TY 2021 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Reiner Scott...................................................................... Chair/CEO thru 12/21	50.00 ................. 0.00	X	X				2,940,088	62,418
(2) Wing Bill...................................................................... Dir/Asst Secr/Vice Chair	50.00 ................. 0.00	X	X				2,459,079	76,222
(3) Jahn Andrew...................................................................... Care Division President	50.00 ................. 0.00			X			1,848,683	72,937
(4) Beaman John...................................................................... Chief Business Officer	50.00 ................. 0.00			X			1,366,110	78,586
(5) Hofheins Todd...................................................................... CFO	50.00 ................. 0.00		X				1,319,147	59,910
(6) Newmyer Joyce...................................................................... Chief Culture Officer	50.00 ................. 0.00			X			1,305,176	68,696
(7) El-Asmar Hoda - Former...................................................................... Chief Clinical Officer thru 10/20	0.00 ................. 0.00					X	1,264,697	23,191
(8) Ashlock Mark - Former...................................................................... Amb/Post-Acute President thru 06/20	0.00 ................. 0.00					X	1,180,696	32,717
(9) Jacobson Carlton...................................................................... Treasurer/Asst Secr AHCL	50.00 ................. 0.00				X		1,138,512	60,316
(10) Nahapetian Arby...................................................................... Care Division Chief Medical Officer	50.00 ................. 0.00			X			1,058,113	78,302
(11) Eller Jeff...................................................................... President, NCR	0.00 ................. 50.00			X			1,100,138	22,996
(12) Kofl Andrea...................................................................... President, AHHF	50.00 ................. 0.00			X			1,033,401	56,796
(13) Wells Jason - Chief Strategy...................................................................... Consumer & Innovation Officer	50.00 ................. 0.00			X			981,858	72,937
(14) Raffoul John...................................................................... President, AHWM	50.00 ................. 0.00			X			986,729	56,796
(15) Issai Alice...................................................................... President, AHGL	50.00 ................. 0.00			X			973,479	56,796
(16) Wolcott Daniel...................................................................... President, AHLM	50.00 ................. 0.00			X			932,279	72,937
(17) Jobe Meredith...................................................................... Secretary	50.00 ................. 0.00		X				932,705	59,761

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Byrnes John - Health........................................................................ Division Chief Medical Officer	50.00 .......................0.00			X			906,436	56,796
(19) Larsen David........................................................................ Senior Finance Officer	50.00 .......................0.00			X			876,757	67,250
(20) Zazone Dana - Health........................................................................ Informatics Officer thru 08/21	50.00 .......................0.00				X		915,848	25,812
(21) Stevens Eric........................................................................ Care Division Operations Executive	50.00 .......................0.00			X			884,611	49,992
(22) Itani Mohamad........................................................................ VP Ambulatory Services thru 04/21	50.00 .......................0.00				X		918,086	15,547
(23) Long Collier - Business........................................................................ Development Executive thru 08/21	50.00 .......................0.00			X			853,660	18,660
(24) Beehler Robert........................................................................ Mkt Dev, M&A Exec thru 12/21	50.00 .......................0.00			X			792,803	56,796
(25) Takahashi Patrick........................................................................ Medical Officer, AHWM	50.00 .......................0.00				X		785,190	48,929
(26) Rawson Richard........................................................................ President, AHRO thru 10/21	50.00 .......................0.00			X			790,001	41,954
(27) Spenst Brett........................................................................ Care Division Finance Officer	50.00 .......................0.00			X			786,101	45,300
(28) Liebowitz Jacalyn........................................................................ System Chief Nursing Officer	50.00 .......................0.00			X			750,899	67,250
(29) Cowan Joshua........................................................................ Vice President, Strategy & Comm thru 02/21	50.00 .......................0.00				X		795,652	16,711
(30) Ferch Wayne........................................................................ Former President, CCR thru 02/20	0.00 .......................0.00					X	586,112	18,351
(31) Raethel Kathryn........................................................................ President, AHCS thru 08/21	50.00 .......................0.00			X			572,765	31,053
(32) Bancarz Gloria - System........................................................................ Chief Quality Officer thru 06/21	50.00 .......................0.00			X			579,986	16,221
(33) Olson Joaline - Former........................................................................ Chief Human Performance Officer, AHRS thru	0.00 .......................0.00					X	560,119	22,512
(34) Briggs Sharlet........................................................................ Former President, AHBD thru 08/20	0.00 .......................0.00					X	548,135	32,738
(35) Heinrich Kerry........................................................................ Dir/CEO Elect as of 11/21	50.00 .......................0.00	X					282,697	2,627
(36) Reppert Joseph........................................................................ Former CFO/Asst Secr thru 08/19	0.00 .......................0.00					X	179,119	11,442
(37) Conklin Jeffrey - Former........................................................................ Payer Strategy Exec thru 07/19	0.00 .......................0.00					X	166,324	16,799
(38) Freedman John........................................................................ Dir/Vice Chair/Chair as of 08/21	4.00 .......................0.00	X	X				26,435	0
(39) Banks David........................................................................ Director	4.00 .......................0.00	X					26,159	0
(40) Cherry Robert........................................................................ Director	4.00 .......................0.00	X					26,159	0
(41) Davis Andrew........................................................................ Director	4.00 .......................0.00	X					26,159	0
(42) Innocent Larry........................................................................ Director	4.00 .......................0.00	X					26,159	0
(43) Reiner Richard........................................................................ Director	4.00 .......................0.00	X					26,159	0
(44) Graham Ricardo........................................................................ Dir/Chair thru 08/21	4.00 .......................0.00	X	X				19,545	0
(45) Woodson Marc........................................................................ Director	4.00 .......................0.00	X					15,909	0
(46) Salazar Velino........................................................................ Director	4.00 .......................0.00	X					6,058	0
(47) Ocampo Lucy........................................................................ Director	4.00 .......................0.00	X					159	0
(48) Fehr Joy........................................................................ Director	4.00 .......................0.00	X					114	0
(49) Newton Bradford........................................................................ Dir/Vice Chair as of 08/21	4.00 .......................0.00	X	X				0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Cerner Corporation 2800 Rockcreek Pkwy Kansas City,MO64117	IT solutions management	6,216,763
Trizetto Provider Solutions LLC 28125 Network Pl Chicago,IL60673	Software solutions	2,893,291
Deloitte and Touche LLP PO Box 844708 Dallas,TX75284	Consulting services	2,722,433
Cope Healthcare Consulting Inc 1150 S Olive St Ste 1200 Los Angeles,CA90015	Consulting services	2,317,395
Latham and Watkins LLP PO Box 894256 Los Angeles,CA90189	Legal services	1,985,782
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 88

- TIN:

SCHEDULE A
(Form 990)

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	96,561	7,311,552	795,492	656,685	5,429,366	14,289,656
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	336,953,180	336,205,379	499,824,640	691,252,418	723,450,627	2,587,686,244
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	337,049,741	343,516,931	500,620,132	691,909,103	728,879,993	2,601,975,900
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons	310,029	7,240,793	9,928,758	14,696,260	16,936,877	49,112,717
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.						0
c	Add lines 7a and 7b..	310,029	7,240,793	9,928,758	14,696,260	16,936,877	49,112,717
8	Public support. (Subtract line 7c from line 6.)						2,552,863,183

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...	337,049,741	343,516,931	500,620,132	691,909,103	728,879,993	2,601,975,900
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	8,329,768	2,629,457	5,992,756	4,347,721	6,697,052	27,996,754
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.	8,329,768	2,629,457	5,992,756	4,347,721	6,697,052	27,996,754
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.	517,858	573,287				1,091,145
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..		660,599	15,292,368	61,655,228	34,557,743	112,165,938
13	Total support. (Add lines 9, 10c, 11, and 12.)..	345,897,367	347,380,274	521,905,256	757,912,052	770,134,788	2,743,229,737

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

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

93.060 %

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

89.490 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

1.020 %

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

4.140 %

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

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

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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.

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.

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.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

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.

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) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

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.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on 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.

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

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) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on 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

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

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?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

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.

Did the activities described on 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

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.

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.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

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 2021 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-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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, Part III, Line 12, Explanation of Other Income:	Miscellaneous revenue

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization Adventist Health SystemWest

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization Adventist Health SystemWest		Employer identification number 95-3484589

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization Adventist Health SystemWest			Employer identification number 95-3484589
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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 Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

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

Adventist Health SystemWest

Employer identification number

95-3484589

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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.

Cat. No. 50084S

Schedule C (Form 990) 2021

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	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) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -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? ...................................................................................................................	Yes No

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

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

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

984,049

Total. Add lines 1c through 1i ....................................................................................................

984,049

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

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
Part II-B, Line 1:	Adventist Health engages lobbyists and belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

2021

Open to Public Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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.

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.

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

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:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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 ....	2,383,951	3,418,916	3,006,309	1,146,338	1,131,235
b	Contributions ...	528,802	656,685	795,400	7,277,972	96,561
c	Net investment earnings, gains, and losses			3,399,636	-3,327,136	18,082
d	Grants or scholarships ...					94,541
e	Other expenditures for facilities and programs ...	482,842	1,691,650	3,782,429	2,090,865	4,999
f	Administrative expenses ....
g	End of year balance ......	2,429,911	2,383,951	3,418,916	3,006,309	1,146,338

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

47.000 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

53.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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 .....	43,409,816		43,409,816
b	Buildings ....	133,709,230	20,013,213	113,696,017
c	Leasehold improvements	12,828,554	2,577,882	10,250,672
d	Equipment ....	367,002,362	238,156,602	128,845,760
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				296,202,265

Schedule D (Form 990) 2021

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 (A) Partnership interests	100,120,152	F
(B) Hedge funds	324,321,981	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	424,442,133

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

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
(1)Receivables from related organizations				371,729,758
(2)Other receivables				15,532,605
(3)Other assets				5,535,930
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				392,798,293

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	683,044,553
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) 2021

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
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
3	Subtract line 2e from line 1..................		3
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
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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
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
3	Subtract line 2e from line 1...................		3
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
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

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 V, Line 4:

A $1M board-designated fund was established to honor a former AH president. The earnings are used to provide funding for paying college student interns and graduate student residents as they participate in tracks such as accounting/finance, human resources, communications and management with the goal of introducing the participants to career options in the integrated health care field. Individuals who participate in the program frequently become employed within the AH system upon completion of their academic studies.

