2023-11-01T16:30:37-05:00 2022-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2022-01-01 930429015 Portland Adventist Medical Center PORT 9164060000 10123 SE Market Street Portland OR 97216 Jason Panasuk Treasurer 9164060000 2023-11-01 1 Jason Panasuk 999009999 0 Tracy S Paglia P00366884 2099556100 2023-10-27 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Adventist Health Portland Kyle King 10123 SE Market Street Portland OR 97216 371288786 0 1071 X www.adventisthealth.org/portland/ X 1900 OR Living God's love by inspiring health, wholeness and hope. 13 11 2059 123 742970 0 275048 3487559 343424879 350753079 13318670 7018452 172792 10008624 357191389 371267714 0 5000 0 0 167806435 186234577 0 0 426502 182944039 199490250 350750474 385729827 6440915 -14462113 362858300 311207507 194182044 183026079 168676256 128181428 X Living God's love by inspiring health, wholeness and hope. 0 0 278745419 5000 355753079 See Schedule O 278745419 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 0 1 0 0 2059 1 1 1 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 1 1 OR X John Beaman CFO 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 Care Division President thru 02/22 0.00 50.00 X 0 1409539 74100 Beaman John CFO/Asst Secretary as of 01/22 0.00 50.00 X 0 1361096 58476 Nahapetian Arby - Care Division Medical Officer thru 02/22 0.00 50.00 X 0 1334111 68537 Stevens Eric - Care Division Operations Executive thru 02/22 0.00 50.00 X 0 1315314 62845 Spenst Brett - Care Division Finance Officer thru 02/22 0.00 50.00 X 0 1322824 36101 Reiner Scott Former Dir/Chair/CEO thru 12/21 0.00 0.00 X 0 1222073 36652 Spear Eugene Physician 40.00 0.00 X 1170282 0 68740 Boskind Jeffrey Physician 40.00 0.00 X 1152542 0 69998 Newmyer Joyce President, OR State Network 15.00 35.00 X 0 1076247 59339 Alhumaid Fawaz Physician 40.00 0.00 X 946575 0 64633 Jobe Meredith Secretary 0.00 50.00 X 0 930036 39184 Molloy Thomas Physician 40.00 0.00 X 885292 0 51432 Rippey Wesley Area Medical Officer, AHPL 50.00 0.00 X 0 780034 39936 Carlston Cory Physician 40.00 0.00 X 745273 0 58946 Welch Donald - Finance Officer/Interim Treas to 08/22 50.00 0.00 X 0 670417 44648 King Kyle President 50.00 0.00 X 0 634519 44891 Leach Judy - Former Strategy & Comm Exec, PNR thru 02/20 0.00 50.00 X 0 474203 57486 Brower Dorane Physician Services Exec thru 02/20 0.00 50.00 X 0 418352 81474 Knox Jody Physician Services Executive 0.00 50.00 X 0 432973 66523 Nutter Lucinda Patient Care Executive 50.00 0.00 X 0 437127 44594 Lee Adam Business Development Executive 50.00 0.00 X 0 322432 86733 Voshell Shane Human Performance Executive, PNR 50.00 0.00 X 0 287390 56928 Panasuk Jason Treasurer/Asst Secr as of 12/22 50.00 0.00 X 0 211312 50740 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 4899964 21487935 1526599 428 1 1 0 Aya Healthcare Inc Department 3519 Dallas TX 75312 Contract labor 5610400 Legacy Health 1919 NW Lovejoy St Portland OR 97209 Physician services 3475317 Weatherby Healthcare PO Box 972633 Dallas TX 75397 Physician services 3322088 Oregon Anesthesiology Group PC 707 SW Washington St Ste 700 Portland OR 97205 Medical services 3049536 Maxim Healthcare Staffing Services Inc 13877 Collections Center Dr Chicago IL 60693 Contract labor 2958374 71 3250443 237116 3487559 Patient service revenue 621110 339086938 339086938 Other revenue 621990 4857948 4114978 742970 Premium revenue 621110 4585492 4585492 Related rental income 531120 2222701 2222701 350753079 6986339 6986339 53185 21072 32113 32113 32113 Settlement proceeds 621990 5008624 5008624 Joint venture revenue 621990 5000000 5000000 10008624 371267714 350010109 742970 17027076 X 5000 5000 18067 18067 149704856 113579970 35885546 239340 4690189 3561241 1120967 7981 20763755 17260460 3485306 17989 11057710 8841747 2201575 14388 32714340 32714340 306952 306952 5055 5055 12461 12461 49169535 40281278 8773305 114952 1104922 1104922 1808520 1417285 385063 6172 10419710 2292795 8126915 8844495 4804430 4017218 22847 698776 495561 203139 76 132454 72305 59609 540 2625108 2625108 14383451 12287079 2096372 3316351 2758975 557376 Patient care supplies 51152135 50967675 182594 1866 Quality assurance fee 16217381 16217381 Rental/leases costs 1284647 1246251 38396 Income taxes 23850 350 23500 5270107 5269756 351 385729827 278745419 106557906 426502 160400444 96683376 48554404 47521984 5080623 5492773 580713 276188 371235634 245665825 142744484 125569809 3091050 2658632 2406582 33004745 362858300 311207507 42799742 42101506 841774 780070 150540528 140144503 194182044 183026079 X 164285428 123763562 4390828 4417866 168676256 128181428 362858300 311207507 X -14462113 -9179715 -16853000 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 12461 12461 0 Part II-B, Line 1: The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. 