2018-11-15T19:17:18-08:00 2017-12-31 800519547 THE ACCOUNTANCY LLP 330 N BRAND BLVD STE 200 GLENDALE CA 912032361 990 2017-01-01 951816017 Glendale Adventist Medical Center GLEN 8184098000 1509 Wilson Terrace Glendale CA 91206 Kreuger Eric Financial Officer 2018-11-15 true S Clement P01218012 8185475701 X 2017 2019-02-21 02:37:17Z Issai Alice 453538483 false false 1071 X www.AdventistHealth.org/Glendale X 1905 CA The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all. 14 9 2881 896 1702920 256548 1617339 2101645 459227965 447493539 1602367 1365957 1153262 2574513 463600933 453535654 -241757 27500 0 196145553 200433280 0 1327707 259258105 259758621 455161901 460219401 8439032 -6683747 381520459 375928464 235584295 247077849 145936164 128850615 Living Gods love by inspiring health, wholeness and hope. false false 386326567 27500 447998037 Adventist Health Glendale (AHGL) provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of AHGL 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 care Providing care to persons covered by governmental programs at below cost Providing health/wellness activities and community education programsNot only does AHGL 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. AAHGL 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 $56,477,079.Inpatient services in 2017 were provided to 20,973 patients. These services included: 2,109 Babies delivered 3,344 Surgeries performed 49,366 Radiology procedures performed 33,501 Cardiac catheterizations and other procedures 544,009 Laboratory tests performed 550 Rehabilitation patients 1,093 Mental health patientsOutpatient services in 2017 were provided to 276,521 patients. These services included: 59,864 Emergency room visits 2,885 Outpatient surgeries performed 72,573 Radiology procedures performed 23,635 Cardiac catheterizations and other procedures 385,998 Laboratory tests performedAHGL 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:Children's Health Outreach InitiativeCenter to Increase Community OrganizationCommunity support groupsCommunity health education classesHQ Newsletter for health promotionParamedic base stationTobacco Control ProgramCancer Survivor DayBeyond Loss Bereavement ProgramMental health support groupsBreast Cancer Awareness MonthCancer screeningsCancer Fitness ProgramAHGLs mission anchors everything we do, extending out to the community in many ways. Collaborative efforts between AHGL, local organizations and donors has created critical programs needed to address the specific health care needs of the residents living throughout our service area. Together we are changing the outcome of the community's health.AHGL is accredited as a Chest Pain Center and has been designated as a STEMI receiving center (SRC) by the Los Angeles County Emergency Services. When emergency medical personnel confirm a heart attack/STEMI diagnosis, they bring a patient directly to the GAMC emergency department for treatment. STEMI is a medical term that means heart attack (ST Evaluation MI).During 2017, AHGL was recognized by the County as a Top Performer and a leading program in Los Angeles County for its exceptional treatment times and mortality rate, well under the benchmark goal of being under 10%. AHGL was identified as having the lowest door-to-balloon time out of 34 Los Angeles County hospitals designated as STEMI receiving centers. Door-to-balloon time is the amount of time between the heart attack patient arriving at the doors of the emergency department and the opening of the clogged cardiac artery in the cardiac catheterization lab. The more quickly the artery is opened, the more quickly blood flow and oxygen can be delivered to the heart muscle. Quicker time means heart muscle is saved.Strokes are another area the hospital has received high recognition. Stroke patients who receive tPA (tissue plasminogen activator) intravenously within the first three hours after the start of stroke symptoms show a significant reversal of the effect of a stroke and it reduces permanent disability. The Neuroscience Institute at AHGL is home to one of the few Advanced Primary Stroke Centers in Los Angeles County and became the first hospital in California to receive Comprehensive Stroke Center accreditation from DNV-GL Healthcare USA, the highest certification that a hospital can receive.AHGL is the only hospital in our market area to be certified as both a Stroke and Chest Pain Center. Both of these designations come about with close cooperation with the local emergency medical system and the physicians who perform the medical procedures and follow up with the patients after their discharge from the hospital. This emphasis on Stroke and Chest Pain along with the focus of all departments in the hospital has enabled it to reduce deaths