2022-05-16T22:26:44-05:00 2021-06-30 470617373 COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD CO 80112 990 2021-01-01 910565539 VIRGINIA MASON MEDICAL CENTER VIRG 2062236600 1100 NINTH AVENUE SEATTLE WA 98101 DAVID NOSACKA CFO 2062236600 2022-05-16 1 DAVID NOSACKA 999009999 PAMELA KROHN P01210500 3032989100 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z KATERIE CHAPMAN 1100 NINTH AVENUE SEATTLE WA 98101 604685936 0 X WWW.VMFH.ORG X 1934 WA VIRGINIA MASON MEDICAL CENTER'S (THE "MEDICAL CENTER") MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PATIENTS IT SERVES THROUGH THE DELIVERY OF HIGH QUALITY, COST EFFECTIVE CARE. THE MEDICAL CENTER PROVIDES INTEGRATED HEALTH SERVICES THROUGH A TEACHING HOSPITAL AND MULTI-SPECIALITY GROUP PRACTICE, OFFERING BOTH PRIMARY AND SPECIALIZED CARE. 14 13 0 486 2283809 0 60533449 5407888 1029684469 560661744 40881723 21114450 6443105 2694086 1137542746 589878168 8190853 1000000 0 0 610472170 319918677 0 0 1750885 522213913 259932306 1140876936 580850983 -3334190 9027185 1429584444 1475989315 874015959 890283362 555568485 585705953 X VIRGINIA MASON MEDICAL CENTER'S (THE MEDICAL CENTER) MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PATIENTS IT SERVICES THROUGH THE DELIVERY OF HIGH QUALITY, COST-EFFECTIVE CARE. THE MEDICAL CENTER PROVIDES INTEGRATED HEALTH SERVICES THROUGH A TEACHING HOSPITAL LICENSES FOR 336 BEDS AND MULTI-SPECIALITY GROUP PRACTICE OF APPROXIMATELY 565 EMPLOYED PHYSICIANS, OFFERING BOTH PRIMARY AND SPECIALIZED CARE, THROUGH A REGIONAL NETWORK OF NEIGHBORHOOD CLINICS AND AMBULATORY SURGERY CENTERS. 0 0 530039396 558196863 HEALTH CARE SERVICESTHE MEDICAL CENTER IS A TERTIARY REGIONAL REFERRAL CENTER WHICH SERVES A PATIENT COMMUNITY THAT INCLUDES SEATTLE AND ITS SURROUNDING SUBURBS, WESTERN WASHINGTON AND ALASKA. THE MAIN CAMPUS LOCATED IN SEATTLE INCLUDES A HOSPITAL, AN OUTPATIENT CLINIC, CENTERS OF EXCELLENCE INCLUDING THE CENTER FOR HYPERBARIC MEDICINE, DIGESTIVE DISEASE INSTITUTE, FLOYD & DELORES JONES CANCER INSTITUTE, HEART INSTITUTE, NEUROSCIENCE INSTITUTE AND UROLOGY. THE MEDICAL CENTER ALSO OPERATES NINE REGIONAL CLINICS, AND BAILEY-BOUSHAY HOUSE, A 35-BED SKILLED NURSING FACILITY. DURING 2021, THE MEDICAL CENTER RECORDED 5,648 HOSPITAL INPATIENT ADMISSIONS, 9,844 EMERGENCY ROOM VISITS AND 470,112 CLINIC VISITS. THE MEDICAL CENTER PROVIDED CHARITY CARE AND UNREIMBURSED MEDICAID SERVICES TO A TOTAL OF 3,596 PATIENTS.A. SUBSIDIZED HEALTH SERVICESTHE MEDICAL CENTER IS COMMITTED TO SUBSIDIZING CERTAIN HEALTH SERVICES DUE TO THE DEMONSTRATED NEED FOR THESE SERVICES IN THE COMMUNITY. SINCE 1992, THE MEDICAL CENTER HAS ADDRESSED THE TREATMENT OF HIV/AIDS BY OPERATING BAILEY-BOUSHAY HOUSE ("BAILEY-BOUSHAY"), A 35-BED SKILLED NURSING FACILITY. THE FIRST FACILITY IN THE NATION BUILT SPECIFICALLY FOR THE CARE OF PEOPLE LIVING WITH AIDS, BAILEY-BOUSHAY NOW ALSO SERVES OTHER INDIVIDUALS WHO NEED INTENSIVE NURSING CARE, MANY OF WHOM ARE MEDICAID RECIPIENTS. IN ADDITION TO THE CARE PROVIDED TO ITS RESIDENTIAL POPULATION, BAILEY-BOUSHAY PROVIDES DAY HEALTH SERVICES TO 302 CLIENTS ANNUALLY, ALLOWING THEM TO LIVE INDEPENDENTLY WITH HIV/AIDS. IN NOVEMBER 2018, BAILEY-BOUSHAY OPENED THE FIRST HIV HOMELESS SHELTER WHICH SERVICES 50 CLIENTS. IN 2020, BAILEY-BOUSHAY BEGAN THE RENTAL ASSISTANCE PROGRAM, WHICH HELPS TO PROVIDE HOUSING TO INDIVIDUALS WHO ARE LOW-INCOME, DIAGNOSED WITH HIV/AIDS, AND REQUIRE ASSISTANCE IN MAINTAINING OR ACQUIRING APPROPRIATE AFFORDABLE PERMANENT HOUSING, WITH CURRENTLY 49 UNITS OCCUPIED. THE MEDICAL CENTER ALSO OFFERS EMERGENCY SERVICES 24 HOURS A DAY, 7 DAYS A WEEK. THE DEPARTMENT IS STAFFED BY BOARD-CERTIFIED EMERGENCY PHYSICIANS, PHYSICIAN ASSISTANTS AND CERTIFIED EMERGENCY NURSES. B. UNCOMPENSATED CARETHE MEDICAL CENTER IS COMMITTED TO PROVIDING NECESSARY MEDICAL SERVICES REGARDLESS OF A PATIENT'S ABILITY TO PAY AND WITHOUT DISCRIMINATION AS TO RACE, COLOR, CREED, NATIONAL ORIGIN, RELIGION, SEX, SEXUAL ORIENTATION, DISABILITY, AGE, SOURCE OF INCOME, OR ANY OTHER CLASS PROTECTED BY FEDERAL OR WASHINGTON STATE LAW, OR WHO HAVE AN EMERGENCY MEDICAL CONDITION. THE MEDICAL CENTER IS A PARTICIPATING HOSPITAL IN THE WASHINGTON STATE MEDICAID CONTRACTING PROGRAM. 1. CHARITY CARECHARITY CARE IS PROVIDED ACCORDING TO A PATIENT'S GROSS FAMILY INCOMES AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. FULL OR PARTIAL CHARITY CARE MAY BE PROVIDED TO PATIENTS WITH GROSS FAMILY INCOMES EXCEEDING 300% OF THE FEDERAL POVERTY LEVEL WHEN CIRCUMSTANCES INDICATE THAT FULL PAYMENT MAY CAUSE FINANCIAL HARDSHIP SO AS TO SIGNIFICANTLY HARM THE PATIENT OR PATIENT'S FAMILY. PATIENTS WITHOUT HEALTH INSURANCE ARE ELIGIBLE FOR A DISCOUNT ON MEDICALLY NECESSARY SERVICES UNDER THE MEDICAL CENTER'S DISCOUNTS FOR UNINSURED PATIENTS POLICY. CHARITY CARE WAS PROVIDED AT A COST OF $4,189,023 DURING THE YEAR, ALONG WITH $17,117,608 OF MEDICAID CONTRACTUAL ALLOWANCES. CHARITY CARE DOES NOT INCLUDE "BAD DEBTS" WHICH IS THE AMOUNT THE MEDICAL CENTER IS NOT PAID BY PATIENTS DEEMED ABLE TO PAY THEIR BILLS. 12224571 1000000 14550 EDUCATION AND RESEARCHTHE MEDICAL CENTER' IS AN INDEPENDENT ACADEMIC MEDICAL CENTER WITH A GRADUATE MEDICAL EDUCATION PROGRAM THAT TRAINS OVER 130 RESIDENTS IN NINE ACCREDITED PROGRAMS IN ANESTHESIOLOGY, INTERNAL MEDICINE, GENERAL SURGERY, DIAGNOSTIC RADIOLOGY, TRANSITIONAL YEAR, AND UROLOGY. IN ADDITION, THE MEDICAL CENTER TRAINS A NUMBER OF FELLOWS IN AREAS SUCH AS PAIN MANAGEMENT, REGIONAL ANESTHESIOLOGY, AND FEMALE PELVIC MEDICINE/RECONSTRUCTIVE SURGERY. THE MEDICAL CENTER IS ALSO AFFILIATED WITH THE UNIVERSITY OF WASHINGTON FOR THE TRAINING OF SUBSPECIALTIES IN THE AREAS OF ANESTHESIOLOGY, ORTHOPEDICS, OBSTETRICS, GYNECOLOGY AND UROLOGY. THE MEDICAL CENTER ALSO PROVIDES TRAINING IN CLINICAL NURSING EDUCATION, ALLIED HEALTH FIELDS, CONTINUING MEDICAL EDUCATION AND GRAND ROUNDS. IN ADDITION, THE MEDICAL CENTER CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATE BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON, A SCIENTIFIC RESEARCH INSTITUTE QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.A. GRADUATE MEDICAL EDUCATIONTHE MEDICAL CENTER'S GRADUATE MEDICAL EDUCATION PROGRAM MAINTAINS EDUCATION AFFILIATION AGREEMENTS WITH COMMUNITY CLINICS UNDER WHICH THE MEDICAL CENTER'S RESIDENTS PROVIDE CARE TO PATIENTS AT CLINICS SERVING LOW-INCOME AND UNINSURED PATIENTS. THE