8477735 283730 -55198 162152 8544115 8877613 118416 186046 704340 8477735 9141943 269503 -213633 320200 8877613 8864875 493428 185688 402048 9141943 8798496 524630 137502 595753 8864875 0.48323 0.00000 0.51677 0 0 4742669 4742669 210184060 140974846 69209214 44673043 11659571 33013472 111635862 93031408 18604454 125569809 Right-of-use assets 27407603 Receivables from third-party payors 1434954 Other receivables 2183490 Receivables from related organizations 1668698 Other assets 310000 33004745 Payables to related organizations 112417457 Other liabilities 27717046 Income taxes payable 10000 140144503 X Part V, Line 4: Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. 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. 1 1 X 1 X 1 X 1 1 1 0 1 1 2922233 2922233 0.00760 92450329 75310156 17140173 0.04440 95372562 75310156 20062406 0.05200 1135078 1135078 0.00290 415190 48151 367039 0.00100 30933904 20667906 10265998 0.02660 65812 65812 0.00020 32549984 20716057 11833927 0.03070 127922546 96026213 31896333 0.08270 25594 25594 0.00010 39141 39141 0.00010 64735 64735 0.00020 1 1955135 444241 45103334 48030749 -2927415 X 1 1 1 Assn-Unit Owners Plaza Conf Condo association mgmt 0.90100 0.09900 1 1 Adventist Health Portland 10123 SE Market Street Portland OR 97216 www.adventisthealth.org/Portland 14-1127 X X X Adventist Health Portland 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment X 1 22 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section A: Audiology (1); Imaging (2); Physician Clinics (22); Rehab (PT/OT/Sp) Clinics (9); Urgent Care (2); Wound Care (1) Adventist Health Portland Part V, Section B, Line 5: The CHNA relied upon community voices and stories to identify and define the root causes of poor health outcomes to be addressed through community improvement efforts. More than 300 people participated in community meetings and over 500 responded to an online survey. Outreach activities included: - Completion of 37 community engagement sessions, seven conducted in a language other than English, engaging 311 community members.- Launching of the community survey on September 30, 2021, which was open to the public for three weeks and available in ten languages. Five hundred three (503) people completed the survey. The list of prioritized communities included: black, indigenous, people of color, and American Indian/Alaska native people (BIPOC-AI/AN) populations, people who identify as lesbian, gay, bisexual, transgender, queer, questioning, two-spirit, intersex, and asexual (LGBTQ2IA) that fall outside of cisgender and heterosexual paradigms, people with disabilities, older adults, 65 years and older people impacted by incarceration, rural communities, unhoused or people experiencing houselessness, immigrant populations, non-English-speaking communities, people with substance use disorders, and youth. Quantitative data was used in the CHNA to compare and identify health trends by examining how an indicator has changed over time. This helps to understand the changing needs of communities to plan and prioritize ways to approach disease prevention and health promotion. Data sources used were the American Community Survey, Oregon Student Health Survey, Oregon Health Authority Hospital Data, Health Statistics and Vital Records, Washington Healthy Youth Survey, and the Behavioral Health Risk Factor Surveillance Survey. Adventist Health Portland Part V, Section B, Line 6a: The Healthy Columbia Willamette Collaborative (HCWC), a public-private partnership of 12 organizations from Clackamas, Multnomah and Washington Counties in Oregon and Clark County in Washington led the development of the CHNA. Hospital facilities included Hillsboro Medical Center, Kaiser Permanente, Legacy Health, and Providence Health and Services. Adventist Health Portland Part V, Section B, Line 6b: Non-hospital facilities included CareOregon, Clackamas County Health, Housing and Human Services, Clark County Public Health, Health Share of Oregon, Multnomah County Health Department, Oregon Health & Science University, Trillium Community Health Plan, and Washington County Public Health. Adventist Health Portland Part V, Section B, Line 11: The COVID-19 global pandemic has caused extraordinary challenges for Adventist Health hospitals and health care systems across the world including keeping front line workers safe, shortages of protective equipment, limited ICU bed space and developing testing protocols. They have also focused on helping patients and families deal with the isolation needed to stop the spread of the virus, and more recently vaccine roll out efforts. Adventist Health, like other health care systems, had to pivot its focus to meet the most urgent healthcare needs of its community during the pandemic, as well as reassess the ability to continue with some community health strategies due to public health guidelines for social distancing. Adjustments have been made to continue community health improvement efforts as possible, while ensuring the health and safety of those participating. Additionally, in 2022, Adventist Health as a system took the following actions in response to the needs created or exacerbated by COVID-19: - Began offering more virtual health care visits to keep community members safe and healthy.