2012-11-16T09:38:34-08:00 2011-12-31 Clement & Associates CPA 2930 Honolulu Avenue Suite 200 La Crescenta CA 91214 990 2011-01-01 951816017 Glendale Adventist Medical Center GLEN 8184098000 1509 Wilson Terrace Glendale CA 91206 Kelly Turner 2012-11-16 true S Clement 8182491065 X 2011 2016-02-24 21:20:13Z Kevin Roberts 1509 Wilson Terrace Glendale CA 91206 346093406 false false 1071 X www.glendaleadventist.com X 1905 CA The hospital mission is to provide our community with physical, mental, and spiritual healing in a way that reflects God's love for all. 13 8 2858 719 2819349 399970 2578991 1627376 352546335 341671081 2326033 1957788 302538 824527 357753897 346080772 114520 184200 0 157806304 168849836 0 1146125 181953102 170403979 339873926 339438015 17879971 6642757 363028605 394424561 227473337 251986535 135555268 142438026 To share God's love with our community by promoting healing and wellness for the whole person. false false 295106692 184200 341671081 Glendale Adventist MedicalCenter 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 Glendale Adventist Medical Center 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: providing free care and/or subsidized care providing care to persons covered by governmental programs at below cost providing health/wellness activities and community education programsNot only does Glendale Adventist MedicalCenter 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. Glendale Adventist MedicalCenter recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2011 was $51,339,029.Inpatient services in 2011 were provided to 19,360 patients. These services included: 2,406 Babies delivered 3,898 Surgeries performed 58,840 Radiology procedures performed 30,966 Cardiac catheterizations and other procedures 802,968 Laboratory tests performed 568 Rehabilitation patients 1,722 Mental health patientsOutpatient services in 2011 were provided to 265,122 patients. These services included: 41,992 Emergency room visits 4,738 Outpatient surgeries performed 58,137 Radiology procedures performed 10,912 Cardiac catheterizations and other procedures 400,445 Laboratory tests performedHome Care services in 2011 were provided to 21,594 patients. These services included: 14,242 RN visits 5,512 Physical Therapy visits 861 Occupational Therapy visitsGlendale Adventist MedicalCenter 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:Children's Health Outreach InitiativeCenter to Increase Community OrganizationCommunity support groupsCommunity health education classesHQ Newsletter for health promotionParamedic base stationTobacco Control ProgramCancer Survivor DayBeyond Loss bereavement programMental health support groupsGlendale Downtown DashBreast Cancer Awareness MonthCancer screeningsCancer Fitness Program 295106692 true true false true false false false false false true true false false true true false false true false false false false false false false false true true true false true false false false false false false true false false false false false false false false false true true true false false true 294 0 true 2858 true true true false false false false false false false false false 0 false false false false false false false false false false false X 13 8 false false false false true false true true true false false false true true true true true true true true true true X Kelly Turner CFO 8184098000 1509 Wilson Terrace Glendale CA 91206 X Scott Reiner 50.00 X X 0 907841 160287 Larry Dodds 50.00 X X 0 685344 96060 Robert Carmen 50.00 X X 0 1749297 39804 Max Torkelsen 1.00 X 0 2381 0 Wes Rippey MD 1.00 X 0 98503 0 Al Reimche 1.00 X 0 1637 0 Helmuth Jones 1.00 X 0 350 0 Meredith Jobe Esq 1.00 X 0 54617 0 Larry Innocent 1.00 X 0 350 0 Steven C Herber MD 1.00 X 0 219911 41678 Ricardo Graham 1.00 X 0 2652 0 Christine E Friestad Esq 1.00 X 0 2927 0 Ruthita Fike 1.00 X 0 635 0 Lynn Creitz 1.00 X 0 3123 0 Larry Caviness 1.00 X 0 2666 0 Robert Bradshaw DDS 1.00 X 0 4652 0 Warren Tetz 50.00 X 0 396274 81574 Kelly Turner 50.00 X 0 367845 65876 Kevin Roberts 50.00 X 0 513141 92795 Morre Dean 50.00 X 0 472637 68812 Bill Wing 50.00 X 0 321581 89967 Rodney Wehtje 50.00 X 0 506336 95494 Douglas Rebok 50.00 X 0 857414 147299 Kimberly Milstien 50.00 X 0 234719 25023 Robert Marchuk 50.00 X 0 220285 58616 Robert deLeon 50.00 X 0 431633 100641 Judy Blair 50.00 X 0 227321 31636 Gwen Matthews 50.00 X 0 331912 70860 Mei Rosado 60.00 X 243909 0 21748 Suvanna Patana 60.00 X 208073 0 16337 Frederico Duran Jr 60.00 X 201828 0 22696 Romic Eskandarian 50.00 X 200077 0 21930 Sergey