MEDICAL CENTER HAS AN AFFILIATION WITH EASTGATE PUBLIC HEALTH CLINIC (OPERATED BY SEATTLE & KING COUNTY PUBLIC HEALTH) TO PROVIDE A RESIDENT CLINIC 4-DAYS A WEEK UNDER THE SUPERVISION OF MEDICAL CENTER PHYSICIANS. THIS AFFILIATION HAS EXPANDED ACCESS TO HEALTH CARE FOR KING COUNTY RESIDENTS AND ENHANCED THE EDUCATIONAL OPPORTUNITIES OF INTERNAL MEDICINE RESIDENTS.B. CONTINUING NURSING EDUCATIONTHE CLINICAL NURSING EDUCATION ("CNE") PROGRAM OFFERED 11 CNE EVENTS IN 2020 TO 163 ATTENDEES. PARTICIPANTS INCLUDE NURSES (THE PRIMARY AUDIENCE RNS AND LPNS), AS WELL AS PATIENT CARE TECHNICIANS, NURSE TECHNICIANS, AND MEDICAL ASSISTANTS. C. ALLIED HEALTH EDUCATION PROGRAMS THE MEDICAL CENTER ALSO SERVES AS AN INTERNSHIP SITE FOR STUDENTS IN A VARIETY OF ALLIED HEALTH PROGRAMS SUCH AS NURSING, PHARMACY, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SOCIAL WORK, SLEEP DISORDERS, MEDICAL INSURANCE, SPEECH AND LANGUAGE THERAPY, RADIOLOGY AND LABORATORY TECHNOLOGY. SUCCESSFUL RELATIONSHIPS HAVE BEEN BUILT WITH VOCATIONAL TRAINING PROGRAMS FOR MEDICAL ASSISTANTS AS WELL. D. CONTINUING MEDICAL EDUCATIONTHE MEDICAL CENTER PROVIDES STRONG SUPPORT FOR CONTINUING MEDICAL EDUCATION ("CME"). THE MEDICAL CENTER'S CME PROGRAM IS ACCREDITED BY THE ACCREDITATION COUNCIL FOR CONTINUING MEDICAL EDUCATION (ACCME) AND WAS LAST REACCREDITED IN 2016, RECEIVING "ACCREDITATION WITH COMMENDATION". DURING THE PERIOD BETWEEN JANUARY 1ST AND JUNE 30, 2021, THE CME DEPARTMENT SPONSORED 6 COURSES (EITHER FULL-, HALF-, OR MULTI-DAY) INCLUDING 5 THAT WERE INTERNET LIVE COURSES, TOTALING 139.75 HOURS OF INSTRUCTION. THESE ACTIVITIES WERE ATTENDED BY 161 PARTICIPANTS, INCLUDING 90 PHYSICIANS. E. REGULARLY SCHEDULED SERIESDURING THE PERIOD BETWEEN JANUARY 1ST AND JUNE 30TH, 2021, 24 ONE-HOUR GRAND ROUNDS PRESENTATIONS WERE PRESENTED AT THE MEDICAL CENTER, WITH THE LIVE AUDIENCE AVERAGING 45 ATTENDEES WEEKLY. THE GRAND ROUNDS SERIES IS PRESENTED FROM THE AUDITORIUM AND IS SIMULTANEOUSLY BROADCAST VIA LIVESTREAM TO SERVE THE ORGANIZATION'S SATELLITE LOCATIONS AND TO 8 COMMUNITY HEALTH CARE SYSTEMS AND MEDICAL EDUCATION SITES IN WASHINGTON, ALASKA, CALIFORNIA AND WISCONSIN. THE CME DEPARTMENT SUPPORTS ANOTHER 22 REGULARLY SCHEDULED SERIES IN INCLUDING 14 SPECIFIC CANCER CARE TUMOR BOARDS, CLINICAL CARDIOVASCULAR, IMAGING, COMPETENCIES AND INCIDENTS, VASCULAR SURGERY, GI RADIOLOGY, GI PATHOLOGY AND THERAPEUTICS. BETWEEN JANUARY 1ST AND JUNE 30TH, 2021, 343.5 HOURS OF INSTRUCTION WERE OFFERED THROUGH THESE 22 SERIES. CUMULATIVE PARTICIPATION HOURS TRACKED FOR ALL SERIES TOTALED 4,568.25, OF WHICH 3,585.25 WERE AWARDED TO PHYSICIAN PARTICIPANTS. F. RESEARCHAPPROXIMATELY 12 OF OUR INVESTIGATORS HAVE FACULTY APPOINTMENTS AT THE UNIVERSITY OF WASHINGTON. THE MEDICAL CENTER ALSO MAINTAINS A MEDICAL LIBRARY TO SUPPORT ITS EDUCATION AND RESEARCH ACTIVITIES. 113931 25083 COMMUNITY HEALTH EDUCATION AND SERVICESTHE MEDICAL CENTER CONTRIBUTES TO IMPROVING THE HEALTH OF THE COMMUNITY THROUGH SPONSORSHIP OF COMMUNITY HEALTH EDUCATION AND SERVICES. A. COMMUNITY HEALTH EDUCATIONCOMMUNITY HEALTH EDUCATION INCLUDES CLASSES, FORUMS, PRESENTATIONS AND OTHER PROGRAMS HELD DURING THE DAY AND EVENING IN THE MEDICAL CENTER NEIGHBORHOOD CLINIC COMMUNITIES AND THE SEATTLE MAIN CAMPUS. B. COMMUNITY HEALTH SERVICESTHE MEDICAL CENTER PROVIDED SUPPORT OF "VIRGINIA MASON GRIEF SERVICES" WHICH PROVIDES SERVICES FOR ADULTS AND CHILDREN (AGES 7-18) WHOSE LOVED ONE HAS DIED AS THE RESULT OF A SUDDEN, VIOLENT DEATH BY CRIMINAL ACT (HOMICIDE), INCLUDING TERRORISM, SUICIDE OR OTHER TYPES OF VIOLENT DEATH. SERVICES AVAILABLE INCLUDE: THERAPY GROUPS, SHORT-TERM THERAPY, PSYCHIATRIC CONSULTATION AND MEDICATION MANAGEMENT, COMMUNITY, WORKPLACE, FAMILY AND SCHOOL CRISIS RESPONSE AND PROFESSIONAL TRAINING. IN 2021, THE MEDICAL CENTER PROVIDED $89,000 TOWARD SUPPORT OF VIRGINIA MASON GRIEF SERVICES. 204014 FINANCIAL AND IN-KIND CONTRIBUTIONSTHE MEDICAL CENTER PROVIDES FUNDS AND IN-KIND SERVICES TO COMMUNITY ORGANIZATIONS WHICH ARE CONSISTENT WITH THE MEDICAL CENTER'S CHARITABLE PURPOSE. A LIST OF COMMUNITY DONATIONS IS INCLUDED ON SCHEDULE I. 204014 542581912 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 X 14 13 0 0 1 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 0 GA OR X MARYANNE OLMSTEAD 2066257371 1100 OLIVE WAY SUITE 605 SEATTLE WA 98101 X BOB CARLIE DIRECTOR 2.00 2.00 X 0 0 0 ULI CHI DIRECTOR/CHAIR 2.00 2.00 X X 0 0 0 JUDE CONNELLY DIRECTOR 2.00 2.00 X 0 0 0 CAROLYN CORVI DIRECTOR 2.00 2.00 X 0 0 0 RUTH GOODWIN DIRECTOR 2.00 2.00 X 0 0 0 TOD HAMACHEK DIRECTOR 2.00 2.00 X 0 0 0 MICHAEL HOFFMAN DIRECTOR 2.00 2.00 X 0 0 0 DENNIS HUNTHAUSEN DIRECTOR 2.00 2.00 X 0 0 0 KAREN LEE DIRECTOR 2.00 2.00 X 0 0 0 ROBERT LEMON DIRECTOR/VICE CHAIR 2.00 4.00 X X 0 0 0 GREGG MEYER DIRECTOR 2.00 2.00 X 0 0 0 JOHN OPPENHEIMER DIRECTOR 2.00 2.00 X 0 0 0 MARVIN O'QUINN DIRECTOR 2.00 2.00 X 0 0 0 DIANN PULS DIRECTOR 2.00 2.00 X 0 0 0 CRAIG GOODRICH CFO 50.00 2.00 X 0 0 0 GARY KAPLAN CEO 50.00 5.00 X 0 0 0 KATERIE CHAPMAN PRESIDENT 50.00 0.00 X 0 0 0 SUZANNE ANDERSON PRESIDENT THRU JAN 2021 50.00 6.00 X 0 0 0 DAVID BUTCHERITE TREASURER 2.00 2.00 X 0 0 0 ROBERT VALENCIA CORPORATE SECRETARY 2.00 2.00 X 0 0 0 0 0 0 0 0 0 0 0 8659 425356 124250 40661 4808962 126929 5407888 MEDICARE/MEDICAID PAYM 621300 383549797 383549797 NET PATIENT REVENUES 561499 150641961 150641961 PHARMACY 561499 23860485 23860485 RETAIL SERVICES 561499 2609501 184253 2425248 560661744 9509009 9509009 196 196 880434 1236953 -356519 -356519 -294223 -62296 24714928 2640 13112323 0 11602605 2640 11605245 11605245 225000 425356 316707 -91707 -91707 167709 141785 25924 25924 PARKING 812930 1787813 126860 1660953 CAFETERIA 721110 1213026 1213026 MEDICAL RECORDS 561499 110409 110409 5140 5140 3116388 589878168 558236496 2283809 23949975 1000000 1000000 5889300 3141187 2748113 274954140 262059273 11803445 1091422 10824485 10221561 602924 8019719 7573021 228593 218105 20231033 19104164 1126869 238540 225253 13287 2414379 2414379 344390 344390 205420 205420 27047594 25541043 1182154 324397 627993 593014 34979 137736001 130064105 7663888 8008 10034196 9475291 558905 19856474 18750468 1105703 303 424533 400887 20883 2763 52034 49136 2173 725 6850656 6469074 381582 19439529 14456266 4982496 767 4691998 4430654 261344 TAXES 13073513 13073513 MEDICAL PURCHASED SVCS 2900938 2739356 161582 DUES AND