2024-11-01T11:17:00-07:00 2023-12-31 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2023-01-01 956064971 Simi Valley Hosp and Hlth Care Services dba Adventist Health Simi Valley SIMI 8059556000 2975 N Sycamore Dr Simi Valley CA 93065 Shepardson Dean Treasurer 2024-11-01 true true Steve Clement P01218012 8185475701 X 2023 2024-10-15 13:58:12Z Jennifer Swenson 216124606 false 1071 X www.adventisthealth.org/simi-valley X 1960 CA Living Gods love by inspiring health, wholeness and hope. 12 11 1339 352021 187483 3408919 4947167 199177546 210360610 -957171 444505 418330 328245 202047624 216080527 205406 309210 0 91468392 98806014 0 520190 132682693 131987719 224356491 231102943 -22308867 -15022416 174224266 169787870 181938159 195159990 -7713893 -25372120 Living Gods love by inspiring health, wholeness and hope. false false 181953465 309210 216080527 Simi Valley Hospital and Health Care Services, dba Adventist Health Simi Valley (AHSV), 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 Simi Valley Hospital and Health Care Services, 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 Simi Valley Hospital and Health Care Services 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.AHSV 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 $ 24,590,146.The following Inpatient services were provided to all our patients:455 babies delivered1,084 surgeries performed30,018 patient days The following Outpatient services were provided to all our patients:45,053 emergency department visits3,698 outpatient surgeries performed37,262 outpatient visits 68,286 clinic visitsAHSV 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 $15,002,641.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 with you a story which illustrates how our hospital cares for those in our community:Mark lived with pain for more than a decade. Ive had back problems since I was 20, it would come and go depending on the year, but it was prevalent through most of my adult life, says the 37-year-old software engineer. The pain became unbearable in late 2023 after returning home from a trip. "Within a few weeks, I was in the emergency room because I had lost feeling in both of my legs." he says. Physicians told Mark that he had lumbar nerve entrapment, meaning the nerves in his spine were compressed by the vertebrae, causing severe pain and numbness. This can build over time because of normal wear and tear or stress on the back from heavy lifting or accidents.After his hospital visit, Mark made an appointment with Zachary Sharfman, MD, an orthopedic surgeon specializing in spinal surgery at Adventist Health Simi Valley. Dr. Sharfman explained, We spent a lot of time working together on a treatment plan and discussing his options, but ultimately, I left the decision in his hands because I like to empower people to make the choice for themselves.Mark says that he had tried several treatments to relieve his back pain over the years, including physical therapy and steroid injections to reduce the inflammation, but nothing lasted. He knew it was time for an operation. Earlier this year, Dr. Sharfman performed a lumbar laminectomy on Mark. "His nerves were really compressed" says Dr. Sharfman. He used special tools to remove small portions of Mark's vertebrae to provide more space for the spinal nerves.Dr. Sharfman recommended this operation for Mark because it didnt require placing metal in or around the spine. The procedure is minimally invasive, meaning it can be performed through small incisions. In addition, patients typically have shorter recovery times and less pain after minimally invasive procedures than with traditional surgeries. Mark recalls, At Adventist Health Simi Valley, everyone was extremely attentive after my surgery. They taught me how to get out of bed, stand, and walk properly. I was only there one night. It was a really warm, welcoming hospital."Mark says that his recovery went well, particularly because he felt prepared for what to expect. He also shared that, Dr. Sharfman was always in contact with him and answering his questions. After three weeks, his pain cut in half every day. By the fourth week, he didn't need any pain medication at all." Mark did physical therapy to rebuild strength in the muscles that support his spine. Mark says, "When my pain was at its worst, I couldn't go to the market or go on a date with my girlfriend, I couldn't even stand for more than 60 seconds. Now, I have virtually no pain. I can do anything I want. My life is no longer restricted by pain."The following additional information illustrates how Adventist Health Simi Valley also supports local organizations in the community to provide much needed school supplies to students and families:In a collaborative effort, the For the Need Foundation partnered with Sinaloa Middle School counselors, Anna Malais and Tammy Herzer, to assist students in their preparations for the upcoming school year. The middle schools orientation, which took place from August 2nd to 4th, provided the platform for this initiative.During this orientation period, the For the Need team distributed backpacks and essential school supplies to a total of 123 students, as well as their siblings. The primary objective was to ensure that these students had the necessary tools for academic success.In addition to these provisions, parents