2025-11-06T11:18:52-06:00 2024-12-31 390859910 Baker Tilly Advisory Group LP 2882 Prospect Park Dr Ste 300 Rancho Cordova CA 95670 990 2024-01-01 930622075 Northwest Medical Foundation Tillamook NORT 9164060000 1000 Third Street Tillamook OR 97141 Micah Smith Treasurer 5038424444 2025-10-25 1 1 Lauren A Haverlock P00545829 9165038100 2025-10-25 2024 2025-03-06 01:10:19Z Adventist Health Tillamook Eric Swanson 1000 Third Street Tillamook OR 97141 127675568 0 1071 X www.adventisthealth.org/tillamook/ X 1973 OR Living God's love by inspiring health, wholeness and hope. 14 13 515 48 0 0 1735344 1071970 114486757 121774032 1664605 4741060 0 0 117886706 127587062 0 488 0 0 49080337 57048703 0 0 4651 57872381 64754557 106952718 121803748 10933988 5783314 100027255 106987903 21750337 23243572 78276918 83744331 X Living God's love by inspiring health, wholeness and hope. 0 0 96746458 488 121774032 See Schedule O 96746458 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 515 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X John Beaman CFO 9164060000 1 Adventist Health Way Roseville CA 95661 X Heinrich Kerry Dir/Chair/CEO 0.00 50.00 X X 0 3974195 57975 Hofheins Todd Dir/Vice Chair/COO 0.00 50.50 X X 0 2407675 65992 Freedman John Director 0.00 4.00 X 0 27203 0 Newton Bradford Director 0.00 4.00 X 0 26939 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 Wagner Jack Director 0.00 4.00 X 0 21611 0 Woodson Marc Director 0.00 4.00 X 0 21611 0 Salazar Velino Director thru 09/24 0.00 4.00 X 0 21181 0 Fehr Joy Director 0.00 4.00 X 0 18680 0 Beckett Ann Director as of 01/24 0.00 4.00 X 0 17930 0 Daggett Jonathan Director as of 01/24 0.00 4.00 X 0 16180 0 Jutzy Kenneth Director as of 01/24 0.00 4.00 X 0 16180 0 Cress John Director as of 10/24 0.00 4.00 X 0 430 0 Beaman John CFO/Assistant Secretary 0.00 50.50 X 0 1980861 79808 Jobe Meredith Secretary 0.00 50.50 X 0 1221104 57975 Swanson Eric President 50.00 0.00 X 0 616941 35853 Smith Micah Treas/Asst Secretary 50.00 0.00 X 0 362235 79538 Newmyer Joyce Pres, OR State Network thru 04/24 10.00 40.00 X 0 1338907 61374 King Kyle - President OR State Service Area as of 04/24 16.70 33.30 X 0 863249 57996 Welch Paul Medical Director 50.00 0.00 X 0 490898 79815 Seufert Regina Clinic and Physician Executive 0.00 50.00 X 0 326344 29086 Thompson Heather Patient Care Executive 0.00 50.00 X 0 271920 69734 LaFleur Brett Physician 40.00 0.00 X 829045 0 51718 Kaba David Physician 40.00 0.00 X 612212 0 36892 Echelberger Amy Physician 40.00 0.00 X 370646 0 38891 Gerken Brittany Physician 40.00 0.00 X 360228 0 48668 Pitts Todd Physician 40.00 0.00 X 359009 0 36892 Welch Donald - Former Treas/Fin Officer, PNR thru 02/20 0.00 50.00 X 0 706292 57975 Wing Bill - Former Dir/Asst Secr/Vice Chair thru 01/22 0.00 0.00 X 0 273263 0 Stevens Eric - Former Care Division Operations Exec thru 02/22 0.00 50.50 X 0 1886146 57975 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0.00 50.00 X 0 1759258 79808 Rippey Wesley - Former Reg Medical Officer, PNR thru 02/20 0.00 50.00 X 0 796263 37321 Jahn Andrew - Former Care Division President thru 02/22 0.00 50.00 X 0 693217 59411 Leach Judy - Former Strategy & Comm Exec, PNR thru 02/20 0.00 50.00 X 0 541661 50219 Lee Adam - Former Dir Marketing & Comm, PNR thru 02/20 0.00 50.00 X 0 375643 79483 Voshell Shane - Former Reg HR Dir, PNR thru 02/20 0.00 50.00 X 0 305087 71269 2531140 21485548 1381668 151 1 1 0 CHG Companies Inc PO Box 972651 Dallas TX 75397 Staffing services 4687393 Tillamook Emergency Services Inc 1000 Third Street Tillamook OR 97141 Medical services 3570127 Oxford Anesthesia Management LLC PO Box 69355 Baltimore MD 21264 Medical services 1952085 Andrew F Nelson 6500 Cedar Spring Pl Tillamook OR 97141 Medical services 950226 Aya Healthcare Inc PO Box 674907 Dallas TX 75267 Staffing services 852918 26 765952 306018 1071970 Patient service revenue 621110 120476051 120476051 Dietary services 722514 453850 453850 340B Pharmacy revenue 456110 293697 293697 Related rental income 531120 34473 34473 CARES Act funding 621110 20852 20852 495109 495109 121774032 4629566 4629566 200000 88506 111494 111494 111494 127587062 121774032 0 4741060 X 488 488 39881 39881 44435710 37921934 6513776 1791185 1528853 262332 7658457 6190386 1468071 3123470 2688193 435277 10041052 10041052 25900 25900 8 8 4417 4417 20934888 20045469 889419 52327 52327 1253921 1091239 162442 240 5041618 512353 4527265 2000 2360758 2360758 372131 263178 108953 29579 24223 5356 221517 221517 1905120 1864687 40433 1274148 1270690 3458 Patient care supplies 14949125 14658636 290478 11 Quality assurance fee 5882476 5882476 Rental/leases costs 106764 106764 298808 70316 226092 2400 121803748 96746458 25052639 4651 68789021 73649792 7563 5983 14936389 18270637 1740545 1359044 28609 70224 55442042 43622024 10372784 11820018 4152344 1812205 100027255 106987903 7290719 8442198 529252 417197 13930366 14384177 21750337 23243572 X 77959868 83440890 317050 303441 78276918 83744331 100027255 106987903 X 5783314 825003 -1140904 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4417 4417 0 Part II-B, Line 1: The Hospital belongs to industry and professional associations - such as the Oregon Association of Hospital and Health Systems - for which a portion of the membership dues is used for lobbying activities. 