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
Adventist Health SystemWest
 
Employer identification number

95-3484589
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity

(1) Adventist Health Outpatient Pharmacy Services LLC
1 Adventist Health Way
Roseville,CA95661
88-2950026
Fortify Market holding CA 6,893,524 0 Adventist Health SystemWest
 
(2) Dwellcare LLC
1 Adventist Health Way
Roseville,CA95661
87-1377097
Inactive CA 0 0 Adventist Health SystemWest
 
(3) Incentive Acute Care Network LLC
1 Adventist Health Way
Roseville,CA95661
86-2987983
Acute care network CA 0 0 Adventist Health SystemWest
 
(4) Incentive Health LLC
1 Adventist Health Way
Roseville,CA95661
86-2977338
MSO CA 146,632 7,298,224 Adventist Health SystemWest
 
(5) Paradise Skyway LLC
1 Adventist Health Way
Roseville,CA95661
Real estate holdings CA 0 0 Adventist Health SystemWest
 


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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


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

(f)
Direct controlling
entity

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

Clearlake,CA95422
68-0395149
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(2)Adventist Health Delano
1401 Garces Hwy

Delano,CA93215
77-0258013
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(3)Adventist Health Foundation
1 Adventist Health Way

Roseville,CA95661
68-0002188
Charitable foundation CA 501(c)(3) Line 7 Adventist Health SystemWest
 
Yes
 
(4)Adventist Health Medical Center Tehachapi
1100 Magellan Drive

Tehachapi,CA93561
81-2240617
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(5)Adventist Health Mendocino Coast
700 River Drive

Fort Bragg,CA95437
84-5174585
Hospital CA 501(c)(3) Line 3 Stone Point Health
 
Yes
 
(6)Adventist Health Physicians Network
1 Adventist Health Way

Roseville,CA95661
68-0357690
Medical foundation CA 501(c)(3) Line 12b, II Adventist Health SystemWest
 
Yes
 
(7)Adventist Health Tulare
869 North Cherry Street

Tulare,CA93274
83-2351753
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(8)Castle Medical Center
640 Ulukahiki Street

Kailua,HI96734
99-0107330
Hospital HI 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(9)Feather River Hospital
1 Adventist Health Way

Roseville,CA95661
94-1101228
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(10)Glendale Adventist Medical Center
1509 Wilson Terrace

Glendale,CA91206
95-1816017
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(11)Hanford Community Hospital
115 Mall Drive

Hanford,CA93230
94-0535360
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(12)Lodi Memorial Hospital Association Inc
975 S Fairmont Avenue

Lodi,CA95240
94-1044474
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(13)Mid-Columbia Medical Center
1700 E 19th Street

The Dalles,OR97058
93-0386936
Hospital OR 501(c)(3) Line 3 Stone Point Health
 
Yes
 
(14)Northwest Medical Foundation of Tillamook
1000 Third Street

Tillamook,OR97141
93-0622075
Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(15)Paradise Valley Hospital
1 Adventist Health Way

Roseville,CA95661
95-1816034
Discontinued Operations CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(16)Portland Adventist Medical Center
10123 SE Market Street

Portland,OR97216
93-0429015
Hospital OR 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(17)Reedley Community Hospital
372 Cypress Avenue

Reedley,CA93654
45-3220509
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(18)Rideout Memorial Hospital
726 Fourth Street

Marysville,CA95901
94-1387866
Acute care hospital CA 501(c)(3) Line 3 Stone Point Health
 
Yes
 
(19)St Helena Hospital
10 Woodland Road

St Helena,CA94574
94-1279779
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(20)San Joaquin Community Hospital
2615 Chester Avenue

Bakersfield,CA93301
95-2294234
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(21)Simi Valley Hospital and Health Care Services
2975 N Sycamore Drive

Simi Valley,CA93065
95-6064971
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(22)Sonora Community Hospital
1000 Greenley Road

Sonora,CA95370
94-1415069
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(23)Stone Point Health
1 Adventist Health Way

Roseville,CA95661
82-3763347
Supporting organization CA 501(c)(3) Line 12b, II Adventist Health SystemWest
 
Yes
 
(24)Ukiah Adventist Hospital
275 Hospital Drive

Ukiah,CA95482
94-1639901
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(25)United Com-Serve
726 Fourth Street

Marysville,CA95901
94-3015356
Skilled nursing/assisted living/home health CA 501(c)(3) Line 12b, II Stone Point Health
 
Yes
 
(26)Walla Walla General Hospital
1 Adventist Health Way

Roseville,CA95661
91-0617726
Hospital - closed July 2017 WA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(27)Western Health Resources
1 Adventist Health Way

Roseville,CA95661
95-3867863
Home care CA 501(c)(3) Line 10 Adventist Health SystemWest
 
Yes
 
(28)White Memorial Medical Center
1720 E Cesar E Chavez Avenue

Los Angeles,CA90033
95-2282647
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
(29)Willits Hospital Inc
1 Marcela Drive

