2011-11-15T17:16:21-08:00 2010-12-31 Clement & Associates CPA 2930 Honolulu Avenue Suite 200 La Crescenta CA 91214 990 2010-01-01 952282647 White Memorial Medical Center WHIT 3232685000 1720 Cesar E Chavez Ave Los Angeles CA 90033 John Raffoul 2011-11-15 S CLEMENT 8182491065 X 2010 2016-03-07 17:11:31Z Beth Zachary 2100 Douglas Blvd Roseville CA 95661 345203414 false false 1071 X www.whitememorial.com X 1963 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 2062 608 -1275577 -1541865 4665841 7624851 274266429 321544234 9361462 11733971 720643 -1113084 289014375 339789972 207260 151760 0 132379929 141034063 0 737819 133728910 165854963 266316099 307040786 22698276 32749186 529588712 571808172 136131908 145602182 393456804 426205990 As a Seventh-day Adventist medical center, we are a family of caring professionals serving our community with: 1) A passion for excellence, 2) A spirit of Christian service, 3) A commitment to medical education. false false 248388186 60000 321144987 As a Seventh-day Adventist medical center, we are a family of caring professionals serving our community with: 1. A spirit of Christian service 2. A passion for excellence and 3. A commitment to medical education.The White Memorial Medical Center 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 the White Memorial 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 careProviding care to persons covered by governmental programs at below costProviding health/wellness activities and community education programsNot only does the White Memorial Medical Center 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. The White Memorial Medical Center 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 2010 was $78,134,579.Inpatient services in 2010 were provided to 23,157 patients. These services included: 4,143 Newborns 4,135 Babies delivered 6,402 Surgeries performed 1,963 Cardiac catherizations and other procedures 454 Skilled nursing patients 318 Rehabilitation patients 530 Neonatal Intensive Care Patients 266 Pediatric Intensive Care Patients 1,820 Psychiatric Care Patients 3,126 Medical Services Outpatient services in 2010 were provided to 111,114 patients. These services included: 43,386 Emergency room visits 3,709 Outpatient surgeries performed100,734 Radiology procedures performed 6,253 Cardiac catherizations and other procedures931,561 Laboratory tests performed 2,704 Cleft Palate visits 7.709 Cancer Center proceduresThe White Memorial Medical Center recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Thanks to support from our community partners, the organization is able to fulfill its mission through the following programs:Early Intervention ProgramHealthy Beginnings Program - 1,946 encounters for free classesHealthy Families Program Rainbow Center Child CarePartners for PreventionParish Nursing - 1,932 encountersHealth Fairs - 5,808 Cancer Screenings & 3,125 Glucose Screenings for DiabetesPatient Healthcare Transportation - provided 14,820 encountersThe Diabetes Care Center at WMMC addresses the high prevalence of diabetes within the community and provides full-service diabetes testing, education, peer counseling and follow-up care and runs a successful Healthy Eating & Lifestyle Program (H.E.L.P.); a six-week program designed to teach children, at-risk of developing diabetes, the benefits of a well-balanced diet and regular exercise. No insurance is needed to access this bilingual program. Recently the HELP program in partnership with Avocados from Mexico organized a flip-cam video contest documenting the journey of HELP students to health awareness. Malachi Cruz, the 12 year old winner of the contest, demonstrated in his video how he uses team sports to remain healthy and fit and shares the recipe of one of his favorite healthy lunch options; a nutrient-rich, low-fat Panini. "The HELP program has helped me in a lot of [ways]. I am more active in sports, I eat better, and I learned a lot...." 248388186 true true false true false false false false false true true false false false true false true false false false false false false false false false true false true false true false false false false false false false false false false false false false false false false true false false false false true 359 0 true 2062 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 false false X John Raffoul TreasurerVP Fin 3232685000 1720 Cesar E Chavez Ave Los Angeles CA 900332443 Wes Rippey MD 1.00 X 0 144704 74 Thao Nguyen 50.00 X 199031 0 23496 Steven C Herber MD 1.00 X 0 146754 74 Stella Nwaigbo 80.00 X 243695 0 0 Sharon McCoy 0.00 X 196672 0 19555 Scott Reiner 50.00 X 0 706956 142451 Ruthita