2025-11-06T11:10:50-06:00 2024-12-31 390859910 Baker Tilly Advisory Group LP 2882 Prospect Park Dr Ste 300 Rancho Cordova CA 95670 990 2024-01-01 770258013 Adventist Health Delano ADVE 9164060000 1401 Garces Hwy Delano CA 93215 Heidar Thordarson Treasurer 9164060000 2025-11-06 1 0 Lauren A Haverlock P00545829 9165038100 2025-10-25 2024 2025-03-06 01:10:19Z Jason Wells 1401 Garces Hwy Delano CA 93215 117075954 0 X www.adventisthealth.org/delano X 1990 CA Living God's love by inspiring health, wholeness, and hope. 14 13 562 10 1416 0 5592068 3525690 100856464 106412471 2687055 7137793 0 0 109135587 117075954 869881 2683657 0 0 44807068 49744835 0 0 171 58770974 64684309 104447923 117112801 4687664 -36847 197804831 203816426 57802557 63607202 140002274 140209224 X Living God's love by inspiring health, wholeness, and hope. 0 0 97230344 2683657 106411055 See Schedule O 97230344 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 562 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA 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 Freedman John Director 0.00 4.00 X 0 27203 0 Newton Bradford Director 0.00 4.00 X 0 26939 0 Cherry Robert Director 0.00 4.00 X 0 26611 0 Davis Andrew Director 0.00 4.00 X 0 26611 0 Innocent Larry Director 0.00 4.00 X 0 26611 0 Reiner Richard Director 0.00 4.00 X 0 26611 0 Wagner Jack Director 0.00 4.00 X 0 21611 0 Woodson Marc Director 0.00 4.00 X 0 21611 0 Salazar Velino Director thru 09/24 0.00 4.00 X 0 21181 0 Fehr Joy Director 0.00 4.00 X 0 18680 0 Beckett Ann Director as of 01/24 0.00 4.00 X 0 17930 0 Jutzy Kenneth Director as of 01/24 0.00 4.00 X 0 16180 0 Daggett Jonathan Director as of 01/24 0.00 4.00 X 0 16180 0 Cress John Director as of 10/24 0.00 4.00 X 0 430 0 Beaman John CFO/Assistant Secretary 0.00 50.50 X 0 1980861 79808 Wells Jason Pres, AHDL/Pres, Central CA Network 8.30 41.70 X 0 1543056 79808 Jobe Meredith Secretary 0.00 50.50 X 0 1221104 57975 Haydock Timothy - Int Treas Ops Exec, Cent CA Ntwrk as of 07/24 8.30 41.70 X 0 727318 79808 Jamaleddine Ghassan Medical Officer as of 07/24 8.30 41.70 X 0 882388 79808 Ayala Raul - Ambulatory Medical Officer, Cent CA Network 8.30 41.70 X 0 820554 36137 Cox Shane - Finance Operations Exec, Cent CA Network thru 12/24 8.30 41.70 X 0 739632 56832 Lavers Jennifer Operations Executive 16.60 33.40 X 0 614658 79808 Reyna Sonja Ambulatory Executive 8.30 41.70 X 0 628786 40807 Van Housen Heather Patient Care Executive 40.00 0.00 X 0 589725 63003 Tomono Olga - Business Development Executive as of 11/24 8.30 41.70 X 0 521544 14186 Tomono Christopher Partnership Executive 8.30 41.70 X 0 448461 79636 Longo James Compliance Officer/IS Director 40.00 0.00 X 0 341740 43946 Orozco-Robles Maritza Nurse Practitioner 40.00 0.00 X 262082 0 44383 Monrian Terrence Supervisor, Pharmacy 40.00 0.00 X 269037 0 23786 Fernandez Reena RN, House Supervisor 40.00 0.00 X 244076 0 45918 Agbayani Noha RN, House Supervisor 40.00 0.00 X 238329 0 13782 Lee Mee Young Pharmacist 40.00 0.00 X 228634 0 21957 Stevens Eric - Former Care Division Operations Exec thru 02/22 0.00 50.50 X 0 1886146 57975 Wolcott Daniel - Former Pres AHDL Pres, Kern County Network thru 01/23 0.00 0.00 X 0 704271 65778 Hutcheson Walter - Frmr Treas Asst Secr/Fin Officer thru 10/21 0.00 50.00 X 0 345696 79018 Wing Bill - Former Dir Asst Secr/Vice Chair thru 01/22 0.00 0.00 X 0 273263 0 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0.00 50.00 X 0 1759258 79808 Jahn Andrew - Former Care Division President thru 02/22 0.00 50.00 X 0 693217 59411 Cantrell Misty - Former Chief Nursing Officer thru 05/21 0.00 50.00 X 0 548840 79687 1242158 23946777 1487032 122 1 1 0 Comfort Anesthesia Associates Inc 2635 G Street Suite 101 Bakersfield CA 93301 Medical services 2415421 PT Solutions Holdings LLC PO Box 724557 Atlanta CA 31139 Medical services 2035244 Rmg Medical Imaging Consultants PO Box 86348 Los Angeles CA 90086 Medical services 1812134 Advanced Building Maintenance Inc 1804 Tribute Rd Ste K Sacramento CA 95815 Building maintenance 1527385 Allied Universal Security Services PO Box 31001-2374 Pasadena CA 91110 Medical services 1066105 32 3060340 465350 7200 3525690 Patient service revenue 621110 100207560 100207560 Pharmacy revenue 456110 5558093 5556677 1416 Related rental revenue 531120 287565 287565 Dietary revenue 621400 241090 241090 Incentive/quality care 531120 50166 50166 67997 67997 106412471 6927693 6927693 210100 0 210100 210100 210100 117075954 106411055 1416 7137793 X 2683657 2683657 39212206 35732931 3479275 1417530 1291753 125777 6340775 5406371 934404 2774324 2564298 210026 7475535 7475535 351311 351311 2409 2409 15554 15554 16576611 14631462 1945149 53764 53764 573934 428629 145208 97 7213706 2901017 4312689 3992274 3985181 7093 110982 101196 9786 15157 14121 1036 1896962 1896962 2346752 2322079 24673 817463 817463 Medical/non-medical