Willits,CA95490
68-0108919
Hospital CA 501(c)(3) Line 3 Adventist Health SystemWest
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2023
Page 2
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



(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) Blue Legacy Ventures LLC

1010 NE 2nd Avenue
Miami,FL33132
87-1254649
Real property rental FL Adventist Health SystemWest
 
Excluded -1,240,682 2,548,085   No   Yes   50.000 %
(2) Blue Zones LLC

200 Southdale Center
Edina,MN55435
27-1603327
Education MN Adventist Health SystemWest
 
Unrelated 7,764,786 32,935,520   No     No 100.000 %
(3) PAR LLC

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
93-1262371
Senior housing OR Adventist Health SystemWest
 
Unrelated 588,023 8,229,923   No   Yes   50.000 %
(4) PVHR LLC DBA Paradise Village

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
26-0622555
Senior housing OR Adventist Health SystemWest
 
Unrelated 123,739 15,058,820   No   Yes   50.000 %
(5) PVHR2 LLC DBA Parkview Memory Care at Paradise Village

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
47-3300170
Senior housing OR Adventist Health SystemWest
 
Unrelated -212,185 3,427,627   No   Yes   50.000 %
(6) WWGHR LLC

8440 SE Sunnybrook Blvd Suite 100
Clackmas,OR97015
81-0591221
Rental OR Adventist Health SystemWest
 
Unrelated -168,215 2,975,165   No   Yes   50.000 %


Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) AdHealth Limited

PO Box HM 2062
Hamilton   HM HX
BD
Pure captive insurance BD Adventist Health SystemWest
 
C 1,045,636 3,160,685 50.000 %   No
(2) Adventist Health Plan Inc

1 Adventist Health Way
Roseville,CA95661
46-3833261
Health insurance CA Adventist Health SystemWest
 
C 51,609,604 13,969,705 100.000 % Yes  
(3) South Coast Medical Center

1 Adventist Health Way
Roseville,CA95661
95-2037291
Wind down after sale of hospital CA Adventist Health SystemWest
 
C     100.000 % Yes  
(4) Thrive Productions Inc

200 Southdale Center
Edina,MN55435
45-3369049
Production company MN Adventist Health SystemWest
 
C 12,500 3,319 100.000 % Yes  






Schedule R (Form 990) 2023
Page 3
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
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
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
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
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
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
(1) Feather River Hospital

C 166,281,000 Cash transfer amount
(2) Walla Walla General Hospital

C 80,707 Cash transfer amount
(3) Adventist Health Clearlake Hospital Inc

L 20,784,554 FMV
(4) Adventist Health Delano

L 10,590,421 FMV
(5) Adventist Health Medical Center Tehachapi

L 6,760,078 FMV
(6) Adventist Health Mendocino Coast

L 9,101,927 FMV
(7) Adventist Health Physicians Network

L 13,121,775 FMV
(8) Adventist Health Tulare

L 8,002,436 FMV
(9) Castle Medical Center

L 26,268,934 FMV
(10) Glendale Adventist Medical Center

L 58,257,222 FMV
(11) Hanford Community Hospital

L 41,793,342 FMV
(12) Lodi Memorial Hospital Association Inc

L 30,690,161 FMV
(13) Northwest Medical Foundation of Tillamook

L 11,758,595 FMV
(14) Portland Adventist Medical Center

L 31,070,199 FMV
(15) Reedley Community Hospital

L 21,711,845 FMV
(16) Rideout Memorial Hospital

L 56,088,713 FMV
(17) San Joaquin Community Hospital

L 56,422,318 FMV
(18) Simi Valley Hospital and Health Care Services

L 23,590,524 FMV
(19) Sonora Community Hospital

L 34,695,999 FMV
(20) St Helena Hospital

L 33,098,529 FMV
(21) Ukiah Adventist Hospital

L 26,275,799 FMV
(22) Western Health Resources

L 3,058,064 FMV
(23) White Memorial Medical Center

L 56,947,399 FMV
(24) Willits Hospital Inc

L 9,729,784 FMV
(25) Adventist Health Clearlake Hospital Inc

O 1,423,487 FMV
(26) Adventist Health Delano

O 301,005 FMV
(27) Adventist Health Medical Center Tehachapi

O 299,657 FMV
(28) Adventist Health Mendocino Coast

O 2,624,020 FMV
(29) Adventist Health Tulare

O 117,849 FMV
(30) Castle Medical Center

O 2,121,989 FMV
(31) Glendale Adventist Medical Center

O 3,651,132 FMV
(32) Hanford Community Hospital

O 3,511,453 FMV
(33) Lodi Memorial Hospital Association Inc

O 2,451,421 FMV
(34) Northwest Medical Foundation of Tillamook

O 1,284,722 FMV
(35) Portland Adventist Medical Center

O 3,021,925 FMV
(36) Reedley Community Hospital

O 134,712 FMV
(37) Rideout Memorial Hospital

O 2,519,259 FMV
(38) San Joaquin Community Hospital

O 3,204,085 FMV
(39) Simi Valley Hospital & Health Care Services

O 1,987,160 FMV
(40) Sonora Community Hospital

O 1,988,130 FMV
(41) St Helena Hospital

O 1,939,468 FMV
(42) Ukiah Adventist Hospital

O 1,660,357 FMV
(43) Western Health Resources

O 528,317 FMV
(44) White Memorial Medical Center

O 3,999,670 FMV
(45) Willits Hospital Inc

O 1,000,350 FMV
(46) Adventist Health Delano

R 18,694,540 Cash transfer amount
(47) Adventist Health Foundation

R 339,456 Cash transfer amount
(48) Adventist Health Medical Center Tehachapi

R 1,487,119 Cash transfer amount
(49) Adventist Health Mendocino Coast

R 55,230,757 Cash transfer amount
(50) Adventist Health Plan Inc

R 4,797,674 Cash transfer amount
(51) Adventist Health Tulare

R 44,602,219 Cash transfer amount
(52) Blue Zones LLC

R 9,273,698 Cash transfer amount
(53) Glendale Adventist Medical Center

R 3,185,361 Cash transfer amount
(54) Hanford Community Hospital

R 47,062,218 Cash transfer amount
(55) Northwest Medical Foundation of Tillamook

R 14,094,677 Cash transfer amount
(56) Rideout Memorial Hospital

R 31,527,826 Cash transfer amount
(57) Rideout Memorial Hospital

R 31,527,826 Cash transfer amount
(58) San Joaquin Community Hospital

R 30,061,962 Cash transfer amount
(59) Sonora Community Hospital

R 23,134,573 Cash transfer amount
(60) United Com-Serve

R 754,772 Cash transfer amount
(61) Willits Hospital Inc

R 9,292,779 Cash transfer amount
(62) Adventist Health Clearlake Hospital Inc

S 292,000 Cash transfer amount
(63) Adventist Health Clearlake Hospital Inc

S 3,813,604 Cash transfer amount
(64) Adventist Health Delano

S 172,000 Cash transfer amount
(65) Adventist Health Medical Center Tehachapi

S 85,000 Cash transfer amount
(66) Adventist Health Mendocino Coast

S 31,000 Cash transfer amount
(67) Adventist Health Physicians Network

S 11,063,029 Cash transfer amount
(68) Adventist Health Tulare

S 135,000 Cash transfer amount
(69) Castle Medical Center

S 343,000 Cash transfer amount
(70) Castle Medical Center

S 19,995,037 Cash transfer amount
(71) Feather River Hospital

S 181,269,346 Cash transfer amount
(72) Glendale Adventist Medical Center

S 991,000 Cash transfer amount
(73) Hanford Community Hospital

S 651,000 Cash transfer amount
(74) Lodi Memorial Hospital Association Inc

S 476,000 Cash transfer amount
(75) Lodi Memorial Hospital Association Inc

S 26,014,795 Cash transfer amount
(76) Northwest Medical Foundation of Tillamook

S 172,000 Cash transfer amount
(77) PAR LLC

S 1,290,000 Cash transfer amount
(78) Portland Adventist Medical Center

S 524,000 Cash transfer amount
(79) Portland Adventist Medical Center

S 42,823,896 Cash transfer amount
(80) Reedley Community Hospital

S 357,000 Cash transfer amount
(81) Reedley Community Hospital

S 3,375,816 Cash transfer amount
(82) San Joaquin Community Hospital

S 832,000 Cash transfer amount
(83) Simi Valley Hospital & Health Care Services

S 356,000 Cash transfer amount
(84) Simi Valley Hospital & Health Care Services

S 18,243,460 Cash transfer amount
(85) Sonora Community Hospital

S 517,000 Cash transfer amount
(86) South Coast Medical Center

S 273,662 Cash transfer amount
(87) St Helena Hospital

S 465,000 Cash transfer amount
(88) St Helena Hospital

S 17,380,852 Cash transfer amount
(89) Ukiah Adventist Hospital

S 405,000 Cash transfer amount
(90) Ukiah Adventist Hospital

S 4,232,329 Cash transfer amount
(91) Walla Walla General Hospital

S 246,181 Cash transfer amount
(92) Western Health Resources

S 45,000 Cash transfer amount
(93) Western Health Resources

S 2,105,686 Cash transfer amount
(94) White Memorial Medical Center

S 913,000 Cash transfer amount
(95) White Memorial Medical Center

S 47,302,342 Cash transfer amount
(96) Willits Hospital Inc

S 152,000 Cash transfer amount
(97) WWGHR LLC

S 180,000 Cash transfer amount
Schedule R (Form 990) 2023
Page 4
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)
(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) 2023
Page 5
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


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