SUBSCRIPTIONS 1485929 1403163 82766 12508189 11811483 592311 104395 580850983 542581912 36518186 1750885 91192918 41347223 113976670 101966013 118336538 136192962 22339150 35017684 5275803 6465938 582575917 19325792 567802809 563250125 396093877 419333407 23919896 27383063 1180233 33180233 89466550 111852667 1429584444 1475989315 160137795 152355887 76060 284220 279833462 291655614 136642141 150981799 297326501 295005842 874015959 890283362 X 488625886 516580468 66942599 69125485 555568485 585705953 1429584444 1475989315 X 9027185 9624799 11485484 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED X 126542 126542 78878 78878 205420 205420 580645563 619522802 580850983 619728222 1000000 1000000 250000 250000 0 0 0 0 1000000 1000000 1000000 1000000 4000000 6000000 294038 307100 209447 205420 1016005 250000 250000 250000 250000 1000000 1500000 180464 183519 129023 205420 698426 0 60824476 82633 5751452 1193438 65465123 16598779 38591356 8224212 2589871 60824476 15347139 82755 2289886 1121001 16598779 16620892 91648 -756306 609095 15347139 14623410 480797 2089543 572858 16620892 0.44240 0.27360 0.28400 1 0 138522760 138522760 313385223 7062887 306322336 28100749 1265462 26835287 88511412 10981356 77530056 14055773 16087 14039686 563250125 PARKING RIGHTS 346926 CURRENT PORTION OF ASSETS WHOSE USE IS LIMITED 196 LONG-TERM RECEIVABLE 303750 CEMETERY PLOTS/NICHES - BBH 15200 BENEFICIAL INTEREST 2078670 RIGHT OF USE ASSET 103546061 SPS REGION 399069 CONTRIBUTION RECEIVABLE 1661174 PLEDGES ALLOWANCE -432499 DISCOUNT ON PLEDGES -9031 EQUITY INVESTMENT - HCSA 3943151 111852667 DUE TO AFFILIATES 2974095 PAYABLE TO THIRD PARTY PAYOR 48283271 RESERVE FOR PROFESSIONAL LIABILITY CLAIMS 13864394 CURRENT PORTION OF PROFESSIONAL LIABILITY 4000000 ACCRUED RETIREMENT EXPENSES 55642541 CURRENT PORTION OF RETIREMENT EXPENSE 5402351 CURRENT PORTION OF ESTIMATED THIRD PARTY PAYOR 62552619 CURRENT PORTION OF LEASE LIABILITY 13517818 ASBESTOS ABATEMENT 188445 FICA PAYABLE DEFERRED 7857524 LONG-TERM LEASE LIABILITY 80522784 OTHER THIRD PARTY INSURANCE 200000 295005842 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE INTENDED TO SUPPPORT THE HEALTH CARE MISSION OF VIRGINIA MASON MEDICAL CENTER AND THE RESEARCH MISSION OF BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON. PART X, LINE 2: VIRGINIA MASON MEDICAL CENTER'S FINANCIAL INFORMATION IS INCLUDED IN COMMONSPIRIT HEALTH'S CONSOLIDATED AUDITED FINANCIAL STATEMENTS, WHICH INCLUDES THE FOLLOWING DISCLOSURE: COMMONSPIRIT REVIEWS ITS TAX POSITIONS QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. 2021 DREAMBUILDERS BALL 102700 102700 5060 2021 BOEING CLASSIC 341700 116700 225000 242088 7 205956 205956 69559 650356 425356 225000 316707 316707 -91707 1 1 1 X 300.000000000000 0 1 1 0 1 1 4124035 4124035 0.00710 44521929 33426047 11095882 0.01910 48645964 33426047 15219917 0.02620 277375 25083 252292 0.00040 6346046 2493247 3852799 0.00660 81348 81348 0.00010 42194 42194 0.00010 6746963 2518330 4228633 0.00720 55392927 35944377 19448550 0.03340 1 111054 100315466 122488841 -22173375 X 1 1 1 1 VIRGINIA MASON MEDICAL CENTER 1100 NINTH AVENUE SEATTLE WA 98101 VIRGINIAMASON.ORG HAC.FS.00000010 X X X X VIRGINIA MASON MEDICAL CENTER 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X SEE SCHEDULE H SUPPLEMENTAL INFO X 1 19 1 SEE SCHEDULE H SUPPLEMENTAL INFO 0 1 X 300.000000000000 0.000000000000 X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 VIRGINIA MASON MEDICAL CENTER PART V, SECTION B, LINE 5: THROUGH THE PUBLIC HEALTH-SEATTLE & KING COUNTY HOSPITALS FOR A HEALTHIER COMMUNITY COLLABORATIVE, VIRGINIA MASON MEDICAL CENTER CONDUCTED KEY INFORMANT INTERVIEWS WITH COMMUNITY COALITIONS AND ORGANIZATIONS, EDUCATION AND GOVERNMENT AGENCIES ABOUT ASSETS AND RESOURCES THAT HELP THEIR COMMUNITIES THRIVE, AS WELL AS CONCERNS AND HEALTH NEEDS WITHIN THEIR COMMNITIES (FULL LIST OF ORGANIZATIONS IN CHNA SUMMARY). VIRGINIA MASON MEDICAL CENTER PART V, SECTION B, LINE 6A: VIRGINIA MASON MEDICAL CENTER WORKED WITH THE FOLLOWING OTHER PUGET SOUND-AREA HOSPITALS ON THE CURRENT CHNA: 1) EVERGREEN HEALTH 2) CHI FRANCISCAN HEALTH 3) KAISER PERMAENTE WASHINGTON 4) MULTICARE HEALTH SYSTEM 5) OVERLAKE MEDICAL CENTER 6) SEATTLE CANCER CARE ALLIANCE 7) SEATTLE CHILDREN'S 8) SWEDISH AND 9) UNIVERSITY OF WASHINGTON MEDICINE. VIRGINIA MASON MEDICAL CENTER PART V, SECTION B, LINE 11: ACCESS TO DENTAL CARE WAS IDENTIFIED AS A HEALTH NEED, BUT VIRGINIA MASON LACKS THE PERSONNEL TO ADDRESS THIS ISSUE AND IT IS BEING ADDRESSED BY OTHER ORGANIZATIONS, SUCH AS PROJECT ACCESS NORTHWEST AND THE SEATTLE KING COUNTY CLINIC. VIRGINIA MASON MEDICAL CENTER PART V, SECTION B, LINE 13H: FULL OR PARTIAL DISCOUNTS MAY BE PROVIDED TO PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FINANCIAL ASSISTACE, I.E., WITH GROSS FAMILY INCOMES ABOVE THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. SUCH DISCOUNTS MAY BE PROVIDED TO PATIENTS WITH CATASTROPHIC COSTS OR CONDITIONS WHEN CIRCUMSTANCES AS DETERMINED BY THE MEDICAL CENTER INDICATE THAT FULL PAYMENT MAY CAUSE EXTRAORDINARY FINANCIAL HARDSHIP TO THE PATIENT OR THE PATIENT'S FAMILY. THE MEDICAL CENTER SHALL DETERMINE, ON A CASE BY CASE BASIS, WHETHER A PATIENT QUALIFIES AS "MEDICALLY INDIGENT" PURSUANT TO ITS POLICY AND SHALL, THROUGH PATIENT FINANCIAL SERVICES, DETERMINE THE AMOUNT OF THE DISCOUNT, IF ANY. DETERMINATIONS SHALL BE MADE EXPEDITIOUSLY AFTER SUBMISSION OF FINANCIAL INFORMATION BY THE PATIENT BUT SHALL NOT BE SUBJECT TO ANY APPEAL RIGHTS. PART V, SECTION B, LINE 7A: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINE 10A: HTTPS://VMFH.ORG/ABOUT-VMFH/WHY-CHOOSE-VMFH/REPORTS-TO-THE-COMMUNITY/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINE 16A: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML PART V, SECTION B, LINE 16B: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML PART V, SECTION B, LINE 16C: HTTPS://WWW.VMFH.ORG/BILLING-INSURANCE/VM-BILLING-INSURANCE/FINANCIAL-ASSISTANCE.HTML 9 1 - VIRGINIA MASON FEDERAL WAY MEDICAL CTR 33501 FIRST WAY S FEDERAL WAY WA 98003 OUTPATIENT MEDICAL CENTER 2 - VIRGINIA MASON EDMONDS MEDICAL CENTER 7315 212TH ST SE SUITE 101/207 EDMONDS WA 98026 OUTPATIENT MEDICAL CENTER 3 - VIRGINIA MASON BELLEVUE MEDICAL CENTER 11695 NE 4TH ST BELLEVUE WA 98004 OUTPATIENT MEDICAL CENTER 4 - VIRGINIA MASON LYNNWOOD MEDICAL CENTER 19116 33RD AVE W LYNNWOOD WA 98036 