sup 13898868 13895923 2871 74 Quality assurance fees 7016341 7016341 Rental/leases costs equ 399639 377952 21687 Provision for bad debt 79715 79715 1847332 1147454 699878 117112801 97230344 19882286 171 106546163 110234712 23293 21778 14110869 13379262 1124316 1131062 144399 339813 65660530 25279393 43565251 40381137 0 218500 32290540 38110162 197804831 203816426 10108245 9524351 11351 23965 47682961 54058886 57802557 63607202 X 139947454 139868502 54820 340722 140002274 140209224 197804831 203816426 X -36847 1271356 -1027559 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 15554 15554 0 Part II-B, Line 1: The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to NL Short Public Affairs were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare. 58683 456559 170657 344585 103192 166287 210796 58683 437140 -2503 331445 103192 0.01121 0.00000 0.98879 0 0 9120000 9120000 37920092 13039457 24880635 17770920 12168521 5602399 849518 71415 778103 40381137 Receivables from third-party payors 33590003 Other receivables 2765475 Receivables from related organizations 1554009 Right-of-use asset 193946 Other assets 6729 38110162 Payables to related organizations 48691308 Payables to third-party-medicare 5232340 Other liabilities 135238 54058886 X Part V, Line 4: 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, 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 397007 397007 0.00340 71194230 66602411 4591819 0.03920 71591237 66602411 4988826 0.04260 423222 423222 0.00360 708287 708287 0.00610 12211993 6211849 6000144 0.05130 26000 26000 0.00020 13369502 6211849 7157653 0.06120 84960739 72814260 12146479 0.10380 4000 4000 0.00000 4000 4000 0.00000 1 279726 158174 7685923 7528730 157193 X 1 1 1 1 Adventist Health Delano 1401 Garces Hwy Delano CA 93215 https://www.adventisthealth.org/delano 120000180 X X X Adventist Health Delano 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X See Sch H Part VI - Needs Assesment X See Sch H Part VI - Needs Assesment X 1 22 1 See Sch H Part VI - Needs Assesment 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X Sch H Part VI-Patient Educ X X X X X X 1 X 0 X X X X 1 X 0 0 Adventist Health Delano Part V, Section B, Line 5: The 2022 CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations - the voices of those with chronic disease, low incomes, and the underserved - were heard.Agricultural workers, civic government, community-based healthcare workers focusing on behavioral health, children, domestic abuse, early education, education, families, formerly incarcerated, higher education, law enforcement, low-income, medically underserved, men, minority populations, older adults, providers, public health, students, unhoused and women populations were represented in twelve focus groups where 78 people participated and 16 individual key informant interviews were held.The 2022 Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS Survey data was gathered from the Central Valley region (region name defined by survey administrator, UC Berkeley IGS). Adventist Health Delano Part V, Section B, Line 6b: Organizations that participated in the 2022 CHNA included: Alliance Against Family Violence, American Indian Health Project, Bakersfield College, Bakersfield Homeless Shelter, Bakersfield Police Department, Bakersfield Women's Homeless Shelter, City of Tehachapi, City Serve, Community Action Partnership of Kern, Delano Union School District, First Five Kern, Garden Pathways, Kern Behavioral Health & Recovery Services, Kern County Children's Dental Health Network, Kern County Department of Public Health, Kern County Hispanic Chamber of Commerce, Kern County Housing Authority, Kern County Network for Children, Kern Family Health Care, Kern Medical, National Association for the Advancement of Colored People, Transitional Youth Mobilizing for Change, and United Farm Workers Foundation Kern County. Adventist Health Delano Part V, Section B, Line 11: Tax year 2024 was Year Two of the Implementation Strategy for the 2022 Community Health Needs Assessment (CHNA). Programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care; Financial Stability and Health Conditions.Priority Need One: Access to Health CareThe goal is to advocate and collaborate with internal and external partners to identify community members experiencing burdens with respect to obtaining access to care through partnerships and referrals among internal and external partners. In 2024, Adventist Health Delano (AHDL) in collaboration with numerous local community partners and organizations, actively engaged in key initiatives to promote wellness education and expand access to healthcare services for medically underserved populations in the Delano and McFarland communities. Through these efforts, our Hospital enhanced awareness of its financial assistance programs, offering both free