2025-11-06T11:18:18-06:00 2024-12-31 390859910 Baker Tilly Advisory Group LP 2882 Prospect Park Dr Ste 300 Rancho Cordova CA 95670 990 2024-01-01 930386936 Mid-Columbia Medical Center MID- 9164060000 1700 E 19th Street The Dalles OR 97058 Wendy Apland CFO 9164060000 2025-10-25 1 1 Lauren A Haverlock P00545829 9165038100 2025-10-25 2024 2025-03-06 01:10:19Z Adventist Health Columbia Gorge Kyle King 1700 E 19th Street The Dalles OR 97058 135817031 0 X www.adventisthealth.org/columbia-gorge/ X 1944 OR Living God's love by inspiring health, wholeness, and hope. 3 2 940 61 0 0 2367426 2278868 71104641 132179260 686760 1290215 55856 68688 74214683 135817031 0 151650 0 0 45941830 82091568 0 0 341747 33309655 73390704 79251485 155633922 -5036802 -19816891 94323835 84021437 57474520 72358008 36849315 11663429 X Living God's love by inspiring health, wholeness, and hope. 0 0 131307115 151650 131680291 See Schedule O 131307115 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 74 0 1 940 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 2 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 OR X John Beaman 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 Innocent Larry Director 0.00 4.00 X 0 26611 0 Reiner Richard Director 0.00 4.00 X 0 26611 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 King Kyle - Pres AHCG Pres, OR Svc Area as of 04/24 16.70 33.30 X 0 863249 57996 Knox Dennis President & CEO thru 04/24 40.00 0.00 X 0 809238 33547 Apland Wendy - CFO Treasurer & Asst Secretary 40.00 0.00 X 0 447010 39002 Newmyer Joyce - President OR State Network thru 04/24 10.00 40.00 X 0 1338907 61374 Eldurkar Jayant Medical Officer 40.00 0.00 X 0 520064 64462 Overton Camie - COO Oper Exec/Int Admin 04/24 thru 11/24 40.00 0.00 X 0 457304 34853 Thompson Jayme-CNO thru 0324 PCE 03/24-11/24/Ops Exec as of 11/24 40.00 0.00 X 0 308782 22158 Lepper Dale CIO 40.00 0.00 X 0 263124 4053 McCall Cheri - Director Human Resources thru 03/24 40.00 0.00 X 0 221873 28210 Reardon James Physician 40.00 0.00 X 817223 0 41268 Scrivens Brian Physician 40.00 0.00 X 764481 0 55482 Wong Winnifred Physician 40.00 0.00 X 750232 0 25940 Moon Paul Physician 40.00 0.00 X 691360 0 31126 McCarthy Caitlin Physician 40.00 0.00 X 630554 0 13440 Cardosi Paul Former Director thru 05/23 40.00 0.00 X 0 323571 41965 3653850 15190179 816626 168 1 1 0 Oregon Health And Science University 1515 SW 5th Ave Ste 920 Portland OR 97201 Medical services 2656062 Oxford Anesthesia Management LLC PO Box 69355 Baltimore MD 21264 Medical services 1137695 Adventist Medical Center Portland 10000 SE Main Ste 60 Portland OR 97216 Internal 961357 GetixHealth Holding Corp PO Box 676339 Dallas TX 75267 Revenue billing services 956241 Weatherby Healthcare PO Box 972633 Dallas TX 75397 Staffing services 885266 29 2020131 40274 218463 2278868 Patient service revenue 621110 125147981 125147981 Premium revenue 621110 2987468 2987468 340B Pharmacy revenue 456110 1602492 1602492 Cafeteria revenue 722514 498969 498969 Management fees 541610 24001 24001 1918349 1918349 132179260 1234982 1234982 39339 15894 0 0 39339 15894 55233 55233 Miscellaneous revenue 900099 68688 68688 68688 135817031 131680291 0 1857872 X 83286 83286 68364 68364 64438922 60176391 4087248 175283 2950056 2841202 105012 3842 10332634 9583983 740970 7681 4369956 3989282 364386 16288 6774365 6774365 217370 217370 14944 14944 5586 5586 19972272 15851477 4041363 79432 163894 163894 892882 422000 460647 10235 7073338 3720573 3326742 26023 1450574 1219828 230746 386634 281083 100033 5518 127695 125943 505 1247 1814911 1814174 737 6680729 6322539 358190 568740 568740 Patient care supplies 18978823 17849702 1128190 931 Quality assurance fee 5848429 5848429 Rental/lease costs equi 482762 456381 22241 4140 Income taxes 5170 1724 3446 1931586 76428 1844031 11127 155633922 131307115 23985060 341747 6517977 2588947 4519343 0 2215 172792 20602096 20143608 1774118 1479714 1366885 330450 86651662 60826322 31683042 25825340 701567 5643600 1045396 952468 952468 26204124 25839122 94323835 84021437 14723597 10311673 0 25500 42750923 62020835 57474520 72358008 X 36621791 9397966 227524 2265463 36849315 11663429 94323835 84021437 X -19816891 -98511 -5270484 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 5586 5586 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. 