Fike 1.00 X 0 405 74 Roland Fargo 50.00 X 0 268661 33028 Rodney Wehtje 50.00 X 0 484703 160891 Robert Carmen 50.00 X X 0 1485849 256139 Robert Bradshaw DDS 1.00 X 0 1321 74 Ricardo Graham 1.00 X 0 2309 74 Ray Morales 50.00 X 9600 424489 37131 Meredith Jobe Esq 1.00 X 13791 2455 74 Max Torkelsen 1.00 X 0 1854 74 Mary Anne Chern 50.00 X 0 231159 54688 Mara Bryant 50.00 X 117717 94339 17663 Lynne Whaley 50.00 X 0 283790 25383 Lynn Creitz 1.00 X 0 2123 74 Larry Dodds 50.00 X X 0 789424 159012 Larry Caviness 1.00 X 0 2505 74 John Saad 50.00 X 195627 0 23387 John Raffoul 50.00 X 0 342091 73036 Douglas Rebok 50.00 X 0 701547 140807 Christine E Friestad Esq 1.00 X 0 1311 74 Blin Richards 80.00 X 188752 0 22539 Beth Zachary 50.00 X 0 596065 113265 Albert Deininger 50.00 X 0 227424 51592 Al Reimche 1.00 X 0 1440 74 1164885 6943678 1354877 267 false true false White Memorial Medical Group 1701 Cesar Chavez Ave Ste 510 Los Angeles CA 90033 Medical Services 1592810 Sodexo 1720 Cesar E Chavez Ave Los Angeles CA 90033 Housekeeping Service 2821867 Mobile Dialysis PO Box 403008 Atlanta GA 30384 Medical Services 1652089 FCS Medical Corporation 5823 York Blvd Ste 1 Highland Park CA 90042 Teaching/Med Svcs 1717446 DVA Renal Healthcare Inc PO Box 403008 Atlanta GA 30384 Medical Services 1794217 101 427091 4250432 2947328 7624851 Rental Income-Pgm Svc 531120 1733229 1696374 268 36587 Patient Svc Revenue 621110 317725030 317725030 Parking 812930 724000 260218 463782 Other Prog Svc Rev 900099 85456 58833 26623 Dietary 722210 1253104 1246464 6640 23415 23415 321544234 11733871 11733871 0 0 3877379 5413442 -1536063 -1536063 -1536063 100 100 100 100 0 0 0 Value Change-Net Asset 900099 394872 394872 Net Assets Rel from Rest 900099 Miscellaneous Revenue 900099 28107 28107 422979 339789972 321144988 -1275577 12295710 151760 151760 0 0 0 144243 144243 0 112357425 104395131 7420180 542114 3847185 3847185 16400786 13790860 2429221 180705 8284424 7676679 607745 0 1245804 1245804 1520927 1505927 15000 0 0 0 19762866 17862490 1900376 535008 535008 4686196 3452014 1234182 8819617 8426790 392827 0 11843827 11835174 8653 259790 137290 122500 0 227301 149814 77487 -62353 -64328 1975 0 15533139 15373582 159557 4408308 4408308 Rental/Lease Costs Equipment 3912445 3801606 110839 Purchased Services 21125730 12690090 8435640 Pt Care Supplies 39232343 39232343 Other Expenses 1597677 1221398 376279 Hospital CHFT Fees 31206338 31206338 0 307040786 248388186 57914781 737819 502650 87144 272304617 297264321 0 35201366 38857425 0 0 0 3697615 3674436 1425054 1396581 341283613 135633167 204020708 205650446 2388563 1554997 0 0 0 10048139 23322822 529588712 571808172 30264027 26891062 72120124 77069150 256000 33491757 41641970 136131908 145602182 X 389706975 421854456 3749829 4351534 393456804 426205990 529588712 571808172 32749186 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 104473 104473 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Allocation of dues paid to industry and professional organizations. The industry and provessional organizations conduct lobbying activity and and a portion of the membership dues is allocated for this purpose. 3749829 2721430 2087752 4383507 4944562 2259777 3454510 3749829 7057839 2814824 4928101 4944562 0.04000 0.96000 false true true 34118 2263420 2297538 262192429 87440305 174752124 66199129 44607278 21591851 10594517 3585584 7008933 205650446 Workers Comp Payable 4451585 Settlements - Medicare, Pay to 3rd Party 34729425 Payables to Related Organizations 2453670 Federal Taxes Payable 7290 41641970 339789972 307040786 32749186 32749186 339789972 339789972 339789972 307040786 307040786 307040786 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Net Assets Released from Restr-Cap Addtn $ -0 Transfers to Affiliates (Unrestr) $ -0 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 true X true true false false true true 14280406 252895 14027511 0.04570 111547921 140094154 -28546233 3501022 2099585 1401437 0.00460 129329349 142446634 -13117285 0.05030 626454 626454 0.00200 13457190 7174507 6282683 0.02050 1354567 1354567 0.00440 317576 317576 0.00100 15755787 7174507 8581280 0.02790 145085136 149621141 -4536005 0.07820 1173792 1173792 0.00380 1173792 1173792 0.00380 true 1430615 1130185 77497897 73638985 3858912 X true false 1 0 White Memorial Medical Center

1720 Cesar E Chavez Ave Los Angeles CA 90033

