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    <Timestamp>2013-11-15T02:31:44-08:00</Timestamp>
    <TaxPeriodEndDate>2012-12-31</TaxPeriodEndDate>
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      <Name>
        <BusinessNameLine1>St Helena Hospital</BusinessNameLine1>
        <BusinessNameLine2>DBA St Helena Hospital Napa Valley</BusinessNameLine2>
      </Name>
      <NameControl>STHE</NameControl>
      <Phone>7079633611</Phone>
      <USAddress>
        <AddressLine1>10 Woodland Road</AddressLine1>
        <City>St Helena</City>
        <State>CA</State>
        <ZIPCode>94574</ZIPCode>
      </USAddress>
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    <Officer>
      <Name>McDonald Edward</Name>
      <Title>Treas/Sr VP Fin</Title>
      <DateSigned>2013-11-15</DateSigned>
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    <TaxYear>2012</TaxYear>
    <BuildTS>2016-02-25 16:41:14Z</BuildTS>
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      <StateLegalDomicile>CA</StateLegalDomicile>
      <ActivityOrMissionDescription>The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all.</ActivityOrMissionDescription>
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      <MissionDescription>To share God's love by providing physical, mental, and spiritual healing.</MissionDescription>
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      <Description>St. Helena Hospital provides quality medical health care regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of St. Helena Hospital, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following will be considered when individuals who need health care cannot pay:a) Providing free care and/or subsidized careb) Providing care to persons covered by governmental programs at below costc) Providing health/wellness activities and community education programsNot only does St. Helena Hospital provide low-cost care to individuals covered by government programs and those unable to afford health care, but it also helps patients find and access private and governmental resources for health care benefits. St. Helena Hospital recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed value of providing care to these patients in 2012 was $5,589,365.Inpatient services in 2012 were provided to 8,058 patients. These services included:Babies delivered - 258Surgeries performed - 2,405Radiology procedures performed - 18,387Cardiac catheterization and other procedures - 8,040Laboratory tests performed - 258,681Rehabilitation Units - 1Outpatient services in 2012 were provided to 92,250 patients. These services included:Emergency Room visits - 7,446Surgeries performed - 3,796Radiology procedures performed - 31,919Cardiac catheterization procedures - 7,736Laboratory tests performed - 258,681Medical clinics - 24Home Care services in 2012 were provided to 1,075 patients. These services included:Home health visits - 12,944 St. Helena Hospital recognizes it has an obligation to provide human services above and beyond its role as a healing facility. The following community benefits demonstrate the tangible ways in which the organization is fulfilling its mission:Early Intervention ProgramHealthy Beginnings ProgramHealthvan One, Project HopeSafe Sitter classesChildren's Activity CenterHealthy Families Program Teddy Bear FairsPediatric S.A.R.T. (Sexual Assault Response Team) ProgramLearning-For-Life CentersSensory Integration Summer CampAsthma CampPhoneFriendGirls Today, Women TomorrowPASS (Parents for Alternate Support Solutions)Partners for PreventionParish NursingHealth FairsBlood Pressure Clinics</Description>
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      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <FSAuditedBasis>
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          <City>RESTRICTED</City>
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      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
      <GrantsOtherOrganizations>false</GrantsOtherOrganizations>
      <DirectContactLegislators>false</DirectContactLegislators>
      <RalliesDemonstrations>false</RalliesDemonstrations>
      <OtherActivities>true</OtherActivities>
      <OtherActivitiesAmount>12087</OtherActivitiesAmount>
      <TotalLobbyingExpendituresIIB>12087</TotalLobbyingExpendituresIIB>
      <NotDescribedIn501c3>false</NotDescribedIn501c3>
      <Form4720Filed4912Tax>false</Form4720Filed4912Tax>
      <Form990ScheduleCPartIV>
        <Identifier>Part II-B, Line 1i</Identifier>
        <ReturnReference>Part II-B, Line 1i - Other Activities Description</ReturnReference>
        <Explanation>Portion of dues paid to membership organizations allocable to political lobbying activities.</Explanation>
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        <Contributions>4272247</Contributions>
        <InvestmentEarningsOrLosses>-559442</InvestmentEarningsOrLosses>
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        <AdministrativeExpenses>1605</AdministrativeExpenses>
        <EndOfYearBalance>6577529</EndOfYearBalance>
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        <Contributions>5947164</Contributions>
        <InvestmentEarningsOrLosses>-345079</InvestmentEarningsOrLosses>
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        <AdministrativeExpenses>1771</AdministrativeExpenses>
        <EndOfYearBalance>5242348</EndOfYearBalance>
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      <BoardDesignatedEOYBalance>0.30780</BoardDesignatedEOYBalance>
      <PermanentEndowmentEOYBalance>0.17570</PermanentEndowmentEOYBalance>
      <TermEndowmentEOYBalance>0.51650</TermEndowmentEOYBalance>
