Form990
Click to see list of attachments
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2017
Open to Public Inspection
A For the 2018 calendar year, or tax year beginning 01-01-2017 , and ending 12-31-2017
BCheck if applicable:
CName of organization
Adventist Health SystemWest
DBA Adventist Health
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
2100 Douglas Blvd
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Roseville, CA95661
D Employer identification number

95-3484589
E Telephone number

(916) 406-0000
G Gross receipts $ 305,493,173
F Name and address of principal officer:
Scott Reiner
 
 
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.adventisthealth.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet1071
K Form of organization:  
L Year of formation: 1980
M State of legal domicile: CA
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: Living Gods love by inspiring health, wholeness and hope.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 14
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 10
5 Total number of individuals employed in calendar year 2017 (Part V, line 2a) ...... 5 1,881
6 Total number of volunteers (estimate if necessary) ............. 6  
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 3,873,153
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 784,634
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 50,000 96,561
9 Program service revenue (Part VIII, line 2g) ......... 488,352,873 266,072,501
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 54,780,986 37,623,779
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) -16,508,915 1,700,332
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 526,674,944 305,493,173
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 368,600 519,657
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 326,443,237 173,221,246
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 245,914,528 198,402,859
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 572,726,365 372,143,762
19 Revenue less expenses. Subtract line 18 from line 12....... -46,051,421 -66,650,589
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,070,778,666 2,097,917,902
21 Total liabilities (Part X, line 26)............. 2,007,273,866 2,146,305,706
22 Net assets or fund balances. Subtract line 21 from line 20..... 63,504,800 -48,387,804
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet 2019-01-25
Signature of officer Date
JumboBullet Joseph A ReppertEVP/CFO
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
 
PTIN
P01218012
Firm's name MediumBullet
THE ACCOUNTANCY LLP
 
Firm's EIN MediumBullet80-0519547
Firm's address MediumBullet
330 N BRAND BLVD STE 200
 