significantly. AHGL was ranked #5 in the nation as having the 5th lowest risk-adjusted mortality rate according to the Centers for Medicare & Medicaid Services based on deaths occurring within 30 days following discharge based on the 2009-2012 time period.The Centers for Medicare & Medicaid Services (CMS) recently released its Star rating with thousands of hospitals across America rated on a one-to-five star scale. AHGL received an impressive four out of five stars, which was given to only ten hospitals out of 57 rated hospitals within a 25 mile radius of AHGL. The score, four out of five stars, places GAMC in the top 20 percent of hospitals in our region.AHGL has been given 8 consecutive "A" grades for safest hospital by The Leapfrog Group. Our physicians, nurses and associates make patient care, safety and outcomes a priority. AHGL was rated as a high performing medical center by U.S. News & World Report in the areas of COPD, geriatrics, heart failure, neurology and orthopedics. Our Comprehensive Community Cancer Program, AHGL Cancer Services is a proud recipient of the Outstanding Achievement Award by the American College of Surgeons for excellence in cancer care. The Cancer Center was also named a Pink Ribbon Facility for providing excellence in breast health paired with exceptional support.AHGL has been voted as the Best Hospital and having the best nurses in the Glendale area for several years by the readers of a local newspaper and more than 100 of the AHGL physicians were nominated by the medical community for Pasadena Magazine's Top Docs.A significant portion of the mission-driven assistance AHGL provides its community is intangible or otherwise difficult to quantify. The following story illustrates this:As an infant, Aren began to show signs of disabilities. His parents knew something wasnt right. Into his second year, their son was not developing like other children his age. Aren seemed unaware of his surroundings. His mom and dad struggled to get his attention and to connect with him. He was not beginning to walk or babble. Unable to chew his food or even drink through a straw, it seemed his brain and his body were somehow disconnected. Desperately needing help coping with these challenges, Arens parents were referred to AHGLs Play to Learn Center, widely recognized for its success with developmentally disabled children. Aren was diagnosed with autism, apraxia of speech and dyspraxia, which limits speech ability and impairs fine and/or gross motor coordination. The centers uniquely skilled physical and occupational therapists, and speech and language pathologists, began working with Aren. Marie Elena Barth was a member of that team. As a former elementary school teacher, she formed a special bond with Aren and his parents. Mom says Marie was Arens guardian angel. After just two sessions, Marie found that music and singing nursery rhymes were keys to gaining Arens attention and encouraging him to communicatebut she didnt stop there. Eager to find another way for Aren to make his needs and wants known, Marie experimented with using an iPad application. At the time, using the iPad for generating speech was revolutionaryand it would change the course of Arens life. Over time, thanks to intensive intervention provided by occupational therapist Steven Bates, Arens fine motor skills improved and he became proficient using picture icons and the iPad keyboard to express thoughts and wishes. He was finally able to say to his parents (I)love you.All the while, other outstanding therapists on the centers team were working with Aren. At times, progress was agonizingly slow, but with patience and tenacity, amazing results occurred.When Aren was 7, his parents made an incredible discovery. He could add, subtract, multiply, and divide. He was reading and typing words and sentences, understanding English, Armenian and other languages.Beneath Arens outer challenges and initial isolation from not being able to speak, hi 386326567 true true false true false false false false false false true false false true true false false false false false false true false false false false true true true false true false false false false false false false false false true false false false false false false true true false false false true 254 0 true 2881 true true true false false false false false false 0 false false false false false false false false false false X 14 9 false false false false true false true true true false false true true true true true true true true true true CA X Eric Krueger CFO 8184098000 1509 Wilson Terrace Glendale CA 91206 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 50.00 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 50.00 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 Roberts Kevin