2024-11-01T11:52:13-07:00 2023-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2023-01-01 812240617 Adventist Health Medical Ctr Tehachapi dba Adventist Health Tehachapi Valley ADVE 6618233000 1100 Magellan Dr Tehachapi CA 93561 Haydock Timothy eff 724 Interim Treas 2024-11-01 true true Steve Clement P01218012 8185475701 X 2023 2024-10-15 13:58:12Z Wells Jason eff 123 1100 Magellan Dr Tehachapi CA 935611380 64924218 false 1071 X www.adventisthealth.org/tehachapi-valley X 2016 CA Living Gods love by inspiring health, wholeness and hope. 12 11 366 15 0 1955736 3421247 54879446 59736971 -251488 1766000 0 56583694 64924218 27066 0 0 23108974 27077256 0 22217 31387649 30851449 54523689 57928705 2060005 6995513 72169748 77336920 71460881 69883218 708867 7453702 Living Gods love by inspiring health, wholeness and hope. false false 45457508 64924218 Adventist Health Medical Ctr Tehachapi, dba Adventist Health Tehachapi Valley (AHTV), 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 Medical Ctr Tehachapi, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths 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 programsNot only does Adventist Health Medical Ctr Tehachapi 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.AHTV 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 2023 was $ 2,334,605.The following Inpatient services were provided to all our patients:57 surgeries performed3,226 patient days The following Outpatient services were provided to all our patients:22,304 emergency department visits155 outpatient surgeries performed17,299 outpatient visits 17,736 clinic visitsAHTV 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 2023 was $568,200.Adventist Healths mission statement of living Gods 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 Gods image has experienced the best health today, hope for tomorrow, and Gods love that endures forever.An illustration of Adventist Health Medical Ctr Tehachapi's commitment to making care accessible in the community is through its Mobile Health Program. We know that accessing healthcare isnt always easy. Thats why our mobile units are rolling into rural communities where people live, work and play. And were partnering with schools and civic organizations to place our clinic in areas that are easily accessible.The Adventist Health Mobile Clinic provides:-Family medicine-Pediatric care-Womens health physicals-Blood draws/lab work-EKG (electrocardiogram)-WIC physicals-Every Woman Counts Program-Vaccinations/immunizations-School/sports physicals-Behavioral health services-Specialty services via Virtual CareThrough our collaboration with our Adventist Health hospitals in Delano, Bakersfield, and Tehachapi, the AIS Cancer Center in Bakersfield and three Quest Imaging locations, we deliver a depth and scope of expertise and technology you can trust to meet every healthcare need. We have partnered with the McFarland Unified School District and Grow Academy in Arvin to serve students. The clinics are also open to the public and children or adult patients do not have to attend the school when the clinic is parked there to receive care. The mobile van is available every Thursday at the Adventist Health Tehachapi Valley Rehabilitation Services. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 45457508 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true 0 0 true 366 true false false false false false false false 0 false false false false false false false X 12 11 true false false false true true true true true false false true true true true true true true true false CA X John Beaman 9164061092 PO Box 619135 Roseville CA 95661 Heinrich Kerry Director/CEO 0.00 50.00 X X 0 3302428 55743 Hofheins Todd COO/Vice Chair 0.00 50.00 X 0 2272592 74489 Beaman John CFO/Asst Secty 0.00 50.00 X 0 1680553 71703 Stevens Eric Former Care Div Ops Exec thru 02/22 50.00 50.00 0 1526293 57900 Nahapetian Arby Former Care Div Med Off thru 02/22 2.00 48.00 0 1482294 67961 Jahn Andrew Former Care Div Pres thru 02/22 0.00 50.00 0 1465906 50625 Wells Jason eff 123 President, CCN 12.50 37.50 X 0 1470582 23881 Wing Billy Former Dir/A Sec/V Chair thru 01/22 0.00 50.00 0 1438460 26777 Jobe Meredith Secretary 0.00 50.00 X 0 959488 60723 Wolcott Daniel thru 123 President, KCN 50.00 0.00 X 0 952733 64057 Jamaleddine Ghassan Medical Officer, KCN 50.00 0.00 0 713217 68356 Cantrell Misty Former Patient Care Exec thru 5/22 0.00 50.00 0 661754 72899 Cox Shane Treas/Asst Sec 12.50 37.50 X 0 637644 58218 SpenstBrett Former Care Div Finance thru 02/22 0.00 50.00 0 520625 44711 Van Housen Heather Patient Care Executive 2.00 48.00 0 478454 70013 ButlerDavid Former President thru 05/22 50.00 0.00 0 445613 38786 Carmien Anne RN II 40.00 0.00 220096 0 83685 Martin II Edward Admin Director 40.00 0.00 231861 0 30528 PettersonBreAnne RN Director 40.00 0.00 201915 0 52345 Harwick Donald Physician Asst 40.00 0.00 187702 