GLENDALE, CA912032361
Phone no. (818) 547-5701
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2017)
Page 2
Form 990 (2017)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: Living Gods love by inspiring health, wholeness and hope.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 367,713,670 including grants of $ 519,657 ) (Revenue $ 263,827,180 )
Form 990, Part III, Line 4a-d Corporate OfficeAdventist Health is a faith-based, nonprofit integrated health system serving more than 80 communities on the West Coast and Hawaii. Founded on Seventh-day Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care agencies, hospice agencies and joint-venture retirement centers in both rural and urban communities. Our compassionate and talented team of 35,000 includes associates, medical staff physicians, allied health professionals and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope. Together, we are transforming the American healthcare experience with an innovative, yet timeless, whole-person focus on physical, mental, spiritual and social healing. Mission-drivenThe healthcare industry continues to experience significant changes. From high and rising costs to regulatory initiatives, these issues are causing hospitals and health systems to re-think who they are and how they want to deliver care. At Adventist Health, we are thriving and growing in the face of this transition by building on our legacy and reestablishing ourselves as the leader in physical, mental, spiritual and social health. We remain committed to living Gods love by inspiring health, wholeness and hope. Our mission represents the heart of our people. It expresses that we know the love of God and consistently reflect that love in our actions, relationships and work. Mission is the reason our organization exists.Community Health DevelopmentWords like prevention, wellness and partnerships are more than the latest buzzwords at Adventist Health. Since St. Helena Sanitarium opened its doors in 1878 in Californias picturesque Napa Valley, the heritage of the Seventh-day Adventist Church has focused on whole-person health. Adventist Health not only strives to promote individual health, but also healthy families and communities a natural fit in todays population health environment.Adventist Healths mission is coupled with a vision to transform the health experience of our community by improving health, enhancing interactions and making care more accessible. Building healthy communities require multiple stakeholders working together with a common purpose. Adventist Health has partnered with over 50 community churches and hundreds of organizations across the system to integrate community benefit programs in their communities. In Northern California, we are reaching out into our communities through the Street Medicine Outreach in Ukiah and Project Restoration in Clear Lake. In Southern California we partnered with local schools to implement programs aimed at reducing obesity and diabetes among school children through healthy lifestyle education. In our Central California Region, we focused on immunizations, screenings, support groups and outreach to support community health. Adventist Health Portland in the Pacific Northwest Region recognizes that stable housing is critical to the improvement of health outcomes. They joined other area hospitals and health systems to address Portlands health and housing needs through the Housing is Health Initiative.2017 saw an improvement in our strategic goal to transform the health of our communities by engaging with our local communities, investing in community wellness and serving the most vulnerable and needy of our community. Population HealthPopulation health is a whole-person, outcomes-based approach that works to improve the health of entire communities. It requires collaboration among researchers, providers, public health entities and policy makers. Population health aligns with Adventist Healths philosophy of care and, as overall health declines in North America, provides unprecedented opportunities.Adventist Health believes that improving the health status of entire populations begins at home. In 2017, Adventist Health entered its fifth year of offering two health plans for employees and their families: Engaged! and Base. Both plans offer wellness-focused programs and tools, including a wellness website, fitness activities, nutrition guidance, smoking cessation workshops and more. Participants complete a free biometric screening and wellness assessment, and those with high-risk conditions take part in a free care management program that provides support and education. Nearly 93 percent of employees signed up for the Engaged! Plan in 2017.Whole-person health involves mind, body and spirit. The health plans empower employees, their families and, by extension, the larger community to take an active role in managing their health so they may live vibrant and productive lives.Care TransformationCare Transformation in Adventist Health reflects our promise to deliver and continually improve care and the patient experience while extending our mission across all care settings. The vision created by the Adventist Health Care Model focuses our transformation efforts by effectively blending people, processes and technology. It includes consistent design, delivery and evaluation of care performance.Our caregivers are working hard every day to exceed top quartile regulatory and quality performance requirements. In 2016, our hospitals as well as our hospital-based home care agencies and clinics were once again accredited through The Joint Commission to ensure the safest, highest quality health care we can provide.QualityAdventist Health focuses not only on quality patient care, but also provides a quality work environment for its employees. Maintaining a culture of teamwork and safety among clinicians and staff is a crucial component to the Care Transformation Model. For the past eight years, Adventist Health has participated in the Culture of Safety survey, which provides insight into focused areas where actions can be taken to improve the safety and teamwork climate in clinical departments.Adventist Health hospitals received quality and safety awards from The Joint Commission, The LeapFrog Group and Healthgrades. Physician AlignmentAmbulatory care clinics throughout Adventist Health provide general medical care as well as specialized care for patients of all ages in an outpatient setting. Adventist Health Physician Services (AHPS) operates within a variety of clinic models, including direct employment, hospital-based clinics, rural health clinics and a medical foundation.The AHPS