2024-11-01T10:40:49-07:00 2023-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2023-01-01 940535360 Hanford Community Hospital dba Adventist Health Hanford HANF 5595829000 115 Mall Dr Hanford CA 93230 Timothy Haydock Treasurer 2024-11-01 true true Steve Clement P01218012 8185475701 X 2023 2024-10-15 13:58:12Z Andrea Kofl 447422292 false 1071 X www.adventisthealth.org/hanford X 1956 CA Living Gods love by inspiring health, wholeness and hope. 12 11 2160 20 482517 1439082 4543010 13595080 371042930 393810371 -6232392 40016841 0 369353548 447422292 354468 66437 0 134313079 153018538 0 206068 235904743 235603552 370572290 388688527 -1218742 58733765 722212194 806386854 292003380 320715861 430208814 485670993 Living Gods love by inspiring health, wholeness and hope. false false 320155348 66437 395324819 Hanford Community Hospital, dba Adventist Health Hanford (AHHF), 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 Hanford Community Hospital, 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 Hanford Community Hospital 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.AHHF 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 $ 19,086,492.The following Inpatient services were provided to all our patients:2,177 babies delivered2,016 surgeries performed40,479 patient days The following Outpatient services were provided to all our patients:101,719 emergency department visits7,050 outpatient surgeries performed142,252 outpatient visits 246,363 clinic visitsAHHF 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 $ 31,818,155.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.Let us share an experience that illustrates how we care for our community:I was in labor, but unfortunately, it wasn't progressing like it should. I was told by Dr. Thomas Enloe that if by 11 p.m. I didn't progress any further, I would need to think about having a C-section.At 11 p.m. I was still the same, so Dr. Enloe was called in to proceed with a C-section. Within a couple of minutes, I felt what I thought was my water breaking. Suddenly, I had every nurse on the floor in my room, including the nursing supervisor, who introduced herself to me.Being a former employee of Adventist Health, I knew if the nursing supervisor was in my room and checking me as well, something was wrong. I was then rushed to the Operating Room because my uterus had ruptured. While there, the nurses and Dr. Enloe worked so fast. Before I knew it, my son was born, and nurses were already tending to him.As I was recovering on the third floor, the nurses were very caring, reassuring me I would be fine. It was very comforting. After I was moved to the second floor, I had two nurses that took great care of me. They made sure my pain level was tolerable, and they helped me and cared for me just as well as the nurses on third floor.I later found out just how potentially fatal the situation could have been. Both Dr. Enloe, as well as the on-call physician Dr. Kryns, said had I not been in the hospital, it could have been fatal to both the baby and/or me.My husband and I are so grateful for the nursing staff that took care of us. Besides being quick to respond, they were very kind and caring during the whole ordeal. If it weren't for Dr. Enloe and the nurses, we may not be here today.My husband and I feel the nurses were our angels watching over us, so we gave them each special angel pins in appreciation.Compassionate, high-quality patient care; life-saving and life-preserving medical and surgical services; advanced treatments in a community-based hospital; essential emergency services-these are the reasons we are in our community.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 320155348 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 true false true false false false false false false false false false false false false false true true true false false true 0 0 true 2160 true true true 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 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358747146 358747146 Premium Revenue 900099 29683008 29683008 Rental Income 1424399 1424399 Revenue fr Related Orgs 920158 920158 1464024 981507 482517 393810371 38019876 38019876 0 0 0 142042 1854923 142042 1854923 1996965 1996965 0 0 0 0 447422292 395324819 482517 38019876 X 66437 66437 0 0 0 0 0 122711979 106240518 16343102 128359 4394233 3785206 605496 3531 17278138 15084334 2164619 29185 8634188 7649339 977379 7470 33401239 33401239 620576 620576 31 31 0 0 0 76349662 73233856 3092263 23543 123154 123154 2900169 1463262 1429357 7550 11253514 2859655 8393859 0 7508144 7501448 6696 380407 245485 133214 1708 0 27523 22870 4374 279 8331645 8331645 0 18058269 17826888 231381 3208299 3208299 Patient Care Supplies 46104326 46104326 Other Expenses 24696111 23891315 800353 4443 Quality Assurance 1034919 1034919 Equipment Rental 1001855 1001837 18 603709 603709 388688527 320155348 68327111 206068 0 399509099 446476852 10069 5625 39501974 46004827 0 0 0 5746149 6375018 654228 876740 420650106 244212741 163423685 176437365 0 0 18424251 19329742 1380000 94942739 109500685 