4989800 4989800 37194437 24228894 12965543 6037339 4301354 1735985 37298545 31795112 5503433 1131541 500962 630579 25825340 Right-of-use assets 22857156 Other assets 2414628 Receivables from related organizations 543776 Other receivables 23562 25839122 Payables to related organizations 39925456 Lease liability 21299425 Payables to third-party payors 757818 Other liabilities 38136 62020835 X 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 4195658 4195658 0.02700 34602398 23467236 11135162 0.07150 38798056 23467236 15330820 0.09850 465937 465937 0.00300 52005 52005 0.00030 10729 10729 0.00010 528671 528671 0.00340 39326727 23467236 15859491 0.10190 6470 6470 0.00000 6470 6470 0.00000 1 1539622 284891 30285045 36268339 -5983294 X 1 1 1 1 Adventist Health Columbia Gorge 1700 E 19th Street The Dalles OR 97058 www.mcmc.net 14-0500 X X X Adventist Health Columbia Gorge 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X 1 22 1 See Sch H Part VI - Needs Assessment 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 Education X Sch H Part VI - Patient Education X Sch H Part VI - Patient Education X X X X X X 1 X 0 X X X X 1 X 0 0 Adventist Health Columbia Gorge Part V, Section B, Line 5: Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge (AHCG) participated as a member of the Gorge Collaborative in a collaborative needs assessment in 2022 which included four hospitals, one county health department, social services agencies in the region, health care providers in the service region and consumer representatives of the same. As part of the data collection process for the CHNA, listening sessions were conducted with representatives from medically underserved communities and leaders who directly serve these populations. Adventist Health Columbia Gorge Part V, Section B, Line 6a: The following hospital facilities participated in the Hospital's CHNA process: Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge (AHCG), Klickitat Valley Health, Providence Hood River Memorial Hospital and Skyline Hospital. Adventist Health Columbia Gorge Part V, Section B, Line 6b: The following non-hospital facilities participated in the Hospital's CHNA process: Columbia Gorge Health Council, Hood River County Health Department, Klickitat Valley Health Department, Mid-Columbia Center for Living, Mid-Columbia Community Action Council, North Central Public Health District, One Community Health, PacificSource Community Solutions, Skamania County Public Health. Adventist Health Columbia Gorge Part V, Section B, Line 11: Tax Year 2024 was Year Two of the Implementation Strategy for the 2022 CHNA. All programs and activities provided to the community were in response to the priority health needs identified in the 2022 Community Health Needs Assessment (CHNA). The AHCG 2022 CHNA identified three areas of significant need: Homelessness and Housing Instability, Access to Health Care Services and Chronic Conditions. Priority Need One - Homelessness and Housing Instability. The goal is to reduce "housing-burden" for community members who are having trouble keeping up with rising costs of housing by helping to provide short term temporary housing for patients and collaborate with community partner organizations on long-term solutions. In 2024, the Health Foundation assisted 12 individuals with temporary emergency hotel stays which totaled $11,017 in spent funds. The work of the Mid-Columbia Houseless collaborative is to prevent and address houselessness in the Columbia Gorge region using a coordinated approach and a commitment to equity. The Houseless Collaborative supports five counties across Oregon and Washington including Wasco, Hood Rover, Sherman, Skamania, and Klickitat counties and includes more than 40 organizations. AHCG's staff collaborate and discuss with other community partners how to address houselessness in the Columbia Gorge area through access to shelters, improved access and navigation of resources, construction of low-income housing, and advocacy of community support. In April 2024, the Case Management staff completed a tour of The Annex, which is a transitional housing and shelter initiative through Mid-Columbia Community Action Council to strengthen knowledge in how to support houseless individuals. Priority Need Two - Access to Health Care Services. The goal is to increase access to culturally and linguistically centered care to the community where social determinants of health have impacting care through a focus on providing increased access to appointments in alignment with strategic initiatives. An increase in visit volumes was demonstrated in 10 clinics including Family Medicine, ENT, Surgical Clinic, Hood River Cardiology, The Dalles Cardiology, Pediatrics, Behavioral Health Pediatrics, Internal Medicine, Behavioral Health Internal Medicine, and Immediate Care. In 2024, there were a total of 67,970 visits compared to 59,136 visits in 2023 and 55,571 visits in 2022. From 2022 to 2023, there was an increase in 6.4% of visits. From 2023 to 2024, there was almost a 15% increase in visits confirming improved access to services. AHCG's primary and secondary service areas are considered a Health Professional Shortage Area, which is a designation given by the Health Resources and Services Admiration (HRSA) to identify geographic areas, populations, or facilities that lack sufficient health care professionals to meet the health needs of the community. Within the area, there are 54,945 people living in a Health Professional Shortage Area which represents 83.83% of the population. Our Hospital worked