ST HELENA HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ST HELENA HOSPITAL (EIN 94-1279779)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-19
IRS object ID
201533239349300543
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-19T20:07:55-08:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN941279779EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Helena HospitalBusinessNameLine1Txt
Business Name Line2DBA St Helena Hospital Napa ValleyBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlSTHEBusinessNameControlTxt
Phone7079633611PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Woodland RdAddressLine1Txt
CitySt HelenaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94574ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBrandon ParkerPersonNm
Person TitleVP Finance/CFOPersonTitleTxt
Signature2015-11-19SignatureDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-04-25 22:37:26ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSteven Herber MDPrincipalOfficerNm
Gross Receipts$210,882,317GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Group Exemption1071GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.adventisthealth.org/napa-valleyWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1898FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionThe hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee1502TotalEmployeeCnt
Total Volunteers114TotalVolunteersCnt
Total Gross UBI$192,159TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$35,238NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,468,889PYContributionsGrantsAmt
CY Contributions Grants$3,616,222CYContributionsGrantsAmt
PY Program Service Revenue$187,875,775PYProgramServiceRevenueAmt
CY Program Service Revenue$202,992,328CYProgramServiceRevenueAmt
PY Investment Income$151,347PYInvestmentIncomeAmt
CY Investment Income$782,566CYInvestmentIncomeAmt
PY Other Revenue$804,902PYOtherRevenueAmt
CY Other Revenue$810,319CYOtherRevenueAmt
PY Total Revenue$193,300,913PYTotalRevenueAmt
CY Total Revenue$208,201,435CYTotalRevenueAmt
PY Grants And Similar Paid$29,800PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$152,387CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$81,592,183PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$85,739,000CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$985,415CYTotalFundraisingExpenseAmt
PY Other Expenses$110,206,362PYOtherExpensesAmt
CY Other Expenses$128,024,993CYOtherExpensesAmt
PY Total Expenses$191,828,345PYTotalExpensesAmt
CY Total Expenses$213,916,380CYTotalExpensesAmt
PY Revenues Less Expenses$1,472,568PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,714,945CYRevenuesLessExpensesAmt
Total Assets BOY$172,657,136TotalAssetsBOYAmt
Total Assets EOY$178,823,213TotalAssetsEOYAmt
Total Liabilities BOY$116,202,847TotalLiabilitiesBOYAmt
Total Liabilities EOY$127,785,099TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$56,454,289NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$51,038,114NetAssetsOrFundBalancesEOYAmt
MissionTo share God's love by providing physical, mental, and spiritual healing.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$183,904,876ExpenseAmt
Grant$152,387GrantAmt
Revenue$203,380,270RevenueAmt
DescSt. 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 2014 was $36,209,539.Inpatient services in 2014 were provided to 7,471 patients. These services included:Babies delivered - 256Surgeries performed - 2,210Radiology procedures performed - 68,904Cardiac catheterization and other procedures - 2,846Laboratory tests performed - 181,520Rehabilitation unit visits - 23,050Outpatient services in 2014 were provided to 100,553 patients. These services included:Emergency Room visits - 7,795Surgeries performed - 3,494Radiology procedures performed - 118,258Laboratory tests performed - 125,890Medical clinic visits - 68,405St. 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 ClinicsDesc
Total Program Service Expenses$183,904,876TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document238IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1502EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBrandon ParkerPersonNm
Phone7079633611PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line110 Woodland RdAddressLine1Txt
CitySt HelenaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94574ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (39 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Caviness Larry
Director0.002.00Yes (X)$0$3,081$0
Dickinson Charles
Director0.002.00Yes (X)$0$6,340$0
Fike Ruthita
Director0.002.00Yes (X)$0$2,050$0
Friestad Christine
Director0.002.00Yes (X)$0$2,557$0
Gabriel Melody
Director0.002.00Yes (X)$0$2,388$0
Graham Ricardo
Director0.002.00Yes (X)$0$7,573$0
Heinrich Kerry
Director0.002.00Yes (X)$0$0$0
Innocent Larry
Director0.002.00Yes (X)$0$2,388$0
Jones Helmuth
Director0.002.00Yes (X)$0$83,882$0
Reimche Allan
Director0.002.00Yes (X)$0$3,958$0
Rippey Wesley
Director0.002.00Yes (X)$0$116,805$0
Torkelsen Max
Director0.002.00Yes (X)$0$3,731$0
Carmen Robert
Dir/Chair0.0050.00Yes (X)$0$440,880$14,928Yes (X)
Reiner Scott
Dir/Chair/Sec0.0050.00Yes (X)$0$1,256,086$211,057Yes (X)
Wing Bill
Dir/VCh/AsstSec0.0050.00Yes (X)$0$903,909$198,325Yes (X)
Jobe Meredith
Secretary0.0050.00$0$432,115$83,255Yes (X)
Rebok Douglas
Asst Secretary0.0050.00$0$800,609$156,007Yes (X)
Wagner Jack
Asst Secretary0.0050.00$0$535,352$27,472Yes (X)
Wehtje Rodney
Asst Treasurer0.0050.00$0$1,607,163$97,250Yes (X)
Herber Steven
Pres/CEO/CMO50.000.00$0$431,536$80,998Yes (X)
Jacobson Carlton
Asst Sec/VP Fin50.000.00$0$243,986$56,865Yes (X)
Parker Brandon
Treas/Asst Sec50.000.00$0$227,303$38,326Yes (X)
McDonald Edward
Treas/AsstSec50.000.00$0$344,933$141,986Yes (X)
Lonto Robert
NCR VP HR50.000.00$0$207,908$26,099Yes (X)
Cowan Joshua
NCR VP Marketing/Corp Dev50.000.00$0$208,082$37,510Yes (X)
Lendaris Antonia
SH Reg CNO50.000.00$0$203,575$28,144Yes (X)
Williams Patricia
NCR VP PopHlth/SHR BehvMed50.000.00$0$239,847$49,771Yes (X)
Kulas Paul
VP Phys Svcs/CMG50.000.00$0$71,073$9,120Yes (X)
Mackay Cristal
VP Human Dev/Perform50.000.00$0$198,272$33,928Yes (X)
Lundin Stephen
CDO50.000.00$255,194$0$41,462Yes (X)
Mann Jeremy
CMO Ambulatory Care50.000.00$242,935$0$46,311Yes (X)
Eller Jeff
NCR President50.000.00$0$737,409$132,908Yes (X)
Kirk Richard
Nurse Practitioner60.000.00$275,778$0$43,341Yes (X)
Nelson Barry
CV Lab Supervisor60.000.00$276,123$0$39,712Yes (X)
Coon Thomas
Medical Director40.000.00$300,000$0$121Yes (X)
Hasso Ruth
RN-Surgery40.000.00$214,844$0$34,375Yes (X)
Adams Charles
Lead CV Tech40.000.00$201,903$0$38,643Yes (X)
Newmyer Terrance
Former VP/Pres NCR0.000.00$0$691,455$41,756Yes (X)
Selivanoff Paul
Former VP Fin Rev Mngt0.000.00$0$211,858$40,891Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,766,777TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$10,228,104TotReportableCompRltdOrgAmt
Total Other Compensation$1,750,561TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K143IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Allen Creative Group
22 West St Ste 1MillburyMA01527Marketing/Design$1,124,420
Patient Access Medical Group
PO Box 742528DallasTX75374Physician Services$1,087,800
Scott Johnson
PO Box 911AngwinCA94508CRNA Services$313,340
Latham & Watkins LLP
PO Box 894284Los AngelesCA90189Legal Services$294,859
Triage Consulting Group
221 Main StSan FranciscoCA94105AR Collection Serv.$212,490
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K31CntrctRcvdGreaterThan100KCnt
All Other Contributions$3,616,222AllOtherContributionsAmt
Total Contributions$3,616,222TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Dietary722210$842,930$842,930
EMR Incentives621110$922,632$922,632
Other Revenue900099$226,258$226,258
Patient Service Revenue621110$199,743,269$199,743,269
Rental Income531120$1,257,239$1,246,184$11,055
FieldValueIRS element (for citing)
Total Program Service Revenue$202,992,328TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$124,968TotalRevenueColumnAmt
Exclusion$124,968ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$236,034SecuritiesAmt
Other$450,000OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$28,436OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$236,034SecuritiesAmt
Other$421,564OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$657,598TotalRevenueColumnAmt
Exclusion$657,598ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$3,004,490GrossSalesOfInventoryAmt
Cost Of Goods Sold$2,652,446CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$352,044TotalRevenueColumnAmt
Unrelated Business Revenue$192,159UnrelatedBusinessRevenueAmt
Exclusion$159,885ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Chg in interest in fnd900099$227,150$227,150
Community services221000$171,847$171,847
Other Revenue900099$59,278$59,278
FieldValueIRS element (for citing)
Other Revenue Total$458,275OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$208,201,435TotalRevenueColumnAmt
Related Or Exempt Func Income$203,380,270RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$192,159UnrelatedBusinessRevenueAmt
Exclusion$1,012,784ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$152,387TotalAmt
Program Services$152,387ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$585,902TotalAmt
Management And General$585,902ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$63,987,668TotalAmt
Program Services$57,490,564ProgramServicesAmt
Management And General$5,967,916ManagementAndGeneralAmt
Fundraising$529,188FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,186,190TotalAmt
Program Services$2,186,190ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$15,393,420TotalAmt
Program Services$12,503,099ProgramServicesAmt
Management And General$2,770,715ManagementAndGeneralAmt
Fundraising$119,606FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,585,820TotalAmt
Program Services$2,993,883ProgramServicesAmt
Management And General$569,540ManagementAndGeneralAmt
Fundraising$22,397FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,040,115TotalAmt
Management And General$1,037,547ManagementAndGeneralAmt
Fundraising$2,568FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$1,883,869TotalAmt
Management And General$1,883,869ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$18,829,367TotalAmt
Program Services$18,200,736ProgramServicesAmt
Management And General$539,567ManagementAndGeneralAmt
Fundraising$89,064FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$3,309,678TotalAmt
Management And General$3,241,584ManagementAndGeneralAmt
Fundraising$68,094FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,657,135TotalAmt
Program Services$1,698,388ProgramServicesAmt
Management And General$942,221ManagementAndGeneralAmt
Fundraising$16,526FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$10,167,088TotalAmt
Program Services$10,068,264ProgramServicesAmt
Management And General$49,404ManagementAndGeneralAmt
Fundraising$49,420FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,629,516TotalAmt
Program Services$3,166,887ProgramServicesAmt
Management And General$462,624ManagementAndGeneralAmt
Fundraising$5FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$393,492TotalAmt
Program Services$189,311ProgramServicesAmt
Management And General$201,071ManagementAndGeneralAmt
Fundraising$3,110FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$21,161TotalAmt
Program Services$20,259ProgramServicesAmt
Management And General$668ManagementAndGeneralAmt
Fundraising$234FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,635,892TotalAmt
Program Services$2,635,892ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$8,748,488TotalAmt
Program Services$8,708,973ProgramServicesAmt
Management And General$39,340ManagementAndGeneralAmt
Fundraising$175FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,131,458TotalAmt
Program Services$1,131,458ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Patient care supplies$34,753,959$34,753,959
Purchased services$20,621,490$12,066,809$8,480,695$73,986
Qlty assurance (hospital) fee$7,401,302$7,401,302
AHPN clinic ops, net of rev$6,769,282$6,769,282

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,031,701TotalAmt
Program Services$1,767,233ProgramServicesAmt
Management And General$2,253,426ManagementAndGeneralAmt
Fundraising$11,042FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$213,916,380TotalAmt
Program Services$183,904,876ProgramServicesAmt
Management And General$29,026,089ManagementAndGeneralAmt
Fundraising$985,415FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$908,670BOYAmt
EOY$3,036,205EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,122,896BOYAmt
EOY$1,123,275EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$32,818,990BOYAmt
EOY$32,897,307EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,603,796BOYAmt
EOY$3,860,506EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,285,335BOYAmt
EOY$1,160,969EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$213,514,417LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$119,004,805LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$86,191,350BOYAmt
EOY$94,509,612EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,668,629BOYAmt
EOY$2,510,638EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$44,057,470BOYAmt
EOY$39,724,701EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$172,657,136BOYAmt
EOY$178,823,213EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$13,859,614BOYAmt
EOY$15,939,400EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,201,780BOYAmt
EOY$1,007,495EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$101,141,453BOYAmt
EOY$110,838,204EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$116,202,847BOYAmt
EOY$127,785,099EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$30,819,844BOYAmt
EOY$17,685,282EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$23,270,010BOYAmt
EOY$30,993,788EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,364,435BOYAmt
EOY$2,359,044EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$56,454,289BOYAmt
EOY$51,038,114EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$172,657,136BOYAmt
EOY$178,823,213EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,714,945ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$298,770OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
ChurchYes (X)ChurchInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed Section4955 TaxfalseForm4720FiledSection4955TaxInd
Correction MadefalseCorrectionMadeInd
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$14,698OtherActivitiesAmt
Total Lobbying Expenditures$14,698TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind
Form4720 Filed4912 TaxfalseForm4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1i - Other Activities DescriptionFormAndLineReferenceDesc
ExplanationThe hospital is a member of industry associations. A portion of the membership dues is used for lobbying purposes.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,066,916BeginningYearBalanceAmt
Contributions$3,282,190ContributionsAmt
Investment Earnings Or Losses-$4,891InvestmentEarningsOrLossesAmt
Other Expenditures$1,789,223OtherExpendituresAmt
End Year Balance$10,554,992EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$9,434,793BeginningYearBalanceAmt
Contributions$4,304,601ContributionsAmt
Investment Earnings Or Losses$373,738InvestmentEarningsOrLossesAmt
Other Expenditures$5,046,216OtherExpendituresAmt
End Year Balance$9,066,916EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,606,949BeginningYearBalanceAmt
Contributions$4,272,247ContributionsAmt
Investment Earnings Or Losses-$559,442InvestmentEarningsOrLossesAmt
Other Expenditures$1,881,883OtherExpendituresAmt
Administrative Expenses$3,078AdministrativeExpensesAmt
End Year Balance$9,434,793EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,742,337BeginningYearBalanceAmt
Contributions$4,197,230ContributionsAmt
Investment Earnings Or Losses$817,479InvestmentEarningsOrLossesAmt
Other Expenditures$3,147,811OtherExpendituresAmt
Administrative Expenses$2,286AdministrativeExpensesAmt
End Year Balance$7,606,949EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,577,529BeginningYearBalanceAmt
Contributions$4,780,055ContributionsAmt
Investment Earnings Or Losses$221,919InvestmentEarningsOrLossesAmt
Other Expenditures$5,835,218OtherExpendituresAmt
Administrative Expenses$1,948AdministrativeExpensesAmt
End Year Balance$5,742,337EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.05000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.95000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$426,637OtherCostOrOtherBasisAmt
Book Value$426,637BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$118,013,829OtherCostOrOtherBasisAmt
Depreciation$66,093,813DepreciationAmt
Book Value$51,920,016BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$16,702,581OtherCostOrOtherBasisAmt
Depreciation$7,665,512DepreciationAmt
Book Value$9,037,069BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$56,479,563OtherCostOrOtherBasisAmt
Depreciation$45,245,480DepreciationAmt
Book Value$11,234,083BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,891,807OtherCostOrOtherBasisAmt
Book Value$21,891,807BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$94,509,612TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
Interest in Consolidated Org$26,240,918
Other Receivables$964,650
Receivables from Related Organization$11,476,831
Receivables from Third Party Payors$1,042,302
FieldValueIRS element (for citing)
Total Book Value Other Assets$39,724,701TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
Other Liabilities$712,277
Payables to Related Organizations$106,450,019
Workers Comp Liability$3,675,908
FieldValueIRS element (for citing)
Total Liability$110,838,204TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart V, Line 4: Intended uses of the endowment fund.FormAndLineReferenceDesc
ExplanationBoard-designated, temporarily, and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$362,701TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue-$2,093DirectOffsettingRevenueAmt
Net Community Benefit Expns$364,794NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,512,183TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,471,672DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,040,511NetCommunityBenefitExpnsAmt
Total Expense0.03760TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,511,562TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,919,640DirectOffsettingRevenueAmt
Net Community Benefit Expns-$408,078NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$41,386,446TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$33,389,219DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,997,227NetCommunityBenefitExpnsAmt
Total Expense0.03930TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$281,762TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$281,762NetCommunityBenefitExpnsAmt
Total Expense0.00130TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,934TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,934NetCommunityBenefitExpnsAmt

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,911,387TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,466,329DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,445,058NetCommunityBenefitExpnsAmt
Total Expense0.01140TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$205,678TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$146,572DirectOffsettingRevenueAmt
Net Community Benefit Expns$59,106NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$235,352TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$235,352NetCommunityBenefitExpnsAmt
Total Expense0.00110TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,636,113TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,612,901DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,023,212NetCommunityBenefitExpnsAmt
Total Expense0.01410TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$50,022,559TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$39,002,120DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,020,439NetCommunityBenefitExpnsAmt
Total Expense0.05340TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,102TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$14,102NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$43TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$43NetCommunityBenefitExpnsAmt

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,838TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,838NetCommunityBenefitExpnsAmt

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$336,742TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$336,742NetCommunityBenefitExpnsAmt
Total Expense0.00160TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$354,725TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$354,725NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,167,383BadDebtExpenseAmt
Bad Debt Expense Attributable$268,498BadDebtExpenseAttributableAmt
Reimbursed By Medicare$71,430,605ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$82,917,415CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$11,486,810MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndEmergency Room24 HrsEmergencyRoom24HrsIndFacility Reporting GroupFacilityReportingGroupCdOtherOtherDesc
St Helena Hospital
110 Woodland RoadSt HelenaCA94574Yes (X)Yes (X)Yes (X)A
SHH Ctr for Behavioral Health
2525 Oregon StreetVallejoCA94590Yes (X)AAcute Psychiatric Hospital

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsfalseCHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Sch H Part VI-Supplemental InfoOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSee Sch H Part VI-Supplemental InfoOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt14ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Sch H Part VI-Supplemental InfoStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.0000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.0000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 5 - Account Input from Persons Who Represent the CommunityTo validate the data for the Live Healthy Napa County (LHNC) CHNA, and to ensure a broad representation of the community, qualitative data was collected from a variety of sources:Brainstorming - the Forces of Change Brainstorming Session, held in November 2012 as part of the LHNC Steering Committee's second meeting, set out to identify the political, cultural, environmental, and social factors that affect health and quality of life in Napa County. It was designed to create a comprehensive but focused understanding of key factors.Surveys - the LHNC Core Support Team worked with community partners across the County to conduct a survey of residents, service providers, and other stakeholders. The survey was a tool to gather data on how participants perceive health in Napa County, what the critical issues are, and how community members are currently accessing services.Workshops - residents and other stakeholders had an opportunity to participate in the community health assessment process through a series of workshops facilitated by volunteers from community organizations and agencies in the fall of 2012. Over 300 residents participated in 28 workshops in October and November 2012.Interviews - In the months of November and December 2012, a total of 16 stakeholder interviews were conducted with key leaders throughout Napa County.
Part V, Line 6a - List Other Hospital Facilities that Jointly Conducted Needs AssessmentLive Healthy Napa County (LHNC) is a public-private partnership bringing together representatives not just from health and healthcare organizations, but also from business, public safety, education,government and the general public to develop a shared understanding and vision of a healthier Napa County. The LHNC CHNA was a collaborative effort of:Kaiser PermanenteNapa County Health & Human Services AgencyNapa Valley Coalition of Nonprofit AgenciesSt. Joseph Health Queen of the Valley (SJHQOV) and St. Helena Hospital.
Part V, Line 11 - Explanation of Needs Not Addressed and Reasons WhyThe 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.
FieldValueIRS element (for citing)
Facility4FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
St Helena Physical Therapy
1030 Main Street Ste 100St HelenaCA94574Outpatient Clinic
St Helena Coon Joint Replacement Institute
6 Woodland Rd Ste 202St HelenaCA94574Outpatient Clinic
St Helena Regional Therapy Services
18990 Coyote Valley Rd Stes 9 10Hidden Valley LakeCA95467Outpatient Clinic
St Helena Medical Specialties OBGYN
935 Trancas St Ste 4BNapaCA94558Outpatient Clinic

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7 - Explanation of Costing MethodologyThe 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 ExpenseUncollected 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 BenefitThe 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 ExpenseThe system-wide audited combined financial statements do not contain a footnote describing bad debt expense.