722212194 806386854 24486633 29919261 2656151 1887350 264860596 288909250 292003380 320715861 X 428829749 484793601 1379065 877392 430208814 485670993 722212194 806386854 X 58733765 -3271586 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 35939 35939 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. Expenditures to Noteware were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. Part IV - Additional Information 1979780 23241 644281 1358740 1829908 1445791 1295919 1979780 1829394 1635113 1634599 1829908 1654754 1454144 396373 883131 1829394 1837835 1515346 189723 1508704 1654754 0.35426 0.64574 false true true 23000 8551446 8574446 260596251 141226261 119369990 11528001 10860961 667040 136054369 89182522 46871847 3897039 2942997 954042 176437365 Investment in Fdtn 1703048 Other Assets 545095 Other Receivables 284432 Receivables from Related Organizations 12930682 Receivables from Third Parties 94037428 109500685 Other Liabilities 22138134 Payables to Related Organizations 257137550 Payables to Third Parties 9633566 288909250 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 1527748 1527748 0.00390 152389247 134830504 17558743 0.04520 153916995 134830504 19086491 0.04910 958443 958443 0.00250 299677 299677 0.00080 38055413 7516188 30539225 0.07860 20811 20811 0.00010 39334344 7516188 31818156 0.08200 193251339 142346692 50904647 0.13110 144176 144176 0.00040 144176 144176 0.00040 true 2312690 555168 48471732 62036684 -13564952 X true true 2 1 Adventist Medical Ctr-Hanford 115 Mall Dr Hanford CA 93230 550001439 X X X X A 2 Adventist Medical Ctr-Selma 1141 Rose Ave Selma CA 93662 550001439 X X X A 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 populations the voices of those with chronic disease, low incomes, and the underserved were heard. Aging, civic government and leadership, community-based organizations focusing on healthcare consumer, law enforcement, low-income, medically underserved, minority populations, substance abuse, transportation and unhoused population participated in seven focus groups with fifty-two individuals participating as well as eight key informant interviews. Represented race/ethnicities were 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 Other hospitals that participated in the 2022 Community Health Needs Assessment included Reedley Community Hospital and Adventist Health Tulare. 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). All programs and activities provided to the community were in response to the priority health needs identified in the 2022 Community Health Needs Assessment (CHNA). Our 2022 CHNA identified three areas of significant need: Financial Stability, Food Security and Mental Health. Priority Need 1-Financial Stability. The goal is to advocate for and collaborate with internal and external partners to identify community members experiencing poverty and connect them to support services to lessen financial burden by partnering with external agencies to provide financial literacy programs. Hanford Community Hospital is working to address financial stability and is actively engaged with Valley Strong Bank and Bank of America to curate opportunities to offer financial literacy courses to students and their families. The Hospital has also partnered with Kings Canyon Unified and Kings County Unified School Districts. Additionally, Hanford Community Hospital, Reedley Community Hospital and Adventist Health Tulare are preparing to open a community partner led and driven Resource Center (RC). The RC will be home to several community-based organizations many of which have signed a usage agreement to provide community members with health-related social needs. The Hospital has met with Kings Canyon Unified School District, and Kings Community Action Organization to discuss opportunities such as Fun Fit Fridays, Parental Support groups that we could offer financial literacy courses.Other financial stability strategies included offering student athletes in Tulare and Kings counties free sports physicals at three events organized by Adventist Health. Schools require a sports physical for student athletes of all ages in order to determine a students medical eligibility to play on a sports team. Sports physicals include a basic medical screening that checks a students height and weight, blood pressure and vision. Physicals usually take 30-45 minutes, and each student received a swag bag that included a water bottle and school supplies. Students were also able to receive the COVID-19 vaccine at the event. These free sports physicals also address issues with access to care in Hanford/Selma area where 76.54% live in a population affected by a health professional shortage area as well as the childhood poverty rate at 24.44% as compared to the national childhood poverty rate of 16.66%.In 2023, Hanford Community Hospital partnered with Parallon to assist community members in the enrollment and approval process for individual or family medical insurance coverage. The Hospital also works with the COPE Health Scholar program to provide educational opportunities for