      <EndowmentsHeldByUnrelatedOrgs>true</EndowmentsHeldByUnrelatedOrgs>
      <EndowmentsHeldByRelatedOrgs>true</EndowmentsHeldByRelatedOrgs>
      <AreRelatedOrgsListedScheduleR>true</AreRelatedOrgsListedScheduleR>
      <Land>
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        <BookValue>426637</BookValue>
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      <Buildings>
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        <Depreciation>57243323</Depreciation>
        <BookValue>51638282</BookValue>
      </Buildings>
      <Equipment>
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        <Depreciation>38687707</Depreciation>
        <BookValue>14062458</BookValue>
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      <OtherLandBuildings>
        <OtherCostOrOtherBasis>25160145</OtherCostOrOtherBasis>
        <Depreciation>5601561</Depreciation>
        <BookValue>19558584</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>85685961</TotalOfBookValueLandBuildings>
      <OtherAssets>
        <Description>Other Receivables</Description>
        <BookValue>1871830</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Interest in Consolidated Org</Description>
        <BookValue>21421935</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>Receivables from Related Organization</Description>
        <BookValue>18646195</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>41939960</TotalBookValueOtherAssets>
      <OtherLiabilities>
        <Description>Other Liabilities</Description>
        <Amount>769456</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Payables to 3rd Party Payors</Description>
        <Amount>6747059</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Workers Comp Liability</Description>
        <Amount>2992783</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>Payables to Related Organizations</Description>
        <Amount>93950910</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>104460208</TotalOfAmounts>
      <Form990ScheduleDPartXIII>
        <Identifier>Part V, Line 4</Identifier>
        <ReturnReference>Part V, Line 4: Intended uses of the endowment fund.</ReturnReference>
        <Explanation>Board-designated, temporarily, and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.</Explanation>
      </Form990ScheduleDPartXIII>
    </IRS990ScheduleD>
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      <FPGReferenceFreeCare>true</FPGReferenceFreeCare>
      <Pcent200>X</Pcent200>
      <FPGReferenceDiscountedCare>true</FPGReferenceDiscountedCare>
      <Pcent200D>X</Pcent200D>
      <FreeDiscCareMedicallyIndigent>true</FreeDiscCareMedicallyIndigent>
      <AmountsBudgetedForCharityCare>true</AmountsBudgetedForCharityCare>
      <ExpensesExceededBudget>false</ExpensesExceededBudget>
      <UnableToProvideCare>false</UnableToProvideCare>
      <AnnualCommunityBenefitReport>true</AnnualCommunityBenefitReport>
      <ReportPublicallyAvailable>true</ReportPublicallyAvailable>
      <CharityCareAtCost>
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        <NetCommunityBenefitExpense>-956858</NetCommunityBenefitExpense>
      </CharityCareAtCost>
      <UnreimbursedMedicaid>
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        <DirectOffsettingRevenue>24516287</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-2282797</NetCommunityBenefitExpense>
      </UnreimbursedMedicaid>
      <UnreimbursedCosts>
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        <DirectOffsettingRevenue>5296878</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>1881649</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00980</PercentOfTotalExpense>
      </UnreimbursedCosts>
      <TotalCharityCare>
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        <DirectOffsettingRevenue>30770023</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-1358006</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00980</PercentOfTotalExpense>
      </TotalCharityCare>
      <CommunityHealthServices>
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        <DirectOffsettingRevenue>88067</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>206043</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00110</PercentOfTotalExpense>
      </CommunityHealthServices>
      <SubsidizedHealthServices>
        <TotalCommunityBenefitExpense>3584167</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>4273464</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-689297</NetCommunityBenefitExpense>
      </SubsidizedHealthServices>
      <Research>
        <TotalCommunityBenefitExpense>255741</TotalCommunityBenefitExpense>
        <DirectOffsettingRevenue>119416</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>136325</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00070</PercentOfTotalExpense>
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      <CashAndInKindContributions>
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        <NetCommunityBenefitExpense>26459</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00010</PercentOfTotalExpense>
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      <TotalOtherBenefits>
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        <DirectOffsettingRevenue>4480947</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-320470</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.00190</PercentOfTotalExpense>
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      <TotalCommunityBenefits>
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        <DirectOffsettingRevenue>35250970</DirectOffsettingRevenue>
