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Adventist Health

Adventist Health is spreading across Northern CA, which makes the company an employer...
If you just want a place to work, AH may soon be the only place!

But getting large is not necessarily good! A recent essay by a former employee follows, and it accurately reflects my experiences with Adventist Health:


What to Expect if Adventist Health Comes to Town
by Michael Turner, MD

So the Adventist advance team has come to town and made a number of vague proposals. It's hard to know what to make of their pitch, isn't it? Having worked in their system for almost two decades I can offer a few observations and perhaps, predictions. I'm not going to tread softly, because I think religious based health organizations, with their secretiveness and unstated goals, are a bad fit for community based health care based on transparency and honest communication.

The effect of Adventist Health coming to your area will be mostly bad, but there will probably be some immediate benefits. Your health facility will be spiffed up. Adventist has deep pockets and can fund improvements in the physical plant far more easily than the local community. The hospital will look better and function better. Outwardly, it will reflect well on the community. You can also expect a surge in employment. (Adventist Health employs 15% of the labor force in inland Mendocino.) And many of these jobs will be good jobs. Over the years I saw many young people begin at entry level positions and advance to stable long term careers in health care. And, because it is well capitalized, many measures of health care will improve.

But what about those negatives?

Loss of Community Control. No matter what they say in their presentation, Adventist does not care about local communities. They think in larger terms. What they actually care about is their planned strategy to control rural health care in Northern California. Financial decisions are always made on a regional level. Your facility's budget will eventually be controlled by a distant corporate executive. If there's a major problem down the road, the local community leaders will never be able to communicate within the upper reaches of the Adventist hierarchy. Adventist will probably propose some plan for shared decision-making with the local community, but in the end it will be window-dressing - all decisions of financial consequence flow downward from corporate headquarters in Roseville. To step back, Adventists are a community to themselves. In their world people are divided into the Adventists, and the "worldly people.” When Adventists talk about doing things for the community, regardless of good intentions, they actually mean for "their" community. Ultimately their myopic decision-making process excludes non-members.

Greatly Increased Cost of Health Care. The Adventist's strategy historically has been to create small geographic monopolies and then jack up prices. For example in Ukiah the cost of diagnostic services are always at least double the price of similar tests done in Santa Rosa. Furthermore their aim is to drive consumers to more expensive care, such as elective surgeries, high tech imaging studies, and hospitalizations vs. preventive medicine and outpatient care. You only have to drive through Ukiah and look at their billboards to see their strategy. If Adventist comes to town you can expect to see a big jump in your health care costs, and the community will see a rise in medically related bankruptcies.

Profiteering. Why, you may ask, would a non-profit health organization try to grossly increase the cost of my community's health care? Because they are non-profit in name only, a huge amount of money goes to directly into the coffers of the larger Adventist organization. It's a corporate secret, but one estimate I heard from someone who would know is that 10% of gross revenue goes directly to the larger corporation. And then there's the matter of nepotism.

Nepotism. Local Adventist administrators make huge amounts of money. The last time I looked the top administrator of the Ukiah hospital was making over $800,000 per year and many others had salaries far in excess of those made by doctors or nurses. And (this is important) you have to be a member of the Church to occupy an upper tier administrative position. Non-Adventists need not apply - it's an explicit rule. In a way health care is their racket; where there is an Adventist community, there will be a health care facility that employs lots of Adventists in well paid white collar roles. Fundamentally Adventist Health is not an actual non-profit organization. What they call "administrative costs" I call a huge salary boondoggle paid for by the working class of the local community.

Incompetence. This is always the necessary corollary of nepotism. Many functionaries obtain their position based solely on their church status, particularly if they are related to other church members. For example, neither of my last two practice managers had any previous health care experience. The result is a laughably incompetent bureaucracy. As a provider I dealt constantly with untrained employees, unworkable communication systems, shortages of supplies, and many more problems caused by by blissfully obtuse management. From the consumer perspective you can expect consequences like poor communication, long wait times, and lots of mistakes in addition, of course, to increased costs.

Loss of choice. The name of the game in health care is "risk management.” That is, Adventist would like to create a large pool of consumers and control them through their insurance coverage, like employee-based insurances, MediCal (Partnership), and Medicare supplemental plans. Once Adventist is assigned care for x amount of patients they then contract with doctors to deliver that care. In this model the more you hold down cost, the higher the profit. And the best way to hold down cost is to limit care, either by outright refusal ("not a covered service"), or by restricting care to a single network, ie. Adventist Health. Thus in Mendocino you can expect to see only an Adventist approved doctor, receive only approved services at an Adventist lab, and receive specialty care in far away Adventist facilities like St. Helena or even Loma Linda. If your doctor isn't on their panel, you'll have to find a new doctor. And forget about going to Santa Rosa or UCF if you want a second opinion.