and discounted care in alignment with the Hospital's financial assistance policy. The organization also facilitated referrals to essential health services tailored to community needs. Throughout the year, AHDL played a vital role in several communitywide collaboratives, including the Delano Community Alliance. These partnerships enabled the delivery of health education, increased awareness of available services, and streamlined referral pathways to care. As part of its preventative wellness strategy, our Hospital partnered with local school districts to provide free flu vaccinations ahead of the 2024 flu season. Additionally, the Hospital collaborated with local organizations to share resources and support the overall health and well-being of the community. Priority Need Two: Financial StabilityThe goal is to advocate for and collaborate with internal and external partners to connect community members to resources that improve financial literacy, lessen financial burden, and/or promote economic development. This will be reached by creating a school-to-work pipeline for healthcare careers, focusing on high school and college students. A multidisciplinary committee includes vocational and nursing college leadership, industry partners, and interested parties who may assist in underwriting the work. In 2024, AHDL continued its strong partnerships with local public and private educational institutions to provide clinical placements for nursing and allied health students. By offering accessible, local clinical training opportunities, AHDL helped students advance their educational goals while reducing barriers to completion. Over the course of the year, AHDL served as a clinical training hub for more than 200 students pursuing careers in nursing and other health-related fields. Additionally, AHDL strengthened its collaboration with the COPE Health Scholars program to further develop a school-to-career pipeline for local high school and college students interested in healthcare professions. Through this program, students gained hands-on experience in a hospital setting, offering them direct exposure to healthcare environments and career pathways. In 2024, more than 22 local students participated in the COPE Scholar program, contributing to the growth of a skilled and locally rooted healthcare workforce. Priority Need Three: Health ConditionsThe goal is to reduce health conditions through education and support services in the community by providing opportunities for educational resources and support to reduce common health conditions related to social determinants and/or family health history. Partnered with Kern County Public Health on health promotion programs in North Kern areas including but not limited to: Know Your Numbers, Grounded in Health, and cooking demonstrations. In addition, AHDL will utilize the Delano Community Garden as a resource to provide local families access to fresh produce, while expanding educational programing around wellbeing and healthy eating. In 2024, AHDL deepened its partnerships with local community-based organizations to address chronic disease prevention and promote wellness education. Our Hospital hosted a bi-monthly series of six workshops at the Delano Senior Center, focusing on key health topics such as services, mobility, nutrition, and diabetes management. To further support participants, the Hospital collaborated with the Community Action Partnership of Kern County and local churches to distribute nutritious food boxes to attendees. AHDL also took significant steps to combat food insecurity in the community. By implementing food insecurity screenings at key intake points including the emergency department and local health clinics our Hospital connected individuals with vital resources and information on local food access. These efforts aimed to raise public awareness, reduce food waste, and promote participation in public assistance programs such as WIC, SNAP, CalFresh, and the reduced-price school lunch program. In support of the unhoused population, AHDL provided 5,200 warm meals to a local homeless navigation center, offering nourishment and dignity to unsheltered community members. For over a decade, our Hospital has also supported a community garden located on hospital-owned land, providing administrative oversight, water, and maintenance. In 2024, AHDL partnered with Bakersfield College and Free Meals on Wheels to offer cooking classes to approximately 50 families who maintain garden plots. These families also receive seedlings and gardening education to encourage seasonal planting. The produce grown in the garden directly supports participating families, helping alleviate food insecurity and promote self-sufficiency. Significant needs not met:No hospital can address all the health needs identified in its community. AHDL 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, food security, environment & infrastructure, inclusion & equity, COVID-19, 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. Adventist Health Delano 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. 