2025-11-12T17:26:46-08:00 2024-12-31 Los Angeles Wildfires and Windstorms 800519547 THE ACCOUNTANCY LLP 500 N BRAND BLVD STE 1930 GLENDALE CA 91203 990 2024-01-01 453220509 Reedley Community Hospital dba Adventist Health Reedley REED 5596388155 372 W Cypress Ave Reedley CA 93654 Thordarson Heidar Treasurer 2025-11-12 true Steve Clement P01218012 8185475701 X 2024 2025-03-06 01:10:19Z Andrea Kofl 238073881 false 1071 X www.adventisthealth.org/reedley X 2011 CA Living Gods love by inspiring health, wholeness and hope. 15 13 1216 0 896491 749921 191432214 225161628 13832580 12158592 0 206161285 238070141 641549 0 86045769 98074139 0 0 108289801 116412556 194335570 215128244 11825715 22941897 296594694 308508836 107140795 97602204 189453899 210906632 Living Gods love by inspiring health, wholeness and hope. false false 184641713 641549 238070141 Reedley Community Hospital, dba Adventist Health Reedley (AHRD), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHRD serves the communities of southern Fresno County andnorthern Tulare County, providing emergency services, inpatient and outpatientsurgery, wound care and birthing services, including a 24- hour neonatologist andpediatricians in partnership with Valley Children's Hospital. Adventist Health Reedley is part of the Adventist Health Central California Network, a non- profit, faith- based organization operating eight hospitals including Bakersfield, Specialty Bakersfield, Delano, Hanford, Selma, Reedley, Tehachapi and Tulare and over 130 clinics throughout the Central Valley.Although, reimbursement for services rendered is critical to the operation and stability of Reedley Community Hospital, the organization recognizes that not all individuals possess the ability to pay for essential medical services.Adventist Healths vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: Free care and/or subsidized care Care to persons covered by governmental programs at/or below cost Health/wellness activities and community education programsNot only does Reedley Community Hospital provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits.AHRD 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 $1,395,591.The following Inpatient services were provided to all our patients:1,106 babies delivered37 surgeries performed5,414 patient days The following Outpatient services were provided to all our patients:38,894 emergency department visits324 outpatient surgeries performed42,937 outpatient visits 525,813 clinic visitsAHRD 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 $16,094,680.AHRDs quality and performance awards include: Baby-Friendly Designation by Baby-Friendly USA.Adventist Healths 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/ 184641713 true true false true false false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true false false false true 0 0 true 1216 true false false false false false false false 0 false false false false false false false X 15 13 false false false false true true true true true false false true true true true true true true true false CA X John Beaman 9164060000 PO Box 619135 Roseville CA 95661 Heinrich Kerry Director/CEO 0.00 50.50 X X 0 3974195 57975 Hofheins Todd COO/Vice Chair 0.00 50.50 X X 0 2407675 65992 Beaman John CFO/Asst Secty 0.00 50.50 X 0 1980861 79808 Stevens Eric eff 724 President 0.00 50.50 X 0 1886146 57975 Nahapetian Arby Form. Care Divi Med Off thru 02/22 0.00 50.00 0 1759258 79808 Wells Jason President 10.00 40.00 X 0 1543056 79808 Jobe Meredith Secretary 0.00 50.50 X 0 1221104 57975 Kofl Andrea thru 124 Ctrl Vally Pres 12.50 37.50 X 0 1085827 54194 Jamaleddine Ghassan Medical Officer 8.30 41.70 0 882388 79808 Ayala Raul Ambulatory Medical Officer, CVN 8.30 41.70 0 820554 36137 Haydock Timothy Treas/Asst Sec 8.30 41.70 X 0 727318 79808 Cox Shane thru 724 Treasurer 16.70 33.30 X 0 739632 56832 Jahn Andrew Frmr Care Div Pres thru 02/22 0.00 50.00 0 736769 17097 Reyna Sonja Ambulatory Executive 8.30 41.70 0 628786 40807 Van Housen Heather Patient Care Executive 40.00 0.00 0 589725 63003 Tomono Olga Busi Devel Exec eff 11/24/2024 8.30 41.70 0 521544 14186 Tomono Christopher Partnership Executive 8.30 41.70 0 448461 79636 Taggart Laurie Patient Care Exec 40.00 0.00 0 483635 44381 Day Lauren Philanthropy Executive, CVN 12.50 37.50 0 356253 84253 Duyst Jennifer Admi Direc,Clinics Strategy 25.00 25.00 0 277659 33672 Chapman Susan Associate Patient Care Exec 50.00 0.00 0 270121 34543 Jones Larry Admin Direc, Ancillary Servic, CVN 12.50 37.50 0 245345 44212 Ayers Richard RN, House Supervsr 40.00 0.00 239311 0 39258 Sadsad Ramon Physician Assistan 40.00 0.00 238545 0 39718 Wing