Part X, Line 2:

The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 50l(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2021 and 2020, no such assets or liabilities were recorded. The System currently files Form 990 (informational return of organizations exempt from income taxes) and Form 990-T (business income tax return for an exempt organization) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2018 in major tax jurisdictions.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
Adventist Health SystemWest

Employer identification number

95-3484589

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Central America and the Caribbean	0	0	Program services	Administration, legal and accounting fees	61,750
	Central America and the Caribbean	0	0	Program services	Reinsurance fees	1,803,000
	Central America and the Caribbean	0	0	Investments in region	N/A	292,242,665
	Europe	0	0	Investments in region	N/A	37,130,599













3a	Sub-total ....	0	0			331,238,014
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			331,238,014

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation
Part I, line 3:	Accrual method
Part III Accounting Method:

Schedule F (Form 990) 2021

Additional Data

Software ID:
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- TIN:

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

2021

Open to Public
Inspection

Name of the organization
Adventist Health SystemWest

Employer identification number
95-3484589

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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	(h) Purpose of grant or assistance
(1) Adventist Development & Relief Agency 12501 Old Columbia Pike Silver Springs,MD20904	52-1314847	501(c)(3)	742,600	COVID-19 Response $25,000 / Mission to Africa $717,600
(2) Andrews University 4145 East Campus Circle Drive Berrien Springs,MI491041502	38-1627600	501(c)(3)	6,250	Urban Mission and Ministry Congress Sponsorship
(3) Baldridge Foundation 1717 Pennsylvania Avenue NW Suite 1025 Washington,DC20006	59-2891462	501(c)(3)	100,000	Founding Membership
(4) Feather River Health Foundation 1 Adventist Health Way Roseville,CA95661	68-0002188	501(c)(3)	420,000	Forklift purchase and general support
(5) General Conference of Seventh Day Adventist 12501 Old Columbia Pike Silver Springs,MD20904	52-0643036	501(c)(3)	15,000	Donation to Sanatorio Adventist/Clinica Belgrano
(6) Gleanings for the Hungry 43029 Rd 104 Dinuba,CA93618	77-0170546	501(c)(3)	8,000	Donation for Columbia Shipments
(7) Inter-American Division Inc PO Box 830518 Miami,FL33283			11,500	Donation to Dental Clinic/Mexico
(8) Northwest Medical Foundation Tillamook 1000 Third Street Tillamook,OR97141	93-0622075	501(c)(3)	6,000	NAAHHR Sponsorship
(9) SonBridge Community Center 1200 SE 12th St Suite 1 College Place,WA99324	20-2958334	501(c)(3)	150,000	Donation to run dental clinic
(10) Walla Walla University 204 S College Ave College Place,WA99324	91-0617727	501(c)(3)	1,855,000	Community Wellbeing Implementation $1,850,000 / Donald Blake Center - Equity Conference $5,000

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2021

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) Caring Connection	12	15,575
(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:	Funding provided to other organizations is provided to recipients with the understanding that the funds are being used only for the designated purposes. No monitoring is conducted by AH.

Schedule I (Form 990) 2021

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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 .....

Yes

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? ....

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

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:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

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:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

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 ............

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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Reiner Scott Chair/CEO thru 12/21	(i) (ii)	1,801,000 ------------- 0	1,112,062 ------------- 0	27,026 ------------- 0	11,644 ------------- 0	50,774 ------------- 0	3,002,506 ------------- 0	0 ------------- 0
2Wing Bill Dir/Asst Secr/Vice Chair	(i) (ii)	1,440,800 ------------- 0	991,833 ------------- 0	26,446 ------------- 0	11,644 ------------- 0	64,578 ------------- 0	2,535,301 ------------- 0	0 ------------- 0
3Jahn Andrew Care Division President	(i) (ii)	1,044,420 ------------- 0	600,285 ------------- 0	203,978 ------------- 0	11,644 ------------- 0	61,293 ------------- 0	1,921,620 ------------- 0	0 ------------- 0
4Beaman John Chief Business Officer	(i) (ii)	892,500 ------------- 0	455,303 ------------- 0	18,307 ------------- 0	11,644 ------------- 0	66,942 ------------- 0	1,444,696 ------------- 0	0 ------------- 0
5Hofheins Todd CFO	(i) (ii)	999,600 ------------- 0	116,549 ------------- 0	202,998 ------------- 0	11,644 ------------- 0	48,266 ------------- 0	1,379,057 ------------- 0	0 ------------- 0
6Newmyer Joyce Chief Culture Officer	(i) (ii)	728,980 ------------- 0	447,399 ------------- 0	128,797 ------------- 0	11,644 ------------- 0	57,052 ------------- 0	1,373,872 ------------- 0	107,631 ------------- 0
7El-Asmar Hoda - Former Chief Clinical Officer thru 10/20	(i) (ii)	0 ------------- 0	407,203 ------------- 0	857,494 ------------- 0	0 ------------- 0	23,191 ------------- 0	1,287,888 ------------- 0	0 ------------- 0
8Ashlock Mark - Former Amb/Post-Acute President thru 06/20	(i) (ii)	0 ------------- 0	426,536 ------------- 0	754,160 ------------- 0	0 ------------- 0	32,717 ------------- 0	1,213,413 ------------- 0	0 ------------- 0
9Jacobson Carlton Treasurer/Asst Secr AHCL	(i) (ii)	267,194 ------------- 0	62,829 ------------- 0	808,489 ------------- 0	12,672 ------------- 0	47,644 ------------- 0	1,198,828 ------------- 0	0 ------------- 0
10Nahapetian Arby Care Division Chief Medical Officer	(i) (ii)	700,000 ------------- 0	222,478 ------------- 0	135,635 ------------- 0	11,644 ------------- 0	66,658 ------------- 0	1,136,415 ------------- 0	0 ------------- 0
11Eller Jeff President, NCR	(i) (ii)	531,828 ------------- 0	547,897 ------------- 0	20,413 ------------- 0	0 ------------- 0	22,996 ------------- 0	1,123,134 ------------- 0	0 ------------- 0
12Kofl Andrea President, AHHF	(i) (ii)	624,000 ------------- 0	263,477 ------------- 0	145,924 ------------- 0	11,644 ------------- 0	45,152 ------------- 0	1,090,197 ------------- 0	0 ------------- 0
13Wells Jason - Chief Strategy Consumer & Innovation Officer	(i) (ii)	654,569 ------------- 0	228,465 ------------- 0	98,824 ------------- 0	11,644 ------------- 0	61,293 ------------- 0	1,054,795 ------------- 0	0 ------------- 0
14Raffoul John President, AHWM	(i) (ii)	598,791 ------------- 0	254,842 ------------- 0	133,096 ------------- 0	11,644 ------------- 0	45,152 ------------- 0	1,043,525 ------------- 0	0 ------------- 0
15Issai Alice President, AHGL	(i) (ii)	606,722 ------------- 0	251,048 ------------- 0	115,709 ------------- 0	11,644 ------------- 0	45,152 ------------- 0	1,030,275 ------------- 0	0 ------------- 0
16Wolcott Daniel President, AHLM	(i) (ii)	601,280 ------------- 0	226,669 ------------- 0	104,330 ------------- 0	11,644 ------------- 0	61,293 ------------- 0	1,005,216 ------------- 0	0 ------------- 0
17Jobe Meredith Secretary	(i) (ii)	616,324 ------------- 0	169,142 ------------- 0	147,239 ------------- 0	14,609 ------------- 0	45,152 ------------- 0	992,466 ------------- 0	0 ------------- 0
18Byrnes John - Health Division Chief Medical Officer	(i) (ii)	622,962 ------------- 0	172,647 ------------- 0	110,827 ------------- 0	11,644 ------------- 0	45,152 ------------- 0	963,232 ------------- 0	0 ------------- 0
19Larsen David Senior Finance Officer	(i) (ii)	567,118 ------------- 0	201,820 ------------- 0	107,819 ------------- 0	11,644 ------------- 0	55,606 ------------- 0	944,007 ------------- 0	0 ------------- 0
20Zazone Dana - Health Informatics Officer thru 08/21	(i) (ii)	263,400 ------------- 0	170,916 ------------- 0	481,532 ------------- 0	0 ------------- 0	25,812 ------------- 0	941,660 ------------- 0	0 ------------- 0
21Stevens Eric Care Division Operations Executive	(i) (ii)	749,000 ------------- 0	76 ------------- 0	135,535 ------------- 0	16,336 ------------- 0	33,656 ------------- 0	934,603 ------------- 0	0 ------------- 0
22Itani Mohamad VP Ambulatory Services thru 04/21	(i) (ii)	110,757 ------------- 0	102,064 ------------- 0	705,265 ------------- 0	14 ------------- 0	15,533 ------------- 0	933,633 ------------- 0	0 ------------- 0
23Long Collier - Business Development Executive thru 08/21	(i) (ii)	388,924 ------------- 0	201,516 ------------- 0	263,220 ------------- 0	1,156 ------------- 0	17,504 ------------- 0	872,320 ------------- 0	0 ------------- 0
24Beehler Robert Mkt Dev, M&A Exec thru 12/21	(i) (ii)	510,962 ------------- 0	150,206 ------------- 0	131,635 ------------- 0	11,644 ------------- 0	45,152 ------------- 0	849,599 ------------- 0	0 ------------- 0
25Takahashi Patrick Medical Officer, AHWM	(i) (ii)	495,519 ------------- 0	177,452 ------------- 0	112,219 ------------- 0	11,644 ------------- 0	37,285 ------------- 0	834,119 ------------- 0	0 ------------- 0
26Rawson Richard President, AHRO thru 10/21	(i) (ii)	507,813 ------------- 0	190,684 ------------- 0	91,504 ------------- 0	0 ------------- 0	41,954 ------------- 0	831,955 ------------- 0	0 ------------- 0
27Spenst Brett Care Division Finance Officer	(i) (ii)	734,400 ------------- 0	38,124 ------------- 0	13,577 ------------- 0	11,644 ------------- 0	33,656 ------------- 0	831,401 ------------- 0	0 ------------- 0
28Liebowitz Jacalyn System Chief Nursing Officer	(i) (ii)	507,000 ------------- 0	165,422 ------------- 0	78,477 ------------- 0	11,644 ------------- 0	55,606 ------------- 0	818,149 ------------- 0	0 ------------- 0
29Cowan Joshua Vice President, Strategy & Comm thru	(i) (ii)	54,806 ------------- 0	108,880 ------------- 0	631,966 ------------- 0	14 ------------- 0	16,697 ------------- 0	812,363 ------------- 0	0 ------------- 0
30Ferch Wayne Former President, CCR thru 02/20	(i) (ii)	0 ------------- 0	585,289 ------------- 0	823 ------------- 0	0 ------------- 0	18,351 ------------- 0	604,463 ------------- 0	0 ------------- 0
31Raethel Kathryn President, AHCS thru 08/21	(i) (ii)	281,445 ------------- 0	198,882 ------------- 0	92,438 ------------- 0	11,644 ------------- 0	19,409 ------------- 0	603,818 ------------- 0	0 ------------- 0
32Bancarz Gloria - System Chief Quality Officer thru 06/21	(i) (ii)	269,028 ------------- 0	0 ------------- 0	310,958 ------------- 0	0 ------------- 0	16,221 ------------- 0	596,207 ------------- 0	0 ------------- 0
33Olson Joaline - Former Chief Human Performance Officer, AHR	(i) (ii)	0 ------------- 0	92,800 ------------- 0	467,319 ------------- 0	0 ------------- 0	22,512 ------------- 0	582,631 ------------- 0	0 ------------- 0
34Briggs Sharlet Former President, AHBD thru 08/20	(i) (ii)	0 ------------- 0	0 ------------- 0	548,135 ------------- 0	0 ------------- 0	32,738 ------------- 0	580,873 ------------- 0	0 ------------- 0
35Heinrich Kerry Dir/CEO Elect as of 11/21	(i) (ii)	138,538 ------------- 0	123,000 ------------- 0	21,159 ------------- 0	0 ------------- 0	2,627 ------------- 0	285,324 ------------- 0	0 ------------- 0
36Reppert Joseph Former CFO/Asst Secr thru 08/19	(i) (ii)	0 ------------- 0	0 ------------- 0	179,119 ------------- 0	0 ------------- 0	11,442 ------------- 0	190,561 ------------- 0	0 ------------- 0
37Conklin Jeffrey - Former Payer Strategy Exec thru 07/19	(i) (ii)	0 ------------- 0	0 ------------- 0	166,324 ------------- 0	0 ------------- 0	16,799 ------------- 0	183,123 ------------- 0	8,402 ------------- 0

Schedule J (Form 990) 2021

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

First-class or charter travel - board directors are reimbursed for travel in business class for flight segments of three hours or more. If business class is unavailable, first class is reimbursed. This policy was adopted to aid in the attendee being able to work during the flight(s). Key employees occasionally utilize charter travel when alternative transportation methods cannot accommodate schedules. This is not reported as taxable income. Tax indemnification and gross-up payments - received by 10 directors; reported as taxable income.

Part I, Lines 4a-b

Severance payments are made based upon agreements between certain qualifying employees and Adventist Health System/West. Details of the terms and conditions of the severance agreements are available to the IRS upon request. Ashlock, Mark - severance payment - $749,559 Bancarz, Gloria - severance payment - $249,922 Briggs, Sharlet - severance payment - $546,914 Conklin, Jeffrey - severance payment - $167,580 Cowan, Joshua - severance payment - $623,422 El-Asmar, Hoda - severance payment - $857,260 Itani, Mohamad - severance payment - $687,764 Long, Collier - severance payment - $188,906 Olson, Joaline - severance payment - $468,375 Reppert, Joseph - severance payment - $179,957 Zazone, Dana - severance payment - $440,689 The Supplemental Executive Retirement Plan (SERP) is a defined contribution plan designed to encourage the participants continued employment with Adventist Health and is subject to the participants satisfying specified substantial risks of forfeiture. The SERP benefit distribution occurs when the executive achieves 30 years of Adventist health care service, 20 of which are to be as an executive and at least 10 are to be with Adventist Health System/West, and reaches age 60. Until that time, the SERP benefit is at risk to the creditors of Adventist Health. The SERP benefit is designed to help the executive receive employer-provided retirement benefit income equal to 60% of pre-retirement income. The SERP plan was frozen for new participants in 2016. Jacobson, Carlton - contributed and distributed - $772,048 Larsen, David - contributed and distributed - $2,496 Raffoul, John - participant, no activity in 2021 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V, for a broader description. Split-Dollar life insurance participants are Mark Ashlock, John Beaman, Jeff Eller, Wayne Ferch, Todd Hofheins, Andrew Jahn, Joyce Newmyer, JoAline Olson, Scott Reiner, Brett Spenst and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Conklin, Jeffrey - $8,402 Jahn, Andrew - participant, no activity in 2021 Newmyer, Joyce - $107,631

Schedule J (Form 990) 2021

Additional Data

Software ID:
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- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Adventist Health SystemWest

Employer identification number
95-3484589

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CSCDA Series A 2007	68-0164610	1307957C5	05-08-2007	57,500,000	See Part VI		X		X		X
B	CHFFA Series B 2009	52-1643828	13033LBC0	05-20-2009	30,000,000	See Part VI		X		X		X
C	CHFFA Series C 2011	52-1643828	000000000	06-09-2011	130,000,000	See Part VI		X		X		X
D	CHFFA Series A 2013	52-1643828	13033LS65	02-14-2013	208,420,907	See Part VI		X		X		X
	CHFFA Series A 2013	52-1643828	13033LS57	02-14-2013	100,741,934	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJL9	06-30-2015	157,990,834	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJM7	06-30-2015	42,422,999	See Part VI		X		X		X
	CHFFA Series A 2016	52-1643828	13032UGL6	09-08-2016	309,720,490	See Part VI		X		X		X
	CSCDA Series A 2018	68-0164610	13080SWK6	09-27-2018	272,074,615	See Part VI		X		X		X
	HFA Multnomah 2019	93-1266280	62551PCX3	11-13-2019	60,886,489	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	21,440,000		14,118,000		49,490,000		44,180,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	57,500,000		30,000,000		130,000,000		208,420,907
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	643,910		216,916		478,200		979,977
8 Credit enhancement from proceeds .............	1,409,177
9 Working capital expenditures from proceeds .............	4,480,297		9,150		2,576
10 Capital expenditures from proceeds .............	50,966,616		29,783,084		129,521,800
11 Other spent proceeds .............	27,000,000		156,488,239				207,440,930
12 Other unspent proceeds .............
13 Year of substantial completion .............	2010		2009		2015		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: CHFFA Series B 2009 Date the Rebate Computation was Performed: 06/17/2019 Issuer Name: CHFFA Series C 2011 Date the Rebate Computation was Performed: 07/14/2021 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CHFFA Series A 2016 Date the Rebate Computation was Performed: 10/19/2021
Part I, Columns (A-D) Issuer's Name:	CSCDA - California Statewide Communities Development Authority CHFFA - California Health Facilities Financing Authority HFA - The Hospital Facilities Authority of Multnomah County, Oregon
Part I, Entity 1, Column (f), Line A:	Construct, equip and remodel the following health care facilities: Feather River Hospital, Paradise, CA Hanford Community Hospital, Hanford, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line B:	Acquire, construct and equip the following health care facilities: Adventist Health Clearlake Hospital Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line C:	Refinance a bank loan used to construct, equip the following health care facilities: Adventist Health Clearlake Hospital, Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 1, Column (f), Line D:	Refund outstanding balance of the following bond issues: 2002 California Health Facilities Financing Authority (AHS/West Series A) bonds issued March 20, 2002 2002 California Health Facilities Financing Authority (AHS/West Series B) bonds issued March 2002 2003 California Health Facilities Financing Authority (AHS/West Series A) bonds issued July 1, 2003
Part I, Entity 2, Column (f), Line A:	Acquire, construct, and equip the following health care facilities: Central Valley General Hospital, Hanford, CA Feather River Hospital Paradise, CA Willits Hospital, Inc, Willits, CA Hanford Community Hospital, Hanford, CA San Joaquin Community Hospital, Bakersfield, CA Ukiah Valley Hospital, Ukiah, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 2, Column (f), Line B:	Refund outstanding balance of the following bond issue: 2005 California Statewide Communities Development Authority (AHS/West Series A) bonds issued on October 18, 2005
Part I, Entity 2, Column (f), Line C:	Acquire, construct, and equip the following health care facilities: Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA
Part I, Entity 2, Column (f), Line D:	Advance refund outstanding balance of the following bond issues: 1998 California Health Facilities Financing Authority (AHS/West Series A) issued February 18, 1998 2007 California Statewide Communities Development Authority (AHS/West Series B) bonds issued May 8, 2007 2007 California Statewide Communities Development Authority (Lodi) bonds issued December 13, 2007 2009 California Health Facilities Financing Authority (AHS/West Series A) bonds issued May 20, 2009
Part I, Entity 3, Column (f), Line A:	Finance the new headquarters facility for the Corporation located in Roseville, CA and refinance the following bond issues: City of Marysville, CA Rideout Series 2011 Bonds acquired in the affiliation with The Fremont-Rideout Health Group and Rideout Memorial Hospital effective April 1, 2018
Part I, Entity 3, Column (f), Line B:	Refund the outstanding balance of the following bond issue: 2009 HFA - The Hospital Facilities Authority of Multnomah County, Oregon (AHS/West Series A) issued September 30, 2009
Part II, Entity 1, Line 11, Column D:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.
Part II, Entity 2, Line 11, Columns B & D:	The other spent proceeds are the refunding proceeds no longer in escrow.
Part II, Entity 3, Line 11, Column A:	The other spent proceeds are the proceeds used to pay off the taxable line of credit which was used to finance initial costs of the project.
Part II, Entity 3, Line 11, Column B:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Adventist Health SystemWest

Employer identification number
95-3484589

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CSCDA Series A 2007	68-0164610	1307957C5	05-08-2007	57,500,000	See Part VI		X		X		X
B	CHFFA Series B 2009	52-1643828	13033LBC0	05-20-2009	30,000,000	See Part VI		X		X		X
C	CHFFA Series C 2011	52-1643828	000000000	06-09-2011	130,000,000	See Part VI		X		X		X
D	CHFFA Series A 2013	52-1643828	13033LS65	02-14-2013	208,420,907	See Part VI		X		X		X
	CHFFA Series A 2013	52-1643828	13033LS57	02-14-2013	100,741,934	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJL9	06-30-2015	157,990,834	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJM7	06-30-2015	42,422,999	See Part VI		X		X		X
	CHFFA Series A 2016	52-1643828	13032UGL6	09-08-2016	309,720,490	See Part VI		X		X		X
	CSCDA Series A 2018	68-0164610	13080SWK6	09-27-2018	272,074,615	See Part VI		X		X		X
	HFA Multnomah 2019	93-1266280	62551PCX3	11-13-2019	60,886,489	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	21,440,000		14,118,000		49,490,000		44,180,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	57,500,000		30,000,000		130,000,000		208,420,907
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	643,910		216,916		478,200		979,977
8 Credit enhancement from proceeds .............	1,409,177
9 Working capital expenditures from proceeds .............	4,480,297		9,150		2,576
10 Capital expenditures from proceeds .............	50,966,616		29,783,084		129,521,800
11 Other spent proceeds .............	27,000,000		156,488,239				207,440,930
12 Other unspent proceeds .............
13 Year of substantial completion .............	2010		2009		2015		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: CHFFA Series B 2009 Date the Rebate Computation was Performed: 06/17/2019 Issuer Name: CHFFA Series C 2011 Date the Rebate Computation was Performed: 07/14/2021 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CHFFA Series A 2016 Date the Rebate Computation was Performed: 10/19/2021
Part I, Columns (A-D) Issuer's Name:	CSCDA - California Statewide Communities Development Authority CHFFA - California Health Facilities Financing Authority HFA - The Hospital Facilities Authority of Multnomah County, Oregon
Part I, Entity 1, Column (f), Line A:	Construct, equip and remodel the following health care facilities: Feather River Hospital, Paradise, CA Hanford Community Hospital, Hanford, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line B:	Acquire, construct and equip the following health care facilities: Adventist Health Clearlake Hospital Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line C:	Refinance a bank loan used to construct, equip the following health care facilities: Adventist Health Clearlake Hospital, Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 1, Column (f), Line D:	Refund outstanding balance of the following bond issues: 2002 California Health Facilities Financing Authority (AHS/West Series A) bonds issued March 20, 2002 2002 California Health Facilities Financing Authority (AHS/West Series B) bonds issued March 2002 2003 California Health Facilities Financing Authority (AHS/West Series A) bonds issued July 1, 2003
Part I, Entity 2, Column (f), Line A:	Acquire, construct, and equip the following health care facilities: Central Valley General Hospital, Hanford, CA Feather River Hospital Paradise, CA Willits Hospital, Inc, Willits, CA Hanford Community Hospital, Hanford, CA San Joaquin Community Hospital, Bakersfield, CA Ukiah Valley Hospital, Ukiah, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 2, Column (f), Line B:	Refund outstanding balance of the following bond issue: 2005 California Statewide Communities Development Authority (AHS/West Series A) bonds issued on October 18, 2005
Part I, Entity 2, Column (f), Line C:	Acquire, construct, and equip the following health care facilities: Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA
Part I, Entity 2, Column (f), Line D:	Advance refund outstanding balance of the following bond issues: 1998 California Health Facilities Financing Authority (AHS/West Series A) issued February 18, 1998 2007 California Statewide Communities Development Authority (AHS/West Series B) bonds issued May 8, 2007 2007 California Statewide Communities Development Authority (Lodi) bonds issued December 13, 2007 2009 California Health Facilities Financing Authority (AHS/West Series A) bonds issued May 20, 2009
Part I, Entity 3, Column (f), Line A:	Finance the new headquarters facility for the Corporation located in Roseville, CA and refinance the following bond issues: City of Marysville, CA Rideout Series 2011 Bonds acquired in the affiliation with The Fremont-Rideout Health Group and Rideout Memorial Hospital effective April 1, 2018
Part I, Entity 3, Column (f), Line B:	Refund the outstanding balance of the following bond issue: 2009 HFA - The Hospital Facilities Authority of Multnomah County, Oregon (AHS/West Series A) issued September 30, 2009
Part II, Entity 1, Line 11, Column D:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.
Part II, Entity 2, Line 11, Columns B & D:	The other spent proceeds are the refunding proceeds no longer in escrow.
Part II, Entity 3, Line 11, Column A:	The other spent proceeds are the proceeds used to pay off the taxable line of credit which was used to finance initial costs of the project.
Part II, Entity 3, Line 11, Column B:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.

Schedule K (Form 990) 2021

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
Adventist Health SystemWest

Employer identification number
95-3484589

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CSCDA Series A 2007	68-0164610	1307957C5	05-08-2007	57,500,000	See Part VI		X		X		X
B	CHFFA Series B 2009	52-1643828	13033LBC0	05-20-2009	30,000,000	See Part VI		X		X		X
C	CHFFA Series C 2011	52-1643828	000000000	06-09-2011	130,000,000	See Part VI		X		X		X
D	CHFFA Series A 2013	52-1643828	13033LS65	02-14-2013	208,420,907	See Part VI		X		X		X
	CHFFA Series A 2013	52-1643828	13033LS57	02-14-2013	100,741,934	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJL9	06-30-2015	157,990,834	See Part VI		X		X		X
	CSCDA Series A 2015	68-0164610	13080SJM7	06-30-2015	42,422,999	See Part VI		X		X		X
	CHFFA Series A 2016	52-1643828	13032UGL6	09-08-2016	309,720,490	See Part VI		X		X		X
	CSCDA Series A 2018	68-0164610	13080SWK6	09-27-2018	272,074,615	See Part VI		X		X		X
	HFA Multnomah 2019	93-1266280	62551PCX3	11-13-2019	60,886,489	See Part VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	21,440,000		14,118,000		49,490,000		44,180,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	57,500,000		30,000,000		130,000,000		208,420,907
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	643,910		216,916		478,200		979,977
8 Credit enhancement from proceeds .............	1,409,177
9 Working capital expenditures from proceeds .............	4,480,297		9,150		2,576
10 Capital expenditures from proceeds .............	50,966,616		29,783,084		129,521,800
11 Other spent proceeds .............	27,000,000		156,488,239				207,440,930
12 Other unspent proceeds .............
13 Year of substantial completion .............	2010		2009		2015		2016
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X		X		X	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...	X			X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X			X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Date Rebate Computation Performed	Issuer Name: CHFFA Series B 2009 Date the Rebate Computation was Performed: 06/17/2019 Issuer Name: CHFFA Series C 2011 Date the Rebate Computation was Performed: 07/14/2021 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CHFFA Series A 2013 Date the Rebate Computation was Performed: 04/06/2018 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CSCDA Series A 2015 Date the Rebate Computation was Performed: 07/20/2020 Issuer Name: CHFFA Series A 2016 Date the Rebate Computation was Performed: 10/19/2021
Part I, Columns (A-D) Issuer's Name:	CSCDA - California Statewide Communities Development Authority CHFFA - California Health Facilities Financing Authority HFA - The Hospital Facilities Authority of Multnomah County, Oregon
Part I, Entity 1, Column (f), Line A:	Construct, equip and remodel the following health care facilities: Feather River Hospital, Paradise, CA Hanford Community Hospital, Hanford, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line B:	Acquire, construct and equip the following health care facilities: Adventist Health Clearlake Hospital Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA
Part I, Entity 1, Column (f), Line C:	Refinance a bank loan used to construct, equip the following health care facilities: Adventist Health Clearlake Hospital, Inc., Clearlake, CA Feather River Hospital, Paradise, CA Glendale Adventist Medical Center, Glendale, CA St. Helena Hospital, St. Helena, CA Simi Valley Hospital and Health Care Services, Simi Valley, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 1, Column (f), Line D:	Refund outstanding balance of the following bond issues: 2002 California Health Facilities Financing Authority (AHS/West Series A) bonds issued March 20, 2002 2002 California Health Facilities Financing Authority (AHS/West Series B) bonds issued March 2002 2003 California Health Facilities Financing Authority (AHS/West Series A) bonds issued July 1, 2003
Part I, Entity 2, Column (f), Line A:	Acquire, construct, and equip the following health care facilities: Central Valley General Hospital, Hanford, CA Feather River Hospital Paradise, CA Willits Hospital, Inc, Willits, CA Hanford Community Hospital, Hanford, CA San Joaquin Community Hospital, Bakersfield, CA Ukiah Valley Hospital, Ukiah, CA Acquire and install a clinical information system: Adventist Health System/West, Roseville, CA
Part I, Entity 2, Column (f), Line B:	Refund outstanding balance of the following bond issue: 2005 California Statewide Communities Development Authority (AHS/West Series A) bonds issued on October 18, 2005
Part I, Entity 2, Column (f), Line C:	Acquire, construct, and equip the following health care facilities: Hanford Community Hospital, Hanford, CA St. Helena Hospital, St. Helena, CA
Part I, Entity 2, Column (f), Line D:	Advance refund outstanding balance of the following bond issues: 1998 California Health Facilities Financing Authority (AHS/West Series A) issued February 18, 1998 2007 California Statewide Communities Development Authority (AHS/West Series B) bonds issued May 8, 2007 2007 California Statewide Communities Development Authority (Lodi) bonds issued December 13, 2007 2009 California Health Facilities Financing Authority (AHS/West Series A) bonds issued May 20, 2009
Part I, Entity 3, Column (f), Line A:	Finance the new headquarters facility for the Corporation located in Roseville, CA and refinance the following bond issues: City of Marysville, CA Rideout Series 2011 Bonds acquired in the affiliation with The Fremont-Rideout Health Group and Rideout Memorial Hospital effective April 1, 2018
Part I, Entity 3, Column (f), Line B:	Refund the outstanding balance of the following bond issue: 2009 HFA - The Hospital Facilities Authority of Multnomah County, Oregon (AHS/West Series A) issued September 30, 2009
Part II, Entity 1, Line 11, Column D:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.
Part II, Entity 2, Line 11, Columns B & D:	The other spent proceeds are the refunding proceeds no longer in escrow.
Part II, Entity 3, Line 11, Column A:	The other spent proceeds are the proceeds used to pay off the taxable line of credit which was used to finance initial costs of the project.
Part II, Entity 3, Line 11, Column B:	The other spent proceeds are the refunding proceeds of the issue that are no longer in escrow.

Schedule K (Form 990) 2021

Additional Data

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) Ashlock M	Former Key employee	Supplemental retirement CASD		X	3,724,014	3,780,692		No	Yes		Yes
(2) Beaman J	Key employee	Relocation		X	125,000	292,150		No	Yes		Yes
(3) Beaman J	Key employee	Supplemental retirement CASD		X	3,133,349	3,176,405		No	Yes		Yes
(4) Beehler R	Key employee	Relocation		X	100,000	72,600		No	Yes		Yes
(5) Byrnes J	Key employee	Relocation		X	200,000	193,600		No	Yes		Yes
(6) Eller J	Key employee	Supplemental retirement CASD		X	7,956,827	8,077,927		No	Yes		Yes
(7) Ferch W	Former Key employee	Supplemental retirement CASD		X	6,584,597	6,684,812		No	Yes		Yes
(8) Hofheins T	Officer	Supplemental retirement CASD		X	1,200,000	1,211,081		No	Yes		Yes
(9) Jahn A	Key employee	Relocation		X	400,000	392,850		No	Yes		Yes
(10) Jahn A	Key employee	Supplemental retirement CASD		X	963,176	971,696		No	Yes		Yes
(11) Jobe M	Officer	Relocation		X	100,000	76,900		No	Yes		Yes
(12) Larsen D	Key employee	Relocation		X	150,000	146,000		No	Yes		Yes
(13) Liebowitz J	Key employee	Relocation		X	150,000	147,300		No	Yes		Yes
(14) Newmyer J	Key employee	Supplemental retirement CASD		X	4,475,347	4,543,460		No	Yes		Yes
(15) Olson J	Former Key employee	Supplemental retirement CASD		X	1,862,254	1,890,597		No	Yes		Yes
(16) Rawson R	Key employee	Relocation		X	100,000	93,600		No	Yes		Yes
(17) Reiner S	Officer	Supplemental retirement CASD		X	12,103,504	12,269,403		No	Yes		Yes
(18) Spenst B	Key employee	Supplemental retirement CASD		X	990,000	998,757		No	Yes		Yes
(19) Stevens E	Key employee	Relocation		X	200,000	198,800		No	Yes		Yes
(20) Wing B	Officer	Relocation		X	200,000	185,200		No	Yes		Yes
(21) Wing B	Officer	Supplemental retirement CASD		X	9,637,107	9,769,159		No	Yes		Yes
(22) Wolcott D	Key employee	Relocation		X	200,000	198,900		No	Yes		Yes
Total ............... $						55,371,889

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) 2021

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Beehler Matthew	Family member of Key EE, B. Beehler	474,800	Employment		No
(2) Bancarz Michelle	Family member of Key EE, G. Bancarz	181,669	Employment		No
(3) Bancarz Theodore	Family member of Key EE, G. Bancarz	150,618	Employment		No
(4) Eller Eric	Family member of Key EE, J. Eller	109,296	Employment		No
(5) Ferch Josiah	Family member of Former Key EE, W. Ferch	121,378	Employment		No
(6) PVHR LLC	Greater than 35% owned by former Director, M. Gabriel and family members		Interest		No
(7) Ashlock Ryan	Family member of Former Key EE, M. Ashlock	536,242	Employment		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference

Explanation

Part II, Supplemental Retirement Benefits:

The organization provides supplemental retirement benefits through an alternative funding arrangement the IRS calls "collateral assignment split dollar" (CASD). Although the IRS requires reporting in the loan section of Schedule L, CASD is not an actual loan - no funds are transferred to the executive. Rather, the "loan" treatment applies because after the executive has received retirement benefits, the organization recovers all outlays plus interest.The recovery right is a key advantage of CASD for the organization. Rather than paying retirement benefits to the executive that would never be recovered, under CASD the organization recovers not only its outlays, but also consideration for the time value of money.CASD works as follows. The organization deposits funds into a cash value life insurance policy on the executive's life. During life, to the extent the executive fulfills service and vesting requirements, the executive can borrow against values in the policy to supplement retirement income. Policy performance is closely monitored. If policy performance lags, the executive's borrowing rights are reduced to protect the organization's recovery rights.At the executive's death, the policy death proceeds are first used to repay the organization its deposits plus compounded interest (at the IRS long-term applicable federal rate). The executive's beneficiary then receives any projected retirement borrowing the executive did not access during life. Any remaining death proceeds were available to be paid to the executive's beneficiary. However, the executives made a gift of the excess proceeds, estimated to total $118 million, to the organization to provide additional funding for the organization's charitable activities.Gift of excess proceeds (estimated):Mark Ashlock $6,524,818; John Beaman $8,065,764; Jeff Eller $14,691,335; Alan Ferch $10,168,008; Todd Hofheins $6,001,825; Andrew Jahn $9,547,699; Joyce Newmyer $5,794,901; JoAline Olson $1,753,593; Brian Reiner $19,715,436; Brett Spenst $2,526,693; Jack Wagner $13,041,026; Bill Wing $17,275,773; Beth Zachary $2,739,445.

Part IV, Page 1, Line 1:

Melody Gabriel, a former AH director, and her husband are owners and officers of businesses that engage in joint ventures with AH and member hospitals. Other family members with ownership and officer positions in these businesses include her parents, her brother and his wife, and trusts established on behalf of her children. The ventures are organized as LLCs. At the end of 2021, PVHR, LLC had an outstanding balance of $1,215,042 secured and unsecured market rate interest bearing loans. This LLC is 50% controlled by another LLC of which Ms. Gabriel and her family have a controlling interest. Interest is accrued on these loans, principal and interest at the end of 2021 was $307,026. Principal and interest payments are being made monthly. Total interest paid during 2021 was $21,722.

Schedule L (Form 990) 2021

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Fixed assets )	X	1	4,900,564	Net book value
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
Part I, Column (b):	The number of contributors is reported in column (b).

Schedule M (Form 990) (2021)

Additional Data

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Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

Return Reference	Explanation
Form 990, Part III, Line 4a:	Adventist Health is a faith-based, nonprofit integrated health system serving more than 80 communities on the West Coast and Hawaii. Founded on Seventh-day Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care agencies, hospice agencies and joint-venture retirement centers in both rural and urban communities. Our compassionate and talented team of 34,000 includes associates, medical staff physicians, allied health professionals and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope. Together, we are transforming the American healthcare experience with an innovative, yet timeless, whole person focus on physical, mental, spiritual and social healing. Mission-driven The healthcare industry continues to experience significant changes. From high and rising costs to regulatory initiatives, these issues are causing hospitals and health systems to re-think who they are and how they want to deliver care. At Adventist Health, we are thriving and growing in the face of this transition by building on our legacy and re-establishing ourselves as the leader in physical, mental, spiritual and social health. We remain committed to "living God's love by inspiring health, wholeness and hope." Our mission represents the heart of our people. It expresses that we know the love of God and consistently reflect that love in our actions, relationships and work. Mission is the reason our organization exists. Community Health Development Adventist Health's commitment to improve well-being not only grew out of our mission to live God's love, but also from the needs we see in communities across our system of 23 hospitals. While diseases of despair continue to escalate along with healthcare costs, we are presented with the opportunity to bring whole person care, philanthropy, public heath, human services, government, community members, and business owners together to change the well-being of people, places, and equity. A key step toward well-being transformation is the integration of well-being into our strategy, providing a foundation for impacting measurable and sustainable well-being improvement for individuals, organizations and communities. This strategy was further strengthened in 2020 after the Adventist Health acquisition of Blue Zones, a pioneer in taking a systemic and environmental approach to improving the health of entire cities and communities. Moving toward our vision to see a time when well-being is accessible to everyone, the Well-Being team works with Blue Zones to design, leverage and demonstrate evidence-informed solutions that measurably and sustainably improve well-being. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint and as we enter 2022 these projects are currently active, with many community members actively taking the pledge to live longer healthier lives. Complementing the broad population-wide impact of Blue Zones specific initiatives, the Well-Being team leads strategies for community health well-being improvement and clinical integration initiatives across the Adventist Health footprint (ex: ACEs, mobile health, transportation, recuperative care, etc.) across our markets that, like Blue Zones Projects, align and respond to overlapping needs identified in each hospital Community Health Needs Assessment (CHNA). The well-being strategies are broken down into three tiers; Tier One: Access to Care, Financial Stability, and Mental Health; Tier Two: Health Risk Behaviors and Health Conditions; Tier Three: Food Security, Housing and Homelessness. Behind the scenes work includes the production of performance management dashboards to achieve functionality and communicate impact, and the development of program-specific logic models. An example of a market meeting all Tier One strategies has been at Adventist Health Rideout, along with Yuba and Sutter Counties. Together, they developed a multi-sector care management program that transforms the care and outcomes of community members with a primary behavioral health diagnosis. This program alone has led to a 16% decline in inpatient visits, 36% drop in overall volume of Emergency Department (ED) visits, and a significant 97% decline in ED utilization. These intentionally targeted and strategically aligned initiatives not only alleviate a significant equity gap in our communities but have also proven to produce lasting, transformative change. Adventist Health has developed a substantiated capacity for vulnerable population community well-being solutions designed for replication-further establishing our commitment to ensuring an equity lens through access to well-being for all. Additionally, our Roseville team supports the research, assessment, data collection and reporting process for the following systemwide community benefit work streams: Community Health Needs Assessment (CHNA), Community Health Implementation Strategy (CHIS) and annual community benefit expense reporting. In 2021, our community benefit team insourced 16 CHNA reports, creating a more collaborative, engaging and equitable CHNA process that prioritized input from minority and underserved populations in our communities. Additionally, operational tasks such as Community Benefit Inventory for Social Accountability (CBISA) entries and editing of 22 community health plan update reports were also insourced, to make our local hospital teams available to drive impactful programs. These activities help ensure that we continue to drive community health improvement and foster collaboration to build stronger communities in which we serve. Together, these system-led support efforts facilitated the following impacts across our system in 2021: A total of $48.2 million was spent on free and discounted care, $206.9 million on public programs such as Medicare, $307.1 million aid to the elderly, $78.4 million in subsidized community healthcare, $26.3 million in community health improvement, and $24.9 million on education and research. These efforts totaled close to $754.9 million in community benefit expenses. Population Health Population health is a whole-person, outcomes-based approach that works to improve the health of entire communities. It requires collaboration among researchers, providers, public health entities, and policymakers. Population health aligns with Adventist Health's philosophy of care and provides unprecedented opportunities as overall health declines in North America. Adventist Health believes that employers have a significant opportunity and responsibility to support overall well-being and influence health status indicators of entire populations by providing access to resources and tools in the workplace, reducing gaps in care, and addressing determinants of health in the surrounding community. In 2021, Adventist Health offered one plan. The health plan worked alongside the associate well-being team to deliver wellness-focused programs for chronic conditions, mental health, physical activity, nutrition, offer a digital wellness platform, and more. Whole-person health involves mind, body, and spirit. The health plan empowers associates, their families, and, by extension, the larger community to take an active role in managing their health so they may live vibrant and productive lives. Care Transformation Care Transformation in Adventist Health reflects our promise to deliver top decile safety and quality performance and top quartile in clinical operations. The transformation focuses on initiatives such as Clinical Leadership Development, High Reliability Organization, Patient Experience, Care Redesign, Population Health and Clinical Workforce. All these efforts focus on effectively blending people, processes and technology, and include consistent design, delivery and evaluation of care performance. Our caregivers are working hard every day to achieve the clinical goals and continue to spread our mission. Patient Safety & Quality Adventist Health focuses not only on patient safety and quality patient care, but also provides a quality work environment for its associates. Maintaining a culture of teamwork and safety among clinicians and staff is foundational to Care Transformation. For the past nine years, Adventist Health has participated in the Culture of Safety survey, which provides insight into focused areas where actions can be taken to improve the safety and teamwork climate in clinical departments. Adventist Health hospitals received quality and safety awards from The Joint Commission, The LeapFrog Group, Healthgrades, CMS and Malcolm Baldrige.
Form 990, Part III, Line 4a (continued):	Physician Alignment Adventist Health operates 379 medical offices across the West Coast and Hawaii. These ambulatory care centers include Rural Health Clinics (RHC), hospital-based outpatient clinics (HBOC), employed physician models in Oregon and Hawaii, medical foundations in California, and community health clinics. These medical offices offer primary care and more than 50 different specialties in medical offices large and small. We have more than 500 primary care providers and about 700 specialists providing services ranging from Addiction Medicine to Wound Care; Audiology to Vascular Surgery. Adventist Health also provides much-needed dental care in 10 of our rural communities. The providers in these medical offices are committed to providing best practice, quality-driven care with excellent health outcomes and exceptional patient experience. We provide more than two million patient visits annually. In the initial months of the pandemic, we pivoted to offering virtual visits and continue to provide those to our most vulnerable populations and those patients who have found it to be a more convenient way to receive care. We have also launched online scheduling for all of our primary care providers to increase access to care for our communities. As an organization, we have had to prioritize continued pay for our providers and employees to minimize the loss of clinicians during the extended public health emergency. Throughout these challenges, our physicians and Advanced Practice Providers have continued to provide excellent patient satisfaction resulting in an overall Adventist Health clinic star rating of 4.7 out of 5 stars. Rural Health Clinics (RHC) As an extension of our mission, high-quality services are provided to rural communities where access to care is often significantly more challenging than in urban areas. We have 69 rural health clinics (RHCs) providing healthcare to underserved populations throughout Northern and Central California, Hawaii, and Oregon. Our system of rural health continues to be the largest network of clinics in the state of California (about 12% of the RHCs in the state are part of Adventist Health). Our RHC network also is one of the largest in the country, representing almost one percent of the nation's RHCs. Adventist Health provides oversight services for all our RHCs to include financial monitoring, program audits, operational support, professional development, advocacy, and education regarding new regulations. Thanks to the RHCs, many of these rural communities' most disenfranchised have access to primary care, dentistry, women's and children's services, and health education. Specialty care services are also available at many RHC locations, including 24 behavioral health programs. Home Care Services Adventist Health Home Care offers advanced, high quality health care in an at-home setting by operating 14 home health agencies and seven hospices. In 2021, care, compassion and high-quality services were provided with 210,225 home health visits and 74,069 hospice days. Many of the agencies provide specialized programs and treatment plans, such as, wound care, CHF and diabetes management. Our home health mission is to help patient's recover, regain independence and become as self-sufficient as possible in the comfort of their home. Our hospice mission is to provide whole-person care that envelopes the body, comforts the mind and nurtures the spirit. We are most proud of the following accomplishments in 2021: 1. Implemented telehealth/remote patient monitoring for CHF patients 2. Bakersfield Hospice cared for their first patient, earned their Medicare certification and CHAP accreditation 3. Mendocino Coast Home Health joined the AH family and became integrated into our EMR, operational processes and platforms 4. New devices were rolled out to all AH associates 5. Enhanced hospice ePrescribe platform was implemented to meet patient, MD and regulatory needs 6. Re-launched and expanded ExactCare pharmacy services to assist patients with medication management 7. Implemented a readmission task force to reduce hospital readmissions and improve hospital partnerships 8. Glendale Home Health and Hospice were accredited by CHAP 9. Received regulatory change of ownership approval for Rideout Home Health Developing a Virtual Care Network The Adventist Health Virtual Care Network allows healthcare professionals to evaluate, diagnose, and treat patients using video conferencing software technology. Virtual Care is the umbrella term for the group of services and functions that include telemedicine, telepharmacy, teleICU, telestroke, teledentistry, teleradiology, and telepathology, but which also includes and can support regional health information sharing, patient education and provider networking. Virtual Care provides patients with access to high-quality, affordable specialty care when and where they need it, aiding in rapid diagnosis, treatment, and improved patient outcomes. This collaboration supports Adventist Health's mission of bringing high-quality health and healing to the communities it serves, and is consistent with the organization's focus on innovation, strategic growth, and population health. Virtual Care services took a huge leap with the onset of the COVID-19 pandemic, and we continue to monitor virtual visit volumes and the Public Health Emergency regulations related to virtual care. We now have an integrated platform that enables providers to see patients in their own home more seamlessly through our patient portal and a direct text-to-video option. Our clinics have recently upgraded their telehealth equipment to provide specialty outpatient care in our rural communities in California and Oregon sites, including a small number of non-Adventist Health sites. We continue to offer store and forward services for dermatology and diabetic retinopathy screenings, as well as peer-to-peer e-consults, as well as a direct-to-consumer service, Adventist Health OnDemand, for consumers. Adventist Health is also a preferred provider for Virtual Care with the California Department of Corrections and Rehabilitation, serving multiple prison locations through the Virtual Care Coordination Center. In 2021, we piloted a virtual behavioral health counseling service to clinic patients in some of our rural communities and we continue to look at how we can duplicate the program across the rest of the communities we serve. Our Hawaii and our Mendocino Coast markets now have sites that have video conferencing software with state-of-the-art virtual stethoscope technology to ensure patients can be seen close to where they live. Inpatient virtual care continues to serve hundreds of patients. Thirteen hospitals use telehealth stroke services, seven hospitals use pediatric services, five sites use infectious disease services with ten sites using emergency psychiatry assessment services. We are looking forward to having a systemwide offering in the next few years in the areas of stroke, general neurology, and psych for all of our ICUs and ERs. Strategic Planning Adventist Health's mission of living God's love, inspiring health, wholeness and hope is our greatest calling as an organization. Our strategic planning builds on a vision to provide exceptional care at every stage of life, inspiring community transformation through health and well-being for all. To support this vision, we have shifted our structure to strategic networks of care, bringing local and system leadership closer together to organize our work around our patients, communities and key opportunities to serve all through a deeply integrated and collaborative network of care. We are engaging our strong, innovative teams to shape a thriving culture. We are expanding our networks creating community relevance and well-being. We are empowering exceptional teams to deliver unparalleled care. We are embedding disciplined stewardship to drive operational excellence.
Form 990, Part VI, Section A, line 4	During the year, the corporation's Bylaws were amended as follows: -Article 2, Members - updated that the CEO and three representatives of the corporation will be members. -Article 3, Board of Directors - updated the language to address who should be a board member when the corporation does not have a president. -Article 8, Legal Instruments, Section 1, Subsection (a) - updated the language to authorize CEO, president, treasurer, secretary or other person or officers to execute all legal instruments and not only real estate transactions. -Article 8, Legal Instrument, Section 1, Subsection (b) and (c) - these subsections were removed and consolidated in 8.1 for the execution of legal documents by the CEO, president, treasurer, or secretary, as authorized by the board. -Article 9, General Provision - Updated to include section 4, Emergency Power. This subsection lists out actions that board members can take during emergency events or circumstances.
Form 990, Part VI, Section A, line 6	Individuals who represent the Seventh-day Adventist Church and lay people who are in good standing with the Seventh-day Adventist Church serve as members of Adventist Health System/West (the Organization") including the following: (a) the president, treasurer, and one other representative from both the Pacific Union Conference and the North Pacific Union Conference; (b) one representative from each of the local conferences of the Church in which affiliated health care facilities are located; (c) two representatives selected from among the colleges and universities affiliated with the Church and located in the Pacific Union Conference or North Pacific Union Conference; (d) the CEO of the Organization, plus three additional representatives of the management of the Organization; (e) three representatives selected from the presidents of the hospitals affiliated with the Organization; (f) three healthcare leaders; (g) up to 16 lay representatives who do not belong to any of the other categories set forth but who otherwise meet the qualifications for membership. Annually, the members meet for the purpose of conducting the business of the membership. Actions are taken as required to enable Adventist Health System/West to continue operating in concert with its Articles and Bylaws.
Form 990, Part VI, Section A, line 7a	The Organization's Board of Directors consists of the following ex-officio members: (a) The president of the Pacific Union and North Pacific Union of the Seventh-day Adventist Church; (b) two presidents selected from among the local conferences of the Church in which are located affiliated health care institutions; (c) The CEO of the Organization; (d) the president of the Organization, if there is no president, such other person as the membership shall appoint; (e) two professional health care providers who are practicing or serving in healthcare leadership; and (f) seven lay representatives as elected by the membership. Ex-officio members are appointed to their positions pursuant to the governing instruments of those organizations.
Form 990, Part VI, Section A, line 7b	Amendments to the Organization's Bylaws require approval by the membership.
Form 990, Part VI, Section B, line 11b	This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the System Senior Finance Officer and System Chief Financial Officer, and shared by electronic communication with the corporation's Board of Directors prior to filing.
Form 990, Part VI, Section B, line 12c	During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, corporate officers, key employees, and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the CEO immediately. The statements for the AHSW Board of Directors are reviewed by the EY auditors as part of the annual financial statement audit. All conflicts are reviewed by the System General Counsel. For potential conflicts, the System General Counsel will determine and present all relevant facts to the governing body for decision. After addressing any questions asked by the governing body, the person with a declared conflict must leave the meeting during the discussion of the matter that involves a conflict and during any vote on the matter.
Form 990, Part VI, Section B, line 15	The Organization's Board of Directors has established a Human Performance Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data; evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 50th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum. A hospital president has a maximum potential incentive of 30 or 35 percent of base salary based upon size and scope of hospital (iIncentive potential is industry norm). Other hospital executives have a maximum potential incentive of 25 to 30 percent of base salary.
Form 990, Part VI, Section C, line 19	The Organization does not make its governing documents publicly available beyond required filings of Articles of Incorporation with the Secretary of State. The Organization does not make its Conflict of Interest Policy available to the public.
Form 990, Part VII:	In recognition of the time commitment directors make to serve on the Adventist Health System/West boards and committees, directors have the option to receive compensation when their employment agreements with their employers allow such payments. In addition, amounts paid for taxable benefits are also reported.
Form 990, Part IX, line 11g	Other purchased services: Program service expenses 12,797,911. Management and general expenses 110,152,099. Fundraising expenses 89,788. Total expenses 123,039,798. Repairs & maintenance: Program service expenses 46,384,846. Management and general expenses 205,939. Fundraising expenses 0. Total expenses 46,590,785. Consulting and other management fees: Program service expenses 1,760,758. Management and general expenses 37,693,818. Fundraising expenses 1,433,148. Total expenses 40,887,724. Contract labor: Program service expenses 6,132,933. Management and general expenses 4,872,297. Fundraising expenses 0. Total expenses 11,005,230. Other professional fees non-medical: Program service expenses 13,559. Management and general expenses 8,606,508. Fundraising expenses 0. Total expenses 8,620,067. Purchased medical services: Program service expenses 106,102. Management and general expenses 1,682,138. Fundraising expenses 0. Total expenses 1,788,240. Physician professional fees: Program service expenses 72,245. Management and general expenses 209,182. Fundraising expenses 0. Total expenses 281,427.
Form 990, Part XI, line 9:	Capital contribution to BlueLegacy 3,000,000. Change in net assets of BlueZones -1,669,560. Change in value of CAP-EX -4,867,122. Partnership loss reported on Sch K-1 8,645,406.
Form 990, Part XI, Line 8:	Prior period adjustments were a result of cash balance correction and clean up books due to prior period activities including debt service, capital expenditures, and other items for $509,121,661.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Adventist Health SystemWest