3 1 - AH Delano Prompt Care - RHC 1201 Jefferson Street Delano CA 93215 Rural health clinic 2 - AH Delano - RHC 1201 Jefferson Street Delano CA 93215 Rural health clinic 3 - AH Wasco Plaza - RHC 2300 7th Street Wasco CA 93280 Rural health clinic Part I, Line 7: The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient 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 California's regulations and policies and the approval of the federal government. Part I, Line 7, Column (f): The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 79,715. Part II, Community Building Activities: The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. 2024 saw continued transformation of our six community Blue Zones Projects through policy initiatives around built environment, tobacco use and food. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease. Part III, Line 2: Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2. Part III, Line 3: The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt. Part III, Line 4: The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense. Part III, Line 8: The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B. Part III, Line 9b: When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income, and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest Part VI, Line 2: Adventist Health Delano (AHDL) 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, Tax Year 2024 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/delano/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: 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.pdf At the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital's billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance. Part VI, Line 4: The greater Delano area is recognized as one of the largest grape-growing regions in the Nation, yet the unique community with a total population of 402,651 in the area offers more: it's a youthful community, with 72% of the population being younger than 44 as well as diverse with Hispanics representing 75.91% of the population. Among this population, 33.82% of children live in poverty, and 3.23% of students are unhoused, compared to the state average of 4.25% and a national average of 2.77%. While residents spend 55.97% of their income on housing and transportation, on average, Delano offers families many opportunities to play and learn together, including activities like fishing and boating at Lake Woollomes and attending a variety of academy classes like college prep and language courses.The following zip codes represent AHDL's primary service area (PSA), accounting for 75% of hospital discharges. Additionally, we took a collaborative approach and expanded our PSA by inviting Steering Committee members to include the zip codes of those they serve. The AHDL CHNA market has a total population of 402,651 (based on the 2020 Decennial Census). The largest city in the service area is Tulare, with a population of 59,312. The service area is comprised of the following zip codes: 93263, 93256, 93250, 93261, 93280, 93249, 93304, 93305, 93270, 93201, 93215, 93274, 93307, 93219. Of the population, 51.05% own their homes and 48.95% of the population are renters. Delano has an enormous shortage of primary care providers compared to the rest of Kern County, California, and the Nation. Approximately 62.47% of the total Delano population lives in a Health Profession Shortage Area (HPSA) compared to 22.5% nationwide. The majority of the population not being able to access primary care readily increases the risk for serious, costly and recurrent health problems. Delano also has fewer Intensive Care Unit hospital beds than the rest of California and the Nation and a slightly higher rate of uninsured population (9.95%) than the rest of California (7.23%) and the Nation (8.73%). In addition, 15.2% of the uninsured are between ages 18 and 64, which is also higher than state and national averages. Multiple barriers to care accessibility at the individual level are evident. Only 40.42% of the population live within half a mile of public transportation, which is well below the statewide average. Over 38% of the population aged 25 and above do not have a high school diploma. In Delano, 33.82% of children aged 0-17 are living in poverty, an alarmingly higher percentage than in California and the rest of the United States (17.48%). Poverty is impacting some populations children at higher rates, with 53.41% of African American children and 8.749% of Native Hawaiian or Pacific Islander children in Delano living in poverty. This can contribute to