Bill Former Dir/Asst Sec/VChair thru1/22 0.00 0.00 0 273263 0 Galbreath Kimberly Physician Assistan 40.00 0.00 245340 0 21136 Aniag Edna May RN 40.00 0.00 203784 0 32754 Torres Ramon RN 40.00 0.00 196815 0 37261 Lemaster Deborah Director, Ambulatory Quality Integr 50.00 0.00 0 217484 10112 Freedman John Dir/Chair 0.00 4.00 X 0 27203 0 Newton Bradford Dir/Vice Chair 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 0.00 4.00 X 0 21181 0 Fehr Joy Director 0.00 4.00 X 0 18680 0 Beckett Ann Director 0.00 4.00 X 0 17930 0 Jutsy Kenneth Director 0.00 4.00 X 0 16180 0 Daggett Jonathan Director 0.00 4.00 X 0 16180 0 Cress John Director 0.00 4.00 X 0 430 0 Thordarson Heidar Treasurer 0.00 0.00 X 0 0 0 1123795 24371448 1422149 184 true true false Valley Childrens Medical Group 9300 Valley Childrens Pl PC03 Madera CA 93638 Medical services 3442073 Aaron J Dominguez MD Inc 4180 N Sherman Fresno CA 93726 Medical services 1706626 Rmg Medical Imaging Consultants PO Box 86348 Los Angeles CA 90086 Medical services 1676582 Advanced Building Maintenance Inc 1804 Tribute Rd Ste K Sacramento CA 95815 Building maintenance 1521901 CHG Companies Inc PO Box 972651 Dallas TX 75397 Staffing services 1232320 68 363649 386272 749921 Dietary/Cafeteria 900099 218883 218883 Incentive & Quality Rev 900099 1045857 1045857 Patient Care Services 900099 219174354 219174354 Pharmacy 340b Revenue 722514 1557141 1557141 Premium Revenue 900099 3132078 3132078 33315 33315 225161628 12162332 12162332 0 0 0 3740 -3740 -3740 -3740 0 0 0 0 238070141 225157888 12162332 X 641549 641549 0 0 0 0 0 75862551 71442317 4420234 2716934 2558628 158306 14012442 12959217 1053225 5482212 5196024 286188 16374157 16374157 116516 116516 1776 1776 0 0 0 51711245 50561976 1149269 94000 94000 1840682 1792132 48550 6482453 947848 5534605 0 11256858 11231438 25420 360422 350397 10025 0 55230 55230 1947092 1947092 0 8180134 7990566 189568 1363377 1363377 Patient Care Supplies 13555633 13555633 Other Expenses 1380773 357138 1023635 Quality Assurance 1147984 1147984 Equipment Rentals 544224 543167 1057 0 215128244 184641713 30486531 0 0 160786653 169174151 0 20142588 23637524 0 0 0 728594 754273 107566 162607 114702320 38164060 77019107 76538260 0 0 0 9711063 9711063 28099123 28530958 296594694 308508836 16567099 14213789 261379 38055 90312317 83350360 107140795 97602204 X 188805537 210408916 648362 497716 189453899 210906632 296594694 308508836 X 22941897 -1489164 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 10773 10773 false false Part II-B, Line 1i - Other Activities Description The organization belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to Noteware were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. Part IV - Additional Information 648362 1910517 2061163 497716 1078456 2195813 2625907 648362 1829394 4679773 -45672 5385039 1078456 1829394 1635112 1634599 1829907 31914 588386 96101 524199 1.00000 false true true 4187994 4187994 47548902 11947924 35600978 6213593 3456573 2757020 56751831 22759563 33992268 76538260 Due from third-party payors 26468510 Other Assets 174731 Other receivables 72500 Receivables from related organizations 1815217 28530958 Other Liabilities 25183487 Payable to third Party Medicare -7524380 Payables to related organizations 65691253 83350360 X Part V, Line 4: Intended uses of the endowment fund. Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended. Part X : FIN48 Footnote The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 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 (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2021 in major tax jurisdictions. true true X true X true X true true true false true true 1395591 1395591 0.00650 118062467 118062467 119458058 118062467 1395591 0.00650 1731700 1731700 0.00800 2994747 229193 2765554 0.01290 40998307 29400881 11597426 0.05390 45724754 29630074 16094680 0.07480 165182812 147692541 17490271 0.08130 true 734856 328449 9877230 10589760 -712530 X true true 1 1 Reedley Community Hospital 372 W Cypress Ave Reedley CA 93654 See Form 990 Question J 040000149 X X X X false false true X X X X X X X X X 22 true true true true X See Sch H Part VI - Needs Assessment X See Sch H Part VI - Needs Assessment X true 22 true See Sch H Part VI - Needs Assessment false false true X 200.0000 400.0000 X X X X true true X X X X true X See Sch H Part VI - Patient Education X See Sch H Part VI - Patient Education X See Sch H Part VI - Patient Education X X X X X X true X false X X X X true X false false Facility: - Part V, Section B, Line 5 The 2022 CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populationsthe voices of those with chronic