Gantman 60.00 X 193200 0 18198 1047087 8617984 1367331 242 false true false ShiftwiseOrigin Inc PO Box 70870 St Paul MN 55170 Registry Staffing 3163214 Family Practice of Glendale Glendale Med Gp 801 S Chevy Chase 201 Glendale CA 91205 Residency Teaching 3063604 Consultants for Anesthesia & Mgmt of Pain 5134 Earl Drive La Canada CA 91011 Medical services 980550 AllHealth Security Services 515 S Figueroa St Suite 1300 Los Angeles CA 90071 Med Service-Dialysis 880071 Albert C Mak MD Cyberknife 707 S Garfield Ave Ste B002 Alhambra CA 91801 Med Svcs-Radiation 2590000 53 1530298 97078 1627376 Rental Income - Prog 531120 1794750 1539029 6000 249721 Patient Svc Revenue 621110 336420639 333618778 2791808 10053 Other Prog Serv Rev 900099 511045 419968 91077 Dietary 722210 1741282 249258 1492024 Dependent Care 624410 1182847 1182847 20518 20518 341671081 1955122 1955122 0 0 0 15300 12634 2666 2666 2666 0 0 0 Other Non-Operating Inc 900099 784390 784390 Mgmt Fees - Related Org 541900 49423 27882 21541 Change Int Fdtn Net Asset 900099 -9286 -9286 824527 346080772 337833384 2819349 3800663 184200 184200 0 0 0 0 0 132871469 121957208 10263724 650537 4265526 3872184 393342 21439151 19197936 2241215 10273690 9510386 763304 0 1434348 1434348 152050 152050 0 0 0 14376190 13267662 1069843 38685 987576 16587 868657 102332 8972068 3390882 5556516 24670 9321381 9321250 131 0 9198197 9096631 12946 88620 566130 353897 174062 38171 0 245789 170828 74961 4508397 4508397 8000 8000 16460940 16460940 3392338 3392338 Rental/Lease Costs Equipment 2983815 2973046 10769 Purchased Services 35330498 25818281 9361224 150993 Pt Care Supplies 50713415 50713415 Other Expenses 11752847 892624 10808106 52117 0 339438015 295106692 43185198 1146125 116487 121391 27898869 44494835 0 58451914 55422506 750000 0 0 0 6714979 6882979 2796497 2479748 428581515 183372196 225638778 245209319 371265 1610586 0 0 0 40289816 38203197 363028605 394424561 26692188 33267744 38610082 37083805 2228246 1861565 3324979 156617842 179773421 227473337 251986535 X 130420182 137528894 4861696 4628274 273390 280858 135555268 142438026 363028605 394424561 X 6642757 240001 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 22663 22663 true false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Allocation of dues paid to industry and professional organizations. 5135086 878394 7469 1111817 4909132 4842628 1113528 25756 846826 5135086 6094608 263886 58093 1573959 4842628 0.05700 0.94300 false true true 3726115 3726115 1018730 328844833 133751182 196112381 3468330 1948055 1520275 65971543 46562665 19408878 25551964 1110294 24441670 245209319 Worker's Comp-Trustee Held Funds Receivables from Third-Party Payors 3076399 Receivables from Related Organizations 28626454 Other Receivables 2471676 Other Assets 4028668 38203197 Workers Compensation Liability 5975198 Tax Liability 25000 Payables to Related Organizations 173740883 Other Liabilities 32340 179773421 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Gifts & Grants-Restricted-Rpt on VII line 1 $878394 Net Assets Released from Restr-Cap Addtn $465954 Net Realized gains/losses on Perm Restr investments $7469 Temp Restr Net Assets Released from Rest $ -1111816 Part V, Line 4 Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. true true X true X 300.000000000 true X 450.000000000 true true true false true true 9289368 9289368 0.02740 79509251 60877044 18632207 0.05490 88798619 60877044 27921575 0.08230 2029778 2029778 292629 292629 0.00090 2322407 2029778 292629 0.00090 91121026 62906822 28214204 0.08320 7264 7264 198700 198700 0.00060 90724 90724 0.00030 226071 226071 253475 253475 252996 252996 1029230 739806 289424 0.00090 true 1824522 912261 140274231 137690279 2583952 X true true 1 0 Glendale Adventist Med Center

1509 Wilson Terrace Glendale CA 91206

X X X X Acute, Psychiatric & Skilled Nursing Glendale Adventist Med Center 1 true true 300.0000 true 450.0000 true X X X X X X true true X X X X X X true false true X X false false 2 GAMC Alcohol & Drug Rehab

335 Mission Rd Glendale CA 912053327

Alcohol & Drug Rehabilitation Services GAMC Home Care Services

381 Harvey Dr Glendale CA 91206