X X X X Acute,Rehab,Skilled Nursing,Psychiatric White Memorial Medical Center 1 false false false false false false false false false true false false Part VI - Additional Information Part V, Section BSchedule H, Part V, Section B is optional for the reporting organization as the tax year began prior to March 23, 2010. Further, IRS Announcement 2011-37 states the entire Part V, Section B is optional for the 2010 Form 990. 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.Additional Information:White Memorial Medical Center (WMMC) is a full service 353-bed, non-profit, faith-based hospital that provides a full range of inpatient, outpatient, emergency and diagnostic services and is located just minutes from downtown Los Angeles. One of the greatest assets an organization can possess is the trust of its community--both internal and external. WMMC devotes a significant amount of financial and human resources to carry on its legacy of close to 100 years of community-centered service to medically underserved communities in our area. Beyond our role as one of the leading providers of health care in our community, we are committed to operating as a socially responsible organization as we meet the needs of our different stakeholders--our patients, physicians, workforce, neighbors, partners and donors. Our goal is to enable people to achieve more than just good health; it is to create opportunities for growth and development that will make a real, lasting impact on the health of our community.For example, the Cecilia Gonzalez De La Hoya Cancer Center, named for the late mother of champion boxer and philanthropist, Oscar De La Hoya, helps address the area's high incidence of breast cancer. The Cancer Center features sophisticated diagnostic and treatment equipment, bilingual breast cancer support groups, a community resource center and free breast exams and mammograms to women who are uninsured or underinsured.The Diabetes Care at WMMC addresses the high prevalence of diabetes within the community and provides full-service diabetes testing, education, peer counseling and follow-up care and runs a successful Healthy Eating & Lifestyle Program (H.E.L.P.); a six-week program designed to teach children, at-risk of developing diabetes, the benefits of a well-balanced diet and regular exercise. No insurance is needed to access this bilingual program. Recently the HELP program in partnership with Avocados from Mexico organized a flip-cam video contest documenting the journey of HELP students to health awareness. Malachi Cruz, the 12 year old winner of the contest, demonstrated in his video how he uses team sports to remain healthy and fit and shares the recipe of one of his favorite healthy lunch options; a nutrient-rich, low-fat Panini. "The HELP program has helped me in a lot of [ways]. I am more active in sports, I eat better, and I learned a lot of [things] about the stuff I eat," said Cruz. It takes special people to create change, people with a passion for making a difference in the lives of others. Not just because it is the right thing to do, but because their passion to help those less fortunate is in their heart. White Memorial invites you to partner with us in building on our legacy of primary care and our unwavering pursuit of excellence in quality, innovation and service. Visit us at www.whitememorial.com! Part V - Explanation of Number of Facility Type The hospital provides outpatient services in multiple locations within its service area. Part VI - States Where Community Benefit Report Filed CA Part VI - Affilated Health Care System Roles and Promotion The hospital is a member of a larger health care system, which provides services in diversified areas of the Western United States. The hospital shares some services with other hospitals in its geographic area. Using today's technology, hospitals outside the geographic area are able to support the hospital by providing remote services such as telepharmacy and robotics surgery. The Corporate Office provides support for the rural health clinics, quality of care, and other clinical needs. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose 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, Cancer, Women's Services, Ortho, Neuro, Behavioral Medicine, Rehabilitative Medicine, Emergency, and Home Care services, as well as a residency program. The hospital cooperates with area physicians to offer both family practice and obstetrics clinics. Part VI - Community Building Activities The hospital is involved in numerious community building activities which promote the health of the communities we serve. Numerous community concerns are addressed, including health and prevention 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. We work with neighborhood programs, including schools, work sites and savety net providers to promote health and wellness and prevent disease. These activities are not included