disease, low incomes and the underservedwere heard.Aging, civic government and leadership, community-based organizations focusing on healthcare consumer, law enforcement, low-income, medically underserved, minority populations, substance abuse, transportation and unhoused population participated in seven focus groups with fifty-two individuals participating as well as eight key informant interviews. Represented race/ethnicities were Black, Hispanic, Multi-Race and White. The 2022 Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS Survey data was gathered from the Central Valley region-region name defined by survey administrator, UC Berkeley IGS). Facility: - Part V, Section B, Line 6a Other hospitals that participated in the 2022 Community Health Needs Assessment included Adventist Health Hanford & Selma and Adventist Health Tulare. Facility: - 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: Financial Stability, Food Security and Mental Health. Priority Need One-Financial Stability. The goal is to advocate for and collaborate with internal and external partners to identify community members experiencing poverty and connect them to support services to lessen financial burden. This will be accomplished through the partnerships with external and internal stakeholders to provide financial literacy programs. In 2024, Reedley Community Hospital partnered with Kings Canyon Unified School District to bring in financial experts to their parent and migrant parent meetings to discuss financial well-being. There were twenty participants in the two groups. This strong partnership with the school district has given opportunities to provide students and their families with resources to address other social determinants of health.In 2024, Reedley Community Hospital continued to use free transportation services to increase access to care through Central Valley Health Transport Services. The Centra Valley Health Transport Service provides rides to and from clinic appointments and other health care services, free of charge. The service increased access to care and decreased the number of no-shows for appointments due to lack of transportation. Additionally, with the use of telehealth, patients were able to receive care in their own homes..Other strategies in 2024 included a strong collaborative partnership with our community and our schools. Reedley Community Hospital providers offered student athletes in Fresno County free sports physicals at two events. These free sports physicals address issues with access to care in Fresno County where there is a poverty rate of 21.3%, and a quarter of the population lives in a health professional shortage area. In 2024, Reedley Community Hospital partnered with Parallon to assist community members in the enrollment and approval process for individual or family medical insurance coverage. The hospital also provided a cash contribution to Lighthouse Rescue Mission which provides temporary shelter for those patients discharged from the hospital who are unsheltered. Priority Need Two-Food Security. The goal is to give access to current food distribution programs to the community identified by clinical screenings by building relationships with external partner who already have an established distribution program. In 2024, Reedley Community Hospital provided a list of food outreach resources in our emergency department and available to our clinics. In 2024, the Central Valley Network Care Coordination team at Reedley Community Hospital focused on identifying patients entering through the Emergency Department or admitted as inpatients who required social services support. Community Health Workers were assigned to these patients to assist with care follow up and connect them to essential resources the support overall well-being. These resources included food assistance, transportation, referral coordination and help overcoming access to care barriers.Priority Need Three - Mental Health. The goal is to provide mental health awareness and access to our communities by working with external and internal stakeholders to provide educational awareness to better serve those patients and others. In 2024, Reedley Community Hospital and Sierra Kings Health Care District worked together to bring awareness to the community of Reedley by working to train physicians to recognize behavioral health issues and address mild to moderate issues, increase local psychologist in person or via telemedicine visits, increase community awareness to reduce the stigma associated with behavioral/mental health, provide Mental Health First Aid training for educators, first responders, health