2017-11-15T15:46:23-06:00 2016-12-31 990 2016-01-01 953858272 LOMA LINDA MERCANTILE LOMA 9095585199 PO BOX 2000 FINANCE LOMA LINDA CA 92354 ANGELA M LALAS CFO 9095585199 2017-11-15 143.197.222.231 2017-11-15 15:42:10 PS P 7BBEDEB7931097FB0C15E38BA4E642E6A6FB6782 7BBEDEB7931097FB0C15E38BA4E642E6A6FB6782 2016 2017-02-10 21:41:12Z KEVIN J LANG 11175 CAMPUS ST CSP 11006 LOMA LINDA CA 92354 131767624 0 1071 X N/A X 1983 CA PURCHASING & DISTRIBUTION OF EQUIPMENT AND MEDICAL SUPPLIES FOR LOMALINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER ORGANIZATIONS. 4 0 0 0 0 0 0 0 0 0 0 0 2436634 2805101 2436634 2805101 0 0 0 0 0 0 0 0 0 2436634 2805101 2436634 2805101 0 0 6836504 3218759 6836504 3218759 0 0 PURCHASING & DISTRIBUTION OF EQUIPMENT AND MEDICAL SUPPLIES FOR LOMALINDA UNIVERSITY HEALTH ORGANIZATIONS. 0 0 2021360 2805101 PURCHASING & DISTRIBUTION OF EQUIPMENT AND MEDICAL SUPPLIES FOR LOMALINDA UNIVERSITY HEALTH ORGANIZATIONS. 2021360 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 83 0 1 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X KEVIN J LANG CFO 9095585199 11175 CAMPUS ST CSP 11006 LOMA LINDA CA 92354 X HADLEY HENRY ROGER TRUSTEE 0.50 49.50 X 0 465902 54554 HART RICHARD HENRY TRUSTEE 0.50 49.50 X 0 474832 51589 HEINRICH KERRY L TRUSTEE 0.50 49.50 X 0 1524103 0 LANG KEVIN J PRESIDENT 0.50 49.50 X X 0 1017015 67589 HANNAMYRNA LEE SECRETARY AS OF 04/14/16 0.50 49.50 X 0 159691 29065 BULL BRIAN SECRETARY THROUGH 04/14/16 0.50 X 0 0 0 0 3641543 202797 0 0 1 0 0 131767624 128962523 2805101 2805101 2805101 2805101 0 0 51294 37135 14159 156760 123343 33417 1000 708 292 17838 13148 4690 LEASED EMPLOYEES 2021737 1452819 568918 DUES & SUBSCRIPTIONS 272121 192613 79508 PURCHASED SERVICES 211914 150235 61679 72437 51359 21078 2805101 2021360 783741 0 3182532 -3188 3653972 3221947 987328 987328 0 0 6836504 3218759 6836504 3218759 6836504 3218759 X 0 0 6836504 3218759 0 0 X X 0 1 X 1 0 X 987328 987328 0 0 1 1 0 0 0 0 1 0 0 HADLEY HENRY ROGER TRUSTEE 0 367571 0 0 0 98331 0 30362 0 24192 0 520456 0 0 HART RICHARD HENRY TRUSTEE 0 391000 0 0 0 83832 0 30466 0 21123 0 526421 0 0 HEINRICH KERRY L TRUSTEE 0 1524103 0 0 0 0 0 0 0 0 0 1524103 0 0 LANG KEVIN J PRESIDENT 0 637000 0 86660 0 293355 0 38338 0 29251 0 1084604 0 0 HANNAMYRNA LEE SECRETARY AS OF 04/14/16 0 124575 0 14900 0 20216 0 17185 0 11880 0 188756 0 0 PART I, LINE 3 PLEASE SEE EXPLANATION FOR PART VI, SECTION B, LINE 15 THAT IS LISTED UNDER SCHEDULE O. PART I, LINES 4A-B THE FOLLOWING LLUH EMPLOYEES PARTICIPATED IN, AND RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: HADLEY, HENRY ROGER $58,173 NET FLEX PLAN CREDITS PAID TO EMPLOYEE IN CASH. $483 TRAVEL FOR COMPANIONS. $6,658 TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. HART, RICHARD HENRY $60,725 NET FLEX PLAN CREDITS PAID TO EMPLOYEE IN CASH. $4,678 TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. LANG, KEVIN J $3,356 EMPLOYER CONTRIBUTIONS/PAYMENTS FOR ELECTIVE BENEFITS (INCLUDES VESTED AND FORFEITED BENEFITS FUNDED IN PRIOR YEARS). $119,514 NET FLEX PLAN CREDITS PAID TO EMPLOYEE IN CASH. $132,369 SERP FUNDING PAID TO EMPLOYEE IN CASH. $634 TRAVEL FOR COMPANIONS. $6,245 TAX INDEMNIFICATION AND GROSS-UP PAYMENTS. PART I, LINE 6 LOMA LINDA UNIVERSITY MEDICAL CENTER A RELATED ORGANIZATION TO LOMA LINDA MERCANTILE HAS AN INCENTIVE PLAN. PAYMENTS FOR INCENTIVE AWARDS ARE TRIGGERED ONLY IF, AMONG OTHER ESTABLISHED CRITERIA, NET INCOME EXCEEDS BUDGET BY AN ESTABLISHED PERCENTAGE. DISCLOSURE ON SCHEDULE J PART III THE OFFICERS LISTED ON THE FORM 990, PART VII, LINE 1A OR ON SCHEDULE J, PART II ARE EMPLOYED BY LLUH. LLUH PAYS THE COMPENSATION FOR THE OFFICERS LISTED AND REPORTS THE COMPENSATION AMOUNTS IN THE FORMS W-2 FOR EACH OFFICER. AMOUNTS REPORTED ON THE FORM 990, PART VII, LINE 1A, COLUMS E AND F, OR ON SCHEDULE J, PART II, COLUMN E(II) REPRESENT TOTAL AMOUNTS OF COMPENSATION RECEIVED BY EACH OFFICER FROM LLUH. THE OFFICERS DO NOT RECEIVE ANY OTHER COMPENSATION AMOUNTS FROM RELATED ORGANIZATIONS. LLUH ALLOCATES THE COMPENSATION AMOUNTS TO THE APPLICABLE ORGANIZATIONS AND RECEIVES REIMBURSEMENT PAYMENTS. ALLOCATION PERCENTAGES OF THE COMPENSATION PAYMENTS FOR THE OFFICERS ARE AS FOLLOWS: HADLEY, HENRY ROGER COMPENSATION: $50,000 FUNDED BY LOMA LINDA UNIVERSITY HEALTH CARE (LLUHC) PRIVATE PRACTICE COMPENSATION: FUNDED BY LOMA LINDA UNIVERSITY UROLOGY GROUP AND THE DEPARTMENT OF VETERAN AFFAIRS COMPENSATION IN EXCESS OF THE $50,000 FUNDED BY LLUHC AND THE PRIVATE PRACTICE COMPENSATION: 100% FUNDED BY LLU HART, RICHARD HENRY COMPENSATION, EXCLUDING SERP BENEFIT: 50% FUNDED BY LLU AND 50% FUNDED BY LLUMC SERP BENEFIT: 100% FUNDED BY LLUMC LANG, KEVIN J. COMPENSATION, EXCLUDING INCENTIVE AND SERP BENEFIT: 70% FUNDED BY LLUMC, 17.5% FUNDED BY LLU, 7.5% FUNDED BY LLUHC, AND 5% FUNDED BY LLUBMC SERP BENEFIT: 92.5% FUNDED BY LLUMC AND 7.5% FUNDED BY LLUHC. INCENTIVE BENEFIT: 100% FUNDED BY LLUMC FORM 990, PART VI, SECTION A, LINE 6 THERE SHALL BE A SINGLE CLASS OF MEMBERS OF LOMA LINDA MERCANTILE (LLM) WHICH SHALL BE LOMA LINDA UNIVERSITY HEALTH (LLUH) ACTING BY AND THROUGH ITS BOARD. MEMBERSHIP