327050 713241 736849 303442 233469 675040 581459 327050 272800 1952471 -9864 1981938 233469 248899 1582574 13649 1572322 272800 151190 358438 260729 248899 0.00000 0.00000 1.00000 0 0 1056181 1056181 30202112 25491462 4710650 286606 152192 134414 19521011 16445156 3075855 4376132 1533214 2842918 11820018 Payables to related organizations 10110340 Payables to third-party payors 3657982 Other liabilities 615855 14384177 X Part V, Line 4: Board-designated, temporary and permanently restricted funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X, Line 2: The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2024 and 2023, 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 (Exempt Organization Business Income Tax Return) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2021 in major tax jurisdictions. 1 1 X 1 X 1 X 1 1 1 0 1 1 916180 916180 0.00750 916180 916180 0.00750 267875 267875 0.00220 27404078 21721785 5682293 0.04670 78500 78500 0.00060 27750453 21721785 6028668 0.04950 28666633 21721785 6944848 0.05700 1 1134972 335911 32122369 31707971 414398 X 1 1 1 1 Adventist Health Tillamook 1000 Third Street Tillamook OR 97141 adventisthealth.org/Tillamook 14-1177 X X X X Adventist Health Tillamook 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment X 1 22 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X X X X X X 1 X 0 X X X X 1 X 0 0 Adventist Health Tillamook 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.Community-based organizations focusing on education, higher education, low-income, medically underserved, minority populations, food insecure, providers and student populations participated in five focus groups with 81 participants and 13 individual interviews ensuring rich primary data. Represented race/ethnicities included 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). Adventist Health Tillamook Part V, Section B, Line 6b: Organizations that participated in the 2022 CHNA included: Tillamook County Community Health Centers (TCCHC), Tillamook Family Counseling Center, Rinehart Clinic, Nehalem Bay Health Center & Pharmacy, Columbia Pacific CCO (serving the Oregon Health Plan), Consejo Hispano, Northwest Senior & Disability Services (a local intergovernmental agency), Oregon Food Bank, Oregon State University Extension Service, Pelican Brewing Company, Tides of Change, Tillamook Chamber of Commerce, Tillamook County, Tillamook County Family YMCA, Tillamook County Office of Education, Tillamook County Transportation District, Tillamook Bay Community College, Tillamook Seventh Day Adventist Church and West Business Development Center. Adventist Health Tillamook Part V, Section B, Line 11: Tax Year 2024 was Year Two 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 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care, Financial Stability, and Housing. Priority Need One - Access to Care. Our Goal is to provide more effective and meaningful care to target populations by improving access to verbal and written translation services, improve awareness, knowledge, provider relationships and health outcomes by increasing health literacy amount Tillamook County residents and work with county organizations to adopt policies that support culturally and linguistically response services. Adventist Health Tillamook (AHTM) has demonstrated a strong commitment to community impact through collective action in partnership with a broad cross section of local organizations working together to improve health outcomes; promote and support diversity, equity and inclusion; and identify, communicate, and increase current resources for language, interpretation and translation services. Activities in 2024 included care teams providing community-based well-checks, blood pressure and A1C screenings throughout the year. On-going screening and data tracking for social determinants of health. On-going distribution of Narcan kits for opioid use response throughout Tillamook County, including Tillamook Family Counseling center, Tides of Change, libraries, fire stations and at the county fair.AHTM launched its Health Equity Committee, with representation across multiple departments from both acute and ambulatory care settings. The committee will focus on workflows for social determinants of health (SDOH) screening and referrals. A