        <NetCommunityBenefitExpense>-1678476</NetCommunityBenefitExpense>
        <PercentOfTotalExpense>0.01170</PercentOfTotalExpense>
      </TotalCommunityBenefits>
      <CommunitySupport>
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        <DirectOffsettingRevenue>22401</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>2244</NetCommunityBuildingExpense>
      </CommunitySupport>
      <Total>
        <TotalCommunityBuildingExpense>24645</TotalCommunityBuildingExpense>
        <DirectOffsettingRevenue>22401</DirectOffsettingRevenue>
        <NetCommunityBuildingExpense>2244</NetCommunityBuildingExpense>
      </Total>
      <BadDebtExpenseReported>true</BadDebtExpenseReported>
      <BadDebtExpenseAmount>1352139</BadDebtExpenseAmount>
      <AmountAttributableTo>283949</AmountAttributableTo>
      <AmountReimbursedByMedicare>67891639</AmountReimbursedByMedicare>
      <CostOfCareReimbursedByMedicare>76532579</CostOfCareReimbursedByMedicare>
      <MedicareSurplusOrShortfall>-8640940</MedicareSurplusOrShortfall>
      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
      <ProvisionForCharityCare>true</ProvisionForCharityCare>
      <NumberOfHospitalFacilities>2</NumberOfHospitalFacilities>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>2</FacilityNumber>
        <Name>
          <BusinessNameLine1>SHH Ctr for Behavioral Health</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>525 Oregon St</AddressLine1>
          <City>Vallejo</City>
          <State>CA</State>
          <ZIPCode>94590</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <Other>Acute Psychiatric Hospital</Other>
      </Form990ScheduleHPartVSectionA>
      <Form990ScheduleHPartVSectionA>
        <FacilityNumber>1</FacilityNumber>
        <Name>
          <BusinessNameLine1>St Helena Hospital</BusinessNameLine1>
        </Name>
        <Address>
          <AddressLine1>10 Woodland Rd</AddressLine1>
          <City>St Helena</City>
          <State>CA</State>
          <ZIPCode>94574</ZIPCode>
        </Address>
        <LicensedHospital>X</LicensedHospital>
        <GeneralMedicalAndSurgical>X</GeneralMedicalAndSurgical>
        <Er24Hours>X</Er24Hours>
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        <CHNAConducted>false</CHNAConducted>
        <EligibilityCriteriaExplained>true</EligibilityCriteriaExplained>
        <UsesFPGFree>true</UsesFPGFree>
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        <UsesFPGDiscounted>true</UsesFPGDiscounted>
        <FPGDiscountPercent>400.0000</FPGDiscountPercent>
        <ExplainsBasis>true</ExplainsBasis>
        <IncomeLevel>X</IncomeLevel>
        <MedicalIndigency>X</MedicalIndigency>
        <InsuranceStatus>X</InsuranceStatus>
        <UninsuredDiscount>X</UninsuredDiscount>
        <MedicaidMedicare>X</MedicaidMedicare>
        <ExplainsApplicationMethod>true</ExplainsApplicationMethod>
        <IncludesPublicityMeasures>true</IncludesPublicityMeasures>
        <PostedOnWebsite>X</PostedOnWebsite>
        <AttachedToInvoices>X</AttachedToInvoices>
        <PostedInEmergencyRoom>X</PostedInEmergencyRoom>
        <PostedInAdmissionOffice>X</PostedInAdmissionOffice>
        <ProvidedOnAdmission>X</ProvidedOnAdmission>
        <AvailableOnRequest>X</AvailableOnRequest>
        <ActionsOnNonpayment>true</ActionsOnNonpayment>
        <CollectionActivities>false</CollectionActivities>
        <NondiscrimEmergencyCarePolicy>true</NondiscrimEmergencyCarePolicy>
        <MedicareRate>X</MedicareRate>
        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
      </Form990ScheduleHPartVSectionB>
      <Form990ScheduleHPartVSectionC>
        <NumberOfOtherFacilities>6</NumberOfOtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>St Helena Physical Therapy</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>1030 Main Street Ste 100</AddressLine1>
            <City>St Helena</City>
            <State>CA</State>
            <ZIPCode>94574</ZIPCode>
          </Address>
          <FacilityType>Outpatient Clinic</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>St Helena Medical Specialties Internal Medicine</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>18990 Coyote Valley Rd Stes 9 10</AddressLine1>
            <City>Hidden Valley Lake</City>
            <State>CA</State>
            <ZIPCode>95467</ZIPCode>
          </Address>
          <FacilityType>Outpatient Clinic</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Adventist Health Home Care Napa Valley</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>27 Woodland Rd</AddressLine1>
            <City>St Helena</City>
            <State>CA</State>
            <ZIPCode>94574</ZIPCode>
          </Address>
          <FacilityType>Home Health Agency</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>Adventist Health Home Care Lake County</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>9245 Hwy 53</AddressLine1>
            <City>Lower Lake</City>
            <State>CA</State>
            <ZIPCode>94574</ZIPCode>
          </Address>
          <FacilityType>Home Health Agency</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>St Helena Medical Specialties OBGYN</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>935 Trancas St Ste 4B</AddressLine1>
            <City>Napa</City>
            <State>CA</State>
            <ZIPCode>94558</ZIPCode>
          </Address>
          <FacilityType>Outpatient Clinic</FacilityType>
        </OtherFacilities>
        <OtherFacilities>
          <Name>
            <BusinessNameLine1>St Helena Coon Joint Replacement Institute</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>6 Woodland Rd Ste 202</AddressLine1>