Duplicity. This is a highly personal issue for me, and I cannot say to what degree it applies in a wider sense. But I remember leaving a meeting with an Adventist exec and thinking "he just lied to me!" It's been my experience that for sanctimonious people, dishonesty employed for a "higher good" is not wrong. Expect that no matter what assurances and promises are given to your local leaders, no matter what it says on a signed piece of paper, your agreement with Adventist will mutate into something you didn't anticipate, and over time, become increasingly favorable to Adventist aims.

Physician flight. Since my arrival in Ukiah two decades ago, the number of practicing physicians has been cut by more than half. Why? First of all, lack of replacement. Adventist Health is regarded as a third tier organization by many young doctors, who choose to work for more competent systems like Kaiser. And more immediately, Adventist drove many practicing doctors from the area by heavy-handed methods like forcing the community hospital (Ukiah General) out of business, and more recently, insisting that local doctors become Adventist employees. If Adventist comes to town, expect a greater than 50/50 likelihood that your doctor will retire or leave town.
AdventHealth headquarters, Altamonte Springs, Florida

If AH really decides to come to the coast, you probably can't stop them. They have been employing a successful takeover strategy in small towns all over Northern California for more than twenty years. But before putting their signature on anything, your leaders should talk to community leaders in places like Ukiah and Lodi and Hanford and Feather River and see what really happens when Adventist Health come to town.

—Michael Turner, MD (retired)

In addition, Adventist Health runs skeleton staff, routinely runs afoul of State and Federal law pertaining to staffing levels, and Adventist Health will regularly and normally risk patient safety to save money.

Adventist Health encourages department managers to lie to staff, abuse and harass staff, and to gas-light the staff.

Do yourself a favor, don't work for AH! If you have to, go for it...

I do not reccommend this employer.

Do not be fooled by the smiles and shiny new building, it is miserable here. We all fake it. Every. Single. Day. Many of the staff and management whom hate it stay because they are Seventh Day Adventist and feel they should try to support an Adventist organization.  Every day all you hear is complaints from theses same people with shoulder shrugs of "what can we do", everyone complains about the lack of accountability, meetings all day and very little getting done. Cerner (EHR system) now runs over half of the Adventist Health corporate building and it is a disaster. Many staff were sold to Cerner last year with almost no notice to staff and no loyalty shown to them by Adventist.  

HR flat out lies about the benefits and time off that you receive. You will not find out that they "misrepresented" the facts until you are already on board. Nothing is done about it. Vacation time is the lowest in the entire area and HR will lie about it during your hiring process. Non existent on-boarding process, a sink or swim atmosphere. Everyone is nice but after 6 months you will start to see the underbelly of dishonesty and gossip. Lower pay than other area hospital systems. Educational benefits non-existent. Wish I had known any of these things before I made the move to Adventist Health. Once again, HR lied. Starting meetings with prayer is nice but if there is nothing done and no follow through on issues/abuses then what is the point? Added bonus: last year AH shut down their hospital in Walla Walla, WA with no notice to the staff. The staff found out via the computer homepage when they came to work. How is that an Adventist value of "living God's love"?????

I am still working here because I have hoped it would improve. Now, just waiting to get my two years in so I can have my resume look less choppy and then I am GONE. I give AH 2 stars because I love some of my coworkers, the new building, and the ability to work out on my break then use the showers/locker room to clean up before I return to work. I love the flexibility of being able to work from other locations in our building and not just at my desk. Without these items, it would be a 1 star. 

Pros: fabulous new building, friendly ancillary staff, treadmill offices, walking path, free coffee and tea, good people, amazing medical plan, good dental, prayer at the beginning of every meeting, attempt at Christian value-based care. 

Cons: vegan cafeteria, culture of fake smiles and ignoring problems, gossip, poor management decision making, HR that is dishonest with no accountability, poor PTO schedule, no training, shaming culture, failure at following through on the being a good Christian organization.

At Adventist Health, in both locations I worked, I immediately found a struggle to exist with the lies I had been told by managerial and administrative persons. Why they just can't tell the truth is beyond me!

Another trait I noticed in the working environment, was sabotage, hazing, and hostility/harassment from my coworkers! Backstabbing is common in small hospitals, but, at AH, it appears to be cultural, and, even encouraged! Guess what? Harassment is illegal!

Your manager will engage in a process called "rounding" which is another word for picking at you, fussing over small details, and, pointing out each infraction of, say, clocking out a minute late, or failing to take lunch at the right moment... It is very annoying and picayune, but this process is repeated at odd intervals, usually when you are tired... They call it "rounding", but I call it gas-lighting... Very common at AH!

The personnel at AH, they complain constantly, and, there is a high turnover rate. Although the salaries are above the market a bit, people are stressed by the overall low staffing levels, and the tendency for the replacement rate to be slow. Your manager will claim he is interviewing, but will fail to hire promptly, causing existing staff to be spread thinly and experience burnout.

Adventist Health cares not for Federal and State law, and, you will often see the result of violations. Patient safety will be risked, and complaints will be met with no action. The lack of action will extend to workplace safety, and you will see violations that other organizations would not tolerate. Be aware, and work safe, because AH does not seem to care about OSHA!

Overall, the attitude of the corporation has not improved over 8 years, but, the continuing expansion of Adventist Health is finally meeting some pushback, and the history of violations and illegal billings in the company has not served AH well. AH is also acquiring quite a reputation for poaching employees, and for losing physicians.

Overall, I would call AH a poor quality employer, with reasonable but expensive benefits, and very dishonest management.

At this point, I would not recommend working at AH, especially not in Napa County, Mendocino County, Sonoma County, Butte County or Sutter/Yuba County, California. Good luck out there! Lots of other places to work!

I work per diem as a CNA while I went through nursing school. From my experience, the work environment is less toxic than some of previous work experiences in an acute care setting and assisted living facility. A lot of the employees are new grads and for the most part, most folks are supportive and understanding. I notice the new grads are a lot more comfortable and confident in their role also. I'm sure bullying happens and nurses eat their young, but I haven't seen or experienced that here nor have been aware of those kinds of incidents. It's pretty much a supportive work environment over all.

In terms of benefits, I've worked here for about a year and have received at least 3 pay raises. Nothing big, but big enough for me to notice it. They are so flexible with my work schedule and work with me as I go to school. I have no complaint there

They are thorough and it feels as though they take the time to invest in their employees through thorough training and such. I'm very impressed. The facility holds true as being "the best place to work". They employ advanced technology in how they deliver their care and how they run the facility. I did a job interview in this facility which utilized facetime to conduct the interview. I was very impressed. This however does not go without cons. 

The charting system, in my opinion, needs work. It maybe that I am used to a different charting system which is more "straight to the point" charting, but I am not impressed with cernur. I find myself spending more time behind a computer rather than with my patients. Cernur focuses on task and charting those tasks accordingly which sometimes feels like they are micromanaging the care I deliver. The charting system, I feel, is not practical if I were the only aid on the floor. There's no way I can implement the scheduled care on 20+ patients and chart on each and every single one of them within 12 hours, but that's just my 2 cents.

I worked for this hospital for over a year and the way the director and supervisor treated the employees was so disrespectful. When an employee was once a patient, the supervisor who was the lab assistant for the day due to short staffing told her to sit down and wait even though she was next to be called up. The tone and inappropriate comments the lab assistant supervisor made was disrespectful and inappropriate and seemed to be only made to the female employees. When situations that needed to be addressed came about, his answer for everything including coverage for days off or other issues were "I don't know. Just figure it out amongst yourselves". He and the director of the lab played favorites with 5 employees all who are lab assistants and no matter what went wrong, they never got in trouble. After many complaints from doctors, patients and other employees about a certain employee who had recently been hired made countless mistakes on patient records and ordering wrong tests, the supervisor and director did nothing. It was so bad, that at one point, the doctors were even sending their patients out to PAL or other laboratories because of the many mistakes being made. San Joaquin Community Hospital has been trying to pass the state tests for CMS for so long but keep failing. It got to the point where they had to have a class for the importance of hand hygiene and what trash goes in which bin and if it considered a biohazard. This is the main reason the Cancer Center that was recently build hadn't been open yet. It was being put on hold for months and months. They gave the reason of "needing to get licensed from other departments" but the real reason was because they could no pass the state tests. NOW, WOULD YOU REALLY WANT TO GO THERE FOR YOUR CARE?  I KNOW I WOULDN'T. Because of everything I witnessed, I will not be coming back as a patient EVER.

Adventist Health (AH) is an organization that has many hospitals throughout the west coast (including Hawaii). They are experienced in the healthcare industry.  

Because they serve in some rural areas those hospitals have the smaller hometown friendliness with the advanced medical facilities of high level hospitals. This includes helipads for incoming and outgoing patients, trauma level ED, large ED department, in house pharmacies, local connected clinics and specialties, specialty and general surgeons, high level equipment in radiology, large L&D suites, many bed MedSurg units, new ICU, New ED, etc. 

The department teams are close and eager to help the staff within their departments. Often it can be found that when unexpected events occur the team will come together to support those struggling (be it with covering shifts or other means- even financially in past experience). A true family of coworkers/friends. 

I can’t speak to all AH hospitals but mine, particularly, allows for experience in other departments as well as their main department.  Ex: if you’re a Medsurg nurse and would like to train in ED they’ll allow time to cross-train. Bonus! 

The surgical department (at my location) in particular is very close. The director is fabulous.  She truly cares for her staff- keeping up with family affairs and life events. The locations of the job change on a day to day basic.  For me, that’s great.  It takes the monotony out of routine and allows for continual experience in multiple locations while performing a variety of jobs. 

HR- great team. Very friendly. Helpful. 

Employee Health- friendly, knowledgeable. 

Local CEO- positive, uplifting, friendly, approachable. 



I worked as a physician in the outpatient setting with Adventist Health.

The good:
Local leadership at my clinic was excellent. The people I worked with genuinely cared about patients and wanted to do right by them. Leadership really did value both patient care and provider wellbeing, so the focus was not just on numbers or productivity. The pay was solid, and when I pushed for changes in my practice, they made it happen, although it usually took some reminding. Lots of leadership opportunities for people who want to be involved. 


Neutral points:
Corporate leadership felt very far removed from what was happening locally. That can be a good thing if you want to run your practice your own way, since you are not micromanaged. It also made things like taking extended leave pretty simple. But if you are trying to get a bigger change off the ground, like starting a new service line, it takes a lot of work.


About the practice itself:
The hardest part of working at my location was the area. The towns nearby are very poor, isolated, and do not have much to offer in terms of recreation, shopping, or job opportunities for spouses, which made it tough to keep providers long term. About half the patients were on Medi-Cal, which usually made coverage for medications and services pretty straightforward. On the flip side, patients often did not have the resources to travel to bigger cities or pay out of pocket for things, so options could be limited. Even so, taking care of this patient population was incredibly rewarding. They really needed the help, and it felt meaningful to be there for them.

Very focused on religion - very focused on prayer during meetings and an emphasis of letting God lead the work. I soon found out that individuals in leadership positions had gotten promoted because they were hard core Adventists or Christians. Leadership not qualified and very poor communication to "associates". I've noticed a lack of action in this organization - there is a lot of talk and new projects are taken on and implemented without a lot of thought or planning. No room for growth here, and associates feel undervalued. Idea of the "ONE Adventist Health" could have been successful, but due to lack of planning, organization, and leadership, it's been set up to fail. 

I've also noticed that there are a lot of individuals who just seem to be at work to collect a paycheck. Lots of employees who never respond to emails, though they're working. I've found an inability to move things forwards and get things accomplished, just since I'm waiting on other people. Very frustrating environment for self-directed people.

Pay is average (on the low side for the market). Benefits are poor - 2 weeks vacation to start and only 24 hours of sick time per year. No continuing education, no reimbursement of licensing. There are also "flex" days which are basically mandatory time off days. Non-essential clinical individuals are obligated to take these flex days - they generally fall on either side of a holiday. This may seem nice, but these days also get taken out of your PTO so if you calculate things, with holidays + flex days, you only get about 5 vacation days a year.

I come into work and say good morning to everyone. Then I log into my computer and get a report from the night clerk letting me know about the patients heart conditions and what to look for on telemetry. I send several different units the nurse locator with names and number so they can be reached in a timely manner.  I always put a hello on it or a good morning or a hi sunshine on the paper to brighten their morning first thing. I send it to the pharmacy, lab, discharge planners, radiology, house supervisor and the operator.  I have the duty to monitor the patients until I get out from work which is a twelve hour shift. I print out at 8, 12 and 4 o'clock readings and interpret each strip and make sure the nurses are aware of any changes in their rhythm. I review the orders on the computer of any 'stat' orders such as radiology emergencies, critical labs, transferring patience to a higher level of care.Then by mid afternoon I tear down all of the charts from the patients that was discharged and re-stuff them with proper papers for the next patient. With-in my work day I usually make conversations pertaining to patient's care or social conversing about life outside of work. I work well with the people at my job and get along with everyone for the most part, some people just aren't happy people but I still tend to make them smile. I like my job but the people I work with make it exceptionally great to be at work.

Typical day was busy and full of constant interruptions and changes in pt condition and plan of care
Learned so much about care and documentation of wounds, drains, lines, infusions, labs, diagnostics, post op care, ostomies, Foley's, ng/peg tubes, chest tubes, communication with interdisciplinary team, hospitalists, specialists and residency teams.  
Management was supportive but really couldn't hear me when I asked for transfer to slower unit where my best skills could be utilized to the fullest.
Culture was supportive and kind. There was a massive turnover. In 2 years time there were only 4 nurses that had been there over 5 years.
The hardest part was feeling you could never get it all done. Ever. There were patient teaching standards to meet that we're never fully realized. Tasks that would be left undone. Feeling defeated on the drive home.
The most enjoyable part were the times when you COULD meet the patients a their point of need. When they thanked you for a job well done. When you finally had a clear understanding of how a process worked. When you could do something completely independently and able to teach someone new how a process worked. Little successes like that made my day.

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