meeting was held with the Executive Director of CARE, Inc. the local anti-poverty agency, regarding referral workflows for homelessness and helping meet people's basic needs. Through Oregon's Measure 110 legislation and funding, CARE is working to expand shelter capacity and are on-boarding several peer support specialists. CARE clients often present at the Emergency Department for non-emergent needs. There is now a workflow in place to contact CARE's peers to come to the Hospital in support of meeting patients' health-related social needs outside of the healthcare system. Local healthcare partners are also utilizing the region's Coordinated Care Organization flex funds for covered SDOH needs, including costs of meals and hotel stays for patients experiencing houselessness.Rural healthcare partner network (TCRHN), with representation from AHTM, Columbia Pacific CCO, Nehalem Bay Health Center & Pharmacy, Oregon Health & Science University, Tillamook County Community Health Center, and Tillamook Family Counseling Center, convened to develop a strategic plan for moving community health implementation plan priorities forward. The plan included: 1. formalization of rural healthcare partner network with quality improvement process and resource and data sharing agreements, 2. collective and systems-driven social determinants of health screenings and referrals, utilizing a health information exchange (such as Unite Us), 3. traditional/Community Health Worker initiatives, and 4. workforce development to equip local health professionals with skills and competencies to address health equity issues with compassion and expertise. Conversations and planning for development of the Rural Healthcare Partner Network (TCRHN) continued during Q4 in preparation for submission of the HRSA 038 Outreach Implementation grant in 2025.A robust health literacy campaign was designed and implemented by the Tillamook County Wellness Access to Care committee, with representation by local healthcare agencies including representation from AHTM. Funded through a grant from the OHSU Knight Cancer Institute, the multi-media messaging campaign rolled out via radio, email, print and social media over a 12-week period. Additionally, a landing page for all content was built into the TCW website to which all campaign materials were directed. Campaign analytics were tracked to determine impact. Building off the success of the Health Literacy campaign, community partners planned a series of Health Fairs in English and Spanish in November 2024.Other activities in 2024 to address access to health care included: 1. Provided significant support for health insurance enrollment. 2. A total of 1,977 Narcan kits were distributed through community channels. 3. A cash contribution of $10,000 toward updating decades old public safety emergency communications system was provided to the Citizens for Tillamook County Public Safety Radio organization.Priority Need Two - Financial Stability. Goal is to increase income earning potential for local residents through enrollment in healthcare career education pathways by increasing nursing career pathways and workforce employment pipelines for skilled healthcare occupations. Other strategies include increasing labor work force participation rates by increasing childcare availability and affordability, improving financial stability for individuals and families by increasing awareness, knowledge and skills related to financial literacy and partnering with individuals in our community to provide resources, skills, and opportunities to return to the workforce. Activities in 2024 included: A partnership with Financial Beginnings - free financial literacy classes are being offered throughout Tillamook County. Classes held at Helping Hands, a homeless reentry program, the Oregon Youth Authority and Tillamook Bay Community College, where classes are offered in both English and Spanish. The program has been well received by volunteers, program partners and participants alike. A presentation was made to the Tillamook Education Consortium where school superintendents of all three school districts expressed interest in adding financial literacy education to K-12 curriculum. In 2024, AHTM donated $50,000 to Tillamook Bay Community College for construction of the new Healthcare Education Building in support of local healthcare workforce development. The Tillamook Bay Community College Health Advisory Committee convened to share updates on the progress of healthcare education pathways and construction of new healthcare education building. The committee is comprised of representatives from the healthcare partner network, community college and school district.AHTM provides charitable prescription services at no cost to recipients. Such patients may be