care staff, faith-based organizations, etc., and provide Trauma Informed Care/ACES training for educators, counselors, health care staff, faith-based communities. Facility: - Part V, Section B, Line 13h Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets. AHCC - Fowler 119 S 6th St Fowler CA 93625 Rural Health Clinic AHCC - Reedley 811 E 11th St Reedley CA 93654 Rural Health Clinic AHCC - Selma Central 2141 High St Selma CA 93662 Rural Health Clinic AHCC - Kerman 1000 S Madera Ave Kerman CA 93630 Rural Health Clinic AH Tulare - RHC 2059 Hillman Street Tulare CA 93274 Rural Health Clinic AHCC - Specialty 1025 N Douty St Hanford CA 93230 Outpatient clinic - specialists AHCC - Kingsburg 1251 Draper St Kingsburg CA 93631 Rural Health Clinic AHCC - Selma 1041 Rose Ave Selma CA 93662 Rural Health Clinic AHCC - AHHF 1025 N Douty St Hanford CA 93230 Rural Health Clinic - Primary Care Services AHCC - Reedley Womens Health 550 W Cypress Ave Reedley CA 93654 Rural Health Clinic AHCC - Lemoore 810 E D St Lemoore CA 93245 Rural Health Clinic AHCC - Sanger 1939 Academy Ave Sanger CA 93657 Rural Health Clinic AHCC - Healthy Beginnings 1025 N Douty St Hanford CA 93230 Outpatient Clinic - Prenatal, Family PACT, and Well Women Services AHCC - Oakhurst 48677 Victoria Lane Oakhurst CA 93644 Rural Health Clinic AHCC - Home Garden 11899 Shaw Pl Hanford CA 93230 Rural Health Clinic AHCC - Dinuba 1451 E El Monte Way Dinuba CA 93618 Rural Health Clinic AHCC - Orosi 41696 Road 128 Orosi CA 93647 Rural Health Clinic AHCC - Behavioral Health 1025 N Douty St Hanford CA 93230 Outpatient mental health services AHCC - Riverdale 3567 Mt Whitney Ave Riverdale CA 93656 Rural Health Clinic AHCC - Reedley Childrens 1433 N Acacia Reedley CA 93654 Rural Health Clinic - Children's Clinic AH Hanford Same Day - RHC 1025 N Douty Street Hanford CA 93230 Rural Health Clinic AHCC - Residency 1025 N Douty Street Hanford CA 93230 Outpatient Teaching Clinic - Family Practice Residents AHCC - Parlier Newmark 155 S Newmark Parlier CA 93648 Rural Health Clinic AHCC - Dental 1025 N Douty Street Hanford CA 93230 Dental clinic - general dentistry for all ages AHCC - Corcoran East 1310 Hanna Ave Corcoran CA 93212 Rural Health Clinic AHCC - Reedley Cypress 372 W Cypress Ave Reedley CA 93654 Rural Health Clinic AHCC - Corcoran 1212 Hanna Ave Corcoran CA 93212 Rural Health Clinic AH Hanford Synchronous BH - RHC 372 W Cypress Avenue Reedley CA 93654 Rural Health Clinic AHCC - Orange Cove 1455 Park Blvd Orange Cove CA 93646 Rural Health Clinic - Children Clinic AHCC - Dinuba Plaza Lab 444 W El Monte Way Dinuba CA 93618 Rural Health Clinic - Children's Clinic AH Hanford Complex Care - RHC 1025 N Douty Street Hanford CA 93230 Rural Health Clinic AHCC - Reedley Jefferson 1150 E Washington Ave Reedley CA 93654 Rural Health Clinic AHCC - Caruthers 2440 W Tahoe Ave Caruthers CA 93609 Rural Health Clinic AHCC - Wasco 1040 7th St Wasco CA 93280 Rural Health Clinic - Family Practice AHCC - Avenal West 337 Kings Street Avenal CA 93204 Rural Health Clinic AHCC - Caurthers East 2357 W Tahoe Caruthers CA 93609 Rural Health Clinic AHCC - Madera Rancho 11976 Road 37 Madera CA 93636 Rural Health Clinic AHCC - Coalinga 155 S 5th St Coalinga CA 93210 Rural Health Clinic AHCC - Avenal 216 Fresno St Avenal CA 93204 Rural Health Clinic AHCC - Huron 16916 5th St Huron CA 93234 Rural Health Clinic AHCC - Taft 501 6th St Taft CA 93268 Rural Health Clinic AHCC - Shafter 406 James St Shafter CA 93263 Rural Health Clinic - Family Practice AH Earlimart - RHC 398 S Church Earlimart CA 93219 Rural Health Clinic AHCC - Oakhurst East 49063 Road 426 Ste CD Oakhurst CA 93644 Rural Health Clinic AHCC - Kerman Central 275 S Madera Ave Ste 201 Kerman CA 93630 Rural Health Clinic Part I, Line 7 - Explanation of Costing Methodology The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on hospital specific data included in the system-wide audited combined financial statements. The formula used for computation equals financial statement data labeled as follows:Total expenses - (Provision for bad debts + Other revenue + Interest income) divided by Gross patient chargesThe hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of Californias regulations and policies and the approval of the federal government. Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio is multiplied times the hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4 - Bad Debt Expense The system-wide audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8 - Explanation Of Shortfall As Community Benefit The Medicare cost report apportions the hospitals costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever-expanding regulatory requirements, shortages of highly skilled labor and evolving medical and information technology. The health care market basket is unrelated to that of the average individual consumer. Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments too many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information please refer to schedule H part III section B. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients When a patient has requested screening for charity care, the hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2 - Needs Assessment Reedley Community Hospital promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the Year Two Update, FY 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at: https://www.adventisthealth.org/central-valley/about-us/community-benefit/.The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 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, Adventist Health supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. In addition to the CHNA, the Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact. Part VI, Line 3 - Patient Education of Eligibility for Assistance The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the hospitals website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the hospitals Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the hospital billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. Part VI, Line 4 - Community Information The Central Valley Network (CVN) is comprised of four cities: Hanford, Tulare, Reedley, and Selma. The CVN is home to a total population of 530,375 residents with the majority age group being children (5-17), making up 22.2% of the population. Centrally located between northern and southern California, CVNs geographic region is one of its biggest assets benefiting farmland businesses as well as residents pursuing recreational activities such as a short road trip to Yosemite National Park or the cool coastlines of Monterey Bay and Big Sur. This young population is vibrant with festivals, events, and small businesses. Of the population, 64.68% are Hispanic. The median household income is $60,367 of which 59.22% is spent on housing and transportation. Among this population, 27.23% of children live in poverty and 2.70% of students are unhoused, compared to the state average of 4.25% and national average of 2.77%. The following zip codes represent Adventist Health Central Valley Networks primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The Adventist Health Central Valley Network CHNA market has a total population of 537,932 (based on the 2020 Decennial Census). The largest city in the service area is Tulare, with population of 59,312. The service area is comprised of the following zip codes: 93219, 93648, 93625, 93646, 93609, 93647, 93631, 93657, 93245, 93234, 93239, 93654, 93204, 93618, 93230, 93615, 93662, 93212, 93630, 93619, 93210, 93656, 93274. 57.31% of the population own their home and 42.69% are renters. Currently 8.57% of the Central Valley population does not have health insurance. The labor force participation rate (57.62%) is lower than that of California (63.29%) and the United States (62.97%). The unemployment rate is at 8.42% and is higher than both the State and the Nation. Unemployment creates financial instability and barriers to access including insurance coverage, health services and education, healthy food, and other necessities that impact health status. The rate is higher for people of multiple races (11.27%) and people who chose some other race (10.49%). The childhood poverty rate is extremely high at 27.23%, higher than that of California (16.8%) and US (17.48%). Racial disparity in childhood poverty is evident, with 67.13% of Native Hawaiian or Pacific Islander children aged 0-17, 26.76% of African American children, and 28.23% of Native American or Alaska Native children living in households with income below the federal poverty level. The median household income is $60,367, which is below both the California rate and that of the Nation, and poses a significant problem given the exceedingly high cost of living and housing costs in the area. The percent of the Central Valley population living in poverty is extremely high (19.22%) and is considerably higher than the rate of poverty in California (12.58%) and in the US (12.84%). The percentage of students eligible for the free or reduced-price school food program represents 75.84% of public-school students, which is higher than the state average of 59.18% and the Nations average of 42.16%. Access to mental health (MH) providers in the Central Valley