2018-12-25T16:10:26-08:00 2017-12-31 California Wildfires DR-4407 and IRS CA-2018-13 800519547 THE ACCOUNTANCY LLP 330 N BRAND BLVD STE 200 GLENDALE CA 912032361 990 2017-01-01 930429015 Portland Adventist Medical Center dba Adventist Health Portland PORT 5032572500 10123 SE Market St Portland OR 97216 Aaron Poole Treasurer 2018-12-25 true S Clement P01218012 8185475701 X 2017 2019-02-21 02:37:17Z David Russell 378681470 false false 1071 X https://www.adventisthealth.org/Portland X 1900 OR Living God's love by inspiring health, wholeness and hope. 14 10 2281 289 1828788 277927 909455 150844 351558801 373699607 3299597 3195897 77093 8179 355844946 377054527 1155 0 160815719 171699297 147497 66302 564316 179882570 205975077 340845786 377741831 14999160 -687304 312157015 320904406 96950807 130157485 215206208 190746921 Living God's love by inspiring health, wholeness and hope. false false 315059910 1155 370976816 Portland Adventist Medical Center (PAMC) 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 of Portland Adventist Medical Center, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's 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 Portland 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. PAMC 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 2017 was $21,330,000.The following volume of services were provided to our patients:30,503 Inpatient Days9,441 Inpatient Discharges794 Deliveries6,849 Surgical Cases6,267 Inpatient Admissions from the Emergency Department51,632 Emergency Department Visits9,410 Inpatient Admissions163,608 Patient VisitsPAMC 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 2017 was $5,631,054.Community Health Improvements Services:Better Living ShowOregon Board of Medical ImagingA Delicious Fair of the Heart Natl Alliance for Mentally Ill Unity CenterAHA Heart and Stroke Walk Health for Life publicationVegfest 2017Cancer Care CoordinatorSmoke Free Support GroupCancer Support GroupRememberance ServiceGrief ClassesNorthwest Parish Nursing MinistriesPrepare Childbirth ClassesNational Cancer Survivor's DayTransportation needs of discharging patientsCancer patient transportationCancer Survivor EventProject Access NowHealth Share of OregonCompassion Connect ClinicsStudent Healthcare Leaders ProgramLivingWell PodcastProject Access NowRadon EducationAnswering Medication QuestionsHealth Professionals Education:PhysiciansAdvanced Life Support for ObstetricsVarious health lecturesMedical Students (3,737 hours)Nursing students (21,768 hours/182 students)Nursing School subsidyOregon Center for NursingOther Health Professionals Education:All City Palliative Care ConferencePlant Based Nutritional ConferenceRehab StudentsSubsidized Health Services:Outpatient Emotional Wellness departmentFinancial and In-Kind Donations:American Cancer SocietyNorth Clackamas Education FoundationMeeting Room OverheadPACS Awards Dinner and AuctionPACS Board Meals on WheelsOAHHS Public Policy MeetingFundraising for PACSAmerican Red Cross Blood drivesCompassion ConnectCelebration of ThanksgivingSalvation ArmySupplies donated to ReStoreSupplies Donated to PACSAmerican Cancer Society Relay for LifeBattle Ground Health CareCommunity Building Activities:Economic DevelopmentVarious Local Chamber of Commerce timeGateway Area Business AssociationRose Community DevelopmentWorkforce Development:Local High School Students MentoringCommunity Benefits Operations:Assigned Staff = 1,505 total hours 315059910 true true false true false false false false false true true false false true true false false true false false false false false true true false true true false false true false false false false false false false false true false true false false false false true true true true false false true 132 0 true 2281 true true true false false false false true true false 0 false false false false false false false false false false X 14 10 false false false false true false true true true false false true true true true true true true true true true OR X Aaron Poole 5032614406 10123 SE Market St Portland OR 97216 X BANKS DAVID Director 0.00 4.00 X 0 1553 0 CHERRY ROBERT Director 0.00 4.00 X 0 11550 0 DAVIS ANDREW Director 0.00 4.00 X 0 10600 0 FREEDMAN JOHN Director 0.00 4.00 X 0 1133 0 FRIESTAD CHRISTINE Director 0.00 4.00 X 0 0 0 