2018-12-21T14:03:16-08:00 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 930622075 Northwest Medical Foundation Tillamook DBA Tillamook Regional Medical Center NORT 5038424444 1000 Third St Tillamook OR 97141 Smith Micah Treasurer 2018-12-21 true S Clement P01218012 8185475701 X 2017 2019-02-21 02:37:17Z David Butler 84242613 false false 1071 X www.adventisthealth.org/tillamook X 1973 OR Living God's love by inspiring health, wholeness and hope. 14 10 566 66 0 146136 135807 77460170 83609460 499590 497302 -74 78105896 84242495 15000 0 37090653 41279912 0 2307 35901022 35359852 72991675 76654764 5114221 7587731 56005159 62712557 6572308 10774153 49432851 51938404 Living God's love by inspiring health, wholeness and hope. false false 69740624 15000 83609386 Tillamook Regopma; Medical Center 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 Tillamook County General Hospital 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 Tillamook Regional Medical Center provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. Tillamook Regional Medical Center recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed value of providing care to these patients in 2017 was $3,872,320.Services in 2017 were provided to 81,965 patients. These services included:Babies delivered 151Surgeries performed 1,402Emergency room visits 10,700Medical clinics visits 359,458Tillamook Regional Medical Center 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:Health FairBlood Pressure ClinicsFaith In ActionMulti ModularRespite careSeniors DayWomens Resource TrainingDoc Talks 69740624 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true false false false false false false false false false false false false false false false false true false false false true 73 0 true 566 true false false false false false false false 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 false OR X Micah Smith 5038152263 1000 Third St Tillamook OR 97141 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 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 0.00 4.00 X 0 118116 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/VCh/AsstSec 0.00 50.00 X X 0 1460244 52693 Jobe Meredith Secretary 0.00 50.00 X 0 654239 42313 Wagner Jack Asst Secretary 0.00 50.00 X 0 1070403 37117 Butler David President/CEO 50.00 0.00 X 0 453166 53858 Larson Walter Treas/Asst Sec 50.00 0.00 X 0 85681 2144 Saxon Kathleen Pt Care Executive 50.00 0.00 X 0 222434 24402 Seufert Regina VP Physician/Clinic Svcs 50.00 0.00 X 0 229303 25093 Newmyer Joyce President PNR 0.00 50.00 X 0 759222 49449 Welch Donald CFO PNR 0.00 50.00 X 0 532071 51564 Leach Judy Strategy & Comm Exec PNR 0.00 50.00 X 0 245118 35320 Voshell Shane VP HR PNR 0.00 50.00 X 0 218423 53805 Lafleur Brett Physician 40.00 0.00 X 640572 0 47693 Kaba David Physician 40.00 0.00 X 547144 0 51316 Naidoo Abendra Physician 40.00 0.00 X 497073 0 38846 Mitchell Brandon Physician 40.00 0.00 X 490252 0 48431 Thompson Albert Physician 40.00 0.00 X 402982 0 27384 Rebok Douglas Former Asst Sec 0.00 0.00 X 0 120028 6244 Wehtje Rodney Former Asst Treas 0.00 0.00 X 0 249427 23299 2578023 8486114 724856 56 true true false Tillamook Emergency Services 1000 Third St Tillamook OR 97141 Physician Services 2180199 Bivens Medical Corporation 20105 Geisendorfer Applegate CA 95703 Physician Services 1651793 Staff Care Inc PO BOX 281923 ATLANTA GA 30384 Professional Fees 718944 Rural Physicians Group 10624 S EASTERN AVE STE A-263 HENDERSON NV 89052 Physician Services 693000 Opdahl Gregory Md Pc 4950 CLAM WAY WEST Tillamook OR 97141 Ophthomology 661165 15 135807 135807 Dietary services 722210 280021 280021 Other revenue 900099 391474 391474 Patient service revenue 900099 82881163 82881163 Rental income 531120 56802 56802 83609460 497302 497302 0 0 0 0 0 0 44 118 -74 -74 0 84242495 83609386 497302 X 15000 15000 0 0 0 0 0 32982716 31212121 1770595 1397512 1380308 17204 4858569 4363346 495223 2041115 1923817 117298 0 18984 18984 -4968 -4968 0 0 0 8032546 7783540 249006 46769 46769 909883 839940 69282 661 4274198 4248870 25328 0 1880584 1872644 7940 288474 101995 184833 1646 0 380904 221318 159586 -2611 -2611 0 1909015 1899898 9117 463922 463922 Purchased services 9390777 5752360 3638417 Patient care supplies 7491311 7491311 Other expenses 210165 108924 101241 Rental/lease equipment 69899 63921 5978 0 76654764 69740624 6911833 2307 159356 0 20767514 25667188 0 11589806 16244774 0 0 0 1393804 1717030 174782 90392 45379240 33575338 12785118 11803902 442741 703463 0 0 0 8692038 6485808 56005159 62712557 5534318 5595548 1037990 5178605 6572308 10774153 X 49391520 51875169 41331 63235 49432851 51938404 56005159 62712557 X 7587731 -5082178 X false true X true false X false false false false false false false false false false true 6058 6058 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations - such as the Oregon Association of Hospitals and Health Systems - for which a portion of the membership dues is used for lobbying activities. 