0 52868 Mayer Wood Angela RN Manager 40.00 0.00 179407 0 51089 Freedman John Director 0.00 4.00 X 0 26770 0 Cherry Robert Director 0.00 4.00 X 0 26611 0 Davis Andrew Director 0.00 4.00 X 0 26611 0 Innocent Larry Director 0.00 50.00 X 0 26611 0 Reiner Richard Director 0.00 4.00 X 0 26611 0 Salazar Velino Director 0.00 4.00 X 0 26611 0 Newton Bradford Dir/Vice Chair 0.00 4.00 X 0 26611 0 Banks David Director 0.00 4.00 X 0 26181 0 Woodson Marc Director 0.00 4.00 X 0 21611 0 Wagner Jack Director 0.00 4.00 X 0 16180 0 Fehr Joy Director 0.00 4.00 X 0 430 0 HaydockTimothy eff724 Interim Treas 0.00 0.00 X 0 0 0 1020981 20259474 1177357 64 true true false Sound Physicians of California III PO Box 742936 Los Angeles CA 90074 Medical Services 1103917 Comfort Anesthesia Associates Inc 2635 G St Ste 101 Bakersfield CA 93301 Medical Staffing 976118 John R Garcia MD Inc 8311 Brimhall Rd Bldg 1900 Ste 1901 Bakersfield CA 93390 Medical Services 536015 Westways Staffing Services Inc 790 The City Dr S 180 Orange CA 92868 Medical Staffing 515401 Quest Imaging Medical Associates Inc PO Box 21178 Bakersfield CA 93390 Medical 481162 19 3139064 282183 3421247 Dietary/Cafeteria Revenue 141656 141656 Incentive and Quality Rev 89725 89725 Patient Care Services 900099 59404438 59404438 Pharmacy Revenue 33971 33971 Rental Income 722514 61572 61572 5609 5609 59736971 1617648 1617648 0 0 0 29520 118832 29520 118832 148352 148352 0 0 0 0 64924218 59885323 1617648 X 0 0 0 0 0 0 21921873 17978449 3927200 16224 690258 574120 116072 66 2977074 2467308 504899 4867 1488051 1283465 204586 5402654 5705 5396949 158832 158832 0 0 0 0 10698957 10391045 307912 54789 54789 337262 173761 163501 1984692 623021 1361671 0 1365045 1324608 40437 263443 128713 134730 0 3063 1393 1670 2498080 2498080 0 2548889 2528839 20050 565036 565036 Patient Care Supplies 4573600 4573600 Equipment Rentals 269553 269445 108 Other Expenses 95862 39228 55574 1060 Quality Assurance 31692 31692 0 57928705 45457508 12448980 22217 0 15325778 16812619 143300 325 8290982 8803951 0 0 0 1341945 1386607 25153 112302 49992265 11041882 40699490 38950383 0 0 0 95443 79050 6247657 11191683 72169748 77336920 4789821 4278168 32420 43449 66638640 65561601 71460881 69883218 X -1470525 6958565 2179392 495137 708867 7453702 72169748 77336920 X 6995513 -250678 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 7372 7372 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Part IV - Additional Information 2189391 258072 1952327 495136 2066923 1892057 -3675 1765914 2189391 1505161 1536692 5118 980048 2066923 850442 724919 16851 53349 1505161 478293 725438 353289 850442 1.00000 false true true 114300 114300 41529218 6975096 34554122 491626 491626 7857121 4066786 3790335 38950383 Other Assets 41660 Other Receivables 1680985 Receivables from related organizations 680062 Receivables from Third Parties 8788976 11191683 Other Liabilities 442634 Payables to 3rd Parties Medicare 39645 Payables to Related Organizations 65079322 65561601 X 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. Part X : FIN48 Footnote 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, 2023 and 2022, 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 2020 in major tax jurisdictions. true true X true X true X true true true false true true 455383 455383 0.00790 19509594 17630372 1879222 0.03240 19964977 17630372 2334605 0.04030 16167 16167 0.00030 1571054 1043021 528033 0.00910 24000 24000 0.00040 1611221 1043021 568200 0.00980 21576198 18673393 2902805 0.05010 true 15419 1788 12396548 12130675 265873 X true true 1 1 Adv Hlth Med Ctr Tehachapi 1100 Magellan Dr Tehachapi CA 93561 120000188 X X X X false false true X X X X X X X X X 22 true true true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 22 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X X true true X X X X true X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The 2022 CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populationsthe voices of those with chronic disease, low incomes, and the underservedwere heard.This CHNA involved interviews with behavioral health, childhood development, city council, city government, domestic violence, education, family and community based organizations, farm workers, formerly incarcerated, grape growers, healthcare, health and human services, higher education, Hispanic Chamber of Commerce, those experiencing homelessness, indigenous populations, food banks, formerly incarcerated, law enforcement, managed care, NAACP, Public Health, senior community-based organizations, students and a transportation agency. A total of 12 focus groups with 78 participants and 16 key informant interviews provided rich primary data for this report. Represented race/ethnicities were American Indian, Asian, Black, Hispanic, Multi-Race and White. The 2022 Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS Survey data was gathered from the Central