uninsured, underinsured, jailed (and thus uninsured by design), or simply require drugs that are too expensive for most households to afford. No-cost prescriptions may also be offered to patients with limited access to a retail pharmacy, such as on the evening of hospital discharge or on holidays. Finally, no-cost medications are provided for emergency supplies, such as EpiPens for fire departments and the Tsunami emergency medication stockpile in Manzanita. Much of the drug cost is offset by the 340B Drug Discount program, which allows eligible facilities such as AHTM to buy medication at "single payer" rates. Many of our charitable prescriptions continue to be needed fill the gap of service due to the loss of Tillamook Pharmacy. Hot meals served on Wednesday evenings at Tillamook Adventist Church by Hospital staff and Nutritional Care Services for anyone in the community facing low income, houselessness, food insecurity, and loneliness.Priority Need Three - Housing.The Hospital is working with our community partners (Rural Healthcare Partner Network, Tillamook County Housing Commission, Tillamook Bay Community College and CARE, Inc.) to reduce housing costs burden and improve quality of life by increasing access to affordable and workforce housing, increase connectivity of resources and housing placement and provide low-barrier shelters to create safe sleeping locations. Collaboration in 2024 included: Part V, Section B, Line 11, continuation: As an appointed member of the Tillamook County Housing Commission, AHTM's Well-Being Director participated in an innovative Housing Production Solutions Fund round to award $400,000 to six housing development projects that will add 145 new housing units in Tillamook County. These funds are accrued through the county's short term rental operator license fees, creating an on-going source of funding for workforce housing projects which often cannot "pencil out" without subsidies. Funds awarded to projects have helped leverage additional funding, ensuring project viability.Significant progress is being made to increase the amount of affordable and workforce housing with 54 planned affordable housing units (60% AMI) and 34 planned workforce housing units (<120% AMI), as well as 24 completed low-income housing units (<30% AMI). Tillamook County leaders approved an ADU Ordinance to allow construction of ADUs in unincorporated rural residential areas, exclusively for long-term rentals.Two potential building sites for multi-family housing identified. The Housing Commission is facilitating pre-lease agreements with non-profit developers for workforce housing of 36 units in pre-development near the Hospital. AHTM has provided a letter in support of pre-leasing units for this development.A cash contribution in the amount of $5,000 was provided to Tillamook County Habitat for Humanity for critical repairs program that serves low income and elderly to provide safe housing.In 2024, AHTM continued its partnership with CARE, a community action resource enterprise that works to provide services and housing for people in crisis. They broke ground for new no/low-barrier shelters. During 2024, a French drain was installed, trees removed, electrician hired, and plumbing was laid out. CARE's current six shelters remain consistently occupied, two of which are expected to become transitional housing for individuals discharged from the Hospital with severe medical conditions and/or on hospice once the new shelters are in place.Significant needs not met:No hospital can address all the health needs identified in its community. AHTM is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed include mental health, health risk behaviors, health conditions, food security, environment & infrastructure, inclusion & equity, COVID-19, education, community vitality and community safety. While these significant health needs are not addressed directly, they are likely to benefit from collective efforts of our community partnerships. 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. 11 1 - AHTM Medical Group 1100 Third Street Tillamook OR 97141 Rural health clinic 2 - AHTM Women's and Family Health 1011 Third Street Tillamook OR 97141 Rural health clinic 3 - AHTM Medical Group Estacada 103 SW Highway 224 Suite B Estacada OR 97023 Rural health clinic 4 - AHTM Manzanita Primary & Specialty Care 10445 Neahkahnie Creek Road Manzanita CA 97130 Rural health clinic 5 - AHTM Bayshore Medical Pacific City 38505 Brooten Road Suite A Pacific City OR 97135 Rural health clinic 6 - AHTM Vernonia 1005 Cougar Street Vernonia OR 97064 Rural health clinic 7 - AHTM Bayshore Medical Lincoln City 1105 SE Jetty Avenue Suite C Lincoln City OR 97367 Rural health clinic 8 - AHTM Occupational Medicine 980 Third Street Suite 100 Tillamook OR 97141 Occupational medicine 9 - AHTM Hoodland 24461 E Welches Road Welches OR 97067 Rural health clinic 10 - AHTM Sheridan Office 222 SE Jefferson Street Sheridan OR 97378 Rural health clinic 11 - AHTM Medical Group Banks 12350 NW Main Suite 112 Banks OR 97106 Rural health clinic Part I, Line 7: The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide 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 II, Community Building Activities: The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. 