OUTPATIENT MEDICAL CENTER 5 - VIRGINIA MASON ISSAQUAH MEDICAL CENTER 100 NE GILMAN ROAD ISSAQUAH WA 98027 OUTPATIENT MEDICAL CENTER 6 - VIRGINIA MASON BAINBRIDGE ISLAND MED CTR 1344 WINTERGREEN LANE NE BAINBRIDGE ISLAND WA 98110 OUTPATIENT MEDICAL CENTER 7 - VIRGINIA MASON KIRKLAND MEDICAL CENTER 11800 NE 128TH ST SUITE 300 KIRKLAND WA 98034 OUTPATIENT MEDICAL CENTER 8 - VIRGINIA MASON UNIV VILLAGE MEDICAL CTR 2671 NE 46TH ST SEATTLE WA 98105 OUTPATIENT MEDICAL CENTER 9 - BAILEY-BOUSHAY HOUSE 2720 EAST MADISON SEATTLE WA 98112 SKILLED NURSING FACILITY PART I, LINE 3C: FULL OR PARTIAL DISCOUNTS MAY BE PROVIDED TO PATIENTS WHO ARE NOT OTHERWISE ELIGIBLE FOR FINANCIAL ASSISTACE, I.E., WITH GROSS FAMILY INCOMES ABOVE THREE HUNDRED PERCENT (300%) OF THE FEDERAL POVERTY GUIDELINES ADJUSTED FOR FAMILY SIZE. SUCH DISCOUNTS MAY BE PROVIDED TO PATIENTS WITH CATASTROPHIC COSTS OR CONDITIONS WHEN CIRCUMSTANCES AS DETERMINED BY THE MEDICAL CENTER INDICATE THAT FULL PAYMENT MAY CAUSE EXTRAORDINARY FINANCIAL HARDSHIP TO THE PATIENT OR THE PATIENT'S FAMILY. THE MEDICAL CENTER SHALL DETERMINE, ON A CASE BY CASE BASIS, WHETHER A PATIENT QUALIFIES AS "MEDICALLY INDIGENT" PURSUANT TO ITS POLICY AND SHALL, THROUGH PATIENT FINANCIAL SERVICES, DETERMINE THE AMOUNT OF THE DISCOUNT, IF ANY. DETERMINATIONS SHALL BE MADE EXPEDITIOUSLY AFTER SUBMISSION OF FINANCIAL INFORMATION BY THE PATIENT BUT SHALL NOT BE SUBJECT TO ANY APPEAL RIGHTS. PART I, LINE 7: THE MEDICAL CENTER USED THE DIRECT EXPENSES AND REVENUES OF THE HOSPITAL TO CALCULATE THE COST-TO-CHARGES RATIO FOR THE AMOUNTS INCLUDED IN THE TABLE REFLECTED IN PART I. THE COST-TO-CHARGE RATIO USED WAS DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE RATIO PER THE INSTRUCTIONS. PART III, LINE 2: THE MEDICAL CENTER CALCULATES THE BAD DEBT EXPENSE BASED ON THE ACTUAL WRITE-OFFS FOR BAD DEBT EXPENSE INCURRED DURING THE YEAR. PART III, LINE 4: AS THE RESULT OF ADOPTING ASU NO. 2014-09, DESCRIBED IN NOTE 2(K), THE MEDICAL CENTER NO LONGER MAINTAINS AN ALLOWANCE FOR PERFORMANCE OBLIGATIONS SATISFIED AFTER JANUARY 1, 2018. ADDITIONALLY, THE MEDICAL CENTER NO LONGER PRESENTS A PROVISION FOR UNCOLLECTIBLE ON THE CONSOLIDATED STATEMENT OF OPERATIONS AND BALANCE SHEETS. THE REMAINING PROVISION FOR UNCOLLECTBLE ACCOUNTS IS CONSIDERED IMMATERIAL AS IT IS MAINTAINED ONLY DUE TO UNFORESEEABLE CIRCUMSTANCES, SUCH AS BANKRUPTCY. PART III, LINE 8: THE MEDICAL CENTER'S CALCULATION OF THE MEDICARE SHORTFALL RELATED TO HOSPITAL-BASED INPATIENT AND OUTPATIENT SHORTFALL IS $22,173,375. THE MEDICAL CENTER EMPLOYS OVER 437 PHYSICIANS WHO PROVIDE PROFESSIONAL SERVICES TO PATIENTS WHICH ARE NOT COVERED IN THIS NUMBER. IN ADDITION, THE MEDICAL CENTER OPERATES SATELLITE CLINICS AND AMBULATORY SURGERY CENTERS WHICH ARE NOT REPORTED IN THE MEDICARE COST REPORT. FOR ALL OF ITS PATIENT SERVICES, THE MEDICAL CENTER UTILIZES A COMPREHENSIVE ELECTRONIC COST REPORTING PACKAGE WHICH USES THE DIRECTLY ASSIGNED GENERAL LEDGER COSTS AND ALLOCATES ALL OVERHEAD COSTS TO OPERATING COSTS USING A MODEL INSPIRED BY THE MEDICARE COST REPORT. THIS MODEL WITH THE MEDICAL CENTER'S CALCULATION SHOWS A MEDICARE SHORTFALL OF $35.0 MILLION WHICH IS NOT INCLUDED IN THE TRADITIONAL COST REPORT PRIMARILY DUE TO SHORTFALL OF MEDICARE PROFESSIONAL FEES VERSUS COSTS. PART III, LINE 9B: VIRGINIA MASON'S MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PATIENTS WE SERVE. TO ENSURE THE MEDICAL CENTER CONTINUES TO HAVE THE RESOURCES TO FULFILL OUR MISSION, WE MUST BALANCE THE FINANCIAL NEEDS OF OUR PATIENTS WITH THOSE OF THE MEDICAL CENTER. IN ALL INSTANCES, WE WILL TREAT OUR PATIENTS WITH DIGNITY, COMPASSION AND RESPECT. THE MEDICAL CENTER EXPECTS PAYMENT IN FULL UPON RECEIPT OF THE PATIENT'S FIRST BILLING. PATIENTS WILL RECEIVE MONTHLY MEDICAL CENTER STATEMENTS UPON DETERMINATION OF THE PATIENT'S PRIVATE RESPONSIBILITY. A VIRGINIA MASON CLINIC STATEMENT WILL BE SENT REPRESENTING THE PROFESSIONAL COMPONENT OF SERVICES PROVIDED. IF SERVICES WERE PROVIDED OR PROCESSED AT THE DOWNTOWN CAMPUS (EXCEPT THE HEALTH RESOURCES BUILDING, WHICH IS NOT LICENSED AS PART OF THE HOSPTIAL), A HOSPITAL STATEMENT WILL ALSO BE SENT REPRESENTING THE FACILITY/TECHNICAL COMPONENT OF SERVICES. AS OUTSTANDING BALANCES AGE, STATEMENT MESSAGES (DUNNING), COLLECTION LETTERS AND/OR TELEPHONE CALLS MAY BE USED AT APPROPRIATE INTERVALS AS DETERMINED BY THE MEDICAL CENTER. DELINQUENT ACCOUNTS MAY BE FORWARDED TO A THIRD PARTY WHERE A SERIES OF COLLECTION CONTRACTS (LETTERS AND PHONE CALLES) WILL BE INITIATED. DELINQUENT SELF PAY ACCOUNTS THAT HAVE NOT BEEN PAID IN FULL OR ESTABLISHED AN APPROVED INSTALLMENT PAYMENT PLAN MAY BE REFERRED TO A COLLECTION AGENCY. THIS OCCURS APPROXIMATELY 130 DAYS FROM DETERMINATION OF PATIENT RESPONSIBILITY. PATIENT FINANCIAL SERVICES MANAGEMENT TEAM HAS RESPONSIBILITY FOR DETERMINING UNDER WHAT CIRCUMSTANCES A BALANCE MAY BE REFERRED FOR COLLECTION AGENCY RESOLUTION. THE MEDICAL CENTER RECOGNIZES THERE ARE OCCASIONS WHEN A PATIENT IS NOT FINANCIALLY ABLE TO PAY THEIR MEDICAL BILL IN FULL. THOSE PATIENTS WHO INDICATE THEY ARE EXPERIENCING FINANCIAL HARDSHIP WILL BE OFFERED THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE. COLLECTION ACTIVITY WILL BE SUSPENDED PENDING ELIGIBILITY DETERMINATION. IF THE PATIENT'S INCOME IS GREATER THAN 300% OF THE CURRENT YEAR'S FEDERAL POVERTY GUIDELINE (FPG), FINANCIAL ASSISTANCE IS DENIED AND ALTERNATIVE PAYMENT ARRANGEMENTS ARE DISCUSSED. IF THE PATIENT'S INCOME IS LESS THAN 300% OF THE CURRENT YEEAR'S FPG, THE PATIENT WILL COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SEND SUPPORTING DOCUMENTATION. IF FINANCIAL ASSISTANCE DETERMINATION IS APPROVED, THE FINANCIAL ASSISTANCE DISCOUNT IS APPLIED TO THE OUTSTANDING ACCOUNT BALANCE BASED ON THE FPG DETERMINATION AND A CONFIRMATORY LETTER IS SENT TO THE PATIENT. IF FINANCIAL ASSISTANCE IS DENIED, THE MEDICAL CENTER WILL SEND A DENIAL LETTER TO THE PATIENT. A SUMMARY REPORT OF COLLECTION ACTIVITIES TAKEN WILL BE PROVIDED TO THE MEDICAL CENTER BOARD ON AN ANNUAL BASIS PER THE WASHINGTON STATE HOSPITAL ASSOCIATION (WSHA) GUIDELINES. PART VI, LINE 2: VIRGINIA MASON CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS. THE CHNA CAN BE FOUND AT VIRGINIAMASON.ORG/CONNECTING-WITH-OUR-COMMUNITIES. OUR CHA DRIVES OUR COMMUNITY WORK AND SERVES AS A GUIDELINE TO HELP US ACHIEVE THREE BASIC GOALS: 1) IMPROVE