            <City>St Helena</City>
            <State>CA</State>
            <ZIPCode>94574</ZIPCode>
          </Address>
          <FacilityType>Outpatient Clinic</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - States Where Community Benefit Report Filed</ReturnReference>
        <Explanation>CA</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Affilated Health Care System Roles and Promotion</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Explanation Of How Organization Furthers Its Exempt Purpose</ReturnReference>
        <Explanation>We do not wait until a community member needs our services through our clinics or our Emergency Department. We are active in the community we serve. By involving ourselves in various activities, groups, and outreaches, we communicate our willingness to serve our community and our commitment to our mission. Our community health needs assessment keeps us current with changes in the health of our community. By working with other groups and agencies we are better able to assess the needs of the community then if we relied only on our own resources.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Building Activities</ReturnReference>
        <Explanation>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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Community Information</ReturnReference>
        <Explanation>The hospital primarily serves the people of Napa, Lake, and Solano counties in California. Additionally, the hospital attracts patients from outside our geographic area with specialized destination medicine programs.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Patient Education of Eligibility for Assistance</ReturnReference>
        <Explanation>At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients also are orally informed of their right to request charity assistance. Signs and other communiques are posted and displayed throughout the hospital in multiple languages informing patients of this right as well. The hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. The hospital charity assistance policy is posted on the hospital website.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part VI - Needs Assessment</ReturnReference>
        <Explanation>The health system retains outside research firms to assess changes in the market and community perception. Data is collected through a variety of vehicles, including phone surveys, paper surveys, and focus groups. Questions were added to the survey to help assess the impact of our community benefit activities and residents' barriers to access for health care services as well as unmet community needs.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 9b - Provisions On Collection Practices For Qualified Patients</ReturnReference>
        <Explanation>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</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 8 - Explanation Of Shortfall As Community Benefit</ReturnReference>
        <Explanation>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 $69,063,455Prior Year Settlements (25,821)Cost Report Reimbursable Bad Debts 357,698Estimates and Accrual Variances (1,240,438)Other (263,255)Subtotal - Amount reported in Pt. III, line 5 $67,891,639Amounts included in Part 1, lines g and f -Total Medicare Revenue $67,891,639*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.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part III, Line 4 - Bad Debt Expense</ReturnReference>
        <Explanation>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.The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense.</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <ReturnReference>Part I, Line 7 - Explanation of Costing Methodology</ReturnReference>
        <Explanation>The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income/Gross patient chargesThe hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of Californias regulations and policies and the approval of the federal government.</Explanation>
      </Form990ScheduleHPartVI>
    </IRS990ScheduleH>
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      <RecordsMaintained>true</RecordsMaintained>
      <TotalNbrOf501C3AndGovtGrants>0</TotalNbrOf501C3AndGovtGrants>
      <TotalNbrOfOtherOrganizations>0</TotalNbrOfOtherOrganizations>
      <Form990ScheduleIPartIII>
        <TypeOfGrant>Psych Intern Stipends</TypeOfGrant>
        <NumberOfRecipients>5</NumberOfRecipients>
      </Form990ScheduleIPartIII>
      <Form990ScheduleIPartIV>
        <Identifier>Grantmaker's Description of How Grants are Used</Identifier>
        <Explanation>Grants 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.</Explanation>
      </Form990ScheduleIPartIV>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="IRS990ScheduleJ" softwareId="12000229" softwareVersion="2012v2.0">
      <CompensationCommittee>X</CompensationCommittee>
      <IndependentConsultant>X</IndependentConsultant>
      <CompensationSurvey>X</CompensationSurvey>
      <BoardOrCommitteeApproval>X</BoardOrCommitteeApproval>
      <SeverancePayment>false</SeverancePayment>
      <SupplementalNonqualRetirePlan>true</SupplementalNonqualRetirePlan>
      <EquityBasedCompArrangement>false</EquityBasedCompArrangement>
      <CompBasedOnRevenueOfFilingOrg>false</CompBasedOnRevenueOfFilingOrg>
      <CompBasedOnRevenueRelatedOrgs>false</CompBasedOnRevenueRelatedOrgs>
      <CompBasedNetEarningsFilingOrg>false</CompBasedNetEarningsFilingOrg>
      <CompBasedNetEarningsRelateOrgs>false</CompBasedNetEarningsRelateOrgs>
      <AnyNonFixedPayments>false</AnyNonFixedPayments>
      <InitialContractException>false</InitialContractException>