President & CEO 0.00 50.00 X X 0 897962 43753 Salazar Velino Dir/V Chair 0.00 0.00 X 0 1928 0 Reiner Scott Dir/Chair 0.00 50.00 X 0 1982804 53885 Tetz Warren Asst Sec/Sr VP/ 0.00 50.00 X 0 528750 48749 Wagner Jack Asst Sec 0.00 50.00 X 0 1083258 37117 Wing Bill Dir/V Chair/Ass 0.00 50.00 X 0 1460244 52693 Krueger Eric Finance 0.00 50.00 X 0 58524 7518 Brandt-Mayo Karen Patient Care Executive 0.00 50.00 X 0 334485 56472 Correa Sharon Information Officer 0.00 50.00 X 0 389500 42349 Fargo Roland Reg Physician Ops Officer 0.00 50.00 X 0 563956 44025 Markarian Ramella Bus Dev/Phys Rel Officer 0.00 50.00 X 0 289013 53838 Nahapetian Arby Medical Officer SCR 0.00 50.00 X 0 880809 58321 Zachary Beth Reg President & CEO 0.00 50.00 X 0 3531840 49519 Bourdon Irene President, Healthcare Fnd 0.00 50.00 X 0 345916 47573 Kayichian Despina Med Affairs/Quality Officer 0.00 50.00 X 0 431758 49739 Wehtje Ronald CFO SCR 0.00 50.00 X 0 698178 36965 Milatovich Natasha Human Resource Officer SCR 0.00 50.00 X 0 379255 53855 Eskandarian Romic Pharmacy Director 55.00 0.00 X 245239 0 38206 Brown Robert Registered Nurse 50.00 0.00 X 242715 0 24511 Sustituido Roberose Registered Nurse 50.00 0.00 X 195642 0 44739 Watson Marion Director, RN 50.00 0.00 X 198599 0 41034 Kanne Claudia Reg Dir Compliance 50.00 0.00 X 195332 0 41886 Giese Jonathan Former Treas 0.00 0.00 X 0 280659 28610 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 1077527 14709917 984900 449 true true false Family Practice of Glendale Glendale Med Gp 801 S Chevy Chase 201 Glendale CA 91205 3244352 Adventist Health Physicians 2100 Douglas Blvd Roseville CA 95661 Medical Services Sound Physicians PO Box 742936 Los Angeles CA 90074 Medical Services 1880536 Faculty Physicians & Surgeon 11175 Campus St 11120 Loma Linda CA 92350 Medical Services 1791889 ShiftwiseOrigin PO Box 7080 St Paul MN 55170 Nurse Staffing 1183965 37 272740 1200912 627993 2101645 Dependent Care 624410 699943 699943 Dietary 722210 1799900 1787900 12000 Other Prog Serv Rev 900099 1912380 1912380 Patient Svc Revenue 621110 440649625 438967284 1682341 Rental Income - Prog 531120 2064596 2064596 367095 367095 447493539 1357121 1357121 5830 5830 0 0 5835 2829 3006 3006 3006 0 0 0 Chg In Fdtn/JV Net Asset 900099 994626 994626 Net Assets Rel from Rest 900099 798840 798840 Other Non-Operating Inc 900099 760047 760047 21000 12421 8579 2574513 453535654 447998037 1702920 1733052 27500 27500 0 0 0 0 0 159975438 149840449 9149483 985506 6301077 6245542 55535 22773639 21298642 1308822 166175 11383126 10877662 505464 2007736 223220 1608490 176026 884442 85632 798810 0 0 0 0 17928038 17471301 456737 924835 5523 919312 1745042 1406776 338266 654639 584537 70102 0 14980017 13460534 1519483 372538 162823 209715 0 190591 147522 43069 4833702 4833702 0 17665845 17597487 68358 344650 344650 Purchased Services 77087937 22999448 54088489 Pt Care Supplies 58106184 58036743 69441 Qual Assur Hosp Fee 57463222 57463222 Other Expenses 4569203 3213652 1355551 0 460219401 386326567 72565127 1327707 54718 -177050 31330723 63631016 467428 69921634 58058170 0 0 0 5390430 5598650 2305690 1181886 474644863 278960767 206186679 195684096 2239950 4100279 0 0 6549969 6196542 57540666 41187447 381520459 375928464 38764795 35817821 30611637 29386935 166207863 181873093 235584295 247077849 X 137974504 120565466 7648463 8004290 313197 280859 145936164 128850615 381520459 375928464 X -6683747 -10401802 X false true X true false X false false false false false false false false false false true 4261 4261 false false Part II-B, Line 1i - Other Activities Description Allocation of dues paid to industry and professional organizations. 3726115 3726115 375072078 208494646 166577432 6279111 3269653 3009458 79495228 64966422 14528806 10072331 2230046 7842285 195684096 Other Assets 5881052 Other Receivables 4320084 Receivables from Related Organizations 14102423 Receivables from Third-Party Payors 16883888 41187447 Other Liabilities 23701 Payables to Related Organizations 172349586 Workers Compensation Liability 9499806 181873093 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. true Russio-Armenia Mission Trip 163010 Travel/Supplies Cost 1 false false false false false false true true X true X 300.000000000 true X 450.000000000 true true false false true true 1980467 1980467 0.00430 165185474 120444945 44740529 0.09720 167165941 120444945 46720996 0.10150 2498447 4800 2493647 0.00540 8647308 2121386 6525922 0.01420 9051977 1412906 7639071 0.01660 169594 169594 0.00040 20367326 3539092 16828234 0.03660 187533267 123984037 63549230 0.13810 17397 17397 18508 18508 1385456 284990 1100466 0.00240 1421361 284990 1136371 0.00240 true 1699960 874120 139369875 140612767 -1242892 X true true 1 1 Adventist Health Glendale 1509 Wilson Terrace Glendale CA 91206 X X X X Acute Psychatric & Skilled Nursing false false true X X X X X X X X X 16 true true false true X X true 17 true See webb address in 7 d above true false true X 300.0000 450.0000 X X X true true X X X true 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 Focus GroupsMeetings with Community LeadersDiscussions with Area Hospitals Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment Glendale Memorial Hospital & Health CenterVerdugo Hills Hospital Part V, Line 7d - Description of Making Needs Assessment Widely Available The Community Benefit Plan for Adventist Health Glendale can be found at https://www.adventisthealth.org/pages/about-us/community-health-needs-assessments.aspx Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why The CHNA seeks to identify every health need in the community. We have prioritized those needs and matched them up with service lines that we have and developed strategies around those. The primary areas we are focused on are cardiovascular disease, stroke care and prevention, diabetes, and cancer. In other areas that were identified we do not have the resources or expertise to address those needs, so are rely on other partners in the community with expertise in those areas. GAMC Alcohol & Drug Rehab 335 Mission Road Glendale CA 91206 Alcohol & Drug Rehabilitation Services 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 combined audited 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. 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.The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL: Revenue Rec. *Medicare Cost Report Revenue $139,369,875 Prior Year Settlements 1,981,166 Cost Report Reimbursable Bad Debts 750,355 Less Amts included in Part 1, lines g & f (1,854,291) Non-Cost Report Revenue 8,913,499 Estimates and Accrual Variances 66,955 Other 8,407,228 ___________ Subtotal - Amount reported in Pt III, line 5 157,634,786 Amount included in Part 1, lines g and f 1,854,291 ___________ Total Medicare Revenue $159,489,077*Note: The Medicare Cost Report revenue does not include the bad debt reimbursement. The Cost Report revenue does include the patient co-pay and deductible amounts. Adding the bad debt reimbursement would have duplicated the revenue already accounted for in the co-pay and deductible amounts. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2 - Needs Assessment For the 2016 CHNA, three Glendale hospitalsAHGL, Glendale Memorial Hospital and Health Center, and Verdugo Hills Hospitalcollaborated, as they have in the past, to work with the Center for Nonprofit Management consulting team in conducting the CHNA. During the initial phase of the CHNA process, community input was collected during a focus group with key stakeholders, including health care professionals, government officials, social service providers, community residents, leaders, and other relevant individuals. Previous CHNAs were reviewed to identify trends. Participants completed an online questionnaire about health needs, drivers, and resources, and ranked each health need according to several criteria including severity, change over time, resources available to address the need or driver. Part VI, Line 3 - Patient Education of Eligibility for Assistance For scheduled cases, hospital staff run patients eligibility and informs patients of their benefits and financial responsibility. If a patient is insured under a government program, staff informs them about any financial responsibility they have, and ask whether the patient has further questions about their government benefits. If a patient is uninsured, staff provides education about government programs that may be available, and including appointment-setting with the on-site state Medi-Cal worker. If a patient is uninsured and unable to meet any portion of their financial responsibility, staff connects them with government programs, and if appropriate, helps them apply for AHGLs hospital assistance program. AHGL communicates to the public through the website, application form and plain language, the FAP, application form and plain language summary (PLS) are available free of charge in registration areas. Notices about financial assistance are posted in high traffic registration areas. Part VI, Line 4 - Community Information AHGL serves greater Glendale and Northeast Los Angeles including Highland Park, Glassell Park, and Eagle Rock. The area includes an medically underserved area as well as a health profession shortage area. Based on the Community Health Needs Assessment prepared in 2016, the population served (about 325,000) is 35.5% Latino, 44.7% Caucasian (including the largest population of Armenians outside of Russia/Armenia), 15.5% Asian (Korean and Filipino), 1.6% African-American, and 2.7% Other. AHGL serves a large immigrant, low-income and uninsured population whose ability to access health services is impacted by barriers such as immigration status, educational attainment, employment status and level of poverty. Overall, 54% of residents are foreign born. Approximately 21% of the households were estimated to earn below the Federal Poverty Level (FPL) which was identified as $23,850 in 2014 for a family of four and $11,670 for a family of one and almost half of the households live below an amount equal to twice the FPL. Part VI Promotion of community health. GAMC has a civic advisory board that meets quarterly to establish or maintain a dialogue with the community. The hospitals mission expresses itself as caring for the whole community by initiating many community collaborative projects, including the development of the Glendale Healthier Community Coalition (GHCC) and Glendale Healthy Kids, obtaining the California Healthy City designation for Glendale. GHCC is the vehicle GAMC uses to coordinate its efforts with the community, including Care Transition, Consortium of Safety Net Providers, and We Own the Health of Our Community. Part VI, Line 4 - Community Building Activities Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. Part VI, Line 5 - Promotion of Community Health The hospital has an operating board composed of community members who advise the president/CEO regarding the needs of the community. Based on their advice, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include cardiac, neuro, spine, cancer, emergency, outpatient services, minimally invasive surgery (robotics and no scar surgery), ortho, behavioral medicine, and rehabilitative medicine, as well as a family medicine residency program. The hospital cooperates with area physicians to offer both family medicine and obstetrics clinics. AHGL has also established a Department of Clinical Research to help our communities gain access to cutting edge clinical advancements. Part VI, Line 6 - Affilated Health Care System The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served. Part VI, Line 7 - States Filing of Community Benefit Report CA Part V - Explanation of Number of Facility Type The hospital provides outpatient services in multiple locations within its service area. true Armenian Apostolic Church 6252 Honolulu Ave La Cresenta CA 91214 952852633 501(c)(3) 7500 0 Sponsorship Armenian Bone Marrow Donor Re 1851 Tyburn St347 W Stocker Glendale CA 91202 050573780 501(c)(3) 10000 0 Sponsorship Asencia 1851 Tyburn St Glendale CA 91204 204233822 501(c)(3) 7150 0 Sponsorship GAMC Foundation 1509 Wilson Terrace Glendale CA 91206 953899682 501(c)(3) 16600 0 Sponsorship Glendale Adventist Academy 700 Kimlin Drive Glendale CA 91206 951816016 501(c)(3) 6200 0 Sponsorship Glendale Comm College Fdtn 1500 N Verdugo Road Glendale CA 91208 953876072 501(c)(3) 10000 0 Sponsorship Glendale Latino Association PO Box 806 Verdugo City CA 91046 954306673 501(c)(3) 6625 0 Sponsorship Simi Valley Hospital Fdtn 2975 N Sycamore Dr Simi Valley CA 93065 912135595 501(c)(3) 5450 0 Sponsorship Wstrn Diocese of the Armenian 3325 N Glenoaks Blvd Burbank CA 91504 956081942 501(c)(3) 10000 0 Sponsorship YMCA of Glendale 140 N Louise St Glendale CA 91206 951661118 501(c)(3) 6000 0 Sponsorship 6 4 Grantmaker's Description of How Grants are Used Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X true true X X X X false true false false false false false false false false Bourdon Irene President, Healthcare Fnd 256675 51623 37618 16356 31217 393489 Brandt-Mayo Karen Patient Care Executive 247480 51492 35513 16356 40116 390957 Brown Robert Registered Nurse 240526 2125 64 14535 9976 267226 Correa Sharon Information Officer 297217 54875 37408 16416 25933 431849 Eskandarian Romic Pharmacy Director 224471 18549 2219 14952 23254 283445 Fargo Roland Reg Physician Ops Officer 360074 76840 127042 10956 33069 607981 42716 Giese Jonathan Former Treas 250457 30202 16536 12074 309269 Kanne Claudia Reg Dir Compliance 176784 15893 2655 11776 30110 237218 Kayichian Despina Med Affairs/Quality Officer 341365 44138 46255 16356 33383 481497 Markarian Ramella Bus Dev/Phys Rel Officer 215973 43063 29977 16356 37482 342851 Milatovich Natasha Human Resource Officer SCR 274992 59594 44669 16356 37499 433110 Nahapetian Arby Medical Officer SCR 535805 114043 230961 16356 41965 939130 81073 Rebok Douglas Former Asst Sec 120028 6244 126272 120028 Reiner Scott Dir/Chair 1184750 324119 473935 16356 37529 2036689 406467 Roberts Kevin President & CEO 523489 148039 226434 16356 27397 941715 89586 Sustituido Roberose Registered Nurse 194642 1000 11164 33575 240381 Tetz Warren Asst Sec/Sr VP/ 328740 83023 116987 16572 32177 577499 92977 Wagner Jack Asst Sec 768843 221735 92680 11160 25957 1120375 Watson Marion Director, RN 184250 