tirelessly to address access to care through the recruitment of physicians in 2024. They were able to recruit eight permanent providers and credential 16 locums and four courtesy providers. Priority Need Three - Chronic Conditions. The goal is to assist community members who experience unmanaged chronic conditions with additional access to primary care providers and specialists by addressing prevention. AHCG continued the Prevent Program which is a free wellness and healthy lifestyle initiative aimed to help people prevent disease, increase overall health and guide participants to lose 4-7% of body weight. It is facilitated by a trained lifestyle coach who teaches participants how to make lifestyle changes through increased physical activity and uses curriculum from the Centers for Disease Control and Prevention. In 2024, a bilingual Lifestyle Coach started a Spanish speaking Prevent Program and led two cohorts, six months each, to support the needs of the Columbia Gorge Latino community. The Prevent sessions in 2024 were shortened to six months as opposed to the year-long program to help with the recruitment and retention of participants. There was a total of eight participants who attended the Spanish sessions and 18 who attended the English sessions in 2024. In collaboration with the Columbia Gorge Health Council, AHCG is one of the sites that offers the Connected Care for Older Adults program that aims to support medically "frail" patients identified by providers and support staff. Our organization hired and trained a bilingual Community Health Worker (CHW) to lead this pilot program throughout 2024. As a result of this program, individuals have received home visits conducted by the CHW to complete the 4M's which include "What Matters, Medication Reconciliation, Mobility, and Mentation" protocols. Depending on their needs, patients are connected to various resources such as Aging & People with Disabilities (APD), Oregon Project Independence (OPI), and assisted living facilities. As of December 2024, 34 patients have been enrolled in the program and 15 have graduated. This pilot program will continue into 2025. Significant needs not met:No hospital can address all the health needs identified in its community. AHCG 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. Areas of significant health needs that will not be directly address at this time include behavioral health (mental health), economic insecurity (financial stability) and food security. While these significant health needs are not address 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. 10 1 - Water's Edge Medical Clinic 551 Lone Pine Boulevard The Dalles OR 97058 Rural health clinic 2 - MCMC Family Medicine 1620 E 12th Street The Dalles OR 97058 Rural health clinic 3 - MCMC Surgical Clinic 1810 E 19th Street Suite 225 The Dalles OR 97058 Outpatient clinic 4 - Columbia Crest Medical Clinic 1935 E 19th Street The Dalles OR 97058 Rural health clinic 5 - Columbia River Women's Center 1810 E 19th Street Suite 209 The Dalles OR 97058 Rural health clinic 6 - Gorge Urology 1805 E 19th Street The Dalles OR 97058 Outpatient clinic 7 - Columbia Gorge Pathology 1700 E 19th Street The Dalles OR 97058 Outpatient clinic 8 - MCMC Specialty Clinics at Nichols Lane 33 Nichols Parkway Hood River OR 97031 Outpatient clinic 9 - Columbia Gorge Ent and Allergy 1815 E 19th Street Suite 1 The Dalles OR 97058 Outpatient clinic 10 - MCMC Occupational Health 1825 E 19th Street Suite 2 The Dalles OR 97058 Outpatient 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: The 2022 Columbia Gorge Regional Community Health Needs Assessment (CHNA), the 2023-2025 Community Health Improvement Plan or Implementation Strategy (CHIS), and the 2023 Community Health Plan (CHP) updated for 2023 are posted on the Hospital's website at:https://www.adventisthealth.org/columbia-gorge/about-us/community-benefit/The 2019 CHNA and 2020 CHIS may also be found there. These reports may also be found at 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, our hospitals support 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 the regions we serve. 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 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: Mid-Columbia Medical Center dba Adventist Health Columbia Gorge (AHCG) is located in the Dalles, Wasco County, Oregon, with the population of Wasco County estimated around 26,561. AHCG serves a wider geographic area of rural North Central Oregon and South-Central Washington along the Columbia River. This service area includes Wasco, Sherman, and Gilliam Counties in Oregon and Klickitat County in Washington for a combined population total of 53,805. Median incomes and ethnic demographics vary by geographic location. Census data for 2021 shows median household incomes range from $51,705 to $59,583.Wasco County has the largest ethnic diversity with a distribution that is 72% White, 21% Hispanic/Latino, 4% American Indian/Alaska Native and 3% other. About 13% of the population lives below the poverty level and 9.8% of the population under the age of 65 is uninsured. Data from the Oregon Health Authority cites December 2022 Medicaid program enrollment in Wasco County at 10,975, up 6% from 10,391 in December 2021.In addition to the year-round population, the Dalles experience an influx of over 15,000 seasonal workers each year in support of the harvest of our agricultural economy. 