys Ops	0.00	50.00		$0	$597,899	$32,932				Yes (X)
Kirby Juliana
Former Key Employee	0.00	50.00		$0	$205,595	$7,476				Yes (X)
Roberts George
Former Highest Paid Employee	0.00	50.00		$0	$184,941	$26,633				Yes (X)
Lewis Paula
Former Highest Paid Employee	0.00	50.00		$0	$134,084	$19,864				Yes (X)
Duffield Douglas
Former Int President	0.00	50.00		$0	$171,938	$5,834				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,062,095	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$17,492,229	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,291,247	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	28	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Premier Emergency Physicians of CA MG
7032 Collection Center Dr	Chicago	IL	60693	Medical Svcs	$668,171
Harmadeep K Gill Med Corp
PO Box 1507	Lancaster	CA	93539	Medical Services	$161,946
Fusion Medical Staffing LLC
PO Box 82674	Lincoln	NE	68501	Medical Services	$139,688
Siemens Healthcare Diagnostics
PO Box 121102	Dallas	TX	75312	Medical Services	$104,236
Psychiatic Med Pract
2421 Tiverton Drive	Bakersfield	CA	93311	Medical - Pyshiatric	$109,920

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$10,000	RelatedOrganizationsAmt
All Other Contributions	$253,203	AllOtherContributionsAmt
Total Contributions	$263,203	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Dietary	722210	$3,188	$3,188
Other program related rev	900099	$44,943	$44,943
Patient serv. revenue	621110	$20,893,956	$20,893,956

Field	Value	IRS element (for citing)
Total Program Service Revenue	$20,942,087	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$37,879	TotalRevenueColumnAmt
Exclusion	$37,879	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$21,243,169	TotalRevenueColumnAmt
Related Or Exempt Func Income	$20,942,087	RelatedOrExemptFuncIncomeAmt
Exclusion	$37,879	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$16,192	TotalAmt
Program Services	$16,192	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$11,719,703	TotalAmt
Program Services	$9,367,370	ProgramServicesAmt
Management And General	$2,262,163	ManagementAndGeneralAmt
Fundraising	$90,170	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$463,741	TotalAmt
Program Services	$454,459	ProgramServicesAmt
Management And General	$5,569	ManagementAndGeneralAmt
Fundraising	$3,713	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,312,157	TotalAmt
Program Services	$1,240,171	ProgramServicesAmt
Management And General	$58,269	ManagementAndGeneralAmt
Fundraising	$13,717	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$748,770	TotalAmt
Program Services	$665,900	ProgramServicesAmt
Management And General	$76,043	ManagementAndGeneralAmt
Fundraising	$6,827	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$1,201,173	TotalAmt
Program Services	$116,094	ProgramServicesAmt
Management And General	$1,085,079	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$231,997	TotalAmt
Management And General	$231,997	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,978,003	TotalAmt
Program Services	$1,576,107	ProgramServicesAmt
Management And General	$401,896	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$40,548	TotalAmt
Management And General	$40,548	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$168,916	TotalAmt
Program Services	$75,627	ProgramServicesAmt
Management And General	$91,130	ManagementAndGeneralAmt
Fundraising	$2,159	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$1,353,470	TotalAmt
Program Services	$652,441	ProgramServicesAmt
Management And General	$701,029	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,239,068	TotalAmt
Program Services	$1,141,305	ProgramServicesAmt
Management And General	$97,763	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$122,871	TotalAmt
Program Services	$43,125	ProgramServicesAmt
Management And General	$73,107	ManagementAndGeneralAmt
Fundraising	$6,639	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$10,601	TotalAmt
Program Services	$5,956	ProgramServicesAmt
Management And General	$2,530	ManagementAndGeneralAmt
Fundraising	$2,115	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,283,868	TotalAmt
Program Services	$1,283,868	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$270,164	TotalAmt
Program Services	$270,164	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$75,908	TotalAmt
Program Services	$75,908	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Management And GeneralManagementAndGeneralAmt	Program ServicesProgramServicesAmt	FundraisingFundraisingAmt
Revenue Cycle Fees	$1,371,842	$1,371,842
Patient Supplies	$1,133,118	$31,906	$1,101,212
Other Purchases	$933,536	$196,830	$700,186	$36,520
Quality Assurance Hospital Fee	$550,395		$550,395