and guardians of the students were invited to participate by completing a survey. This survey aimed to identify the specific needs of each family for the school year ahead. The provided list of items included essentials such as socks, underwear, shampoo & conditioner, deodorant, toothbrush & toothpaste, shoes, among others. Families were given the opportunity to select items based on their individual requirements.On Saturday, August 26th, 2023, the For the Need team, in collaboration with Sinaloa Middle School counselors, distributed bags containing the requested items to families. Furthermore, families were offered the chance to obtain additional supplies, including detergent, new shoes, clothing, and more school essentials.Beyond material support, informational resources were provided to families, highlighting locations where they could access free meals and food resources throughout the week. Guidance on free laundry facilities was also made available, ensuring that families had access to vital services.Remarkably, approximately 30 families took part in the Bow & Arrow Mentorship Program, showing their commitment to this initiative. They also expressed their intent to attend the upcoming Financial Literacy event.As the school year progresses, the For the Need Foundation remains dedicated to maintaining regular contact with these families. The objective is to provide ongoing support, ensuring that students and their families can focus on their academic pursuits without the added stress of basic needs.This collaborative endeavor was made possible through the generous support of Adventist Health Simi Valley, Soroptimist, Supervisor Janice Parvins Office, and Simi Sunset Rotary. Their contributions have significantly impacted the community, providing valuable resources to students and their families, ultimately contributing to a brighter future for all involved.Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ 181953465 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 1339 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 true true true true true true true true true true CA X John Beaman 9164060000 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 StevensEric Former Care Div Ops Exec thru 02/22 0.00 50.00 0 1526293 57900 Nahapetian Arby Former Care Div Med Off thru 02/22 2.00 48.00 0 1482294 67961 JahnAndrew President, Southern CA Network 12.50 37.50 0 1465906 50625 WingBilly Former Dir/A Sec/V Chair thru 01/22 0.00 50.00 0 1438460 26777 Raffoul John Former Finance Officer, SCR 0.00 50.00 0 998414 58763 Jobe Meredith Secretary 0.00 50.00 X 0 959488 60723 Burke James Medical Officer, SCR 12.50 37.50 0 791165 41894 Swenson Jennifer President, AHSV 50.00 0.00 X 0 728760 21175 Milatovic Natasa Reg HR Dir, SCR thru 4/23 10.00 40.00 0 535036 63415 Schneider Nicole Medical Officer 50.00 0.00 0 523493 58290 Spenst Brett Former Care Div Finance thru 02/22 0.00 50.00 0 520625 44711 Combis Theodore Tres/Asst Secty 50.00 0.00 X 0 328581 97350 Ferrier Corbett Bus Dev Exec 50.00 0.00 0 358454 62706 Stone Patricia Interim Patient Care Exec 50.00 0.00 0 273013 57972 Saad John RN, Administrative 40.00 0.00 248701 0 80480 Nguyen Truong RN 40.00 0.00 257869 0 37380 Mallari Christopher RN Nurse Lead 40.00 0.00 252439 0 26233 Riddell Stella Patient Care Exec thru 10/23 50.00 0.00 0 265127 1842 PatelAmish RN 40.00 0.00 226489 0 28714 Deamer Carol Director, Pharmacy 40.00 0.00 221833 0 25735 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 4.00 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 Director 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 1207331 19701520 1172581 295 true true false Advanced Building Maintenance LLC 1804 Tribute Rd Ste K Sacramento CA 95815 Janitorial Services 3459337 Menalam Health Services PC 2975 North Sycamore Dr Simi Valley CA 93065 Physician Services 1834484 Radnet Management Inc 1687 Erringer Rd 210 Simi Valley CA 93065 Medical Services 1419471 Allied Universal Security Services 161 Washington St Ste 600 Conshohocken PA 19428 Security Services 1334344 Sodexo Inc and Affiliates 9801 Washington Boulevard Gaithersburg MD 20878 Food and Facilities Mgmt 1064327 44 445 4690316 256406 4947167 Dietary 722514 376216 376216 Medical Office Rentals 531120 1597440 1597440 Other Program Services 2412379 2412379 Patient Care Services 900099 205717737 205717737 Revenue from related orgs 176203 176203 80635 80635 210360610 70463 70463 0 0 0 404842 30800 374042 374042 374042 0 0 341524 13279 328245 -23776 352021 0 216080527 210710876 352021 70463 X 309210 309210 0 0 0 0 0 80437485 68743378 11335238 358869 2882255 2428669 440043 13543 9677688 8239248 1392866 45574 5808586 5118859 666510 23217 18853547 24569 18828978 436752 436752 0 0 0 0 29816515 21538192 8246876 31447 132434 132434 917143 524569 367146 25428 6739117 1994786 4742198 2133 0 5806285 4767136 1039149 438190 146482 282965 8743 0 48149 14356 30070 3723 6701259 6701259 0 9485552 9467368 18184 1727206 1727206 Patient Care Supplies 28705828 28700815 5013 Quality Assurance 13203067 13203067 Other Expenses 7506203 7115780 387923 2500 Equipment Rentals 1470472 1188516 281956 0 231102943 181953465 48629288 520190 0 0 73506 0 30331738 34736225 0 0 0 3208683 3394059 810920 1287992 250934536 138441772 117289929 112492764 0 134372 134372 2227323 2227324 1355879 1355879 18791916 14159255 