41331 96447 19446 55097 63235 697451 101947 758067 41331 1324795 159334 786678 697451 1830000 187892 693097 1324795 2417200 150062 737262 1830000 1.00000 false false false 1056181 1056181 27674697 19290772 8383925 1991936 1247792 744144 14656426 13036774 1619652 11803902 Other assets 26078 Other receivables 337598 Receivables from 3rd party 325690 Receivables from related organizations 5796442 6485808 Payables to rel orgs 4452247 Workers comp liability 726358 5178605 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted funds are for specified operating and capital projects. The funds are released as project costs are expended. true true X true X true X true true false false true true 1244504 1244504 0.01620 1244504 1244504 0.01620 557027 78869 478158 0.00620 121410 121410 0.00160 70890 3450 67440 0.00090 749327 82319 667008 0.00870 1993831 82319 1911512 0.02490 7889 7889 0.00010 48246 48246 0.00060 625644 300 625344 0.00820 681779 300 681479 0.00890 true 1279330 724357 27903440 24618692 3284748 X true true 1 1 Northwest Med Found Tillamook 1000 Third St Tillamook OR 97141 adventisthealth.org/Tillamook 14-1177 X X X X Northwest Med Found Tillamook 1 false false true X X X X X X X X X 16 true true 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 400.0000 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, engaging with community focus groups and conducting key stakeholder interviews.Community Survey: Tillamook Regional Medical Center conducted community organization surveys that asked about the health problems and health needs of the community. The community organization survey was emailed to organizations that collaborate with Tillamook Regional Medical Center in the form of an online survey. The survey addressed what community the organization serves, what is healthy in their community, what is not and what their community needs to be healthy. Twenty-five people responded to the online survey.Community Focus Groups: Twenty-eight people participated in three different focus groups. The focus groups were conducted at Tillamook Regional Medical Center and at Tillamook Seventh-day Adventist Church from March 21-22, 2016. Members of the focus groups included individuals or organizations that represented the medically underserved, low-income, and minority populations served by our hospital, as well as, community members at large. Focus group participants were snowball sampled through existing support groups and classes at Tillamook Regional Medical Center and leveraging of hospital administration's professional networks. Key Informant Interviews: Sixty-three people were surveyed in the form of ten key informant interviews. The groups were comprised of key leaders from an array of agencies including, local coalitions, not-for-profits, healthcare providers, and human service agencies. These were conducted by phone from February to April 2016. Key informants were identified through existing partnerships with community based organizations. Secondary data sources included publicly available state and nationally recognized data sources. Data on key health indicators, morbidity, mortality, and various social determinants of health were collected from the Census, Centers for Disease Control and Prevention, Community Commons, Nielsen, and various other state and federal databases. The quantitative data includes County specific data, and if available, data disaggregated to primary service area has been provided. When feasible, health metrics have been further compared to benchmarks, such as Healthy People 2020 objectives and State estimates. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment None, TRMC is the only hospital in the County of Tillamook. AH Tillamook Medical Group 980 Third St Tillamook OR 97141 Outpatient Clinic AH Tillamook Women and Family Clinic 1011 Third St Tillamook OR 97141 Outpatient Clinic Manzanita Primary & Specialty Care 10445 Neahkahnie Creek Rd Manzanita OR 97130 Rural Health Clinic Bayshore Family Medicine 38505 Brooten Rd Ste A Pacific City OR 97135 Rural Health Clinic Bayshore Family Medicine 1105 SE Jetty Ave Ste C Lincoln City OR 97367 Rural Health Clinic Adventist Health Banks 12350 NW Main Suite 112 Banks OR 97106 Rural Health Clinic Adventist Health TillamookMedical Group-Estacada 103 SW Hwy 224 Suite B Estacada OR 97023 Rural Health Clinic Adventist Health Tillamook Medical GroupHoodland 24461 E Welches Road Welches OR 97067 Rural Health Clinic Tillamook Medical Plaza 1100 Third Street Tillamook OR 97141 Outpatient Clinic Adventist Health - Vernonia 1005 Cougar Street Vernonia OR 97064 Rural Health Clinic Specialty Clinic - Occupational Therapy 980 Third Street Tillamook OR 97141 Outpatient Clinic Adventist Health Medical Group Surgery Services 980 Third Street Suite 100 Tillamook OR 97141 Outpatient Clinic 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 charges Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio 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. 