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$629,263	TotalAmt
Program Services	$512,619	ProgramServicesAmt
Management And General	$115,934	ManagementAndGeneralAmt
Fundraising	$710	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$26,855,304	TotalAmt
Program Services	$19,849,099	ProgramServicesAmt
Management And General	$6,843,635	ManagementAndGeneralAmt
Fundraising	$162,570	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,800	BOYAmt
EOY	$1,799	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,796,658	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$5,309,976	BOYAmt
EOY	$6,096,848	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$239,777	BOYAmt
EOY	$544,146	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$85,258	BOYAmt
EOY	$363,044	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$40,849,508	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$364,486	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$30,661,790	BOYAmt
EOY	$40,485,022	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$886,114	BOYAmt
EOY	$979,482	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$6,564,687	BOYAmt
EOY	$8,144,587	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$45,546,060	BOYAmt
EOY	$56,614,928	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,766,003	BOYAmt
EOY	$4,903,051	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$44,944,489	BOYAmt
EOY	$58,488,444	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$46,710,492	BOYAmt
EOY	$63,391,495	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$1,389,522	BOYAmt
EOY	-$7,254,860	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$225,090	BOYAmt
EOY	$478,293	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	-$1,164,432	BOYAmt
EOY	-$6,776,567	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$45,546,060	BOYAmt
EOY	$56,614,928	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$5,612,135	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Form4720 Filed Section4955 Tax	false	Form4720FiledSection4955TaxInd
Correction Made	false	CorrectionMadeInd
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$3,785	OtherActivitiesAmt
Total Lobbying Expenditures	$3,785	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1i - Other Activities Description	FormAndLineReferenceDesc
Explanation	The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$225,090	BeginningYearBalanceAmt
Contributions	$253,203	ContributionsAmt
End Year Balance	$478,293	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$100,125	BeginningYearBalanceAmt
Contributions	$124,965	ContributionsAmt
End Year Balance	$225,090	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Contributions	$100,125	ContributionsAmt
End Year Balance	$100,125	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Term Endowment Balance EOY	1.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$39,585,560	OtherCostOrOtherBasisAmt
Depreciation	$230,000	DepreciationAmt
Book Value	$39,355,560	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,263,948	OtherCostOrOtherBasisAmt
Depreciation	$134,486	DepreciationAmt
Book Value	$1,129,462	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$40,485,022	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Other assets	$41,661
Other receivables
Receivable from related orgs	$941,917
Receivable from third party payors	$7,161,009

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$8,144,587	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
Payable to Rel Orgs	$46,989,115
ST Financing	$11,290,353
Worker's Comp Liability	$208,976

Field	Value	IRS element (for citing)
Total Liability	$58,488,444	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part V, Line 4: Intended uses of the endowment fund.	FormAndLineReferenceDesc
Explanation	Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,599	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,599	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,832,489	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,274,990	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,557,499	NetCommunityBenefitExpnsAmt
Total Expense	0.24420	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,849,088	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,274,990	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,574,098	NetCommunityBenefitExpnsAmt
Total Expense	0.24480	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,831	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,831	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,048	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,048	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,085,835	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$491,827	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,594,008	NetCommunityBenefitExpnsAmt
Total Expense	0.09660	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$60	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$60	NetCommunityBenefitExpnsAmt

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,133,774	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$491,827	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,641,947	NetCommunityBenefitExpnsAmt
Total Expense	0.09840	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,982,862	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,766,817	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,216,045	NetCommunityBenefitExpnsAmt
Total Expense	0.34320	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,828	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,828	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,082,561	BadDebtExpenseAmt
Bad Debt Expense Attributable	$870,927	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$6,029,463	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,667,795	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$3,638,332	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Adv Hlth Med Ctr Tehachapi	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1100 Magellan Dr	AddressLine1Txt
City	Tehachapi	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	93561	ZIPCd

