Form 990 for tax year 2022

Revenue

Part VIII, the statement of revenue.

• 1e · Government grants (contributions)

  $51,667

• 1f · All other contributions, gifts and grants

  $16,017

• 2a · Program service revenue: Patient service revenue

  total $763,131 · related or exempt $763,131

• 2b · Program service revenue: Related rental revenue

  total $104,497 · related or exempt $104,497

• 2c · Program service revenue: Dietary revenue

  total $15,196 · related or exempt $15,196

• 2f · All other program service revenue

  total $593 · related or exempt $593

• 3 · Investment income

  total $6,136,827 · excluded $6,136,827

• 7a · Gross sales of assets other than inventory

  other assets $4,000,000

• 7b · Less cost or other basis and sales expenses

  other assets $2,274,090

• 7c · Gain or loss

  other assets $1,725,910

• 7d · Net gain or loss

  total $1,725,910 · unrelated business $172,336 · excluded $1,553,574

• 11a · Other revenue: Insurance proceeds

  total $100,001,286 · excluded $100,001,286

• 11b · Other revenue: Gain from discontinued operations

  total $344,065 · excluded $344,065

• 11e · Other revenue, total

  $100,345,351

Functional expenses

Part IX, the statement of functional expenses.

• 7 · Other salaries and wages

  total $3,029 · management and general $3,029

• 9 · Other employee benefits

  total $1,480 · management and general $1,480

• 11b · Fees: legal

  total $78,664 · management and general $78,664

• 11c · Fees: accounting

  total $142 · management and general $142

• 11g · Fees: other

  total $192,656 · program services $19,302 · management and general $173,354

• 13 · Office expenses

  total $81,268 · program services $79,045 · management and general $2,223

• 14 · Information technology

  total $5,706 · program services $5,706

• 16 · Occupancy

  total $282,235 · program services $122,771 · management and general $159,464

• 17 · Travel

  total $242 · program services $242

• 20 · Interest

  total $571,013 · program services $571,013

• 22 · Depreciation, depletion and amortization

  total $539,666 · program services $539,666

• 24a · Other expenses: Income taxes

  total $21,454 · program services $21,454

• 24b · Other expenses: Patient care supplies

  total $5,982 · program services $5,982

• 24c · Other expenses: Quality assurance fee

  total $4 · program services $4

Balance sheet

Part X, book values.

• 2 · Savings and temporary cash investments

  beginning of year $78,252,843 · end of year $182,778,782

• 4 · Accounts receivable

  beginning of year $342,877 · end of year $0

• 9 · Prepaid expenses and deferred charges

  beginning of year $129 · end of year $0

• 10a · Land, buildings and equipment: cost or other basis

  $11,767,148

• 10b · Land, buildings and equipment: accumulated depreciation

  $2,224,981

• 10c · Land, buildings and equipment, net

  beginning of year $10,312,359 · end of year $9,542,167

• 15 · Other assets

  beginning of year $13,911,133 · end of year $7,620,851

• 17 · Accounts payable and accrued expenses

  beginning of year $1,004,168 · end of year $419,839

• 19 · Deferred revenue

  beginning of year $97,075 · end of year $29,391

• 25 · Other liabilities

  beginning of year $18,806,927 · end of year $18,000,950

• 27 · Net assets without donor restrictions

  beginning of year $80,372,506 · end of year $179,290,194

• 28 · Net assets with donor restrictions

  beginning of year $2,538,665 · end of year $2,201,426

The filer's explanations (Part III)

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 - $465,750 Gonzalez, Eduardo - severance payment - $162,089 Wing, Bill - severance payment - $1,584,880 Select executives agreed to participate in CAP-EX in place of a traditional insurance SERP. See Schedule L, Part V of Adventist Health System/West, for a broader description. Split-Dollar life insurance participants are John Beaman, Jeff Eller, Kerry Heinrich, Todd Hofheins, Andrew Jahn, Scott Reiner, Brett Spenst, and Bill Wing. A flexible benefits plan (CAA) is offered to groups of highly-compensated employees meeting certain criteria. The participants are provided with an of their corporate provided benefits. The balance is set aside for forfeiture and is at risk to the creditors of Adventist Health. Payouts substantial risks of forfeiture have lapsed. The plan was frozen for new amount equivalent to 41 percent of their base compensation, less the value nonvested deferred compensation that is subject to substantial risk of occur according to the participants' payment elections after all non-vested contributions in 2016. Jahn, Andrew - participant, no activity in 2022 Part II: Eller, Jeff, Former President, NCR was paid through an unrelated organization, Jeffrey D. Eller dba Mountaingate Coaching that was reported on Form 1099 and included in Schedule J, Part II.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

• Blue Legacy Ventures LLC

  Real property rental · FL

• Blue Zones LLC

  Education · MN

• PAR LLC dba CherryWood Village

  Senior housing · OR

• PVHR LLC dba Paradise Village

  Senior housing · OR

• PVHR2 LLC dba Parkview Memory Care at Paradise Village

  Senior housing · OR

• WWGHR LLC dba Wheatland Village

  Senior housing · OR

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

• AdHealth Limited

  C · Pure captive insurance · BD

• Adventist Health Plan Inc

  C · Health insurance · CA

• South Coast Medical Center

  C · Wind down after sale of hospital · CA

• Thrive Productions Inc

  C · Production company · MN