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 audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue 24,782,925Prior Year Settlements 108,637Cost Report Reimbursable Bad Debts 63,345Estimates and Accrual Variances 149,640Other 2,798,893Subtotal - Amount reported in Pt III, line 5 27,903,440Amounts included in Part I, lines f and g -Total Medicare Revenue 27,903,440*Note: 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 already accounted for in the co-pay and deductible amounts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part 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/tillamook/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 the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact.Committee/Board Participation includes: NW Regional Education Service District; Head Start Child and Family Development Program; Community Action Resource Enterprises (CARE, Inc.); Oregon Food Bank-Tillamook County Services; Food, Education, Agriculture, Solutions Together (FEAST); Tillamook Seventh-day Adventist Church; North County Food Bank-Nehalem; Tillamook Family Counseling Center; Northwest Oregon Regional Housing Center; and others. 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/tillamook/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 Tillamook Regional Medical Centers service area is all of Tillamook County, which contains three geographic areas: Nehalem (North), Tillamook (Central), and Cloverdale (South). In addition to serving patients at the hospital, patients are also served at the five rural health clinics in our network. In the primary service area, the current year population is approximately 25,000. The largest age group is comprised of persons aged 45-64 years, with a median age of 49.2 compared to the U.S. median age of 37.9. The population is primarily composed of individuals who identify as White (89.8%) and the smallest group is composed of individuals who identify as Pacific Islander (0.3%) followed by African Americans (0.5%). In terms of ethnicity, 12.2% of the population is of Hispanic origin. English is the dominant language spoken in the service area. The percent of the population older than five years old that speaks English less than very well is low in the primary service area at 6% for Nehalem, 0.5% for Cloverdale, and 2.8% for Tillamook. The median income for all households is $43,037 which is lower than both the State of Oregon ($50,521) and the U.S. ($53,046). 29.2% of household in the area have an annual income of less than $25,000 compared to 24.1% for Oregon State and 23.4% for the U.S. Part VI, Line 4 - Community Building Activities The hospital is involved in numerous community building activities that 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 that 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 false Tillamook Cty Comm Health PO Box 489 Tillamook OR 97141 10000 0 Public health grant 1 0 X X X X true true false false false false false false false false Butler David President/CEO 285685 65302 102179 16356 37502 507024 22295 Jobe Meredith Secretary 395752 98614 159873 16356 25957 696552 60017 Kaba David Physician 547144 16356 34960 598460 Lafleur Brett Physician 640572 10956 36737 688265 Leach Judy Strategy & Comm Exec PNR 214584 30534 12712 22608 280438 Mitchell Brandon Physician 490252 16356 32075 538683 Naidoo Abendra Physician 497073 16356 22490 535919 Newmyer Joyce President PNR 603848 136813 18561 16356 33093 808671 Rebok Douglas Former Asst Sec 120028 6244 126272 120028 Reiner Scott Dir/Chair 1184750 324119 473935 16356 37529 2036689 406467 Saxon Kathleen Pt Care Executive 172121 27602 22711 11503 12899 246836 Seufert Regina VP Physician/Clinic Svcs 161786 25811 41706 12197 12896 254396 Thompson Albert Physician 402982 16356 11028 430366 Voshell Shane VP HR PNR 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 CFO PNR 363147 94666 74258 16356 35208 583635 Wing Bill Dir/VCh/AsstSec 953512 273121 233611 16356 36337 1512937 172851 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 Decreases Transfers to related organizations = -$5082178 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 Ave 18 at Hwy 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki St Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Rd 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 Greenfield Ave Hanford CA 93230 940535360 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 Portland Adventist Medical Center 10123 SE Market St Portland OR 97216 930429015 Hospital OR 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 & Health 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 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 Willits Hospital Inc 1 Marcela Dr Willits CA 95490 680108919 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 Reedley Community Hospital 372 W Cypress Ave Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Western Health Resources 2100 Douglas Blvd Roseville CA 95661 953867863 Home care CA 501(c)(3) 1 N/A 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 115 W E St Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 1 Adventist Health SystemWest 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 true false false false false false false false false false false false true true true false false 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.