174224266 169787870 15135603 15300071 250000 66528 166552556 179793391 181938159 195159990 X -8196499 -25818996 482606 446876 -7713893 -25372120 174224266 169787870 X -15022416 -2635811 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 33051 33051 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 555974 395644 441374 510244 465156 596208 505390 555974 762186 129269 426299 465156 760455 302549 70000 230818 762186 815425 229369 35000 249339 760455 0.12400 0.87600 false true true 8393945 8393945 177071716 92739037 84332679 2052478 2051486 992 52969786 38344375 14625411 10446611 5306874 5139737 112492764 Investment in ASV 1774151 Investment in Fdtn 983148 Other Assets 489467 Other Receivables 2044956 Receivables from Related Organizations 4201695 Receivables from Third Parties 4665838 14159255 Cash Overdraft 58114548 Other Liabilities 7103561 Payables to Related Organizations 114575282 179793391 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. 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Data gathering from community members. The CHNA findings result from the extensive analysis of primary and secondary data sources. The main source for the secondary data, or data that have been previously collected, is the community indicator database maintained by Conduent Healthy Communities Institute. The following is list of both local and national sources used in Ventura Countys Community Health Needs Assessment: Ventura County, American Community Survey, American Lung Association, California Department of Education, California Department of Health Care Access and Information, California Department of Justice, California Department of Public Health , California Department of Public Health, Immunization Branch, California Department of Public Health, STD Control Branch, California Health Interview Survey, California Health Interview Survey, Neighborhood Edition , California Healthy Kids Survey, California Opioid Overdose Surveillance Dashboard, California Secretary of State, California State Highway Patrol, CDC PLACES, Centers for Disease Control and Prevention 118, Centers for Medicare & Medicaid Services, Child Welfare Dynamic Report System, Claritas Pop-Facts, Claritas Consumer Profiles, Controlled Substance Utilization Review and Evaluation System, County Health Rankings, Feeding America, Healthy Communities Institute, Lucile Packard Foundation for Children's Health, National Cancer Institute, National Center for Education Statistics, National Environmental Public Health Tracking Network, U.S. Bureau of Labor Statistics, U.S. Census - County Business Patterns, U.S. Department of Agriculture - Food Environment Atlas, U.S. Environmental Protection Agency and United For ALICE. Secondary data used for this assessment were collected and analyzed from HCIs community indicator database. This database, maintained by researchers and analysts at HCI, includes over 241 community indicators from at least 32 state and national data sources. HCI carefully evaluates sources based on the following three criteria: the source has a validated methodology for data collection and analysis; the source has scheduled, regular publication of findings; and the source has data values for small geographic areas or populations. Secondary Data Scoring HCIs Data Scoring Tool was used to systematically summarize multiple comparisons in order to rank indicators based on highest need. For each indicator, the community value was compared to a distribution of California and US counties, state and national values, Healthy People 2030, and significant trends were noted. These comparison scores range from 0-3, where 0 indicates the best outcome and 3 the worst. Availability of each type of comparison varies by indicator and is dependent upon the data source, comparability with data collected for other communities and changes in methodology over time. The comparison scores were summarized for each indicator, and indicators were then grouped into topic areas for a systematic ranking of community health needs. Primary data methods and analysis included surveys, focus groups, and focus group profiles. The Community Health Assessment Survey (2022) was designed and disseminated by the Ventura County Community Health Needs Assessment Collaborative (VCCHIC). Furthermore, VCCHIC participated in a Centers for Disease Control and Prevention health equity pilot which required the inclusion of survey questions on racial trauma and discrimination. The community survey was distributed online through Qualtrics from February 9th through March 30th of 2022. The survey was made available in both English and Spanish. Paper surveys were also made available and answers to the paper survey were entered into Qualtrics. A total of 3,066 responses were collected. One of the key objectives of this assessment was to engage the community, including socially marginalized populations, and other stakeholders to share their perceptions on the health needs for Ventura County residents. Eighteen focus groups were conducted in February and March 2022. The groups were organized and facilitated by members of VCCHIC and partners from California State Channel Islands University and Pacifica High School. Participants were recruited using multiple modes: direct recruitment by partner community-based organizations, email