- Developed an online symptom tracker to help community members determine if they may have COVID-19 or some other flu-type illness and what steps to take.- Was part of community wide efforts by the local health system to vaccinate eligible community members to help stop the spread of the virus. Locally, Adventist Health Portland (AHPL) took the following steps in 2022: - Provided health translators to those who spoke a language other than English.- Provided financial assistance to community members that needed help with medical bills.- Supported the local Compassion Clinic to ensure health activities continued. Services offered throughout the pop-up clinics included but are not limited to health and well-being checks, dental services, mental health therapy services and provided free meals to those in need. - Gave away free COVID-19 test kits at community events.Tax year 2022 was year three of the Implementation Strategy for AHPL's 2019 Community Health Needs Assessment (CHNA). Programs and activities provided to the community were in response to the priority health needs identified in the 2019 CHNA. AHPL's 2019 CHNA identified four significant health needs: chronic disease, access to care, behavioral health and well-being, and social determinants: food insecurity/access. Priority Need 1 - Chronic Disease - The goal is to work collaboratively to reduce the incidence and impact of chronic diseases like heart disease, cancer, and diabetes through culturally sensitive screening, education and treatment, including the use of lifestyle medicine approaches. Strategy 1 - Community Health Screenings and interactive education activities around certain health conditions (CVD, CA, COVID-19, Diabetes and Obesity) with attention to the benefits/"How to" of moving towards a more whole food, plant-based diet, and other healthy lifestyle practices (e.g. sleep, exercise, and stress management). Activity 1.1 - Targeted Screening & Learning Activities/Events and Activity 1.2 - Professional Lifestyle Medicine - Partnered with the OHSU Vaccine Equity committee on vaccinations; produced health topic videos for website/social media and did health and safety stations at our community events.Priority Need 2 - Access to Care - The goal is to work with others to improve the access to quality, culturally appropriate health care services in our service area, and to work proactively to increase the numbers of those entering health care careers. Strategy 1 - Provide greater access to culturally responsive medical/dental services for low-income, underserved and immigrant individuals and families through direct services and selected partnerships. Strategy 2 - Provide educational opportunities to improve access to health professionals in the future. Activity 1.1 - Impact Your Health/Compassion Connect clinic events - 350 people received dental, vision and health screenings.Activity 1.2 - Project Access Now - Program support continued in 2022. Funding support provided direct patient care for an estimated 1,701 individuals and additional assistance with enrolling in health plans. Activity 1.3 - Slavic Navigator Outreach Program - Much of their work was directed towards COVID-19 prevention education and answering community questions. Activities included media articles/posts, radio interviews and phone-based work with patients, providers, civic leaders, etc. with 11,556 connections reported specific to the Slavic community. Activity 1.4 - Student Healthcare Leaders Program - There were two sessions in 2022. The number of graduating high school students in the summer included 24 students served. The number of graduating high school students in the fall included 24 students served for a total of 48 students. Additional activities included: - Patient transport - program services were significantly reduced but a total of 5,000 miles of roundtrip transportation services were provided. - Student Externships & Internships: A total of 160 RN students and 39 externships were able to complete their academic