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. 2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. 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 III, Line 2: Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3: The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. 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: The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8: The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B. Part III, Line 9b: When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income, and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2: Adventist Health Tillamook promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in Tax Year 2023, and the Year Two Update, Tax Year 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/tillamook/about-us/community-benefit/The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2022, 2023 and 2024 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, the Hospital 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, our 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: The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's 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's 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: Tillamook County is nestled in the fertile Oregon Coast Range and recognized for its plentiful region of dairy farms. Tillamook, or "Land of Many Waters," is comprised of 75 miles of coastline, four bays, nine rivers, and is home to the Tillamook Cheese Factory, attracting many tourists. Tillamook City, the largest city in the county, has a population of 4,971 with a majority age group of older adults (65 and older) making up 25.3% of the population. The total population of the area included in this needs assessment is 27,216 people. The Tillamook County Fair, summer parades, rodeos, and unity of the community contribute to the smalltown rural feel of this community. Residents are 89.4% non-Hispanic, 10.6% Hispanic and have a median household income of $55,214 of which 62.83% is spent on housing and transportation. Among this population, 15.96% of children live in poverty and 4.81% of students are unhoused, compared to the state average of 3.99% and national average of 2.77%. The following zip codes represent Tillamook County's 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 zip codes of those they serve. The Tillamook County CHNA has a total population of 27,216 (based on the Decennial Census). The largest city in the service area is Tillamook with a population of 4,971. The service area is comprised of the following zip codes: 97107, 97118, 97131, 97136, 97108, 97147, 97122, 97149, 97134, 97130, 97135, 97141, 97112. 69.82% of the population own their home and 30.18% are renters. The availability of primary care providers is extremely limited in Tillamook County, with 70.07 primary care providers per 100,000 population as compared with 130.37 in Oregon and 104.44 in the United States. A shortage of mental health providers as compared to Oregon is also seen, with 169.11 mental health care providers per 100k people in Tillamook County compared to 312.16 in Oregon. The number of intensive care unit hospital beds is also limited, with 14.95 beds per 100k people as compared to 20 in Oregon and 28.05 in the United States. Only 26% of the population lives within half a mile of public transportation. This is less than half of the rate of Oregon as a whole, which creates a substantial barrier for many. Sixteen percent of children under 18 years of age are living in poverty, as compared to 15% in Oregon. When examining poverty levels by race though the numbers tell a very different story, the rates are especially staggering for children who are Native American or Alaska Natives (87.9%) and Native Hawaiian or Pacific Islanders (80.6%). These groups are undoubtedly experiencing significantly greater health disparities than the overall population. The average household income and the median household income are both lower in Tillamook ($55,214) than in Oregon ($65,667) and the US ($64,994). Affordability and housing costs, by calculating the percentage of household income needed for housing and transportation costs comes up to a high rate of 62.8% as compared to 54.4% in Oregon and 54.3% nationally. One-hundred percent of African America residents in the area rent their homes, as compared to 29% of whites, 48% of Asians, 49% of Native Americans or Alaska Natives, and 46% of multi-race persons. Part VI, Line 5: Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low-income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache 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 healthy - even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population, 2. Factors that cause the present outcomes distribution, and3. 