generational health and well-being challenges. The median household income of $38,237 in Delano is only around half of the California median and around $25,000 below the United States average, which is an enormous difference. Over a third of the population has debt in collections, and 44% spend more than 30% of their income on housing. Approximately 37.28% of Delano's adult population meets the medical criteria for obesity, which is 10% higher than the state average and 6% higher than the national average. Delano also had a higher heart disease mortality rate than California and the Nation by a substantial degree, with 3,373 persons dying of heart disease between 2016 and 2020. Delano's lung disease death rate is also higher in California and the United States. Similarly, liver disease death rates are higher in Delano than in California and the Nation to a significant degree. 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 CA Part VI: Other Information: Inspiring health, wholeness and hope in the communities we serve requires that we provide services that allow everyone to reach their optimal health. Ensuring that everyone in our communities has that opportunity is the definition of health equity. Adventist Health is committing the time and effort to ensuring health equity in all of our markets. A Health Equity Committee has been formed with champions from every market. "We are especially sensitive to addressing health equity gaps for the underserved, frail, elderly, and minority populations," says Raul Ayala, MD, MHCM, Adventist Health Ambulatory Medical Officer, Central Valley Network family practitioner, and leader of our Health Equity Committee. "We are assessing the gaps in care for these populations and finding ways to close those gaps. The Health Equity Committee is looking at the programs we currently have that successfully meet the needs of underserved groups and are figuring out how we can duplicate these efforts in other markets. Programs such as our technological language support, mobile clinics, ACO nurse navigators, Community Connect, community health workers, and our substance abuse navigators. We know we must also create more access to care and enhance the patient/customer experience." In 2024, screenings for social determinants of health at our Hospital reached 88.3% which included screenings for housing instability, food insecurity, utility difficulties and transportation needs. This robust data enabled our Hospital to identify key areas of concern and strategically develop and refine programs to better support our community's health. 1 California Health Fund & Trust 1215 K Street Suite 800 Sacramento CA 95814 941498697 501(c)(3) 2673782 0 Health services un/underinsured patients 1 0 Part I, Line 2: Grants are made to public charities. No formal monitoring of the grants is completed. X X X X 1 1 0 0 0 0 0 0 0 Heinrich Kerry Dir/Chair/CEO 0 2342000 0 1586113 0 46082 0 13296 0 44679 0 4032170 0 0 Hofheins Todd Dir/Vice Chair/COO 0 1474000 0 888115 0 45560 0 13296 0 52696 0 2473667 0 0 Beaman John CFO/Assistant Secretary 0 1261000 0 698818 0 21043 0 13296 0 66512 0 2060669 0 0 Stevens Eric - Former Care Division Operations Exec thru 02/22 0 1196000 0 495682 0 194464 0 13296 0 44679 0 1944121 0 0 Nahapetian Arby - Former Care Division Medical Officer thru 02/22 0 1111000 0 458435 0 189823 0 13296 0 66512 0 1839066 0 0 Wells Jason Pres, AHDL/Pres, Central CA Network 0 968000 0 423321 0 151735 0 13296 0 66512 0 1622864 0 0 Jobe Meredith Secretary 0 796100 0 281132 0 143872 0 13296 0 44679 0 1279079 0 0 Jamaleddine Ghassan Medical Officer as of 07/24 0 632373 0 184644 0 65371 0 13296 0 66512 0 962196 0 0 Ayala Raul - Ambulatory Medical Officer, Cent CA Network 0 602279 0 159029 0 59246 0 13296 0 22841 0 856691 0 0 Haydock Timothy - Int Treas Ops Exec, Cent CA Ntwrk as of 07/24 0 492108 0 178559 0 56651 0 13296 0 66512 0 807126 0 0 Cox Shane - Finance Operations Exec, Cent CA Network thru 12/24 0 517317 0 150937 0 71378 0 13296 0 43536 0 796464 0 0 Wolcott Daniel - Former Pres AHDL Pres, Kern County Network thru 01/23 0 0 0 0 0 704271 0 0 0 65778 0 770049 0 0 Jahn Andrew - Former Care Division President thru 02/22 0 281190 0 407001 0 5026 0 55610 0 3801 0 752628 0 0 Lavers Jennifer Operations Executive 0 463068 0 102341 0 49249 0 13296 0 66512 0 694466 0 0 Reyna Sonja Ambulatory Executive 0 287169 0 176766 0 164851 0 13296 0 27511 0 669593 0 0 Van Housen Heather Patient Care Executive 0 429414 0 113214 0 47097 0 13296 0 49707 0 652728 0 0 Cantrell Misty - Former Chief Nursing Officer thru 05/21 0 348988 0 123428 0 76424 0 13296 0 66391 0 628527 0 0 Tomono Olga - Business Development Executive as of 11/24 0 395901 0 93831 0 31812 0 13296 0 890 0 535730 0 0 Tomono Christopher Partnership Executive 0 323323 0 88917 0 36221 0 13296 0 66340 0 528097 0 0 Hutcheson