Valley region (region name defined by survey administrator, UC Berkeley IGS). Facility: - Part V, Section B, Line 6a San Joaquin Community Hospital DBA Adventist Health Bakersfield and Adventist Health Delano participated in the 2022 CHNA process. Facility: - Part V, Section B, Line 11 Tax year 2023 was Year One of the Implementation Strategy for the 2022 Community Health Needs Assessment (CHNA). Programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care; Health Conditions and Health Risk Behaviors. Priority Need One-Access to Care. The goal is to collaborate with community partners to provide access to care to underserved populations through the utilization of mobile health units in eastern Kern County. Adventist Health Medical Center Tehachapi Valley expanded access to care via a mobile health rural health clinic. The clinic provided primary care services in the communities of Tehachapi and McFarland removing barriers for local families. In addition, the mobile health unit expanded access to year-round immunizations such as the flu vaccine and additional seasonal immunization needs. The mobile health team attended several community-based events providing health information and seasonal immunizations for underserved communities in eastern Kern County. These events expanded access to community members with limited means of transportation. Goal of events was connecting the community to primary care services for ongoing preventative wellness. Services provided included vaccinations for covid and flu and vitals. Adventist Health Medical Center Tehachapi Valley partnered with Parallon and Elevate to assist community members in the enrollment and approval process for individual or family medical insurance coverage. The Hospital partnered with Kern Family Healthcare to provide thirty-three free school and sports physicals creating a pathway for families to gain access to care. Services included general immunizations, vaccines, and wellness checks. Priority Need Two-Health Conditions. The goal is to reduce chronic health conditions by providing education and support services in the community through partnerships with Kern County Public Health and other community partner. These partnerships will offer opportunities for resources and support services to reduce common health conditions related to social determinants of health. In 2023, Adventist Health Medical Center Tehachapi Valley sponsored and participated in six monthly community farmers markets with the goal of connecting with residents and sharing wellness information related to chronic diseases and preventive care. In total, over 10,000 residents were reached though the local farmers markets. In 2023 the Hospital initiated a partnership with Kern County Public Health and Community Action Partnership of Kern to expand reach of wellness lifestyles and healthy eating through social determinants of health screenings and referrals of local residents in need. Once again the Hospital participated in National Night Out in Tehachapi where over several hundred individuals were seen and provided with healthcare prevention information along with information addressing behavioral health.Priority Need Three-Health Risk Behaviors. The goal is to partner with local organizations on education and resources contributing to health risk behaviors by expanding partnerships with local community gardens to provide a platform on health education and resources. In 2023, Adventist Health Medical Center Tehachapi Valley continued to support local community gardens in Tehachapi and California City. Through these partnerships, the Hospital was able to provide access to local fresh fruits and vegetables and healthier alternatives. Through support of local community gardens, the Hospital was also able to collaborate with local community resources such as Community Action Partnership of Kern and local school districts to provide access and referrals for additional wrap around services in addition to food access. Facility: - 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. Adventist Health Community Care-California City 9350 North Loop Blvd California City CA 93505 Rural Health Clinic Adventist Health Community Care-Tehachapi 105 West E Street Tehachapi CA 93561 Rural Health Clinic Adventist Health Community Care-Mojave 2041 Belshaw Street Mojave CA 93501 Rural Health Clinic Adventist Health Tehachapi Mobile Services 1100 Magellan Dr Tehachapi CA 93561 Rural Health Clinic Adventist Health Outpatient Physical Therapy 116 W F St Tehachapi CA 93561 Outpatient Physical Therapy Part I, Line 7 - Explanation of Costing Methodology 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:Total expenses - (Provision for bad debts + Other revenue + Interest income)/Gross patient chargesAdventist Health Tehachapi is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government. Part III, Line 2 - Methodology Used To Estimate 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 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 - Methodology of Estimated Amount & Rationale for Including in Community Benefit 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 from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide combined audited financial statements do not contain a footnote describing bad debt expense. 