GABRIEL MELODY Director 0.00 4.00 X 0 1203 0 GRAHAM RICARDO Director 0.00 4.00 X 0 2074 0 HEINRICH KERRY Director 0.00 4.00 X 0 15866 0 INNOCENT LARRY Director 0.00 4.00 X 0 17608 0 PEDERSEN JAMES Director 0.00 4.00 X 0 2101 0 REINER RICHARD Director 0.00 4.00 X 0 19819 0 RIPPEY WESLEY Director 9.00 4.00 X 100600 17516 0 SALAZAR VELINO Director 0.00 4.00 X 0 1928 0 REINER SCOTT Dir/Chair 0.00 50.00 X X 0 1982804 53885 WING BILL Dir/VChair 0.00 50.00 X X 0 1460244 52693 JOBE MEREDITH Secretary 0.00 50.00 X 0 654239 42313 RUSSELL DAVID President 50.00 0.00 X 0 530592 42360 WELCH DONALD Treas/Asst Sec 50.00 0.00 X 0 532071 51564 POOLE AARON Treas/Asst Sec 50.00 0.00 X 0 315893 43701 WAGNER JACK Asst Secretary 0.00 50.00 X 0 1070403 37117 NUTTER LUCINDA Patient Care Exec 50.00 0.00 X 0 306188 43686 TKACHUCK DERRIK VP Support Svcs 50.00 0.00 X 0 277789 57744 BROWER DORANE VP Integrated Phys & Hlth Plan Svcs 50.00 0.00 X 0 303772 53841 PROWS RALPH CMO Medical Grp 50.00 0.00 X 0 522326 42313 VOSHELL SHANE VP HR 50.00 0.00 X 0 218423 53805 KING KYLE VP Network Dev 50.00 0.00 X 0 164935 31989 LEACH JUDY Strategy & Comm Exec 50.00 0.00 X 0 245118 35320 NEWMYER JOYCE PNR President 0.00 50.00 X 0 759222 49449 Joo Elliot Physician 40.00 0.00 X 1138593 0 56861 Tella Mallik Physician 40.00 0.00 X 906443 0 28685 Molloy Thomas Physician 40.00 0.00 X 763272 0 62089 Estes Christopher Physician 40.00 0.00 X 740137 0 28685 Aranda-Michel Jaime Physician 40.00 0.00 X 727950 0 51634 WEHTJE RODNEY Former Asst Treas 0.00 0.00 X 0 249427 23299 REBOK DOUGLAS Former Asst Secretary 0.00 0.00 X 0 120028 6244 4376995 9816425 949277 270 true true false Oregon Anesthesiology Group PC 120 NW 14th Ave Ste 300 Portland OR 97209 Medical Services 1100846 Icon Medical Network 8100 SW Nyberg St Ste 400 Tualatin OR 97062 Temp Staffing 688497 Accountable Healthcare Staff PO Box 650539 Dallas TX 752650539 Temp Staffing 642071 ECG Management Consultants PO Box 74008176 Chicago IL 60674 Consulting Servics 522801 Comphealth PO Box 972651 Dallas TX 753972651 Temp Staffing 495471 48 95883 36000 18961 2100 150844 Dietary 895628 895628 Other Revenue 900099 7252071 7252071 Patient Service Revenue 621110 358043262 358043262 Reference Lab 621500 1652595 1652595 Rental Revenue - MOBs/Oth 531120 5537752 5537752 318299 142106 176193 373699607 2773736 2773736 0 0 0 1862900 1440739 422161 422161 422161 30417 95883 65723 -35306 -35306 0 162341 120481 41860 41860 Security/Maint 1625 1625 1625 377054527 370976816 1828788 4098079 1155 1155 0 0 0 100600 100600 0 133260772 122779298 10160233 321241 5302697 5250733 51964 23568864 20515126 3001445 52293 9466364 8767941 678177 20246 0 539561 539561 77001 77001 0 66302 66302 0 11426016 8802221 2603344 20451 1600273 1600273 1826582 1712296 100012 14274 14371611 14312852 58759 0 12439469 12198286 227307 13876 867183 602309 262174 2700 0 150210 134587 15173 450 2064094 2064094 0 10989141 10940907 48234 1135022 1082690 52332 Purchased Services 89358929 50378081 38969027 11821 Pt Care Supplies 40661046 40638815 22231 Quality Assurance-Hospital Fee 12930680 12930680 All other expense 3821508 218585 3593883 9040 1716751 1628654 78706 9391 377741831 315059910 62117605 564316 3909673 30781 112343364 130909668 0 37537022 36431424 0 0 0 4995800 4664020 1911753 1030688 316191333 211906306 110310938 104285027 1282159 2006047 279606 0 -68931 2588550 3111050 36998150 38504632 312157015 320904406 17025367 20000415 907901 859750 79017539 109297320 96950807 130157485 X 210443797 186101221 2181025 4645700 2581386 215206208 190746921 312157015 320904406 X -687304 -23771983 X false true X true false X false false false false false false false false false false true 20409 20409 false false Part II-B, Line 1i - Other Activities Description A portion of the dues paid to the following organization has been determined to be related to lobbying: Oregon Association of Hospitals and Health Systems 8797541 423076 115160 537081 8798496 8000751 861239 450598 515047 8797541 7740323 827094 -3219 563447 8000751 7803519 767460 169943 1000599 7740323 7469528 710285 171979 548273 7803519 0.29340 0.70660 false false false 6921144 6921144 204282033 122722254 81559779 3279916 2693916 586000 101708240 86490136 15218104 104285027 Other receivables 339464 Receivables from related entities 