      <RebuttablePresumptionProcedure>false</RebuttablePresumptionProcedure>
      <Form990ScheduleJPartII>
        <NamePerson>Jacobson Carlton</NamePerson>
        <Title>VP Finance</Title>
        <CompBasedOnRelatedOrgs>188442</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>21351</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>24234</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>37185</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22899</NontaxableBenefitsRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Bockmann Rick</NamePerson>
        <Title>VP Administrative</Title>
        <CompBasedOnRelatedOrgs>231270</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>31915</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>13027</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>12898</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>18749</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>307859</TotalCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Matthews Gwen</NamePerson>
        <Title>Sr VP Operations</Title>
        <CompBasedOnRelatedOrgs>279250</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>93422</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>60447</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22955</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>456074</TotalCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Williams Patricia</NamePerson>
        <Title>VP Business Dev</Title>
        <CompBasedOnRelatedOrgs>191000</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>26912</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>11936</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>34783</DeferredCompRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Selivanoff Paul</NamePerson>
        <Title>VP Finance</Title>
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        <NontaxableBenefitsRelatedOrgs>21011</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>222310</TotalCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Olson David</NamePerson>
        <Title>VP Physician Svcs/CMG</Title>
        <CompBasedOnRelatedOrgs>123382</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>21552</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>6844</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>25901</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>177679</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lendaris Antonia</NamePerson>
        <Title>VP Pt Care Svcs</Title>
        <CompBasedOnRelatedOrgs>175715</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>12269</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>6010</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>11311</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>15350</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>220655</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Fillman Orvin</NamePerson>
        <Title>Reg VP Behav Med</Title>
        <CompBasedOnRelatedOrgs>175100</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>22174</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>8315</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>11972</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>18715</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>236276</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Cowan Joshua</NamePerson>
        <Title>VP Marketing</Title>
        <CompBasedOnRelatedOrgs>179511</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>25697</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>12776</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>13415</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22895</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>254294</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Herber Steven</NamePerson>
        <Title>Executive VP/CMO</Title>
        <CompBasedOnRelatedOrgs>252750</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>24029</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>5077</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>48387</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22939</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>353182</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>McDonald Edward</NamePerson>
        <Title>Treas/Asst Sec</Title>
        <CompBasedOnRelatedOrgs>258190</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>35221</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>47507</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>117687</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22943</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>481548</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>31182</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Newmyer Terrance</NamePerson>
        <Title>President</Title>
        <CompBasedOnRelatedOrgs>448840</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>91763</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>181341</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>102066</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>20937</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>844947</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>79806</CompReportPrior990RelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Wing Bill</NamePerson>
        <Title>Asst Secretary</Title>
        <CompBasedOnRelatedOrgs>554320</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>77197</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>33678</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>131876</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>22737</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>819808</TotalCompensationRelatedOrgs>
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      <Form990ScheduleJPartII>
        <NamePerson>Wehtje Rodney</NamePerson>
        <Title>Asst Treasurer</Title>
        <CompBasedOnRelatedOrgs>362899</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>71582</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>100009</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>191288</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>18827</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>744605</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>63809</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Rebok Douglas</NamePerson>
        <Title>Asst Secretary</Title>
        <CompBasedOnRelatedOrgs>561780</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>137623</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>172912</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>138641</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>21090</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1032046</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>116805</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Reiner Scott</NamePerson>
        <Title>V Chair/Sec</Title>
        <CompBasedOnRelatedOrgs>654000</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>149534</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>111866</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>160719</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>23025</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1099144</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>42890</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Carmen Robert</NamePerson>
        <Title>Chairman</Title>
        <CompBasedOnRelatedOrgs>982571</CompBasedOnRelatedOrgs>
        <BonusRelatedOrgs>240680</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>591191</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>15298</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>23566</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>1853306</TotalCompensationRelatedOrgs>
        <CompReportPrior990RelatedOrgs>472760</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Jobe Meredith</NamePerson>
        <Title>Dir/VP/Gen Cnsl</Title>
        <CompBasedOnRelatedOrgs>262685</CompBasedOnRelatedOrgs>
        <OtherCompensationRelatedOrgs>55336</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>56358</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>17397</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>391776</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Scherencel Tobin</NamePerson>
        <Title>RN OT PT Surgery</Title>
        <BaseCompensationFilingOrg>207807</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>500</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>12605</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>14639</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>235551</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Nelson Barry</NamePerson>
        <Title>CV Lab Supervisor</Title>
        <BaseCompensationFilingOrg>226635</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>500</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>13913</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>16659</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>257707</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Kirk Richard</NamePerson>
        <Title>Nurse Practitioner</Title>
        <BaseCompensationFilingOrg>220000</BaseCompensationFilingOrg>
        <OtherCompensationFilingOrg>12548</OtherCompensationFilingOrg>
        <DeferredCompFilingOrg>10758</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>18735</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>262041</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Lundin Stephen</NamePerson>
        <Title>Chief Dev. Officer</Title>
        <BaseCompensationFilingOrg>240371</BaseCompensationFilingOrg>
        <DeferredCompFilingOrg>14054</DeferredCompFilingOrg>
        <NontaxableBenefitsFilingOrg>21427</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>275852</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Coon Thomas</NamePerson>
        <Title>Medical Director</Title>
        <BaseCompensationFilingOrg>301151</BaseCompensationFilingOrg>
        <NontaxableBenefitsFilingOrg>147</NontaxableBenefitsFilingOrg>
        <TotalCompensationFilingOrg>301298</TotalCompensationFilingOrg>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>Dodds Larry</NamePerson>
        <Title>Former V Chair/Sec</Title>
        <BonusRelatedOrgs>78280</BonusRelatedOrgs>
        <OtherCompensationRelatedOrgs>562</OtherCompensationRelatedOrgs>
        <DeferredCompRelatedOrgs>3564</DeferredCompRelatedOrgs>
        <NontaxableBenefitsRelatedOrgs>14928</NontaxableBenefitsRelatedOrgs>
        <TotalCompensationRelatedOrgs>97334</TotalCompensationRelatedOrgs>
      </Form990ScheduleJPartII>
    </IRS990ScheduleJ>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="12000229" softwareVersion="2012v2.0">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Cambria Wehtje-Sim</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Officer Child</Relationship>
        <AmountOfTransaction>92117</AmountOfTransaction>
        <DescriptionOfTransaction>Employment</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Maria Lendaris</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Officer Child</Relationship>
        <AmountOfTransaction>65957</AmountOfTransaction>
        <DescriptionOfTransaction>Employment</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Gregory Williams</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Officer Spouse</Relationship>
        <AmountOfTransaction>32568</AmountOfTransaction>
        <DescriptionOfTransaction>Consulting Services</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="12000229" softwareVersion="2012v2.0">
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 9</Identifier>
        <ReturnReference>Other Changes In Net Assets Or Fund Balances - Other Decreases</ReturnReference>
        <Explanation>Change in value of split interest agreements = -$663932</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 9</Identifier>
        <ReturnReference>Other Changes In Net Assets Or Fund Balances - Other Increases</ReturnReference>
        <Explanation>Chg in interest of fnd rest net assets = $619973</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy publicly available. The hospital files monthly/quarterly summary financial reports with the state health planning agency.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15a</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15a: Compensation Review &amp; Approval Process - CEO, Top Management</ReturnReference>
        <Explanation>See explanation of process for setting CEO compensation below on Form 990, Part VI, Line 15b explanation.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b: Form 990 Review Process</ReturnReference>
        <Explanation>The 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.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 7b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders</ReturnReference>
        <Explanation>The hospital bylaws define its board of directors to be the same individuals who are members of the Adventist Health System/West board of directors. Adventist Health System/West, a California not-for-profit religious corporation, is the sole corporate member of the hospital.The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 6</Identifier>
        <ReturnReference>Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder</ReturnReference>
        <Explanation>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.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Reedley Community Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>372 W Cypress Ave</AddressLine1>
          <City>Reedley</City>
          <State>CA</State>
          <ZIPCode>93654</ZIPCode>
        </AddressUS>
        <EIN>453220509</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Adventist Health Physicians Network</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2100 Douglas Blvd</AddressLine1>
          <City>Roseville</City>
          <State>CA</State>
          <ZIPCode>95661</ZIPCode>
        </AddressUS>
        <EIN>680357690</EIN>
        <PrimaryActivities>Medical Foundation</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11b, II</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Willits Hospital Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1 Madrone St</AddressLine1>
          <City>Willits</City>
          <State>CA</State>
          <ZIPCode>95490</ZIPCode>
        </AddressUS>
        <EIN>680108919</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>White Memorial Medical Center</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1720 Cesare E Chavez Ave</AddressLine1>
          <City>Los Angeles</City>
          <State>CA</State>
          <ZIPCode>90033</ZIPCode>
        </AddressUS>
        <EIN>952282647</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Walla Walla General Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1025 S Second Ave</AddressLine1>
          <City>Walla Walla</City>
          <State>WA</State>
          <ZIPCode>99362</ZIPCode>
        </AddressUS>
        <EIN>910617726</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>WA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>Ukiah Adventist Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>275 Hospital Dr</AddressLine1>
          <City>Ukiah</City>
          <State>CA</State>
          <ZIPCode>95482</ZIPCode>
        </AddressUS>
        <EIN>941639901</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
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          <BusinessNameLine1>Sonora Community Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>1000 Greenley Rd</AddressLine1>
          <City>Sonora</City>
          <State>CA</State>
          <ZIPCode>95370</ZIPCode>
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        <EIN>941415069</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Simi Valley Hospital &amp; Health Care Svcs</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>2975 N Sycamore Dr</AddressLine1>
          <City>Simi Valley</City>
          <State>CA</State>
          <ZIPCode>93065</ZIPCode>
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        <EIN>956064971</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>San Joaquin Community Hospital</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>2615 Chester Ave</AddressLine1>
          <City>Bakersfield</City>
          <State>CA</State>
          <ZIPCode>93301</ZIPCode>
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        <EIN>952294234</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Adventist Health Clearlake Hospital Inc</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>Ave 18 at Hwy 53</AddressLine1>
          <City>Clearlake</City>
          <State>CA</State>
          <ZIPCode>95422</ZIPCode>