THE COMMUNITY'S HEALTH STATUS AND OVERALL QUALITY OF LIFE; 2) REDUCE HEALTH DISPARITIES WITHIN THE COMMUNITY; AND 3) INCREASE ACCESS TO PREVENTIVE SERVICES. THE LATEST CHNA AS PUBLISHED IN 2018. IT WAS DEVELOPED IN PARTNERSHIP WITH PUBLIC HEALTH - SEATTLE & KING COUNTY. VIRGINIA MASON'S 2018-2021 CHNA IS AN UPDATED AND EXPANDED VERSION OF THE COLLABORATIVE CHNA. IT INCLUDES SECONDARY DATA FROM A VARIETY OF LOCAL, STATE AND FEDERAL AGENCIES, INCLUDING PUBLIC HEALTH - SEATTLE & KING COUNTY. IT ALSO INCLUDES KEY INFORMANT INTERVIEWS WITH INDIVIDUALS REPRESENTING PUBLIC HEALTH, CITY GOVERNMENT, THE HEALTH CARE SAFETY NET, CULTURAL COMMUNITIES, SCHOOLS AND HEALTH ADVOCACY. A 2018-2021 CHNA IMPLEMENTATION STRATEGY WAS ALSO DEVELOPED AND SERVES AS A LIVING DOCUMENT TO GUIDE OUR COMMUNITY BENEFIT PROGRAMS. VIRGINIA MASON'S COMMUNITY BENEFIT PROGRAM FOCUSES OUR RESOURCES ON COMMUNITY NEEDS AND STRENGTHS OF THE MEDICAL CENTER. EXAMPLES INCLUDE: A) SUBSIDIZED HEALTH SERVICES - EVERY COMMUNITY NEEDS CERTAIN HEALTH CARE SERVICES THAT TYPICALLY COST MORE TO DELIVER THAN THE PROVIDER OF THE SERVICES RECEIVES. THESE "SUBSIDIZED HEALTH SERVICES" ARE PART OF THE MEDICAL CENTER'S MISSION BECAUSE THEY ARE NEEDED IN THE COMMUITY AND OTHERWISE WOULD NOT BE AVAILABLE T MEET PATIENT NEEDS. THEY INCLUDE: 1) EMERGENCY DEPARTMENT OPEN TO ALL; 2) BAILEY-BOUSHAY HOUSE (BBH), AN INPATIENT AND OUTPATIENT CENTER FOR PEOPLE LIVING WITH HIV/AIDS AND OTHER COMPLEX DISEASES; 3) PARTNERSHIP WITH PUBLIC HEALTH - SEATTLE & KING COUNTY TO HELP SUPPORT THE EDWARD THOMAS HOUSE MEDICAL RESPITE PROGRAM FOR HOMELESS ADULTS IN KING COUNTY; 4) PARTNERSHIP WITH PROJECT ACCESS NORTHWEST (PANW) TO PROVIDE SPECIALITY CARE SERVICES TO COMMUNITY CLINIC PATIENTS AND PREMIUM ASSISTANCE TO LOW-INCOME PATIENTS; 5) UNCOMPENSATED CARE - AS A NONPROFIT ORGANIZATION, VIRGINIA MASON IS COMMITTED TO SERVING PATIENTS WHO ARE UNINSURED, UNDERINSURED OR OTHERWISE UNABLE TO PAY FOR THEIR MEDICAL ARE; 6) RESEARCH - THE MEDICAL CENTER CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATED BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASO (BRI); 7) EDUCATION - A) VIRGINIA MASON IS A PREMIER TEACHING HOSPITAL THAT OFFERS POSTGRADUATE EDUCATIO PROGRAMS THROUGH ITS GRADUATE MEDICAL EDUCATION (GME) DEPARTMENT. ALL GME POSTGRADUATE TRAINING PROGRAMS ARE ACCREDITED BY THE ACCREDITATION COUNCIL ON GRADUATE MEDICAL EDUCATION (ADGME); B) THE MEDICAL CENTER'S GME PROGRAM PARTNERS WITH PUBLIC HEALTH - SEATTLE & KING COUNTY HEALTH SERVICES DIVISION TO PROVIDE 12 RESIDENTS FOR THE EASTGATE PUBLIC HEALTH CENTER IN BELLEVUE, WASHINGTON; 8) COMMUNITY PARTNERSHIP - THE MEDICAL CENTER IS AN ACTIVE MEMBER OF THE KING COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COLLABORATIVE, A PARTNERSHIP THAT INCLUDES ALL KING COUNTY HOSPITALS, PUBLIC HEALTH - SEATTLE & KING COUNTY AND THE WASHINGTON STATE HOSPITAL ASSOCIATION. IN ADDITION TO COLLABORATING ON FUTURE CHNAS, THIS PARTNERSHIP HAS FORMED HOSPITALS FOR A HEALTHIER COMMUNITY (HHC) AND IS RESEARCHING AND PLANNING COLLABORATIVE COMMUNITY BENEFIT ACTIVITIES THAT COMPREHENSIVELY ADDRESS COMMUNITY HEALTH ISSUES THROUGHOUT KING COUNTY. 9) COMMJUNITY HEALTH IMPROVEMENT SERVICES, INCLUDING A) COMMUNITY HEALTH IMPROVEMENT SERVICES; B) COMMUNITY HEALTH EDUCATION, SUCH AS NUTRITION AND FITNESS FOR LIFE PEDIATRIC PROGRAM AND CLASSES; C) NUTRITION AND FITNESS EDUCATION AT MARY'S PLACE NORTHSHORE IN KENMORE, WASHINGTON, A DAY SHELTER FOR HOMELESS WOMEN AND CHILDREN; D) PROVIDING EDUCATIONAL INFORMATION THROUGH OUR PEDIATRIC DEPARTMENTS AND COMMUNITY EVENTS TO PARENTS REGARDING FIREARM SAFETY IN HOMES WHERE THEIR CHILDRE VISIT AND PLAY; E) SUPPORT OF THE ALLIANCE FOR GUN RESPONSIBILITY; F) SUPPORT OF PLYMOUTH HOUSING'S AND SOLID GROUNDS' EFFORTS TO PROVIDE SAFE HOUSING TO INDIVIDUALS AND FAMILIES WHO ARE HOMELESS; G) HEALTH FAIR SPONSORSHIPS IN THE COMMUNITY; H) FREE FLU SHOTS AND HEALTH SCREENINGS FOR UNINSURED/UNDERINSURED AND THE HOMELESS; I) PARTNERSHIP WITH WITHINREACH TO PROVIDE HEALTH CARE RESOURCES TO FAMILIES AND SOCIAL SERVICE EDUCATION TO COMMUNITY PARTNERS; J) PROVIDING RESOURCES TO REFUGEES NORTHWEST TO ASSIST REFUGEES AND IMMIGRANTS WITH ACCESS TO HEALTH CARE; K) PARTNERSHIP WITH SEATTLE/KING COUNTY CLINIC TO PROVIDE FLU SHOTS DURING THEIR FOUR-DAY FREE HEALTH CLINIC; AND L) BEREAVEMENT SUPPORT THROUGH VIRGINIA MASON'S GRIEF SERVICES DEPARTMENT. PART VI, LINE 3: THE MEDICAL CENTER INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE MEDICAL CENTER'S CHARITY CARE POLICY AT VARIOUS POINTS BEGINNING AND SCHEDULING AND CONTINUING THROUGH THE PATIENT BILLING PROCESS. AT SCHEDULING, IF A PATIENT INDICATES THEY ARE WITHOUT INSURANCE AND UNABLE TO PAY FOR THE SERVICES, THEIR ACCOUNT IS FLAGGED FOR A FINANCIAL NAVIGATOR TO CONTACT THEM TO DISCUSS ASSISTANCE. AT ARRIVAL FOR AN APPOINTMENT, THE MEDICAL CENTER'S ADMISSIONS LOBBY AREAS HAVE SIGNAGE REGARDING AVAILABILITY OF CHARITY CARE, A COPY OF THE CHARITY CARE POLICY AND INFORMATION REGARDING WHO TO CONTACT FOR ASSISTANCE. DURING THE ARRIVAL PROCESS, THE MEDICAL CENTER'S ADMISSIONS PERSONNEL WILL CONFIRM ABILITY TO PAY. IF FINANCIAL NEED OR FINANCIAL HARDSHIP IS INDICATED, THE MEDICAL CENTER FINANCIAL NAVIGATORS WILL WORK WITH THE PATIENT TO DETERMINE WHETHER MEDICAID, STATE PROGRAM OPTIONS, OR CHARITY CARE WOULD BE APPROPRIATE. THE MEDICAL CENTER'S CHARITY POLICY AND FINANCIAL ASSISTANCE CONTACT INFORMATION IS ALSO INCLUDED ON PATIENT BILLS. THE MEDICAL CENTER'S PATIENT GUIDE TO FEES AND BILLING INCLUDES INFORMATION ON CHARITY CAE AVAILABILITY AND CONTACT INFORMATION TO INITIATE AN ASSESSMENT. THE BROCHURE IS AVAILABLE IN ALL LOBBIES FOR PATIENTS TO PICK UP. THE BROCHURE IS ALSO SENT OUT BY PATIENT ACCOUNT SERVICES STAFF BASED ON A PATIENT'S EXPRESSED CONCERNS (EITHER VIA PHONE OR LETTER). THE MEDICAL CENTER'S WEBSITE ALSO INCLUDES INFORMATION ABOUT CHARITY CARE AVAILABILITY AND THE CONTACT NUMBER TO INITIATE AN ASSESSMENT. PART VI, LINE 4: VIRGINIA MASON MEDICAL CENTER PROVIDED CARE FOR 60,320 INPATIENT DAYS; 862,486 OUTPATIENT VISITS; AND 19,366 EMERGENCY DEPARTMENT VISITS. THE MEDICAL CENTER'S SERVICE AREA ENCOMPASSES THE COMMUNITIES WHERE ITS FACILITES ARE LOCATED AND WHERE 75 PERCENT OF ITS PATIENTS RESIDE; KING COUNTY, THE SOUTHWEST REGION OF SNOHOMISH COUNTY, AN BAINBRIDGE ISLAND IN KITSAP COUNTY. RESIDENCES OF MEDICAL CENTER