Home Care Services Part VI - Additional Information Part V, Section BSchedule H, Part V, Section B, Lines 1 through 7 is optional for the reporting organization as the tax year began prior to March 23, 2012, according to the instructions for Schedule H. Lacerte software has not provided a tool for an organization to indicate that it is opting not to complete Part V, Section B. In addition, the software has been programmed so that it populates responses when the organization chooses to provide no data inputs. Part V, Section B should be blank as the reporting organization opts to not complete it. Part V - Explanation of Number of Facility Type The hospital has a governing board composed of community members who advise the president/CEO regarding the healthcare needs of the community. At the direction of the governing board, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include cardiac, neuro, spine, cancer, emergency, outpatient services, minimally invasive surgery (robotics and no scar surgery), ortho, behavioral medicine, rehabilitative medicine and home care services, as well as a family medicine residency program. The hospital cooperates with area physicians to offer both family medicine and obstetrics clinics. Glendale Adventist has also established a Department of Clinical Research to help our communities gain access to cutting edge clinical advancements. Part VI - States Where Community Benefit Report Filed CA Part VI - Affilated Health Care System Roles and Promotion The hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communites served Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The hospital has an operating board composed of community members who advise the president/CEO regarding the needs of the community. Based on their advice, the hospital has developed outpatient and home care programs focused on rendering care in the most effective and efficient manner. The hospital's key medical services include cardiac, neuro, spine, cancer, emergency, outpatient services, minimally invasive surgery (robotics and no scar surgery), ortho, behavioral medicine, rehabilitative medicine and home care services, as well as a family medicine residency program. The hospital cooperates with area physicians to offer both family medicine and obstetrics clinics. Glendale Adventist has also established a Department of Clinical Research to help our communities gain access to cutting edge clinical advancements. Part VI - Community Building Activities Our hospital is involved in numerous community building activities which promote the health of the communities it serves. Numerous community concerns are addressed, including health improvement, education, poverty, workforce development and access to care. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. And, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H. Part VI - Community Information The hospital is located in Los Angeles County, serving primarily the City of Glendale (including La Canada, La Crescenta and Montrose), the Northeast portion of the City of Los Angeles (Eagle Rock, Highland Park and Glassell Park) and the Northeast portion of the San Fernando Valley. Significant numbers of Armenian, Hispanic and Asian people live in the hospital service area with many having limited English language proficiency. Several zip codes in the hospital service area have been designated as Medically Underserved Areas and a significant number of children in these areas are uninsured and/or qualify for state or federal insurance. The hospital provides support for several community organizations that provide coverage for children in these areas.The community has recognized GAMC as the best hospital in Glendale for several years running, one of the top 10 best places to work in Los Angeles County and many of the physicians on staff have been honored as top doctors by the local media.The hospital is fully accredited and has been designated a Primary Stroke Center by The Joint Commission, a STEMI Receiving Center and an Approved Stroke Center by Los Angeles County. Glendale Adventist has also been named a Blue Cross Center of Distinction for cardiac care. Additionally, the hospital is seeking accreditation as a Chest Pain Center. This means that the hospital is specially equipped and staffed to provide rapid treatment and diagnosis of strokes, heart attacks and chest pain. GAMC is focused on finding ways to provide high quality service to our community in a cost effective manner. Part VI - Patient Education of Eligibility for Assistance 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 are displayed in the patient business office, patient registration areas and the emergency room 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. Part VI - Needs Assessment The hospital 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 community 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. Number of Hospital Faciltiy - 0 Part V, Line 19d - Other Billing Determination of Individuals Without Insurance The hospital's financial assistance policy has three income ranges for patients who received emergency medical care, which provides a discount based on Medicare rates. There are also three income ranges for patients who received non-emergency medical care; the two lower income ranges provide a discount based on Medicare rates. The higher income range provides a discount from the balance due after the uninsured discount, that is available to all uninsured patients without regard to income. Only five of the six income ranges are discounted based on Medicare rates. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income" and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Since the 1997 Balanced Budget Act, Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to 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 $137,097,001 Prior Year Settlements - Cost Report Reimbursable Bad Debts 3,362,134 Estimates and Accrual Variances (359,594) Other 174,690 ___________ Subtotal - Amount reported in Pt III, line 5 140,274,231 Amount included in Part 1, lines g and f 2,029,778 Total Medicare Revenue $142,304,009*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 4 - Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the hospital's bad debt expense as reported in the system-wide combined audited 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 combined audited financial statements do not contain a footnote describing bad debt expense. true YWCA of Glendale 735 E Lexington Dr Glendale CA 91206 951644057 501(c)(3) 10000 0 Event Sponsorship YMCA 140 N Louise St Glendale CA 91206 951661118 501(c)(3) 10500 0 General Operations White Memorial Med Cntr Fdtn 1720 Cesar E Chavez Ave Los Angeles CA 90033 953760201 501(c)(3) 8000 0 Fundraising Western Diocese-Armenian Ch 3325 N Glenoaks Blvd Burbank CA 91504 956081942 501(c)(3) 6500 0 Event Sponsorship Salvation Army 180 E Ocean Blvd 9th Floor Long Beach CA 90802 954605502 501(c)(3) 10000 0 Partnership Proposal Glendale Community Free Healt 134 N Kenwood St Glendale CA 91206 870732681 501(c)(3) 15000 0 General Operations Glendale Arts 116 W California Glendale CA 91203 954416336 501(c)(3) 10000 0 Event Sponsorship Glendale Adventist Academy 700 Kimlin Dr Glendale CA 91206 953928295 501(c)(3) 7000 0 Event Sponsorships City of Glendale 613 E Broadway 200 Glendale CA 91206 956000714 City Government 12500 0 Event Sponsorships Armenian Bone Marrow Dnr Rgst 347 W Stocker St 208 Glendale CA 91202 050573780 501(c)(3) 10000 0 General Operations Armenian American Medical Soc PO Box 32 Glendale CA 91209 954108352 501(c)(3) 15600 0 Event Sponsorships 11 0 Grantmaker's Description of How Grants are Used Grants are donations made to US tax exempt organizations who are community partners known to us and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X true true X X X X false true false true false false false false false false Warren Tetz 287980 39690 68604 62778 18796 477848 44632 Suvanna Patana 92269 250 115554 12429 3908 224410 Steven C Herber MD 212461 7450 27400 14278 261589 Sergey Gantman 94340 250 98610 11388 6810 211398 Scott Reiner 577345 149092 181404 138780 21507 1068128 119583 Romic Eskandarian 162277 24313 13487 11226 10704 222007 Rodney Wehtje 340430 78784 87122 78557 16937 601830 52751 Robert Marchuk 184690 24850 10745 37715 20901 278901 Robert deLeon 338840 46970 45823 76899 23742 532274 Robert Carmen 934340 267209 547748 18150 21654 1789101 424494 Morre Dean 251461 86835 134341 54474 14338 541449 80124 Mei Rosado 116168 2318 125423 14938 6810 265657 Larry Dodds 303557 171094 210693 79089 16971 781404 120139 Kimberly Milstien 194850 24850 15019 13910 11113 259742 Kevin Roberts 340675 74482 97984 76432 16363 605936 58469 Kelly Turner 270000 36820 61025 56987 8889 433721 45522 Judy Blair 152642 40322 34357 12545 19091 258957 Gwen Matthews 242462 32760 56690 49444 21416 402772 32649 Frederico Duran Jr 109949 351 91528 11992 10704 224524 Douglas Rebok 533280 149092 175042 128096 19203 1004713 123894 Bill Wing 305801 15780 74419 15548 411548 Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Part I, Line 1BAny items checked on this line are reported as taxable income to the employee, except first class or charter travel, which is only approved for business purposes on an exception basis. Dro Abrahamian Executive Housing Ln X 25000 25000 false true true Morre Dean Executive Housing Ln X 750000 false true true 25000 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The hospital does not make its governing documents publicly available, beyond required filings of articles of incorporation with the secretary of state. The hospital does not make its conflict of interest policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The hospital board of directors has established a Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital CEOs and CFOs, that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data.The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital CEOs and executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 24 percent spread from minimum to maximum (industry norm is approximately a 50 percent spread). A hospital CEO has a maximum potential incentive of 30 percent of base salary. (This incentive potential is less than the industry norm.) Other hospital executives have a maximum potential incentive of 20 percent of base salary. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation, to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The corporate internal audit staff reviews these questionnaires and disclosures each year during the audit process. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process 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. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders The sole corporate member, Adventist Health System/West, must approve all changes to the articles of incorporation and bylaws. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder The hospital is organized as a not-for-profit religious corporation. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The hospital bylaws define its board of directors to be the same individuals who are members of Adventist Health System/West board of directors. Willits Hospital Inc 1 Madrone St Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false White Memorial Medical Center 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital WA 501(c)(3) 1 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Dr Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Simi Valley Hospital & Health Care Svcs 2975 N Sycamore Dr Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Ave Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false St Helena Hospital 10 Woodland Rd St Helena CA 94574 941279779 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Reedley Community Hospital 372 W Cypress Ave Reedley CA 93654 453220509 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Portland Adventist Medical Center 10123 SE Market St Portland OR 97216 930429015 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilit CA 501(c)(3) 1 Adventist Health SystemWest false Northwest Medical Fdtn of Tillamook 1000 Third St Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 Adventist Health SystemWest false Hanford Community Hospital 450 Greenfield Ave Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Glendale Adventist Medical Center Fdtn 1509 Wilson Terrace Glendale CA 91206 953899682 Fundraising for Hospital CA 501(c)(3) 11, Type 1 Adventist Health SystemWest false Feather River Hospital 5974 Pentz Rd Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Central Valley General Hospital 1025 N Douty St Hanford CA 93230 770324630 Hospital CA 501(c)(3) 1 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki St Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 Adventist Health SystemWest false Adventist Health Physicians Network 2100 Douglas Blvd Roseville CA 95661 680357690 Hospital CA 501(c)(3) 11b,II Adventist Health SystemWest false Adventist Health Clearlake Hospital Inc Ave 18 at Hwy 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health SystemWest 2100 Douglas Blvd Roseville CA 95661 953484589 Support and Manage System-Wide Activities CA 501(c)(3) 1 N/A false Glendale Adventist Medical Building LP 1509 Wilson Terrace Glendale CA 91206 953752800 Med Ofc Bld CA N/A 169269 2233625 false true 0.54614 Physician Medical Terrace LP 1509 Wilson Terrace Glendale CA 91206 954277400 Med Ofc Bld CA N/A -62642 4313546 false true 0.56596 South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Wind down after sale of hospital CA C-Corp true false false true true false false false false true true true false true true true false false Glendale Adventist Medical Building LP p 1345331 Glendale Adventist Medical Building LP k 5106 Glendale Adventist Medical Building LP j 87768 Glendale Adventist Medical Building LP d 229345 Physician Medical Terrace LP p 2309994 Physician Medical Terrace LP k 4883 Physician Medical Terrace LP j 173363 Physician Medical Terrace LP d 4130371