elsewhere on Schedule H.The hospital serves a community where 28% of families fall below the federal poverty line and whose residents are predominantly Latino. WMMC is positioned to provide this historically medically underserved population with Latino-focused in-language programs and education, including Spanish bilingual doctors and nurses and is dedicated to providing all its patients with the same level of high quality health care. This care includes highly advanced specialty services including advanced certifications, specialty care services and state-of-the-art procedures. WMMC has adopted rigorous national quality standards and has won four Eureka Awards for Performance Excellence from the California Council on Excellence. WMMC mission anchors everything we do and extends out to the community in many ways. Collaborative efforts between WMMC, local organizations and donors has created critical programs needed to address the specific health care needs of the more than 2 million residents living throughout eastern Los Angeles. Together we can change the outcome of our community's health. Part VI - Community Information WMMC is located in the City of Los Angeles serving primarily the communities of East Los Angeles, Boyle Heights, Chinatown, Commerce, El Sereno, Glassel Park, Highland Park, Huntington Park, Lincoln Heights, Los Angeles, Maywood and Montebello. The largest ethnic group in our Primary Service Area is Hispanic, comprising 87% of the population of our service area and our second largest ethnic group is Asian at 7%. The median income for our service area is approximately $30,000 and 87% of our patients are covered by Medical or Medicare. Based on the diversity of our service area we work to accomodate the diverse language and cultural needs. Part VI - Patient Education of Eligibility for Assistance At the time of registration, patients who do not possess third party coverage are counseled on how to apply for assistance via government programs. In many Adventist Health facilities, outside vendors are hired to assist in this area. Patients are also informed of their right to request charity assistance at the time of registration and via signs and other communiques posted and displayed throughout the hospital. Brochures are also provided at the time of registration that explain 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 in multiple languages. Part VI - Needs Assessment The hospital retains outside research firms every 3 years to assess changes in the market and community needs. 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. 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 Revenue Rec. *Medicare Cost Report Revenue $75,770,986 Prior Year Settlements (1,102,223) Cost Report Reimbursable Bad Debts 2,338,254 Estimates and Accrual Variances (8,307,710) Other 8,798,590 __________ Subtotal - Amount reported in Pt III, line 5 77,497,897 Amounts included in Part 1, lines g and f 2,383,006 __________ Total Medicare Revenue 79,880,903 *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 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. 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, those accounts would have been reclassified from bad debt expense to charity care.The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. YMCA Metropolitan LA 625 S New Hampshire Ave Los Angeles CA 90005 951644052 6000 0 General Operations WMMC Foundation 1720 Cesar E Chavez Ave Los Angeles CA 90033 953760201 9000 0 Fundraising White Memorial Church 401 North State St Los Angeles CA 90033 951994597 30000 0 General Operations TELACU Education Foundation 5400 E Olympic Blvd Ste 120 Los Angeles CA 90022 954384333 15000 0 General Operations 33 9 X X X X X false true false false false true true false false false Thao Nguyen 184404 10303 4324 11962 11534 222527 Stella Nwaigbo 243695 243695 Sharon McCoy 191580 5092 7202 12353 216227 Scott Reiner 510580 135332 61044 122323 20128 849407 Roland Fargo 213300 36099 19262 15014 18014 301689 Rodney Wehtje 324430 71576 88697 144827 16064 645594 54524 Robert Carmen 920840 235922 329087 235392 20747 1741988 211163 Ray Morales 329360 61741 9600 33388 15014 22117 9600 461620 Mary Anne Chern 190400 35430 5329 38704 15984 285847 Mara Bryant 88615 88020 26583 2519 6319 4508 3135 10020 120852 108867 Lynne Whaley 233000 43214 7576 15014 10369 309173 Larry Dodds 588930 152891 47603 142912 16100 948436 John Saad 159898 30870 4859 11466 11921 219014 John Raffoul 269580 50758 21753 52972 20064 415127 Douglas Rebok 512780 137782 50985 122488 18319 842354 Blin Richards 162232 22044 4476 10825 11714 211291 Beth Zachary 410300 114313 71452 