requirements and provide much needed support within departments across AHPL and the community. Priority Need 3 - Behavioral Health & Well-Being - The goal is to support the development of a robust and sustainable behavioral health care system for the Greater Portland Area, and create school support resources that nurture overall well-being.Strategy 1 - Improve access to stable emergency and other more formal behavioral health/addiction recovery services through direct services funded partnerships. Strategy 2 - Provide a variety of addiction, grief, social and spiritual support, and education services. Activity 1.1 - BH/SUD IP/Emergent Care via UNITY Center - Our ongoing partner support of the UNITY Center for Behavioral Health - a total of 60 transfers to UNITY Center were completed in 2022.Activity 1.2 - Enhancing SUD Care via FORA Health partnership - FORA Health opened on campus.Activity 1.3 - First Friday - In 2022, a total of three sessions were offered, with approximately 375 people served. Activity 1.4 - Support Groups (Smoking, Grief, Cancer) and virtual Behavioral Health classes - A total of 40 people were served through the Grief Support Group Series. Grief and Resiliency were provided in 2022 and offered to our community. Several dozen people attended each session. We also created support videos for the website and distribution to the community.Priority Need 4 - Food Insecurity/Access - The goal is to improve access to quality nutrition for food insecure groups and build capacity for greater community nutrition self-support. Strategy 1 - Support community and school gardens for low-cost fresh produce, outdoor exercise, community-building, and increased self-sufficiency especially for Black, Indigenous, People of Color (BIPOC)/refugee community. Activity 1.1 - Community Garden - The Market Street Garden continued in 2022. The garden provided 27 refugee families with a total of 42,000 square feet of growing space with an emphasis on the production of hard to find, culturally specific produce items. Priority needs not addressed:No hospital can address all the health needs identified in its community. AHPL is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Significant health needs that will not be address include the following: 1. Housing - AHPL has made significant investments in this area in the past and will continue to support small projects/facilities as possible. There are limited current resources for large projects. 2. Alcohol & Drug Misuse - This is addressed somewhat through AHPL's clinics and there are other community organizations taking the lead on this health priority. One is Fora Health who is moving in next door to AHPL. AHPL is looking at other partnership possibilities for the future. 3. Liver Disease and Sexually Transmitted Diseases - There are others working in this area and resources are limited in this area outside of our primary care work, and support of community clinics. 4. Transportation - Beyond a limited program for some patients, addressing this need will effectively require more financial resources than AHPL can commit to at this time. Adventist Health Portland Part V, Section B, Line 13h: Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. 37 1 - AH Gresham Station Imaging Center 831 NW Council Drive Suite 100 Gresham OR 97030 Imaging Services 2 - AH Medical Group-NW Reg Heart & Vasc Portl 10000 SE Main Street Suite 60B Portland OR 97216 Physician Clinic 3 - AH Physical Therapy-Campus Rehab 10101 SE Main Street Portland OR 97216 Physical Therapy Clinic 4 - AH Medical Group-Multi Spec Surgery Clinic 10000 SE Main Street Suite 316 Portland OR 97216 Physician Clinic 5 - AH Medical Group-Cherry Park FP 10201 SE Main Street Suite 10 12 Portland OR 97216 Physician Clinic 6 - AH Medical Group-Gresham Station 831 NW Council Drive Suite 101 125 Gresham OR 97030 Physician Clinic 7 - AH Medical Group-Gastroenterology Clinic 10000 SE Main Street Suite 112 Portland OR 97216 Physician Clinic 8 - AH Medical Group-Parkrose Primary CareInt 1350 NE 122nd Avenue Suite 100 Portland OR 97230 Physician Clinic 9 - AH Wound Healing and Hyperbaric Medicine 10201 SE Main Street Suite 9 Portland OR 97216 Wound Care Services-Hospital Outpatient 10 - AH Medical Group-Clackamas 10151 SE Sunnyside Road Suite 100 Clackamas OR 97015 Physician Clinic 11 - AH Medical Group-NW Orthopedic Specialists 10000 SE Main Street Suite 224 Portland OR 97216 Physician Clinic 12 - AH Medical Group-NW Reg Heart & Vasc-McMin 2700 SW Stratus Avenue Suite 406 McMinnville OR 97128 Physician Clinic 13 - AH Medical Group-Parkrose Urgent Care 1350 NE 122nd Avenue Suite 200 Portland OR 97230 Physician Clinic/Urgent Care 14 - AH Medical