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: Other community impact activities not included elsewhere include: Serving Oregon and Its Migrants by Offering Solutions (SOMOS) are a series of health fairs hosted at cherry orchards to provide free health screenings to migrant and seasonal farmworkers. The health screenings provided include height & weight, blood pressure, and blood glucose checks. Multiple community partners attend the SOMOS events to offer services and resources. Community partners that have participated include Advantage Dental, One Community Health, North Central Public Health District, Oregon Human Development Corporation, The Next Door, Inc., and Migrant Education Program. The goal of SOMOS is to provide accessible and culturally specific care. In 2024, AHCG led two SOMOS Health Fairs which happened on June 27th at McClaskey Orchard and on July 11th at Orchard View. The Hospital collaborates with different community partners to join and offer additional resources to migrant farmworkers. Community partners who attended included Advantage Dental, One Community Health, North Central Public Health Department, OHSU Knight Cancer Institute, and the Migrant Education Program. A total of 123 migrant farmworkers were served. Our Hospital is proud to partner with the Columbia Gorge Community College to serve as a clinical site for students who are in the local nursing program. This collaboration showcases the importance of our partnership since 2002. In 2024, about 41 students (including returning students) were provided with a clinical site to assist them with meeting their nursing school requirements. Participation in community coalitions and other collaborative efforts with the community to strengthen the community's capacity to address health and safety issues: The Case Management department at AHCG has a partnership with the Bridges to Health Program, which is part of the Columbia Gorge Health Council. This partnership enables the organization to hire and retain two Community Health Workers to support patients with community resources that are based on their identified health-related social needs (HRSN's). The use of community resources provided will ultimately lead to better health outcomes. A few HRSN's that can be addressed included housing instability, food instability, transportation, and the connection with other local agencies. Columbia Gorge Health Council's Clinical Advisory Panel (CAP): The CAP offers clinical guidance and direction to the Columbia Gorge Health Council to improve health outcomes for PacificSource Community Solutions members and the community. The Director of Quality Resources, Case Management, & Medical staff and an Inpatient Case Management Social Worker attend monthly meetings to share their knowledge and serve as advocates for the population served by AHCG.Columbia Gorge Crisis Resolution Center: The Columbia Gorge Resolution Center is an initiative and advisory workgroup whose purpose is to build a crisis resolution center and residential treatment facilities to address mental health and substance use disorders. AHCG, Behavioral Health manager is an active participant in the advisory workgroup. 1 Columbia Gorge Community College 400 E Scenic Drive The Dalles OR 97058 930700843 501(c)(3) 7621 0 Great 'n Small Playground Mosier Community College PO Box 307 Mosier OR 97040 931326258 501(c)(3) 9747 0 Scholarships Euvalcree 67 SW 2nd Avenue Ontario OR 97914 462224467 501(c)(3) 9538 0 General Support North Wasco County School District 3632 W 10th Street The Dalles OR 97058 753154866 501(c)(3) 5526 0 Scholarships Sherman County School District 65912 High School Loop Moro OR 97039 936011904 501(c)(3) 5375 0 Scholarships 5 0 Scholarships 38 43843 Patient and other assistance 48 24521 Part I, Line 2: Charitable support and assistance are provided with no reporting required by the recipient. X X X X 0 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 Newmyer Joyce - President 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 - Pres AHCG Pres, OR Svc Area as of 04/24 0 666769 0 131700 0 64780 0 13296 0 44700 0 921245 0 0 Reardon James Physician 794935 0 0 0 22288 0 13296 0 27972 0 858491 0 0 0 Knox Dennis President & CEO thru 04/24 0 231387 0 93323 0 484528 0 5272 0 28275 0 842785 0 0 Scrivens Brian Physician 701292 0 0 0 63189 0 13296 0 42186 0 819963 0 0 0 Wong Winnifred Physician 690718 0 0 0 59514 0 13296 0 12644 0 776172 0 0 0 