individuals interested in making a difference in health care by working together to advance their careers through firsthand experience in clinical and administrative health care settings to become an integral part of the care delivery team. Cope Scholars assist with basic care for patients alongside nurses, physicians and other members of the care delivery team, and have opportunities to learn the business of health care, preparing them for a health care career and helping earn volunteer hours for medical school, nursing school, and other graduate programs while positioning students well for entry-level positions in healthcare.Hanford Community Hospital continued the Inspire Hope program through a partnership with World Vision whose focus is on helping the most vulnerable children overcome poverty and experience fullness of life. Hanford Community Hospital received over ten shipments of donated goods and partnered with local community-based organizations for distribution to those in need.Priority Need Two Food Security. The goal is to give access to current food distribution programs to the community identified by clinical screenings by building relationships with external partner who already have an established distribution program. In 2023, Hanford Community Hospital provided a list of food outreach resources in our emergency department and available to our clinics. The Hospital partnered with Kings Community Action Organization to help restock their emergency pantry for those in need. Hospital staff donated canned goods, boxed items and ready to eat healthy foods during May 2023 as part of May Stroke Awareness Month. Priority Need Three- Mental Health. The goal is to provide mental health awareness and access to our communities by working with external and internal stakeholders to provide educational awareness to better serve those patients and others, Hanford Community Health began a partnership in 2023 with the Selma Healthcare District on a $222,000 year long pilot project to better coordinate mental health care in the community. The district is committing $100,000 and Adventist Health is dedicating the remaining funds toward a two-person clinical team to assess and treat patients and direct them to local resources more quickly. Funds will be used to hire a licensed clinical social worker to care for patients in the emergency department, Selma clinics and mobile clinic visits in Selma. Faster emergency department assessments will allow patients to get the care they need more quickly rather than waiting for a transfer. The social worker can also direct patients for follow-up care at a clinic in town to meet their needs on an ongoing basis and promote long-term healing. At the clinic, a medical assistant will be dedicated to supporting referred mental health patients with their needs. 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 Radiology and Imaging 1142 Rose Ave Ste A Selma CA 93662 Clinical laboratory and radiology services Adventist Health Gastroenterology 125 Mall Drive Suite 101 Hanford CA 93230 Gastrointestinal Lab Kerr Outpatient Surgery Center 470 N Greenfield Ave Hanford CA 93230 Ambulatory surgery center Breast Care Center 125 Mall Dr Ste 203 Hanford CA 93230 Services related to breast disease Adventist Health Hanford Therapy 210 W Lacey Blvd Hanford CA 93230 Rehabilitation services Adventist Health Lemoore Physical Therapy 75 W Hanford-Armona Road Lemoore CA 93245 Rehabilitation services Adventist Health Sleep Apnea Center 815 N Douty St Hanford CA 93230 Sleep study center Adventist Health PET Unit Hanford Medical Pavilion 125 Mall Dr Hanford CA 93230 PET imaging/Proton therapy Adventist Health Nuclear Medicine 450 N Greenfield Ave Hanford CA 93230 Nuclear medicine services/Hospital Department Adventist Health Lung Care Ctr 125 Mall Dr Ste 305 Hanford CA 93230 Specialized services related to lung disease 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) divided by Gross patient charges 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 audited combined 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 Hanford Community Hospital 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/central-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 The Central Valley Network (CVN) is comprised of four cities: Hanford, Tulare, Reedley, and Selma. The CVN is home to a total population of 530,375 residents with the majority age group being children (5-17), making up 22.2% of the population. Centrally located between northern and southern California, CVNs geographic region is one of its biggest assets benefiting farmland businesses as well as residents pursuing recreational activities such as a short road trip to Yosemite National Park or the cool coastlines of Monterey Bay and Big Sur. This young population is vibrant with festivals, events, and small businesses. Of the population, 64.68% are Hispanic. The median household income is $60,367 of which 59.22% is spent on housing and transportation. Among this population, 27.23% of children live in poverty and 2.70% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. The following zip codes represent Adventist Health Central Valley Networks 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 Central Valley Network CHNA market has a total population of 537,932 (based on the 2020 Decennial Census). The largest city in the service area is Tulare, with population of 59,312. The service area is comprised of the following zip codes: 93219, 93648, 93625, 93646, 93609, 93647, 93631, 93657, 93245, 93234, 93239, 93654, 93204, 93618, 93230, 93615, 93662, 93212, 93630, 93619, 93210, 93656, 93274. 