is extremely limited. The rate of MH providers is 43.82 per 100k people, as compared to 150.31 in California and 132.27 in the United States. The percentage of adults with poor mental health is higher in the Central Valley (16.1%) than in California (12.5%) and in the US (13.6%). Deaths of despair, which include any deaths due to intentional self-harm, alcohol related disease, and drug overdose are at 43.4 per 100k people and are elevated than the rate in the rest of the state of California (37.1). Part VI, Line 4 - Community Building Activities The hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 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 VI, Line 5 - Promotion of Community Health Our hospitals mission is, Living Gods love by inspiring health, wholeness and hope. Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the Triple Aim. The Triple Aim concept broadly known and accepted within health care includes:1) Improve the experience of care for our residents.2) Improve the health of populations.3) Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given todays state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders. As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy. Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthyeven though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1) The distribution of specific health statuses and outcomes within a population; 2) Factors that cause the present outcomes distribution; and 3) Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to: 1) Increase the prevalence of evidence-based preventive health services and preventive health behaviors, 2) Improve care quality and patient safety, and 3) Advance care coordination across the health care continuum. We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community. Part VI, Line 6 - Affilated Health Care System The hospital is a member of Adventist Health System/West, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as tele pharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals. Part VI, Line 7 - States Filing of Community Benefit Report CA Part VI - Additional Information Listing of Organizations that Particpated in the Hospital's CHNA -Organizations that participated in the 2022 CHNA included: Champions Recovery, City of Hanford, City of Reedley, Family Healthcare Network, Fresno County Department of Public Health, Kings Area Regional Transit, Kings County, Kings County Commission on Aging, Kings County Department of Public Health, Kings Partnership for Prevention, Kings County Sheriffs Department, Kings Tulare Homeless Alliance, National Association for the Advancement of Colored People (NAACP) and Tulare County Department of Public Health.Identified Needs from CHNA, Not Addressed and Why -No hospital can address all the health needs identified in its community. Reedley Community Hospital is committed to serving the community by adhering to its mission, and using its skills, expertise, and resources to provide a range of community benefit programs. Significant health needs that will not be directly addressed but fulfilled by other community organizations include housing, health risk behaviors, health conditions, access to care, environment & infrastructure, inclusion & equity, COVID, education, community vitality and community safety. While these significant health needs are not address directly, they are likely to benefit from collective efforts of our community partnerships.Additional Information / Community benefit - 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 89.9% 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 communitys health. Other Items - Primary website address: See Form 990, Pg 1, Item JNeeds Assessment website: See Sch H Part VI - Needs AssessmentFAP website: See Sch H Part VI-Patient Education true CA Health Foundation & Trust 1215 K St Ste 800 Sacramento CA 95814 941498697 501(c)(3) 641549 0 Funds Transfer Uninsured/Underinsured Patients 1 0 Grantmaker's Description of How Grants are Used Grants are donations made to US tax exempt organizations, Government Entities and Civic organizations who are community partners, known to us, and present a valid purpose for their donation request. It is anticipated that no further monitoring is required. X X X X true true false false false false false false false Aniag Edna May RN 201412 2372 10217 22537 236538 Ayala Raul Ambulatory Medical Officer, CVN 602279 159029 59246 13296 22841 856691 Ayers Richard RN, House Supervsr 234766 2891 1654 11738 27520 278569 Beaman John CFO/Asst Secty 1261000 698818 21043 13296 66512 2060669 Chapman Susan Associate Patient Care Exec 187049 