invitations, flyers, newspaper, and social media postings. The following groups, who are more likely to be socially marginalized, were recruited for participation in the focus groups: persons from the black community, monolingual Hispanic or Latino Spanish speakers, older adults, LGBTQIA+ persons, students, and those accessing mental health and substance use treatment services among others. In collaboration with California State Channel Islands University and Pacifica High School in Oxnard, CA, VCCHIC was also able to receive input from local high school and college students about the issues impacting them. Each focus group included both a facilitator and a note taker from to capture the conversation verbatim. The focus group transcripts and notes were analyzed qualitatively to code the transcripts according to a list of major health and quality of life topics. Facility: - Part V, Section B, Line 6a The Ventura County Community Health Improvement Collaborative (VCCHIC) is a formal, charter-bound partnership of seven health agencies that came together in June 2018 to participate in the development of a joint CHNA exercise and report. They have continued their successful partnership through the 2022 CHNA assessment period. The agencies that constitute the VCCHIC are Adventist Health Simi Valley, Camarillo Health Care District, Clinicas Del Camino Real, Inc., Community Memorial Health System and St. Johns regional Medical Center, Dignity Health. Facility: - Part V, Section B, Line 11 Tax year 2023 was Year One of the Implementation Strategy for the 2022 of the 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 CHNA. Our 2022 CHNA in conjunction with the Ventura County Community Health Improvement Collaborative (VCCHIC) identified three areas of significant need: Mental Health and Substance Use, Health Conditions, Access to Care. Priority Need One-Mental Health and Substance Use. The goal is to increase access to mental health and substance related services in Ventura County. In the spirit of enhancing programs and services to expand access to mental health and substance use services, Simi Valley Hospital and Health Care Services in collaboration with the Ventura County Community Health Improvement Collaborative (VCCHIC) is on track with developing a Community Information Exchange for community members in need. A new substance use navigator (SUN) was hired in May of 2023 and works directly with emergency department, case management and social worker teams as a liaison to patients experiencing homeless and substance use. On average, the SUN meets with 60 patients monthly and coordinates services including treatment facilities, medically assisted treatment, and other essential services. The SUN was continually active in community engagement at Hospital sponsored events providing essential education and awareness including distribution of Narcan. Additional activities in 2023 included: 1). Every 15 Minutes: The Emergency Department collaborated with Simi Valley Unified School District, PTSA, AMR, and the Simi Valley Police Department to participate in the statewide annual Every 15 Minutes, a two-day simulated impaired driving awareness event for 1,000 junior and senior high schoolers. 2). Fentanyl Community Meeting: The Hospital collaborated with Soroptimist of Simi Valley in a Fentanyl Community Meeting. Providers, staff, and the substance abuse navigator engaged more than 200 audience members with education training on the proper usage of a Narcan kit. More than 115 Narcan kits were distributed. 3). Grace Brethren High School Narcan Training: 20 Grace Brethren teachers participated in a Narcan education and awareness training on school campus to learn about how to effectively use Narcan in an emergency situation. Priority Need Two-Health Conditions. The goal is to address some of the social determinants of health (SDOH) that contribute to chronic conditions and inhibit healthy lifestyles in Ventura County. With an equitable lens and in partnership with VCCHIC, the Hospital will work to identify policies and programs focused on healthy behaviors, access to physical activities and healthy foods working toward the following milestones that will evolve quarterly over the next three years. Simi Valley Hospital and Health Care Services is deeply rooted in the community and participates in several community events annually supporting physical activity, outreach and education, guest speaker series, training and collaboration with organizations who are involved in servicing our vulnerable populations, along with advocacy for better health.Activities throughout 2023 included: Simi Valley Womens Club: Hospital nurse was the guest speaker at the Simi Valley Womens Club and provided hands only CPR education and awareness training. Body Brain Train: The Hospital participated with an outreach and education booth in the first annual Punch-a-thon event that specializes in health and wellness education and awareness classes to the senior community including people living with dementia and Parkinsons disease. Junior Olympics: Engaged in the annual Junior Olympics event where 1,200 athletes in grades 4-6 competed in seventeen different Olympic style events including softball throw, track and field, volleyball, and more. Sports medicine students volunteered at the Hospitals first aid booth to help