57.31% of the population own their home and 42.69% are renters. Currently 8.57% of the Central Valley population does not have health insurance. The labor force participation rate (57.62%) is lower than that of California (63.29%) and the United States (62.97%). The unemployment rate is at 8.42% and is higher than both the State and the Nation. Unemployment creates financial instability and barriers to access including insurance coverage, health services and education, healthy food, and other necessities that impact health status. The rate is higher for people of multiple races (11.27%) and people who chose some other race (10.49%). The childhood poverty rate is extremely high at 27.23%, higher than that of California (16.8%) and US (17.48%). Racial disparity in childhood poverty is evident, with 67.13% of Native Hawaiian or Pacific Islander children aged 0-17, 26.76% of Black children, and 28.23% of Native American or Alaska Native children living in households with income below the federal poverty level. The median household income is $60,367, which is below both the California rate and that of the Nation, and poses a significant problem given the exceedingly high cost of living and housing costs in the area. The percent of the Central Valley population living in poverty is extremely high (19.22%) and is considerably higher than the rate of poverty in California (12.58%) and in the US (12.84%). The percentage of students eligible for the free or reduced-price school food program represents 75.84% of public-school students, which is higher than the State average of 59.18% and the Nations average of 42.16%. Access to mental health (MH) providers in the Central Valley is extremely limited. The rate of MH providers is 43.82 per 100k people, as compared to 150.31 in California and 132.27 in the United States. The percentage of adults with poor mental health is higher in the Central Valley (16.1%) than in California (12.5%) and in the US (13.6%). Deaths of despair, which include any deaths due to intentional self-harm, alcohol related disease, and drug overdose are at 43.4 per 100k people and are elevated than the rate in the rest of the state of California (37.1). 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 System/West, 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 can 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: Champions Recovery, City of Hanford, City of Reedley, Family Healthcare Network, Fresno County Department of Public Health, Kings Area Regional Transit, Kings County, Kings County Commission on Aging, Kings County Department of Public Health, Kings Partnership for Prevention, Kings County Sheriffs Department, Kings Tulare Homeless Alliance, National Association for the Advancement of Colored People (NAACP) and Tulare County Department of Public Health.Identified Needs from CHNA, Not Addressed and Why - No hospital can address all the health needs identified in its community. Adventist Health Hanford & Selma 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. Climate Change: We feel that this is not our area of expertise and while we are willing to partner with organization who are engaging in activities to address Climate Change, this is not a top priority at this time. Substance Abuse/Tobacco- will be addressed through Mental Health, Access to Care, and Healthy Eating Active Living (HEAL). Oral Health- will be addressed through Access to Care. Asthma- will be addressed through Access to Care. CVD/Stroke- will be addressed through Access to Care and HEAL. HIV/AIDS/STIs- will be addressed through Access to Care and Maternal/Infant Health. Cancer- will be address through Access to Care and HEAL. Violence/Injury Prevention- will be address through Economic Security/Homelessness, Access to Care and Maternal/Infant Health. Other Information - Hanford Community Hospital also addressed access to care issue in 2023 by providing over 550 free visits in the greater Central Valley area along with Reedley Community Hospital and Adventist Health Tulare by attending special events. In 2023, the Hanford Community Hospital Family Medicine Residency Program continued. This is a community-based program and provides each resident the benefit of clinical experiences and innovative educational opportunities through a multi-disciplinary approach. The Programs mission is to provide quality training and exceptional opportunities to our residents. In this program, the Hospital trains competent, well-rounded physicians, that will provide compassionate care to the patients in the Central Valley, as well as to increase the primary care workforce in the community. The strength of the program lies in its people who comprise it, our family-oriented faculty who are diverse in background and interests, dedicated residents, and staff.Walk with a Doc launched in 2023 post covid and provided the community an opportunity to meet the physicians who provide clinical care in an unstructured social setting. Providers discussed health education topics including breast cancer, flu/pneumonia, health tips, heart health, pediatrics, and general wellness.