Form990
Click to see attachment
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
A For the 2020 calendar year, or tax year beginning 01-01-2020 , and ending 12-31-2020
BCheck if applicable:
CName of organization
GARY AND MARY WEST HEALTH INSTITUTE
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
10350 NORTH TORREY PINES ROAD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LA JOLLA, CA92037
D Employer identification number

26-4146730
E Telephone number

G Gross receipts $ 22,500,002
F Name and address of principal officer:
SHELLEY LYFORD
10350 NORTH TORREY PINES ROAD
LA JOLLA,CA92037
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.WESTHEALTH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 2009
M State of legal domicile: DE
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: CONDUCTING MEDICAL RESEARCH WITH HOSPITALS TO REDUCE HEALTHCARE COSTS WITH A FOCUS ON SENIORS.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 3
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 3
5 Total number of individuals employed in calendar year 2020 (Part V, line 2a) ...... 5 22
6 Total number of volunteers (estimate if necessary) ............. 6 4
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 23,000,000 22,500,000
9 Program service revenue (Part VIII, line 2g) ......... 0 0
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 920 2
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 828 0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 23,001,748 22,500,002
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 19,280 51,820
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 5,578,561 4,690,470
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 18,533,484 18,720,671
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 24,131,325 23,462,961
19 Revenue less expenses. Subtract line 18 from line 12....... -1,129,577 -962,959
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 9,611,066 9,921,581
21 Total liabilities (Part X, line 26)............. 4,738,567 6,012,041
22 Net assets or fund balances. Subtract line 21 from line 20..... 4,872,499 3,909,540
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2020)
Form 990 (2020)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: CONDUCTING APPLIED MEDICAL AND SCIENTIFIC RESEARCH INTO ACTIONS TO LOWER HEALTHCARE COSTS AND IMPROVE HEALTHCARE DELIVERY AND SUCCESSFUL AGING FOR SENIOR AMERICAN CITIZENS AND LEGAL RESIDENTS. FURTHERMORE, TO LOWER THE COST OF HEALTHCARE AND ENABLE SENIORS TO SUCCESSFULLY AGE, LIVING LIFE ON THEIR OWN TERMS WITH ACCESS TO HIGH-QUALITY HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 16,705,214 including grants of $ 51,820 ) (Revenue $   )
IN 2020, THE GARY AND MARY WEST INSTITUTE (REFERRED TO BELOW VARIOUSLY AS WHI, WEST HEALTH INSTITUTE OR INSTITUTE) CONTINUED TO ACTIVELY CONDUCT APPLIED MEDICAL RESEARCH, IN CONJUNCTION WITH THE HOSPITALS LISTED ON SCHEDULE A, TO GENERATE THE EVIDENCE NEEDED FOR HEALTHCARE PROVIDERS, POLICYMAKERS AND COMMUNITIES TO ADOPT ADVANCING HEALTHCARE DELIVERY MODELS THAT IMPROVE CARE AND ACCESS, WHILE REDUCING COSTS, FOR THE NATION'S FAST-GROWING, DIVERSE POPULATION OF SENIORS. THESE MEDICAL RESEARCH EFFORTS DIRECTLY SUPPORTED WHI'S MISSION OF LOWERING THE COST OF HEALTHCARE AND ENABLING SENIORS TO SUCCESSFULLY AGE IN PLACE WITH ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE.OVER THE COURSE OF 2020, WHI PURSUED MEDICAL RESEARCH IN THE FOLLOWING KEY AREAS: 1. ADVANCING SENIOR-APPROPRIATE ACUTE CARE MODELS: THE INSTITUTE CONTINUES TO RESEARCH HOW PROVIDING SENIOR-FOCUSED CARE IN AN ACUTE SETTING, SUCH AS IN THE EMERGENCY DEPARTMENT, HOME AND COMMUNITY, CAN HELP SENIORS AGE SUCCESSFULLY AND AVOID THE FUNCTIONAL DECLINE THAT MAY OFTEN ACCOMPANY HOSPITALIZATION2. ADVANCING SENIOR-APPROPRIATE CHRONIC CARE MODELS: THE INSTITUTE CONTINUES TO RESEARCH HOW TO IMPROVE CARE FOR FRAIL, MEDICALLY COMPLEX SENIORS WHILE PRESERVING THEIR FUNCTION AND ALLOWING THEM TO REMAIN IN THEIR HOMES IN ACCORDANCE WITH THEIR WISHES. IN PARTICULAR, STUDYING THESE MODELS IN THE CONTEXT OF PACE (THE FEDERALLY-ESTABLISHED PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY) A WHOLE-PERSON, VALUE-BASED MODEL OF CARE, WAS AN AREA OF FOCUS.3. SENIOR-FRIENDLY TELEHEALTH MODELS: THE CORONAVIRUS PANDEMIC IN 2020 WAS A TIPPING POINT YEAR FOR TELEHEALTH, AND THE INSTITUTE CONDUCTED AND DEMONSTRATED SEVERAL RESEARCH EFFORTS TO DETERMINE HOW TELEHEALTH, DONE CORRECTLY, CAN ENABLE BETTER CARE EXPERIENCE AND OUTCOMES FOR SENIORS, BOTH DURING A PANDEMIC AND IN MORE NORMAL TIMES.4. ADDITIONAL AREAS: OTHER RESEARCH PROJECTS PURSUED WITH HOSPITAL AND HEALTHCARE COLLABORATORS FOCUSED ON ORAL HEALTH FOR SENIORS AND UNDERSTANDING THE IMPACT AND RISK FACTORS ASSOCIATED WITH COVID-19. THESE RESEARCH PROGRAMS ARE DESCRIBED IN FURTHER DETAIL BELOW.SENIOR-APPROPRIATE ACUTE CARE IN 2020, THE INSTITUTE CONTINUED AND EXPANDED ITS RESEARCH ACTIVITIES WITH HOSPITALS, HEALTHCARE SYSTEMS, AND OTHER KEY STAKEHOLDERS TO ADDRESS BETTER RESPONSES TO UNPLANNED ACUTE CARE OF SENIOR AMERICANS. UNPLANNED ACUTE CARE FUNDAMENTALLY DRIVES THE MAJORITY OF COST FOR VULNERABLE SENIORS AND RESULTS IN DEBILITATION AND FUNCTIONAL DECLINE AFTER INPATIENT HOSPITAL STAYS. TO ADDRESS THESE FACTORS, THE INSTITUTE CONDUCTED RESEARCH EFFORTS TO IDENTIFY MORE PROACTIVE AND OPPORTUNISTIC CARE THAT IS DELIVERED IN PLACE, WHENEVER POSSIBLE, AND TO ADVANCE HOME AND COMMUNITY-BASED ACUTE CARE ALTERNATIVES. THE RESEARCH OBJECTIVES WERE TO CONTINUE ADVANCING INNOVATIVE, PERSON-CENTERED, SCALABLE, AND SUSTAINABLE MODELS FOR ACUTE CARE OF SENIORS IN THE HOSPITAL EMERGENCY DEPARTMENT, HOME AND COMMUNITY.RESEARCH PROJECTS:GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC)THE INSTITUTE HAS FORMED, WITH MAJOR HEALTH SYSTEMS INCLUDING UNIVERSITY OF NORTH CAROLINA AND MOUNT SINAI IN NEW YORK, THE GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC), WHICH NOW INCLUDES EXPERT GERIATRIC EMERGENCY DEPARTMENT (GED) CLINICIANS FROM OVER 40 MEMBER EDS/HEALTH SYSTEMS TO PROVIDE RESEARCH, EDUCATION, AND TRAINING FOR OTHER HEALTHCARE PROVIDERS. GEDC MEMBERS' IMPLEMENTATION RESEARCH HAS ALSO PROVIDED EARLY EVIDENCE THAT GED GUIDELINE-BASED CARE IMPROVES PATIENT OUTCOMES AND IS COST EFFECTIVE, DEMONSTRATING THE VALUE OF GEDS TO PATIENTS, HOSPITALS, PAYORS, AND THE PUBLIC AT-LARGE.IN DIRECT RESPONSE TO THE GLOBAL PANDEMIC, THE GEDC ADAPTED THEIR EDUCATIONAL AND TRAINING OFFERINGS TO A WEB-BASED PLATFORM TO ACCOMMODATE VIRTUAL AUDIENCES; CONVENED SUBJECT MATTER EXPERTS FOR MONTHLY WEBINARS; PUBLISHED AND DISSEMINATED BEST PRACTICES; DEVELOPED A COVID-19 TOOLKIT; AND ESTABLISHED AN ONLINE RESOURCE LIBRARY WHICH FEATURES THREE TOOLKITS ON IMPLEMENTING DISTINCT GED-SPECIFIC QUALITY IMPROVEMENT INITIATIVES (DEMENTIA, DELIRIUM, AND FALLS/MOBILITY) THAT WERE CO-DEVELOPED BY GEDC AND WHI. DESPITE THE ONGOING PUBLIC HEALTH CRISIS, THE GEDC FACILITATED 17 EDUCATIONAL AND TRAINING EVENTS IN 2020, REACHING OVER 1,600 PARTICIPANTS (CLINICIANS AND HOSPITAL ADMINISTRATORS) FROM 15 COUNTRIES. GEDC ALSO CONTINUED OFFERING ITS SIGNATURE GED BOOTCAMPS IN DURHAM, NC WHICH INCLUDED TEAMS FROM TEN DIFFERENT VETERAN AFFAIRS (VA) HOSPITALS FROM AROUND THE UNITED STATES IN FEBRUARY 2020 AS WELL AS VIRTUAL BOOTCAMP SESSIONS FOR SAN DIEGO COUNTY'S 18 EDS. THE GEDC AND WHI ALSO JOINTLY LAUNCHED A HEALTHCARE SYSTEMS ROUNDTABLE TO LEVERAGE INSIGHTS FROM EIGHT ALREADY ACCREDITED HEALTH SYSTEMS (REPRESENTING 126 EDS) TO DEVELOP IMPLEMENTATION RESOURCES (E.G., GUIDE, TOOLKITS) FOR PROSPECTIVE HEALTH SYSTEMS WANTING TO BECOME ACCREDITED.ADDITIONALLY, GEDC RESEARCHERS DEMONSTRATED THAT A GED NURSE INTERVENTION WAS ASSOCIATED WITH REDUCED RISK OF HOSPITAL ADMISSION AT BOTH INITIAL ED VISIT AND 30 DAYS POST-ENCOUNTER AND THAT A GED PROGRAM INCLUDING SPECIALIZED NURSE OR SOCIAL WORKER CONSULTATION WAS ASSOCIATED WITH SIGNIFICANT REDUCTIONS IN READMISSIONS AND IN TOTAL MEDICARE EXPENDITURES AT 30- AND 60-DAYS POST-ED VISITS. S. THESE RESULTS WERE PRESENTED AT NATIONAL CONFERENCES AND PUBLISHED IN SCIENTIFIC JOURNALS.THE GEDC HAS EXTENDED THE PILOT PHASE OF THE NATIONAL RESEARCH DATA WAREHOUSE TO ENCOMPASS HOSPITAL AND PATIENT-LEVEL DATA FOR OVER 280,000 UNIQUE ED ENCOUNTERS ACROSS 12 EMERGENCY DEPARTMENTS, WITH DATA TRANSFER PENDING FROM TWO MORE SITES. WHI IS SEEKING DATA FROM AN ADDITIONAL 20 EDS IN 2021 AND WILL EXPAND UPON PRELIMINARY ANALYSES SUMMARIZING PATIENT DEMOGRAPHICS AND KEY ENCOUNTER AND DIAGNOSES INFORMATION. GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION (GEDA) PROGRAMIN 2018, THE INSTITUTE COMMENCED AN EFFORT WITH THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS TO ADVANCE THE GEDA PROGRAM, WHICH EXCEEDED ITS PRIMARY GOAL TO ACCREDIT AN ADDITIONAL 135 EDS IN 2020 DESPITE THE EFFECTS OF OF COVID-19. BY THE END OF 2020, OVER 200 EDS WERE FULLY ACCREDITED AND THERE ARE NOW GEDS IN OVER 170 CITIES AND TOWNS ACROSS 36 STATES. IN 2020, APPROXIMATELY 2.2 MILLION (OR APPROXIMATELY ONE IN TEN) OLDER ADULT ED VISITS IN THE US WERE MADE AT A HOSPITAL WITH AN ACCREDITED GED. DEMONSTRATING INTEREST FROM HEALTH SYSTEMS IN ACCREDITATION, 24 HEALTH SYSTEMS HAD MULTIPLE EDS APPLY FOR ACCREDITATION IN 2020, INCLUDING THE VETERANS HEALTH ADMINISTRATION (VHA) SYSTEM AND SHARP HEALTHCARE AND SCRIPPS HEALTH AS PART OF THE SAN DIEGO COUNTY SENIOR EMERGENCY CARE INITIATIVE. WHI, THE JOHN A. HARTFORD FOUNDATION AND THE AMERICAN COLLEGE OF EMERGENCY PHYSICIANS ARE SEEKING TO EXPAND THE GEDA PROGRAM THROUGH A HEALTH SYSTEMS APPROACH.SAN DIEGO COUNTY GERIATRIC EMERGENCY CARE INITIATIVETHE INSTITUTE, BASED IN SAN DIEGO COUNTY, CALIFORNIA, IS SEEKING TO HAVE 18 HOSPITALS IN SAN DIEGO COUNTY CERTIFIED AS GEDS THUS RENDERING THE COUNTY THE FIRST IN THE NATION TO HAVE ALL OF ITS EMERGENCY DEPARTMENTS ACCREDITED AS SENIOR-FRIENDLY. THE INSTITUTE, TOGETHER WITH THE GEDC AND UNIVERSITY OF CALIFORNIA SAN DIEGO, CONDUCTED A VIRTUAL TRAINING SESSION AND TWO QUALITY IMPROVEMENT IMPLEMENTATION WEBINARS FOR THE SAN DIEGO COUNTY EDS. SO FAR, TEN SITES HAVE BEEN ACCREDITED BY ACEP AND THE REMAINING EIGHT APPLICATIONS ARE UNDER REVIEW. WHI SEEKS TO TAKE THE LEARNING FROM THE SAN DIEGO COUNTY GED INITIATIVE TO COMMENCE SIMILAR EFFORTS THROUGHOUT CALIFORNIA.DARTMOUTH-HITCHCOCK EXPANSION OF GEDS TO RURAL AREAS (VIA TELEHEALTH)WHI PURSUED RESEARCH WITH THE DARTMOUTH-HITCHCOCK (D-H) HEALTH SYSTEM TO CREATE AND EVALUATE A NOVEL RURAL HUB-AND-SPOKE TELEHEALTH MODEL AND TRAINING SESSIONS. D-H HAS IMPLEMENTED NEW AND REVISED GERIATRIC ED WORKFLOWS AND PROTOCOLS, CONDUCTED THEIR FIRST GED PATIENT CONSULTATION, AND APPLIED FOR ED ACCREDITATION. VETERANS HEALTH ADMINISTRATION (VHA) GERIATRIC EMERGENCY DEPARTMENT SCALE AND SPREADTHE INSTITUTE WORKED TO IMPLEMENT AND SCALE GEDS THROUGHOUT HOSPITALS IN THE ENTIRE VHA SYSTEM. IN 2020, THE INSTITUTE SUPPORTED TRAINING, QUALITY IMPROVEMENT AND ACCREDITATION ACTIVITIES FOR 20 EDS (18% OF ALL VHA EDS). AS OF DECEMBER 2020, 17 EDS HAD APPLIED FOR ACCREDITATION AND THREE SITES ANTICIPATE APPLYING IN EARLY 2021. WHI SEEKS TO INCLUDE THE MAJORITY OF EDS IN THE VHA HEALTH SYSTEM IN ITS ACCREDITATION EFFORTS, WITH AN ULTIMATE GOAL OF ESTABLISHING A NATIONAL GED OFFICE WITHIN THE VHA.
4b (Code:   ) (Expenses $ 311,673 including grants of $   ) (Revenue $   )
THE RISING COST OF HEALTHCARE IS A GROWING ECONOMIC AND PUBLIC HEALTH CRISIS THAT HURTS THE U.S. ECONOMY, THREATENS INDIVIDUAL FINANCIAL SECURITY, COMPROMISES CARE, AND REDUCES PATIENT ACCESS. THE COVID-19 PANDEMIC LAID BARE VULNERABILITIES IN OUR HEALTHCARE PAYMENT SYSTEM, SHINING LIGHT ON THE NEED TO LOWER COSTS AND IMPROVE ACCESS TO NEEDED CARE. IT IS ESSENTIAL TO NOTE THAT MANY ERRONEOUSLY ASSUME THAT DUE TO MEDICARE, OLDER ADULTS ARE INSULATED FROM THE TOXIC EFFECTS OF HIGH HEALTHCARE COSTS, BUT THE TRUTH IS THAT MANY SENIORS ARE HARD-HIT BY THE OUT-OF-POCKET BURDEN OF BOTH DRUG AND OTHER HEALTH COSTS. RAISE AWARENESS OF SPENDING CRISIS AND URGENCYTO FOCUS THE ATTENTION OF POLICYMAKERS, ADMINISTRATORS, THE BUSINESS COMMUNITY, AND THE GENERAL PUBLIC ON THE HEALTHCARE CRISIS, THE GARY AND MARY WEST HEALTH INSTITUTE (WHI OR WEST HEALTH INSTITUTE), IN CONJUNCTION WITH THE WEST HEALTH POLICY CENTER (WHPC), RELEASED SEVEN HIGHLY SUCCESSFUL NATIONAL POLLS IN PARTNERSHIP WITH GALLUP. THESE POLLS EXPOSED THE REALITY THAT AMERICANS' CONCERNS ABOUT THE COST OF CARE HAVE ONLY INCREASED AS A RESULT OF THE PANDEMIC. MOREOVER, NEARLY NINE IN TEN U.S. ADULTS ARE CONCERNED THAT THE PHARMACEUTICAL INDUSTRY WILL LEVERAGE THE COVID-19 PANDEMIC TO RAISE DRUG PRICES. ADDITIONAL PUBLIC AWARENESS ACTIVITIES IN 2020 INCLUDED A NATIONAL WEBINAR ON "WHY AMERICANS ARE SO WORRIED ABOUT RISING HEALTHCARE COSTS AND WHAT CAN BE DONE ABOUT IT" IN PARTNERSHIP WITH GALLUP, AS WELL AS A MEDIA FELLOWSHIP FOR JOURNALISTS COVERING THE HEALTH COST CRISIS. DEVELOP ACTIONABLE POLICIES TO LOWER DRUG COSTSSTRATEGIES TO REDUCE THE RISING COST OF PHARMACEUTICALS WERE A KEY COMPONENT OF WORK TO LOWER HEALTHCARE SPENDING. IN PARTICULAR, DEMONSTRATING PUBLIC SUPPORT FOR AND A POLICY STRATEGY TO EMPOWER CMS (THE SINGLE LARGEST PURCHASER OF HEALTHCARE IN THE US) TO NEGOTIATE DRUG PRICES FOR MEDICARE IS A KEY PRIORITY. THE AMERICAN BUSINESS COMMUNITY IS A KEY STAKEHOLDER THAT IS IMPORTANT IN ADDING MOMENTUM TO DRIVING LOWER DRUG PRICES. AS SUCH, WHI HAS CONTINUED WORK WITH BUSINESS GROUPS ON DRUG COST ISSUES, INCLUDING BUILDING A COALITION OF BOTH LARGE AND SMALL COMPANIES THAT ARE SHARING THE BURDEN PLACED ON BOTH EMPLOYERS AND EMPLOYEES BY HIGH HEALTH CARE AND DRUG COSTS. DEVELOP ACTIONABLE POLICIES TO REDUCE VOLUME INCENTIVES IN FEE-FOR-SERVICEVALUE-BASED CARE (VBC)WHICH INCORPORATES RISK FOR BOTH HEALTH AND SPENDING OUTCOMES INTO PAYMENT RATESHAS THE POTENTIAL TO REDUCE MANY OF THE VOLUME-BASED FINANCIAL INCENTIVES THAT ARE DRIVING UP PER-CAPITA HEALTHCARE COSTS. A PARTNERSHIP CONSISTING OF THE INSTITUTE, THE WEST HEALTH POLICY CENTER, AND THE DUKE-MARGOLIS CENTER FOR HEALTH POLICY HAS RELEASED NATIONAL AND STATE ROADMAPS IN 2020 WITH RECOMMENDATIONS FOR POLICYMAKERS ON WAYS TO ACCELERATE THE ADOPTION OF VBC PAYMENT MODELS. THIS WORK INFORMED THE DESIGN AND LAUNCH OF A THREE-YEAR COLLABORATION WITH THE DUKE-MARGOLIS TEAM TO TURN THESE POLICY RECOMMENDATIONS INTO ON-THE-GROUND ACTIONPRODUCING A HIGH-PROFILE WEBINAR IN 2020 TO EXAMINE THE ADVANTAGES THAT VBC OFFERS IN THE COVID-19 ENVIRONMENT, SPOTLIGHTING THE GARY AND MARY WEST PACE. COST OF CARE - PREPARING FOR OPPORTUNITIES TO EFFECT CHANGE:THE CONFLUENCE OF AN ELECTION YEAR COMING DURING A PERIOD WHEN HEALTH CARE HAS (RE)EMERGED AS ONE OF THE TOP ISSUES IN PUBLIC, SOCIAL, ECONOMIC, AND POLITICAL DISCOURSE HAS PRESENTED AN IMPORTANT OPPORTUNITY FOR WHI TO LEVERAGE ITS UNIQUE STRUCTURE OF HAVING BOTH MEDICAL RESEARCH AND POLICY EXPERTISE TO CATALYZE CHANGE FOR HEALTH COSTS AT A NATIONAL LEVEL AT WHAT IS POTENTIALLY A WATERSHED MOMENT FOR THE COST OF CARE. BEGINNING IN MID-2020, THE INSTITUTE, IN CLOSE COORDINATION WITH THE WEST HEALTH POLICY CENTER, ADVANCED A NUMBER OF COORDINATED WORKSTREAMS DESIGNED TO LEVERAGE WEST HEALTH INSTITUTE'S EXPERTISE AND RESOURCES TO PROVIDE POLICYMAKERS WITH THE TECHNICAL INFORMATION AND PUBLIC OPINION POLLING NECESSARY TO PRIORITIZE LOWERING THE COST OF CARE. THESE WORKSTREAMS ARE FOCUSED NOT ONLY ON NEAR-TERM ACTIVITIES SURROUNDING THE 2020 ELECTIONS AND THE INITIAL WORK OF THE EXECUTIVE AND LEGISLATIVE BRANCHES BUT ALSO CONTEMPLATE MID-TERM (2022) ELECTIONS AND THE IMPORTANT WORK TO BE DONE OVER THE NEXT SEVERAL YEARS. DRIVE INSIGHTS THAT EMPOWER LIKE-MINDED STAKEHOLDERS GARY AND MARY WEST HEALTH INSTITUTE IS NOT ALONE IN ITS MISSION TO REDUCE THE COST OF HEALTH CARE AT BOTH AN INDIVIDUAL AND SOCIETAL LEVEL. IN ORDER TO BUILD MOMENTUM DURING THIS CRITICAL PERIOD, WHI HAS SUPPORTED SEVERAL INITIATIVES DESIGNED TO PROVIDE OTHER LIKE-MINDED CO-TRAVELERS INCLUDING CURRENT/FUTURE LEGISLATIVE AND ADMINISTRATIVE POLICYMAKERS AND REGULATORS WITH NEW INFORMATION AND INSIGHTS THAT CAN BE USED TO DETERMINE OPTIMAL PATHS FORWARD IN PRESSING FOR HEALTHCARE COST REFORM. TO THIS END WHI ENGAGED A SELECT GROUP OF INDIVIDUALS AND ORGANIZATIONS TO ASSIST WITH A NUMBER OF ACTIVITIES INCLUDING: *STATE-LEVEL SURVEYS FOR 2020 AND 2022 RACES ON HEALTHCARE PRIORITIES IN VOTING *OFFENSIVE AND DEFENSIVE MESSAGE TESTING ON PUBLIC OPTION AND BROADER HEALTH COVERAGE REFORMS *POLLING ON PUBLIC EXPERIENCE AND SENTIMENT (ALSO USED GALLUP INC. FOR THIS WORK)THE IMPORTANT INSIGHTS DISTILLED FROM THE ABOVE ACTIVITIES HAVE BEEN PACKAGED AND USED FOR TARGETED DISSEMINATION OF KEY MESSAGES TO POLICY INFLUENCERS AND AS WELL AS TECHNICAL ASSISTANCE INCLUDING INVITATION-ONLY BRIEFINGS TO KEY STAKEHOLDERS. PERFORM RESEARCH TO SUPPORT EVIDENCE-BASED POLICYBE IT MODELING THE EXPECTED FINANCIAL IMPACT CHANGES TO POLICY, DEFINING THE EXACT CONTOURS OF AN ISSUE FOR WHICH A POLICY FIX IS NEEDED, OR ASSESSING FEASIBILITY OF A SUITE OF VARYING POLICY SCENARIOS, RESEARCH IS A CORNERSTONE OF SOUND POLICYMAKING. TO INFORM AND EMPOWER CURRENT AND NEAR-TERM FUTURE POLICIES THAT ARE (OR WILL LIKELY BE) "ON THE TABLE AND THAT ARE WITH THE GRAIN OF HEALTHCARE COST REDUCTION, OVER THE SECOND HALF OF THE 2020 WHI (AND WHPC) LEVERAGED THE RESEARCH EXPERTISE OF SEVERAL EXTERNAL PARTIES. KEY ACTIVITIES IN THIS WORKSTREAM HAVE INCLUDED: *MODELING KEY COMPONENTS OF PUBLIC OPTION AND MEDICARE ADVANTAGE IMPROVEMENTS *DEVELOPING CBO-STYLE SCORES AND PROCEDURAL MEMOS TO INFORM POLICYMAKERS *ASSESSING CAPITALIZED DRUG MANUFACTURING COSTS (TO COUNTER REBUTTALS FROM PHARMA THAT PRICE REDUCTIONS EQUATE TO REDUCED INNOVATION)SIMILAR TO OPINION POLLING INSIGHTS, OUR RESEARCH HAS BEEN DISTRIBUTED TO A NETWORK OF STAKEHOLDERS FOR WHOM HEALTH COST CONTAINMENT IS A FOCUS (OR PARTIAL FOCUS- OFTEN COST CONTAINMENT TRAVELS ALONG WITH HEALTH ACCESS ISSUES). BY INTENTION, MANY OF THE EXPERTS WE HAVE ENGAGED TO DO THIS WORK ARE THEMSELVES IMPORTANT CONDUITS TO POLICYMAKERS IN A POSITION TO USE THIS RESEARCH. AMPLIFY THE NATIONAL CONVERSATION ABOUT THE NEED TO ACT NOWLIKE OUR WORK AROUND RAISING AWARENESS OF THE SPENDING CRISIS BUT WITH A MORE TIME-LIMITED FOCUS, OVER THE LATTER HALF OF THE YEAR WHI ENGAGED IN EFFORTS TO INFORM BOTH THE PUBLIC AS WELL AS DECISIONMAKERS ABOUT THE NEED TO SEIZE CURRENT OPPORTUNITIES TO TAKE ACTION. WHI ADVANCED A NUMBER OF CAMPAIGNS DESIGNED TO CATALYZE ACTION AT BOTH THE STATE AND NATIONAL LEVEL. SOME NOTABLE EXAMPLES INCLUDED: *A DIGITAL MEDIA CAMPAIGN IN KEY STATES INCLUDING ARIZONA, COLORADO, GEORGIA, IOWA, MAINE, MONTANA, AND NORTH CAROLINA USING BOTH TWITTER (2.8 MILLION IMPRESSIONS) AND FACEBOOK (1.9 MILLION IMPRESSIONS) TO SHARE MESSAGES AROUND THE ISSUE OF HEATH COSTS AND THE NEED FOR CHANGE AT STATE AND FEDERAL LEVELS *A TELE-TOWN HALL FEATURING MICHIGAN GOVERNOR GRETCHEN WHITMER ON WHAT CAN BE DONE ABOUT THE DEVASTING IMPACTS OF INACCESSIBLE/COSTLY CARE. THIS EVENT HAD OVER 19,000 ACTIVE PARTICIPANTS *EXPLAINER ANIMATIONS ON THE HIGH COST OF DRUGS AND HEALTHCARE CONSOLIDATION *TELE-TOWN HALLS FEATURING CONSUMERS WITH COMPELLING STORIES RELATED TO THE HIGH COST OF PRESCRIPTION DRUGS (REACHING OVER 20,000 TARGETS)
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet17,016,887
Form 990 (2020)
Form 990 (2020)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment......................
12a
Yes
 
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
 
No
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part IIClick to see attachment...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
38
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2020)
Form 990 (2020)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
22
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
 
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
 
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
Form 990 (2020)
Form 990 (2020)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
3
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
3
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
 
No
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
CA , DE
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletSALLY HALLAK10350 N TORREY PINES ROAD   LA JOLLA,CA92037 (858) 535-7000
Form 990 (2020)
Form 990 (2020)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) CHARLES SEDERSTROM......................................................................
DIRECTOR
 5.00
.................
1.00 		X           0 0 0
(2) GARY L WEST......................................................................
DIRECTOR, CHAIRMAN
 15.00
.................
12.00 		X           0 0 0
(3) MARK MCCLELLAN......................................................................
DIRECTOR
 10.00
.................
5.00 		X           0 0 0
(4) NICHOLAS VALERIANI......................................................................
DIRECTOR
 15.00
.................
5.00 		X           0 0 0
(5) SALLY HALLAK......................................................................
VP OF F&C/SECRETARY AND TREASURER
 40.00
.................
15.00 		    X       0 247,662 23,606
(6) SHELLEY M LYFORD......................................................................
PRESIDENT & CEO
 30.00
.................
35.00 		    X       720,385 238,338 31,794
(7) SIOBHAN GRAHAM......................................................................
VP, OPERATIONS & HR
 50.00
.................
  		    X       0 237,262 24,207
(8) TIMOTHY LASH......................................................................
EVP AND CHIEF STRATEGY OFFICER
 30.00
.................
35.00 		    X       622,632 150,542 48,520
(9) ZIA AGHA......................................................................
CHIEF MEDICAL OFFICER & EVP
 40.00
.................
8.00 		    X       672,259 42,708 52,978
(10) JONATHAN ZIFFERBLATT......................................................................
EVP, STRATEGY & SUCCESSFUL AG
 50.00
.................
  		    X       0 378,035 42,393
(11) ADRIAN KWONG......................................................................
PRINCIPAL DATA SECURITY ARCHIT
 40.00
.................
  		        X   201,098 0 20,787
(12) AMY STUCK......................................................................
SR. DIR., VALUE-BASED ACUTE CARE
 40.00
.................
  		        X   182,690 0 49,998
(13) CHRISTOPHER CROWLEY......................................................................
PROGRAM MANAGER
 40.00
.................
  		        X   225,233 0 29,313
(14) JOSE UNPINGCO......................................................................
TECHNICAL DIRECTOR
 40.00
.................
  		        X   259,115 0 48,252
(15) LIANE WARDLOW......................................................................
DIRECTOR, CLINICAL RESEARCH
 40.00
.................
  		        X   189,195 0 40,496
(16) JOSEPH M SMITH......................................................................
FORMER CO-MANAGER/CMO THRU 3/31/16
 0.00
.................
40.00 		          X 0 823,220 10,073


Form 990 (2020)
Form 990 (2020)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 3,072,607 2,117,767 422,417
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet14
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
GLOBAL STRATEGY GROUP LLC

215 PARK AVE SOUTH 15TH FLOOR
NEW YORK,NY10003 		CONSULTANTS 935,000
GALLUP INC

PO BOX 310284
DES MOINES,IA50331 		CONSULTANTS 824,800
STG LLC

818 CONNECTICUT AVE NW SUITE 200
WASHINGTON,DC20006 		CONSULTANTS 387,231
99 TEN BUSINESS SOLUTIONS

5800 ARMADA DRIVE SUITE 100
CARLSBAD,CA92008 		IT CONSULTANTS 329,267
WILLIAM SCANLON

3055 CROSEN COURT
HERNDON,VA20171 		CONSULTANTS 238,428
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet10
Form 990 (2020)
Form 990 (2020)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 22,500,000
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 22,500,000
Program Service RevenueAmt Business Code
2a
b
c
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet  
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 2     2
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents     6a
b Less: rental expenses     6b
c Rental income or (loss)     6c
d Net rental income or (loss).......MediumBullet        
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory     7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss)     7c
d Net gain or (loss).........MediumBullet        
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet  
12 Total revenue. See instructions.....MediumBullet 22,500,002 0 0 2
Form 990 (2020)
Form 990 (2020)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 51,820 51,820
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 1,617,047 1,275,705 341,342  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 2,428,674 2,118,326 310,348  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 146,503 146,503    
9 Other employee benefits ....... 278,373 278,373    
10 Payroll taxes ........... 219,873 185,875 33,998  
11 Fees for services (non-employees):        
a Management ...... 2,153,951 688,401 1,465,550  
b Legal ......... 98,656 5,277 93,379  
c Accounting ........... 80,987   80,987  
d Lobbying ........... 291,000 291,000    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 12,816,477 10,439,400 2,377,077  
12 Advertising and promotion ....        
13 Office expenses ....... 11,016 640 10,376  
14 Information technology ...... 675,876 114,822 561,054  
15 Royalties ..        
16 Occupancy ........... 1,534,137 920,561 613,576  
17 Travel ............ 119,438 45,284 74,154  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 12,396 9,157 3,239  
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 505,918 254,414 251,504  
23 Insurance ... 62,059   62,059  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a TELECOMMUNICATIONS/WEB 159,364 102,000 57,364  
b SUBSCRIPTIONS & PUBLICA 121,043 70,566 50,477  
c RECRUITING & RETENTION 34,294 4,807 29,487  
d EQUIPMENT & SUPPLIES 30,805 8,613 22,192  
e All other expenses 13,254 5,343 7,911  
25 Total functional expenses. Add lines 1 through 24e 23,462,961 17,016,887 6,446,074 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2020)
Form 990 (2020)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 7,157,996 1 2,236,268
2 Savings and temporary cash investments ......... 9,787 2 9,789
3 Pledges and grants receivable, net ......   3 6,000,000
4 Accounts receivable, net ............. 540,820 4 406,662
5 Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
  6  
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 840,065 9 590,411
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 10,594,489
b Less: accumulated depreciation 10b 9,951,995 964,419 10c 642,494
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 .....   12  
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 97,979 14 35,957
15 Other assets. See Part IV, line 11 ...........   15  
16 Total assets. Add lines 1 through 15 (must equal line 33)... 9,611,066 16 9,921,581
Liabilities 17 Accounts payable and accrued expenses ..... 4,035,452 17 5,288,424
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 703,115 25 723,617
26 Total liabilities. Add lines 17 through 25.. 4,738,567 26 6,012,041
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 1,536,103 27 815,056
28 Net assets with donor restrictions ........... 3,336,396 28 3,094,484
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... 4,872,499 32 3,909,540
33 Total liabilities and net assets/fund balances ........ 9,611,066 33 9,921,581
Form 990 (2020)
Form 990 (2020)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
22,500,002
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
23,462,961
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-962,959
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
4,872,499
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
3,909,540
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2020)
Form 990 (2020)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support. Add lines 7 through 10  
12
12
 
13
First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose            
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge            
6 Total. Add lines 1 through 5            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support. (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2016 (b) 2017 (c) 2018 (d) 2019 (e) 2020 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in 11a above?
11b
 
 
c
A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.
11c
 
 
Section B. Type I Supporting Organizations
Yes
No
1
Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    
Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors
(explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by 0.035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    
Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7
Schedule A (Form 990 or 990-EZ) 2020

Schedule A (Form 990 or 990-EZ) 2020
Page 7
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes 1  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity 		2  
3 Administrative expenses paid to accomplish exempt purposes of supported organizations 3  
4 Amounts paid to acquire exempt-use assets 4  
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) 5  
6 Other distributions (describe in Part VI). See instructions 6  
7Total annual distributions. Add lines 1 through 6. 7  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions 		8  
9 Distributable amount for 2020 from Section C, line 6 9  
10 Line 8 amount divided by Line 9 amount 10  
Section E - Distribution Allocations (see instructions) (i)
Excess Distributions 		(ii)
Underdistributions
Pre-2020 		(iii)
Distributable
Amount for 2020
1 Distributable amount for 2020 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2020:
a From 2015.......  
b From 2016.......  
c From 2017.......  
d From 2018.......  
e From 2019.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2020 distributable amount  
i Carryover from 2015 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2020 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2020 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2020, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions. 		 
6 Remaining underdistributions for 2020. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions. 		 
7 Excess distributions carryover to 2021. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2016.....  
b Excess from 2017.....  
c Excess from 2018.....  
d Excess from 2019.....  
e Excess from 2020.....  
Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2
Name of organization
GARY AND MARY WEST HEALTH INSTITUTE
  		Employer identification number
26-4146730
Part I
Contributors
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
 
 
 
 
  ,    

$ RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 3
Name of organization
GARY AND MARY WEST HEALTH INSTITUTE
  		Employer identification number

26-4146730
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
(a)
No. from Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(See instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Page 4
Name of organization
GARY AND MARY WEST HEALTH INSTITUTE
  		Employer identification number

26-4146730
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a)
No. from Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)
Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet Complete if the organization is described below. SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6
For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2020

Schedule C (Form 990 or 990-EZ) 2020
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................ 291,000  
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 291,000  
d Other exempt purpose expenditures ............................................................................... 23,171,961  
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 23,462,961  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000  
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................................................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................ 0  
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................ 0  
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		6,000,000
c Total lobbying expenditures 230,184 430,000 402,000 291,000 1,353,184
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 1,500,000
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2020


Schedule C (Form 990 or 990-EZ) 2020
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes|No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
SCHEDULE C, PART IV THE GARY AND MARY WEST HEALTH INSTITUTE DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE.
Schedule C (Form 990 or 990EZ) 2020


Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ...................... 2a  
b Total acreage restricted by conservation easements .................... 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included on Form 990, Part VIII, line 1 .........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b If "Yes," explain the arrangement in Part XIII and complete the following table: Amount
c Beginning balance ............................. 1c  
d Additions during the year ............................ 1d  
e Distributions during the year .......................... 1e  
f Ending balance ................................ 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....
Part V
Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back (d) Three years back (e) Four years back
1a Beginning of year balance ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .......................
3a(i)
 
 
(ii) Related organizations .......................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis
(investment) 		(b) Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .....      
b Buildings ....        
c Leasehold improvements   6,796,830 6,552,204 244,626
d Equipment ....   2,163,499 2,004,988 158,511
e Other .....   1,634,160 1,394,803 239,357
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 642,494
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 3
Part VII
Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(1) Financial derivatives.........    
(2) Closely-held equity interests........    
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
(1) Federal income taxes  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 723,617
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2020

Schedule D (Form 990) 2020
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1 22,500,002
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1.................. 3 22,500,002
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c 0
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5 22,500,002
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1 23,462,961
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e 0
3 Subtract line 2e from line 1................... 3 23,462,961
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5 23,462,961
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART X, LINE 2: IN ACCORDANCE WITH FASB ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE INSTITUTE EVALUATES ANNUALLY ANY UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN BY APPLYING A THRESHOLD OF MORE LIKELY THAN NOT FOR RECOGNITION. MANAGEMENT EVALUATED ITS TAX POSITIONS AND DETERMINED THAT IT HAS NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2020. THERE HAVE BEEN NO RELATED TAX PENALTIES OR INTEREST, WHICH WOULD BE CLASSIFIED AS TAX EXPENSE IN THE STATEMENT OF ACTIVITIES.
Schedule D (Form 990) 2020


Additional Data


Software ID:  
Software Version:  





Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number
26-4146730
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) GARY AND MARY WEST SENIOR DENTAL CENTER INC
1525 FOURTH AVE
SAN DIEGO,CA92101 		47-3001738 501(C)(3)   5,661 FMV OFFICE SPACE DONATION OF OFFICE SPACE
(2) FRONT PORCH COMMUNITIES AND SERVICES
800 N BRAND BLVD 19TH FLOOR
GLENDALE,CA91203 		95-4538269 501(C)(3)   14,941 FMV DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT
(3) SEACREAST VILLAGE RETIREMENT COMMUNITIES
211 SAXONY ROAD
ENCINITAS,CA92024 		95-1455284 501(C)(3)   13,558 FMV DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT
(4) SERVING SENIORS
1525 FOURTH AVE
SAN DIEGO,CA92101 		95-2850121 501(C)(3)   17,660 FMV DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT DONATION OF SERVICES, SUPPLIES, AND EQUIPMENT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
4
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2020

Schedule I (Form 990) 2020
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: GRANTS WILL ONLY BE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE NON-CASH ITEMS WILL BE USED PROPERLY.
Schedule I (Form 990) 2020



Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
Graphic Arrow Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Graphic Arrow Attach to Form 990.
Graphic Arrow Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation in column (B) reported as deferred on prior Form 990
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1SHELLEY M LYFORD
PRESIDENT & CEO 		(i)

(ii)		 505,595
-------------
202,421 		194,450
-------------
35,917 		20,340
-------------
0 		11,140
-------------
6,967 		3,855
-------------
9,832 		735,380
-------------
255,137 		0
-------------
0
2JOSEPH M SMITH
FORMER CO-MANAGER/CMO THRU 3/31/16 		(i)

(ii)		 0
-------------
231,782 		0
-------------
0 		0
-------------
591,438 		0
-------------
10,073 		0
-------------
0 		0
-------------
833,293 		0
-------------
0
3TIMOTHY LASH
EVP AND CHIEF STRATEGY OFFICER 		(i)

(ii)		 469,897
-------------
129,654 		132,875
-------------
20,888 		19,860
-------------
0 		7,448
-------------
10,043 		31,029
-------------
0 		661,109
-------------
160,585 		0
-------------
0
4ZIA AGHA
CHIEF MEDICAL OFFICER & EVP 		(i)

(ii)		 536,025
-------------
42,708 		115,906
-------------
0 		20,328
-------------
0 		14,250
-------------
0 		38,728
-------------
0 		725,237
-------------
42,708 		0
-------------
0
5JONATHAN ZIFFERBLATT
EVP, STRATEGY & SUCCESSFUL AG 		(i)

(ii)		 0
-------------
296,321 		0
-------------
61,000 		0
-------------
20,714 		0
-------------
14,250 		0
-------------
28,143 		0
-------------
420,428 		0
-------------
0
6JOSE UNPINGCO
TECHNICAL DIRECTOR 		(i)

(ii)		 228,104
-------------
0 		30,506
-------------
0 		505
-------------
0 		13,163
-------------
0 		35,089
-------------
0 		307,367
-------------
0 		0
-------------
0
7SALLY HALLAK
VP OF F&C/SECRETARY AND TREASURER 		(i)

(ii)		 0
-------------
196,884 		0
-------------
50,600 		0
-------------
178 		0
-------------
12,436 		0
-------------
11,170 		0
-------------
271,268 		0
-------------
0
8SIOBHAN GRAHAM
VP, OPERATIONS & HR 		(i)

(ii)		 0
-------------
198,692 		0
-------------
38,300 		0
-------------
270 		0
-------------
11,921 		0
-------------
12,286 		0
-------------
261,469 		0
-------------
0
9CHRISTOPHER CROWLEY
PROGRAM MANAGER 		(i)

(ii)		 206,657
-------------
0 		17,324
-------------
0 		1,252
-------------
0 		11,261
-------------
0 		18,052
-------------
0 		254,546
-------------
0 		0
-------------
0
10AMY STUCK
SR. DIR., VALUE-BASED ACUTE CARE 		(i)

(ii)		 156,061
-------------
0 		26,019
-------------
0 		610
-------------
0 		9,270
-------------
0 		40,728
-------------
0 		232,688
-------------
0 		0
-------------
0
11LIANE WARDLOW
DIRECTOR, CLINICAL RESEARCH 		(i)

(ii)		 166,702
-------------
0 		22,275
-------------
0 		218
-------------
0 		9,653
-------------
0 		30,843
-------------
0 		229,691
-------------
0 		0
-------------
0
12ADRIAN KWONG
PRINCIPAL DATA SECURITY ARCHIT 		(i)

(ii)		 184,551
-------------
0 		16,301
-------------
0 		246
-------------
0 		9,332
-------------
0 		11,455
-------------
0 		221,885
-------------
0 		0
-------------
0
Schedule J (Form 990) 2020

Schedule J (Form 990) 2020
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A THE USE OF BUSINESS CLASS MAY BE AUTHORIZED UNDER THE CIRCUMSTANCES LISTED BELOW: (1) INTERNATIONAL TRAVEL; (2) BUSINESS OR FIRST CLASS IS THE ONLY SERVICE OFFERED BETWEEN TWO POINTS; (3) COACH CLASS WOULD BE MORE EXPENSIVE OR TIME CONSUMING, E.G., WHEN, BECAUSE OF SCHEDULING DIFFICULTIES, TRAVELING BY COACH WOULD REQUIRE AN UNNECESSARY HOTEL EXPENSE, CIRCUITOUS ROUTING (2 OR MORE LAYOVERS), OR AN UNDULY LONG LAYOVER WHEN MAKING CONNECTIONS; (4) AN ITINERARY INVOLVES OVERNIGHT TRAVEL WITHOUT THE OPPORTUNITY FOR NORMAL REST BEFORE THE COMMENCEMENT OF WORKING HOURS; OR (5) THE USE OF BUSINESS CLASS IS NECESSARY TO REASONABLY ACCOMMODATE A DISABILITY OR MEDICAL NEED OF A TRAVELER.
PART I, LINE 3 COMPENSATION FOR THE CEO WAS ESTABLISHED BY THE BOARD OF DIRECTORS OF THE GARY AND MARY WEST HEALTH INSTITUTE AND PAID BY THE INSTITUTE. THE FOLLOWING WAS USED TO ESTABLISH THE COMPENSATION: 1)COMPENSATION COMMITTEE; 2)FORM 990 OF OTHER ORGANIZATIONS; 3)COMPENSATION SURVEY OR STUDY; 4)APPROVAL BY THE BOARD OF DIRECTORS.
PART I, LINES 4A-B JOSEPH SMITH IS AN OFFICER WITH REFLEXION HEALTH, INC., A RELATED ORGANIZATION WITH WHI. HE RECEIVED A SEVERANCE PAYMENT OF $591,012 UPON TERMINATION IN 2020. EACH OF THE FOLLOWING INDIVIDUALS TIM LASH, ZIA AGHA AND SHELLEY M. LYFORD (LISTED ON SCHEDULE J) PARTICIPATED IN THE 457(B) NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE WEST HEALTH INSTITUTE. THE GARY AND MARY WEST HEALTH INSTITUTE MAKES AN ANNUAL CASH CONTRIBUTION FOR EACH EMPLOYEE IN AN AMOUNT EQUAL TO THE APPLICABLE DOLLAR AMOUNT IN EFFECT FOR THAT YEAR. FOR 2020 THIS AMOUNT WAS $19,500. CONTRIBUTIONS WERE MADE FOR TIM LASH, ZIA AGHA AND SHELLEY LYFORD. JONATHAN ZIFFERBLATT ALSO LISTED ON SCHEDULE J PARTICIPATED IN THE 409A NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED ORGANIZATION. FOR 2020 THIS AMOUNT WAS $19,500. CONTRIBUTIONS WAS MADE FOR JONATHAN ZIFFERBLATT.
PART I, LINE 7 EACH OF THE MANAGERS IS ELIGIBLE FOR AN ANNUAL DISCRETIONARY BONUS, SUBJECT TO BOARD APPROVAL, WHICH IS BASED ON INDIVIDUAL PERFORMANCE AND LIMITED TO A MAXIMUM PERCENTAGE OF BASE COMPENSATION.
Schedule J (Form 990) 2020