Walter - Frmr Treas Asst Secr/Fin Officer thru 10/21 0 256638 0 62944 0 26114 0 12832 0 66186 0 424714 0 0 Longo James Compliance Officer/IS Director 0 0 0 0 0 341740 0 0 0 43946 0 385686 0 0 Orozco-Robles Maritza Nurse Practitioner 209654 0 50626 0 1802 0 10483 0 33900 0 306465 0 0 0 Monrian Terrence Supervisor, Pharmacy 254373 0 4588 0 10076 0 12719 0 11067 0 292823 0 0 0 Fernandez Reena RN, House Supervisor 241241 0 2835 0 0 0 12064 0 33854 0 289994 0 0 0 Wing Bill - Former Dir Asst Secr/Vice Chair thru 01/22 0 0 0 0 0 273263 0 0 0 0 0 273263 0 0 Agbayani Noha RN, House Supervisor 233770 0 300 0 4259 0 11688 0 2094 0 252111 0 0 0 Lee Mee Young Pharmacist 217848 0 3916 0 6870 0 10892 0 11065 0 250591 0 0 0 Part I, Lines 4a-b Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Jahn, Andrew - severance payment - $15,065 Longo, James - severance payment - $342,000 Reyna, Sonja - severance payment - $127,631 Wing, Bill - severance payment - $271,535 Wolcott, Daniel - severance payment - $708,700 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Jack Wagner, Jason Wells, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an 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. Jahn, Andrew - participant, no activity in 2024 Form 990, Part III, Line 4a: Adventist Health Delano (AHDL) provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. AHDL 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. Over the course of half a century, AHDL has expanded in size and technical sophistication. Located in the second-largest city in Kern County, the cultural variety of the rural areas the Hospital serves infuses our daily lives with passion and vigor. AHDL has always been devoted to providing an extraordinary patient experience to the central California rural towns it serves. Although reimbursement for services rendered is critical to the operation and stability of AHDL, 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 AHDL 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. AHDL 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 $397,007. The following Inpatient services were provided to all our patients: - 43,376 clinic visits - 585 deliveries - 2,565 discharges - 29,017 emergency room visits - 236 inpatient surgeries - 53,515 outpatient hospital visits - 763 outpatient surgeries - 23,573 patient days AHDL 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 $6,000,144. AHDL's quality and performance awards include: Five-Star performance in hospital cleanliness by the Centers for Medicare and Medicaid Services. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Form 990, Part VI, Section A, line 7a The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors. Form 990, Part VI, Section A, line 7b The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members. Form 990, Part VI, Section B, line 11b This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing. Form 990, Part VI, Section B, line 12c During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System Chief Legal Officer/General Counsel immediately. The System Chief Legal Officer/General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System Chief Legal Officer/General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System Chief Legal Officer/General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board. Form 990, Part VI, Section B, line 15 The Adventist Health Board of Directors has established an Executive Compensation Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 40 percent spread from minimum to maximum. Form 990, Part VI, Section C, line 19 The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency. Form 990, Part VII: 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 8,442,546. Management and general expenses 881,558. Fundraising expenses 0. Total expenses 9,324,104. Contract labor: Program service expenses 1,339,926. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,339,926. Other purchased services: Program service expenses 815,260. Management and general expenses 350,996. Fundraising expenses 0. Total expenses 1,166,256. Purchased medical services: Program service expenses 2,419,978. Management and general expenses 46,315. Fundraising expenses 0. Total expenses 2,466,293. Repairs and maintenance: Program service expenses 1,556,383. Management and general expenses 542,766. Fundraising expenses 0. Total expenses 2,099,149. Consulting and other management fees: Program service expenses 27,057. Management and general expenses 115,915. Fundraising expenses 0. Total expenses 142,972. Other non-medical professional fees: Program service expenses 30,312. Management and general expenses 7,599. Fundraising expenses 0. Total expenses 37,911. Form 990, Part XI, Line 8: Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items. 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