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 true CA Health Fund & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 413653 0 Funds Transfer Health services for uninsured pts. Greater Reedley Chamber of Co 1044 G Street Reedley CA 93654 270636938 501(c)(6) 7500 0 Funds Transfer Sponsorship Hanford Main Street Program 219 W Lacey Blvd Hanford CA 93230 770551552 501(c)(6) 7500 0 Funds Transfer Sponsorship Links for life inc PO Box 766 Hanford CA 93232 931088003 501(c)(3) 10000 0 Funds Transfer Sponsorship 2 2 Grantmaker's Description of How Grants are Used Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X X X X true true false false false false false false false Abukhazneh Ahmed Dir, Pharmacy 253131 61799 25166 11644 48157 399897 Ammon Edward Former Fdtn Exec thru 1/21 65154 54942 183706 11127 52302 367231 Ayala Raul Ambulatory Medical Officer, CVN Cli 542452 131817 7966 11644 37123 731002 Beaman John CFO/Asst Secty 1091769 569149 19635 11644 60059 1752256 Cano Nina Dir, Laboratory 204343 17007 26906 7985 44364 300605 Chapman Susan Asso Patient Care Exec & Site Admin 221395 36760 33847 292002 Day Lauren Philanthropy Executive, CVN 255764 62028 20669 13419 50650 402530 Denham Michael Director, RN 193316 15229 29786 8689 50624 297644 Duyst Jennifer Admin Director, Clinics & Strategy 226189 37555 16763 11753 31645 323905 Haydock Timothy Treas/Asst Sec 459037 112145 57582 11644 27856 668264 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 Jobe Meredith Secretary 660525 168715 130248 14609 46114 1020211 Jones Larry Admin Director, Ancillary Services 200090 33231 21422 8148 46781 309672 Kaur Gurvinder Medical Officer, CVN 536229 130845 48563 11644 56881 784162 Kofl Andrea Ctrl Vally Pres 746000 254602 172740 11644 57778 1242764 Lally-DeAlba Mary Associate Patient Care Executive 215547 35709 25580 10576 92683 380095 Lin Lihong Nurse Practitioner 232544 18407 2606 8195 29383 291135 Nahapetian Arby Former Care Div Med Off thru 02/22 967385 329621 185288 11644 56317 1550255 Reyna Sonja Operations Executive, CVN 404892 144793 37590 12352 56005 655632 Spenst Brett Former Care Div Finance thru 04/23 259692 250809 10124 12160 32551 565336 Stevens Eric Former Care Div Ops Exec thru 02/22 1045616 319995 160682 11644 46256 1584193 Taggart Laurie Patient Care Executive,CVN 373096 90513 46009 11654 43771 565043 Warren Oksun RN 244664 1576 6829 8511 59651 321231 Wells Jason Central CA Network Pres Ef 01/23/23 892808 337640 240134 23881 1494463 WingBilly Former Dir/A Sec/V Chair thru 01/22 1438460 26777 1465237 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 Change in Foundation Net Assets = -$319200 Form 990, Part XI, Line 9 Transfer to Other Funds = -$26363 Form 990, Part XI, Line 9 Transfer to Related Entities = -$2926023 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 Med Ctr Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 3 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 NA 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 Lodi Memorial Hospital Association 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 Svc 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/Assisted Living/Hm Hlth 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 Central Valley Health Foundation 450 N Greenfield Ave 400 Hanford CA 93230 770578450 Fundraising for Hospital CA 501(c)(3) 3 Western Health Resources true Fowler Business & Professional Park LLC 9300 Valley Childrens Place Madera CA 93636 471813772 Property Development and Leasor CA Valley Childrens He false false 0.50000 Butano Dialysis LLC C/O Tax Dept Po Box 3004 Tacoma WA 98401 452930832 Outpatient Dialysis Treatment Center WA Total Renal Care false false 0.25000 Lighthouse Dialysis LLC C/O Tax Dept PO Box 3004 Tacoma WA 98401 272454736 Outpatient Dialysis Treatment Center WA Total Renal Care false false 0.25000 SRCC- Medical Oncology LLC 400 W Mineral King Visalia CA 93291 522377302 Outpatient Oncology Treatment Center CA Kaweah Delta 15000 false false 0.15000 Sequoia Regional Cancer Center LLC 400 W Mineral King Visalia CA 93291 770541676 Outpatient Oncology Treatment Center CA Kaweah Delta false false 0.25000 TKC Development LLC 922 W Center Ave Visalia CA 93291 200995368 Property Development and Leasor CA Kaweah Delta false false 0.25000 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 257137550 Notes Payable Adventist Health SystemWest m 41793342 Operating Exp Adventist Health SystemWest o 3479297 Compensation Adventist Health SystemWest s 47062218 Cash Mgt Funds