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. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too 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 - 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 VI, Line 2 - Needs Assessment Adventist Health Medical Center Tehachapi Valley promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the Year One Update, FY 2023 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/tehachapi-valley/about-us/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2021, 2022 and 2023 Community Health Plan Updates are also available on the Adventist Health Corporate website at https://www.adventisthealth.org/about-us/community-benefit/.The Community Health Needs Assessment (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, Adventist Health supports 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 our region. 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. In addition to the CHNA, the Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Part VI, Line 3 - Patient Education of Eligibility for Assistance The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospitals website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the hospitals Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt 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 - Community Information Nestled in the Tehachapi Valley, the city of Tehachapi is surrounded by mountains and scenery on all sides, with a significant and meaningful history of Native American tribes. Its high elevation, desert landscape, and nearby popular Pacific Crest Trail attract the ultimate adventurer. Our geographically distinctive Tehachapi Valley service area consists of a population of 122,230. Of those, about 54% are non-Hispanic. Part of what makes the community of Tehachapi Valley unique is the diverse age group of its residents, with 12.3% of people being over 65 and 36.7% being young than 35. Of this population, 31.2% of children live in poverty and 4.24% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. This small, rural community is known for being family-friendly and unique for living outside regular suburbia conventions. Residents spend 57.68% of their income on housing and transportation. DEMOGRAPHIC PROFILE The following zip codes represent Adventist Health Medical Center Tehachapi Valleys primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The Adventist Health Medical Center Tehachapi Valley CHNA market has a total population of 122,230 (based on the 2020 Decennial Census). The largest city in the service area is Arvin, with a population of 19,304. The service area is based on the following zip codes: 93528, 93558, 93501, 93519, 93518, 93516, 93531, 93554, 93241, 93560, 93561, 93203, 93505, 93523, 93527, 93524. 63.06% of the population owns their home and 36.94% of the population rents their home. Total Population by Age Groups, Total Adventist Health Tehachapi Valley Age 0-4: 7.7%, Age 5-17: 20.1%, Age 18-24: 8.9%, Age 25-34: 15.4%, Age 35-44: 13.2%, Age 45-54: 10.7%, Age 55-64: 11.7%, Age 65+: 12.3%.Only 1.69% of the population in Tehachapi Valley lives within a mile of a hospital with an emergency room. This is well below the states rate of 8.71% and the United States at 7.68%. There are also fewer ICU beds in Tehachapi Valley than in California and the US, further complicating the availability of care. With only 17.57% of the population living within a half mile of public transportation, traveling long distances to see a small pool of providers paints a dire picture for people needing a doctor. By comparison, 63% of Californians and 35% of all Americans have easier access to public transportation so this represents a major problem for this community. Additionally, 28.11% of the population older than 25 have no high school diploma. Currently, 17.79% of adults in Tehachapi Valley smoke tobacco, which is a full 6% greater than the state average. Additionally, 17.46% of adults binge drink which is a higher than national average. When specifically looking at Medicare beneficiaries in the Tehachapi Valley, 2.5% have an alcohol use disorder, and 5.1% have a substance use disorder. The alcohol use numbers are consistent with state and local figures, but the substance use disorder rates are more than 1% higher. Along with that, 6.2% of local Medicare beneficiary drug claims are for opioids, which is 2 percentage points higher than the state and countrywide averages. Additionally, 13.6% of all live births were of infants born with low birthweight. Thirty-five percent of the adult population in the Tehachapi Valley are obese, which is higher than state and national averages. Part VI, Line 4 - 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. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 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. Part VI, Line 5 - Promotion of Community Health Our Hospitals mission is, Living Gods 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 todays state of health, where cost and heartache is 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 healthyeven 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 - Affilated Health Care System 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 tele pharmacy 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 - States Filing of Community Benefit Report CA Part VI - Additional Information Listing of Organizations that Particpated in the Hospital's CHNA - Organizations that participated in the 2022 CHNA included: Alliance Against Family Violence, American Indian Health Project, Bakersfield College, Bakersfield Homeless Shelter, Bakersfield Police Department, Bakersfield Womens Homeless Shelter, City of Tehachapi, City Serve, Community Action Partnership of Kern, Delano Union School District, First Five Kern, Garden Pathways, Kern Behavioral Health & Recovery Services, Kern County Childrens Dental Health Network, Kern County Department of Public Health, Kern County Hispanic Chamber of Commerce, Kern County Housing Authority, Kern County Network for Children, Kern Family Health Care, Kern Medical, National Association for the Advancement of Colored People, Transitional Youth Mobilizing for Change, and United Farm Workers Foundation Kern County. Identified Needs from CHNA, Not Addressed and Why -No hospital can address all the health needs identified in its community. Adventist Health Medical Center Tehachapi Valley 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 directly addressed but fulfilled by other community organizations include housing, financial stability, mental health, food security, environment & infrastructure, inclusion & equity, COVID, education, community vitality and community safety. While these significant health needs are not address directly, they are likely to benefit from collective efforts of our community partnerships.Other Items:Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education X X X X true true false false false false false false false Beaman John CFO/Asst Secty 1091769 569149 19635 11644 60059 1752256 ButlerDavid Former President thru 05/22 445613 11644 27142 484399 Cantrell Misty Former Patient Care Exec thru 5/22 277192 124207 260355 11644 61255 734653 Carmien Anne RN II 218596 1500 7109 76576 303781 Cox Shane Treas/Asst Sec 482709 97773 57162 11644 46574 695862 Harwick Donald Physician Asst 183939 2082 1681 5308 47560 240570 Heinrich Kerry Director/CEO 2017000 1208880 76548 11644 44099 3358171 Hofheins Todd COO/Vice Chair 1389462 735265 147865 11644 62845 2347081 Jahn Andrew Former Care Div Pres thru 02/22 1044420 406990 14496 50625 1516531 Jamaleddine Ghassan Medical Officer, KCN 550638 109444 53135 11644 56712 781573 Jobe Meredith Secretary 660525 168715 130248 14609 46114 1020211 Martin II Edward Admin Director 183172 24943 23746 7810 22718 262389 Mayer Wood Angela RN Manager 159801 19606 4942 46147 230496 Nahapetian Arby Former Care Div Med Off thru 02/22 967385 329621 185288 11644 56317 1550255 PettersonBreAnne RN Director 163499 17543 20873 6634 45711 254260 SpenstBrett Former Care Div Finance thru 02/22 259692 250809 10124 12160 32551 565336 Stevens Eric Former Care Div Ops Exec thru 02/22 1045616 319995 160682 11644 46256 1584193 Van Housen Heather Patient Care Executive 361260 70116 47078 11644 58369 548467 Wells Jason eff 123 President, CCN 892808 337640 240134 23881 1494463 Wing Billy Former Dir/A Sec/V Chair thru 01/22 1438460 26777 1465237 Wolcott Daniel thru 123 President, KCN 190804 217108 544821 11644 52413 1016790 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 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 Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. 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 or the System General Counsel 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 15a 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 at least 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 60th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section B, Line 15b See Line 15a explanation. 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 XI, Line 9 Transfer to Related Entities = -$10835 Form 990, Part XI, Line 9 Transfer to Related Entities = -$239843 Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Delano 1401 Garces Hwy Delano CA 93215 770258013 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Foundation 1 Adventist Health Way Roseville CA 95661 680002188 Charitable foundation CA 501(c)(3) 7 Adventist Health SystemWest false Adventist Health Mendocino Coast 700 River Drive Fort Bragg CA 95437 845174585 Hospital CA 501(c)(3) 3 Stone Point Health false Adventist Health Physicians Network 1 Adventist Health Way Roseville CA 95661 680357690 Medical Foundation CA 501(c)(3) 12b2 Adventist Health SystemWest false Adventist Health SystemWest 1 Adventist Health Way Roseville CA 95661 953484589 Integrated health system CA 501(c)(3) 10 N/A false Adventist Health Tulare 869 North Cherry Street Tulare CA 93274 832351753 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Castle Medical Center 640 Ulukahiki Street Kailua HI 96734 990107330 Hospital HI 501(c)(3) 3 Adventist Health SystemWest false Feather River Hospital 1 Adventist Health Way Roseville CA 95661 941101228 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Glendale Adventist Medical Center 1509 Wilson Terrace Glendale CA 91206 951816017 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi CA 95240 941044474 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Mid-Columbia Medical Center 1700 E 19th Street The Dalles OR 97058 930386936 Hospital OR 501(c)(3) 3 Stone Point Health false Northwest Medical Fdtn of Tillamook 1000 Third Street Tillamook OR 97141 930622075 Hospital OR 501(c)(3) 3 Adventist Health SystemWest false Paradise Valley Hospital 1 Adventist Health Way Roseville CA 95661 951816034 Discontinued Operations CA 501(c)(3) 3 Adventist Health SystemWest false Portland Adventist Medical Center 10123 SE Market Street Portland OR 97216 930429015 Hospital OR 501(c)(3) 3 Adventist Health SystemWest false Reedley Community Hospital 372 Cypress Avenue Reedley CA 93654 453220509 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Rideout Memorial Hospital 726 Fourth Street Marysville CA 95901 941387866 Acute care hospital CA 501(c)(3) 3 Stone Point Health false St Helena Hospital 10 Woodland Road St Helena CA 94574 941279779 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false San Joaquin Community Hospital 2615 Chester Avenue Bakersfield CA 93301 952294234 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Simi Valley Hospital and Health Care Ser 2975 N Sycamore Drive Simi Valley CA 93065 956064971 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Sonora Community Hospital 1000 Greenley Road Sonora CA 95370 941415069 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Stone Point Health 1 Adventist Health Way Roseville CA 95661 823763347 Supporting organization CA 501(c)(3) 12b2 Adventist Health SystemWest false Ukiah Adventist Hospital 275 Hospital Drive Ukiah CA 95482 941639901 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false United Com-Serve 726 Fourth Street Marysville CA 95901 943015356 Skilled Nursing/Asstd Living/Home Health CA 501(c)(3) 12b2 Stone Point Health false Walla Walla General Hospital 1 Adventist Health Way Roseville CA 95661 910617726 Hospital - closed July 2017 WA 501(c)(3) 3 Adventist Health SystemWest false Western Health Resources 1 Adventist Health Way Roseville CA 95661 953867863 Home Care CA 501(c)(3) 10 Adventist Health SystemWest false White Memorial Medical Center 1720 E Cesar E Chavez Avenue Los Angeles CA 90033 952282647 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Willits Hospital Inc 1 Marcela Drive Willits CA 95490 680108919 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Blue Legacy Ventures LLC 1010 NE 2nd Avenue Miami FL 33132 871254649 Real Property Rental FL AHSWest false false Blue Zones LLC 200 Southdale Center Edina MN 55435 271603327 Education MN AHSWest false false PAR LLC dba CherryWood Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 931262371 Senior Housing OR AHSWest false false PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 260622555 Senior Housing OR AHSWest false false PVHR2 LLC dba Parkview Memory Care 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 473300170 Senior Housing OR AHSWest false false WWGHR LLC dba Wheatland Village 8440 SE Sunnybrook Blvd Suite 100 Clackamas OR 97015 810591221 Senior Housing OR AHSWest false false South Coast Medical Center PO Box 619135 Roseville CA 95661 952037291 Wind down after sale of hospital CA AHSWest C-Corp false Adventist Health Plan Inc 1 Adventist Health Way Roseville CA 95661 463833261 Health Insurance CA AHSWest C-Corp false Thrive Productions Inc 200 Southdale Center Edina MN 55435 453369049 Production Company MN AHSWest C-Corp false AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure Captive Insurance BD AHSWest C-Corp false false false false false true false false false false false false false true false true false false false true Adventist Health SystemWest e 65079322 Notes Payable Adventist Health SystemWest m 6760078 Operating Exp Adventist Health SystemWest o 243329 Compensation Adventist Health SystemWest s 1487119 Cash Mgt funds