2023-11-01T12:54:46-05:00 2022-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2022-01-01 910617726 Walla Walla General Hospital WALL 9164060000 1 Adventist Health Way Roseville CA 956613266 Meredith Jobe Treasurer 9164060000 2023-10-26 1 Meredith Jobe 999009999 1 Tracy S Paglia P00366884 2099556100 2023-10-25 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Andrew Jahn 1 Adventist Health Way Roseville CA 956613266 0 0 1071 X www.adventisthealth.org/ X 1900 WA Living God's love by inspiring health, wholeness and hope. 13 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 784001 754942 784001 754942 -784001 -754942 1008618 246303 10435 3062 998183 243241 Living God's love by inspiring health, wholeness and hope. 0 0 0 0 0 After many years of seeking solutions to be able to continue providing health care services in the community of Walla Walla, WA and surrounding area while incurring unsustainable operating losses, the decision was made to close the Hospital and all the ancillary services offered in conjunction with the Hospital. The Hospital closedon July 24, 2017. The Hospital was winding down operations between 2018 and 2022.The building was sold during 2018 and the sale proceeds were transferred to Adventist Health System/West, the sole member of the Hospital. 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X John Beaman 9164060000 1 Adventist Health Way Roseville CA 95661 X Wing Bill Dir/Asst Secr/Vice Chair thru 01/22 0.00 50.00 X X 0 2511347 56319 Heinrich Kerry Dir/Chair/CEO as of 01/22 0.00 50.00 X X 0 2131443 75065 Hofheins Todd Dir/Vice Chair/COO as of 01/22 0.00 50.00 X X 0 1971652 72279 Jahn Andrew - President AHWW Care Division President thru 02/22 10.00 40.00 X 0 1409539 74100 Beaman John CFO/Asst Secretary as of 01/22 0.00 50.00 X 0 1361096 58476 Reiner Scott Former Dir/Chair/CEO thru 12/21 0.00 0.00 X 0 1222073 36652 Newmyer Joyce Former President, PNR thru 08/20 0.00 50.00 X 0 1076247 59339 Jobe Meredith Secretary/Treasurer 0.00 50.00 X 0 930036 39184 Welch Donald Interim Treas/Asst Sec thru 06/20 0.00 50.00 X 0 670417 44648 King Kyle Network Dev Exec thru 02/17 0.00 50.00 X 0 634519 44891 Givens Linda Patient Care Executive thru 09/17 0.00 50.00 X 0 412758 55812 Freedman John Director 0.00 4.00 X 0 26858 0 Woodson Marc Director 0.00 4.00 X 0 26728 0 Banks David Director 0.00 4.00 X 0 26478 0 Cherry Robert Director 0.00 4.00 X 0 26478 0 Davis Andrew Director 0.00 4.00 X 0 26478 0 Innocent Larry Director 0.00 4.00 X 0 26478 0 Reiner Richard Director 0.00 4.00 X 0 26478 0 Newton Bradford Director 0.00 4.00 X 0 25180 0 Salazar Velino Director 0.00 4.00 X 0 21478 0 Fehr Joy Director 0.00 4.00 X 0 430 0 Ocampo Lucy Director 0.00 4.00 X 0 430 0 0 14564621 616765 0 1 1 0 0 0 0 0 0 Loss from discontinued 754942 754942 754942 0 754942 0 143532 246228 633772 63 231314 12 1008618 246303 0 3062 10435 0 10435 3062 X 998183 243241 998183 243241 1008618 246303 -754942 0 X 0 1 X 1 1 1 X 0 X Part X, Line 2: The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 50l(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2022 and 2021, no such assets or liabilities were recorded. The System currently files Form 990 (informational return of organizations exempt from income taxes) and Form 990-T (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2019 in major tax jurisdictions. X X X X 1 1 0 0 0 0 0 0 0 Wing Bill Dir/Asst Secr/Vice Chair thru 01/22 0 263334 0 662638 0 1585375 0 12220 0 44099 0 2567666 0 0 Heinrich Kerry Dir/Chair/CEO as of 01/22 0 1817710 0 76 0 313657 0 12220 0 62845 0 2206508 0 0 Hofheins Todd Dir/Vice Chair/COO as of 01/22 0 1358421 0 376216 0 237015 0 12220 0 60059 0 2043931 0 0 Jahn Andrew - President AHWW Care Division President thru 02/22 0 1047840 0 349414 0 12285 0 12220 0 61880 0 1483639 0 0 Beaman John CFO/Asst Secretary as of 01/22 0 1047636 0 298600 0 14860 0 12220 0 46256 0 1419572 0 0 Reiner Scott Former Dir/Chair/CEO thru 12/21 0 348458 0 870709 0 2906 0 12220 0 24432 0 1258725 0 0 Newmyer Joyce Former President, PNR thru 08/20 0 774426 0 262849 0 38972 0 12220 0 47119 0 1135586 0 0 Jobe Meredith Secretary/Treasurer 0 639741 0 154687 0 135608 0 12220 0 26964 0 969220 0 0 Welch Donald Interim Treas/Asst Sec thru 06/20 0 435619 0 154115 0 80683 0 12220 0 32428 0 715065 0 0 King Kyle Network Dev Exec thru 02/17 0 461412 0 114443 0 58664 0 12220 0 32671 0 679410 0 0 Givens Linda Patient Care Executive thru 09/17 0 301372 0 78175 0 33211 0 12220 0 43592 0 468570 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Wing, Bill - severance payment - $1,584,880 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Joyce Newmeyer, Scott Reiner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an of their corporate provided benefits. The balance is set aside for forfeiture and is at risk to the creditors of Adventist Health. Payouts substantial risks of forfeiture have lapsed. The plan was frozen for new amount equivalent to 41 percent of their base compensation, less the value nonvested deferred compensation that is subject to substantial risk of occur according to the participants' payment elections after all non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2022 Newmyer, Joyce - participant, no activity in 2022 Form 990, Part VI, Section A, line 6 The Hospital is organized as a religious corporation and was operated as a not-for-profit hospital until its closure in 2017. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital was operated as an affiliate of Adventist Health System/West. Form 990, Part VI, Section A, line 7a The Hospital's Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, line 7b The sole corporate member, Adventist Health System/West, must approve all changes to the Articles of Incorporation and Bylaws. Form 990, Part VI, Section B, line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate 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 market president immediately. The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders, and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, line 15 The Hospital's Board of Directors has established a Human Resources 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 presidents and finance officers 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, and 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 executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section C, line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. Form 990, Part VII: Board compensation is for Adventist Health System/West Board of Directors only - not hospital Board of Directors. 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