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, and3. Advance care coordination across the health care continuum.We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6: The Hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as 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, Reports Filed With States OR Part VI: Other Information: Inspiring health, wholeness and hope in the communities we serve requires that we provide services that allow everyone to reach their optimal health. Ensuring that everyone in our communities has that opportunity is the definition of health equity. Adventist Health is committing the time and effort to ensuring health equity in all of our markets. A Health Equity Committee has been formed with champions from every market. "We are especially sensitive to addressing health equity gaps for the underserved, frail, elderly, and minority populations," says Raul Ayala, MD, MHCM, Adventist Health Ambulatory Medical Officer, Central Valley Network family practitioner, and leader of our Health Equity Committee. "We are assessing the gaps in care for these populations and finding ways to close those gaps. The Health Equity Committee is looking at the programs we currently have that successfully meet the needs of underserved groups and are figuring out how we can duplicate these efforts in other markets. Programs such as our technological language support, mobile clinics, ACO nurse navigators, Community Connect, community health workers, and our substance abuse navigators. We know we must also create more access to care and enhance the patient/customer experience." In 2024, screenings for social determinants of health at our Hospital reached 89.5% which included screenings for housing instability, food insecurity, utility difficulties and transportation needs. This robust data enabled our Hospital to identify key areas of concern and strategically develop and refine programs to better support our community's health. X X X X 1 1 0 0 0 0 0 0 0 Heinrich Kerry Dir/Chair/CEO 0 2342000 0 1586113 0 46082 0 13296 0 44679 0 4032170 0 0 Hofheins Todd Dir/Vice Chair/COO 0 1474000 0 888115 0 45560 0 13296 0 52696 0 2473667 0 0 Beaman John CFO/Assistant Secretary 0 1261000 0 698818 0 21043 0 13296 0 66512 0 2060669 0 0 Stevens Eric - Former Care Division Operations Exec thru 02/22 0 1196000 0 495682 0 194464 0 13296 0 44679 0 1944121 0 0 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0 1111000 0 458435 0 189823 0 13296 0 66512 0 1839066 0 0 Newmyer Joyce Pres, OR State Network thru 04/24 0 934154 0 378860 0 25893 0 16695 0 44679 0 1400281 0 0 Jobe Meredith Secretary 0 796100 0 281132 0 143872 0 13296 0 44679 0 1279079 0 0 King Kyle - President OR State Service Area as of 04/24 0 666769 0 131700 0 64780 0 13296 0 44700 0 921245 0 0 LaFleur Brett Physician 829045 0 0 0 0 0 13296 0 38422 0 880763 0 0 0 Rippey Wesley - Former Reg Medical Officer, PNR thru 02/20 0 551182 0 131994 0 113087 0 13296 0 24025 0 833584 0 0 Welch Donald - Former Treas/Fin Officer, PNR thru 02/20 0 465504 0 150507 0 90281 0 13296 0 44679 0 764267 0 0 Jahn Andrew - Former Care Division President thru 02/22 0 281190 0 407001 0 5026 0 55610 0 3801 0 752628 0 0 Swanson Eric President 0 447000 0 116449 0 53492 0 13296 0 22557 0 652794 0 0 Kaba David Physician 612072 0 0 0 140 0 13296 0 23596 0 649104 0 0 0 Leach Judy - Former Strategy & Comm Exec, PNR thru 02/20 0 379600 0 111692 0 50369 0 13296 0 36923 0 591880 0 0 Welch Paul Medical Director 0 394050 0 52608 0 44240 0 13296 0 66519 0 570713 0 0 Lee Adam - Former Dir Marketing & Comm, PNR thru 02/20 0 298456 0 48371 0 28816 0 13296 0 66187 0 455126 0 0 Smith Micah Treas/Asst Secretary 0 271632 0 62011 0 28592 0 13296 0 66242 0 441773 0 0 Echelberger Amy Physician 370646 0 0 0 0 0 13296 0 25595 0 409537 0 0 0 Gerken Brittany Physician 360228 0 0 0 0 0 13296 0 35372 0 408896 0 0 0 Pitts Todd Physician 359009 0 0 0 0 0 13296 0 23596 0 395901 0 0 0 Voshell Shane - Former Reg HR Dir, PNR thru 02/20 0 234959 0 46691 0 23437 0 11748 0 59521 0 376356 0 0 Seufert Regina Clinic and Physician Executive 0 237481 0 54350 0 34513 0 11874 0 17212 0 355430 0 0 Thompson Heather Patient Care Executive 0 205613 0 44749 0 21558 0 10281 0 59453 0 341654 0 0 Wing Bill - Former Dir/Asst Secr/Vice