95153 18112 709330 23940 Albert Deininger 177460 33091 16873 35616 15976 279016 Sch J, Part I, Line 6b Part I, Line 6b: Explanation of organization compensation contingent on net earnings from related or An incentive plan is included as part of the board-approved compensation plan for hospital executives. The hospital has a similar plan for department directors. The purpose of these plans is to provide incentives to hospital management to accomplish the financial, operational, quality, and mission objectives of the hospital during each fiscal year. Each member of the management team is evaluated against pre-determined objectives to arrive at the incentive amount, if any, for the fiscal year. See Schedule O for additional detail. Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. Part I, Line 1aAny 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.Part I, Line 3The Board Compensation Committee establishes the compensation and benefits of the hospital CEO, using all of the methods indicated on Line 3 except "Form 990 of other organizations" and "written employment contract." Form 990, Part VII, Line 1a - Board Comp The directors serve on the Board without compensation. Amounts reported generally are for taxable benefits. Further explanation for those directors who receive compensation for services rendered in their professional capacity follows. Steven Herber, MD is the Chief Medical Officer (CMO) for St. Helena Hospital. The hospital paid Dr. Herber $144,001 for his services. The CMO services were provided under contract approved by the Board Compliance Committee.Jobe & Stoterau, a law practice with which Meredith Jobe is affiliated, provided legal services regarding real estate matters to White Memorial Medical Center in the amount of $13,791. Wesley Rippey, MD is the Chief Medical Officer for Portland Adventist Medical Center. The hospital paid Dr. Rippey $57,600 for his CMO services. Additionally, Dr. Rippey provides vascular study interpretations and on call coverage for patients of the hospital. The hospital paid $85,818 for these professional services. These services were provided under contract approved by the Board Compliance Committee. 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 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 operates as an affiliate of Adventist Health System/West. Willits Hospital Inc 1 Madrone St Willits CA 95490 680108919 Hospital CA 501(c)(3) 1 N/A false White Memorial Medical Center Fdtn 1720 Cesar E Chavez Ave Los Angeles CA 90033 952282647 Fundraising for Hospital CA 501(c)(3) 11, Type 1 N/A false Walla Walla General Hospital 1025 S Second Ave Walla Walla WA 99362 910617726 Hospital CA 501(c)(3) 1 N/A false Ukiah Adventist Hospital 275 Hospital Dr Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 1 N/A false South Coast Medical Center 2100 Douglas Blvd Roseville CA 95661 952037291 Hospital CA 501(c)(3) 3 N/A false Sonora Community Hospital 1000 Greenley Rd Sonora CA 95370 941415069 Hospital CA 501(c)(3) 1 N/A false Simi Valley Hospital & Health Care Svcs 2975 N Sycamore Dr Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 1 N/A false Selma Community Hospital Inc 1141 Rose Ave Selma CA 93662 770509133 Supporting Hanford Community Hospital CA 501(c)(3) 11 Type 3 Integrated N/A false San Joaquin Community Hospital 2615 Chester Ave Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 1 N/A false St Helena Hospital 10 Woodland Rd St Helena CA 94574 941279779 Hospital OR 501(c)(3) 1 N/A false Portland Adventist Medical Center 10123 SE Market St Portland OR 97216 930429015 Hospital OR 501(c)(3) 1 N/A false Paradise Valley Hospital 2100 Douglas Blvd Roseville CA 95661 951816034 Wind Down After Sale of Hospital Facilities CA 501(c)(3) 1 N/A false Northwest Medical Fdtn of Tillamook 1000 Third St Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 1 N/A false Hanford Community Hospital 450 Greenfield Ave Hanford CA 93230 940535360 Hospital CA 501(c)(3) 1 N/A false Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 953899682 Hospital CA 501(c)(3) 1 N/A false Feather River Hospital 5974 Pentz Rd Paradise CA 95969 941101228 Hospital CA 501(c)(3) 1 N/A false Central Valley General Hospital 1025 N Douty St Hanford CA 93230 770324630 Hospital CA 501(c)(3) 1 N/A false Castle Medical Center 640 Ulukahiki St Kailua HI 96734 990107330 Hospital HI 501(c)(3) 1 N/A false Adventist Health Clearlake Hospital Inc Ave 18 at Hwy 53 Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 N/A 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 false true false true true false false false false false true true true true true false false false