Group-Troutdale Clinic 1700 SW 257th Avenue Troutdale OR 97060 Physician Clinic 15 - AH Clackamas Imaging Center 10151 SE Sunnyside Road Suite 100 Clackamas OR 97015 Imaging Services 16 - AH Medical Group-Rheumatology & Endocrine 10101 SE Main Street Suite 2011 Portland OR 97216 Physician Clinic 17 - AH Physical Therapy Gresham 831 NW Council Drive Suite 200 Gresham OR 97030 Physical Therapy Clinic 18 - AH Medical Group-Portland Lung Clinic 10201 SE Main Street Suite 11 Portland OR 97216 Physician Clinic 19 - AH Medical Group-Women's Health 10101 SE Main Street Suite 3001 Portland OR 97216 Physician Clinic 20 - AH Physical Therapy Clackamas 10151 SE Sunnyside Road Suite 100 Clackamas OR 97015 Physical Therapy Clinic 21 - AH Occupational Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Occupational Therapy Clinic 22 - AH Speech Therapy 10201 SE Main Street Suite 4 Portland OR 97216 Speech Therapy Services 23 - AH Physical Therapy Parkrose 1350 NE 122nd Avenue Suite 200 Portland OR 97230 Physical Therapy Clinic 24 - AH Medical Group-Sandy Urgent Care 17055 Ruben Lane Sandy OR 97055 Physician Clinic/Urgent Care 25 - AH Physical Therapy Sandy 37095 SE Hwy 26 Suite 102 Sandy OR 97055 Physical Therapy Clinic 26 - AH Medical Group-Damascus 14450 SE Royer Road Damascus OR 97089 Physician Clinic 27 - AH Medical Group-Diabetes Clinic 10101 SE Main Street Suite 2011 Portland OR 97216 Physician Clinic 28 - AH Medical Group-NW Regional Surgical Asso 10000 SE Main Street Suite 365 Portland OR 97216 Physician Clinic 29 - AH Medical Group-Sandy Family Practice 17055 Ruben Lane Sandy OR 97055 Physician Clinic 30 - AH Medical Group-Wound Health & Hyperbaric 10201 SE Main Street Suite 9 Portland OR 97216 Physician Clinic 31 - AH Medical Group-Sleep Clinic 10201 SE Main Street Suite 29 Portland OR 97216 Physician Clinic 32 - AH Specialty Rehab 10201 SE Main Street Suite 1 Portland OR 97216 Specialty Rehab Clinic 33 - AH Medical Group-Occupational Med Parkrose 1350 NE 122nd Avenue Suite 200 Portland OR 97230 Physician Clinic 34 - AH Audiology 10201 SE Main Street Suite 1 Portland OR 97216 Audiology Services 35 - AH Physical Therapy Vancouver 16096 SE 15th Avenue Vancouver WA 98683 Physical Therapy Clinic 36 - AH Medical Group-Infectious Disease Clinic 10201 SE Main Street Suite 29 Portland OR 97216 Physician Clinic 37 - AH Medical Group-Pre-Op Medicine Clinic 10000 SE Main Street Suite 128 Portland OR 97216 Physician Clinic Part I, Line 7: 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 audited combined financial statements. The formula used for computation equals financial statement data labeled as follows for 7a-c:(Total expenses - (Provision for bad debts + Other revenue + Interest income))/Gross patient chargesLines 7e, f, g, and i are calculated based on specific expenses and revenues Part II, Community Building Activities: The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare - treating people once they are ill - to transformative well-being - changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint, and as we enter 2022 these projects are active. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. 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. In addition, 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 III, Line 2: 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. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3: 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. Part III, Line 4: The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8: The Medicare Cost Report apportions the Hospital's 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 involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer. 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. For further information, please refer to Schedule H, Part III, Section B. Part III, Line 9b: 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 VI, Line 2: The Hospital's 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the 2022 Community Health Plan (CHP) updated for fiscal year 2022 are posted on the Hospital's website at: https://www.adventisthealth.org/about-us/community-benefit/The two most recent CHNAs, the two most recent CHIS reports and the 2020, 2021 and 2022 CHP Updates are also available on the Adventist Health Corporate website at:https://www.adventisthealth.org/about-us/community-benefit/The CHNA includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, our hospitals support local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of the regions we serve. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. Part VI, Line 3: The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at AH_Financial_Assistance_Policy_2022.pdf (adventisthealth.org):1. https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ 2. https://www.adventisthealth.org/documents/financial-assistance/13863-Self-Pay-Billing-and-Collection-Policy.pdfThese documents are available in multiple languages.At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also 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. Part VI, Line 4: The prime service area of AHPL is the quad-county region which includes Clackamas County, Clark County, Multnomah County, and Washington County. The total population in the quad-county region is 2,277,802 which is an increase of 13% from 2009. Of this population, 88.0% identify as not Hispanic or Latino/a and 12.0% identify as Hispanic or Latino/a. The median age in Clackamas County, Oregon is 41.6 years of age. Of this population, 87.5% identify as White, 4.1% identify as multi-racial, 8.7% as Hispanic or Latinx, 0.9% as Black, 4.3% as Asian; and 1.1% as American Indian, Alaska Native, Native Hawaiian or Other Pacific Islander. The median age in Clark County, Washington is 38.4 years of age. Of this population, 84.6% identify as White, 5.1% identify as multi-racial, 9.6% as Hispanic or Latinx, 1.8% as Black, 4.6% as Asian; and 1.4% as American Indian, Alaska Native, Native Hawaiian or Other Pacific Islander. The median age in Multnomah County, Oregon is 37.2 years of age. Of this population, 77.9% identify as White, 5.4% identify as multi-racial, 11.6% as Hispanic or Latinx, 5.5% as Black, 7.4% as Asian; and 1.5% as American Indian, Alaska Native, Native Hawaiian or Other Pacific Islander. The median age in Washington County, Oregon is 36.7 years of age. Of this population, 75.9% identify as White, 5.4% identify as multi-racial, 16.7% as Hispanic or Latinx, 2.0% as Black, 10.6% as Asian; and 1.0% as American Indian, Alaska Native, Native Hawaiian or Other Pacific Islander. For the quad-county, approximately 10.5% of the population are living at or below the poverty level and 4.8% are living in deep poverty defined as having income which is less than half of the federal poverty level. Approximately 26.4% of children are living in poverty and 13.1% of the quad-county residents born outside the US are living at or below poverty level. In 2019, 20.5% of all residents in the region or 50,387 people were low-income and experienced living more than one mile from a grocery store. The regional unemployment rate in 2015-2019 was 4.7%. Among people with any disability, the unemployment rate doubled to 10.8%. Black/African American (8.6%), American Indian and Alaska Natives (8.1%), and Multiracial (7.4%) groups experienced higher rates of unemployment, compared to the total population.Among all households in the region, the severe housing cost burden decreased two percentage points, from 16.5% in 2015 to 14.6% in 2019, respectively, while dropping one percentage point among renting households, from 24.4% to 23.4%, respectively. While the median household income increased 16.1% between 2015 and 2019, respectively, the change in average rent rose 18.9% over the same period (from $1,114 in 2015 to $1,360 in 2019).In 2019, nearly 25% of adults (18 years or older) reported being diagnosed with depression. This is higher than the United States at 19%. Adults with asthma was significantly higher in the region at 9.8%, compared to the United States at 8.9%. Other chronic diseases included high blood pressure (27.4% of adults) and high cholesterol (26.1% of adults), while the two most prevalent in the region were significantly lower than rates in the United States. Cancer and heart disease continue to be the top two causes of death in 2018-2020, representing: 11,065 deaths due to cancer 9,614 deaths due to heart disease While deaths due to cancer and heart disease decreased between 2014-2016 and 2018-2020, cerebrovascular diseases, such as stroke, increased from 18.7 to 30.3 per 100,000 deaths. Part VI, Line 5: Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache are soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population; 2. Factors that cause the present outcomes distribution; and 3. Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1. Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2. Improve care quality and patient safety, and 3. Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6: 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 communities served by all member hospitals. Part VI, Line 7, Reports Filed With States OR 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 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 Nahapetian Arby - Care Division Medical Officer thru 02/22 0 927049 0 234212 0 172850 0 12220 0 56317 0 1402648 0 0 Stevens Eric - Care Division Operations Executive thru 02/22 0 896507 0 250602 0 168205 0 12220 0 50625 0 1378159 0 0 Spenst Brett - Care Division Finance Officer thru 02/22 0 817612 0 416845 0 88367 0 12220 0 23881 0 1358925 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 Spear Eugene Physician 1153666 0 5324 0 11292 0 12220 0 56520 0 1239022 0 0 0 Boskind Jeffrey Physician 1056003 0 73574 0 22965 0 12220 0 57778 0 1222540 0 0 0 Newmyer Joyce President, OR State Network 0 774426 0 262849 0 38972 0 12220 0 47119 0 1135586 0 0 Alhumaid Fawaz Physician 917680 0 5417 0 23478 0 12220 0 52413 0 1011208 0 0 0 Jobe Meredith Secretary 0 639741 0 154687 0 135608 0 12220 0 26964 0 969220 0 0 Molloy Thomas Physician 841417 0 43875 0 0 0 12220 0 39212 0 936724 0 0 0 Rippey Wesley Area Medical Officer, AHPL 0 527416 0 153245 0 99373 0 12220 0 27716 0 819970 0 0 Carlston Cory Physician 745273 0 0 0 0 0 12220 0 46726 0 804219 0 0 0 Welch Donald - Finance Officer/Interim Treas to 08/22 0 435619 0 154115 0 80683 0 12220 0 32428 0 715065 0 0 King Kyle President 0 461412 0 114443 0 58664 0 12220 0 32671 0 679410 0 0 Leach Judy - Former Strategy & Comm Exec, PNR thru 02/20 0 348505 0 85586 0 40112 0 12220 0 45266 0 531689 0 0 Brower Dorane Physician Services Exec thru 02/20 0 303436 0 81108 0 33808 0 12220 0 69254 0 499826 0 0 Knox Jody Physician Services Executive 0 303622 0 79756 0 49595 0 12220 0 54303 0 499496 0 0 Nutter Lucinda Patient Care Executive 0 317303 0 78675 0 41149 0 12220 0 32374 0 481721 0 0 Lee Adam Business Development Executive 0 245847 0 50972 0 25613 0 9673 0 77060 0 409165 0 0 Voshell Shane Human Performance Executive, PNR 0 209514 0 56469 0 21407 0 8622 0 48306 0 344318 0 0 Panasuk Jason Treasurer/Asst Secr as of 12/22 0 157878 0 40462 0 12972 0 6339 0 44401 0 262052 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 SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Joyce Newmyer, Scott Reiner, Brett Spenst, 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 Brower Charles Family member of Key EE, D. Brower 18067 Employment 0 Form 990, Part III, Line 4a: Portland Adventist Medical Center, dba Adventist Health Portland (AHPL), provides quality medical healthcare 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 AHPL, 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 coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHPL provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHPL 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 2022 was $20,062,406. The following Inpatient services were provided to all our patients: - 572 babies delivered - 1,512 surgeries performed - 35,095 patient days The following Outpatient services were provided to all our patients: - 42,979 emergency department visits - 3,904 outpatient surgeries performed - 204,339 outpatient visits - 280,420 clinic visits AHPL recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2022 was $11,833,927. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Form 990, Part VI, Section A, line 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, 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; 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. 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 VII: Board compensation is for Adventist Health System/West Board of Directors only - not hospital Board of Directors. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 8,746,337. Management and general expenses 5,942,725. Fundraising expenses 0. Total expenses 14,689,062. Contract labor: Program service expenses 16,826,850. Management and general expenses 105,256. Fundraising expenses 0. Total expenses 16,932,106. All other purchased services: Program service expenses 10,499,416. Management and general expenses 2,300,456. Fundraising expenses 114,952. Total expenses 12,914,824. Purchased medical services: Program service expenses 2,905,161. Management and general expenses 54,224. Fundraising expenses 0. Total expenses 2,959,385. Consulting and other management fees: Program service expenses 206,401. Management and general expenses 366,027. Fundraising expenses 0. Total expenses 572,428. Other non-medical professional fees: Program service expenses 791,339. Management and general expenses 0. Fundraising expenses 0. Total expenses 791,339. Repairs and maintenance: Program service expenses 301,592. Management and general expenses 4,617. Fundraising expenses 0. Total expenses 306,209. Other professional medical fees: Program service expenses 4,182. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,182. Form 990, Part XI, Line 8: Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items. 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