PATIENTS INCLUDE: 1) SEATTLE: 68,340; 2) SEATTLE SUBURBS (KING COUNTY OUTSIDE OF SEATTLE): 91,736; 3) SNOHOMISH COUNTY: 7,215; 4) BAINBRIDGE ISLAND: 9,370; 5) SERVICE AREA TOTAL: 176,661; 6) OTHER WASHINGSTON STATE: 45,742; 7) REST OF THE NORTHWEST: 4,367; 8) REST OF UNITED STATES: 2,740; 8) OTHER: 233 FOR A TOTAL OF 229,743. THE SERVICE AREA (KING COUNTY) POPULATION WAS 2,195,502 (2019 U.S. CENSUS BUREA DATA). THE AGE AND RACIAL/ETHNIC PROFILE OF THE TOTAL POPULATION WAS AS FOLLOWS: 1) TOTAL POPULATIO: 2,195,502; 2) UNDER 5 YEARS OLD: 5.8 PERCENT; 3) 18 AND OLDER: 79.6 PERCENT; 4) 65 YEARS OR OLDER: 13 PERCET; 5) WHITE: 64 PERCENT; 6) HISPANIC OR LATINO: 9.7 PERCENT; 7) BLACK OR AFRICAN AMERICAN ALONE: 6.5 PERCENT; 8) ASIAN ALONE: 17.6 PERCENT; 9) AMERICAN INDIAN OR ALASKA NATIVE ALONE: 0.6 PERCENT; 10) NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER ALONE: 0.8 PERCENT; 11) TWO OR MORE RACES: 6.4 PERCENT; 12) SOME OTHER RACE ALONE: 4.2 PERCENT. ACCORDING TO THE UNITED STATES CENSUS BUREAU, THE MEDIAN HOUSEHOLD INCOME FO KING COUNTY AS $94,974 WITH 10.4 PERCENT OF CHILDREN UNDER 18 LIVING IN POVERTY. WITHIN KING COUNTY, MEDIAN INCOME WAS LOWEST FOR BLACKS AND AMERICAN INDIANS/ALASKA NATIVES AND IN URBAN SOUTH KING COUNTY. IN KING COUNTY, POVERTY RATES ARE HIGHEST IN WHITE CENTER/BOULEVARD PARK, SEVERAL CENTRAL AND SOUTHEAST SEATTLE NEIGHBORHODS AND AUBURN. MEDIAN EARNINGS FOR FULL-TIME, YEAR-ROUND WORKERS BY SEX WERE $60,979 FOR FEMALES AND $81,217 OR MALES. KING COUNTY'S EMPLOYMENT RATE AS 67.2 PERCENT, COMPARED TO A NATIONAL AVERAGE OF 59.6 PERCENT. PART VI, LINE 5: VIRGINIA MASON'S COMMUNITY BENEFIT PROGRAM IS DESIGNED TO IMPROVE OUR COMMUNITY'S HEALTH STATUS AND OVERALL QUALITY OF LIFE, REDUCE HEALTH DISPARITIES WITHIN THE COMMUNITY AND INCREASE ACCESS TO PREVENTIVE SERVICES. TO ACCOMPLISH THIS, OUR ORGANIZATION CONTRIBUTES TIME, ENERGY AND MONEY IN THE AREAS OF IMPROVING HEALTH, PROVIDING FREE AND SUBSIDIZED CARE, HEALTH PROFESSIONAL'S EDUCATION AND RESEARCH. UNCOMPENSATED CARE. AS A NON-PROFIT ORGANIZATION, VIRGINIA MASON IS COMMITTED TO SERVING PATIENTS WHO ARE UNINSURED, UNDERINSURED OR OTHERWISE UNABLE TO PAY FOR THEIR MEDICAL CARE. UNDER VIRGINIA MASON'S CHARITY CARE POLICY, FREE OR REDUCED-COST MEDICALLY NECESSARY CARE (AFTER ALL HEALTH INSURANCE HAS BEEN EXHAUSTED) IS PROVIDED TO INDIVIDUALS MAKING UP TO 300 PERCENT OF THE FEDERAL POVERTY LEVEL IN KEEPING WITH THE WASHINGTON STATE HOSPITAL ASSOCIATION VOLUNTARY GUIDELINES ON BILLING THE UNINSURED. IN 2021, VIRGINIA MASON PROVIDED CHARITY CARE TO 3,596 PATIENTS AT A COST OF $4,189,033. IN ADDITION, VIRGINIA MASON'S UNREIMBURSED MEDICAID WAS PROVIDED AT A COST OF $17,117,608.COMMUNITY HEALTH IMPROVEMENT SERVICES. IMPROVING HEALTH AND QUALITY OF LIFE EXTENDS BEYOND DIAGNOSIS AND TREATMENT. IT ALSO REQUIRES COMMUNITY HEALTH EDUCATION AND OUTREACH SERVICES. HEALTH IMPROVEMENT AND OUTREACH SERVICES PROVIDED BY VIRGINIA MASON INCLUDE THE FOLLOWING: (1) COMMUNITY HEALTH EDUCATION, SUCH AS CLASSES IN THE DIABETES TEACHING CENTER; (2) FREE HEALTH SCREENINGS AT COMMUNITY HEALTH FAIRS; (3) FREE FLU SHOTS AND HEALTH SCREENINGS FOR THE HOMELESS IN CONJUNCTION WITH UNITED WAY OF KING COUNTY'S COMMUNITY RESOURCE EXCHANGE; (4) SPONSORSHIP OF MANY PROFESSIONALLY FACILITATED SUPPORT GROUPS, INCLUDING DIABETES PREVENTION AND MANAGEMENT; (5) BEREAVEMENT SUPPORT THROUGH OUR SEPARATION AND LOSS SERVICES; AND (6) LEADERSHIP ROLES IN SEVERAL COMMUNITY ORGANIZATIONS, WHICH FOCUS ON HEALTH CARE.HEALTH PROFESSIONS EDUCATION. VIRGINIA MASON STRONGLY SUPPORTS MEDICAL EDUCATION TO ENSURE OUR PATIENTS AND THE COMMUNITY BENEFIT FROM ADVANCES IN MEDICAL CARE. VIRGINIA MASON IS A PREMIER TEACHING HOSPITAL THAT OFFERS POSTGRADUATE EDUCATION PROGRAMS THROUGH ITS GRADUATE MEDICAL EDUCATION DEPARTMENT (GME). ALL GME POSTGRADUATE TRAINING PROGRAMS ARE FULLY APPROVED BY THE ACCREDITATION COUNCIL ON GRADUATE MEDICAL EDUCATION (ACGME). VIRGINIA MASON TRAINS MORE THAN 130 RESIDENTS AND FELLOWS ANNUALLY. VM'S GME PROGRAM IS PARTNERED WITH PUBLIC HEALTH SEATTLE & KING COUNTY HEALTH SERVICES DIVISION, PROVIDING RESIDENTS FOR THE EASTGATE PUBLIC HEALTH CENTER, AS WELL AS PROVIDING RESIDENTS AT THE CAROLYN DOWNS FAMILY MEDICAL CENTER, PIKE MARKET MEDICAL CLINIC AND NORTH PUBLIC HEALTH CENTER.VIRGINIA MASON'S COLLABORATION WITH THE EASTGATE PUBLIC HEALTH CENTER COMBINES THE MEDICAL CENTER'S COMMITMENT TO TEACHING AND COMMUNITY BENEFIT THROUGH AN INNOVATIVE PUBLIC-PRIVATE PROGRAM WHICH ALLOWS RESIDENTS TO BE MORE INVOLVED IN THE CARE OF THE UNDERSERVED AND UNINSURED. THE EASTGATE CLINIC IS THE LARGEST OF THREE COUNTY PUBLIC HEALTH CLINICS IN EAST KING COUNTY AND OFFERS A VARIETY OF PRIMARY CARE SERVICES TO ADULTS AND CHILDREN. APPROXIMATELY 50 PERCENT OF PATIENTS SEEN AT THE CLINIC DO NOT HAVE INSURANCE OR THE MEANS TO PAY, AND APPROXIMATELY THE SAME PERCENTAGE DO NOT SPEAK ENGLISH AND REQUIRE INTERPRETIVE SERVICES. THIS RESIDENT CLINIC IMPROVES OVERALL HEALTH IN THE COMMUNITY AND GIVES BACK TO OUR COMMUNITY IN A MEANINGFUL WAY.VIRGINIA MASON SERVES AS AN INTERNSHIP SITE FOR STUDENTS IN A VARIETY OF OTHER HEALTH PROGRAMS, SUCH AS NURSING, PHARMACY, RESPIRATORY THERAPY AND LABORATORY TECHNOLOGY. SUBSIDIZED HEALTH SERVICES. EVERY COMMUNITY NEEDS CERTAIN HEALTH CARE SERVICES THAT TYPICALLY COST MORE TO DELIVER THAN THE PROVIDER OF THESE SERVICES RECEIVES. THESE SUBSIDIZED HEALTH SERVICES INCLUDE BAILEY-BOUSHAY HOUSE (BBH), A NURSING RESIDENCE AND ADULT DAY HEALTH CENTER FOR PEOPLE LIVING WITH HIV/AIDS AS WELL AS END-OF-LIFE CARE FOR PEOPLE WITH ALS AND OTHER COMPLEX CONDITIONS. SAFETY AND SECURITY WERE KEY DRIVERS FOR OPENING BAILEY-BOUSHAY'S EMERGENCY NIGHT SHELTER IN NOVEMBER 2018, PROVIDING 50 BEDS TO ADDRESS RISING HOMELESSNESS IN THEIR OUTPATIENT POPULATION. IT IS THE FIRST HOMELESS SHELTER IN THE WORLD SPECIFICALLY DESIGNED FOR PEOPLE WITH HIV.RESEARCH. VIRGINIA MASON CONDUCTS MEDICAL RESEARCH THROUGH ITS AFFILIATE, BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON (BRI). BRI IS A NON-PROFIT BIOMEDICAL RESEARCH INSTITUTE THAT WORKS TO UNLOCK THE MYSTERIES OF THE IMMUNE SYSTEM. ITS TEAM OF WORLD-RENOWNED SCIENTISTS IS FOCUSED ON IDENTIFYING CAUSES AND CURES FOR DEVASTATING DISEASES INCLUDING DIABETES, ARTHRITIS, HEART DISEASE AND CANCER. IN 2021, THE MEDICAL CENTER PROVIDED $1,000,000 TO SUPPORT RESEARCH ACTIVITIES AT BRI. ENVIRONMENTAL