19960008 Receivables from third-party payors 18205160 38504632 Other liabilities 499205 Payable to related entities 93457054 Payable to third parties 12404997 Workers Comp Liability 2936064 109297320 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. X X X X X true TSM Donor Engagement 155 Commerce Dr Freedom PA 15402 Telephone Solicitation false 13079 36302 gEvents LLC 11815 SW Terra Linda St Beaverton OR 97005 Golf Tournament false 126300 30000 96300 false 139379 66302 96300 Golf Tournament 126300 95883 30417 400 7993 13000 9024 35306 126300 95883 30417 400 7993 13000 9024 35306 65723 -35306 true true X true X true X true true false false true true 9300365 9300365 0.02460 59400097 47370463 12029634 0.03180 68700462 47370463 21329999 0.05640 4879227 9115 4870112 0.01290 485512 48151 437361 0.00120 113682 68066 45616 0.00010 170173 170173 0.00050 107892 100 107792 0.00030 5756486 125432 5631054 0.01500 74456948 47495895 26961053 0.07140 25379 25379 0.00010 3103 3103 2400 2400 464 464 31346 31346 0.00010 true 3603423 1472719 59272897 41635296 17637601 X true true Gresham Family Medical Ctr Physician Services 1.00000 ASSN-Unit Owners Plaza Cond Condo association mgmt 0.90000 0.10000 1 1 Portland Adventist Medical Ctr 10123 SE Market St Portland OR 97216 adventisthealth.org/Portland 14-1127 X X X Portland Adventist Medical Ctr 1 false false true X X X X X X X X X 16 true false true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 17 true See Sch H Part VI - Needs Assessment false false true X 200.0000 399.0000 X X X X true true 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 X true X false X X X X true X false false Part V, Line 5 - Account Input from Persons Who Represent the Community The 2016 CHNA data collection process can be summarized as follows: 1. review of prior CHNA reporting efforts; 2. collection of most recently available demographic, socioeconomic and health indicator data.Data gathering was accomplished by using a widely-distributed community survey. Portland Adventist Medical Center (PAMC) has chosen two different community surveys to be able to take into account the various groups that need to be represented. In order to not duplicate responses, PAMC has chosen to use the Healthy Columbia Willamette (HCWC) as their main source of primary data for our service area. A second survey (service provider survey) was conducted to gather the opinions of the community from various health experts in our community. The following groups were represented and responded to our service provider survey: Pearl Health Center, Multnomah County Health Department, Human Solutions, Portland Adventist Community Services, Adventist Health Medical Group, and The Healthy Columbia Willamette Collaborate. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Illicit Drugs- Adventist Health will not focus on this health need due to lack of professional expertise and resources. There are other groups within our community addressing this important need. Please see our community resources section for some of these groups. Poverty- Adventist Health addresses part of the growing poverty problem in our community with our access to health care initiatives. . Besides some limited annual programs like our Holiday Food basket and Warm Winter Clothing programs that are supported generously by employees and directed to those in need, the greater challenges in this area are being served by community groups better suited to address those needs. Adventist Health does not have the resources or expertise to make a greater impact in this area. Hunger- This area of concern is directly related to the issue of poverty. The same reasons for Adventist Health not directing resources to this area in a substantial matter is as for poverty. Adventist Health will continue to sponsor an annual Celebration of Thanksgiving free community concert in the fall where donations to the Oregon Food Bank are collected at the door for admission. Thousands of pounds of non-perishable food has been collected. Part V, Line 13h - Other Factors Used in Determing Amounts Charged Patients Income level and family size are considered. Individuals eligible for Medicaid also qualify for financial assistance Adventist Health Gresham Station Imaging Center 831 NW Council Dr Suite 100 Gresham OR 97030 Imaging Services Adventist Health Wound Healing and Hyperbaric Medicine 10201 SE Main St Suite 9 Portland OR 97216 Wound Care Services-Hospital Outpatient Adventist Hlth Medical Grp-GI Clinic 10000 SE Main Street Suite 112 Portland OR 972162441 Physician Clinic Adventist Hlth Medical Group-NW Orthopedic Specialists 10000 SE Main St 224 Portland OR 97216 Physician Clinic Northwest Regional Heart & Vascular-Portland 10000 SE Main St 60 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Cherry Park FP 10201 SE Main Suite 10 Portland OR 97216 Physician Clinic Adventist Health Physical Therapy-Campus Rehab 10101 SE Main Street LL Portland OR 97216 Physical Therapy Clinic Adventist Health Physical Therapy Gresham 831 NW Council Dr Suite 200 Gresham OR 97030 Physical Therapy Clinic Adventist Health Physical Therapy Sandy 35401 Hwy 26 Sandy OR 97055 Physical Therapy Clinic Adventist Health Medical Group-Rockwood Urgent Care 18750 SE Stark Street Portland OR 97233 Physician Clinic/ Urgent Care Adventist Hlth Med Grp-Sandy Family Practice 17055 Ruben Lane Sandy OR 97055 Physician Clinic and Urgent Care Advenstist Health Medical Group-Clackamas 11211 SE Sunnyside Road Clackamas OR 97015 Physician Clinic Adventist Hlth Medical Group-NW Regional Surgical Assoc 10000 SE Main St 365 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Arthritis and Bone Care 10101 SE Main St Suite 2011 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Internal Medicine Assoc 10201 SE Main St Suite 12 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Diabetes & Endo Ctr 10101 SE Main Street Suite 1001 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Portland Lung Clinic 10201 SE Main St Suite 11 Portland OR 97216 Physician Clinic Northwest Regional Heart & Vascular-McMinnville 2700 SW Stratus Ave Ste 406 McMinnville OR 97128 Physician Clinic Adventist Hlth Medical Grp-Wound Healing & Hyperbaric 10201 SE Main St Suite 9 Portland OR 97216 Physician Services Adventist Health Medical Group-Gresham Station 831 NW Council Drive Suite 101 125 Gresham OR 97030 Physician Clinic Adventist Health Medical Group-Fishers Landing 417 SE 164th Ave Suite 300 Vancouver WA 986848944 Physician Clinic Adventist Health Physical Therapy Parkrose 1350 NE 122nd Avenue 200 Portland OR 97230 Physical Threapy Clinic Adventist Hlth Medical Group-Occupational Med Parkrose 1350 NE 122nd Ave 200 Portland OR 97230 Physician Clinic Adventist Health Medical Group-Troutdale Clinic 1700 SW 257th Ave Troutdale OR 97060 Physician Clinic Adventist Health Medical Group-Damascus 14450 SE Royer Road Damascus OR 97089 Physician Clinic Adventist Health Physical Therapy Clackamas 13435 SE 97th LL101 Clackamas OR 970157787 Physical Therapy Clinc Adventist Health Medical Group-Mt Scott Internal Med 9200 SE 91st Ave Suite 300 Portland OR 97286 Physician Clinic Adventist Health Medical Group-Parkrose Urgent Care 1350 NE 122nd Ave 200 Portland OR 97230 Physician Clinic/Urgent Care Adventist Health Physical Therapy Vancouver 16096 SE 15th Ave Vancouver WA 98683 Physical Therapy Clinic Adventist Health Audiology 10201 SE Main Street Suite 1 Portland OR 97216 Audiology Services Adventist Health Speech Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Speech Theraphy Services Adventist Hlth Medical Group-Creekside Family Medicine 9200 SE 91st Ave 220 Happy Valley OR 97086 Physician Clinic Adventist Health Speciality Rehab 10201 SE Main St 1 Portland OR 97216 Speciality Rehab Clinic Adventist Health Medical Group-Sleep Clinic 10201 SE Main St Suite 29 Portland OR 97216 Physician & DME Clinic Adventist Health Occupational Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Occupational Therapy Clinic Adventist Health Medical Group-Sandy Urgent Care 17055 Ruben Lane Sandy OR 97055 Physician Clinic/Urgent Care Adventist Health Medical Group-Gladstone Family Med 19220 McLoughlin Blvd Gladstone OR 97027 Physician Clinic Adventist Health Medical Group-Resilience Center 10000 SE Main St Suite 236 Portland OR 97216 Physician Clinic Adventist Health Medical Group-Electrophysiology 10000 SE Main Street Suite 60B Portland OR 97216 Physician Clinic Adventist Health Medical Group-Parkrose PrimIM 1350 NE 122nd Avenue 100 Portland OR 97230 Physician Clinic Adventist Health Medical Group-Willamette View Clinic 13021 SE River Road Suite 3000 Portland OR 97222 Physician Clinic Emotional Wellness Center 10101 SE Maint St 3001 Portland OR 97216 Outpatient Behavioral Medicine Adventist Health Medical Group-Interventional Pain Clinic 10000 SE Main St 128 Portland OR 97216 Physician Clinic Adventist Hlth Med Grp-NW Orthopedic Spec-Tillamook 1100 Third St Tillamook OR 97141 Physician Clinic Adventist Health Med Grp-Womens Ctr Happy Valley 9300 SE 91st Avenue Suite 300 Happy Valley OR 97086 Physician Clinic Adventist Hlth Med Grp-Womens Center-Gresham Station 831 NW Council Drive Suite 145 Gresham OR 97086 Physician Clinic Part I, Line 7g - Costs Associated With Physicans Clinics Department: Outpatient Emotional Wellness 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 as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information, those accounts would have been reclassified from bad debt expense to charity care.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs based on 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 healthcare 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.Our mission is to promote health in the community regardless of a person's ability to pay. We provide care to those with Medicare coverage who present themselves to our facility without consideration that the costs may or may not be fully reimbursed. The Medicare shortfall is a community benefit because care is provided to Medicare beneficiaries who are primarily elderly and disabled individuals on fixed incomes and who usually have no other resources with which to obtain medical care. We are thus relieving a local and federal government burden by caring for these people. Medicare revenue reconciliation from the Medicare cost report to general ledger: Medicare cost report revenue* 40,452,099 Prior year settlements 471,717 Cost report reimbursable bad debts 443,426 Estimates and accrual variances 122,695 Other 17,782,957 Subtotal-Amt reported in Part III, Line 5 59,272,897 Amts in Part I, Lines 7f-g 0 Total Medicare revenue 59,272,897*The Medicare cost report revenue includes the patient co-pay and deductible amounts while excluding the bad debt reimbursement related to the patients' portion of the billed 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 The hospital's 2016 CHNA, 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, are posted on the hospital's website at https://www.adventisthealth.org/portland/about-us/community-benefit/. The CHNA, Implementation Strategy, and the CHPs are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.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: Multnomah County Health Department, Healthy Columbia Willamette Collaborative, Portland Adventist Community Services, UNITY Center, Compassion Connect, Adventist Medical Evangelism Network, Meals on Wheels, Project Access Now, and BUILD Project Partners. 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/portland/patient-resources/patient-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 The prime service area for Portland Adventist Medical Center is the following areas of Multnomah and Clackamas Counties: Mid County, East County, and the eastern most portions of Central Eastside and Southeast. Also included would be the areas of Clackamas County that border East County and Southeast Multnomah County and the Sandy region.The population in the top ten zip codes for charity patients is primarily composed of individuals who identify as White (67.1%), followed by Hispanic/Latino (14.18%), Asian (8.87%), African American (4.66%), Pacific Islander (0.77%), Native American (0.71%), and the remaining 3.71% being of mixed race or other. The median income for all households in the top ten zip codes for charity patients is $46,024 which is lower than both the State of Oregon ($50,521) and the U.S. ($53,046). 