Employer identification number

95-3484589

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
(1) Adventist Health Outpatient Pharmacy Services LLC 1 Adventist Health Way Roseville,CA95661	Inactive	CA	0	0	Adventist Health SystemWest
(2) Dwellcare LLC 1 Adventist Health Way Roseville,CA95661	Inactive	CA	0	0	Adventist Health SystemWest
(3) Incentive Acute Care Network LLC 1 Adventist Health Way Roseville,CA95661	Acute care network	CA	0	0	Adventist Health SystemWest
(4) Incentive Health LLC 1 Adventist Health Way Roseville,CA95661	MSO	CA	1,337,608	5,857,533	Adventist Health SystemWest
(5) Paradise Skyway LLC 1 Adventist Health Way Roseville,CA95661	Inactive	CA	0	0	Adventist Health SystemWest

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?
(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	Yes	No
(1)Adventist Health Clearlake Hospital Inc 15630 18th Avenue Clearlake,CA95422 68-0395149	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(2)Adventist Health Delano 1401 Garces Highway Delano,CA93215 77-0258013	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(3)Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi,CA93561 81-2240617	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(4)Adventist Health Mendocino Coast 700 River Drive Fort Bragg,CA95437 84-5174585	Hospital	CA	501(c)(3)	Line 3	Stone Point Health	Yes
(5)Adventist Health Physicians Network 1 Adventist Health Way Roseville,CA95661 68-0357690	Medical foundation	CA	501(c)(3)	Line 12b, II	Adventist Health SystemWest	Yes
(6)Adventist Health Tulare 869 North Cherry Street Tulare,CA93274 83-2351753	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(7)Castle Medical Center 640 Ulukahiki Street Kailua,HI96734 99-0107330	Hospital	HI	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(8)Feather River Hospital 1 Adventist Health Way Roseville,CA95661 94-1101228	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(9)Glendale Adventist Medical Center 1509 Wilson Terrace Glendale,CA91206 95-1816017	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(10)Hanford Community Hospital 115 Mall Drive Hanford,CA93230 94-0535360	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(11)Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi,CA95240 94-1044474	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(12)Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook,OR97141 93-0622075	Hospital	OR	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(13)Paradise Valley Hospital 1 Adventist Health Way Roseville,CA95661 95-1816034	Discontinued Operations	CA	501(c)(3)	Line 1	Adventist Health SystemWest	Yes
(14)Portland Adventist Medical Center 10123 SE Market Street Portland,OR97216 93-0429015	Hospital	OR	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(15)Reedley Community Hospital 372 Cypress Avenue Reedley,CA93654 45-3220509	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(16)Rideout Memorial Hospital 726 Fourth Street Marysville,CA95901 94-1387866	Acute care hospital	CA	501(c)(3)	Line 3	Stone Point Health	Yes
(17)St Helena Hospital 10 Woodland Road St Helena,CA94574 94-1279779	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(18)San Joaquin Community Hospital 2615 Chester Avenue Bakersfield,CA93301 95-2294234	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(19)Simi Valley Hospital and Health Care Services 2975 N Sycamore Drive Simi Valley,CA93065 95-6064971	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(20)Sonora Community Hospital 1000 Greenley Road Sonora,CA95370 94-1415069	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(21)Stone Point Health 1 Adventist Health Way Roseville,CA95661 82-3763347	Supporting organization	CA	501(c)(3)	Line 12b, II	Adventist Health SystemWest	Yes
(22)Ukiah Adventist Hospital 275 Hospital Drive Ukiah,CA95482 94-1639901	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(23)United Com-Serve 726 Fourth Street Marysville,CA95901 94-3015356	Skilled nursing/assisted living/home health	CA	501(c)(3)	Line 12b, II	Stone Point Health	Yes
(24)Walla Walla General Hospital 1 Adventist Health Way Roseville,CA95661 91-0617726	Hospital - closed July 2017	WA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(25)Western Health Resources 1 Adventist Health Way Roseville,CA95661 95-3867863	Home care	CA	501(c)(3)	Line 10	Adventist Health SystemWest	Yes
(26)White Memorial Medical Center 1720 Cesar E Chavez Avenue Los Angeles,CA90033 95-2282647	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes
(27)Willits Hospital Inc 1 Marcela Drive Willits,CA95490 68-0108919	Hospital	CA	501(c)(3)	Line 3	Adventist Health SystemWest	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) Blue Legacy Ventures LLC 1010 NE 2nd Avenue Miami,FL33132 87-1254649	Real property rental	FL	Adventist Health SystemWest	Excluded	-251,084	3,250,335		No		Yes		50.000 %
(2) Blue Zones LLC 200 Southdale Center Edina,MN55435 27-1603327	Education	MN	Adventist Health SystemWest	Unrelated	5,171,361	17,328,204		No	-6,964,869		No	100.000 %
(3) PAR LLC 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 93-1262371	Real property rental	OR	Adventist Health SystemWest	Unrelated	253,229	-1,994,688		No	254,518	Yes		50.000 %
(4) PVHR LLC dba Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 26-0622555	Real property rental	OR	Adventist Health SystemWest	Unrelated	-311,296	16,475,236		No	-304,104	Yes		50.000 %
(5) PVHR2 LLC dba Parkview at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 47-3300170	Real property rental	OR	Adventist Health SystemWest	Unrelated	-331,776	3,471,190		No	-331,776	Yes		50.000 %
(6) WWGHR LLC 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 81-0591221	Rental	OR	Adventist Health SystemWest	Unrelated	-86,241	4,341,132		No	-84,913	Yes		50.000 %

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?
(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	Yes	No
(1) AdHealth Limited PO Box HM 2062 Hamilton HM HX BD	Pure captive insurance	BD	Adventist Health SystemWest	C	655,916	2,111,677	50.000 %		No
(2) Adventist Health Plan Inc 1 Adventist Health Way Roseville,CA95661 46-3833261	Health insurance	CA	Adventist Health SystemWest	C	36,274,058	7,772,843	100.000 %	Yes
(3) South Coast Medical Center 1 Adventist Health Way Roseville,CA95661 95-2037291	Wind down after sale of hospital	CA	Adventist Health SystemWest	C			100.000 %	Yes
(4) Thrive Productions Inc 200 Southdale Center Edina,MN55435 45-3369049	Production company	MN	Adventist Health SystemWest	C	30,000	44,964	100.000 %	Yes

Schedule R (Form 990) 2021

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

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
(1) Feather River Hospital	C	4,900,564	Net book value
(2) Adventist Health Clearlake Hospital Inc	L	22,109,724	FMV
(3) Adventist Health Delano	L	13,605,218	FMV
(4) Adventist Health Medical Center Tehachapi	L	6,660,761	FMV
(5) Adventist Health Mendocino Coast	L	1,980,735	FMV
(6) Adventist Health Physicians Network	L	17,475,979	FMV
(7) Adventist Health Tulare	L	10,360,091	FMV
(8) Castle Medical Center	L	26,526,108	FMV
(9) Glendale Adventist Medical Center	L	75,198,683	FMV
(10) Hanford Community Hospital	L	51,789,543	FMV
(11) Lodi Memorial Hospital Association Inc	L	36,812,610	FMV
(12) Northwest Medical Foundation of Tillamook	L	12,953,126	FMV
(13) Portland Adventist Medical Center	L	41,134,241	FMV
(14) Reedley Community Hospital	L	27,631,643	FMV
(15) Rideout Memorial Hospital	L	69,034,358	FMV
(16) San Joaquin Community Hospital	L	66,368,948	FMV
(17) Simi Valley Hospital and Health Care Services	L	28,908,427	FMV
(18) Sonora Community Hospital	L	40,075,108	FMV
(19) St Helena Hospital	L	35,257,813	FMV
(20) Ukiah Adventist Hospital	L	30,028,005	FMV
(21) Western Health Resources	L	3,430,725	FMV
(22) White Memorial Medical Center	L	70,819,255	FMV
(23) Willits Hospital Inc	L	12,207,156	FMV
(24) Adventist Health Clearlake Hospital Inc	N	529,299	FMV
(25) Adventist Health Delano	N	458,778	FMV
(26) Adventist Health Medical Center Tehachapi	N	56,423	FMV
(27) Adventist Health Mendocino Coast	N	786,051	FMV
(28) Castle Medical Center	N	973,548	FMV
(29) Glendale Adventist Medical Center	N	1,881,745	FMV
(30) Hanford Community Hospital	N	1,376,913	FMV
(31) Lodi Memorial Hospital Association Inc	N	850,121	FMV
(32) Northwest Medical Foundation of Tillamook	N	450,813	FMV
(33) Portland Adventist Medical Center	N	1,513,492	FMV
(34) Rideout Memorial Hospital	N	1,560,823	FMV
(35) San Joaquin Community Hospital	N	2,111,860	FMV
(36) Simi Valley Hospital and Health Care Services	N	950,409	FMV
(37) Sonora Community Hospital	N	954,153	FMV
(38) St Helena Hospital	N	979,920	FMV
(39) Ukiah Adventist Hospital	N	313,212	FMV
(40) White Memorial Medical Center	N	1,744,458	FMV
(41) Willits Hospital Inc	N	320,348	FMV
(42) Adventist Health Clearlake Hospital Inc	Q	801,540	FMV
(43) Adventist Health Delano	Q	95,140	FMV
(44) Adventist Health Medical Center Tehachapi	Q	2,009,434	FMV
(45) Adventist Health Medical Center Tehachapi	Q	130,213	FMV
(46) Adventist Health Physicians Network	Q	72,690	FMV
(47) Adventist Health Tulare	Q	183,481	FMV
(48) Castle Medical Center	Q	72,549	FMV
(49) Glendale Adventist Medical Center	Q	2,397,987	FMV
(50) Hanford Community Hospital	Q	1,617,603	FMV
(51) Lodi Memorial Hospital Association Inc	Q	1,000,884	FMV
(52) Northwest Medical Foundation of Tillamook	Q	533,721	FMV
(53) Portland Adventist Medical Center	Q	1,590,174	FMV
(54) Reedley Community Hospital	Q	838,740	FMV
(55) Rideout Memorial Hospital	Q	7,287,588	FMV
(56) San Joaquin Community Hospital	Q	1,829,325	FMV
(57) Simi Valley Hospital and Health Care Services	Q	812,247	FMV
(58) Sonora Community Hospital	Q	988,521	FMV
(59) St Helena Hospital	Q	579,466	FMV
(60) Ukiah Adventist Hospital	Q	833,190	FMV
(61) United Com-Serve	Q	728,696	FMV
(62) Western Health Resources	Q	275,308	FMV
(63) White Memorial Medical Center	Q	1,991,800	FMV
(64) Willits Hospital Inc	Q	311,675	FMV
(65) Adventist Health Clearlake Hospital Inc	R	3,910,804	Cash transfer amount
(66) Adventist Health Delano	R	7,572,491	Cash transfer amount
(67) Adventist Health Medical Center Tehachapi	R	8,174,876	Cash transfer amount
(68) Adventist Health Mendocino Coast	R	7,630,211	Cash transfer amount
(69) Adventist Health Physicians Network	R	13,057,513	Cash transfer amount
(70) Adventist Health Tulare	R	17,971,543	Cash transfer amount
(71) Blue Legacy Ventures LLC	R	3,500,000	Cash transfer amount
(72) Blue Zones LLC	R	9,975,812	Cash transfer amount
(73) Feather River Hospital	R	82,175,071	Cash transfer amount
(74) Glendale Adventist Medical Center	R	54,801,533	Cash transfer amount
(75) Hanford Community Hospital	R	63,056,525	Cash transfer amount
(76) Lodi Memorial Hospital Association Inc	R	25,800,278	Cash transfer amount
(77) Northwest Medical Foundation of Tillamook	R	99,227	Cash transfer amount
(78) Portland Adventist Medical Center	R	38,351,203	Cash transfer amount
(79) Reedley Community Hospital	R	83,608,841	Cash transfer amount
(80) Rideout Memorial Hospital	R	37,795,566	Cash transfer amount
(81) San Joaquin Community Hospital	R	50,646,327	Cash transfer amount
(82) Simi Valley Hospital and Health Care Services	R	16,834,155	Cash transfer amount
(83) Sonora Community Hospital	R	9,354,999	Cash transfer amount
(84) St Helena Hospital	R	29,565,433	Cash transfer amount
(85) Ukiah Adventist Hospital	R	15,256,094	Cash transfer amount
(86) United Com-Serve	R	1,005,419	Cash transfer amount
(87) Walla Walla General Hospital	R	54,245	Cash transfer amount
(88) Western Health Resources	R	7,303,251	Cash transfer amount
(89) White Memorial Medical Center	R	497,662	Cash transfer amount
(90) Willits Hospital Inc	R	9,573,497	Cash transfer amount
(91) Adventist Health Clearlake Hospital Inc	S	26,832,246	Cash transfer amount
(92) Adventist Health Medical Center Tehachapi	S	4,469,501	Cash transfer amount
(93) Adventist Health Physicians Network	S	3,222,609	Cash transfer amount
(94) Castle Medical Center	S	14,817,024	Cash transfer amount
(95) Castle Medical Center	S	21,320,471	Cash transfer amount
(96) Feather River Hospital	S	2,377,456	Cash transfer amount
(97) Glendale Adventist Medical Center	S	88,594,642	Cash transfer amount
(98) Hanford Community Hospital	S	48,080,868	Cash transfer amount
(99) Lodi Memorial Hospital Association Inc	S	6,636,043	Cash transfer amount
(100) Northwest Medical Foundation of Tillamook	S	12,084,442	Cash transfer amount
(101) PAR LLC	S	9,270,000	Cash transfer amount
(102) Portland Adventist Medical Center	S	21,228,331	Cash transfer amount
(103) Reedley Community Hospital	S	31,128,291	Cash transfer amount
(104) Rideout Memorial Hospital	S	76,041,811	Cash transfer amount
(105) San Joaquin Community Hospital	S	29,888,085	Cash transfer amount
(106) Simi Valley Hospital and Health Care Services	S	17,506,801	Cash transfer amount
(107) Sonora Community Hospital	S	34,479,058	Cash transfer amount
(108) South Coast Medical Center	S	675,584	Cash transfer amount
(109) St Helena Hospital	S	45,779,570	Cash transfer amount
(110) Ukiah Adventist Hospital	S	19,583,716	Cash transfer amount
(111) Western Health Resources	S	11,537,350	Cash transfer amount
(112) White Memorial Medical Center	S	56,739,998	Cash transfer amount
(113) WWGHR LLC	S	56,000	Cash transfer amount

Schedule R (Form 990) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Living God's love by inspiring health, wholeness and hope.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	4,980
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-263,334
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,538,110

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	656,685	5,429,366
9	Program service revenue (Part VIII, line 2g) .........	594,258,703	727,224,459
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	5,929,276	26,246,985
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	57,591,236	30,520,577
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	658,435,900	789,421,387
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,181,946	3,335,425
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)	389,662,256	396,550,549
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 2,784,570
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	347,228,956	508,629,879
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	740,073,158	908,515,853
19	Revenue less expenses. Subtract line 18 from line 12.......	-81,637,258	-119,094,466
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,118,796,040	3,327,906,475
21	Total liabilities (Part X, line 26).............	3,317,448,358	3,061,460,820
22	Net assets or fund balances. Subtract line 21 from line 20.....	-198,652,318	266,445,655

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 364,688,763 including grants of $ 3,335,425 ) (Revenue $ 727,224,459 )
	See Schedule O

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses364,688,763

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	36,551,206	0	1,675,054

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,900,564
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	528,802

g	Noncash contributions included in lines 1a - 1f:$		1g	4,900,564

h Total. Add lines 1a-1f.......		5,429,366

		Business Code
2a	Management fees	541610	706,746,506	702,972,674	3,773,832
b	Other program service rev	621990	20,477,953	20,477,953
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		727,224,459

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,697,052			6,697,052
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(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).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,000	19,548,933	7a
b	Less: cost or other basis and sales expenses	0	0	7b
c	Gain or (loss)	1,000	19,548,933	7c
d	Net gain or (loss).........			19,549,933			19,549,933
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..
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..
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..
Business Code			Miscellaneous Revenue
11a	Health plan liability adj		561000	26,351,268			26,351,268
b	Vendor rebates		621990	11,717,659		4,608,240	7,109,419
c	Other revenue		900099	1,376,000			1,376,000
d	All other revenue ....			-8,924,350		-8,645,406	-278,944
e	Total. Add lines 11a–11d ......			30,520,577
12	Total revenue. See instructions.....			789,421,387	723,450,627	-263,334	60,804,728

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	3,319,850	3,319,850
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	15,575	15,575
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 ...........	28,862,704		28,862,704
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	6,216,954	1,574,002	4,642,952
7	Other salaries and wages........	275,663,627	79,037,492	196,008,740	617,395
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	17,532,092	2,421,750	15,090,260	20,082
9	Other employee benefits .......	48,946,139	11,905,213	36,972,776	68,150
10	Payroll taxes ...........	19,329,033	5,131,609	14,153,231	44,193
11	Fees for services (non-employees):
a	Management ......	2,524,074		2,524,074
b	Legal .........	8,659,440		8,659,440
c	Accounting ...........	8,174,345		8,174,345
d	Lobbying ...........	984,049	984,049
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)	232,213,271	67,268,354	163,421,981	1,522,936
12	Advertising and promotion ....	24,371,258		24,371,258
13	Office expenses .......	8,657,988	882,413	7,773,093	2,482
14	Information technology ......	167,435,767	154,756,270	12,175,004	504,493
15	Royalties ..
16	Occupancy ...........	6,541,169	5,318,258	1,222,911
17	Travel ............	2,419,984	427,309	1,988,878	3,797
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	75,803	2,537	72,224	1,042
20	Interest ...........	18,514,594	18,514,594
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	14,905,721	6,633,383	8,272,338
23	Insurance ...	428,126	404,173	23,953
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	Income taxes	2,054,137	1,603,826	450,311
b	Patient care supplies	1,183,789	1,183,789
c	Rental/lease costs equi	194,889	74,180	120,709
d
e	All other expenses	9,291,475	3,230,137	6,061,338
25	Total functional expenses. Add lines 1 through 24e	908,515,853	364,688,763	541,042,520	2,784,570
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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			109,284,618	2	135,374,941
3	Pledges and grants receivable, net ......			97,245	3	89,184
4	Accounts receivable, net .............			726	4	9,297
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 .......
				54,208,997	5	55,371,889
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 ...........			5,870,461	7	14,305,802
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			47,575,339	9	63,431,497
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	556,949,962
b	Less: accumulated depreciation	10b	260,747,697	308,997,175	10c	296,202,265
11	Investments—publicly traded securities .			2,019,971,606	11	1,786,832,863
12	Investments—other securities. See Part IV, line 11 .....			179,586,727	12	424,442,133
13	Investments—program-related. See Part IV, line 11 ..			143,935,557	13	159,048,311
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			249,267,589	15	392,798,293
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,118,796,040	16	3,327,906,475

17	Accounts payable and accrued expenses .....	261,367,830	17	318,646,602
18	Grants payable ...		18
19	Deferred revenue .........	0	19	2,936,887
20	Tax-exempt bond liabilities .........	2,043,611,693	20	2,026,833,028
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 ..	59,997,108	23	29,999,750
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	952,471,727	25	683,044,553
26	Total liabilities. Add lines 17 through 25..	3,317,448,358	26	3,061,460,820

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-199,886,561	27	265,165,453
28	Net assets with donor restrictions ...........	1,234,243	28	1,280,202
	Organizations that do not follow FASB ASC 958, check here 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 ...........	-198,652,318	32	266,445,655
33	Total liabilities and net assets/fund balances ........	3,118,796,040	33	3,327,906,475

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No