IMPROVEMENTS. VIRGINIA MASON'S ENVIRONMENTAL STEWARDSHIP PROGRAM, ENVIROMASON, PROVIDES THE FRAMEWORK FOR VARIOUS FOOTPRINT REDUCTION INITIATIVES, SUCH AS CONSERVING ENERGY AND WATER, DESIGNING GREENER BUILDINGS, GENERATING LESS WASTE, AND BUYING ENVIRONMENTALLY PREFERABLE PRODUCTS. VIRGINIA MASON HAS EMPLOYED A FULL TIME SUSTAINABILITY DIRECTOR SINCE 2011. THE PURPOSE OF THIS POSITION AND THE ENVIROMASON PROGRAM IS TO PRESERVE LONG-TERM ENVIRONMENTAL QUALITY THAT WE ALL RELY UPON FOR GOOD HEALTH.IN 2007, VIRGINIA MASON BECAME THE FIRST HOSPITAL IN THE PACIFIC NORTHWEST TO ELIMINATE STYROFOAM USE AND BEGIN COMPOSTING FOOD WASTE. SINCE 2011, OUR ENERGY CONSERVATION PROJECTS HAVE SAVED OVER 4.5 MILLION KILOWATT HOURS PER YEAR. OUR WATER CONSERVATION PROJECTS IN THE SAME PERIOD HAVE SAVED MORE THAN 7 MILLION GALLONS OF WATER PER YEAR.BETWEEN 2011 AND 2021, VIRGINIA MASON DIVERTED MORE THAN 8,900 TONS OF WASTE FROM THE LANDFILL. WE ACCOMPLISHED THIS BY EXPANDING RECYCLING ACROSS OUR FACILITIES; IMPROVING OUR ELECTRONICS RECYCLING; PROVIDING COMPOSTING TO ALL LUNCH AND BREAK ROOMS; IMPLEMENTING A CONSTRUCTION DEBRIS RECYCLING PROGRAM; RECYCLING THE FIBER FROM OUR SHREDDED OFFICE PAPER; AND REPROCESSING MEDICAL SUPPLIES THAT CAN BE REUSED. ADDITIONALLY, VIRGINIA MASON WAS THE FIRST HOSPITAL IN THE REGION TO IMPLEMENT AN OPERATING ROOM (OR) RECYCLING PROGRAM.ENVIROMASON'S TEAM APPROACH EXTENDS FROM STRONG SENIOR LEADERSHIP SUPPORT TO ACTIVE ENGAGEMENT OF OUR TEAM MEMBERS. OUR GOAL IS TO REDUCE THE ENVIRONMENTAL IMPACT OF VIRGINIA MASON'S OPERATIONS BY EDUCATING AND EMPOWERING TEAM MEMBERS TO MAKE MORE SUSTAINABLE CHOICES. IN 2019, THIS APPROACH LED TO THE ANESTHESIOLOGY DEPARTMENT AT THE MAIN CAMPUS SUCCESSFULLY ELIMINATING THE USE OF DESFLURANE, AN ANESTHETIC GAS WITH 20 TIMES THE GLOBAL WARMING POTENTIAL AS ITS PRIMARY ALTERNATIVE GAS.ENVIROMASON SPECIAL EVENTS ALSO HELP US ENGAGE OUR TEAM MEMBERS WITH SUSTAINABILITY EFFORTS. WE SPONSOR EVENTS SUCH AS OUR FARMERS MARKET, COMMUNITY SUPPORTED AGRICULTURE (CSA) PROGRAM, AND ECOCHALLENGE CARBON REDUCTION PROGRAM. VIRGINIA MASON RECENTLY SIGNED ONTO THE NATIONAL COOL FOOD PLEDGE, WHOSE AIM IS TO REDUCE THE GREENHOUSE GAS EMISSIONS ASSOCIATED WITH THE FOOD WE SERVE BY 25% BY 2030. AS AN ORGANIZATION DEDICATED TO PRESERVING HEALTH, VIRGINIA MASON IS REDUCING OUR GREENHOUSE GAS EMISSIONS THROUGH ENERGY EFFICIENCY; COMMUTE TRIP REDUCTION; LANDFILL DIVERSION ACTIVITIES, LIKE RECYCLING, COMPOSTING, AND FOOD DONATION; AND BUYING LOCAL GOODS AND SERVICES.MEDICAL STAFF. VIRGINIA MASON HAS 565 MEMBERS ON ITS ACTIVE HOSPITAL STAFF, INCLUDING VIRGINIA MASON PHYSICIANS, AND OTHER COMMUNITY PROVIDERS.ACCOUNTABILITY TO THE COMMUNITY. THE MEDICAL CENTER IS ACCOUNTABLE TO THE PUBLIC THROUGH ITS BOARD, THE VOTING MEMBERS OF WHICH ARE COMMUNITY MEMBERS WHO REPRESENT THE DIVERSE POPULATIONS AND NEEDS OF COMMUNITIES SERVED BY THE MEDICAL CENTER. BAILEY-BOUSHAY HOUSE, A DIVISION OF THE MEDICAL CENTER WHICH PROVIDES DAY HEALTH AND SKILLED NURSING FACILITY SERVICES TO INDIVIDUALS LIVING WITH HIV/AIDS, ALSO HAS AN ADVISORY BOARD COMPRISED PRIMARILY OF REPRESENTATIVES OF THE COMMUNITY WHO PROVIDE INPUT AND GUIDANCE ON SERVING THE COMMUNITY.USE OF FINANCIAL SURPLUSES. ALL FINANCIAL SURPLUSES FROM THE OPERATION OF THE MEDICAL CENTER ARE USED EXCLUSIVELY TO FURTHER ITS CHARITABLE PURPOSES. NO INDIVIDUAL RECEIVES ANY PORTION OF THE ORGANIZATIONS' RESPECTIVE SURPLUS AS A RESULT OF OWNERSHIP OR ANY OTHER "INSIDER" RELATIONSHIP. PART VI, LINE 7, REPORTS FILED WITH STATES WA 1 BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON 1201 NINTH AVENUE SEATTLE WA 98101 910653422 501(C)(3) 1000000 OPERATING SUPPORT 1 PART I, LINE 2: THE FUNDS PROVIDED TO VIRGINIA MASON HEALTH SYSTEM ARE FOR OPERATIONAL SUPPORT OR SPECIFIC ACTIVITIES. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HSS5 2017-08-31 287837574 REFINANCE OUTSTANDING DEBT 0 0 0 A 287843556 2428792 285412975 1789 1 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 1 0 0 0 1 A 1 PART I, LINE A, COLUMN C 93978HSD8, 93978HSE6, 93978HSF3, 93978HG1, 93978HSH9, 93978HSJ5, 93978HSK2, 93978HSL0, 93978HSM8, 93978HSN6, 93978HSP1, 93978HSQ9, AND 93978HSR7 PART I, LINE A, COLUMN F THE PROCEEDS OF THE SERIES 2017 BONDS WILL BE USED FOR THE PURPOSE OF PROVIDING PART OF THE FUNDS NECESSARY TO 1) REFUND, ON AN CURRENT BASIS THE AUTHORITY'S REVENUE BONDS, SERIES 1997B, THE SERIES 2007A, THE SERIES 2007B BONDS, AND THE SERIES 2007C BONDS; AND 2) PAY COSTS OF ISSUANCE OF THE BONDS. THE 1997B BONDS WERE REISSUED DECEMBER 1, 2007. THE ORIGINAL BOND PROCEEDS WERE USED TO 1) FINANCE OR REIMBURSE THE MEDICAL CENTER FOR THE COSTS OF CONSTRUCTING, REMODELING AND/OR ACQUIRING HEALTH CARE FACILITIES; 2) FUND THE INITIAL DEPOSIT TO THE RESERVE ACCOUNTS FOR THE BONDS; 3) PAY THE PREMIUM FOR THE INSURANCE POLICY; AND 4) PAY CERTAIN OF THE OTHER COSTS OF ISSUING THE BONDS. THE SERIES 2007A BONDS, THE SERIES 2007B BONDS AND THE SERIES 2007C BONDS WERE ORIGINALLY ISSUED DECEMBER 1, 2007. THE ORIGINAL BONDS PROCEEDS OF THE REOFFERED 1997B BONDS TOGETHER WITH THE PROCEEDS OF THE SERIES 2007 BONDS WERE TO BE USED FOR THE PURPOSE OF PROVIDING PART OF THE FUNDS NECESSARY TO 1) REFUND, ON AN ADVANCED AND CURRENT BASIS, AND TO REDEEM THE AUTHORITY'S REVENUE BONDS, SERIES 1997A; 2) REISSUE, REFUND, ON A CURRENT BASIS AND REPLACE THE SERIES 1997B BONDS AS A VARIABLE RATE OBLIGATION; 3) REIMBURSE THE MEDICAL CENTER FOR, OR PAY, THE COSTS OF ACQUIRING, CONSTRUCTING, REMODELING, RENOVATING AND EQUIPPING CERTAIN HEALTH CARE FACILITIES; 4) PAY INTEREST ON THE SERIES 2007 BONDS DURING CONSTRUCTION; 5) FUND THE INITIAL DEPOSITS INTO RESPECTIVE DEBT SERIVCE RESERVES FOR THE SERIES 2007 BONDS; 6) PAY THE COST OF CREDIT ENHANCEMENT, IF ANY, AND 7) PAY ISSUANCE COSTS. PART II, LINE 3 DIFFERENCE THE DIFFERENCE BETWEEN THE ISSUE PRICE AND THE PROCEEDS OF THE BOND ISSUE IS DUE TO INVESTMENT EARNINGS. PART II, LINE 7 DIFFERENCE THE DIFFERENCE BETWEEN PART II LINE 7 AND FORM 8038 LINE 24 IS DUE TO LOWER ISSUANCE COSTS THAN THE ESTIMATED COSTS INCLUDED IN THE PROCEEDS. COLUMBIA HOSPITALITY INC COMPANY FOUNDED BY JOHN OPPENHEIMER, DIRECTOR 780919 PROVISION OF MANAGEMENT SERVICES TO THE MEDICAL CENTER 0 X 6 46470 FMV X 18 1748 REPLACEMENT COST X LODGING/ENTERTINAMENT/EXPERIENCES 22 51965 REPLACEMENT COST X MEDICAL SUPPLIES 5 18920 REPLACEMENT COST X ITEMS