students with injuries and/or health related issues. Moorpark College Symposium: Hosted an Athletic Training Symposium at Moorpark College for 35 certified athletic trainers to earn credential requirements, demonstrate best safety practices, identify risk factors, injury and treatment diagnosis, and develop problem solving skills. Senior Wellness Expo: In collaboration with the City of Simi Valley Council on Aging, the Hospital participated in the annual Senior Wellness Expo for more than 500 community members. Hospital staff conducted 75 blood pressure screenings and engaged with the senior community by providing general wellness information include heart health, stroke awareness, robotic surgery, geriatric, and resistance band work-out program,Senior Community Games: Partnered with the Rancho Simi Recreation and Park District and sponsored the annul Senior Community Games to more than 250 senior athletes. This program promotes healthy activities, well-being education, social engagement, and mental health well-being.2023 Summer Kidz Fun Zones: An opportunity for youth and families to interact and participate in free active play at Fun Zone play areas to socialize, increase physical movement and build friendships for a purpose of health, wholeness, and well-being at local community events including Body Brain Train Punchathon, Kiwanis Round Up Festival and the Simi Valley Street Fair. 13 Souls Memorial 5K/10K/Half Marathon: Collaborated with the 13 Souls Organization by participating in the event (700 in attendance) with an education and awareness booth focusing on healthy lifestyle and encouraging movement and activity. Engaged conversations with community members included heart health, medication difference awareness, service line specialties, and easy work-out programs that included resistance band giveaways. Stop the Bleed Training: Participated in Stop the Bleed training. Twelve community members were provided education training for City of Simi Valley disaster service workers who are part of a community-wide group that assist during emergencies or other disaster situations. Simi Valley Cops N Cruisers: As part of our community outreach efforts, the Hospital participated in the Simi Valley Explorers annual event that helps raise awareness and much needed funds for the Police Explorer program. Staff hosted an educational booth that included Narcan awareness and training, hands only CPR training, heart health education and stroke education. 57 Narcan kits were distributed to community members. Simi vs. Royal Football Game: Through our Athletic Training Program, the Hospital collaborates with area school districts, providing experienced athletic trainers to local school sports teams. This partnership helps keep student athletes healthy and safe by preventing, reducing, and treating sports injuries. Our trainers also are involved with educating students and encouraging them to pursue healthcare-related careers. Throughout the school, 4,000 students can meet and receive care and education from the athletic trainer. Supported the annual rivalry game with a VIP dinner for distinguished school guests and families. Handed out giveaways at game entrance area to 2,000 individuals in attendance. Moorpark College Football Community Night: The Moorpark College Athletics Community Night football game, sponsored by Simi Valley Hospital and Health Care Services, highlights the importance of the student athletic training program and urgent care services available at the Moorpark Urgent Care facility. Power of Pink Event. The Hospital hosted a community-wide event focusing on womens health and breast cancer awareness. The event attracted more than 150 guests who experienced physician-led discussions and heard a cancer survivor story. Educational vendors were on site promoting health and wellness services. 21 guests participated in the Adventist Health Early All-Around Detection (AHEAD) genetic testing program and eight signed up for a clinic visitation. The Simi Valley community of more than 26,000 residents received the Inspire Magazine via mail that included a story with Jessica Haff, a Hospital staff member and breast cancer survivor. American Heart Association and Bank of America Walk with a Doc: Dr. Sidhu, staff cardiologist, participated and led a Walk with a Doc event for Bank of America employees engaging in discussions focusing on heart health, well-being, and self-care with twenty-one attendees. Samaritan Center CPR Training Class: Hospital and Samaritan Center collaboration efforts assist in providing resources and services for the homeless population in Simi Valley. The Hospital hosted a CPR training class for their staff and volunteers. Crestview Elementary Healthy Living Week: Crestview Elementary celebrates Healthy Living Week focusing on well-being and eye and skin protection. As part of the celebration, the Hospital donated reusable bags filled with chap sticks, hot/cold cow themed gel packs, and sunglasses to more than 28 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. Aspen Outpatient Center 2750 N Sycamore Dr Simi Valley CA 93065 Outpatient Imaging & Surgery Child Development Center 1900 E Los Angeles Ave Simi Valley CA 93065 Outpatient Pediatric Therapy Nancy Reagan Breast Center 2750 N Sycamore Dr Simi Valley CA 93065 Outpatient Women's Imaging 