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 The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report OR Part V - Explanation of Number of Facility Type Physician Clinics (32), Imaging (1), Rehab (PT/OT/Sp) Clinics (10), Wound Care (1); Radiation Oncology (1), Urgent Care (3) Part VI - Additional Information Supplemental for Part I, Line 7 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 for 7a-c: (Total expenses - (Provision for bad debts + Other revenue + Interest income)) divided by Gross patient charges7e,f,h,i are calculated based on specific expenses and revenues.7g uses specific cost to charge ratios for those departments X true true X X X X true true false false false false false false false false Aranda-Michel Jaime Physician 723450 4500 16676 34958 779584 BROWER DORANE VP Integrated Phys & Hlth Plan Svcs 228714 41124 33934 16356 37485 357613 Estes Christopher Physician 703231 36906 16676 12009 768822 JOBE MEREDITH Secretary 395752 98614 159873 16356 25957 696552 60017 Joo Elliot Physician 1084807 53786 16676 40185 1195454 KING KYLE VP Network Dev 143607 21328 7913 24076 196924 LEACH JUDY Strategy & Comm Exec 214584 30534 12712 22608 280438 Molloy Thomas Physician 761664 1608 16676 45413 825361 NEWMYER JOYCE PNR President 603848 136813 18561 16356 33093 808671 NUTTER LUCINDA Patient Care Exec 233120 42150 30918 16356 27330 349874 POOLE AARON Treas/Asst Sec 241060 38879 35954 16356 27345 359594 PROWS RALPH CMO Medical Grp 386280 64329 71717 16356 25957 564639 REBOK DOUGLAS Former Asst Secretary 120028 6244 126272 120028 REINER SCOTT Dir/Chair 1184750 324119 473935 16356 37529 2036689 406467 RUSSELL DAVID President 363709 77303 89580 16407 25953 572952 28796 Tella Mallik Physician 894058 12385 16676 12009 935128 TKACHUCK DERRIK VP Support Svcs 206182 36496 35111 15829 41915 335533 VOSHELL SHANE VP HR 172284 11645 34494 11900 41905 272228 WAGNER JACK Asst Secretary 755988 221735 92680 11160 25957 1107520 WEHTJE RODNEY Former Asst Treas 158863 90564 213 23086 272726 79970 WELCH DONALD Treas/Asst Sec 363147 94666 74258 16356 35208 583635 WING BILL Dir/VChair 953512 273121 233611 16356 36337 1512937 172851 Part I, Line 1a: Relevant information in regards to selections on 1a. Any items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. WGW LLC Gabriel JV LLC JV Ownership false Rippey Wesley Director/CMO 100600 Professional srvs false Schedule L, Part V Supplemental Information Melody Gabriel, an AH director, and her husband are owners and officers of businesses that engage in a joint venture with the hospital. Other family members with ownership and officer positions in these businesses include her parents, her brother and his wife, and trusts established on behalf of her children. The businesses are organized as LLCs.Wesley Rippey, MD is the Medical Officer (MO) for Portland Adventist Medical Center. The hospital paid Dr. Rippey $60,500 for his MO services. Additionally, Dr. Rippey provides vascular study interpretations and on call coverage for patients of the hospital. The hospital paid $40,100 for these professional services. These services were provided under contracts approved by the Board Compliance Committee. Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Part VI, Line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors.Part VI, Line 7bThe 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 The completed Form 990 is shared with members of the corporation's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board 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 questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process. 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 Human Performance Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for executives with midpoints set at the median of the peer group and having a 50 percent spread (about 20% above and below midpoint) from minimum to maximum. The system CEO and Sr Vice Presidents (Executive Cabinet) have a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other executives have a maximum potential incentive of 25 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 and Bylaws with the Oregon Secretary of State and Oregon Department of Justice. The hospital does not make its conflict of interest policy publicly available. The hospital files monthly/quarterly summary financial reports with the Oregon Health Authority. Other Changes In Net Assets Or Fund Balances - Other Increases Additional Contributions = $383530 Other Changes In Net Assets Or Fund Balances - Other Decreases Change in Value of AUOPA Investment = -$83604 Other Changes In Net Assets Or Fund Balances - Other Decreases Other = -$1495 Other Changes In Net Assets Or Fund Balances - Other Decreases Restricted Funds Released From Restriction = -$136745 Other Changes In Net Assets Or Fund Balances - Other Increases Temporarily Restricted Investment Income = $37039 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer To/From Related Organizations = -$750 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfers to related organizations = -$23969958 Healthcare Resources Northwest LLC 2625 SE 98th Ave Portland OR 97266 461719208 Managed Care Mgmt OR 49020944 19414222 Portland Adventist Medical Center Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 NA false Adventist Health Clearlake Hospital Inc 15630 Ave 18th Ave Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Road Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Glendale Adventist Medical Center 1509 Wilson Ter Glendale CA 91206 951816017 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Hanford Community Hospital 450 Mall Dr Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Willits Hospital Inc 1 Marcela Dr Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilities CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Rd St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Ave Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital & Hlth Care Svcs 2975 N Sycamore Dr Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Fnd of Tillamook 1000 Third St Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Dr Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital WA 501(c)(3) 1 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Reedley Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Physicians Network 2100 Douglas Blvd Roseville CA 95661 680357690 Medical Foundation CA 501(c)(3) 11b,II Adventist Health SystemWest false Western Health Resources 2100 Douglas Blvd Roseville CA 95661 953867863 Home care CA 501(c)(3) 1 Adventist Health SystemWest false Lodi Memorial Hospital Association Inc 975 S Fairmont Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Hlth Medical Ctr Tehachapi 15 W E St Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false PAR LLC 10610 SE Clay Street Portland OR 97216 931262371 Sr Living OR N/A true 39 false 0.50000 Gresham Family Medical Center PC 1700 SW 257th Ave Troutdale OR 97060 911768081 Medical Office OR N/A C Corp 1.00000 true Assn Unit Owners Portland Adv Condo 10101 SE Main St Portland OR 97216 930887521 Condo Assn-MOB OR N/A C corp 0.90100 false South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C Corp false false false false false true false false false false true false true false false false true true false true The reporting organization, a member of Adventist Health (System), is requesting abatement of late filing penalties due to extraordinary events occurring within the System caused by the Camp Fire in Butte County, California that erupted on November 8, 2018. On November 12, 2018, President Donald J Trump issued a Presidential Major Disaster Declaration. We request that the relief provided by the Internal Revenue Service in CA-2018-13 under IRC 7508A and Regulation 301.7508A-1 be applied to the reporting organization. The System experienced a catastrophic loss to the hospital in Paradise and multiple other buildings. Included in that loss was the building that housed critical information technology infrastructure. The morning following the start of the fire, the information technology area experienced System-wide loss of service over the following two weeks. The IT function had to make changes to accommodate the losses to infrastructure due to the fire. Tax software was not functional through November 30, 2018. During 2017 the System transitioned to an Enterprise Resource Planning cloud-based system and adopted a shared services model. This change resulted in the loss of personnel knowledgeable about the organizational structure, activities, and financial reporting of the entity. The ability to aggregate data consistent with prior years' reporting was challenging. More time was required to ensure reporting was in alignment with the tax format. Inquiry and reassignment of accounts was needed as we became aware of the constraints in the new ERP environment from within which we obtained the reporting data. Rebalancing of the income statement and net assets was critical and took extensive effort to complete.