management team provides key leadership and business functions such as administrative, operational, financial and clinical services, recruitment, acquisitions, quality and patient satisfaction tracking and reporting, and information and application technology.Our physician practices are characterized by clinical excellence and have a reputation for quality service, high physician satisfaction with the working environment, high patient satisfaction and a physician-driven culture that continually works on improvements and is accountable for results.Active partnerships with our physicians are critical for building clinically integrated networks. By developing new partnerships, we can reach beyond the doors of our clinics to maintain a healthier population in our communities. Our delivery of highly coordinated care coupled with the involvement of patients and their families in health care decisions is integral to our goal of providing whole-person care, the core of our mission and values.Rural Health Clinics (RHC)As an extension of our mission, high quality services are provided to small communities where access to care is often significantly less available than more urbanized areas. People living in rural or underserved communities are often at a disadvantage when accessing health care. At the end of August 2018, we had 61 clinics providing health care to underserved populations throughout Northern and Central California, Oregon and Washington. Our system of rural health continues to be the largest network of clinics in the state of California (more than 10 percent of the RHCs in the state are part of Adventist Health). Our RHC network also is one of the largest in the country, representing almost one percent of the nations RHCs.Services for RHCs include financial monitoring, program audits, operational support, professional development, advocacy and education regarding new regulations. But the real evidence of success is the patients served1,124,645 visits in 2017. Thanks to the RHCs, many of the communitys most disenfranchised now have access to primary care, dentistry, womens and childrens services and health education. A variety of specialty care also is available at many RHC locations, including 19 behavioral health programs.One example of this is the Konocti Wellness Center, a rural health clinic located inside Lower Lake High School in Lower Lake, California. The center offers basic clinic services as well as dental care and nutrition education. The partnership is part of a long-term plan to improve the health and academic perf
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
Home Care ServicesAdventist Health/Home Care Services offers advanced, quality health care in an at-home setting by operating 14 home health agencies and eight hospices. In 2017, care, compassion and quality services were provided with 226,530 home health and 60,444 hospice visits. Many of the agencies provide specialized programs and treatment plans, such as pediatric, diabetes and palliative care. Through home care, Adventist Health offers personal care in two locations throughout the network, which helps patients stay at home and maintain as much independence as possible. To further assist with the needs of our patients, three home medical equipment agencies supply oxygen, mobility aids, respiratory service and even Lifeline. In addition to providing treatment or care management, we strive to improve overall quality of life, hasten recovery and positively influence the emotional, physical and spiritual well-being of our home care patients.Developing a Virtual Care NetworkThe Adventist Health Virtual Care Network allows health care professionals to evaluate, diagnose and treat patients in both remote and urban locations using telecommunications technology. Virtual Care is the umbrella term for the group of services and functions that include telemedicine, telepharmacy, teleICU, teleradiology, and telepathology, but which also includes and can support regional health information sharing, patient education and provider networking.Virtual Care provides patients with access to high-quality, affordable specialty care when and where they need it, aiding in rapid diagnosis, treatment and improved patient outcomes. This collaboration supports Adventist Healths mission of bringing high-quality health and healing to the communities it serves, and is consistent with the organizations focus on innovation, strategic growth, and population health.During 2017, telehealth services continued to develop and grow. Seven hospitals receive telehealth stroke services, seven hospitals receive pediatric services, and three sites receive infectious disease services. Under an initiative with Blue Shield of California, funds from a USDA grant, and hospital investment, telehealth equipment was provided for medical specialty outpatient care and deployed to 29 sites in California and Oregon including three non-Adventist Health sites. Sixteen specialties including behavioral health are available for outpatient facilities. Adventist Health is a preferred provider for Virtual Care with the California Department of Correction and Rehabilitation, serving multiple prison locations through the Virtual Care Care Coordination Center. Strategic PlanningTo strengthen our ability to deliver optimal health, Adventist Health deployed a robust and aggressive strategic plan in 2013 which continues to evolve and now looks at strategy through 2020 and beyond. Guided by our mission, this plan positions our organization as one of the most significant health systems on the West Coast. By the end of 2020, Adventist Health with our engaged physicians, workforce and community, will transform the health (including experience, outcomes and status) for our defined populations, especially the underserved. We will partner with a fully integrated, affordable value-based network of services to serve one million lives with the ability to manage and leverage information in a full-risk payment environment. Our presence in Western states, including rural markets, where we have an advantageous, competitive position, enables us to expand our mission and double the number of people served.
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet367,713,670
Form 990 (2017)
Page 3
Form 990 (2017)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment..............
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment.................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment..................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part IIIClick to see attachment.............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
22
 
No
Form 990 (2017)
Page 4
Form 990 (2017)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I............ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I...................Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L,
Part IV
........................Click to see attachment
28a
Yes
 
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV.....................Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I.
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II...........
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
8,165
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2017)
Page 5
Form 990 (2017)
Page 5
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,881
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
0
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
No
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
No
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? .........................
8
 
No
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
No
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
No
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
No
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see instructions and file Form 4720, Schedule N .....
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income?
If "Yes," complete Form 4720, Schedule O ................
16
 
 
Form 990 (2017)
Page 6
Form 990 (2017)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
14
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJoseph Reppert2100 Douglas Blvd   Roseville,CA95661 (916) 406-0000
Form 990 (2017)
Page 7
Form 990 (2017)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Banks David......................................................................
Director
4.00
.................
0.00
X           1,553 0 0
(2) Cherry Robert......................................................................
Director
4.00
.................
0.00
X           11,550 0 0
(3) Davis Andrew......................................................................
Director
4.00
.................
0.00
X           10,600 0 0
(4) Freedman John......................................................................
Director/VChair
4.00
.................
0.00
X   X       1,133 0 0
(5) Gabriel Melody......................................................................
Director
4.00
.................
0.00
X           1,203 0 0
(6) Graham Ricardo......................................................................
Director/Chair
4.00
.................
0.00
X   X       2,074 0 0
(7) Heinrich Kerry......................................................................
Director
4.00
.................
0.00
X           15,866 0 0
(8) Innocent Larry......................................................................
Director
4.00
.................
0.00
X           17,608 0 0
(9) Pedersen James......................................................................
Director
4.00
.................
0.00
X           2,101 0 0
(10) Reiner Richard......................................................................
Director
4.00
.................
0.00
X           19,819 0 0
(11) Rippey Wesley......................................................................
Director
4.00
.................
9.00
X           17,516 100,600 0
(12) Salazar Velino......................................................................
Director
4.00
.................
0.00
X           1,928 0 0
(13) Reiner Scott......................................................................
Dir/CEO
50.00
.................
0.00
X   X       1,982,804 0 53,885
(14) Wing Bill......................................................................
Dir/Pres
50.00
.................
0.00
X   X       1,460,244 0 52,693
(15) Wagner Jack......................................................................
AsstSec/CFO/SVP
50.00
.................
0.00
    X       1,070,403 0 37,117
(16) Jobe Meredith......................................................................
Sec/VP Gen Cnsl
50.00
.................
0.00
    X       654,239 0 42,313
(17) Ashlock Mark......................................................................
Sr VP Physician Strategy
50.00
.................
0.00
      X     1,068,008 0 42,313
Form 990 (2017)
Page 8
Form 990 (2017)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Asmar Hoda........................................................................
Sr VP/CCO
50.00
.......................0.00
      X     526,870 0 26,397
(19) Bancarz Gloria........................................................................
VP/CNO
50.00
.......................0.00
      X     674,110 0 29,394
(20) Beaman John........................................................................
VP Finance/SFO
50.00
.......................0.00
      X     635,030 0 59,517
(21) Beehler Bob........................................................................
VP Mkt Dev, M&A
50.00
.......................0.00
      X     660,772 0 42,312
(22) Church Lowell........................................................................
VP Materiel Mgmt
50.00
.......................0.00
      X     499,255 0 43,784
(23) Conklin Jeffrey........................................................................
VP/Pres Managed Care
50.00
.......................0.00
      X     710,719 0 58,321
(24) Dickinson Chip........................................................................
VP Business Solutions
50.00
.......................0.00
      X     501,071 0 49,449
(25) Eller Jeff........................................................................
Sr VP/Pres NCR
50.00
.......................0.00
      X     1,037,468 0 45,013
(26) Ferch Wayne........................................................................
Sr VP/Pres CCR
50.00
.......................0.00
      X     957,186 0 45,065
(27) Gordon Daniel........................................................................
VP Financial Srvs
50.00
.......................0.00
      X     1,586,313 0 42,503
(28) Gustin John........................................................................
VP Facilities, Const, RE
50.00
.......................0.00
      X     506,586 0 42,421
(29) Jakobsen Dag........................................................................
VP/COO AHPS
50.00
.......................0.00
      X     624,300 0 31,933
(30) Marchuk Robert........................................................................
VP Ancillary Srvs
50.00
.......................0.00
      X     437,507 0 53,859
(31) Newmyer Joyce........................................................................
Sr VP/Pres PNR
50.00
.......................0.00
      X     759,222 0 49,449
(32) Olson JoAline........................................................................
Sr VP/CHPIO
50.00
.......................0.00
      X     915,027 0 49,524
(33) Patterson Leeanne........................................................................
VP/CRO, Risk Mgmt
50.00
.......................0.00
      X     447,273 0 42,434
(34) Tetz Doris........................................................................
VP Talent & Strategy
50.00
.......................0.00
      X     411,977 0 43,186
(35) Wilson Kathleen........................................................................
VP Benefits Admin
50.00
.......................0.00
      X     496,843 0 29,326
(36) Zachary Beth........................................................................
Sr VP/Pres SCR
50.00
.......................0.00
      X     3,531,840 0 49,519
(37) Longo Kevin........................................................................
AVP Compliance
50.00
.......................0.00
        X   1,442,337 0 53,851
(38) Roberts Kevin........................................................................
President GAMC
50.00
.......................0.00
        X   897,962 0 43,753
(39) Nahapetian Arby........................................................................
Reg Med Off SCR
50.00
.......................0.00
        X   880,809 0 58,321
(40) Raffoul John........................................................................
President WMMC
50.00
.......................0.00
        X   759,980 0 49,429
(41) Wehtje Ronald........................................................................
Reg Fin Off SCR
50.00
.......................0.00
        X   698,178 0 36,965
(42) Rebok Douglas........................................................................
Former Asst Secretary
0.00
.......................0.00
          X 120,028 0 6,244
(43) Wehtje Rodney........................................................................
Former Asst Sec/VP Treasurer
0.00
.......................0.00
          X 249,427 0 23,299
(44) Doram Keith MD........................................................................
Former VP Clin Effectiveness/CMO
0.00
.......................0.00
          X 539,962 0 53,109
(45) McKague Kirby........................................................................
Former VP/CFO AHPN
0.00
.......................0.00
          X 478,910 0 43,752
(46) Chilton Harold........................................................................
Former VP Support Srvs
0.00
.......................0.00
          X 538,222 0 42,304
(47) Soderblom Alan........................................................................
Former VP/CIO
0.00
.......................0.00
          X 447,917 0 53,927
(48) Russell Thomas........................................................................
Former VP Pop Hlth Innov
0.00
.......................0.00
          X 347,624 0 37,345
(49) Fults Kendall........................................................................
Former COO CCR
0.00
.......................0.00
          X 1,130,802 0 42,343
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 30,790,176 100,600 1,606,369
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet543
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
Deloitte Consulting LLP

980 9th St Ste 1800
Sacramento,CA95814
Hlthcare Consulting 29,798,431
Cerner Corporation

2800 Rockcreek Parkway
Kansas City,MO64117
IT Solutions Mgmt 25,584,971
OPTUMRX

11000 Optum Cir
Eden Prairie,MN55344
Pharm Ben Mngmnt 13,928,476
Brown Parker & Demarinis

620 Newport Ctr Dr
Newport Beach,CA92660
Hlthcare Marketing 6,027,683
Quest Media & Supplies Inc

5822 Roseville Rd
Sacramento,CA95842
Contr Labor Cons 3,985,041
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet141
Form 990 (2017)
Page 9
Form 990 (2017)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d  
e Government grants (contributions)1e 94,211
f All other contributions, gifts, grants, and similar amounts not included above1f 2,350
g Noncash contributions included in lines 1a - 1f:$  
h Total.Add lines 1a-1f.......MediumBullet 96,561
 Program Service RevenueAmt Business Code
2a Insurance Trust Reimburse 900099 18,878,706 18,878,706    
b Management Fees 900099 230,987,250 229,302,889 1,684,361  
c Other Program Service Rev 900099 2,647,101 2,647,101    
d Prtnrshp Inc Rltd Prgm Sr 541900 13,559,444 12,998,484 560,960  
e
f All other program service revenue .        
g Total.Add lines 2a–2f....MediumBullet 266,072,501
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 8,257,268     8,257,268
4 Income from investment of tax-exempt bond proceedsMediumBullet 0      
5 Royalties...........MediumBullet 0      
(ii) Personal (i) Real
6a Gross rents   72,500
b Less: rental expenses    
c Rental income or (loss)   72,500
d Net rental income or (loss)......MediumBullet 72,500     72,500
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 122,286 29,244,225
b Less: cost or other basis and sales expenses    
c Gain or (loss) 122,286 29,244,225
d Net gain or (loss).....MediumBullet 29,366,511     29,366,511
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities..MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances ..
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Business Code Miscellaneous Revenue
11a Clinical Engineering 811000 1,627,832   1,627,832  
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 1,627,832
12 Total revenue. See Instructions......MediumBullet 305,493,173 263,827,180 3,873,153 37,696,279
Form 990 (2017)
Page 10
Form 990 (2017)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 514,657 514,657
2 Grants and other assistance to domestic individuals. See Part IV, line 22 5,000 5,000
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16. 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 23,319,745 23,319,745    
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 110,229,043 110,229,043    
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 7,066,476 7,066,476    
9 Other employee benefits ....... 24,238,163 24,238,163    
10 Payroll taxes ........... 8,367,819 8,367,819    
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 3,136,325   3,136,325  
c Accounting ........... 1,293,767   1,293,767  
d Lobbying ........... 0      
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 31,017,696 31,017,696    
12 Advertising and promotion .... 3,218,067 3,218,067    
13 Office expenses ....... -17,960,305 -17,960,305    
14 Information technology ...... 67,886,137 67,886,137    
15 Royalties .. 0      
16 Occupancy ........... 10,417,732 10,417,732    
17 Travel ............ 4,886,212 4,886,212    
18 Payments of travel or entertainment expenses for any federal, state, or local public officials . 0      
19 Conferences, conventions, and meetings .... 487,321 487,321    
20 Interest ........... 16,251,973 16,251,973    
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization .. 22,690,519 22,690,519    
23 Insurance ... 268,416 268,416    
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 Purchased services 52,282,499 52,282,499    
b Miscellaneous expenses 2,399,547 2,399,547    
c Income taxes 126,953 126,953    
d
e All other expenses 0      
25 Total functional expenses. Add lines 1 through 24e 372,143,762 367,713,670 4,430,092 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2017)
Page 11
Form 990 (2017)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 1,700 1 1,700
2 Savings and temporary cash investments ......... 9,390,454 2 31,010,593
3 Pledges and grants receivable, net ......   3 0
4 Accounts receivable, net ............. 10,316,975 4 12,396,893
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
2,586,588 5 2,564,720
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
  6 0
7 Notes and loans receivable, net .... 17,915,909 7 9,634,156
8 Inventories for sale or use ........   8 0
9 Prepaid expenses and deferred charges ...... 21,679,600 9 30,188,611
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 399,442,149
b Less: accumulated depreciation 10b 178,393,542 188,012,745 10c 221,048,607
11 Investments—publicly traded securities . 970,262,117 11 946,091,525
12 Investments—other securities. See Part IV, line 11 ..... 49,783,605 12 59,471,656
13 Investments—program-related. See Part IV, line 11 .. 2,261,429 13 4,501,715
14 Intangible assets ...............   14 0
15 Other assets. See Part IV, line 11 ........... 798,567,544 15 781,007,726
16 Total assets. Add lines 1 through 15 (must equal line 34)... 2,070,778,666 16 2,097,917,902
Liabilities 17 Accounts payable and accrued expenses ..... 183,535,853 17 243,669,918
18 Grants payable ...   18  
19 Deferred revenue ......... 447,677 19 6,042
20 Tax-exempt bond liabilities ......... 1,074,870,000 20 1,097,361,144
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .. 543,145,845 24 652,268,429
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 205,274,491 25 153,000,173
26 Total liabilities. Add lines 17 through 25.. 2,007,273,866 26 2,146,305,706
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets 63,433,020 27 -48,461,604
28 Temporarily restricted net assets ........... 71,780 28 73,800
29 Permanently restricted net assets   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund ...   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 63,504,800 33 -48,387,804
34 Total liabilities and net assets/fund balances ........ 2,070,778,666 34 2,097,917,902
Form 990 (2017)
Page 12
Form 990 (2017)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
305,493,173
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
372,143,762
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-66,650,589
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
63,504,800
5
Net unrealized gains (losses) on investments ...............
5
-16,043,914
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-29,198,101
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
-48,387,804
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2017)
Form 990 (2017)
Additional Data


Software ID: 17005038
Software Version: 2017v2.2
Form 990, Special Condition Description:
Special Condition Description