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 combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income)/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 Simi Valley Hospital and Health Care Services promote 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/simi-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 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 Located in Southern California, Ventura County has a land area of 1,843.1 square miles which encompasses 10 cities, 23 census-designated places, and 15 other unincorporated communities. In 2022, Ventura Countys population had a median age of 39.3 and a median household income of $101,407. Additionally, 50.5% of the population is female, 5.7% are below five years of age, 22.1% are below 18 years and 17.3% are 65 years and above and 38.6% of the people in Ventura County speak a non-English language at home. (Claritas Pop-Facts, 2022) The homeownership rate is 59.4%, households with an internet subscription are 89.8%, and among county residents, 5.8% have veteran status and 21.3% are foreign born (American Community Survey, 2016-2020). In 2021, the percent of households with a computer is 89.6% (Claritas Consumer Profiles, 2021).According to 2022 Claritas Pop-Facts, Ventura County has a population of 842,465 and is the 13th largest county in terms of population. Figure 5 illustrates the population size in Ventura County by zip code. The most populated zip codes are 93033 (Oxnard), 93065 (Simi Valley), 93030 (Oxnard), and 93063 (Simi Valley) with population totals of 82,273; 74,289; 60,815; and 55,685. In Ventura County, 44.66% of residents identify as Hispanic/Latino (of any race) and 55.34% identify as Non-Hispanic/Latino. Compared to California, Ventura County has a larger White population (65.13%) and smaller African American and Asian populations (2.07% and 7.62%, respectively). Ventura has a median household income above the state value and the national values. Ventura County has an estimated median household income of approximately $101,407, which was $11,926 higher than the median household income of California ($89,481) and $36,413 higher than the national value of $64,994 (American Community Survey 2016- 2020). Ventura County has lower rates of poverty compared to the state and national poverty rates. Ventura County has a poverty rate of 8.9%, while state and national rates of poverty are 12.6% and 12.8%, respectively. According to the American Community Survey, for the 2016-2020 period, 12.2% of children in Ventura County were living below the federal poverty level. This is lower than the percentage of children living below the poverty level in California (16.8%) and the United States (17.5%). Examining this by race, American Indian/Alaska Native children and Hispanic/Latino children had the highest disparity, with 43.3% of American Indian/Alaska Native children living in poverty. The next highest populations are those identifying as Some Other Race (20%) and Hispanic or Latino (17.1%). Ventura County has a lower food insecurity rate in 2019 (7.8%) compared to the State (10.2) and the Nation (10.9). 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 telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report CA Part VI - Additional Information Listing of Organizations that Particpated in the Hospital's CHNA -Ventura County Health Care Agency Community Health Center, Gold Coast Health Plan and Ventura County Public Health participated in the CHNA process.Describe how the hospital has addressed the significant needs identified in the 2022 Community Health Needs Assessment CHNA)continued-Simi Valley Hospital and Health Care Services Cafeteria New Food Options and Farmers Market: To address healthier food options at the Hospitals cafeteria, a new salad bar and deli station with fresh produce are available for employees, patients, and community members visiting the hospital. A new Simi Valley Hospital and Health Care Services Farmers Market is in the development stage for community members to visit once a week that will promote healthier food options from local certified vendors in an outdoor space.Simi Valley Hospital and Health Care Services also assessed and promoted available community resources in 2023.Priority Need Three-Access to Care. The goal is to expand access to preventative care services to reduce the need for emergency visits in Ventura County. In 2023, Simi Valley Hospital and Health Care Services worked to implement policies and programs aimed at expanding and promoting access to culturally appropriate preventative care services among underserved populations in Ventura County through building relationships, forming coalitions, and engaging with new partnerships in order to improve access to care.Simi Valley Hospital and Health Care Services is a founding member of the Ventura County Community Health Improvement Collaborative (VCCHIC). VCCHIC and Communities Lifting Communities (CLC) entered into a two-year collaboration agreement to develop a sustainable structure of the VCCHIC members and community partnerships for the long-term implementation of population health strategies from the 2022 Community Health Needs Assessment (CHNA) and Community Health Implementation Strategy (CHIS). CLC will serve as the backbone organization of a collective impact partnership