IN THIS CORPORATION SHALL TERMINATE WHEN AN INDIVIDUAL CEASES, FOR WHATEVER REASON, TO BE A MEMBER OF THE LLUH BOARD. NO MEMBER SHALL HAVE ANY RIGHT OR INTEREST IN ANY OF THE PROPERTY OR ASSETS OF LLM. NO MEMBER SHALL TRANSFER FOR VALUE OR OTHERWISE A MEMBERSHIP OR ANY RIGHT ARISING THEREFROM. FORM 990, PART VI, SECTION A, LINE 7A LLUH, AS THE CORPORATE MEMBER, ELECTS THE BOARD OF TRUSTEES AT ITS QUINQUENNIAL MEETING. LLUH SHALL ALSO HAVE THE POWER TO FILL VACANCIES ON THE BOARD OF TRUSTEES BETWEEN THE QUINQUENNIAL ORGANIZATION MEETINGS. FORM 990, PART VI, SECTION A, LINE 7B THE POWERS RESERVED BY LLUH, WHICH SHALL ONLY BE EXERCISED BY THE LLUH BOARD UPON A MAJORITY VOTE OF LLUH'S TRUSTEES PRESENT AND VOTING AT A REGULAR OR SPECIAL MEETING WHENEVER A QUORUM IS PRESENT, ARE TO: 1 APPROVE OR RATIFY ALL CHANGES TO THE ARTICLES OF INCORPORATION OR BYLAWS OF LLM. 2 ESTABLISH GUIDELINES FOR BORROWING OF FUNDS BY LLM. 3 APPROVE ANY MERGER, CONSOLIDATION, DISSOLUTION, SALE, OR TRANSFER OF MORE THAN TEN MILLION DOLLARS OF LLM. 4 APPROVE ANY EXCEPTIONS TO THE GUIDELINES FOR THE BORROWING OF FUNDS REQUESTED BY LLM'S BOARD. 5 REQUIRE THAT LLM ESTABLISH CONTRACTING GUIDELINES. 6 REQUIRE THAT LLM HAVE A COMPLIANCE PROGRAM. FORM 990, PART VI, SECTION B, LINE 11B THIS FORM 990 HAS BEEN REVIEWED BY INTERNAL AUDIT AND MANAGEMENT AND IS MADE AVAILABLE TO THE AUDIT COMMITTEE AND THE BOARD FOR REVIEW AND COMMENT BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C GENERAL COUNSEL ANNUALLY OBTAINS STATEMENTS OF DISCLOSURE FROM TRUSTEES, OFFICERS, ADMINISTRATORS, KEY EMPLOYEES, AND OTHERS WHO MAKE OR AFFECT SIGNIFICANT DECISIONS AND REVIEWS THE FINDINGS WITH APPROPRIATE BOARDS AND COMMITTEES. THE BOARD OF TRUSTEES MAKES THE DECISIONS REGARDING QUESTIONS WHICH HAVE NOT BEEN SATISFACTORILY ANSWERED AFTER ADMINISTRATIVE CONSIDERATION. FORM 990, PART VI, SECTION B, LINE 15 LLUH, LOMA LINDA MERCANTILE'S PARENT ORGANIZATION, EMPLOYS AN INDEPENDENT OUTSIDE CONSULTING FIRM TO BENCHMARK COMPENSATION FOR LLUH EMPLOYEES. LOMA LINDA MERCANTILE'S CEO AND CFO ARE EMPLOYED BY LLUH. THE LLUH EXECUTIVE COMPENSATION COMMITTEE USES THE RESULTS OF THE INDEPENDENT SURVEY TO ESTABLISH PAY SCALES FOR THE NEXT FISCAL YEAR. THE EXECUTIVE COMPENSATION COMMITTEE SETS THE TOTAL COMPENSATION BELOW THE INDUSTRY MEAN AND MEDIAN AMOUNTS PROVIDED IN THE SURVEY. THE EXECUTIVE COMPENSATION COMMITTEE IS COMPOSED OF TRUSTEES APPOINTED BY THE LLUH BOARD WHO ARE INDEPENDENT OF LLUH'S MANAGEMENT. THE EXECUTIVE COMPENSATION COMMITTEE IS APPOINTED BY THE LLUH BOARD OF TRUSTEES TO HAVE DIRECT RESPONSIBILITY FOR ESTABLISHING COMPENSATION, POLICIES, AND BENEFITS FOR THE SENIOR EXECUTIVES OF LLUH. THE COMMITTEE'S PROCESS INCLUDES CONTEMPORANEOUS SUBSTANTIATION OF DELIBERATIONS AND DECISIONS. THIS PROCESS WAS LAST UNDERTAKEN IN DECEMBER OF 2015 FOR THE POSITION OF PRESIDENT, LLUH HELD BY HART, RICHARD HENRY. THIS PROCESS WAS LAST UNDERTAKEN IN DECEMBER OF 2015 FOR THE POSITION OF EVP, FINANCE & ADMINISTRATION, LLUH HELD BY LANG, KEVIN J.. THIS PROCESS WAS LAST UNDERTAKEN IN DECEMBER OF 2015 FOR THE POSITION OF EVP LLUH, CEO UHS, DEAN SCHOOL OF MEDICINE HELD BY HADLEY, HENRY R.. FORM 990, PART VI, SECTION C, LINE 18 THE IRS FORM 990 IS AVAILABLE ON THE GUIDESTAR.COM WEBSITE AND ALSO MAY BE OBTAINED BY MAKING A REQUEST TO THE CFO AT 11234 ANDERSON ST., LOMA LINDA, CA 92354. FORM 990, PART VI, SECTION C, LINE 19 LOMA LINDA MERCANTILE WILL MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AND IN ACCORDANCE WITH IRS GUIDELINES. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE FOR EMPLOYEES. THE FINANCIAL STATEMENTS ARE INCLUDED IN THE IRS FORM 990 WHICH IS AVAILABLE TO THE PUBLIC ON THE GUIDESTAR WEBSITE. FORM 990, PART VII, LINE 1A: FOR EMPLOYEES OF LLUH OR LLUH AFFILIATES (ORGANIZATION(S)) RELATED TO THE FILING ORGANIZATION WHO DEVOTE LESS THAN FULL-TIME TO THE FILING ORGANIZATION (BASED UPON THE AVERAGE NUMBER OF HOURS PER WEEK SHOWN IN PART VII, SECTION A, COLUMN (B) OF THE RETURN) THE COMPENSATION AMOUNTS SHOWN IN COLUMNS (E) AND (F) WERE PROVIDED IN CONJUNCTION WITH THEIR RESPONSIBILITIES AND ROLES IN OTHER POSITIONS FOR ORGANIZATIONS RELATED TO THE FILING ORGANIZATION. THESE INDIVIDUALS EACH DEVOTE APPROXIMATELY 50 HOURS PER WEEK SERVING IN THEIR RESPECTIVE POSITIONS WITHIN THE ORGANIZATION. FORM 990, PART XII, LINE 2B: THE FINANCIAL STATEMENTS OF LOMA LINDA MERCANTILE WERE AUDITED BY AN INDEPENDENT FIRM AS PART OF THE 2016 COMBINED FINANCIAL STATEMENT AUDIT OF LOMA LINDA UNIVERSITY MEDICAL CENTER AND ITS AFFILIATES (WHICH ENCOMPASSES LOMA LINDA UNIVERSITY MEDICAL CENTER, LOMA LINDA MERCANTILE, LOMA LINDA UNIVERSITY MEDICAL ENTERPRISES, LOMA LINDA UNIVERSITY FACULTY PHARMACY, LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL, LOMA LINDA UNIVERSITY BEHAVIORAL MEDICAL CENTER, THE LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL FOUNDATION, LOMA LINDA UNIVERSITY HEALTHCARE PROPERTIES, LLC, AND LOMA LINDA UNIVERSITY MEDICAL CENTER-MURRIETA). FORM 990, PART XII, LINE 2C: DUE TO THE FACT THAT LOMA LINDA MERCANTILE'S FINANCIAL STATEMENTS ARE AUDITED AS PART OF THE COMBINED FINANCIAL STATEMENT AUDIT FOR LOMA LINDA UNIVERSITY MEDICAL CENTER AND ITS AFFILIATES, LLUMC'S FINANCE AND AUDIT COMMITTEES OF THE BOARD OF TRUSTEES ALSO ASSUME RESPONSIBILITY FOR OVERSIGHT OF LOMA LINDA MERCANTILE'S FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT FIRM. GENERAL CONFERENCE OF SEVENTH-DAY ADVENTISTS 12501 OLD COLUMBIA PIKE SILVER SPRING MD 20904 520643036 CHURCH CA 501(C)(3) 1 N/A 0 LOMA LINDA UNIVERSITY HEALTH 11175 CAMPUS ST LOMA LINDA CA 92354 953804495 PARENT COMPANY CA 501(C)(3) 1 N/A 0 LOMA LINDA UNIVERSITY 11145 ANDERSON ST LOMA LINDA CA 92350 951816009 UNIVERSITY CA 501(C)(3) 2 N/A 0 LOMA LINDA MERCANTILE PO BOX 2000 LOMA LINDA CA 92354 953858272 PURCHASING COMPANY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY MEDICAL CENTER 0 LOMA LINDA UNIVERSITY BEHAVIORAL MEDICINE CENTER 1710 BARTON RD REDLANDS CA 92373 330245579 PSYCHIATRIC HOSPITAL CA 501(C)(3) 3 LOMA LINDA UNIVERSITY MEDICAL CENTER 0 LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL FOUNDATION PO BOX 2000 LOMA LINDA CA 92354 330565591 FOUNDATION CA 501(C)(3) 11A LOMA LINDA UNIVERSITY MEDICAL CENTER 0 LOMA LINDA UNIVERSITY HEALTH CARE 11175 CAMPUS ST LOMA LINDA CA 92354 330364239 HEALTHCARE MANAGEMENT SERVICE ORGANIZATION CA 501(C)(3) 11A N/A 0 LOMA LINDA UNIVERSITY MEDICAL ENTERPRISES 11234 ANDERSON ST LOMA LINDA CA 92354 330873998 OUTPATIENT PHARMACY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY MEDICAL CENTER 0 LOMA LINDA UNIVERSITY FACULTY PHARMACY 11234 ANDERSON ST LOMA LINDA CA 92354 202834636 OUTPATIENT PHARMACY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY MEDICAL CENTER 0 NATIONAL MEDICAL TECHNOLOGY TESTBED 11175 CAMPUS ST LOMA LINDA CA 92354 330578722 RESEARCH ORGANIZATION CA 501(C)(3) 1 N/A 0 UNIVERSITY INSURANCE COMPANY OF VERMONT 126 COLLEGE ST SUITE 400 BURLINGTON VT 05401 030311174 CAPTIVE INSURANCE PROVIDER VT 501(C)(3) 1 N/A 0 LOMA LINDA UNIVERSITY HEALTH SERVICES 11175 CAMPUS ST LOMA LINDA CA 92354 810661056 SERVICE ORGANIZATION CA 501(C)(3) 1 N/A 0 LOMA LINDA UNIVERSITY MEDICAL CENTER-MURRIETA 28062 BAXTER RD MURRIETA CA 92653 202859948 ACUTE CARE HOSPITAL CA 501(C)(3) 3 N/A 0 LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL 11234 ANDERSON ST LOMA LINDA CA 92354 463214504 HOSPITAL CA 501(C)(3) 3 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 MEDICAL PROPERTIES OF LOMA LINDA 11175 CAMPUS ST LOMA LINDA CA 92354 953669452 PROPERTY OWNERSHIP CA LOMA LINDA UNIVERSITY HEALTH C 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 LOMA LINDA UNIVERSITY MEDICAL CENTER P 2805101