2017-11-16T00:11:57-08:00 2016-12-31 990 2016-01-01 956064971 Simi Valley Hosp & Hlth Care Serv SIMI 8059556000 2975 N Sycamore Dr Simi Valley CA 93065 Brian Anderson VP Fin/CFO 2017-11-16 2016 2017-02-10 21:41:12Z Jennifer Swenson 151306035 false false X www.adventisthealth.org/simi-valley-hospital X 1960 CA Living Gods love by inspiring health, wholeness and hope. 11 7 1069 286 1389923 540299 483748 2452935 136563974 147181681 1131578 1542077 3169 1663 138182469 151178356 21688 -1156 0 69774786 68530429 0 363546 65468410 78022271 135264884 146551544 2917585 4626812 177621305 176440001 222937057 220503078 -45315752 -44063077 Living Gods love by inspiring health, wholeness and hope. false false 123852756 -1156 146645435 In support of the hospital's mission statement, Simi Valley Hospital & Health Care Services (SVHHCS) 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 Simi Valley 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 community and our patients in a new definition of a 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: 1.providing free care and/or subsidized care 2.providing care to persons covered by governmental programs at below cost 3.providing health/wellness activities and community education programsNot only does SVHHCS 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. SVHHCS 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 $33,301,565.Inpatient services in 2016 were provided to 6,525 patients. These services included: Babies delivered - 549 Surgeries performed - 1,288 Radiology procedures performed - 12,583 Cardiac catheterization procedures - 964 Laboratory tests performed - 254,457Outpatient visits in 2016 were 85,455. These services included: Emergency room visits - 35,886 Surgeries performed - 2,820 Radiology procedures performed - 14,269 Cardiac catheterization procedures - 190 Laboratory tests performed - 163,276SVHHCS 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: Simi Valley Free Clinic Child Birth Classes Breastfeeding Classes Newborn Classes Breastfeeding Support Group Siblings Classes Nutrition Classes Breast Cancer Education Heart Health Education Community CPR Classes Prostate Cancer Screenings for Men in the Community Lifeline Program Community Flu Clinics Grief Recovery Support Group Look Good Feel Better Support Group Stroke & Brain Injury Support Group COPE Health Stericycle Visit our website, at https://www.adventisthealth.org/simi-valley-hospital/pages/default.aspx, for more information about Simi Valley Hospital and Health Services. 123852756 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 false false true false false false false false false false false false false false false false false false false true false false false false true 186 0 true 1069 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 true true X Brian Anderson 8059556215 2975 N Sycamore Dr Simi Valley CA 93065 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 Swenson Jennifer President 50.00 0.00 X 0 409352 140442 Anderson Brian CFO/AsstSec/VP 50.00 0.00 X 0 229086 55860 Ruditsky Crystal Interim CFO 50.00 0.00 X 0 58733 3908 Zachary Beth President SCR 50.00 0.00 X 0 1031265 201025 Wehtje Ronald CFO SCR 50.00 0.00 X 0 501328 27873 Nahapetian Arby Reg CMO SCR 50.00 0.00 X 0 631536 141957 Fargo Roland SVP Reg Phys Ops SCR 50.00 0.00 X 0 456293 97883 Esparza Caroline COO/CNO 50.00 0.00 X 0 294993 68084 Werner William VP Support Srvs 50.00 0.00 X 0 237579 69815 Deamer Carol Pharmacy Director 40.00 0.00 X 224803 0 13648 Nakamura Bridget Dir of IT/CIS 40.00 0.00 X 185005 0 32513 Bercier-Gorcey Joan Dir of Nursing 40.00 0.00 X 189192 0 25528 Percival Kathleen Dir Org/Perf 40.00 0.00 X 200563 0 11801 Crabtree Susan Dir HR 40.00 0.00 X 174599 0 35005 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 974162 9667318 1695578 58 true true false HFS Consultants 504 14th St 5th Floor Oakland CA 94612 Consulting Services 557780 Extracorporeal Stat LLC 50 Moreland Rd Simi Valley CA 93065 Dialysis Services 424262 WIPFLI LLP PO Box 3160 Miwaukee WI 53201 Consulting Services 370129 CA Cardiovascular Thoracic Surgeons 168 N Brent St Ventura CA 93003 Medical Services 304000 Studer Group PO Box 71676 Chicago IL 60694 Consulting Services 299472 11 402213 2050722 2452935 Dietary 722210 460121 460121 Other Program Services 900099 116098 116098 Patient Service Revenue 621110 143523897 143127483 396414 Rent 531120 984976 869887 115089 Services to ASC 561000 2318722 1575986 742736 -222133 -222133 147181681 1130018 717993 135684 276341 0 0 0 412059 412059 412059 412059 4215 23694 -19479 -19479 0 125127 103985 21142 21142 0 151178356 146645435 1389923 690063 -1156 -1156 0 0 0 0 0 54343557 50891596 3208836 243125 2251769 2251769 7948942 6992233 910982 45727 3986161 3738760 230433 16968 0 371567 371567 -4278 -4278 0 0 0 4964669 2997051 1953457 14161 306534 306484 50 1997150 1263314 724055 9781 5864455 5852486 3104 8865 0 3267161 3138480 128681 272276 167918 99449 4909 0 47230 24101 23129 2570261 2570261 0 7256528 7238114 18414 391839 391839 Purchased services 21153207 6821529 14311733 19945 Pt care supplies 14635940 14635940 Quality Assurance/Hosp. Fees 9538911 9538911 Other Misc. Expenses 4071431 4022220 49196 15 1317390 1317390 146551544 123852756 22335242 363546 877310 209849 614253 935613 0 21753212 19539462 0 0 0 2448354 2416627 901230 821132 216001273 82584158 133460253 133417115 1403119 1523187 0 3755106 3183634 1755459 2210459 10653009 12182923 177621305 176440001 10553894 12740073 13109836 12711224 199273327 195051781 222937057 220503078 X -48787210 -45860034 3471458 1796957 -45315752 -44063077 177621305 176440001 X 4626812 -3374137 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 10541 10541 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. 3471458 2049302 -1648602 2075200 1796958 3178248 54691 288054 49535 3471458 2829912 88226 322286 62176 3178248 2635714 136310 148137 90249 2829912 2396079 97606 210223 68194 2635714 1.00000 false false false 6378565 6378565 162096417 54986464 107109953 1716295 1654192 62103 31368099 22980262 8387837 14441897 2963240 11478657 133417115 Sycamore Med Partners 100121 C Aspen Surgery Venture, LLC 856190 C Oncure 2227323 C Interest in SVH Foundation 2423534 Other Receivables 211388 Receivables from Related Organizations 7575436 Receivables from Third-Party Payors 1972565 12182923 Income Taxes Payable 68996 Payables to Related Organizations 190507855 Payables to third-party payors 2200182 Workers Comp Payable 2274748 195051781 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 true X true X true X true true false false true true 324843 324843 0.00220 35394620 21066964 14327656 0.09780 35719463 21066964 14652499 0.10000 599212 62861 536351 0.00370 1103918 1103918 0.00750 7750237 5953204 1797033 0.01230 104901 104901 0.00070 9558268 6016065 3542203 0.02420 45277731 27083029 18194702 0.12420 40538 40538 0.00030 58371 58371 0.00040 3827 3827 4647 4647 107383 107383 0.00070 true 1405651 38373211 45380558 -7007347 X true true Aspen Surgery Venture LLC Ambulatory surgery center 0.72500 0.27500 1 1 Simi Valley Hospital 2975 N Sycamore Drive Simi Valley CA 93065 X X X Simi Valley Hospital 1 false false true X X X X X X X X 16 true false false true X See Sch H Part VI-Supplemental Info X See Sch H Part VI-Supplemental Info X true 15 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 2013 CHNA includes collection and analyses of secondary and primary data:Secondary Data - The CHNA examines up-to-date data sources for the hospital service area to present community demographics, social and economic factors, health access, birth characteristics, leading causes of death, chronic disease, and health behaviors. When applicable, these data sets are presented in the context of Ventura County and compared to the Healthy People 2020 objectives.Primary Data - Simi Valley Hospital convened a community meeting with individuals who are leaders and representatives of medically underserved, low-income, minority and chronic disease populations, or regional, State or local health or other departments or agencies that have current data or other information relevant to the health needs of the community served by the hospital facility. The participants reviewed the secondary data for the hospital service area and participated in a facilitated discussion that included their views of community needs that impacted the well-being of area residents. The information gathered in the community meeting served to validate the community health needs. Part V, Line 11 - Explanation of Needs Not Addressed and Reasons Why Simi Valley Hospital has chosen not to actively address some of the health needs identified in their Community Health Needs Assessment. These include: autism, Social Determinants of Health, tobacco use and transportation. Taking existing hospital and community resources into consideration, SVH will concentrate on those health needs that we can most effectively address given our areas of focus and expertise. Therefore, the hospitals charitable resources will be allocated to the selected priority health needs as defined in this document. Child Development Center 1900 E Los Angeles Ave Simi Valley CA 93065 Outpatient Pediatric Therapy Nancy Reagan Breast Center 2750 Sycamore Dr Simi Valley CA 93065 Outpatient Women's Imaging Aspen Outpatient Center 2750 N Sycamore Dr Simi Valley CA 93065 Outpatient Imaging & Surgery Wood Ranch Imaging Center 124 Macaw Lane Simi Valley CA 93065 Outpatient Imaging 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 charges Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide audited combined financial statements. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments 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 $38,464,064Prior Year Settlements (901,721)Cost Report Reimbursable Bad Debts 310,866Estimates and Accrual Variances 3,042,522Other (2,542,520)Subtotal - Amount reported in Pt. III, line 5 $38,373,211Amounts included in Part 1, lines g and f -Total Medicare Revenue $38,373,211*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 In addition to the data that is available through various websites that track discharges, based on the health issues we know our community is dealing with, we focus on those issues that rise to the top. In this community, the need for emergency services has grown dramatically over the last 5 years leading to an expansion of our emergency department. In addition, we have convened community groups, including leaders of non-profit organizations, leaders from the public sector, city and county health officials, to add their insight and assistance for our strategies going forward.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/simi-valley-hospital/pages/about-us/community-health-needs.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 Simi Valley Hospital is committed to keeping our community healthy and as a result an inability to pay will never stop anyone from seeking needed care. Every in-patient and out-patient that comes to Simi Valley Hospital is assessed and treated appropriately. After that that process is completed, a member of the team from Patient Financial Services meets with the patient and/or the individual responsible for them, to determine their financial needs and to provide information and direction regarding the assistance they may be eligible for. They will also assist them in completing the necessary applications. Our financial assistance policies state that: If you are uninsured, you may be eligible to receive a prompt payment discount if you pay for your services at the time of treatment. Our financial counselors will help patients find out if they qualify for a government program and assist with the application process. Financial counselors and applications are available in both English and Spanish. 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/simi-valley-hospital/pages/patients-and-visitors/financial-services/financial-assistance.aspx Part VI - Community Information Among the residents in the Simi Valley Hospital service area, 5.7% are at or below 100% of the federal poverty level (FPL) and 16.8% are at 200% of FPL or below. Simi Valley has higher rates of poverty among individuals (6.2%) than Moorpark (3.9%). Children tend to suffer at higher rates of poverty in the service area (7.1%). Among seniors, 7.3% in Moorpark and 6% in Simi Valley live in poverty. The median household income in the area ranges from $84,813 in Simi Valley 93063 to $103,214 in Moorpark. 21.6% of service area adults are high school graduates and 41.4% are college graduates. The Ventura County Homeless Count and Homeless Survey showed 5 homeless in Moorpark at the time of the 2012 survey and 284 homeless in Simi Valley. This was an increase in homeless from the 2010 count. In the hospital service area, 88.1% of the population is insured. Adults, ages 18-64, have the lowest rates of health insurance at 84.5%. Children have the highest insurance rates at 93.4%.The northern part of Simi Valley 93063 is designated as a Health Professionals Shortage Area (HPSA) for a population group. 94.4% of children in Ventura County have a usual source of care. 9.2% of children in Ventura County have never been to a dentist. This is lower than the state rate of 11.6%. 4% of children had not visited the dentist in the past year. 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 At Simi Valley Hospital, each of our 30 plus hospital leaders is engaged with a non-profit community organization, including serving on their boards. In addition to providing medical services at our hospital, we take our focus, values and resources out into the community. We are working with them, serving with them and listening to them. Our partnership with the Free Clinic of Simi Valley is a prime example of how we provide services, volunteer staff and financial support to help meet the needs of people in this community. We have partnerships with a sports medicine medical group and local high schools to study and help minimize the incidence and impact of concussions. We also have a partnership with the local school district to provide drug testing for students. We are the designated education provider for the Simi Valley Senior Center. Part VI - Affilated Health Care System Roles and Promotion The hospital is a member of a larger health care system, which provides services in diversified areas of the Western United States. The hospital shares some services with other hospitals in its geographic area. Using today's technology, hospitals outside the geographic area are able to support the hospital by providing remote services such as telepharmacy and robotics surgery. The Corporate Office provides support for the rural health clinics, quality of care, and other clinical needs. Part VI - States Where Community Benefit Report Filed CA true true X X X X true true false false false false false false false false Anderson Brian CFO/AsstSec/VP 205210 17251 6625 30162 25698 284946 Bercier-Gorcey Joan Dir of Nursing 174768 10960 3464 10975 14553 214720 Carmen Robert Former Dir/Chair 358716 7952 366668 358716 Crabtree Susan Dir HR 158584 8986 7029 9975 25030 209604 Deamer Carol Pharmacy Director 194231 19592 10980 13366 282 238451 Dickinson Charles Director 184932 32532 37740 16432 271636 Esparza Caroline COO/CNO 220724 52583 21686 43633 24451 363077 14513 Fargo Roland SVP Reg Phys Ops SCR 332464 59878 63951 65541 32342 554176 35798 Jobe Meredith Secretary 364469 95028 92588 74172 25651 651908 56774 Nahapetian Arby Reg CMO SCR 495897 88816 46823 108751 33206 773493 39400 Nakamura Bridget Dir of IT/CIS 161594 17036 6375 10419 22094 217518 Percival Kathleen Dir Org/Perf 179963 11367 9233 11669 132 212364 Reiner Scott Dir/Chair 1018912 299575 393047 249575 36698 1997807 326648 Swenson Jennifer President 342407 36575 30370 73003 67439 549794 Wagner Jack Asst Secretary 698200 200386 219119 16384 25442 1159531 Wehtje Rodney Former Asst Treasurer 380418 8013 16393 25442 430266 Wehtje Ronald CFO SCR 335653 80000 85675 10880 16993 529201 Werner William VP Support Srvs 192100 39729 5750 34550 35265 307394 Wing Bill Dir/VCh/AsstSec 855884 253689 209482 203961 34394 1557410 155912 Zachary Beth President SCR 696556 171232 163477 168659 32366 1232290 113672 Brian Ruditsky KEmpSpouse 153523 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 operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders Part VI, line 7aThe hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.Part VI, line 7bThe sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws Form 990, Part VI, Line 11b: Form 990 Review Process The completed Form 990 is shared with members of the corporation's board of directors by electronic communication for their review prior to filing. A special board meeting is scheduled to answer questions and receive input from the board prior to filing. Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff review these questionnaires and disclosures each year during the audit process. Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation. Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a 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 Decreases Change in interest - Foundation = -$1648602 Other Changes In Net Assets Or Fund Balances - Other Decreases PY balance restatement = -$1010425 Other Changes In Net Assets Or Fund Balances - Other Decreases Transfers to related organizations = -$715110 ADVENTIST HEALTH SYSTEMWEST 2100 Douglas Blvd Roseville CA 95661 953484589 SUPPORT AND MANAGE SYSTEM-WIDE ACTIVITIES CA 501(c)(3) 1 NA false ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Ave 18 at Hwy 53 Clearlake CA 95422 680395149 HOSPITAL CA 501(c)(3) 3 Adventist Health SystemWest false CASTLE MEDICAL CENTER 640 Ulukahiki St Kailua HI 96734 990107330 HOSPITAL HI 501(c)(3) 1 Adventist Health SystemWest false FEATHER RIVER HOSPITAL 5974 Pentz Rd Paradise CA 95969 941101228 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false GLENDALE ADVENTIST MEDICAL CENTER 1509 Wilson Ter Glendale CA 91206 951816017 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false HANFORD COMMUNITY HOSPITAL 450 Greenfield Ave Hanford CA 93230 940535360 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false NORTHWEST MEDICAL FOUNDATION OF TILLAMOO 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 ST HELENA HOSPITAL 10 Woodland Rd St Helena CA 94574 941279779 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false SAN JOAQUIN COMMUNITY HOSPITAL 2615 Chester Ave Bakersfield CA 93301 952294234 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital Foundation 2975 N Sycamore Dr Simi Valley CA 93065 912135595 FUNDRAISING FOR HOSPITAL CA 501(c)(3) 11a, I Western Health Resources false SONORA COMMUNITY HOSPITAL 1000 Greenley Rd Sonora CA 95370 941415069 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false UKIAH ADVENTIST HOSPITAL 275 Hospital Dr Ukiah CA 95482 941639901 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false WALLA WALLA GENERAL HOSPITAL 1025 S Second Ave Walla Walla WA 99362 910617726 HOSPITAL WA 501(c)(3) 1 Adventist Health SystemWest false WHITE MEMORIAL MEDICAL CENTER 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false WILLITS HOSPITAL INC 1 Marcela Dr Willits CA 95490 680108919 HOSPITAL CA 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Physicians Network 2100 Douglas Blvd Roseville CA 95661 680357690 Medical Foundation CA 501(c)(3) 11b, II Adventist Health SystemWest false Reedley Community Hospital 372 W Cypress Ave Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Western Health Resources 2100 Douglas Blvd Roseville CA 95661 953867863 Home care CA 501(c)(3) 1 Adventist Health SystemWest false Lodi Memorial Hospital Association Inc 975 S Fairmont Ave Lodi CA 95240 941044474 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Hlth Medical Ctr Tehachapi 115 W E St Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false ASPEN SURGERY VENTURE LLC 2975 SYCAMORE DRIVE SIMI VALLEY CA 93065 263913327 SURGERY CENTER CA SIMI VALLEY HOSPITAL false true 0.72500 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C Corp false false false false false false false false false false false false false false false false false false false false