Moon Paul Physician 603957 0 0 0 87403 0 13296 0 17830 0 722486 0 0 0 McCarthy Caitlin Physician 572137 0 0 0 58417 0 13296 0 144 0 643994 0 0 0 Eldurkar Jayant Medical Officer 0 390220 0 47356 0 82488 0 13296 0 51166 0 584526 0 0 Overton Camie - COO Oper Exec/Int Admin 04/24 thru 11/24 0 293105 0 77254 0 86945 0 10912 0 23941 0 492157 0 0 Apland Wendy - CFO Treasurer & Asst Secretary 0 332158 0 40083 0 74769 0 12571 0 26431 0 486012 0 0 Cardosi Paul Former Director thru 05/23 0 308880 0 0 0 14691 0 13296 0 28669 0 365536 0 0 Thompson Jayme-CNO thru 0324 PCE 03/24-11/24/Ops Exec as of 11/24 0 266582 0 25883 0 16317 0 8928 0 13230 0 330940 0 0 Lepper Dale CIO 0 54835 0 74 0 208215 0 2742 0 1311 0 267177 0 0 McCall Cheri - Director Human Resources thru 03/24 0 180353 0 10127 0 31393 0 8291 0 19919 0 250083 0 0 Part I, Line 4b 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. Knox, Dennis - severance payment - $307,346 Lepper, Dale - severance payment - $182,784 Overton, Camie - severance payment - $34,703 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, and Joyce Newmyer. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Newmyer, Joyce - participant, no activity in 2024 Form 990, Part III, Line 4a: Mid-Columbia Medical Center DBA Adventist Health Columbia Gorge (AHCG), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHCG has served the Columbia River Gorge since 1901. It includes a 49-bed hospital located in The Dalles, Oregon, with 24/7 emergency care, a birth center and cancer center and robust outpatient services including immediate care, primary care, specialty care, behavioral health, rehabilitation and more. AHCG employs more than 500 associates and healthcare providers. It is part of Adventist Health, a faith-based nonprofit health system serving more than 90 communities on the West Coast and Hawaii. AHCG is part of the Columbia River Gorge Regional Community Health Assessment, partnering with seven other community organizations to create equity and health outcomes in our community. Although reimbursement for services rendered is critical to the operation and stability of AHCG, 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 AHCG 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. AHCG 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 $4,195,658. The following Inpatient services were provided to all our patients: - 89,272 clinic visits - 172 deliveries - 1,631 discharges - 14,089 emergency room visits - 446 inpatient surgeries - 82,054 outpatient hospital visits - 1,631 outpatient surgeries - 5,821 patient days AHCG 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 $0. AHRO's quality and performance awards include: The Joint Commission's Gold Seal of Approval for Hospital Accreditation, The Joint Commission's Gold Seal of Approval for Home Health Accreditation, The Joint Commission's Gold Seal of Approval for Laboratory Accreditation, American College of Radiology Lung Cancer Screening Center, Patient-Centered Primary Care Home 5-Star Rated, American Academy of Sleep Medicine Accredited Facility, Planetree Certified for Excellence in Person-Centered Care. 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 Stone Point Health Board of Directors. Form 990, Part VI, Section A, line 7b The Board of Directors of the Corporation shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Stone Point Health. 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 annually to review comparability data from outside consultants; 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 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: 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 5,203,357. Management and general expenses 31,156. Fundraising expenses 0. Total expenses 5,234,513. Consulting and other management fees: Program service expenses 45,114. Management and general expenses 77,763. Fundraising expenses 0. Total expenses 122,877. Contract labor: Program service expenses 3,744,251. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,744,251. Repair and maintenance: Program service expenses 2,119,950. Management and general expenses 62,274. Fundraising expenses 0. Total expenses 2,182,224. All other purchased services: Program service expenses 3,855,450. Management and general expenses 3,010,731. Fundraising expenses 79,317. Total expenses 6,945,498. Purchased medical services: Program service expenses 879,042. Management and general expenses 859,409. Fundraising expenses 115. Total expenses 1,738,566. Other medical professional fees: Program service expenses 4,213. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,213. Other professional fees non-medical: Program service expenses 100. Management and general expenses 30. Fundraising expenses 0. Total expenses 130. Form 990, Part XI, line 9: Write-down as result of affiliation -5,312,879. Change in investment in subsidiary 42,395. 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