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2020
Schedule L (Form 990 or 990-EZ) 2020
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SEE PART V DISCLOSURE
  		        No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
PART IV: BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS GARY WEST, CHAIRMAN OF THE WEST HEALTH INSTITUTE, IS A MEMBER OF 99 TEN BUSINESS SOLUTIONS, LLC. GARY WEST IS TREATED AS AN INTERESTED PERSON FOR PURPOSES OF SCHEDULE L, PART IV. ADDRESSING BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. THERE WERE BUSINESS TRANSACTIONS BETWEEN THE INSTITUTE AND 99 TEN BUSINESS SOLUTIONS, LLC DURING 2020. TOTAL TRANSACTION AMOUNT IS $355,585 FOR IT CONSULTING SERVICES
PART IV: BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS WEST HEALTH INSTITUTE ("WHI") SHARE A COMMON OFFICERS. TIMOTHY LASH, ZIA AGHA AND JONATHAN ZIFFERBLATT. IN 2020, GARY AND MARY WEST SENIOR SERVICES AND WHI ENTERED INTO A JOINT RESEARCH COLLABORATION AGREEMENT VALUED AT $2,045,000.
Schedule L (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2020
Open to Public
Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Return Reference Explanation
FORM 990, PART III, LINE 2 FORM 990, PART III, LINE 1 CONTAINS A REVISED MISSION STATEMENT FOR THE ORGANIZATION, AND LINES 2 AND 3 ARE ANSWERED "YES" FOR THE PURPOSES OF UPDATING THE STATEMENT OF THE ORGANIZATION'S PROGRAM SERVICES SINCE THE DESCRIPTIONS INCLUDED IN THE ORGANIZATION'S FORM 1023 APPLICATION FOR RECOGNITION OF EXEMPTION HAVE EVOLVED. MOST, IF NOT ALL, OF THESE CHANGES HAVE BEEN REPORTED IN PREVIOUSLY FILED FORMS 990, BUT THE ORGANIZATION WISHES TO SET FORTH A CLEAR STATEMENT OF ITS CURRENT MISSION AND PROGRAM ACTIVITIES. WHEN THE ORGANIZATION WAS CONCEIVED AND ESTABLISHED IN 2009, IT HAD A BROAD MISSION OF IMPROVING HEALTHCARE AND LOWERING ITS COST THROUGH MEDICAL RESEARCH IN CONJUNCTION WITH ONE OR MORE HOSPITALS, BUT IT HAD A NARROW METHODOLOGY IN MIND AT THE TIME USING WIRELESS COMMUNICATIONS TECHNOLOGIES. IN THE INTERVENING YEARS, THE ORGANIZATION HAS NARROWED ITS MISSION BUT BROADENED ITS METHODOLOGY. THE ORGANIZATION IS STILL A MEDICAL RESEARCH ORGANIZATION ENGAGED IN MEDICAL RESEARCH IN CONJUNCTION WITH MULTIPLE HOSPITALS, BUT IT HAS NARROWED ITS MISSION TO FOCUS ON IMPROVING HEALTHCARE FOR SENIOR AMERICAN CITIZENS AND LEGAL RESIDENTS, BASICALLY MEANING THOSE ELIGIBLE FOR PARTICIPATION IN THE FEDERAL MEDICARE PROGRAM. AFFORDABLE COST FOR HEALTHCARE IS STILL AN IMPORTANT OBJECTIVE, BUT IMPROVEMENTS IN THE QUALITY OF HEALTHCARE AND SUPPORTIVE SERVICES FOR SENIOR AMERICANS, SUCH AS ADEQUATE NUTRITION, ARE ALSO CRITICAL CONSIDERATIONS. THE FOCUS ON WIRELESS COMMUNICATIONS TECHNOLOGIES HAS BEEN REDIRECTED TO THE IDENTIFICATION OF POLICIES, HOSPITAL PROTOCOLS, STANDARDS OF CARE, INTEGRATION AND COORDINATION OF CARE FOR BOTH INPATIENTS AND OUTPATIENTS, AND SIMILAR IMPROVEMENTS IN MEDICAL, DENTAL, PREVENTATIVE AND RESTORATIVE CARE FOR SENIOR AMERICANS. CURRENTLY, THE ORGANIZATION CONDUCTS ITS MEDICAL RESEARCH IN CONJUNCTION WITH HOSPITALS IN THE HEALTHCARE SYSTEMS OPERATED BY THE UNIVERSITY OF CALIFORNIA, SAN DIEGO HEALTH SYSTEM IN LA JOLLA, CA, DARTMOUTH-HITCHCOCK CLINIC IN LEBANON, N.H., MOUNT SINAI HEATH SYSTEM IN NEW YORK, N.Y., JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE IN BALTIMORE, MD., THE UNIVERSITY OF NORTH CAROLINA HEALTH SYSTEM IN CHAPEL HILL, N.C., THE FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH IN MANHASSET, NY., AND MANY OTHERS. THE ORGANIZATION USES THE RESULTS OF ITS MEDICAL RESEARCH TO INFORM POLICY ANALYSES AND PROPOSALS FOR PRESENTATION TO FEDERAL AND STATE HEALTHCARE AGENCIES AND LEGISLATIVE BODIES IN WASHINGTON, D.C. AND SACRAMENTO, CA, CAREFULLY LIMITING THOSE ACTIVITIES TO REMAIN WITHIN THE REALM OF POLICY ADVOCACY PERMITTED BY FEDERAL AND STATE TAX LAW. EXAMPLES OF CURRENT RESEARCH PROJECTS INCLUDE A MEDICAL ANALYSIS OF THE OUTCOMES OF THE USE OF TELEMEDICINE IN CONJUNCTION WITH GERIATRIC EMERGENCY ROOM CARE AND PATIENT-INITIATED TECHNOLOGICAL INPUTS, THE DEGREE OF SUCCESS IN USING TECHNOLOGY TO SCREEN HOSPITAL PATIENTS AND THE MEDICAL OUTCOMES POSSIBLE THROUGH EXPANDING ACCESS TO PHARMACEUTICALS BY LOWERING PRODUCTION AND DISTRIBUTION COSTS FOR HOSPITALS.
FORM 990, PART III, LINE 3 SEE NARRATIVE TO FORM 990, PART III, LINE 2, NEW PROGRAM SERVICES, WHICH INCLUDEDS A DESCRIPTION OF CHANGES TO PROGRAM SERVICES.
FORM 990, PART III, LINE 4A, (CONTINUATION): DELIRIUM RESOURCES FOR THE EMERGENCY DEPARTMENT IN 2020, WHI ENGAGED EDS AT ST. MARY MERCY (LIVONIA, MICHIGAN), MAINE MEDICAL CENTER AND UNIVERSITY OF NORTH CAROLINA HILLSBOROUGH (COMMUNITY HOSPITAL UNDER THE UNC HEALTH CARE SYSTEM) TO TEST UPDATED DELIRIUM PROTOCOLS. DATA AND RESPONSES WILL BE INCORPORATED INTO FINAL PROTOCOLS IN 2021. HOME-BASED ACUTE CARE LEARNING AND ACTION NETWORK (HOMELAN) IN 2020, THE INSTITUTE COMPLETED A RESEARCH EFFORT CALLED THE HOME-BASED ACUTE CARE LEARNING AND ACTION NETWORK (HOMELAN), DESIGNED TO PROMOTE HOME AND COMMUNITY-BASED ACUTE CARE ALTERNATIVES TO HOSPITALIZATIONS. THIS WORK WAS DONE WITH 11 HOSPITALS AND HEALTHCARE PROVIDERS ACROSS THE US, INCLUDING: MOUNT SINAI, INTEGRA, GEISINGER, TRINITY HEALTH, UC SAN DIEGO, UNITYPOINT, VNA HEALTH GROUP OF NEW JERSEY, MONTEFIORE-WHITE PLAINS HOSPITAL, BELLIN HEALTH, HEALTH PARTNERS, AND THE INTEGRATED HEALTH CARE ALLIANCE. THE INVESTIGATED ALTERNATIVES FOCUSED ON SERVICES THAT WERE BOTH LOWER IN COST AND ALSO PROVIDED CARE BETTER MATCHED TO THE NEEDS OF COMPLEX, FRAIL OLDER ADULTS AND SHOULD LEAD TO NATIONAL EFFORTS TO CONVINCE PROVIDERS TO ASSUME FINANCIAL RISK AND DIMINISH VOLUME-BASED FINANCIAL INCENTIVES SUCH AS THOSE IN TRADITIONAL FEE-FOR-SERVICE MEDICARE. DESPITE THE DISRUPTIONS CAUSED BY THE COVID-19 PANDEMIC, THE 2020 HOMELAN RESULTS INCLUDED AVOIDANCE OF OVER 1,280 EMERGENCY ROOM VISITS AND MORE THAN 625 INPATIENT HOSPITAL ADMISSIONS, SAVING MEDICARE A GROSS AMOUNT OF NEARLY $8M. THIS RESEARCH WILL CONTINUE IN 2021, WITH A FOCUS ON TRACKING AND OPTIMIZING THE BOTTOM-LINE (NET) FINANCIAL RESULTS, BOTH TO MEDICARE AND TO THE PROVIDERS THEMSELVES. INSTITUTE FOR ACCOUNTABLE CARE (IAC) IN 2020, THE INSTITUTE UNDERTOOK TO PROVIDE A NATIONAL PERSPECTIVE ON ITS DATA-DRIVEN EFFORTS TO PROMOTE VALUE-BASED MEDICAL CARE. THIS WORK WAS DONE WITH THE INSTITUTE FOR ACCOUNTABLE CARE (IAC), THE RESEARCH ARM OF THE NATIONAL ASSOCIATION OF ACCOUNTABLE CARE ORGANIZATIONS (NAACOS). IN 2020, THE INSTITUTE AND THE IAC CONDUCTED AND COMPLETED A NATIONWIDE INVENTORY OF HOME-BASED CARE SERVICES ADOPTED BY ACCOUNTABLE CARE ORGANIZATIONS AND RELATED RISK-BEARING ORGANIZATIONS. THE FINDINGS WERE THAT SOME ORGANIZATIONS ACCELERATED THEIR HOME-BASED CARE SERVICES IN THE FACE OF THE COVID PANDEMIC, IN PART DUE TO THE AVAILABILITY OF INFRASTRUCTURE ORIGINALLY CONTEMPLATED FOR THEIR VALUE-BASED CARE INITIATIVES AND THAT MANY ORGANIZATIONS CITED DIFFICULTIES IN MAINTAINING AN OPERATIONAL RETURN ON INVESTMENT (ROI) AS A MAJOR CHALLENGE TO EXPANDING THEIR HOME-BASED RESOURCES. IN THE LAST QUARTER OF 2020, THE INSTITUTE COMPLETED ADDITIONAL RESEARCH WITH THE IAC LOOKING SPECIFICALLY AT THE UTILIZATION OF TELEMEDICINE AND OTHER FEDERAL EMERGENCY WAIVERS. THESE RESULTS ARE CURRENTLY IN THE ANALYSIS PHASE WITH RESULTS AVAILABLE IN EARLY 2021. WHI'S RESEARCH EFFORTS WITH THE IAC IN 2021 WILL CONTINUE WORK TO CORROBORATE AND EXPAND WHI'S DATA-DRIVEN AND VIRTUAL APPROACHES TO VALUE-BASED CARE DESIGN, AS WELL AS CONTINUING TO AFFORD WHI MORE DIRECT INSIGHT INTO THE EVOLVING PAYMENT AND POLICY LANDSCAPE. SENIOR-APPROPRIATE CHRONIC CARE WHILE ALL SENIORS (AND INDEED ALL HUMANS) SEEK TO HAVE A HIGH QUALITY OF LIFE, THIS MAY TAKE DIFFERENT FORMS AND EXPRESSIONS DEPENDING ON THE INDIVIDUAL. SYSTEMATICALLY ADDRESSING THE ONGOING COMPLEX MEDICAL, BEHAVIORAL, AND SOCIAL NEEDS OF OLDER ADULTS IN A COST-EFFECTIVE MANNER WHILE ENSURING THAT WHAT MATTERS MOST TO THEM IS TAKEN INTO ACCOUNT IS AN IMPORTANT PART OF THE INSTITUTE'S RESEARCH. THESE ACTIVITIES COVER A VARIETY OF AREAS. HOME-BASED PRIMARY CARE RESEARCH PROJECTS: HOME-BASED PRIMARY CARE (HBPC) IS A MULTIDISCIPLINARY ONGOING CARE STRATEGY FOR PROVIDING IN-HOME TREATMENT PRIMARILY TO ADDRESS MEDICALLY COMPLEX HOMEBOUND SENIORS' NEEDS. RECENT STUDIES HAVE DEMONSTRATED THAT HBPC CAN BE A COST-EFFECTIVE STRATEGY FOR DELIVERING CARE TO FRAIL PATIENTS WHILE MAINTAINING OR IMPROVING QUALITY OF CARE AND PATIENT SATISFACTION. SUSTAINABILITY FOR A QUALIFIED CLINICAL DATA REGISTRY (QCDR) FOR HBPC PRACTICES IN 2016, THE INSTITUTE BEGAN A COLLABORATION WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, JOHNS HOPKINS UNIVERSITY, AND THE JOHN A. HARTFORD FOUNDATION TO ESTABLISH THE NATIONAL HOME-BASED PRIMARY CARE & PALLIATIVE CARE REGISTRY, WHICH CONTINUED INTO 2020. THE REGISTRY AND ITS CUSTOM MEASURES FOR HOME-BASED CARE OF MEDICALLY COMPLEX FRAIL SENIORS HAS BEEN SUCCESSFULLY APPROVED EACH YEAR BY THE CENTERS FOR MEDICARE AND MEDICAID AS A QUALIFIED REGISTRY, WHICH ALLOWS PRACTITIONERS OF HOME-CARE MEDICINE TO PARTICIPATE IN VALUE-BASED PAYMENTS AND QUALITY IMPROVEMENT ACTIVITIES. THE REGISTRY, WHICH CONTAINS DATA FROM OVER 400 PROVIDERS CARING FOR OVER 50,000 PATIENTS, WAS SUCCESSFULLY REAPPROVED AS A QUALIFIED REGISTRY BY CMS FOR 2020. THE INSTITUTE CONTINUED TO PARTICIPATE IN THE SECOND ITERATION OF THE NATIONAL HOME-BASED PRIMARY & PALLIATIVE CARE LEARNING COLLABORATIVE. DUE TO CHANGES IN REGULATIONS AT THE CMS LEVEL, THE VENDOR HOSTING THE REGISTRY PROGRAM MADE THE DECISION NOT TO CONTINUE TO SUPPORT SUCH REGISTRIES. NEVERTHELESS, THE INSTITUTE SUCCESSFULLY COMPLETED ITS GOAL OF CONTRIBUTING TO THE FIELD OF HOME-BASED PRIMARY CARE BY DEVELOPING MEASURES THAT WILL IMPROVE QUALITY OF CARE FOR MILLIONS OF SENIORS AND SERIOUSLY ILL POPULATIONS ACROSS THE COUNTRY. NORTHWELL HOME-BASED MONITORING WHI IN 2020 CONTINUED ITS RESEARCH PROJECT WITH NORTHWELL HEALTH IN A HOME-BASED MONITORING PROGRAM, AIMING TO EXPAND THE PATIENT CENSUS IN THIS PRACTICE THROUGH REDESIGN OF THE SCHEDULED IN-HOME VISITS USING DIFFERENT CARE TEAM COMPOSITION AND TELEHEALTH TECHNOLOGY. THIS NEW TELEHEALTH MODEL, FIRST IMPLEMENTED IN 2019, EXTENDED THE REACH OF THE PRIMARY CARE PROVIDER TO ADDRESS ACUTE CHANGE IN CONDITIONS IN THEIR PATIENTS BY USING TELEHEALTH WITH EMERGENCY MEDICAL TECHNICIANS (EMTS) AS A "FACILITATED TELEHEALTH MODEL." THE MODEL ALLOWED FOR PROVIDERS TO EXPAND THEIR REACH AND CONDUCT TEN VISITS IN A DAY VERSUS FIVE VISITS A DAY WITHOUT TELEHEALTH. SURVEY RESULTS FROM THE INITIAL EFFORTS DEMONSTRATED THAT 97% OF PATIENTS OR CAREGIVERS WERE SATISFIED WITH MANAGEMENT OF THEIR MEDICAL ISSUE WITH THIS FACILITATED TELEHEALTH MODEL. WHI AND, NORTHWELL HEALTH WILL CONTINUE TO EVALUATE THIS CARE MODEL. PALLIATIVE CARE RESEARCH PROJECTS: PALLIATIVE CARE PROVIDES AN EXTRA LAYER OF SUPPORT FOR THE SERIOUSLY ILL, GIVING THEM RELIEF FROM SYMPTOMS AND THE STRESS OF DISEASE BURDEN, ULTIMATELY IMPROVING THE PATIENT'S AND FAMILY'S QUALITY OF LIFE. THE INSTITUTE'S GOAL IS TO SPUR ADOPTION OF HOME AND COMMUNITY-BASED PALLIATIVE CARE PROGRAMS FOR SENIORS WITH SERIOUS ILLNESS AND IS CONDUCTING TWO MAJOR RESEARCH PROJECTS THAT AIM TO ADDRESS THIS GOAL. PROJECT HOPE HOME-BASED PALLIATIVE CARE THE INSTITUTE CONTINUES TO COLLABORATE WITH THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI TO CREATE, DELIVER, AND EVALUATE A CLINICAL MODEL WHICH PROVIDES PALLIATIVE CARE TO PATIENTS IN THEIR HOME. A KEY OBJECTIVE OF THIS WORK IS DISSEMINATION OF THE COMMUNITY-BASED PALLIATIVE CARE MODEL; TO THIS END, THE RESEARCH TEAM HAS COMPLETED DEVELOPMENT OF A PLAYBOOK AND IMPLEMENTATION TOOLKIT THAT OUTLINE HOW HEALTH SYSTEMS CAN ADOPT THIS MODEL WITHIN THEIR SYSTEM. THE PLAYBOOK AND TOOLKIT WILL BE ACTIVELY DISSEMINATED IN 2021. BLUE SHIELD HOME-BASED PALLIATIVE CARE EVALUATION AND DISSEMINATION STUDY BLUE SHIELD OF CALIFORNIA ("BLUE SHIELD") IS CURRENTLY CONTRACTING WITH ITS PROVIDERS ACROSS CALIFORNIA TO DELIVER HOME-BASED PALLIATIVE CARE TO SERIOUSLY ILL INDIVIDUALS AS A PLAN BENEFIT. AS PART OF A RESEARCH STUDY, THE INSTITUTE HAS SERVED AS AN INDEPENDENT EVALUATOR OF THE PALLIATIVE CARE PROGRAM AND IS INVESTIGATING THE 49,000 LIVES COVERED BY BLUE SHIELD OF CALIFORNIA CURRENTLY ELIGIBLE FOR HOME-BASED PALLIATIVE CARE, AND WHAT FACTORS INFLUENCE ENROLLMENT INTO THE PROGRAM. TO DRIVE THE DISSEMINATION OF THIS PROGRAM TO OTHER HEALTHCARE PAYERS, THE INSTITUTE ALSO EVALUATED THE COST-SAVINGS OF THE PROGRAM RELATIVE TO THE COST OF DELIVERING THE PROGRAM. IN 2020, THE INSTITUTE COMPLETED ANALYSIS OF HEALTH CARE UTILIZATION OF BLUE SHIELD MEMBERS WHO RECEIVED THE HOME-BASED PALLIATIVE PROGRAM. RESULTS OF THE STUDY SHOWED THAT BLUE SHIELD MEMBERS WHO RECEIVED HOME-BASED PALLIATIVE CARE USED HEALTH CARE SERVICES MORE THAN MEMBERS WHO DID NOT RECEIVE SERVICES. HOWEVER, THE MEMBERS WHO RECEIVED HOME-BASED PALLIATIVE CARE SERVICES WERE HIGHLY VARIABLE WITH SOME MEMBERS DECREASING UTILIZATION AND OTHER MEMBERS INCREASING OR NOT CHANGING UTILIZATION. IN 2021, THE INSTITUTE WILL EVALUATE THESE DIFFERENCES IN AN EFFORT TO IDENTIFY THE CHARACTERISTICS OF MEMBERS WHO BENEFIT THE MOST FROM HOME-BASED PALLIATIVE CARE.
FORM 990, PART III, LINE 4A, (CONTINUATION): CENTER TO ADVANCE PALLIATIVE CARE (CAPC) MEDICARE ADVANTAGE AND ACCOUNTABLE CARE ORGANIZATION LEARNING COMMUNITY PROJECT IN MAY 2019, THE INSTITUTE PARTNERED WITH CAPC TO BEGIN A THREE-YEAR LEARNING COMMUNITY PROJECT AIMED AT EXPANDING PALLIATIVE CARE SERVICES WITHIN HEALTH INSURANCE PLANS AND ACOS. ACTIVITIES OF THE LEARNING COMMUNITY INCLUDE CONVENING MEDICARE ADVANTAGE (MA) PLANS AND HEALTH PROVIDERS PARTICIPATING IN ACO MODELS AND PROVIDING ACCESS TO EXPERTS AND TECHNICAL ASSISTANCE TO EXPEDITE THE DISSEMINATION OF PALLIATIVE CARE STRATEGIES. THE OUTCOME IS TO HAVE PARTICIPATING HEALTH PLANS AND ACOS IMPLEMENT AT LEAST ONE OF FOUR STRATEGIES, RELATING TO CASE MANAGER SKILL BUILDING, PROACTIVE BENEFICIARY IDENTIFICATION, DEVELOPMENT OF HOME-BASED PALLIATIVE CARE SERVICES, OR CREATION OF NETWORK STANDARDS AND INCENTIVES. IN 2020, THE INSTITUTE WORKED WITH CAPC AS AN ACTIVE PARTICIPANT IN COACHING CALLS WITH THE 40+ ACOS AND MA PLANS. THE TEAM ATTENDED VIRTUAL CONVENINGS AND VIRTUAL OFFICE HOURS FOR THE LEARNING COMMUNITY THROUGHOUT THE YEAR. THE INSTITUTE PARTICIPATED IN THE DEVELOPMENT OF TOOLKITS SUMMARIZING LEARNINGS FROM THE VIRTUAL EVENTS. PACE-RELATED RESEARCH PROJECTS: THE PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PROVIDES WRAP-AROUND MEDICAL AND SOCIAL SERVICES FOR SENIORS WHO WOULD OTHERWISE NEED NURSING HOME LEVEL CARE. MANAGING THE CHRONIC CONDITIONS AND NEEDS OF THIS HIGH-COST, HIGH-NEED POPULATION SEGMENT REQUIRES COORDINATED CARE TO ENABLE AGING-IN-PLACE AT HOME. THE INSTITUTE IS WORKING CLOSELY WITH THE GARY AND MARY WEST PACE CENTER TO DEVELOP AND EXECUTE ON AN INNOVATIVE PROGRAM OF APPLIED MEDICAL RESEARCH STUDIES TO ENHANCE AND EXPAND THE SERVICE DELIVERY OF PACE PROGRAMS AT A NATIONAL SCALE. IDENTIFYING AND ADDRESSING CAREGIVERS' NEEDS APPROXIMATELY 17.7 MILLION PEOPLE IN THE UNITED STATES ARE SERVING AS CAREGIVERS FOR A SENIOR WITH THE MAJORITY PROVIDING CARE TO AN OLDER ADULT WITH SIGNIFICANT HEALTH AND/OR FUNCTIONING NEEDS. CAREGIVERS ARE OFTEN SUPPORTING AND ATTENDING TO THE HEALTH CARE NEEDS OF THE CARE RECIPIENT WHILE ALSO NEEDING TO SUPPORT THEMSELVES AND SOMETIMES OTHERS. CAREGIVERS ARE MORE LIKELY TO EXPERIENCE PHYSICAL, EMOTIONAL, AND ECONOMIC HARM DUE TO THE TOLL OF EXTENSIVE CAREGIVING THAN NON-CAREGIVERS. THESE NEGATIVE EFFECTS OF CAREGIVING CAN BE EXACERBATED BY POOR HEALTH IN THE CAREGIVER, WORK IN LOW-WAGE JOBS WITH LIMITED FLEXIBILITY AND/OR THE LACK OF CHOICE ABOUT ASSUMING THE CAREGIVING ROLE DUE TO FINANCIAL CONSTRAINTS. IN 2020, THE INSTITUTE HAD PLANNED TO ASSESS THE LEVEL OF BURDEN OF CAREGIVERS USING THE ZARIT BURDEN SCALE TO IDENTIFY UNMET NEEDS AND DETERMINE THE TYPES OF SERVICES THAT CAN BE DEPLOYED TO ADDRESS THOSE NEEDS. HOWEVER, DUE TO THE COVID-19 PANDEMIC, WHI WAS UNABLE TO HAVE A STAFF MEMBER MAKE HOME VISITS ON A REGULAR BASIS, POTENTIALLY SPREADING COVID-19 AND/OR EXPOSING PARTICIPANTS AND THEIR CAREGIVERS UNNECESSARILY. CONSEQUENTLY, WHI SHIFTED TO EFFORTS TO 1) SUPPORT THE IMPLEMENTATION OF TELEHEALTH, 2) WRITE AND DISSEMINATE (THROUGH WEBINARS AND PRESENTATIONS) IMPLEMENTATION RESOURCES RELATED TO PROVIDING SAFE, VIRTUAL CARE FOR PACE PARTICIPANTS, AND 3) REDESIGN THE CAREGIVER PROGRAM SO THAT IT COULD BE RUN SAFELY AND EFFICIENTLY DURING AND POST-PANDEMIC. WHI HAS NOW REDESIGNED THE CAREGIVER PROGRAM AND IS ACTIVELY WORKING TOWARDS IMPLEMENTATION IN Q1 2021. IMPROVING PALLIATIVE AND END-OF-LIFE CARE IN PACE PACE PROGRAMS PROVIDE MEDICAL CARE AND NON-MEDICAL SERVICES TO SERIOUSLY ILL PATIENTS AND THEIR CAREGIVERS USING AN INTERDISCIPLINARY TEAM (IDT) APPROACH THAT ENABLES THE PATIENT TO REMAIN IN THEIR HOME AND COMMUNITY AND PROVIDES THE CAREGIVER WITH MUCH NEEDED SUPPORT. PALLIATIVE CARE IS AN ESSENTIAL COMPONENT TO THE CARE DELIVERY IN THE PACE MODEL. HOWEVER, LITTLE IS KNOWN ABOUT THE BEST PRACTICES, PROCESSES, AND GAPS IN PROVIDING THIS CARE IN THE PACE ORGANIZATION. WEST HEALTH INSTITUTE AND THE CENTER TO ADVANCE PALLIATIVE CARE HAVE CONVENED A LEARNING COMMUNITY TO INCREASE QUALITY OF PALLIATIVE CARE IN PACE. THE PACE PALLIATIVE CARE LEARNING COMMUNITY WILL FOCUS ON (1) INCREASING TRAINING FOR PACE STAFF, (2) IDENTIFYING PALLIATIVE CARE QUALITY METRICS FOR PACE, AND (3) DEVELOPING CARE PROCESSES FOR END-OF-LIFE CARE FOR PACE PARTICIPANTS. IN 2020, THE INSTITUTE WORKED WITH GMW PACE TO: * FORM A PALLIATIVE CARE WORKGROUP THAT PARTICIPATED IN THE CAPC LEARNING COMMUNITY AND DEVELOPED A PLAN TO IDENTIFY WORKFLOWS THAT SUPPORT GOALS OF CARE DISCUSSIONS WITH PACE PARTICIPANTS AS WELL AS DATA COLLECTION OF POLST (PHYSICIANS ORDERS FOR LIFE-SUSTAINING TREATMENT) AND GOALS OF CARE CONVERSATION METRICS * HAVE STAFF COMPLETE PALLIATIVE CARE TRAINING MODULES AND TRACK PROGRESS * IMPLEMENT WORKFLOWS AND DEFINE MEASURES TO TRACK PROCESS (CONTINUE TRACKING NUMBER OF POLST COMPLETIONS, DOCUMENTATION OF MEDICAL DECISION MAKERS AND GOALS OF CARE CONVERSATIONS AND FACILITATE THE STAFF TO ATTEND THE MEETING OF PACE LEARNING COMMUNITY CONVENING * ITERATE ON PALLIATIVE CARE WORKFLOWS THROUGH A PLAN-DO-STUDY-ACT (PDSA) CYCLE (AS NEEDED) * EVALUATE THE IMPACT OF THIS WORK AND DISSEMINATE AS APPROPRIATE. CLINICAL-DECISION SUPPORT DASHBOARD BUILDING ON WEST HEALTH INSTITUTE'S EXISTING WORK TO ADVANCE THE USE OF DATA AND DATA ANALYTICAL TOOLS SUCH AS DECISION-SUPPORTING DASHBOARDS, THE INSTITUTE WILL ESTABLISH A CLINICAL DECISION SUPPORT DASHBOARD FOR USE IN PACE ORGANIZATIONS ACROSS THE US. THE HYPOTHESIS ASSUMES THAT DELIVERING TIMELY METRICS IN AN EASY-TO-CONSUME MANNER WILL HELP PACE CLINICAL STAFF DELIVER TARGETED SERVICES MORE EFFICIENTLY AND EFFECTIVELY TO THE MOST AT-RISK PACE PARTICIPANTS. IN 2020, THE RESEARCH PROJECT SOUGHT TO 1) IDENTIFY THE MOST CLINICALLY RELEVANT MEASURES TO AID CLINICAL DECISION SUPPORT FOR THE PACE CARE TEAM, 2) DOCUMENT THE FEATURES AND DATA ARCHITECTURE REQUIRED FOR THE DASHBOARD, 3) EXECUTE A CONTRACT WITH A VENDOR WHO CAN PROVIDE AN APPLICATION THAT FITS WHI'S SPECIFICATIONS, AND 4) BEGIN IMPLEMENTATION AND DASHBOARD DEVELOPMENT. CENTER TO ADVANCE PALLIATIVE CARE (CAPC) PACE LEARNING COMMUNITY PROJECT AS MENTIONED ABOVE IN THE PALLIATIVE CARE RESEARCH SECTION, WHI PARTNERED WITH CAPC TO BEGIN A THREE-YEAR LEARNING COMMUNITY PROJECT AIMED AT ENHANCING PALLIATIVE CARE TRAINING AND PROGRAMS WITHIN PACE PROGRAMS ACROSS THE COUNTRY. NINE PACE PROGRAMS WERE SELECTED, REPRESENTING SEVEN STATES AND OVER 8,000 PACE PARTICIPANTS. TWO OF THE NATION'S LARGEST PACE PROGRAMS ARE AMONG THE PARTICIPANTS. IN 2020, THE INSTITUTE PARTNERED WITH CAPC AND NATIONAL PACE ASSOCIATION TO LEAD THREE VIRTUAL CONVENINGS ON VARIOUS TOPICS, THREE VIRTUAL OFFICE HOURS, AND COACHING CALLS WITH EACH OF THE NINE LEARNING COMMUNITY PARTICIPANTS. THE TEAMS STAYED APPRISED OF PARTICIPATING PACE PROGRAMS' UTILIZATION OF THE CAPC MEMBERSHIP AND PROVIDED RESOURCES THROUGHOUT THE YEAR AS NEEDED. ALTHOUGH THE COVID-19 PANDEMIC AFFECTED ALL THE PARTICIPATING PROGRAMS, THE PACE PROGRAMS WERE HIGHLY ENGAGED GIVEN THE IMPORTANCE OF PALLIATIVE CARE DURING THIS TIME. REDUCING POTENTIALLY AVOIDABLE HOSPITAL AND ED ADMISSIONS PACE PARTICIPANTS PRESENT WITH A HIGHER PREVALENCE OF CHRONIC DISEASE, DISABILITY, AND SOCIAL COMPLEXITY, ALL OF WHICH INCREASE THE LIKELIHOOD OF COSTLY UNPLANNED ACUTE EPISODES, LEADING TO EMERGENCY DEPARTMENT (ED) VISITS AND HOSPITAL ADMISSIONS. IN 2020, TO RESEARCH THE UNDERPINNINGS OF A MORE EFFECTIVE EARLY WARNING SYSTEM, A "CALL PACE FIRST" INITIATIVE WAS IMPLEMENTED. PARTICIPANTS, DURING THEIR ON-BOARDING PROCESS AND ORIENTATION TO THE PACE PROGRAM, ARE GIVEN VERBAL AND WRITTEN INSTRUCTIONS TO CALL THE PACE CLINIC IF THEY ARE EXPERIENCING NON-LIFE-THREATENING HEALTH ISSUES. THEY ARE PROVIDED A 24/7 PHONE NUMBER TO CALL AND A REFRIGERATOR MAGNET FOR EASY ACCESS. WHI ALSO BEGAN PRELIMINARY INVESTIGATIONS INTO ASYNCHRONOUS TECHNOLOGIES THAT DO NOT REQUIRE AN ACTUAL PHONE CALL. GIVEN AN ADEQUATE EARLY WARNING, THE PACE CLINIC IS ALREADY EQUIPPED WITH SOME AGILE RESPONSE INFRASTRUCTURE, INCLUDING SAME-DAY APPOINTMENTS AND TRANSPORTATION TO AND FROM THE CLINIC. BECAUSE SOME PACE PARTICIPANTS REMAIN CONDITIONED TO CALL 911 IN AN EMERGENCY, THE INSTITUTE ALSO LOOKED FOR OPPORTUNITIES TO INTERCEPT PARTICIPANTS NON-LIFE-THREATENING MEDICAL CONCERNS DURING A 911 ACTIVATION. MIDWAY THROUGH 2020, THE INSTITUTE ENGAGED IN A PARTNERSHIP WITH THE CALIFORNIA PARAMEDIC FOUNDATION TO DEVELOP A "TREAT AND REFER" PILOT PROJECT IN COLLABORATION WITH THE NORTH COUNTY JOINT POWERS AUTHORITY, UC SAN DIEGO BASE-HOSPITAL ED PHYSICIANS AND OCEANSIDE FIRE. WHI AND THESE PARTNERS DEVELOPED WORKFLOWS AND CONDUCTED LIVE "TABLE-TOP" SIMULATIONS IN AN ENTIRELY VIRTUAL SETTING.
FORM 990, PART III, LINE 4A, (CONTINUATION): TELEHEALTH AT THE ONSET OF THE 2019-2020 PANDEMIC, LOCAL AND NATIONAL HEALTH SYSTEMS AND OTHER HEALTHCARE PROVIDERS SOUGHT GUIDANCE FROM WEST HEALTH INSTITUTE IN RAPIDLY IMPLEMENTING AN EFFECTIVE TELEHEALTH PROGRAM. WHI WORKED WITH LOCAL POST-ACUTE/LONG-TERM CARE FACILITIES (PALTCS) AND HOSPITAL EMERGENCY DEPARTMENTS TO DEVELOP ELECTRONIC MEANS TO FACILITATE COVID-19 TESTING AND TELEHEALTH VISITS. WHI WAS ALSO ABLE TO SHARE KNOWLEDGE AND BEST PRACTICES IN TELEHEALTH DURING THIS CRITICAL TIME, INCLUDING VIRTUAL PRESENTATIONS/WORKSHOPS AND PUBLICATIONS. RESEARCH PROJECTS: EMERGENCY DEPARTMENT TO PALTC ACTIVITIES TO AID THE RESPONSE TO COVID-19, THE TELEHEALTH TEAM CREATED LOCAL ED TO PALTC TELEHEALTH TOOLKITS, INCLUDING DOCUMENTATION ON HOW TO ENGAGE WITH LOCAL PROVIDERS FOR TELEHEALTH ENABLED APPOINTMENTS. MOREOVER, PATHWAYS TO CONTINUE THIS ACTIVITY POST-COVID-19 WERE LAID OUT TO ENABLE A MORE ROBUST SYSTEM GOING FORWARD. TELEHEALTH IMPLEMENTATION AND "HOW-TO" GUIDE FOR LOCAL CLINICS THE TEAM FACILITATED DEVELOPMENT OF TELEHEALTH PROCESSES FOR SENIORS AT THE GARY AND MARY WEST SENIOR WELLNESS CENTER AND RELATED SITES, INCLUDING PROVISION OF EQUIPMENT, CONSULTATION, AND WORKFLOWS. AS PART OF THIS, A "HOW-TO" DOCUMENT WAS CREATED FOR LOCAL CLINICS AND CONGREGATE HOUSING FOR HOW TO ENGAGE WITH LOCAL PROVIDERS FOR TELEHEALTH ENABLED APPOINTMENTS. SPECIFIC TO COVID-19, THE TEAM PROVIDED CONSULTATIVE SUPPORT FOR PROCESSES AND COMMUNICATION FOR VIRAL TESTING AT SENIOR HOUSING SITES IN SAN DIEGO (RUN BY LOCAL ORGANIZATION SERVING SENIORS) AND HELPED ESTABLISH WORKFLOWS AND LOGISTICS FOR TESTING AND TELEHEALTH. DISSEMINATION AND KNOWLEDGE SHARING IN ADDITION TO PARTICIPATING/MODERATING OVER A DOZEN PANELS AT A VARIETY OF CONFERENCES, THE TEAM'S DISSEMINATION EFFORTS INCLUDED LEADING VIRTUAL WORKSHOPS AT THE AMERICAN TELEMEDICINE ASSOCIATION (ATA) ANNUAL CONFERENCE AND THE AMERICAN ACADEMY OF AMBULATORY CARE NURSING (AAACN) ANNUAL CONFERENCE. ADDITIONALLY, A SUITE OF DOWNLOADABLE RESOURCES FOR TELEHEALTH WAS CREATED ACROSS THE FOLLOWING TOPICS: * PALTC PROGRAM LAUNCH CHECKLIST * PROVIDER PROGRAM LAUNCH CHECKLIST * TELEHEALTH VISIT WORKFLOW FOR POST-ACUTE AND LONG-TERM CARE FACILITIES * HOW TO PROVIDE TELEHEALTH TO PACE PARTICIPANTS IN THEIR HOMES * TELEHEALTH WORKFLOW (DIRECT-TO-PATIENT) * HOW TO PROVIDE HOME-BASED PRIMARY CARE USING TELEHEALTH: DIRECT-TO-PATIENT MODEL ADDITIONAL COLLABORATIONS COVID-19 RISK FACTORS RESEARCH: IN 2020, WHI ENGAGED IN RESEARCH WITH JOHNS HOPKINS UNIVERSITY AND FAIR HEALTH TO UTILIZE MEDICARE AND PRIVATE INSURANCE CLAIMS DATA TO DETERMINE THE MOST COMMON UNDERLYING COMORBIDITIES AND RISK FACTORS ASSOCIATED WITH MORTALITY FROM COVID-19. THESE ANALYSES ALSO INVESTIGATED THE ROLE OF MEDICATIONS IN THE COURSE OF COVID-19 INFECTION, ELUCIDATING THE FACTORS ASSOCIATED WITH A SHORTER COVID-19 HOSPITALIZATION AND A FULL COVID-19 RECOVERY. THE RESULTS OF THESE ANALYSES WERE DISSEMINATED WIDELY AND GUIDED VACCINE ALLOCATION PLANNING AND THE IMPROVEMENT OF FUTURE RESPONSES TO COVID-19. THIS RESEARCH ACTIVITY WILL CONTINUE IN 2021. ORAL HEALTHCARE RESEARCH: ACROSS THE NATION, MANY SENIORS CANNOT AFFORD DENTAL CARE. MEDICARE, THE PRIMARY HEALTH INSURER FOR SENIORS, DOES NOT COVER ROUTINE DENTAL CARE. THE INSTITUTE'S APPLIED RESEARCH WITH COLLABORATORS HAS BEEN ADDRESSING THE CRITICAL NEED FOR IMPROVED ORAL HEALTHCARE FOR VULNERABLE SENIORS AND HAS PRODUCED RESULTS THAT WERE PREPARED FOR PUBLICATION IN 2020.
FORM 990, PART VI, SECTION A, LINE 2 THE MAJORITY OF THE CURRENT DIRECTORS AND OFFICERS HAVE A "BUSINESS RELATIONSHIP" AS DEFINED IN THE FORM 990 INSTRUCTIONS, WITH EACH OF THE OTHER CURRENT OFFICERS AND DIRECTORS BECAUSE OF POSITIONS THEY HOLD WITH AFFILIATED ORGANIZATIONS.
FORM 990, PART VI, SECTION A, LINE 3 GARY AND MARY WEST MANAGEMENT COMPANY, INC., ("WMC") IS A NON-PROFIT, TAXABLE ENTITY THAT PROVIDES SERVICES TO AFFILIATED ORGANIZATIONS. CERTAIN SUPERVISORY, FINANCIAL AND OTHER ADMINISTRATIVE FUNCTIONS ARE PERFORMED BY EMPLOYEES OF GARY AND MARY WEST MANAGEMENT COMPANY, INC. SALLY HALLAK, SIOBHAN GRAHAM, AND JONATHAN ZIFFERBLATT ARE OFFICERS OF WHI AND RELATED ORGANIZATIONS BUT ARE DIRECT EMPLOYEES OF WMC. (REFER TO SCHEDULE J). TOTAL OFFICER COMPENSATION PAID TO THESE OFFICERS IS $953,165.
FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-PROFIT, NON-STOCK CORPORATION WITH THREE MEMBERS DURING 2020. ONE INCORPORATED MEMBER DESIGNATED AS A PERMANENT MEMBER, THE GARY AND MARY WEST FOUNDATION, AND TWO NON-INCORPORATED MEMBERS WHICH ARE ELECTED AND TERM-BASED MEMBERS, JAMES K HASSON AND THOMAS CULHANE. ADDITIONALLY, MEMBERS APPOINT AND CAN REMOVE DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION HAVE THE AUTHORITY TO ELECT AND REMOVE MEMBERS OF THE GOVERNING BODY.
FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS REQUIRE MEMBER APPROVAL: 1. THE DISSOLUTION, LIQUIDATION, MERGER, CONSOLIDATION, RECAPITALIZATION OR OTHER REORGANIZATION OF THE CORPORATION; 2. THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION; AND 3. ANY CHANGES PROPOSED TO BE MADE BY THE CORPORATION'S BOARD OF DIRECTORS TO THE CORPORATION'S CERTIFICATE OF INCORPORATION OR BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INFORMATION WAS COMPILED FROM THE ORGANIZATION'S CORPORATE AND ACCOUNTING RECORDS AND PROVIDED TO THE ORGANIZATION'S OUTSIDE TAX PREPARER. THE COMPLETED FORM 990 WAS REVIEWED BY THE ORGANIZATION'S CFO, OUTSIDE LEGAL COUNSEL AND CEO. UPON SATISFACTORY COMPLETION OF THE INTERNAL REVIEW PROCESS, A DRAFT OF THE FORM 990 WAS CIRCULATED TO THE ORGANIZATION'S AUDIT COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW. THE FORM 990 WAS THEN FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS AND OFFICERS OF THE INSTITUTE MET REGULARLY THROUGHOUT 2020 AND DISCUSSED ALL ACTUAL AND POTENTIAL CONFLICTS OF INTEREST THAT EXISTED WITH RESPECT TO OTHER NON-PROFIT AND BUSINESS ORGANIZATIONS. THE DIRECTORS AND OFFICERS ALSO COLLECTED ANNUAL WRITTEN CONFLICT OF INTEREST STATEMENTS FROM ALL DIRECTORS AND OFFICERS. NO FAILURES OF COMPLIANCE WITH THE POLICY WERE FOUND.
FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION APPROVAL PROCESS FOR ITS EMPLOYEES. FOR THOSE PAID IN EXCESS OF $100,000, A BASIC COMPENSATION STUDY IS PERFORMED AND COMPENSATION RANGES ARE REQUIRED TO BE APPROVED BY THE BOARD OF DIRECTORS. FOR THOSE PAID IN EXCESS OF $250,000, SUCH AS THE CEO, AN ENHANCED STUDY OF COMPARABLE COMPENSATION IS PERFORMED AND THE BOARD OF DIRECTORS REVIEWS AND APPROVES COMPENSATION LEVELS. THE ORGANIZATION HAS ALSO RETAINED THE SERVICES OF AN OUTSIDE COMPENSATION CONSULTANT.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CERTIFICATE OF INCORPORATION AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON THE REQUEST FOR SUCH DOCUMENTS.
FORM 990, PART VII: THE ORGANIZATION HAS A MANAGEMENT SERVICES AGREEMENT WITH THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED NON-PROFIT CORPORATION, WHEREBY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC. PROVIDES CERTAIN ADMINISTRATIVE SUPPORT SERVICES TO THE ORGANIZATION. SUCH SERVICES INCLUDE THAT OF VARIOUS SENIOR MANAGEMENT ROLES. THE BELOW OFFICER'S COMPENSATION FROM GARY AND MARY WEST FOUNDATION WERE PRORATED AND REPORTED ON PART VII: SHELLEY LYFORD, TIMOTHY LASH AND ZIA AGHA. THE PERIOD THAT GARY AND MARY WEST FOUNDATION WAS CONSIDERED A RELATED PARTY IS 3/1/2020 - 12/31/2020.
FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 539,461. MANAGEMENT AND GENERAL EXPENSES 2,370,914. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,910,375. STUDIES/WHITEPAPERS/RESEARCH: PROGRAM SERVICE EXPENSES 9,893,314. MANAGEMENT AND GENERAL EXPENSES 1,750. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,895,064. STAKEHOLDER COMMUNICATIONS: PROGRAM SERVICE EXPENSES 6,625. MANAGEMENT AND GENERAL EXPENSES 3,426. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,051. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 987. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 987.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2020


Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2020
Open to Public Inspection
Name of the organization
GARY AND MARY WEST HEALTH INSTITUTE
 
Employer identification number

26-4146730
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity










Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)GARY AND MARY WEST HEALTH POLICY CENTER
1909 K STREET NW SUITE 730

WASHINGTON,DC20006
27-5388874 		SEE SCH R, PART VII DE 501(C)(3) PF N/A
 
No
(2)GARY AND MARY WEST HEALTH ENDOWMENT INC
1313 N MARKET ST SUITE 5300

WILMINGTON,DE19801
27-2953865 		FINANCIAL SUPPORT DE 501(C)(3) 11 N/A
 
No
(3)GARY AND MARY WEST FOUNDATION
10350 N TORREY PINES RD

LA JOLLA,CA92037
47-0793015 		SEE SCH R, PART VII DE 501(C)(3) PF N/A
 
No








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) GARY AND MARY WEST MANAGEMENT COMPANY INC

5800 ARMADA DRIVE SUITE 100
CARLSBAD,CA92008
45-4040871 		SEE SCH R, PART VII DE N/A
 C         No
(2) REFLEXION HEALTH INC

225 BROADWAY SUITE 650
SAN DIEGO,CA92101
45-5417842 		SEE SCH R, PART VII DE DIGITAL HEALTH CORP
  		C         No
(3) DIGITAL HEALTH CORP

225 BROADWAY SUITE 650
SAN DIEGO,CA92101
82-0903337 		SEE SCH R, PART VII DE GARY AND MARY WEST HEALTH ENDOWMENT INC
  		C         No








Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2020
Schedule R (Form 990) 2020
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference Explanation
PART II: IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST HEALTH POLICY CENTER, INC. PRIMARY ACTIVITY: POLICY RESEARCH TO DEVELOP MORE AFFORDABLE HEALTHCARE MODELS ENABLING SENIORS TO SUCCESSFULLY AGE.
PART II: IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST WEST FOUNDATION PRIMARY ACTIVITY: PROVIDES OUTCOMES-BASED FUNDING TO SUPPORT INITIATIVES THAT LOWER THE COST OF HEALTHCARE TO ENABLE SENIORS TO SUCCESSFULLY AGE. PERIOD THAT GARY AND MARY WEST FOUNDATION WAS CONSIDERED A RELATED PARTY IS 3/1/2020 - 12/31/2020.
PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST MANAGEMENT COMPANY, INC. TYPE OF ENTITY: GARY AND MARY WEST MANAGEMENT COMPANY, INC. IS A NON-STOCK, NON-PROFIT CORPORATION TAXED AS A C-CORPORATION THAT PROVIDES CERTAIN ADMINISTRATIVE SUPPORT SERVICES. PRIMARY ACTIVITY: PROVIDING MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES.
PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: REFLEXION HEALTH INC. PRIMARY ACTIVITY: DEVELOPING SOFTWARE TO BE USED BY PHYSICAL THERAPISTS AND PATIENTS IN PHYSICAL REHABILITATION TO LOWER THE COST OF HEALTH CARE.
PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: DIGITAL HEALTH CORP. PRIMARY ACTIVITY: HEALTHCARE COMPANY THAT HARNESSES THE POWER OF THE LATEST TECHNOLOGY TO ACCELERATE AND IMPROVE PATIENT RECOVERY AT HOME.
Schedule R (Form 990) 2020

Additional Data


Software ID:  
Software Version: