SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
right arrowComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
right arrowAttach 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
United Com-Serve
 
Employer identification number

94-3015356
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)Adventist Health Clearlake Hospital Inc
15630 18th Avenue

Clearlake,CA95422
68-0395149
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(2)Adventist Health Delano
1401 Garces Highway

Delano,CA93215
77-0258013
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(3)Adventist Health Medical Center Tehachapi
1100 Magellan Drive

Tehachapi,CA93561
81-2240617
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(4)Adventist Health Mendocino Coast
700 River Drive

Fort Bragg,CA95437
84-5174585
Hospital CA 501(c)(3) Line 3 Stone Point Health
 
 
No
(5)Adventist Health Physicians Network
1 Adventist Health Way

Roseville,CA95661
68-0357690
Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest
 
 
No
(6)Adventist Health SystemWest
1 Adventist Health Way

Roseville,CA95661
95-3484589
Integrated health system CA 501(c)(3) Line 10 N/A
 
No
(7)Adventist Health Tulare
869 North Cherry Street

Tulare,CA93274
83-2351753
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(8)Castle Medical Center
640 Ulukahiki Street

Kailua,HI96734
99-0107330
Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(9)Feather River Hospital
1 Adventist Health Way

Roseville,CA95661
94-1101228
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(10)Glendale Adventist Medical Center
1509 Wilson Terrace

Glendale,CA91206
95-1816017
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(11)Hanford Community Hospital
115 Mall Drive

Hanford,CA93230
94-0535360
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(12)Lodi Memorial Hospital Association Inc
975 S Fairmont Avenue

Lodi,CA95240
94-1044474
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(13)Northwest Medical Foundation of Tillamook
1000 Third Street

Tillamook,OR97141
93-0622075
Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(14)Paradise Valley Hospital
1 Adventist Health Way

Roseville,CA95661
95-1816034
Discontinued Operations CA 501(c)(3) Line 1 Adventist Health SystemWest
 
 
No
(15)Portland Adventist Medical Center
10123 SE Market Street

Portland,OR97216
93-0429015
Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(16)Reedley Community Hospital
372 Cypress Avenue

Reedley,CA93654
45-3220509
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(17)Rideout Memorial Hospital
726 Fourth Street

Marysville,CA95901
94-1387866
Acute care hospital CA 501(c)(3) Line 3 Stone Point Health
 
 
No
(18)St Helena Hospital
10 Woodland Road

St Helena,CA94574
94-1279779
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(19)San Joaquin Community Hospital
2615 Chester Avenue

Bakersfield,CA93301
95-2294234
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(20)Simi Valley Hospital & Health Care Services
2975 N Sycamore Drive

Simi Valley,CA93065
95-6064971
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(21)Sonora Community Hospital
1000 Greenley Road

Sonora,CA95370
94-1415069
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(22)Stone Point Health
1 Adventist Health Way

Roseville,CA95661
82-3763347
Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest
 
 
No
(23)Ukiah Adventist Hospital
275 Hospital Drive

Ukiah,CA95482
94-1639901
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(24)Walla Walla General Hospital
1 Adventist Health Way

Roseville,CA95661
91-0617726
Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(25)Western Health Resources
1 Adventist Health Way

Roseville,CA95661
95-3867863
Home care CA 501(c)(3) Line 10 Adventist Health SystemWest
 
 
No
(26)White Memorial Medical Center
1720 Cesar E Chavez Avenue

Los Angeles,CA90033
95-2282647
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
(27)Willits Hospital Inc
1 Marcela Drive

Willits,CA95490
68-0108919
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2022
Page 2
Schedule R (Form 990) 2022
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



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

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




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



(k)
Percentage
ownership


Yes No Yes No
(1) FRD Management Company LLC

PO Box 2128
Marysville,CA95901
94-3335136
Operation of cancer center CA N/A
        No     No  
(2) Blue Legacy Ventures LLC

1010 NE 2nd Avenue
Miami,FL33132
87-1254649
Real property rental FL N/A
        No     No  
(3) Blue Zones LLC

200 Southdale Center
Edina,MN55435
27-1603327
Education MN N/A
        No     No  
(4) PAR LLC dba CherryWood Village

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
93-1262371
Senior housing OR N/A
        No     No  
(5) PVHR LLC dba Paradise Village

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
26-0622555
Senior housing OR N/A
        No     No  
(6) 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  
(7) 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?
Yes No
(1) Fremont-Rideout Management Services Organization Inc

726 Fourth Street
Marysville,CA95901
27-1350379
DME Sales CA N/A
C         No
(2) AdHealth Limited

PO Box HM 2062
Hamilton   HM HX
BD
Pure captive insurance BD N/A
C         No
(3) Adventist Health Plan Inc

1 Adventist Health Way
Roseville,CA95661
46-3833261
Health insurance CA N/A
C         No
(4) South Coast Medical Center

1 Adventist Health Way
Roseville,CA95661
95-2037291
Wind down after sale of hospital CA N/A
C         No
(5) Thrive Productions Inc

200 Southdale Center
Edina,MN55435
45-3369049
Production company MN N/A
C         No




Schedule R (Form 990) 2022
Page 3
Schedule R (Form 990) 2022
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) 2022
Page 4
Schedule R (Form 990) 2022
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2022
Page 5
Schedule R (Form 990) 2022
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) 2022

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