Chair thru 01/22 0 0 0 0 0 273263 0 0 0 0 0 273263 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Jahn, Andrew - severance payment - $15,065 Wing, Bill - severance payment - $271,535 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Joyce Newmyer, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an of their corporate provided benefits. The balance is set aside for forfeiture and is at risk to the creditors of Adventist Health. Payouts substantial risks of forfeiture have lapsed. The plan was frozen for new amount equivalent to 41 percent of their base compensation, less the value nonvested deferred compensation that is subject to substantial risk of occur according to the participants' payment elections after all non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2024 Newmyer, Joyce - participant, no activity 2024 Tracy Welch Family member of Key Employee Paul Welch 39881 Employment 0 Form 990, Part III, Line 4a: Northwest Medical Foundation Tillamook, DBA Adventist Health Tillamook (AHTM), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHTM has been serving Tillamook County as a faith-based, nonprofit healthcare organization since 1973. It includes a 25-bed critical access medical center in Tillamook, the largest hospital-based ambulance service in Oregon with four stations, and six rural health and urgent care medical offices across the northern Oregon coast and inland communities of Vernonia and Estacada. With over 500 associates and healthcare providers, AHTM is part of Adventist Health, an integrated nonprofit system serving over 80 communities on the West Coast and Hawaii with more than 400 care sites. Although reimbursement for services rendered is critical to the operation and stability of AHTM, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHTM 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. AHTM 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 2024 was $916,180. The following services were provided to all our patients: - 87,544 clinic visits - 86 deliveries - 882 discharges - 10,619 emergency room visits - 186 inpatient surgeries - 88,346 outpatient hospital visits - 993 outpatient surgeries - 3,368 patient days AHTM 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 2024 was $5,682,292. AHTM's quality and performance awards include: Reputation 800 Customer Service Award, Lown Institute Hospital Index "A" Scores in Community Benefit, Value, Avoiding Overuse, and Cost Efficiency, Becker's Hospital Review Critical Access Hospitals to Know and Best Places to Work, Forbes Best Employers in Oregon, ranked 4th overall and top healthcare employer, Ragan Workplace Wellness Recognition for Employee Experience Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Form 990, Part VI, Section A, line 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 Chief Legal Officer/General Counsel immediately. The System Chief Legal Officer/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 Chief Legal Officer/General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System Chief Legal Officer/General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, line 15 The Adventist Health Board of Directors has established an Executive Compensation 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; 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 40 percent spread from minimum to maximum. Form 990, Part VI, Section C, line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part VII, Section A: Board compensation is for Adventist Health System/West Board of Directors only - not hospital Board of Directors. Form 990, Part IX, line 11g Physician professional fees: Program service expenses 14,053,977. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,053,977. Consulting and other management fees: Program service expenses 380,387. Management and general expenses 42,924. Fundraising expenses 0. Total expenses 423,311. Repairs and maintenance: Program service expenses 1,082,857. Management and general expenses 426,211. Fundraising expenses 0. Total expenses 1,509,068. All other purchased services: Program service expenses 1,249,013. Management and general expenses 206,864. Fundraising expenses 0. Total expenses 1,455,877. Other professional nonmedical fees: Program service expenses 14,735. Management and general expenses 0. Fundraising expenses 0. Total expenses 14,735. Contract Labor: Program service expenses 2,934,507. Management and general expenses 159,636. Fundraising expenses 0. Total expenses 3,094,143. Purchased medical services: Program service expenses 329,993. Management and general expenses 53,784. Fundraising expenses 0. Total expenses 383,777. Form 990, Part XI, Line 8: Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items. 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