with hospitals, local health department, community clinics, Medi-Cal Managed Care plan and CBO's. As part of the VCCHIC collaborative, 2022-25 Community Health Needs Assessment booklets and AHSVs CHIS strategy reports were developed to use as a communication and education piece with community members and organizations demonstrating the healthy equity of Ventura County. In addition, a special VCCHIC presentation was done at a Simi Valley City Council meeting. One hundred and fifty CHNA booklets and one hundred CHIS booklets were distributed throughout the community.Additional activities in 2023 included: Simi Valley Chamber of Commerce Street Fair: As Ventura County's only Center of Excellence in robotic surgery distinction, the Hospital proudly displayed three showbots - Da Vinci, Mako and Globus, where physicians and clinical teams engaged with community members by providing a hands-on learning approach and education and awareness about advance robotic abilities for improved health outcomes. Associates engaged in thoughtful conversations about the importance of access to care services, mental health awareness including Narcan distribution of twenty-six kits, and healthy living practices for improved health outcomes. The Hospital sponsored the Fun Zone for kids and families to interact and participate in free active play to socialize, increase physical movement, and build friendships for a purpose of health, wholeness, and well-being.National Night Out-SVPD: Participated in the Simi Valley Police Department National Night Out, an annual community-building campaign that promotes police-community partnerships, neighborhood camaraderie and neighborhood safety for a more caring place to live. The Hospital outreach and education booth included Narcan education and awareness training, hands-on CPR training, and urgent care services. 2,000 community members were in attendance, thirty-two individuals received hands only CPR training and thirty-six Narcan kits were distributed. Athletic Trainer (AT) ProgramEMS Education: In collaboration with Ventura County Fire Department Station 41, the Hospital team conducted an education session to facilitate collaboration with the AT Program and EMS responders. Reviewed current AT policy and procedures, including scope of practice. Thirteen individuals were in attendance. City of Simi Valley City Council Meeting: Since 1965, Simi Valley Hospital and Health Care Services has been a mainstay in Simi Valley by providing essential health care services to the communities it serves. The Hospital appreciated the support of the community during the COVID-19 pandemic and wanted to give back by creating a video summarizing the hospital and associates experience. Jennifer Swenson, President, and CEO, made a special presentation at the City of Simi Valley City Council meeting to council members, city staff and the Simi Valley community.Moorpark Country Days: Proudly participated in the annual community event. The Hospitals education and awareness booth included associates who engaged in thoughtful conversations celebrating Breast Cancer Awareness Month, womens health and wellness, Moorpark Urgent Care, Hospital services, and healthy living practices for improved health outcomes. The Hospital sponsored the Fun Zone for Kids and families to interact and participate in free active play to socialize, increase physical movement, and build friendships for a purpose of health, wholeness, and well-being. More than 9, 000 community members were in attendance. Simi Valley Chamber of Commerce Street Fair: We proudly participated in the bi-annual community-wide Street Fair with more than 22,000 community members in attendance. Associates engaged in thoughtful conversations about the importance of the Nancy Reagan Breast Centers mammogram services and cancer screenings, access to care services, mental health awareness including Narcan distribution of twenty-six kits, and healthy living practices for improved health outcomes. The Hospital sponsored the Fun Zone for kids and families to interact and participate in free active play to socialize, increase physical movement, and build friendships for a purpose of health, wholeness, and well-being. City of Simi Valley Council Meeting: Seleta Dobrosky, Director of Public Health Nursing (County of Ventura) and Epidemiologist Mohnisha Jit representing CLC made an informative presentation to the City Council about the VCCHIC 2022 2025 CHNA. CLC provided history, data, and summarized goals of the VCCHIC and CHNA. CHNA/CHIS booklets were distributed to council, city staff and made available to community members in attendance. City Council meeting streamed online for at home viewers. City Focus Newsletter: City of Simi Valleys community newsletter highlighted the VCCHIC presentation for easy viewing access. City of Moorpark City Council Meeting: Since 1965, Simi Valley Hospital and Health Care Services has been a mainstay in Simi Valley by providing essential health care services to the communities it serves including Moorpark, the adjacent community. The Hospital appreciated the support of the community during the COVID-19 pandemic and wanted to give back by creating a video summarizing the hospital and associates experience. Jennifer Swenson, president, made a special presentation at the City of Moorpark City Council meeting to council members, city staff and the Moorpark community. The video illustrates how we are continuing the partnership and collaborative efforts with community organizations including Ventura County Public Health, Moorpark Unified School District, and local agencies. The video is posted on the City of Moorparks website under the City Council meeting/agenda section for the community to view at their convenience. VCCIE Committee is developing the framework of a Ventura County-wide Communication Information System (CIE), and is the process of hiring a Community Hub Director to lead the CIE program and in the selection process of a Technology Vendor to support the CIE. In 2023, the Hospital continued to develop the framework and collaboration with external partners (VCCHIC/VCCIE) to create the first Ventura County Community Information Exchange (CIE) through the evaluation of potential technology vendors that have the capability to connect to health systems electronic health records and improve access to care. Identified Needs from CHNA, Not Addressed and Why- No hospital can address all the health needs identified in its community. Simi Valley Hospital and Health Care Services 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. The following significant health needs that will not be addressed directly by Simi Valley Hospital and Health Services due to limited resources, expertise and feasibility of viable interventions include the true For the Need Foundation 4110 Tapo Canyon Road Simi Valley CA 93063 810657985 501(c)(3) 15500 0 Funds Transfer Event Sponsorship Kiwanis Club of Simi Valley PO Box 477 Simi Valley CA 93062 753114651 501(c)(4) 10000 0 Funds Transfer Sponsorship Moorpark College Foundation 7075 Campus Road Moorpark CA 93021 953533986 501(c)(3) 55000 0 Funds Transfer Nursing Scholarship Rotary Club of Moorpark PO Box 172 Moorpark CA 93020 952114272 501(c)(4) 10000 0 Funds Transfer Sponsorship Simi Valley Education Fdtn PO Box 1439 Simi Valley CA 93062 770299495 501(c)(3) 10000 0 Funds Transfer Enhancement Grant Soaring Spirits Loss Fdtn 2828 Cochoran St Unit 194 Simi Valley CA 93065 383787893 501(c)(3) 30000 0 Funds Transfer Event Sponsorship Westminister Free Clinic 2975 N Sycamore Drive Simi Valley CA 91360 770563241 501(c)(3) 25000 0 Funds Transfer General Support 5 2 Additional Supplemental Information 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 Beaman John CFO/Asst Secty 1091769 569149 19635 11644 60059 1752256 Burke James Medical Officer, SCR 625000 134319 31846 41894 833059 Combis Theodore Tres/Asst Secty 272185 30301 26095 16654 80696 425931 Deamer Carol Director, Pharmacy 187124 21705 13004 25735 247568 Ferrier Corbett Bus Dev Exec 290228 45601 22625 12213 50493 421160 Heinrich Kerry Director/CEO 2017000 1208880 76548 11644 44099 3358171 Hofheins Todd COO/Vice Chair 1389462 735265 147865 11644 62845 2347081 JahnAndrew President, Southern CA Network 1044420 406990 14496 50625 1516531 Jobe Meredith Secretary 660525 168715 130248 14609 46114 1020211 Mallari Christopher RN Nurse Lead 250939 1500 11268 14965 278672 Milatovic Natasa Reg HR Dir, SCR thru 4/23 115231 96102 323703 11644 51771 598451 Nahapetian Arby Former Care Div Med Off thru 02/22 967385 329621 185288 11644 56317 1550255 Nguyen Truong RN 245701 6300 5868 8342 29038 295249 PatelAmish RN 222589 3900 6897 21817 255203 Raffoul John Former Finance Officer, SCR 673546 178639 146229 11644 47119 1057177 Riddell Stella Patient Care Exec thru 10/23 84711 41316 139100 1842 266969 Saad John RN, Administrative 235491 9255 3955 8120 72360 329181 Schneider Nicole Medical Officer 459865 6291 57337 12193 46097 581783 Spenst Brett Former Care Div Finance thru 02/22 259692 250809 10124 12160 32551 565336 StevensEric Former Care Div Ops Exec thru 02/22 1045616 319995 160682 11644 46256 1584193 Stone Patricia Interim Patient Care Exec 270845 2168 9478 48494 330985 Swenson Jennifer President, AHSV 517093 113990 97677 21175 749935 WingBilly Former Dir/A Sec/V Chair thru 01/22 1438460 26777 1465237 Form 990, Part VI, Section A, Line 2 See Sch L p2 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 NA = $145227 Form 990, Part XI, Line 9 Change in interest-Joint Venture = -$227693 Form 990, Part XI, Line 9 Transfer to Other Funds = -$11285 Form 990, Part XI, Line 9 Transfers to Related Entities = -$2542060 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 Hanford Community Hospital 115 Mall Drive Hanford CA 93230 940535360 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 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 Simi Valley Hospital Foundation 2975 N Sycamore Dr Simi Valley CA 93065 912135595 Fundraising for Hospital CA 501(c)(3) 3 Adventist Health SystemWest true Aspen Surgery Venture LLC 2975 Sycamore Dr Simi Valley CA 93065 263913327 Surgery Center CA Simi Valley Hospital false true 0.69000 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 Simi Valley Imaging Group LLC 1510 Cotner Ave Los Angeles CA 90025 853207723 Imaging Center DE N/A false false 0.40000 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 true true true true true true true true Adventist Health SystemWest e 114575282 Notes Payable Adventist Health SystemWest m 23590524 Operating Exp Adventist Health SystemWest o 1814114 Compensation Adventist Health SystemWest r 18243460 Cash Mgt Funds