Field	Value	IRS element (for citing)
Website Address	See Form 990, Pg 1, Item J	WebsiteAddressTxt
State License	120000188	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Adv Hlth Med Ctr Tehachapi	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	false	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Sch H Part VI - Needs Assessment	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	See Sch H Part VI - Needs Assessment	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	18	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	See Sch H Part VI - Needs Assessment	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0000	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Sch H Part VI-Patient Education	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Sch H Part VI-Patient Education	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Sch H Part VI-Patient Education	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare	Yes (X)	LookBackMedicareInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	Facility: Adv Hlth Med Ctr Tehachapi - Part V, Section B, Line 11	FormAndLineReferenceDesc
Explanation	The Tehachapi Valley Healthcare District (TVHD) 2015 CHNA identified a number of areas of significant needs, among which access to care, chronic disease, and mental health ranked highest. The main goal was to improve the overall health and wellness of our communities through provision of services, community collaboration and innovation. Priority Need 1-Access to Health Care the main goals: to expand accessibility and increase awareness of resources. Interventions:1. Flu Clinics - In response to a severe flu season in 2017, Adventist Health Tehachapi Valley expanded the number and type of clinics offering free adult flu shots to the public. This included adding a flu shot drive-thru clinics in Tehachapi Valley. Number of Community Members Served 46.2. Tehachapi Health & Senior Resource Fair - The hospital offered low-cost lab tests and screening services at this event. This included low-cost blood tests for prostate cancer and low-cost mammograms. Staff also passed out basic health information. Number of Community Members Served 100.3. Tehachapi Farmers Market - The hospital provided a cash contribution to the farmers market to encourage access to nutritious, wholesome produce. Hospital staff, who also live in the community, were given coupons redeemable for free produce. Hospital representatives distributed health information to the public. Number of Community Members Served 200.4. American Cancer Society Relay for Life Tehachapi Valley - Adventist Health Tehachapi Valley financially supported the Event. The donation helped fund groundbreaking cancer research and patient care programs. Hospital representatives distributed health information to raise cancer awareness. Number of Community Members Served 300.5. Tehachapi Gran Fondo - Adventist Health Tehachapi Valley financially supported the event, which promotes a healthy lifestyle that includes exercise. The long-distance, mass-participation cycling event is open to recreational and competitive amateur cyclists, and thousands of riders of all abilities participate. Number of Community Members Served 1,000.Priority Areas Not Addressed:Two needs identified in the CHNA, but not addressed in this plan are chronic disease and mental health. Our network has not specifically addressed these prioritized health needs as part of this Community Health Plan due to limited resources and the need to allocate significant resources to the other priority health needs identified above. Even though we dont directly address these health issues in our current year CHP, our network attempts to link patients to resources that can assist in their needs.	ExplanationTxt

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Adventist Health Community Care-California City
9350 North Loop Blvd	California City	CA	93505	Rural Health Clinic
Adventist Health Community Care-Mojave
2041 Belshaw Street	Mojave	CA	93501	Rural Health Clinic
Adventist Health Community Care-Tehachapi
105 West E Street	Tehachapi	CA	93561	Rural Health Clinic
Adventist Health Outpatient Physical Therapy
115 W E St	Tehachapi	CA	93561	Outpatient Physical Therapy

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)/Gross patient chargesFeather River Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government.
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 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.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL:Medicare Cost Report Revenue 6,029,463Prior Year Settlements 434,347Cost Report Reimbursable Bad Debts 143,377Estimates and Accrual Variances 197,391Other 1,127,708 _________Total Medicare Revenue 7,932,287Note: The Medicare Cost Report Revenue includes the patient co-pay and deductible amounts, but not the bad-debt reimbursement. Adding the bad-debt reimbursement would have duplicated the revenue 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 VI, Line 2 - Needs Assessment	Tehachapi Valley Healthcare District, the prior operator of the hospital prepared a CHNA in 2015 although as a district hospital it was not required to do so. Adventist Health assumed operations of the hospital and three rural clinics in November 2016 as Adventist Health Medical Center Tehachapi. Under the IRC Section 501(r) regulations, a CHNA is not requried before 2018.The link below is for the 2017 Community Health Plan (CHP) Update/Annual Report, and the 2016 Implementation Strategy (adopted in May 2017), known as the 2017 Community Health Plan (Implementation Strategy) & 2016 Update/Annual Report: https://www.adventisthealth.org/tehachapi-valley/about-us/community-benefit/.The Implementation Strategy and the CHPs are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.The 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. The 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. Committee/Board Participation includes: American Cancer Society, Tehachapi Farmers Market, Tehachapi Health and Senior Resource Fair.
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 https://www.adventisthealth.org/tehachapi-valley/patient-resources/financial-services/financial-assistance/. These 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	Adventist Health Medical Center Tehachapis (AHMCT) service area is comprised primarily of communities in Kern county. The major communities are the cities of Tehachapi, California City, Mojave, Rosamond, Boron, and Edwards. The demographics of the communities we serve are wide scope, including urban, suburban, and rural, and from all income levels. Although we primarily serve those in the Kern county, our destination services also bring us patients from larger and further demographics, such as Bernadino, Ventura, and Los Angeles counties. The total population served in our primary and secondary service areas is estimated to be around 80,000. The majority of residents in AHMCTs service area are adults between the ages of 25 and 64; almost 20% are children under the age of 18. The three major ethnic groups in the primary and secondary service area are Caucasian (54.2%), Hispanic (31.7%) and Black (7.4%). The unemployment rate in Kern county in 2015 was between 10 and 11%, almost double that of the country as a whole for the same period. The median household income varies between $31,483 and $57,468 in our primary and secondary service areas.
Part VI, Line 4 - Community Building Activities	The 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. 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.
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	Adventist Health Medical Center Tehachapi is part of Adventist Health, a faith-based, not-for-profit, integrated health care delivery system headquartered in Roseville, California. We provide compassionate care in communities throughout California, Hawaii, Oregon and Washington.Adventist Health entities include:20 hospitals with more than 2,700 bedsMore than 235 clinics and outpatient centers14 home care agencies and 7 hospice agenciesFour joint-venture retirement centers Workforce of 28,600 includes more than 20,500 employees; 4,500 medical staff physicians; and 3,600 volunteersAdventist Health Medical Center Tehachapi believes that partnerships are effective tools in improving the health of our community. Together, we are able to leverage our resources and strengths and have a greater impact. We can build a greater sense of community and a shared commitment toward the health improvement.
Part VI, Line 7 - States Filing of Community Benefit Report	CA

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CA Hlth Fund & Trust	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1215 K St Ste 800	AddressLine1Txt
City	Sacramento	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95814	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	941498697	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$28,456	CashGrantAmt
Non Cash Assistance	$0	NonCashAssistanceAmt

Field	Value	IRS element (for citing)
Total501c3 Org	0	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Additional Supplemental Information	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd
Rebuttable Presumption Proc	false	RebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (27 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt
Adalberto Renteria
Medical Officer, CCR	$400,000	$45,200	$25,500	$9,540	$480,240
Badders Brett
RN House Superviso						$174,958	$10,003	$28,371	$213,332
Bhakta Dixit
Manager, Pharmacy						$178,897	$10,495	$28,717	$218,867	$758
Briggs Sharlet
President	$407,049	$116,869	$16,682	$10,941	$623,175						$71,634
Cantrel Misty
CNO						$95,333		$42,801	$242,576	$104,442
Chen Steven
Treas/Asst Sec	$334,561	$54,259	$16,682	$43,239	$492,338						$43,597
Duffield Douglas
Former Int President	$8,769			$5,834	$177,772						$163,169
Fargo Roland
Former SVP Reg Phys Ops	$175,272	$95,874	$10,964	$21,968	$630,831						$326,753
Ferch Wayne
President, CCR	$740,094	$327,200		$21,068	$1,253,694						$165,332
Haworth Scott
Pharmacist						$180,440	$9,514	$2,119	$192,073
Jobe Meredith
Secretary	$419,684	$111,013	$16,682	$21,646	$704,943						$135,918
Kirby Juliana
Former Key Employee	$154,676	$35,050	$3,131	$4,345	$213,071						$15,869
Larsen David
Finance Officer, CCR	$427,072	$107,292	$320,716	$30,339	$1,018,088						$132,669
Lewis Paula
Former Highest Paid Employee	$132,245		$6,737	$13,127	$153,948						$1,839
Lingerfelt Jeffrey
President	$260,132	$24,750	$16,382	$25,101	$361,677						$35,312
Nahapetian Arby
Former Reg CMO SCR	$557,553	$165,709	$16,682	$34,487	$1,017,704						$243,273
Reiner Scott
Dir/Chair	$1,339,257	$747,881	$16,682	$27,790	$2,502,908						$371,298
Reppert Joseph
CFO	$686,470	$152,446	$16,682	$30,164	$1,000,461						$114,699
Rippey Wesley
Dir Thru 5/18	$565,539		$20,249	$27,319	$671,511						$58,404
Roberts George
Former Highest Paid Employee	$183,071		$6,822	$19,811	$211,574						$1,870
Roberts George
RN Supervisor						$183,071	$6,822	$19,811	$211,574	$1,870
Tetz Warren
Construction Executive	$277,933	$75,073	$16,682	$51,282	$532,643						$111,673
Wagner Jack
A Sec Thru 3/18	$180,671	$414,342	$11,182	$22,894	$1,366,983						$737,894
Wehtje Ronald
Former Finance Officer SCR	$525,772	$154,336	$16,682	$21,088	$871,398						$153,520
Wehtje Ronald
SCR CFO	$525,772	$154,336	$16,682	$21,088	$871,398						$153,520
Wing Bill
Dir/Vice Chair	$1,015,353	$603,273	$16,682	$32,633	$1,924,626						$256,685
Zachary Beth
Former Int President	$191,196	$270,398	$16,682	$25,683	$1,352,946						$848,987

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part I, Line 1a: Relevant information in regards to selections on 1a.	FormAndLineReferenceDesc

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (6 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Linda Henry
Key EE Sister	$59,434	Employment	false
Brent Wagner
Son of Officer	$82,281	Employment	false
Cambria Wehtje-Sim
Dghtr-Fmr Ofcr	$89,784	Employment	false
Doris Tetz
Dghtr-Key EE	$464,679	Employment	false
Josiah Ferch
Key EE-Son	$42,946	Employment	false
Carol Jobe
Officer's Spouse	$4,429	Employment	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule L, Part V Supplemental Information	FormAndLineReferenceDesc
Explanation	Additional information regarding interested persons listed above:1. Linda Henry is the daughter of Adventist Health board member, Wesley Rippey.2. Brent Wagner is the son of former Adventist Health CFO, Jack Wagner.3. Cambria Wehtje-Sim is the daughter of former officer Rodney Wehtje.4. Doris Tetz is the daughter of former key employee, Warrent Tetz.5. Josiah Ferch is the son of Key Employee Wayne Ferch.6. Carol Jobe is the wife of Meredith Jobe, an officer of Adventist Health.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately.The Corporate General Counsel distributes, collects, and reviews for signatures theCOIs for all board members. In addition, the foundations administration is responsible for keeping record to ensure all board members have submitted their COIs.Further inquiries on any potential significant conflicts are made as needed.Conflicts are documented and reviewed with the Board member.
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 publicly available. The hospital files monthly/quarterly summary financial reports with the state health planning agency.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
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
15630 18th Avenue	Clearlake	CA	95422	680395149	Hospital	CA	501(c)(3)	3	Adventist Health SystemWest	false
Adventist Health Physicians Network
PO Box 619135	Roseville	CA	95661	680357690	Medical Foundation	CA	501(C)(3)	12b2	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
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	Roseville	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
1509 Wilson Terrace	Glendale	CA	91206	951816017	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	Ukiah	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	Advenstist Health System West	false
Western Health Resources
PO Box 61935	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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	South Coast Medical Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 619135	AddressLine1Txt
City	Roseville	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95661	ZIPCd

Field	Value	IRS element (for citing)
EIN	952037291	EIN
Primary Activities	Wind down after sale of hospital	PrimaryActivitiesTxt
Legal Domicile State	CA	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Entity Type	C Corp	EntityTypeTxt
Controlled Organization	false	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd