TY 2023 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) Heinrich Kerry...................................................................... Dir/Chair/CEO	0.00 ................. 50.50	X	X				0	3,302,428	57,395
(2) Hofheins Todd...................................................................... Dir/Vice Chair/COO	0.00 ................. 50.50	X	X				0	2,272,592	76,141
(3) Beaman John...................................................................... CFO/Assistant Secretary	0.00 ................. 50.50		X				0	1,680,553	73,355
(4) Stevens Eric - President...................................................................... Northern CA/HI State Network	5.00 ................. 45.50			X			0	1,526,293	59,552
(5) Jahn Andrew - Former...................................................................... Care Division President thru 02/22	0.00 ................. 50.00					X	0	1,465,906	103,785
(6) Nahapetian Arby - Former Care...................................................................... Division Medical Officer thru 02/22	0.00 ................. 50.00					X	0	1,482,294	69,613
(7) Wing Bill - Former...................................................................... Dir/Asst Secr/Vice Chair thru 01/22	0.00 ................. 0.00					X	0	1,438,460	40,073
(8) Jobe Meredith...................................................................... Secretary	0.00 ................. 50.50		X				0	959,488	59,410
(9) Howe Judson - President...................................................................... North Coast Network thru 03/23	8.30 ................. 41.70			X			0	808,895	28,997
(10) Herber Steven...................................................................... President	50.00 ................. 0.00		X				0	737,596	54,766
(11) Tetz Warren...................................................................... Former Treasurer thru 12/22	0.00 ................. 0.00					X	0	560,025	58,835
(12) Spenst Brett - Former Care...................................................................... Division Finance Officer thru 02/22	0.00 ................. 50.00					X	0	520,625	45,847
(13) Mock Jeffrey...................................................................... Treasurer/Asst Secr as of 09/23	10.00 ................. 40.50		X				0	470,391	67,797
(14) Mensch Deborah...................................................................... Patient Care Executive	50.00 ................. 0.00			X			0	382,720	59,972
(15) Lungu John - Administrative...................................................................... Director, Behavioral Health	40.00 ................. 0.00				X		319,688	0	88,306
(16) Nonescan Cindy...................................................................... RN	40.00 ................. 0.00				X		270,351	0	70,792
(17) Hasso Ruth...................................................................... RN	40.00 ................. 0.00				X		292,991	0	47,451

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Tomlinson Sean........................................................................ Director, Pharmacy	40.00 .......................0.00			X		284,332	0	42,125
(19) Byrnes John - Former........................................................................ Medical Officer, NCR thru 02/20	0.00 .......................0.00				X	0	263,659	34,955
(20) Roberts Janice........................................................................ Director, Cardiac Service Line	40.00 .......................0.00			X		274,589	0	22,667
(21) Vichi Julie........................................................................ Finance Officer	50.00 .......................0.00		X			0	238,955	57,054
(22) Freedman John........................................................................ Director	0.00 .......................4.00	X				0	26,770	0
(23) Cherry Robert........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(24) Davis Andrew........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(25) Innocent Larry........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(26) Newton Bradford........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(27) Reiner Richard........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(28) Salazar Velino........................................................................ Director	0.00 .......................4.00	X				0	26,611	0
(29) Banks David........................................................................ Director	0.00 .......................4.00	X				0	26,181	0
(30) Woodson Marc........................................................................ Director	0.00 .......................4.00	X				0	21,611	0
(31) Wagner Jack........................................................................ Director	0.00 .......................4.00	X				0	16,180	0
(32) Fehr Joy........................................................................ Director	0.00 .......................4.00	X				0	430	0
(33) Ocampo Lucy........................................................................ Director thru 08/23	0.00 .......................4.00	X				0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
Galen Inpatient Physicians Inc 2100 Powell St Ste 400 Emeryville,CA94608	Physicians	2,607,952
PT Solutions Holdings LLC PO Box 724557 Atlanta,GA31139	Physicians	2,312,471
Sound Inpatient Physicians Inc PO Box 742936 Los Angeles,CA90074	Physicians	1,636,495
GE Precision Healthcare LLC PO Box 96483 Chicago,IL60693	Construction	1,635,420
Aya Healthcare Inc PO Box 123519 Dallas,TX75312	Physicians	1,343,703
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 56

- 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

2023

Open to Public
Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

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

2023

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization St Helena Hospital

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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization St Helena Hospital		Employer identification number 94-1279779

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization St Helena Hospital			Employer identification number 94-1279779
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) (2023)

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

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2022

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

St Helena Hospital

Employer identification number

94-1279779

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 .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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

38,664

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

38,664

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:	The Hospital belongs to industry and professional associations for which a portion of the membership dues is used for lobbying activities. Expenditures to NL Short Public Affairs were paid for the purpose of working with legislators and government officials relating to legislation affecting hospitals and healthcare.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....	39,224,435	39,609,878	23,344,620	21,759,518	29,940,604
b	Contributions ...	2,176,115	5,174,604	16,012,718	1,247,814	1,550,642
c	Net investment earnings, gains, and losses	1,336,765	-2,054,872	4,064,487	1,116,727	1,795,537
d	Grants or scholarships ...					127,557
e	Other expenditures for facilities and programs ...	2,002,985	3,505,175	3,811,947	779,439	11,399,708
f	Administrative expenses ....
g	End of year balance ......	40,734,330	39,224,435	39,609,878	23,344,620	21,759,518

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

Board designated or quasi-endowment right arrow

35.052 %

Permanent endowment right arrow

0 %

Term endowment right arrow

64.948 %

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)

Yes

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

Yes

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 .....	425,124		425,124
b	Buildings ....	183,676,634	107,406,314	76,270,320
c	Leasehold improvements	29,853,242	17,636,273	12,216,969
d	Equipment ....	76,492,400	63,766,886	12,725,514
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				101,637,927

Schedule D (Form 990) 2022

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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)Interest in Foundation				38,840,188
(2)Receivables from third-party payors				7,838,778
(3)Right-of-use assets				6,163,407
(4)Receivables from related organizations				4,714,664
(5)Other receivables				2,717,966
(6)Johnson Trust assets				1,229,456
(7)Other assets				91,811
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				61,596,270

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
Payables to related organizations	81,443,218
Other liabilities	5,624,405
Payables to third-party payors	4,921,621
Annuity payable	101,524





Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	92,090,768
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) 2022

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:

Board-designated, temporary and permanently restricted endowment funds are for specified operating and capital projects. The funds are released as project costs are expended.

Part X, Line 2:

The principal operations of the System are exempt from taxation pursuant to Internal Revenue Code Section 501(c)(3) and related state provisions. The System recognizes tax benefits from any uncertain tax positions only if it is more-likely-than-not the tax position will be sustained, based solely on its technical merits, with the taxing authority having full knowledge of all relevant information. The System records a liability for unrecognized tax benefits from uncertain tax positions as discrete tax adjustments in the first interim period the more-likely-than-not threshold is not met. The System recognizes deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of its assets and liabilities, along with net operating loss and tax credit carryovers only for tax positions that meet the more-likely-than-not recognition criteria. At December 31, 2023 and 2022, no such assets or liabilities were recorded. The System currently files Form 990 (Informational Return of Organizations Exempt From Income Taxes) and Form 990-T (Exempt Organization Business Income Tax Return) in the U.S. federal jurisdiction and the state of California. The System is not subject to income tax examinations prior to 2020 in major tax jurisdictions.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	411,467		411,467	0.130 %
b	Medicaid (from Worksheet 3, column a) . . . . .	52,484,444	68,099,272	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	52,895,911	68,099,272	411,467	0.130 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,879,098		2,879,098	0.920 %
f	Health professions education (from Worksheet 5) . . .	454,734		454,734	0.140 %
g	Subsidized health services (from Worksheet 6) . . . .	47,001,491	20,836,038	26,165,453	8.320 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	76,004		76,004	0.020 %
j	Total. Other Benefits . .	50,411,327	20,836,038	29,575,289	9.400 %
k	Total. Add lines 7d and 7j .	103,307,238	88,935,310	29,986,756	9.530 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			939,127		939,127	0.300 %
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building			10,447		10,447	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total			949,574		949,574	0.300 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

286,224

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

30,176

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

83,313,326

Enter Medicare allowable costs of care relating to payments on line 5.....

89,591,487

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-6,278,161

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)					Other (describe)	Facility reporting group
1	St Helena Hospital 10 Woodland Road St Helena,CA94574 www.adventisthealth.org/sthelena 110000073	X	X	X		A
2	Adventist Health Vallejo 525 Oregon Street Vallejo,CA94590 www.adventisthealth.org/sthelena 110000042	X			Acute Psychiatric Hospital	A

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): See Sch H Part VI - Needs Assesment

Other website (list url): See Sch H Part VI - Needs Assesment

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): See Sch H Part VI - Needs Assesment

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

Sch H Part VI-Patient Educ

The FAP application form was widely available on a website (list url):

Sch H Part VI-Patient Educ

A plain language summary of the FAP was widely available on a website (list url):
Sch H Part VI-Patient Educ

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: St. Helena Hospital, - Facility 2: Adventist Health Vallejo
Facility Reporting Group - A Part V, Section B, line 5:	The CHNA Steering Committee identified vulnerable populations and worked with local organizations to coordinate focus groups and key informant interviews to ensure that minority populations - the voices of those with chronic disease, low incomes, and the underserved - were heard. Agricultural workers, civic government, community-based healthcare workers focusing on behavioral health, education, first responders, health & human services, providers, law enforcement, low-income, medically underserved, minority populations, older adults, public health, students, and the unhoused populations. In total, 12 focus groups were conducted with 78 participants, and 16 key informant interviews were held.This Community Health Needs Assessment was developed using four separate sources of primary and secondary data. This mixed methods approach is considered a preferred practice for needs assessments because it allows for the greatest understanding of community needs from the broadest range of perspectives. Primary data refers to data collected and analyzed specifically for this project, while secondary data refers to data compiled and analyzed by external groups and utilized here. Qualitative primary data collection involved focus group interviews with local service providers and service recipients and individual key informant interviews with local leaders. These were conducted in-person and virtually. Direct quotes were taken from a transcription of key informant interviews and are intended to be 100% accurate but could not be verified in all situations. This information was collected by the Adventist Health Community Well-Being team and evaluation consultants from the Center for Behavioral Health Integration. Secondary data was amassed and analyzed across 45 different data sets by the University of Missouri Extension Center for Applied Research and Engagement Systems (CARES). Finally, survey data sets of registered voters in the community were collected and analyzed by UC Berkeley Institute of Governmental Studies (IGS). Survey data was gathered from the Bay Area region (region name defined by survey administrator, UC Berkeley IGS).
Facility Reporting Group - A Part V, Section B, line 6b:	American Canyon Police Department, Calistoga Fire Department, Calistoga Joint Unified School District, Catholic Charities' Nightingale Center, Chateau Calistoga Mobile Home Park, City of Calistoga, Mentis, Molly's Angels, Napa County Department of Health & Human Services, Napa County Department of Public Health, Napa Valley Grape Growers Foundation, Napa Valley Transportation Authority, Partnership Health Plan of California and Up Valley Family Center participated in the 2022 CHNA process.
Facility Reporting Group - A Part V, Section B, line 11:	Tax year 2023 was Year One of the Implementation Strategy for the 2022 CHNA. Programs and activities provided to the community were in response to the priority health needs identified in the 2022 CHNA. Our 2022 CHNA identified three areas of significant need: Access to Care, Health Conditions-Physical and Mental Health.Priority Need One - Access to Care.The goal is to reduce transportation barriers by informing the community of resources available and increasing mobile van medical services. To address access to care, the Hospital offered a shuttle service for cancer patients who live in Lake County to get to their cancer treatment appointments at Adventist Health St. Helena (AHSH). The AHSH Cancer Center is the closest one in this rural area where 48% of our patients live. Many patients fall under the poverty line and one of the barriers to accessing appropriate care is the lack of transportation. Our shuttle service alleviates this issue and provides two trips per day Monday through Friday. St. Helena Hospital Foundation's Mobile Health - affectionately named Mobi - and team serve our community's adults, families and most vulnerable residents, including older adults and students. This versatile team provides preventative screenings which include height, weight, BMI, A1C, total cholesterol panel (including education on results), help with medications, education on chronic disease management, and sports physicals for students. The Mobile Health team has also eliminated barriers such as cost, transportation, language, and technology in order to provide COVID-19 vaccines, flu vaccines, and Tdap vaccines. More than one quarter of the population in the AHSH primary and secondary service area are deemed to be living in a health professional shortage area. In addition, only 8.36% of the population live within one mile to the nearest hospital with an emergency room. The Hospital committed in 2023 to recruit physicians to the area and was successful in recruiting physicians in occupational medicine, two primary care providers, and two advanced practice providers.Priority Need Two - Health Conditions/Physical Health.The goal is to reduce barriers that lead to chronic health conditions by creating an environment that discourages commercial tobacco and nicotine use, provides healthy tobacco-free spaces and places, supports prevention, cessation, and enforcement efforts, and limits/regulates the retail of tobacco products. To encourage behaviors that reduce preventable diseases and provide chronic disease and cancer screenings, AHSH committed to addressing behaviors that can lead to chronic illness in 2023 by directing contributions and programming in the community. These included donations to UpValley Family Centers (UVFC) to allow them to encourage healthy behaviors and reduce preventable diseases through their Promotoras and Senior Lunch and Learn programs. The Promotoras are a group of community health workers who are trained lay people and have a strong capacity for grassroots community engagement, like spreading key wellness information to the Spanish speaking members of the community. The Lunch and Learns at UVFC are aimed at the older adults of the community to help keep them informed of helpful resources when it comes to their health and well-being. Some workshops have covered topics from emergency preparedness to housing rights to Medi-Cal expansion. It also provided the opportunity to socialize with others to alleviate the loneliness that many older adults face. The Hospital provided contributions for the Run/Walk event for Zero Prostate Cancer event. The organization's goal is to help create Generation ZERO - the first generation free from prostate cancer. Contributions to their Run/Walk event help them keep their fundraising costs low and ensure that more money goes towards saving lives and keeping families together. The Hospital continued to offer free mammograms to those who are at risk and cannot afford the screening.Utilization of the mobile health van in 2023 addressed more than access to care issues. It also addressed food insecurity issues by providing 45,000 pounds of fresh produce (equivalent to approximate $68,400 in value). The mobile van was available at three sites per month (Calistoga, Saint Helena, Napa). It provided food to 100 families per site for a total of almost 500 individuals each month. Provided a total of 357 health assessments that included blood pressure, height, weight, A1c, total cholesterol panels and health education on the results. Administered 45 high school sports physicals at Saint Helena High School. Administered over 4,000 vaccines in 2023, including Monovalent COVID-19 vaccine (1,900 doses), regular flu season (1,200 doses), high dose flu season (757 doses) and RSV (48 doses).Adventist Health and Blue Zones continued their partnership in 2023 through the desire to improve community well-being. Issues related to health risk behaviors, mental health, and chronic illnesses are seen throughout the community. Activities in 2023 that focused work around addressing behavior and the systems preventing our communities from achieving optimal health included: 1. Blue Zones Project Upper Napa Valley (BZPUNV) worked with the town of Yountville to update their event policies to include smoke-free requirements. 2. Expansion of tobacco education on campus in St. Helena Unified and Calistoga Joint Unified Districts, including a student tobacco-free poster design. 3. BZPUNV Tobacco Policy Committee embarked on a community education campaign, presenting key tobacco issues in our community, discussing tobacco policy solutions, and building support through signature collection. Presenters met to tailor the presentation slides to the recipients. 4. Napa County Tobacco Control Program and UpValley Family Centers supported Spanish translation for Spanish presentations. The Tobacco Policy Committee reviewed our organization outreach list at monthly committee meetings starting in September 2022. The list included all organizations to provide outreach to for a presentation. The group divided up contacting and scheduling with organizations. 5. Launched three walking moai's in Yountville and Calistoga to encourage natural movement and social connections. 6. Facilitated 29 healthy plant-based cooking demonstrations with 271 participants in English and Spanish throughout Yountville, Calistoga, and St. Helena to educate and encourage healthy eating. 7. Created a food resource guide for use by healthcare providers with St. Helena Hospital to serve as a referral tool when speaking with food insecure community members and support ongoing use of the tool within the hospital system. 8. Blue Zones Project (BZP) committees partnered with COAD and the St. Helena Hospital Foundation to implement a health and wellness fair. The Calistoga Health and Emergency Preparedness Fair, took place on April 29, 2023, bringing together community partners to help residents enroll in benefit programs such as CalFresh resources through the County's Self-Sufficiency team, a food distribution, and a cooking demonstration hosted by Blue Zones Project.9. The St. Helena substance use navigator served as a public educator bringing to light the harmful effects fentanyl has on the individual, community and environment. The substance use navigator attended Farmer's Markets in Saint Helena and Napa to educate the public as well as distribute free Narcan kits. Fentanyl test strips are also offered to community members who encounter opioids and other illicit drugs.Priority Need Three - Mental Health.The goal is to work with mental health partners to provide additional treatment and programs to our service area while stimulating an environment that increases mental well-being. This will be accomplished through the connection of the people of Upper Napa Valley to opportunities that impact individual well-being through engagement, education, and inspiration.
Part V, Section B, Line 11, continuation:	In 2023, contributions were provided to Napa Valley Grapegrowers, a community of wine industry leaders committed to working together to advance the heritage and reputation of the Napa Valley appellation by providing valuable educational opportunities that elevate the lives of grape growers, farmworkers, and the community at-large. This local organization supports farmworkers by providing opportunities and preserving land. AHSH supported their Harvest STOMP event, which since 2008 has connected Napa Valley Grapegrowers. (NVG) and the Napa Valley Farmworker Foundation (FWF) with individuals passionate about preserving agricultural land and providing opportunity to farmworkers and their families. The Blue Zones Upper Napa Valley Project facilitated 25 purpose workshops with a total of 110 participants throughout Yountville, St. Helena and Calistoga in English and Spanish. Purpose workshops help community members pinpoint their purpose and find their "why." It's known that when an individual finds clarity of purpose, they can enjoy a more centered and vibrant life and even live longer. At the end of the workshop, attendees walk away encouraged and equipped with a purpose statement and tools to live a happier and more purposeful life. Adventist Health Vallejo participated in coalition building through the attendance at the Solano County Behavioral Health LPS/PED bi-monthly meetings. This meeting is a county wide consortium comprised of entities, both public and private, that care for the uninsured, underinsured, homeless, disabled and persons living with mental illness. It is a collaborative group whose main focus is to strategize on a multi-system approach to the above-mentioned groups for their betterment and care. They also participated in the Napa County Behavioral Health bi-monthly meetings to address mental health care in Napa Valley.Significant needs not met:No hospital can address all the health needs identified in its community. AHSH is committed to serving the community by adhering to its mission, and using its skills, expertise and resources to provide a range of community benefit programs. Significant needs that will not be directly addressed include financial stability, health risk behaviors, housing, food security, environment and infrastructure, homelessness, COVID-19, education, inclusion and equity, community safety and community vitality. While these significant health needs are not addressed directly, they are likely to benefit from collective efforts of our community partnerships.
Part V, Section B, Line 13h:	Patients who do not meet the income criteria, may be eligible for financial assistance based on essential living expenses and resources. The following two (2) qualifications must both apply:1. Essential living expenses: Exceed fifty percent (50%) of the household income; and2. Resources: The patient's excess medical expenses (the amount that allowable medical expenses are greater than 50% of annual household income) must be greater than available qualifying assets.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?6
Name and address		Type of Facility (describe)
1	1 - Adventist Health Vallejo Behavioral Heal 525 Oregon Street Vallejo,CA94590	Behavior Health
2	2 - AH St Helena - Martin ONeil Cancer Ctr 10 Woodland Road St Helena,CA94574	Cancer treatment
3	3 - Mental Health 913 Washington Street Calistoga,CA94558	Psych/mental health
4	4 - AH St Helena - Coon Joint Replacement 6 Woodland Road St Helena,CA94574	Orthopedics
5	5 - AH St Helena - Cardiology 999 Adams Street St Helena,CA94574	Outpatient clinic
6	6 - Occupational Medicine 10 Woodland Road St Helena,CA94574	Job care
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 7:	The costs were determined by using a cost-to-charge ratio. The cost-to-charge computation is based on Hospital specific data included in the system-wide combined audited financial statements. The formula used for computation equals financial statement data as follows:Total expenses - (provision for bad debts + other revenue + interest income)/gross patient chargesThe Hospital is located in a medically underserved area and participates in a quality assurance fee program with the State of California to fund certain Medi-Cal coverage expansions. The state redistributes funds to hospitals that provide patient care to a higher proportion of indigent and medically underprivileged patients, who otherwise would most likely not have access to physicians and other medical services. The community benefit analysis includes receipts from this redistribution that are used to assist in partially offsetting the significant costs associated with providing patient care to this population group. The program may or may not continue in the future based on the State of California's regulations and policies and the approval of the federal government.
Part II, Community Building Activities:	The Hospital is involved in numerous community building activities which promote the health of the community. Overwhelmingly, we see diseases of despair including suicide, substance abuse, mental health and chronic illnesses plaguing the communities in which we have a significant presence in. These community concerns are addressed through health improvement, education, poverty, workforce development and access to care. This is why we have focused our work around addressing behavior and the systems keeping the most vulnerable people in cycles of poverty and high utilization. In an effort to heal these communities, we have strategically invested in our communities by partnering with national leaders in community well-being. We believe the power of community transformation lies in the hands of the community. Our solution for transformation is to create a sustainable model of well-being that measurably impacts the well-being of people, well-being of place and equity. In 2020, Adventist Health acquired Blue Zones as the first step toward reaching our solution. By partnering with Blue Zones, we will be able to gain ground in shifting the balance from healthcare treating people once they are ill to transformative well-being changing the way communities live, work and play. In 2021, Adventist Health committed to launching six Blue Zone Projects within our community footprint. In 2022, these projects were active and growing. In 2023, we saw tremendous growth in several of our markets promoting walking moais, worksite wellness, Blue Zones Project school pledges to create an environment that instills healthy lifestyle choices for our children and Blue Zones Project restaurant pledges to provide healthy options. Blue Zones widens our impact from only reaching our hospitals' communities in four states to a global mission practice. We also encourage our employees to serve on community collaboration boards, health advocacy programs, and physical improvement projects to promote the health of the communities we serve. In addition, we work with neighborhood programs, including schools, work sites and safety net providers to promote health and wellness and prevent disease.
Part III, Line 2:	Uncollected patient accounts are analyzed using written patient financial services policies that apply standard procedures for all patient accounts. The result of the analysis is what is recognized as bad debt expense. For example, all self-pay patients receive a discount. If the discounted account is unpaid after collection efforts, the unpaid balance is classified as bad debt. The cost-to-charge ratio described for Part I, Line 7 is multiplied times the Hospital's bad debt expense. The resulting figure has been reported as bad debts at cost on Part III, Line 2.
Part III, Line 3:	The portion of the bad debts attributed to charity care as reported on Part III, Line 3 was calculated by an independent third-party consulting firm. This is an estimate of additional charity care that would have been granted if patients had cooperated by furnishing family financial information. A statistically valid sampling of patient accounts written-off was evaluated. The evaluation used various factors to determine which patients would have been eligible for charity care. Had the Hospital obtained sufficient information from all patients who qualified for financial assistance, these additional accounts would have been recorded as charity care instead of bad debt.
Part III, Line 4:	The Adventist Health audited combined financial statements do not contain a footnote describing bad debt expense.
Part III, Line 8:	The Medicare Cost Report apportions the Hospital's costs on the basis of inpatient days and ancillary and outpatient charges to establish the costing methodology.Healthcare delivery by hospitals is a complex, highly regulated business in the United States. Healthcare unit cost inflation is driven by compliance with ever expanding regulatory requirements, shortages of highly skilled labor and involving medical and information technology. The health care "market basket" is unrelated to that of the average individual consumer.Medicare annual payment updates have fallen behind actual healthcare cost inflation to the point that Medicare payments to many U.S. hospitals are well below the cost of providing care. These unreimbursed costs are a community benefit for seniors and others in the community as these individuals are continuing to receive care without which many would become dependent on other governmental resources such as Medicaid. The benefit to the community for healthier Medicare recipients is no different than those benefits the community realizes for uninsured and underinsured patients who are eligible for partial and full charity care. Medicare is a safety net for seniors and others. Without Medicare coverage, many individuals would undoubtedly qualify for charity care.In addition to the mismatch between Medicare payment increases and healthcare cost inflation, the highly complex Medicare payment systems and formulas produce disparate payment levels from one hospital to another for the same service. These disparate payment levels create disparate results within groups of hospitals. For further information, please refer to Schedule H, Part III, Section B.
Part III, Line 9b:	When a patient has requested screening for charity care, the Hospital must immediately cease collection activity and place the account in a charity pending status. If 100% charity is approved, the entire account balance is written off to charity care. If the patient has a sliding scale liability based on the federal poverty guidelines, they are billed only for that liability. If the patient fails to pay their after-charity liability, they are assigned to a collection agency with an identifier that indicates to the agency that the patient is "low income", and the following criteria must be followed by the agency:1. They may not report the patient to a credit bureau2. They may not file a lawsuit to recover the outstanding liability3. They may not charge interest
Part VI, Line 2:	Adventist Health St. Helena promotes access to their 2022 Community Health Needs Assessment (CHNA), the 2023 Community Health Implementation Strategy (CHIS) approved in fiscal year 2023, and the Year One Update, FY 2023 for the Community Health Implementation Strategy by posting their reports on the Hospital's website at:https://www.adventisthealth.org/st-helena/about-us/community-benefit/ The two most recent Community Health Needs Assessments, the two most recent Implementation Strategy reports and the 2021, 2022, and 2023 Community Health Plan Updates are also available on the Adventist Health Corporate website at:https://www.adventisthealth.org/about-us/community-benefit/ The Community Health Needs Assessment (CHNA) includes both the activity and product of identifying and prioritizing a community's health needs, accomplished through the collection and development of a community health plan. The second component of the CHNA, the community health plan, includes strategies and plans to address prioritized needs, with the goal of contributing to improvements in the community's health. Qualitative and quantitative data sources were used in conducting the CHNA. To accomplish the many important systemic goals that are underway in our community, the Hospital supports local partners to augment our own efforts, and to promote a healthier community. Partnership is not used as a legal term, but a description of the relationships of connectivity that are necessary to collectively improve the health of our region. One of our objectives is to partner with other nonprofit and faith-based organizations that share our values and priorities to improve the health status and quality of life of the community we serve. This is an intentional effort to avoid duplication and leverage the successful work already in existence in the community. In addition to the CHNA, our Hospital engages in a process of continuous quality improvement, focusing on questions such as: are our interventions making a difference in improving health outcomes; are we providing the appropriate resources in the appropriate locations; and how are we using technology to track our health improvements and provide relevant feedback at the local level. Building a healthy community requires multiple stakeholders working together with a common purpose. With that in mind, our hospital leadership serves on a variety of community boards and committees focused on addressing community-specific needs, allowing for ongoing responsiveness to the health care needs of the community and collaboration with local agencies and organizations, enabling maximum effectiveness through collective impact.
Part VI, Line 3:	The plain language summary of the Financial Assistance Policy (FAP) is posted along with the complete FAP policy and FAP Application on the Hospital's website at: https://www.adventisthealth.org/patient-resources/bill-pay/financial-assistance/ The documents are available in multiple languages. The link to the Hospital's Self-Pay Billing and Collection Policy is posted at: https://www.adventisthealth.org/documents/system/13863-self-pay-billing-and-collection-policy.pdfAt the time of registration, patients who are uninsured and underinsured are provided information about government healthcare programs. Patients are also orally informed of their right to request charity assistance. Signs are displayed in the patient business office, patient registration areas and the emergency room in multiple languages informing patients of this right as well. The Hospital also provides a brochure during the registration process that explains the Hospital's billing and collection procedures, and how to request financial assistance. In addition, every billing statement sent to patients contains information on how to request financial assistance.
Part VI, Line 4:	The AHSH service area exemplifies diversity and is known for beautiful vineyards, a culinary scene with renowned dining, and a popular tourist destination that brings visitors from across the country. Just over 196,000 residents call our service area home now, and the growth continues as the tranquility of this beautiful place becomes known. Total population of 196,116 is based on the 2020 decennial census. 65.40% of the population owns their home and 34.60% rents their home. Household income levels are slightly higher than the California average, with 54% of annual income going towards housing and transportation. Age ranges are consistent, with children ages 0 to 4 being the smallest population group at 5.3%, to age 65, the largest community group by age is those 65 and older, 19.7% of the population. The largest groups by population are Caucasian, followed by LatinX and Black.Nearly 30 percent of the St. Helena population is obese, and cancer risk (7.3%) and cancer mortality rates (152 per 100,000) are higher than in California and the United States. In the AHSH service area, 13.5% of adults report having poor mental health and 30% of Medicare beneficiaries have mental health and substance use conditions. Also among Medicare recipients, 4.6% have a substance use disorder, while 17.6% of the overall adult population binge drink. Unemployment and high cost of living contributes to increased stress by creating financial instability and barriers to basic needs like health services, food and housing. The suicide rate in our community (14.8 per 100,000) is higher than in California overall (10.5 per 100,000).
Part VI, Line 5:	Our Hospital's mission is, "Living God's love by inspiring health, wholeness and hope." Our community benefit work is rooted deep within our mission and merely an extension of our mission and service. We have also incorporated our community benefit work to be an integral component of improving the "Triple Aim." The "Triple Aim" concept broadly known and accepted within health care includes:1. Improve the experience of care for our residents.2. Improve the health of populations.3. Reduce the per capita costs of health care.Our strategic investments in our community are focused on a more planned, proactive approach to community health. The basic issue of good stewardship is making optimal use of limited charitable funds. Defaulting to charity care in our emergency rooms for the most vulnerable is not consistent with our mission. An upstream and more proactive and strategic allocation of resources enables us to help low-income populations avoid preventable pain and suffering; in turn allowing the reallocation of funds to serve an increasing number of people experiencing health disparities.Hospitals and health systems are facing continuous challenges during this historic shift in our health system. Given today's state of health, where cost and heartache is soaring, now more than ever, we believe we can do something to change this. These challenges include a paradigm shift in how hospitals and health systems are positioning themselves and their strategies for success in a new payment environment. This will impact everyone in a community and will require shared responsibility among all stakeholders.As hospitals move toward population health management, community health interventions are a key element in achieving the overall goals of reducing the overall cost of health care, improving the health of the population, and improving access to affordable health services for the community both in outpatient and community settings. The key factor in improving quality and efficiency of the care hospitals provide is to include the larger community they serve as a part of their overall strategy.Population health is not just the overall health of a population, but also includes the distribution of health. Overall health could be quite high if the majority of the population is relatively healthy - even though a minority of the population is much less healthy. Ideally such differences would be eliminated or at least substantially reduced.Community health can serve as a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:1. The distribution of specific health statuses and outcomes within a population, 2. Factors that cause the present outcomes distribution, and3. Interventions that may modify the factors to improve health outcomes.Improving population health requires effective initiatives to:1. Increase the prevalence of evidence-based preventive health services and preventive health behaviors,2. Improve care quality and patient safety, and3. Advance care coordination across the health care continuum.We will work together with our community to ensure the community health improvements are identified and then targeted for programs to influence behaviors to obtain improved health within the whole community.
Part VI, Line 6:	The Hospital is a member of Adventist Health, a health care system which provides healthcare services in diverse markets within the Western United States. A member hospital may share some services with other member hospitals in its geographic area, such as clinical, management and support services. Using today's technology, hospitals outside the geographic area are able to provide support through remote services such as telepharmacy and robotics surgery. The Corporate Office provides important shared administrative support for member hospitals' rural health clinics and home care agencies, quality of care, other clinical needs, financing and risk management, and shared clinical and financial information technology. As many experienced and new physicians search for alternatives to independent practice, there is also corporate administrative support for hospital affiliated medical groups that engage physicians through employment or other contracts. This provides stability and growth of qualified physicians across many specialties, which is very important to make healthcare services available and to maintain and improve health within the communities served by all member hospitals.
Part VI, Line 7, Reports Filed With States	CA
Part VI: Other Information:	Other activities that contributed to community impact in 2023 included: 1. Blue Zones Project Upper Napa Valley (BZPUNV) the completion of Vine Trail from St. Helena to Calistoga creating new multi-modal transportation between St. Helena and Calistoga. BZPUNV translated trail signage and promotional materials in Spanish. 2. BZPUNV hosted a walking moai, purpose workshop and cooking demonstration for Calistoga Wellness Week in April 2023. 3. In partnership with UpValley Family Center, BZPUNV launched a cooking demonstration and natural movement series within Rancho de Calistoga Senior Mobile Home Park to promote natural movement, healthy eating and social connection with 16 participants. 4. Adventist Health Vallejo participated in the Angel Tree Giving program which supports community members through staff donations of Christmas gifts to families with children in need. An associate coordinates the program and organizes the gift drive.

