2017-11-17T16:55:48-08:00 2016-12-31 990 2016-01-01 941279779 St Helena Hospital DBA St Helena Hospital Napa Valley STHE 7079633611 10 Woodland Rd St Helena CA 94574 Steven Herber President & CEO 2017-11-17 2016 2022-09-23 18:48:47Z Herber Steven 10 Woodland Road St Helena CA 94574 258124369 false false 1071 X www.adventisthealth.org/napa-valley X 1898 CA Living Gods love by inspiring health, wholeness and hope. 11 7 1641 76 107439 -134179 5627877 4893207 207328174 248492473 660259 2180557 1026721 471642 214643031 256037879 61788 21926 0 88202783 90323195 0 1121952 137810800 170028587 226075371 260373708 -11432340 -4335829 182675771 199587270 141725572 161907411 40950199 37679859 Living Gods love by inspiring health, wholeness and hope. false false 220980718 21926 248748614 St. Helena Hospital 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 St. Helena 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:a) Providing free care and/or subsidized careb) Providing care to persons covered by governmental programs at below costc) Providing health/wellness activities and community education programsNot only does St. Helena Hospital 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. St. Helena Hospital 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 2016 was $38,828,463.Inpatient services in 2016 were provided to 8,359 patients. These services included:Babies delivered - 214Surgeries performed - 2,538Radiology procedures performed - 12,140Cardiac catheterization and other procedures - 1,008Laboratory tests performed - 168,889Rehabilitation unit visits - 5,274Outpatient services in 2016 were provided to 82,929 patients. These services included:Emergency Room visits - 8,449Surgeries performed - 4,052Radiology procedures performed - 29,687Cardiac catheterization and other procedures - 1,760Laboratory tests performed - 131,071Medical clinic visits - 66,151St. Helena Hospital 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:Early Intervention ProgramHealthy Beginnings ProgramHealthvan One, Project HopeSafe Sitter classesChildren's Activity CenterHealthy Families Program Teddy Bear FairsPediatric S.A.R.T. (Sexual Assault Response Team) ProgramLearning-For-Life CentersSensory Integration Summer CampAsthma CampPhoneFriendGirls Today, Women TomorrowPASS (Parents for Alternate Support Solutions)Partners for PreventionParish NursingHealth FairsBlood Pressure Clinics 220980718 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 false true 335 0 true 1641 true true true false false false false false false 0 false false false false false false false false false false X 11 7 false false false false true false true true true false false true true true true true true true true false X Edward McDonald 7075712888 10 Woodland Rd St Helena CA 94574 X Dickinson Charles Director 0.00 4.00 X 0 217464 54172 Freedman John Director 0.00 4.00 X 0 300 0 Friestad Christine Director 0.00 4.00 X 0 968 0 Gabriel Melody Director 0.00 4.00 X 0 2269 0 Graham Ricardo Director 0.00 4.00 X 0 4246 0 Heinrich Kerry Director 0.00 4.00 X 0 683 0 Innocent Larry Director 0.00 4.00 X 0 1503 0 Reimche Allan Director 0.00 4.00 X 0 4407 0 Rippey Wesley Director 0.00 4.00 X 0 129770 0 Salazar Velino Director 0.00 4.00 X 0 3915 0 Torkelsen Max Director 0.00 4.00 X 0 4102 0 Reiner Scott Dir/Chair 0.00 50.00 X X 0 1711534 286273 Wing Bill Dir/VCh/AsstSec 0.00 50.00 X X 0 1319055 238355 Jobe Meredith Secretary 0.00 50.00 X 0 552085 99823 Wagner Jack Asst Secretary 0.00 50.00 X 0 1117705 41826 Herber Steven President/CEO 50.00 0.00 X 0 464565 99372 Parker Brandon Treas/Asst Sec 50.00 0.00 X 0 249228 38994 McDonald Edward Asst Sec/IntCFO 50.00 0.00 X 0 412999 150378 Lonto Robert VP HR NCR 0.00 50.00 X 0 244632 51397 Cowan Joshua VP Marketing/Corp Dev NCR 0.00 50.00 X 0 295839 78487 Lendaris Antonia SH Reg CNO 50.00 0.00 X 0 239740 35707 Williams Patricia Sr VP PopHlth/BehvMed 50.00 0.00 X 0 172554 31999 Kulas Paul VP Phys Svcs/CMG 50.00 0.00 X 0 278820 53296 Lundin Stephen CDO 50.00 0.00 X 274469 0 43666 Mann Jeremy CMO Ambulatory Care 50.00 0.00 X 302756 0 44716 Eller Jeff President NCR 0.00 50.00 X 0 832743 161295 Reppert Joseph Reg SVP Fin NCR 0.00 50.00 X 0 253911 11913 Chilton Harold SVP/COO SHNV CBH 50.00 0.00 X 0 473834 91410 Nonescan Cindy RN 40.00 0.00 X 236506 0 55934 Kirk Richard NP 55.00 0.00 X 308403 0 37470 McCarthy Terry Pharmacy Manager 40.00 0.00 X 230702 0 29435 Hasso Ruth RN 50.00 0.00 X 241942 0 38023 Barnes Geoffrey Lab Manager 50.00 0.00 X 237668 0 32718 Carmen Robert Former Dir/Chair 0.00 0.00 X 0 358716 7952 Wehtje Rodney Former Asst Treasurer 0.00 0.00 X 0 388431 41835 1832446 9736018 1856446 251 true true false Patient Access Medical Group PO Box 742528 Dallas TX 75374 Physician Services 1080000 PC Bhaisaja 22 Hillcrest St Helens CA 94574 Physician Services 914807 Allen Creative Group 22 West Street Ste1 Millbury MA 01527 Advertising/Design 908281 D&Y PO Box 635715 Cincinnati OH 45263 Physician Services 717938 Horizon Health PO Box 840839 Dallas TX 75284 Physician Services 650652 56 4893207 4893207 Dietary 722210 872382 872382 EMR Incentives 621110 -185014 -185014 Other Revenue 900099 343441 343441 Patient Service Revenue 621110 246414013 246414013 Rental Income 531120 1047651 1047651 248492473 103220 103220 0 0 0 2077337 2077337 2077337 2077337 0 0 2301991 2086490 215501 107439 108062 Community services 221000 48281 48281 Other revenue 900099 207860 207860 256141 256037879 248748614 107439 2288619 21926 21926 0 0 0 665607 0 70885992 63590081 6572892 723019 2732077 2732077 11390151 9565722 1702399 122030 4649368 4127470 474069 47829 0 548761 546529 2232 6302 6302 0 0 0 25170654 24142692 952762 75200 3222309 3174614 47695 2296688 1257949 1010112 28627 8771858 8729584 11636 30638 0 3075586 2935794 138986 806 252131 83407 161092 7632 0 57650 46256 7888 3506 4662850 4662850 0 9570858 9543459 27295 104 525713 525713 Purchased services 50515551 27931099 22553924 30528 Patient care supplies 41251888 41251888 Qlty assurance (hospital) fee 9895495 9895495 Other 8990565 8747497 242750 318 1213728 1189759 22181 1788 260373708 220980718 37605431 1121952 327228 165125 1123063 2123063 0 35397579 34500200 0 0 0 4286564 4656687 1648713 1343869 230045924 138143472 94962778 91902452 1995797 4350896 0 0 0 42934049 60544978 182675771 199587270 16500843 21000156 798223 572809 124426506 140334446 141725572 161907411 X 3407258 -1300898 35287275 35130124 2255666 3850633 40950199 37679859 182675771 199587270 X -4335829 399882 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 11826 11826 false false Part II-B, Line 1i - Other Activities Description The hospital is a member of industry associations. A portion of the membership dues is used for lobbying purposes. 11794102 3901050 18350 3458159 12255343 10554992 5424873 -228210 3957553 11794102 9066916 3282190 -4891 1789223 10554992 9434793 4304601 373738 5046216 9066916 7606949 4272247 -559442 1881883 3078 9434793 0.07000 0.93000 true false false 426637 426637 142484693 76639603 65845090 19935396 9810350 10125046 59764210 51693519 8070691 7434988 7434988 91902452 Interest in Consolidated Org 27407946 Other Receivables 2174294 Receivables from Related Organization 28086619 Receivables from Third Party Payors 2876119 60544978 Other Liabilities 618438 Payables to Related Organizations 131879171 Payables to third party payors 3760360 Workers Comp Liability 4076477 140334446 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporarily, and permanently restricted endowment 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 1599840 1599840 0.00610 49393599 53435357 8387 279 8108 51001826 53435636 1607948 0.00610 103021 103021 0.00040 4568667 4568667 0.01750 57942 57942 0.00020 4729630 4729630 0.01810 55731456 53435636 6337578 0.02420 687 687 9325 9325 241192 241192 0.00090 5000 5000 256204 256204 0.00090 true 719005 57520 92863260 92497526 365734 X true true 2 1 St Helena Hospital 10 Woodland Road St Helena CA 94574 X X X A 2 SHH Ctr for Behavioral Health 525 Oregon Street Vallejo CA 94590 X Acute Psychiatric Hospital A A 12 false false true X X X X X X X X 16 true true false true X See Sch H Part VI-Supplemental Info X See Sch H Part VI-Supplemental Info X true 14 true See Sch H Part VI-Supplemental Info false false true X 200.0000 400.0000 X X X X true true X X X true X See Sch H Part VI-Supplemental Info X See Sch H Part VI-Supplemental Info X See Sch H Part VI-Supplemental Info 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 process used a mixed-methods approach to collect and compile data to provide a robust assessment of health in Napa County. A broad lens in qualitative and quantitative data allowed for the consideration of many potential health needs as well as in-depth analysis. Data sources included:1. Analysis of over 150 health indicators from publicly available data sources such as the California Health Interview Survey, American Community Survey, and the California HealthyKids Survey. Secondary data were organized by a framework developed from KaiserPermanentes list of potential health needs, and expanded to include a broad list of needsrelevant to Napa County.2. Interviews were conducted with 18 key informants from the local public health department, aswell as leaders, representatives, and members of medically underserved, low-income, minoritypopulations, and those with a chronic disease. Other individuals from various sectors withexpertise in local health needs were also consulted.3. Four focus groups were conducted in English and Spanish, reaching 47 residents, representingpopulations identified as having worse health outcomes or at risk for worse health outcomes. Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs Assessment While conducting the 2016 Community Health Needs Assessment we solicited feedback and input from a broad range of stakeholders. Contributors to the process included a partnership with: Kaiser Permanente and St. Joseph Health Queen of the Valley Medical Center. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why The following areas of need were not addressed in our hospital's Community Health Improvement Plan: Develop approaches to address disparities identified throughout our needs assessment. Increase access to fresh, healthy foods, especially in schools.St. Helena Hospital Napa Valley set community benefit goals to address areas of need that could best benefit from our capabilities and resources. We are working with the LHNC collaborative to develop a countywide Community Health Improvement Plan that will address all identified priority areas of need. This plan will be completed in early 2014. St Helena Physical Therapy 1030 Main Street Ste 100 St Helena CA 94574 Outpatient Clinic Heart & Vascular Institute 6 Woodland Road Suite 304 St Helena CA 94574 Outpatient Clinic St Helena Coon Joint Replacement Institute 6 Woodland Rd Ste 202 St Helena CA 94574 Outpatient 1206(d) Clinic St Helena Regional Therapy Services 18990 Coyote Valley Rd Stes 9 10 Hidden Valley Lake CA 95467 Outpatient Clinic St Helena Womens Center 821 South St Helena Highway Suite 1 St Helena CA 94574 Outpatient Clinic St Helena Medical Specialties OBGYN 935 Trancas St Ste 4B Napa CA 94558 Outpatient Clinic St Helena Med Specialties - Nephrology 3273 Claremont Way Suite 201 Napa CA 94558 Outpatient Clinic St Helena Med Specialties - Psychiatry 913 Washington Street Calistoga CA 94515 Rural Health Clinic St Helena Med Specialties - Urology 18990 Coyote Valley Road Suite 8 Hidden Valley Lake CA 95467 Rural Health Clinic St Helena Med Specialties - Neurology 821 S St Helena Hwy Suite 2 St Helena CA 94574 Outpatient Clinic St Helena Ear Nose Throat 18990 Coyote Valley Road Suite 8 Hidden Valley Lake CA 95467 Rural Health Clinic St Helena Cardiac Rehabilitation 999 Adams Street St Helena CA 94574 Outpatient Clinic St Helena Med Specialties-Napa-Neurology 18990 Coyote Valley Road Suite 8 Hidden Valley Lake CA 95467 Rural Health Clinic Hidden Valley - Internal Medicine 18990 Coyote Valley Road Suite 10 Hidden Valley Lake CA 95467 Rural Health Clinic St Helena Med Specialties - Plastic Surgery 6 Woodland Road Suite 302 St Helena CA 94574 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 combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income/Gross patient chargesThe hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of Californias regulations and policies and the approval of the federal government. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense 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 too many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals.Reconciliation of Medicare Revenue from the hospital's Medicare Cost Report to GL*Medicare Cost Report Revenue $82,964,761Prior Year Settlements -Cost Report Reimbursable Bad Debts 454,499Estimates and Accrual Variances 529,908Other 8,914,092Subtotal - Amount reported in Pt. III, line 5 $92,863,260Amounts included in Part 1, lines g and f -Total Medicare Revenue $92,863,260*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 - Needs Assessment We have utilized the data from outside research firms to asses any changes in the market and community perception. This is collected through multiple channels such as phone surveys, paper surveys, and focus groups. We also attend many symposiums of such research companies that reveal key findings within those channels. These surveys are done to help us assess the impact of our community benefit activities and healthcare access barriers for the residents in the communities we serve. The unmet community needs is also revealed in the survey findings allowing us to alter our initiatives to include ways to meet those needs.In 2016, LHNC embarked on a collaborative process to conduct a comprehensive Community Health Assessment that aims to establish the foundation for sustainable improvements in health in Napa County. As part of the comprehensive assessment LHNC conducted three community assessmentsThe CHNA includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and analysis of data, including input from community stakeholders that is used to inform the development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health.In addition to needs assessment, we have utilized the data from outside research firms to asses any changes in the market and community perception. This is collected through multiple channels such as phone surveys, paper surveys, and focus groups. We also attend many symposiums of such research companies that reveal key findings within those channels. These surveys are done to help us assess the impact of our community benefit activities and healthcare access barriers for the residents in the communities we serve. The unmet community needs is also revealed in the survey findings allowing us to alter our initiatives to include ways to meet those needs. Implementation of the Affordable Care Acts Health Benefit Exchange Board. As of March 1, 2014, 5,496 people in Napa County and 9,879 in Solano County were enrolled in health care benefits purchased through Covered California, the States official Health Benefit Exchange Board. Covered California improved access to healthcare services to Napa and Solanos uninsured and underinsured populations, and brought relief to many families who struggle to afford health insurance. However, SHNVs experience with the first Covered California open enrollment period was that it was plagued with significant confusion over whom was eligible, how to enroll, and what physicians and services were covered under which plan. In response to the challenges faced in the 2013-2014 enrollment, SHNV became a Certified Enrollment Entity with Covered California. We now have seven trained Enrollment Counselors trained and available to provide one-on-one enrollment assistance for both Covered California and Medi-Cal benefits. Access will be a major area of focus in 2017 for our Community Benefit programming.Implementation and Evaluation of the Live Healthy Napa County 2014-2017 Community Health Plan. Live Healthy Napa County (LHNC) is a coalition of over 50 non-profits with common missions of improving health and wellbeing in Napa County. In order to ensure our collective activities are adequately addressing the needs identified in our 2016 Community Health Plan, we engaged an external evaluator who will report findings in early 2017. The implementation of the LHNC Community Health Plan brought forth several new opportunities to support our community that were not in our original Community Benefit Plan. Copies of the hospital's 2016 CHNA study and the 2015 Community Health Plan Update are posted on the hospital's website, https://www.adventisthealth.org/napa-valley/pages/about-us/community.aspx, as well as on the Adventist Health Corporate website, https://www.adventisthealth.org/Pages/About-Us/Community-Health-Needs-Assessments.aspx Part VI - Patient Education of Eligibility for Assistance Patients at St. Helena Napa Valley and St. Helena Hospital Center for Behavioral Health who are uninsured or underinsured are provided with information about government healthcare programs at the time of registration. In addition to that, patients are also orally informed of their right to request assistance. There also signs throughout the hospital, in multiple languages informing patients of their rights as a patient in our facility. To explain the billing and collection procedures, patients are given a brochure at the time of registration. Every billing statement sent out to our patients also includes instructions on how to request financial assistance. The hospital charity assistance policy is posted on the hospital website to be easily accessible to patients as well. Patient financial advisors are also readily available to speak with patients should they have any further questions. The Financial Assistance Policy (FAP) is being posted and summarized and the FAP Application is made widely available on the hospital's website, at: https://www.adventisthealth.org/napa-valley/pages/patients-and-visitors/pay-bill.aspx Part VI - Community Information Our hospital facilities primarily serve the people of Napa, Lake, and Solano counties in California. The demographics of the communities we serve are a wide scope, all across the board, including urban, suburban, and rural and patients of all income levels. Not only do we serve individuals locally, we also have become a destination hospital through our specialized medicine programs. Part VI - 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 - Explanation Of How Organization Furthers Its Exempt Purpose 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; and3) 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.Our mission as a health system is to live Gods love by inspiring health, wholeness and hope. We believe the best way to re-imagine our future business model with a major emphasis of community health is by working together with our community. Part VI - Affilated Health Care System Roles and Promotion The hospital is part of the the Adventist Health System. of Adventist Health, a faith-based, not-for-profit, integrated health care delivery system headquartered in Roseville, California. We provide compassionate care in communities throughout California, Hawaii, Oregon and Washington.Adventist Health entities include:19 hospitals with more than 2,700 bedsMore than 235 clinics and outpatient centers14 home care agencies and 7 hospice agenciesFour joint-venture retirement centers Workforce of 28,600 includes more than 20,500 employees; 4,500 medical staff physicians; and 3,600 volunteers Part VI - States Where Community Benefit Report Filed CA true CA Hlth Fnd & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 21926 0 Hlth srvs uninsured/underinsured pt 1 0 X X X X true true false false false false false false false false Barnes Geoffrey Lab Manager 237668 14436 18282 270386 Carmen Robert Former Dir/Chair 358716 7952 366668 358716 Chilton Harold SVP/COO SHNV CBH 342319 87810 43705 68378 23032 565244 Cowan Joshua VP Marketing/Corp Dev NCR 229903 60524 5412 45135 33352 374326 Dickinson Charles Director 184932 32532 37740 16432 271636 Eller Jeff President NCR 584311 130384 118048 132539 28756 994038 80834 Hasso Ruth RN 240197 1745 12055 25968 279965 Herber Steven President/CEO 355340 41006 68219 71230 28142 563937 36513 Jobe Meredith Secretary 364469 95028 92588 74172 25651 651908 56774 Kirk Richard NP 296005 300 12098 12180 25290 345873 Kulas Paul VP Phys Svcs/CMG 226353 38553 13914 16180 37116 332116 Lendaris Antonia SH Reg CNO 210898 17264 11578 25750 9957 275447 Lonto Robert VP HR NCR 199066 33532 12034 14803 36594 296029 Lundin Stephen CDO 236407 38062 16180 27486 318135 Mann Jeremy CMO Ambulatory Care 258197 43575 984 16180 28536 347472 McCarthy Terry Pharmacy Manager 230702 14161 15274 260137 McDonald Edward Asst Sec/IntCFO 318804 52000 42195 120001 30377 563377 31362 Nonescan Cindy RN 235806 700 14571 41363 292440 Parker Brandon Treas/Asst Sec 228720 20508 10206 28788 288222 Reiner Scott Dir/Chair 1018912 299575 393047 249575 36698 1997807 326648 Reppert Joseph Reg SVP Fin NCR 153509 90000 10402 11913 265824 Wagner Jack Asst Secretary 698200 200386 219119 16384 25442 1159531 Wehtje Rodney Former Asst Treasurer 380418 8013 16393 25442 430266 Williams Patricia Sr VP PopHlth/BehvMed 127737 17596 27221 15214 16785 204553 12317 Wing Bill Dir/VCh/AsstSec 855884 253689 209482 203961 34394 1557410 155912 Timothy Herber Officer Child 32487 Employment false Maria Lendaris Officer Child 271 Employment false Tammy McDonald Officer Wife 500 Cookie sales 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 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 The hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.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 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 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 publicly available. The hospital files monthly/quarterly summary financial reports with the state health planning agency. Other Changes In Net Assets Or Fund Balances - Other Increases Change in interest - Foundation = $976575 Other Changes In Net Assets Or Fund Balances - Other Increases Change in value of split interest agreements = $18350 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfer to related organization = -$595043 Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and manage system-wide activities CA 501(c)(3) 1 NA false St Helena Hospital Foundation 10 Woodland Rd St Helena CA 94574 201384250 Fundraising and Investment Management CA 501(c)(3) 11a, I NA 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 NW Medical Foundation of Tillamook 1000 Third St 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 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 Adventist Health Clearlake Hospital Inc Ave 18 at Hwy 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 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 Cesare 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 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 Health Med Ctr Tehachapi 115 W E Street 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 false true true false false false true true true true true true true true true false false