11440 2909 11841 29193 239633 Wehtje Rodney Former Asst Treas 158863 90564 213 23086 272726 79970 Wehtje Ronald CFO SCR 490826 90579 116773 11008 25957 735143 Wing Bill Dir/V Chair/Ass 953512 273121 233611 16356 36337 1512937 Zachary Beth Reg President & CEO 768341 221735 2541764 16426 33093 3581359 143418 Part I, Line 1a: Relevant information in regards to selections on 1a. Part I, Line 1BAny 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. Kevin Roberts Brother 161046 Employment false 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 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 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 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 General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees and the board. In addition, the hospitals administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The Corporate General Counsel reviews all the disclosures on the board and Corporate employees COIs. Corporate General Counsel retains the COIs for the board members. The officers and key employees COIs are kept in their personnel files.During the year-end audit process, the auditors review all board member COIs and a sample of the Corporate officers, key employees, and hospital CEOs COIs. If a conflict is reported on a COI, the auditors will bring it to the attention of the AVP, Audit Services for follow-up.Further inquiries on any potential significant conflicts are made as needed. Conflicts were documented and reviewed with the Board, which in turn determined the conflicts were not inappropriate for the situations identified and that the terms of the arrangements would likely not be better for the organization. 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 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 hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Other Changes In Net Assets Or Fund Balances - Other Increases Change in Value of Split-Interest Agreements = $20122 Other Changes In Net Assets Or Fund Balances - Other Decreases Net Assets Released fr Restrictions 502,621 = -$1301461 Other Changes In Net Assets Or Fund Balances - Other Increases Net Assets Released from Restr-Cap Addtn = $0 Other Changes In Net Assets Or Fund Balances - Other Increases Net Realized gains/losses on Perm Restr investments = $0 Other Changes In Net Assets Or Fund Balances - Other Increases Restricted Gifts & Grants = $951711 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfers to Affliated Organizations = -$10072174 Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 N/A true Adventist Health Clearlake Hospital Inc Avenue 18 at Highway 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Hlth Medical Ctr Tehachapi 115 W E St Techapi CA 93561 812240617 Hospital CA 501(c)(3) 11b,II Adventist Health SystemWest false Adventist Health Physicians Ntwk 2100 Douglas Blvd Roseville CA 95661 680357690 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua CA 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 Fdtn 1509 Wilson Terrace Glendale CA 91206 953899682 Fundraising for Hospital CA 501(c)(3) 11, Type 1 Adventist Health SystemWest false Hanford Community Hospital 450 Greenfield Avenue Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Lodi Memorial Hospital Association Inc 975 Fairmount Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Fdtn of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilit 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) 1 Adventist Health SystemWest false Reedley Community Hospital 372 W Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital & Health Care Svcs 2975 N Sycamore Drive Bakersfield CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Stone Point Health 2100 Douglas Blvd Roseville CA 95661 823763347 Support & Manage Hosp & Health Entities CA 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Drive 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 Avenue Los Angeles CA 90033 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 Physician Medical Terrace LP 1509 Wilson Terrace Glendale CA 91206 954277400 Med Ofc Bld CA N/A false true 0.63686 Glendale Adventist Medical Building LP 1509 Wilson Terrace Glendale CA 91206 953752800 Med Ofc Bld CA N/A false true 0.54613 Physicians Surgery Center at GAMC 1500 E Chevy Chase Dr Ste 101 Glendale CA 91206 464085815 Ambulatory Surgical Center CA N/A false true 0.58549 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA C-Corp false false false false true true false false false false true true true true true true true true true true Glendale Adventist Medical Center Fdtn l 176026 Cost Glendale Adventist Medical Center Fdtn n 23556 Cost Glendale Adventist Medical Center Fdtn o 1151681 Cost Glendale Adventist Medical Center Fdtn s 272740 Fund Transfers