2023-11-01T12:58:03-05:00 2022-12-31 910189318 Moss Adams LLP 3121 W March Ln Ste 200 Stockton CA 952192367 990 2022-01-01 680357690 Adventist Health Physicians Network ADVE 9164060000 1 Adventist Health Way Roseville CA 956613266 John Beaman Treasurer 9164060000 2023-10-26 1 John Beaman 999009999 1 Tracy S Paglia P00366884 2099556100 2023-10-25 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z Arby Nahapetian 1 Adventist Health Way Roseville CA 956613266 229933051 0 1071 X www.myahphysician.org/ X 1995 CA Living God's love by inspiring health, wholeness and hope. 13 11 8 0 0 0 9623094 0 205065735 228903287 287559 1025767 0 0 214976388 229929054 0 400 0 0 50978627 59778645 0 0 0 164070523 168850187 215049150 228629232 -72762 1299822 39004576 38870916 25066770 24933073 13937806 13937843 X Living God's love by inspiring health, wholeness and hope. 0 0 188062031 400 228903287 See Schedule O 188062031 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 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 1 1 0 0 0 1 0 0 8 1 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 CA 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 Beaman John Treasurer/Asst Secretary as of 01/22 0.00 50.00 X 0 1361096 58476 Nahapetian Arby President as of 09/22 20.00 30.00 X 0 1334111 68537 Reiner Scott Former Dir/Chair/CEO thru 12/21 0.00 0.00 X 0 1222073 36652 Jobe Meredith Secretary 0.00 50.00 X 0 930036 39184 Rippey Wesley Former Director thru 05/18 0.00 50.00 X 0 780034 39936 El-Asmar Hoda Former President thru 10/20 0.00 0.00 X 0 661321 64633 Serna Adrian President thru 06/22 50.00 0.00 X 0 625803 58350 Ashlock Mark Former President thru 04/20 0.00 0.00 X 0 385805 32805 Hutcheson Walter Finance Officer 50.00 0.00 X 0 319723 90288 Perloshyan Armenui Director, Credentialing 40.00 0.00 X 151544 0 47204 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 151544 14467938 739728 1 1 1 0 Pacific Heart and Vascular Medical Group 1801 E March Ln Ste D400 Stockton CA 95210 Provider Fees 2306891 Ercolani Medical PC 79 Sugar Mill Drive Osprey FL 34229 Provider Fees 1230183 Pavel Moldavskiy MD PC 15506 Domaine Chandon Avenue Bakersfield CA 93314 Provider Fees 1178913 Satish Kesavaramanujam MD Inc 107 N Hall Street Suite B Visalia CA 93291 Provider Fees 1148380 Timothy Galan MD Inc PO Box 2287 Bakersfield CA 93303 Provider Fees 1064455 37 Patient service revenue 621110 120552633 120552633 Affiliated org subsidies 900099 86978796 86978796 Premium revenue 621400 14433440 14433440 Incentive & quality revenue 900099 4491078 4491078 2447340 2447340 228903287 1029764 1029764 3997 -3997 -3997 -3997 229929054 228903287 0 1025767 X 400 400 45984506 36434053 9550453 1502300 1236583 265717 9017565 7190103 1827462 3274274 2604963 669311 14026156 14026156 111406124 90662067 20744057 7351 7351 1688832 1337518 351314 3758065 3733496 24569 9250567 7780084 1470483 168097 160414 7683 14155 12176 1979 4001677 2076172 1925505 417132 414130 3002 Patient care supplies 19126314 16155683 2970631 Rental/lease cost equip 4070986 3342237 728749 Income taxes 14239 14171 68 900492 881625 18867 228629232 188062031 40567201 0 7447766 18621907 12238004 11720297 13699 17976 19305107 8510736 39004576 38870916 5103688 4256013 2974558 687766 16988524 19989294 25066770 24933073 X 13937806 13937843 13937806 13937843 39004576 38870916 1299822 -1299785 0 X 0 1 X 1 1 1 X X 17 Adventist Health SystemWest 953484589 10 1 0 0 Adventist Health Clearlake Hospital Inc 680395149 3 0 0 0 Adventist Health Delano 770258013 3 0 0 0 Adventist Health Mendocino Coast 845174585 3 0 0 0 Adventist Health Tulare 832351753 3 0 0 0 Glendale Adventist Medical Center 951816017 3 0 0 0 Hanford Community Hospital 940535360 3 0 0 0 Lodi Memorial Hospital Association Inc 941044474 3 0 0 0 Reedley Community Hospital 453220509 3 0 0 0 Rideout Memorial Hospital 941387866 3 0 0 0 San Joaquin Community Hospital 952294234 3 0 0 0 Simi Valley Hospital & Health Care Services 956064971 3 0 0 0 Sonora Community Hospital 941415069 3 0 0 0 St Helena Hospital 941279779 3 0 0 0 Ukiah Adventist Hospital 941639901 3 0 0 0 White Memorial Medical Center 952282647 3 0 0 0 Willits Hospital Inc 680108919 3 0 0 0 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Part IV, Section A, Line 1: Adventist Health System/West (AHRS), the permanent member, designates supported organizations of Adventist Health Physicians Network (AHPN) that are affiliates of the permanent member and operate a hospital in a service area in which AHPN has established clinic operations. 0 Receivables from related organizations 8386007 Other receivables 77279 Receivables from third-party payors 47450 8510736 Payables to related organizations 16243247 Payables to third-party payors 2324544 Other liabilities 1421503 19989294 X Part X, Line 2: The principal operations of the System is exempt from taxation pursuant to Internal Revenue Code Section 501(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 Beaman John Treasurer/Asst Secretary as of 01/22 0 1047636 0 298600 0 14860 0 12220 0 46256 0 1419572 0 0 Nahapetian Arby President as of 09/22 0 927049 0 234212 0 172850 0 12220 0 56317 0 1402648 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 Jobe Meredith Secretary 0 639741 0 154687 0 135608 0 12220 0 26964 0 969220 0 0 Rippey Wesley Former Director thru 05/18 0 527416 0 153245 0 99373 0 12220 0 27716 0 819970 0 0 El-Asmar Hoda Former President thru 10/20 0 0 0 0 0 661321 0 12220 0 52413 0 725954 0 0 Serna Adrian President thru 06/22 0 449767 0 112652 0 63384 0 12220 0 46130 0 684153 0 0 Ashlock Mark Former President thru 04/20 0 69 0 0 0 385736 0 11574 0 21231 0 418610 0 0 Hutcheson Walter Finance Officer 0 247790 0 45095 0 26838 0 9592 0 80696 0 410011 0 0 Perloshyan Armenui Director, Credentialing 144777 0 6767 0 0 0 4546 0 42658 0 198748 0 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. Ashlock, Mark - severance payment - $386,312 El-Asmar, Hoda - severance payment - $659,431 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 insurance participants are Mark Ashlock, John Beaman, Kerry Heinrich, Todd Hofheins, Scott Reiner, and Bill Wing. Form 990, Part III, Line 4a: Adventist Health Physicians Network (AHPN) is a California medical foundation that provides physicians' opportunities to improve patient care coordination, enhance quality initiatives and creates greater physician alignment while successfully operating in the environment of health care reform. AHPN 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 Adventist Health Physicians Network, 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 Working with providers, AHPN delivers a more integrated, seamless, and affordable approach to caring for patients and their communities. Not only does AHPN 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. 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 Adventist Health System/West, a California not-for-profit religious corporation, is the permanent member of the Organization. Form 990, Part VI, Section A, line 7a The Organization'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 permanent member may admit additional members that are affiliates of the permanent member and operate a hospital in a service area in which the Organization has established clinic operations. The permanent member may terminate membership of any member if it is in the best interest of the Organization. Amendments to the Organization's governing documents require approval of the permanent member. 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, 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 president immediately. The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable individuals. The System General Counsel reviews all the disclosures and retains the COIs for all individuals. Copies for the corporate officers and key employees' COIs are kept in the Office of the General Counsel. 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 Organization'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 Organization does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Organization does not make its Conflict of Interest Policy publicly available. Form 990, Part VII: Board compensation is for Adventist Health System/West Board of Directors only - not AHPN's Board of Directors. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 86,393,720. Management and general expenses 19,047,285. Fundraising expenses 0. Total expenses 105,441,005. Purchased medical services: Program service expenses 2,392,366. Management and general expenses 139,066. Fundraising expenses 0. Total expenses 2,531,432. All other purchased services: Program service expenses 1,370,023. Management and general expenses 891,973. Fundraising expenses 0. Total expenses 2,261,996. Contract labor: Program service expenses 128,348. Management and general expenses 35,195. Fundraising expenses 0. Total expenses 163,543. Consulting and other management fees: Program service expenses 112,422. Management and general expenses 465,966. Fundraising expenses 0. Total expenses 578,388. Professional fees non-medical: Program service expenses 156,135. Management and general expenses 88. Fundraising expenses 0. Total expenses 156,223. Other medical professional fees: Program service expenses 35,004. Management and general expenses 34,000. Fundraising expenses 0. Total expenses 69,004. Repairs & maintenance: Program service expenses 74,049. Management and general expenses 130,484. Fundraising expenses 0. Total expenses 204,533. Adventist Health Accountable Care LLC 1509 Wilson Terrace Suite 215 Glendale CA 91206 822267429 Medical services CA 0 0 Adventist Health Physicians Network Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Delano 1401 Garces Highway Delano CA 93215 770258013 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Adventist Health Mendocino Coast 700 River Drive Fort Bragg CA 95437 845174585 Hospital CA 501(c)(3) Line 3 Stone Point Health 0 Adventist Health SystemWest 1 Adventist Health Way Roseville CA 95661 953484589 Integrated health system CA 501(c)(3) Line 10 N/A 0 Adventist Health Tulare 869 North Cherry Street Tulare CA 93274 832351753 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest 0 Feather River Hospital 1 Adventist Health Way Roseville CA 95661 941101228 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi CA 95240 941044474 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Paradise Valley Hospital 1 Adventist Health Way Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) Line 1 Adventist Health SystemWest 0 Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest 0 Reedley Community Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Rideout Memorial Hospital 726 Fourth Street Marysville CA 95901 941387866 Acute care hospital CA 501(c)(3) Line 3 Stone Point Health 0 St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Simi Valley Hospital & Health Care Services 2975 N Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Stone Point Health 1 Adventist Health Way Roseville CA 95661 823763347 Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest 0 Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 United Com-Serve 726 Fourth Street Marysville CA 95901 943015356 Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Stone Point Health 0 Walla Walla General Hospital 1 Adventist Health Way Roseville CA 95661 910617726 Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest 0 Western Health Resources 1 Adventist Health Way Roseville CA 95661 953867863 Home care CA 501(c)(3) Line 10 Adventist Health SystemWest 0 White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest 0 Blue Legacy Ventures LLC 1010 NE 2nd Avenue Miami FL 33132 871254649 Real property rental FL N/A 0 0 Blue Zones LLC 200 Southdale Center Edina MN 55435 271603327 Education MN N/A 0 0 PAR LLC dba CherryWood Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 931262371 Senior housing OR N/A 0 0 PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 260622555 Senior housing OR N/A 0 0 PVHR2 LLC dba Parkview Memory Care at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 473300170 Senior housing OR N/A 0 0 WWGHR LLC dba Wheatland Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas OR 97015 810591221 Senior housing OR N/A 0 0 AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure captive insurance BD N/A C 0 Adventist Health Plan Inc 1 Adventist Health Way Roseville CA 95661 463833261 Health insurance CA N/A C 0 South Coast Medical Center 1 Adventist Health Way Roseville CA 95661 952037291 Wind down after sale of hospital CA N/A C 0 Thrive Productions Inc 200 Southdale Center Edina MN 55435 453369049 Production company MN N/A C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1