Schedule H (Form 990) 2023

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 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

2023

Open to Public
Inspection

Name of the organization
St Helena Hospital

Employer identification number
94-1279779

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) California Health Fund & Trust 1215 K Street Suite 800 Sacramento,CA95814	94-1498697	501(c)(3)	43,898	Hlth srvs uninsured/underinsured pt
(2) Zero Prostate Cancer Run 515 King Street Suite 420 Alexandria,VA22314	59-3400922	501(c)(3)	10,000	Prostate cancer run
(3) UpValley Family Centers of Napa County 1440 Spring Street St Helena,CA94574	80-0023012	501(c)(3)	25,000	Promotoras (health care workers)
(4) Mentis Sponsorship 709 Franklin Street Napa,CA94559	94-1236934	501(c)(3)	10,000	Mental wellness services
(5) Napa Valley Grapegrowers 831 Latour Court Suite A Napa,CA94558	82-2012860	501(c)(3)	10,000	Community wellbeing sponsor

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) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
Part I, Line 2:	Grants are made to public charities. No formal monitoring of the grants is completed.

Schedule I (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

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 .....

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? ....

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) 2023

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)
1Heinrich Kerry Dir/Chair/CEO	(i) (ii)	0 ------------- 2,017,000	0 ------------- 1,208,880	0 ------------- 76,548	0 ------------- 13,296	0 ------------- 44,099	0 ------------- 3,359,823	0 ------------- 0
2Hofheins Todd Dir/Vice Chair/COO	(i) (ii)	0 ------------- 1,389,462	0 ------------- 735,265	0 ------------- 147,865	0 ------------- 13,296	0 ------------- 62,845	0 ------------- 2,348,733	0 ------------- 0
3Beaman John CFO/Assistant Secretary	(i) (ii)	0 ------------- 1,091,769	0 ------------- 569,149	0 ------------- 19,635	0 ------------- 13,296	0 ------------- 60,059	0 ------------- 1,753,908	0 ------------- 0
4Stevens Eric - President Northern CA/HI State Network	(i) (ii)	0 ------------- 1,045,616	0 ------------- 319,995	0 ------------- 160,682	0 ------------- 13,296	0 ------------- 46,256	0 ------------- 1,585,845	0 ------------- 0
5Jahn Andrew - Former Care Division President thru 02/22	(i) (ii)	0 ------------- 1,044,420	0 ------------- 406,990	0 ------------- 14,496	0 ------------- 53,160	0 ------------- 50,625	0 ------------- 1,569,691	0 ------------- 0
6Nahapetian Arby - Former Care Division Medical Officer thru 02/22	(i) (ii)	0 ------------- 967,385	0 ------------- 329,621	0 ------------- 185,288	0 ------------- 13,296	0 ------------- 56,317	0 ------------- 1,551,907	0 ------------- 0
7Wing Bill - Former Dir/Asst Secr/Vice Chair thru 01/22	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 1,438,460	0 ------------- 13,296	0 ------------- 26,777	0 ------------- 1,478,533	0 ------------- 0
8Jobe Meredith Secretary	(i) (ii)	0 ------------- 660,525	0 ------------- 168,715	0 ------------- 130,248	0 ------------- 13,296	0 ------------- 46,114	0 ------------- 1,018,898	0 ------------- 0
9Howe Judson - President North Coast Network thru 03/23	(i) (ii)	0 ------------- 538,154	0 ------------- 186,337	0 ------------- 84,404	0 ------------- 13,296	0 ------------- 15,701	0 ------------- 837,892	0 ------------- 0
10Herber Steven President	(i) (ii)	0 ------------- 524,908	0 ------------- 111,643	0 ------------- 101,045	0 ------------- 13,296	0 ------------- 41,470	0 ------------- 792,362	0 ------------- 0
11Tetz Warren Former Treasurer thru 12/22	(i) (ii)	0 ------------- 17,731	0 ------------- 125,629	0 ------------- 416,665	0 ------------- 13,296	0 ------------- 45,539	0 ------------- 618,860	0 ------------- 0
12Spenst Brett - Former Care Division Finance Officer thru 02/22	(i) (ii)	0 ------------- 259,692	0 ------------- 250,809	0 ------------- 10,124	0 ------------- 13,296	0 ------------- 32,551	0 ------------- 566,472	0 ------------- 0
13Mock Jeffrey Treasurer/Asst Secr as of 09/23	(i) (ii)	0 ------------- 344,451	0 ------------- 53,131	0 ------------- 72,809	0 ------------- 13,296	0 ------------- 54,501	0 ------------- 538,188	0 ------------- 0
14Mensch Deborah Patient Care Executive	(i) (ii)	0 ------------- 289,214	0 ------------- 43,395	0 ------------- 50,111	0 ------------- 13,296	0 ------------- 46,676	0 ------------- 442,692	0 ------------- 0
15Lungu John - Administrative Director, Behavioral Health	(i) (ii)	238,607 ------------- 0	39,481 ------------- 0	41,600 ------------- 0	13,116 ------------- 0	75,190 ------------- 0	407,994 ------------- 0	0 ------------- 0
16Nonescan Cindy RN	(i) (ii)	265,374 ------------- 0	4,977 ------------- 0	0 ------------- 0	9,146 ------------- 0	61,646 ------------- 0	341,143 ------------- 0	0 ------------- 0
17Hasso Ruth RN	(i) (ii)	287,404 ------------- 0	4,977 ------------- 0	610 ------------- 0	12,009 ------------- 0	35,442 ------------- 0	340,442 ------------- 0	0 ------------- 0
18Tomlinson Sean Director, Pharmacy	(i) (ii)	252,030 ------------- 0	20,643 ------------- 0	11,659 ------------- 0	9,470 ------------- 0	32,655 ------------- 0	326,457 ------------- 0	0 ------------- 0
19Byrnes John - Former Medical Officer, NCR thru 02/20	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 263,659	0 ------------- 13,183	0 ------------- 21,772	0 ------------- 298,614	0 ------------- 0
20Roberts Janice Director, Cardiac Service Line	(i) (ii)	220,615 ------------- 0	18,233 ------------- 0	35,741 ------------- 0	0 ------------- 0	22,667 ------------- 0	297,256 ------------- 0	0 ------------- 0
21Vichi Julie Finance Officer	(i) (ii)	0 ------------- 184,188	0 ------------- 23,277	0 ------------- 31,490	0 ------------- 11,948	0 ------------- 45,106	0 ------------- 296,009	0 ------------- 0

Schedule J (Form 990) 2023

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, 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. Byrnes, John - severance payment - $262,731 Tetz, Warren - severance payment - $416,673 Wing, Bill - severance payment - $1,440,800 Select executives agreed to participate in CAP-EX in place of a traditional SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Brett Spenst, Jack Wagner, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an amount equivalent to 41 percent of their base compensation, less the value of their corporate provided benefits. The balance is set aside for nonvested deferred compensation that is subject to substantial risk of forfeiture and is at risk to the creditors of Adventist Health. Payouts occur according to the participants' payment elections after all substantial risks of forfeiture have lapsed. The plan was frozen for new non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2023

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

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. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

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




Total ............... $

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) 2023

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) Herber Timothy	Family member of Officer, S. Herber	71,641	Employment		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2023

Additional Data

Software ID:
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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

Return Reference	Explanation
Form 990, Part III, Line 4a:	St. Helena Hospital, DBA Adventist Health St. Helena (AHSH), provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of AHSH, the organization recognizes that not all individuals possess the ability to pay for essential medical services. Adventist Health's vision is to enhance the health of the communities where we live and serve by engaging our communities and our patients in a new definition of and partnership for personal community health. In keeping with this commitment to serve all members of the community, the following coverage will be considered when individuals who need health care cannot afford to pay: - Free care and/or subsidized care - Care to persons covered by governmental programs at/or below cost - Health/wellness activities and community education programs Not only does AHSH provide low-cost care to individuals covered by government programs, and those unable to afford healthcare, it also helps patients find and access private and governmental resources for healthcare benefits. AHSH recognizes below-cost reimbursement as charity and uncompensated care in meeting its mission to the entire community. The unreimbursed cost of providing care to these patients in 2023 was $411,467. The following Inpatient services were provided to all our patients: - 1,087 surgeries performed - 37,484 patient days The following Outpatient services were provided to all our patients: - 7,303 emergency department visits - 5,039 outpatient surgeries performed - 46,328 outpatient visits - 73,991 clinic visits AHSH recognizes it has an obligation to provide human services above and beyond its role as a healing facility. Schedule H provides more details on the tangible ways in which the organization is fulfilling its mission. The total unreimbursed cost of these community benefits in 2023 was $29,575,290. Adventist Health's mission statement of living God's love by inspiring health, wholeness and hope is coupled with a vision to transform the health experience of our communities through collaborative programs, community investments and community outreach. We are inspired by the healing ministry, as represented by the life of Jesus Christ, and believe we are called to live out our mission intentionally in the communities we serve. In the small towns, suburbs, and inner cities we serve, we continue our journey to provide quality healthcare until every person made in God's image has experienced the best health today, hope for tomorrow, and God's love that endures forever. Websites for our community benefit information: https://www.adventisthealth.org/about-us/community-benefit/ Two years ago, with only four days notice of the impending rollout of the COVID-19 vaccine, St. Helena Hospital Foundation converted its mobile health van, into a COVID-19 vaccine program. Allowing it to become the first responder in the County to provide vaccines to the most vulnerable in the Napa County community. This week, the St. Helena Hospital Foundation celebrates the two-year anniversary of its heroic staff and technologically advanced facilities that enabled the Foundation's early and successful rollout of the COVID-19 vaccines to the most vulnerable members of the Napa Valley community. Along with the hundreds of doctors, nurses, staff and community volunteers that enabled this life-saving campaign, the Foundation celebrates its unique, converted mobile health van that was itself a complete COVID-19 vaccine program on wheels. Since those early days of the new vaccines in early January 2021, the Foundation's mobile health unit has since hosted 450 clinics (including home visits) that provided 60,000 vaccines and boosters - a program recognized at a global telehealth conference in Denmark as a model for other community-based public health programs. When the idea for the mobile health van was first discussed by Foundation Board members in 2018, the goal was to reach underserved communities with general health services, in particular, Upvalley seniors. When the pandemic hit, given the dire need for testing among farmworkers, the Foundation pivoted and forged partnerships with dedicated testing labs. With support from the Napa Valley Farmworker Foundation, the Foundation became the first to take large-scale COVID-19 testing directly to the Napa County agricultural workforce. When the vaccines were rolled out in January 2021, the mobile health van allowed the program to pivot again. "We knew on Day 1 that the technology needed to register for a vaccine, as well as time and transportation to get to vaccine sites, would create barriers, so with the mobile health van, we were able to remove those barriers, making it easy and welcoming for everyone to receive their vaccines - and later, boosters," says Noemi Mauricio, RN, Community Educator RN for the St. Helena Hospital Foundation Mobile Health Unit (MOBI). "We were able to vaccinate the most vulnerable in their homes and the rest of the community at community vaccination sites, schools, businesses, churches, community centers, and even in the middle of vineyards, all across Napa County," said Glen Newhart, President and CEO of the St. Helena Hospital Foundation. "While other agricultural areas in the state were ravaged by seemingly endless waves of infections, we were able to help keep Napa County workers safe." "Another key to success was our community volunteers. In the first week that vaccines were available, 150 medical and community volunteers - including nursing students from Pacific Union College and Napa Valley College as well as countless community supporters and partners like Napa Valley Vintners, Napa Valley Grapegrowers, Napa Valley Farmworker Foundation, and Napa County Farm Bureau - stepped up. Everyone came together for the health of our community." "We see mobile primary care as a key to our overall commitment to the health of our community - the last few years have shown that this is an excellent way to rapidly pivot to address the need to open up access to quality care to those who have not had access," says Newhart. "Care for our vulnerable farmworkers and seniors has always been important to St. Helena Hospital. We provide health assessments and testing, in addition to COVID-19 and flu vaccines, free of charge when and where our community needs us." "For 145 years, St. Helena Hospital has been part of the rich history of Napa County, and we are proud to celebrate all of our doctors, nurses, staff and community volunteers who have helped our communities survive and prevail over this awful pandemic - including taking our mobile health van where it is needed. We're excited about the new ways we can improve the health of our family, friends, and neighbors by taking healthcare out of the hospital and into our community with our mobile health team. We might be in a vineyard in Carneros one day, in Pope Valley the next, a school in Calistoga or community center on another, but wherever there is a need, we will be there."
Form 990, Part VI, Section A, line 4	The Hospital's Articles of Incorporation were amended for the following: 1. Article III was updated to allow for the Board of Directors of the Hospital to have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital has no members within the meaning of Section 5056 of the California Corporations Code. The Hospital's Bylaws were amended for the following: 1. Article 2 was removed and the Hospital has no members. All sections relating to the membership were removed. 2. Article 5 was revised to indicate that only directors may serve as the chair of the Board and that the vice chair of the Board is designated by the Chief Executive Officer of Adventist Health System/West. 3. Article 6 was revised to change the language of governing board to community board in all instances.
Form 990, Part VI, Section A, line 7a	The Hospital Bylaws define its Board of Directors to be the same individuals who are members of the Adventist Health System/West Board of Directors.
Form 990, Part VI, Section A, line 7b	The Board of Directors of the Hospital shall have sole authority to amend or repeal the Articles of Incorporation, subject to the additional approval of the Board of Directors of Adventist Health System/West. The Hospital does not have any Members.
Form 990, Part VI, Section B, line 11b	This Form 990 including all supporting schedules was prepared by a public accounting firm, reviewed by the Corporate Finance Officer and Market Financial Officer, and shared by electronic communication with the Corporation's Board of Directors prior to filing.
Form 990, Part VI, Section B, line 12c	During the first quarter of each year, the annual conflict of interest questionnaire is sent to board members, hospital corporate officers, key employees and department directors for completion and signature. The questionnaire is accompanied by a letter of explanation to illustrate examples of a conflict and to remind the recipient that if any perceived conflict should arise before the next annual questionnaire, he/she is to notify the market president or the System General Counsel immediately. The System General Counsel distributes, collects, and reviews for signatures the COIs for all applicable Corporate employees, stakeholders and the board. In addition, the hospital's administration is responsible for keeping record to ensure all hospital-based individuals with director and above positions have submitted their COIs. The System General Counsel reviews all the disclosures on the board and Corporate employees' COIs. System General Counsel retains the COIs for all individuals. Further inquiries on any potential significant conflicts are made as needed. Conflicts are documented and reviewed with the Board.
Form 990, Part VI, Section B, line 15	The Hospital's Board of Directors has established a Human Resources Committee to oversee the executive compensation program. This committee is composed of independent directors with no conflicts of interest. The committee performs the following functions: recommends a total compensation philosophy to the board; assures compliance with the board-approved philosophy; meets at least annually to review comparability data from outside consultants; recommends any adjustments to current executive compensation, including salary ranges for hospital presidents and finance officers that would be indicated by the data evaluates executive performance against annual goals; recommends appropriate incentive awards to the board for approval; follows a diligent process that meets regulatory requirements for a rebuttable presumption of reasonableness; records committee deliberations and decisions in timely minutes; selects, engages and supervises any consultant hired to advise and provide comparability data. The board-approved executive compensation philosophy specifies that salary ranges will be established for hospital executives, with midpoints aligned with the 60th percentile of comparable system hospital data, and having a 50 percent spread from minimum to maximum.
Form 990, Part VI, Section C, line 19	The Hospital does not make its governing documents publicly available, beyond required filings of Articles of Incorporation with the Secretary of State. The Hospital does not make its Conflict of Interest Policy available upon request, but does file monthly/quarterly summary financial reports with the state health-planning agency.
Form 990, Part VII:	Board compensation is for Adventist Health System/West Board of Directors only - not hospital Board of Directors.
Form 990, Part IX, line 11g	Physician professional fees: Program service expenses 23,010,962. Management and general expenses 280,170. Fundraising expenses 0. Total expenses 23,291,132. Purchased medical services: Program service expenses 18,457,944. Management and general expenses 0. Fundraising expenses 0. Total expenses 18,457,944. All other purchased services: Program service expenses 9,157,303. Management and general expenses 1,396,419. Fundraising expenses 22,810. Total expenses 10,576,532. Contract labor: Program service expenses 3,969,693. Management and general expenses 181,373. Fundraising expenses 0. Total expenses 4,151,066. Other medical professional fees: Program service expenses 3,005,943. Management and general expenses 0. Fundraising expenses 0. Total expenses 3,005,943. Repairs and maintenance: Program service expenses 3,992,982. Management and general expenses 27,049. Fundraising expenses 3,936. Total expenses 4,023,967. Consulting and other management fees: Program service expenses 206,102. Management and general expenses 351,370. Fundraising expenses 0. Total expenses 557,472. Other professional fees non-medical: Program service expenses 100,308. Management and general expenses 71,910. Fundraising expenses 0. Total expenses 172,218.
Form 990, Part XI, line 9:	Change in interest in Foundation 1,602,554. Split-interest agreements - change in value 21,752.
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 Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

St Helena Hospital

Employer identification number

94-1279779

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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) - Charitab	Line 3	Adventist Health SystemWest		No
(2)Adventist Health Delano 1401 Garces Hwy Delano,CA93215 77-0258013	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(3)Adventist Health Foundation 1 Adventist Health Way Roseville,CA95661 68-0002188	Charitable foundation	CA	501(c)(3) - Charitab	Line 7	Adventist Health SystemWest		No
(4)Adventist Health Medical Center Tehachapi 1100 Magellan Drive Tehachapi,CA93561 81-2240617	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(5)Adventist Health Mendocino Coast 700 River Drive Fort Bragg,CA95437 84-5174585	Hospital	CA	501(c)(3) - Charitab	Line 3	Stone Point Health		No
(6)Adventist Health Physicians Network 1 Adventist Health Way Roseville,CA95661 68-0357690	Medical foundation	CA	501(c)(3) - Charitab	Line 12b, II	Adventist Health SystemWest		No
(7)Adventist Health SystemWest 1 Adventist Health Way Roseville,CA95661 95-3484589	Integrated health system	CA	501(c)(3) - Charitab	Line 10	N/A		No
(8)Adventist Health Tulare 869 North Cherry Street Tulare,CA93274 83-2351753	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(9)Castle Medical Center 640 Ulukahiki Street Kailua,HI96734 99-0107330	Hospital	HI	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(10)Feather River Hospital 1 Adventist Health Way Roseville,CA95661 94-1101228	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(11)Glendale Adventist Medical Center 1509 Wilson Terrace Glendale,CA91206 95-1816017	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(12)Hanford Community Hospital 115 Mall Drive Hanford,CA93230 94-0535360	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(13)Lodi Memorial Hospital Association Inc 975 S Fairmont Avenue Lodi,CA95240 94-1044474	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(14)Mid-Columbia Medical Center 1700 E 19th Street The Dalles,OR97058 93-0386936	Hospital	OR	501(c)(3) - Charitab	Line 3	Stone Point Health		No
(15)Northwest Medical Foundation of Tillamook 1000 Third Street Tillamook,OR97141 93-0622075	Hospital	OR	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(16)Paradise Valley Hospital 1 Adventist Health Way Roseville,CA95661 95-1816034	Discontinued Operations	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(17)Portland Adventist Medical Center 10123 SE Market Street Portland,OR97216 93-0429015	Hospital	OR	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(18)Reedley Community Hospital 372 Cypress Avenue Reedley,CA93654 45-3220509	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(19)Rideout Memorial Hospital 726 Fourth Street Marysville,CA95901 94-1387866	Acute care hospital	CA	501(c)(3) - Charitab	Line 3	Stone Point Health		No
(20)San Joaquin Community Hospital 2615 Chester Avenue Bakersfield,CA93301 95-2294234	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(21)Simi Valley Hospital and Health Care Services 2975 N Sycamore Drive Simi Valley,CA93065 95-6064971	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(22)Sonora Community Hospital 1000 Greenley Road Sonora,CA95370 94-1415069	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(23)Stone Point Health 1 Adventist Health Way Roseville,CA95661 82-3763347	Supporting organization	CA	501(c)(3) - Charitab	Line 12b, II	Adventist Health SystemWest		No
(24)Ukiah Adventist Hospital 275 Hospital Drive Ukiah,CA95482 94-1639901	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(25)United Com-Serve 726 Fourth Street Marysville,CA95901 94-3015356	Skilled nursing/assisted living/home health	CA	501(c)(3) - Charitab	Line 12b, II	Stone Point Health		No
(26)Walla Walla General Hospital 1 Adventist Health Way Roseville,CA95661 91-0617726	Hospital - closed July 2017	WA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(27)Western Health Resources 1 Adventist Health Way Roseville,CA95661 95-3867863	Home care	CA	501(c)(3) - Charitab	Line 10	Adventist Health SystemWest		No
(28)White Memorial Medical Center 1720 E Cesar E Chavez Avenue Los Angeles,CA90033 95-2282647	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No
(29)Willits Hospital Inc 1 Marcela Drive Willits,CA95490 68-0108919	Hospital	CA	501(c)(3) - Charitab	Line 3	Adventist Health SystemWest		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

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	(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	N/A				No			No
(2) Blue Zones LLC 200 Southdale Center Edina,MN55435 27-1603327	Education	MN	N/A				No			No
(3) PAR LLC DBA CherryWood Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 93-1262371	Senior housing	OR	N/A				No			No
(4) PVHR LLC DBA Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 26-0622555	Senior housing	OR	N/A				No			No
(5) PVHR2 LLC DBA Parkview Memory Care at Paradise Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 47-3300170	Senior housing	OR	N/A				No			No
(6) WWGHR LLC DBA Wheatland Village 8440 SE Sunnybrook Blvd Suite 100 Clackmas,OR97015 81-0591221	Senior housing	OR	N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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	N/A	C					No
(2) Adventist Health Plan Inc 1 Adventist Health Way Roseville,CA95661 46-3833261	Health insurance	CA	N/A	C					No
(3) South Coast Medical Center 1 Adventist Health Way Roseville,CA95661 95-2037291	Wind down after sale of hospital	CA	N/A	C					No
(4) Thrive Productions Inc 200 Southdale Center Edina,MN55435 45-3369049	Production company	MN	N/A	C					No

Schedule R (Form 990) 2023

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) ............................

Yes

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) ............................

Yes

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

Yes

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) .................

Yes

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

Schedule R (Form 990) 2023

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) 2023

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) 2023

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	13
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 2023 (Part V, line 2a) ......	5	1,284
6	Total number of volunteers (estimate if necessary) .............	6	31
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	41,397
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,063

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,535,459	4,720,671
9	Program service revenue (Part VIII, line 2g) .........	274,484,951	293,121,306
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-134,665	195,730
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,661,572	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	286,547,317	298,037,707
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	146,275	103,898
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)	100,252,956	102,256,072
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 829,153
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	209,796,871	212,007,909
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	310,196,102	314,367,879
19	Revenue less expenses. Subtract line 18 from line 12.......	-23,648,785	-16,330,172
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	203,273,737	205,326,410
21	Total liabilities (Part X, line 26).............	207,621,120	224,822,773
22	Net assets or fund balances. Subtract line 21 from line 20.....	-4,347,383	-19,496,363

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 263,214,040 including grants of $ 103,898 ) (Revenue $ 293,079,909 )
	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 expenses263,214,040

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	1,441,951	18,361,718	1,218,888

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,576,470
e	Government grants (contributions)		1e	2,144,201

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

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		4,720,671

		Business Code
2a	Patient service revenue	621110	234,916,319	234,874,922	41,397
b	Premium revenue	531120	28,648,550	28,648,550
c	340B Pharmacy	456110	10,893,215	10,893,215
d	Related rental revenue	532000	1,759,564	1,759,564
e	Cafeteria revenue	722514	732,073	732,073
f	All other program service revenue.		16,171,585	16,171,585
g	Total. Add lines 2a–2f .....		293,121,306

3 Investment income (including dividends, interest, and othersimilar amounts) ......			37,190			37,190
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		158,540
b	Less: cost or other basis and sales expenses	7b		0
c	Gain or (loss)	7c		158,540
d	Net gain or (loss).........			158,540			158,540
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
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			298,037,707	293,079,909	41,397	195,730

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	103,898	103,898
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	71,641	71,641
7	Other salaries and wages........	82,981,861	70,822,989	11,669,685	489,187
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	3,033,950	2,563,209	453,371	17,370
9	Other employee benefits .......	10,192,034	8,798,782	1,285,660	107,592
10	Payroll taxes ...........	5,976,586	5,213,523	726,148	36,915
11	Fees for services (non-employees):
a	Management ......	26,452,344	732,360	25,719,984
b	Legal .........	78,975		78,975
c	Accounting ...........	16,943		16,943
d	Lobbying ...........	38,664	38,664
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)	64,236,274	61,901,237	2,308,291	26,746
12	Advertising and promotion ....	64,686		64,686
13	Office expenses .......	1,023,190	572,400	341,262	109,528
14	Information technology ......	8,062,241	1,391,229	6,652,513	18,499
15	Royalties ..
16	Occupancy ...........	5,487,251	5,406,652	78,000	2,599
17	Travel ............	195,235	141,779	46,117	7,339
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	17,330	7,794	5,804	3,732
20	Interest ...........	8,981,731	8,981,731
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	10,579,704	10,497,409	82,295
23	Insurance ...	1,977,673	1,591,394	386,279
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	Patient care supplies	57,729,229	57,729,229
b	Quality assurance fees	11,826,868	11,826,868
c	Rental/lease costs	819,261	814,887		4,374
d
e	All other expenses	14,420,310	14,006,365	408,673	5,272
25	Total functional expenses. Add lines 1 through 24e	314,367,879	263,214,040	50,324,686	829,153
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 .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			29,462,173	4	34,190,703
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			7,030,544	8	6,930,547
9	Prepaid expenses and deferred charges ......			497,734	9	970,963
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	290,447,400
b	Less: accumulated depreciation	10b	188,809,473	103,283,495	10c	101,637,927
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			62,999,791	15	61,596,270
16	Total assets. Add lines 1 through 15 (must equal line 33)...			203,273,737	16	205,326,410

17	Accounts payable and accrued expenses .....	115,131,297	17	132,732,005
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	92,489,823	25	92,090,768
26	Total liabilities. Add lines 17 through 25..	207,621,120	26	224,822,773

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-29,686,130	27	-45,952,409
28	Net assets with donor restrictions ...........	25,338,747	28	26,456,046
	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 ...........	-4,347,383	32	-19,496,363
33	Total liabilities and net assets/fund balances ........	203,273,737	33	205,326,410