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        <EIN>680395149</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
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        <PublicCharityStatus>3</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Portland Adventist Medical Center</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>10123 SE Market St</AddressLine1>
          <City>Portland</City>
          <State>OR</State>
          <ZIPCode>97216</ZIPCode>
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        <EIN>930429015</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>OR</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Paradise Valley Hospital</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>2100 Douglas Blvd</AddressLine1>
          <City>Roseville</City>
          <State>CA</State>
          <ZIPCode>95661</ZIPCode>
        </AddressUS>
        <EIN>951816034</EIN>
        <PrimaryActivities>Wind down after sale of hospital facilities</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>NW Medical Foundation of Tillamook</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1000 Third St</AddressLine1>
          <City>Tillamook</City>
          <State>OR</State>
          <ZIPCode>97141</ZIPCode>
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        <EIN>930622075</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>OR</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Hanford Community Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>450 Greenfield Ave</AddressLine1>
          <City>Hanford</City>
          <State>CA</State>
          <ZIPCode>93230</ZIPCode>
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        <EIN>940535360</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Glendale Adventist Medical Center</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1509 Wilson Ter</AddressLine1>
          <City>Glendale</City>
          <State>CA</State>
          <ZIPCode>91206</ZIPCode>
        </AddressUS>
        <EIN>951816017</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Feather River Hospital</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>5974 Pentz Rd</AddressLine1>
          <City>Paradise</City>
          <State>CA</State>
          <ZIPCode>95969</ZIPCode>
        </AddressUS>
        <EIN>941101228</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Central Valley General Hospital</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>1025 N Douty St</AddressLine1>
          <City>Hanford</City>
          <State>CA</State>
          <ZIPCode>93230</ZIPCode>
        </AddressUS>
        <EIN>770324630</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Castle Medical Center</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>640 Ulukahiki St</AddressLine1>
          <City>Kailua</City>
          <State>HI</State>
          <ZIPCode>96734</ZIPCode>
        </AddressUS>
        <EIN>990107330</EIN>
        <PrimaryActivities>Hospital</PrimaryActivities>
        <LegalDomicileState>HI</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>St Helena Hospital Foundation</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>10 Woodland Rd</AddressLine1>
          <City>St Helena</City>
          <State>CA</State>
          <ZIPCode>94574</ZIPCode>
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        <EIN>201384250</EIN>
        <PrimaryActivities>Fundraising and Investment Management</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11a, I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Adventist Health SystemWest</BusinessNameLine1>
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        <AddressUS>
          <AddressLine1>2100 Douglas Blvd</AddressLine1>
          <City>Roseville</City>
          <State>CA</State>
          <ZIPCode>95661</ZIPCode>
        </AddressUS>
        <EIN>953484589</EIN>
        <PrimaryActivities>Support and manage system-wide activities</PrimaryActivities>
        <LegalDomicileState>CA</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>1</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>NA</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
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      <Form990ScheduleRPartIV>
        <NameOfRelatedOrg>
          <BusinessNameLine1>South Coast Medical Center</BusinessNameLine1>
        </NameOfRelatedOrg>
        <AddressUS>
          <AddressLine1>2100 Douglas Blvd</AddressLine1>
          <City>Roseville</City>
          <State>CA</State>
          <ZIPCode>95661</ZIPCode>
        </AddressUS>
        <EIN>952037291</EIN>
        <PrimaryActivity>Wind down after sale of hospital</PrimaryActivity>
        <LegalDomicileState>CA</LegalDomicileState>
        <DirectControllingEntityNA>N/A</DirectControllingEntityNA>
        <TypeOfEntity>C Corp</TypeOfEntity>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartIV>
      <ReceiptOfIntAnnRentsRoyalties>false</ReceiptOfIntAnnRentsRoyalties>
      <GiftGrantOrCapContrToOtherOrg>false</GiftGrantOrCapContrToOtherOrg>
      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>true</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>true</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
      <SaleOfAssetsToOtherOrg>false</SaleOfAssetsToOtherOrg>
      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>true</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>true</SharingOfFacilities>
      <SharingOfPaidEmployees>true</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>false</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>false</OtherTransferFromOtherOrg>
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  </ReturnData>
</Return>