42911 40161 9352 25191 304664 Cox Shane thru 724 Treasurer 517317 150937 71378 13296 43536 796464 Day Lauren Philanthropy Executive, CVN 261124 73945 21184 13056 71197 440506 Duyst Jennifer Admi Direc,Clinics Strategy 232975 43330 1354 11649 22023 311331 Galbreath Kimberly Physician Assistan 207550 33870 3920 10377 10759 266476 Haydock Timothy Treas/Asst Sec 492108 178559 56651 13296 66512 807126 Heinrich Kerry Director/CEO 2342000 1586113 46082 13296 44679 4032170 Hofheins Todd COO/Vice Chair 1474000 888115 45560 13296 52696 2473667 Jahn Andrew Frmr Care Div Pres thru 02/22 281190 407001 48578 13296 3801 753866 Jamaleddine Ghassan Medical Officer 632373 184644 65371 13296 66512 962196 Jobe Meredith Secretary 796100 281132 143872 13296 44679 1279079 Jones Larry Admin Direc, Ancillary Servic, CVN 206093 38830 422 10305 33907 289557 Kofl Andrea thru 124 Ctrl Vally Pres 203715 284676 597436 10186 44008 1140021 Lemaster Deborah Director, Ambulatory Quality Integr 197044 18824 1616 9852 260 227596 Nahapetian Arby Form. Care Divi Med Off thru 02/22 1111000 458435 189823 13296 66512 1839066 Reyna Sonja Ambulatory Executive 287169 176766 164851 13296 27511 669593 Sadsad Ramon Physician Assistan 203099 33270 2176 10155 29563 278263 Stevens Eric eff 724 President 1196000 495682 194464 13296 44679 1944121 Taggart Laurie Patient Care Exec 8700 106405 368530 435 43946 528016 Tomono Christopher Partnership Executive 323323 88917 36221 13296 66340 528097 Tomono Olga Busi Devel Exec eff 11/24/2024 395901 93831 31812 13296 890 535730 Torres Ramon RN 194248 2567 9864 27397 234076 Van Housen Heather Patient Care Executive 429414 113214 47097 13296 49707 652728 Wells Jason President 968000 423321 151735 13296 66512 1622864 Wing Bill Former Dir/Asst Sec/VChair thru1/22 273263 273263 Susan Chapman Key EE-Owner 295453 Contract-Wmns Hlth Ctr false Schedule L, Part V Supplemental Information Additional information regarding interested persons listed above:1. Susan Chapman, a Key Employee, is the Owner of Pali Women's Health Center which the hospital does business with. Form 990, Part VI, Section A, Line 6 The Hospital is organized as a religious corporation and operates as a not-for-profit hospital. The sole corporate member is Adventist Health System/West, a California not-for-profit religious corporation. The Hospital operates as an affiliate of Adventist Health System/West. Form 990, Part VI, Section A, Line 7a The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, Line 7b The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. Form 990, Part VI, Section B, Line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, Line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System General Counsel immediately.The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, Line 15a The Hospital's Board of Directors has established a Human Resources Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. Form 990, Part VI, Section B, Line 15b See Line 15a explanation. Form 990, Part VI, Section C, Line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part XI, Line 9 Transfer to Related Entities = -$1489164 Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake CA 95422 680395149 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Delano 1401 Garces Hwy Delano CA 93215 770258013 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Foundation 1 Adventist Health Way Roseville CA 95661 680002188 Charitable Foundation CA 501(c)(3) 7 Adventist Health SystemWest false Adventist Health Med Ctr Tehachapi 1100 Magellan Drive Tehachapi CA 93561 812240617 Hospital CA 501(c)(3) 3 Adventist Health SystemWest false Adventist Health Mendocino Coast 700 River Drive Fort Bragg CA 95437 845174585 Hospital CA 501(c)(3) 3 Stone Point Health false Adventist Health Physicians Network 1 Adventist Health Way Roseville CA 95661 680357690 Medical Foundation CA 501(c)(3) 12b2 Adventist Health SystemWest false Adventist Health SystemWest 1 Adventist Health Way Roseville CA 95661 953484589 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Roseville CA 95661 463833261 Health Insurance CA AHSWest C-Corp false Thrive Productions Inc 200 Southdale Center Edina MN 55435 453369049 Production Company MN AHSWest C-Corp false AdHealth Limited PO Box HM 2062 Hamilton BD HM HX Pure Captive Insurance BD AHSWest C-Corp false false false false false true false false false false false false false true false true false false true false Adventist Health SystemWest e 65691253 Notes Payable Adventist Health SystemWest m 21908762 Operating Exp Adventist Health SystemWest o 1453231 Compensation Adventist Health SystemWest r 8387498 Cash Mgt Funds