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe 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 $70,807,909Prior Year Settlements 1,920,993Cost Report Reimbursable Bad Debts 453,021Estimates and Accrual Variances (852,625)Other (898,693)Subtotal - Amount reported in Pt. III, line 5 $71,430,605Amounts included in Part 1, lines g and f -Total Medicare Revenue $71,430,605*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 PatientsWhen 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 AssessmentWe 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 2012, 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. In 2014, we saw the following environmental changes that impacted our community health outreach efforts:2014 South Napa Earthquake. On August 24, 2014 at 3:20 am, a 6.0 magnitude earthquake struck on the Napa Ridge Fault south of the City of Napa near American Canyon. One person was killed and over 200 people were injured. Over 600 buildings were red or yellow tagged causing massive displacement of families, businesses, and services. Thankfully, SHNV and its clinics did not sustain major structural damage. While the Queen of the Valley Hospitals Emergency Room received the majority of those injured due to its proximity to the epicenter, SHNV quickly responded to the crisis through support of affected employees, monetary support of relief agencies, a series of donation drives, and disaster preparedness outreach and education. This signified a major shift in our community benefit programming in 2014.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 2015 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. After LHNC completed our Community Health Needs Assessment in 2013, we developed a Community Health Plan, ratified the plan in early 2014. We spent the remainder of the year implementing the plan. In order to ensure our collective activities are adequately addressing the needs identified in the Community Health Plan, we engaged an external evaluator who will report findings in early 2015. 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 2013 CHNA study and the 2014 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 AssistancePatients 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 is summarized on the hospital's website, at: https://www.adventisthealth.org/napa-valley/pages/patients-and-visitors/pay-bill.aspx
Part VI - Community InformationOur 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 ActivitiesOur 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 PurposeSt. Helena Napa Valley and St. Helena Hospital Center for Behavioral Health are consistently active in the communities we serve by involving ourselves in various support groups, collaborations, community initiatives, schools, and athletic events to further carry out our mission and show our commitment to it. Many of our employees sit on various boards and consistently attend support group meetings and coalitions to ensure that we are up to date with the changes of the current needs of the communities we serve. The Community Health Needs Assessment also acts as a guideline for us to better serve our patients and makes sure that we are addressing the biggest needs. Having an active presence in the community allows us to better assess the needs we are needing to address. Any surplus funds accrued are evaluated and repurposed toward the greatest need at the time which can be, but is not limited to, remolding units, sponsorship in the prevention of childhood obesity, or disaster relief.
Part VI - Affilated Health Care System Roles and PromotionThe 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 FiledCA

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CA Hlth Fnd & TrustBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K St Ste 800AddressLine1Txt
CitySacramentoCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd
FieldValueIRS element (for citing)
Recipient EIN941498697RecipientEIN
IRC Section501(c)(3)IRCSectionDesc
Cash Grant$152,387CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantHlth srvs uninsured/underinsured ptPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceGrantmaker's Description of How Grants are UsedFormAndLineReferenceDesc
ExplanationGrants are made to student interns working alongside licensed psychiatric clinicians at our mental health facility. The grant funds are given to help defray general living costs while the students are actively working in the facility and are only given during the the period of their internship.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (26 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmount
Adams Charles
Lead CV Tech$201,903$12,067$26,576$240,546
Carmen Robert
Dir/Chair$327,030$113,850$14,928$455,808
Coon Thomas
Medical Director$300,000$121$300,121
Cowan Joshua
NCR VP Marketing/Corp Dev$188,580$19,502$29,265$245,592$8,245
Eller Jeff
NCR President$513,652$165,273$37,798$870,317$95,110$58,484$69,418
Hasso Ruth
RN-Surgery$213,338$10,536$23,839$249,219$1,506
Herber Steven
Pres/CEO/CMO$312,032$68,004$29,338$512,534$51,660$51,500$38,735
Jacobson Carlton
Asst Sec/VP Fin$213,724$30,262$29,280$300,851$27,585$24,738
Jobe Meredith
Secretary$340,482$91,633$12,925$515,370$70,330$46,949
Kirk Richard
Nurse Practitioner$266,463$11,960$31,381$319,119$9,315
Lendaris Antonia
SH Reg CNO$193,338$10,237$16,318$231,719$11,826
Lonto Robert
NCR VP HR$185,888$22,020$26,099$234,007
Lundin Stephen
CDO$229,403$15,860$25,602$296,656$25,791
Mackay Cristal
VP Human Dev/Perform$191,672$6,600$22,306$232,200$11,622
Mann Jeremy
CMO Ambulatory Care$242,935$15,160$31,151$289,246
McDonald Edward
Treas/AsstSec$285,172$59,761$28,163$486,919$113,823$40,224
Nelson Barry
CV Lab Supervisor$273,029$15,860$23,852$315,835$3,094
Newmyer Terrance
Former VP/Pres NCR$461,828$229,627$25,896$733,211$15,860$186,474
Parker Brandon
Treas/Asst Sec$194,924$15,513$29,271$265,629$9,055$16,866
Rebok Douglas
Asst Secretary$588,532$212,077$24,672$956,616$131,335$122,223
Reiner Scott
Dir/Chair/Sec$880,711$375,375$29,376$1,467,143$181,681$273,487
Selivanoff Paul
Former VP Fin Rev Mngt$187,724$24,134$29,265$252,749$11,626
Wagner Jack
Asst Secretary$433,694$101,658$16,812$562,824$10,660
Wehtje Rodney
Asst Treasurer$376,932$1,230,231$22,415$1,704,413$74,835$1,192,595
Williams Patricia
NCR VP PopHlth/SHR BehvMed$201,224$38,623$29,273$289,618$20,498$26,047
Wing Bill
Dir/VCh/AsstSec$740,333$163,576$29,604$1,102,234$168,721$118,557

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Gregory Williams
KeyEmpSpouse$3,230Consulting Servicesfalse
Maria Lendaris
KeyEmp Child$8,406Employmentfalse
Cambria Wehtje-Sim
Officer Child$1,242Employmentfalse
Tammy McDonald
Officer Wife$1,179Cookie salesfalse

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe 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 ShareholdersThe 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 ProcessThe completed Form 990 is shared with members of the hospital'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 after their review but prior to filing.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsDuring 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 ManagementSee 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 EmployeesThe 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 AvailableThe 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 IncreasesChange in interest - Foundation = $6070111
Other Changes In Net Assets Or Fund Balances - Other DecreasesChange in value of split interest agreements = -$4891
Other Changes In Net Assets Or Fund Balances - Other DecreasesTransfer to related organization = -$5766450

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Adventist Health SystemWest
2100 Douglas BlvdRosevilleCA95661953484589Support and manage system-wide activitiesCA501(c)(3)1NAfalse
St Helena Hospital Foundation
10 Woodland RdSt HelenaCA94574201384250Fundraising and Investment ManagementCA501(c)(3)11a, INAfalse
Castle Medical Center
640 Ulukahiki StKailuaHI96734990107330HospitalHI501(c)(3)1Adventist Health SystemWestfalse
Central Valley General Hospital
1025 N Douty StHanfordCA93230770324630HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Feather River Hospital
5974 Pentz RdParadiseCA95969941101228HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Glendale Adventist Medical Center
1509 Wilson TerGlendaleCA91206951816017HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Hanford Community Hospital
450 Greenfield AveHanfordCA93230940535360HospitalCA501(c)(3)1Adventist Health SystemWestfalse
NW Medical Foundation of Tillamook
1000 Third StTillamookOR97141930622075HospitalOR501(c)(3)1Adventist Health SystemWestfalse
Paradise Valley Hospital
2100 Douglas BlvdRosevilleCA95661951816034Wind down after sale of hospital facilitiesCA501(c)(3)1Adventist Health SystemWestfalse
Portland Adventist Medical Center
10123 SE Market StPortlandOR97216930429015HospitalOR501(c)(3)1Adventist Health SystemWestfalse
Adventist Health Clearlake Hospital Inc
Ave 18 at Hwy 53ClearlakeCA95422680395149HospitalCA501(c)(3)3Adventist Health SystemWestfalse
San Joaquin Community Hospital
2615 Chester AveBakersfieldCA93301952294234HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Simi Valley Hospital & Health Care Svcs
2975 N Sycamore DrSimi ValleyCA93065956064971HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Sonora Community Hospital
1000 Greenley RdSonoraCA95370941415069HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Ukiah Adventist Hospital
275 Hospital DrUkiahCA95482941639901HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Walla Walla General Hospital
1025 S Second AveWalla WallaWA99362910617726HospitalWA501(c)(3)1Adventist Health SystemWestfalse
White Memorial Medical Center
1720 Cesare E Chavez AveLos AngelesCA90033952282647HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Willits Hospital Inc
1 Madrone StWillitsCA95490680108919HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Adventist Health Physicians Network
2100 Douglas BlvdRosevilleCA95661680357690Medical FoundationCA501(c)(3)11b, IIAdventist Health SystemWestfalse
Reedley Community Hospital
372 W Cypress AveReedleyCA93654453220509HospitalCA501(c)(3)1Adventist Health SystemWestfalse
Western Health Resources
2100 Douglas BlvdRosevilleCA95661953867863Home careCA501(c)(3)1Adventist Health SystemWestfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
South Coast Medical Center
2100 Douglas BlvdRosevilleCA95661952037291Wind down after sale of hospitalCAN/AC Corpfalse
Adventist Health Plan Inc
2100 Douglas BlvdRosevilleCA95661463833261InsuranceCAC CorpfalseNA
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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