USED AT AUCTION/EVENT 18 7826 REPLACEMENT COST 0 1 1 PART I, LINE 32B: VIRGINIA MASON USES A BROKERAGE FIRM TO SELL DONATED PUBLICLY TRADED SECURITIES. FORM 990, PART III, LINE 1 (CONTINUED): THE MEDICAL CENTER ALSO OPERATES BAILEY-BOUSHAY HOUSE, A SKILLED NURSING FACILITY AND DAY HEALTH CENTER SERVING THE HIV/AIDS COMMUNITY. THE MEDICAL CENTER PATIENT CARE SERVICES ARE INTEGRATED WITH AND ENHANCED BY EDUCATION AND RESEARCH ACTIVITIES WHICH INCLUDE A GRADUATE MEDICAL EDUCATION PROGRAM PROVIDING TRAINING TO OVER 130 RESIDENTS, FELLOWS AND MEDICAL STUDENTS EACH YEAR. IN ADDITION, THE MEDICAL CENTER SPONSORS TRAINING PROGRAMS FOR PHARMACY AND A VARIETY OF OTHER HEALTH SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, SPEECH AND LANGUAGE THERAPY AND LABORATORY TECHNOLOGY. FORM 990, PART VI, SECTION A, LINE 1 THE GOVERNING BODY DELEGATES TO AN EXECUTIVE COMMITTEE COMPRISED OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASUER THE AUTHORITY OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE CORPORATION TO ACT ONLY IN TIME SENSITIVE OR EMERGENCY SITUATIONS AS DETERMINED BY THE EXECUTIVE COMMITTEE, SUCH AUTHORITY TO BE EXERCISED IN TIME PERIODS BETWEEN REGULARLY SCHEDULED MEETINGS OF THE BOARD OF DIRECTORS. ALL MEMBERS OF THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION. THE EXECUTIVE COMMITTEE ARE MEMBERS OF THE GOVERNING BODY OF THE CORPORATION. THE EXECUTIVE COMMITTEE DOES NOT HAVE THE AUTHORITY TO AMEND, ALTER OR REPEAL THE BYLAWS, ELECT, APPOINT OR REMOVE ANY MEMBER OF THE EXECUTIVE COMMITTEE OR ANY DIRECTOR OR OFFICER OF THE CORPORATION; AMEND THE ARTICLES OF INCORPORATION; ADOPT A PLAN OF MERGER OR ADOPT A PLAN OF CONSOLIDATION WITH ANOTHER CORPORATION; AUTHORIZE THE SALE, LEASE O EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY AND ASSETS OF THE CORPORATION NOT IN THE ORDINARY COURSE OF BUSINESS; AUTHORIZE THE VOLUNTARY DISSOLUTION OF THE CORPORATION OR REVOKE PROCEEDINGS THEREFORE; ADOPT A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF THE CORPORATION; AMEND, ALTER OR REPEAL ANY RESOLUTION OF THE BOARD WHICH BY ITS TERMS PROVIDES THAT IT SHALL NOT BE AMENDED, ALTERED OR REPEALED BY THE EXECUTIVE COMMITTEE; OR TERMINATE THE CHIEF EXECUTIVE OFFICER. THE EXECUTIVE COMMITTEE ALSO PERIODICALLY EVALUATES THE EFFECTIVEESS OF VIRGINIA MASON MEDICAL CENTER'S ("VMMC") SYSTEMS FOR RESOLVING INTERNAL CONFLICTS. THE BOARD ALSO DELEGATES TO THE EXECUTIVE COMMITTEE THE AUTHORITY OF THE BOARD TO MAKE ALL APPOINTMENTS AND REAPPOINTMENTS TO THE MEDICAL STAFF OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JANUARY 1, 2021 FRANCISCAN HEALTH SYSTEM (FHS), VIRGINIA MASON HEALTH SYSTEM (VMHS), AND COMMONSPIRIT HEALTH (COMMONSPIRIT), A MEMBER OF FHS, COMPLETED THE AFFILIATION TRANSACTION (THE AFFILIATION) CONTEMPLATED BY THE AFFILIATION AGREEMENT, DATED AS OF DECEMBER 31, 2020, PURSUANT TO WHICH, AMONG OTHER THINGS, COMMONSPIRIT FORMED VIRGINIA MASON FRANCISCAN HEALTH, A WASHINGTON NONPROFIT CORPORATION (VMFH). AFTER THE EFFECTIVE DATE, COMMONSPIRIT AND VMHS ARE THE SOLE CORPORATE MEMBERS OF VMFH, WHICH IS A CONTROLLED SUBSINDARY OF COMMONSPIRIT AND WILL BE CONSOLIDATED WITH COMMONSPIRIT FOR ACCOUNTING PURPOSES. AS A RESULT OF THE AFFILIATION, VMFH NOW GOVERNS AND MANAGES THE COMBINED OPERATIONS OF FHS, VIRGINIA MASON MEDICAL CENTER (VMMC) BENAROYA RESEARCH INSTITUE (BRI), AND CERTAIN OTHER AFFILIATES OF FHS AND VMMC (THE COMBINED SYSTEM), SUBJECT TO CERTAIN VMHS PROTECTIVE RESERVED POWERS AND OTHER RESERVED POWERS HELD BY COMMONSPIRIT AND VMFH IS NOW THE SOLE CORPORATE MEMBER OF BOTH VMMC AND BRI. FORM 990, PART VI, SECTION A, LINE 6 ACCORDING TO THE BYLAWS OF VIRGINIA MASON MEDICAL CENTER THE ENTITY'S SOLE MEMBER IS VIRGINIA MASON FRANCISCAN HEALTH, A WASHINGTON NONPROFIT CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A VIRGINIA MASON FRANCISCAN HEALTH IS THE SOLE CORPORATE MEMBER OF VIRGINIA MASON MEDICAL CENTER. ACCORDING TO THE ORGANIZATION'S BYLAWS, DIRECTORS SHALL BE APPOINTED OR REFUSED BY THE CORPORATE MEMBER. THE CORPORATE MEMBER MAY APPOINT ONE OR MORE INDIVIDUALS TO THE BOARD OF DIRECTORS, AND MAY AT ANY TIME REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBER OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B VIRGINIA MASON FRANCISCAN HEALTH ("VMFH") IS THE SOLE CORPORATE MEMBER OF VIRGINIA MASON MEDICAL CENTER ("VMMC"). EXCEPT AS OTHERWISE PROVIDED IN THE CORPORATION'S ARTICLES OF INCORPORATION, ELSEWHERE IN THESE BYLAWS, OR IN THE LAWS OF THE STATE OF WASHINGTON, THE CORPORATE MEMBER SHALL HAVE THE SPECIFIC RIGHTS SET FORTH IN THE GOVERNANCE MATRIX. THE RIGHTS OF THE CORPORATE MEMBER SHALL BE FURTHER SUBJECT TO THE POWERS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX (SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER) AND AS OTHERWISE SET FORTH IN THE BYLAWS OF THE CORPORATE MEMBER. IN ADDITION, SUBJECT TO THE BYLAWS OF THE CORPORATE MEMBER, THE RESERVED POWERS OF CSH SET FORTH IN THE GOVERNANCE MATRIX MAY BE UNILATERALLY EXERCISED BY CSH ON BEHALF OF THE CORPORATION, AT CSH'S SOLE DISCRETION, IF THE CORPORATION'S BOARD OF DIRECTORS FAILS TO ACT UPON SUCH MATTERS DESCRIBED IN THESE BYLAWS, OR IF THE CORPORATION'S BOARD OF DIRECTORS ATTEMPTS TO ACT IN A MANNER THAT CONFLICTS WITH OR OVERRIDES THE ACTIONS OR DESIRES OF CSH WITH RESPECT TO SUCH MATTERS. THE GOVERNANCE MATRIX MAY BE AMENDED FROM TIME TO TIME BY CSH, AND SUCH AMENDMENTS SHALL BE DEEMED TO BE A PART OF THESE BYLAWS WITHOUT FURTHER ACTION. THE CORPORATION SHALL BE DEEMED A "SUBSIDIARY" OF CSH FOR PURPOSES OF THE GOVERNANCE MATRIX. IN ADDITION TO THE RIGHTS RESERVED TO CSH UNDER THE GOVERNANCE MATRIX, CSH SHALL HAVE THE POWER TO TRANSFER ASSETS OF THE CORPORATION OR TO REQUIRE THE CORPORATION TO TRANSFER ASSETS TO CSH, TO THE EXTENT NECESSARY TO ACCOMPLISH CSH'S GOALS AND OBJECTIVES, AND TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF CSH OR AN ENTITY CONTROLLED BY, CONTROLLING, OR UNDER COMMON CONTROL WITH CSH (FOR PURPOSES OF THIS SECTION, A "CSH AFFILIATE"), ISSUED OR INCURRED BY OR ON BEHALF OF CSH OR A CSH AFFILIATE IN FURTHERANCE OF CSH'S GOALS AND OBJECTIVES. THE CORPORATION SHALL NOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THESE BYLAWS OR ITS ARTICLES OF INCORPORATION, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS OR OTHER CONTRACTS AS A RESULT OF ANY ASSET TRANSFERS MADE OR DIRECTED BY CSH. EXCEPT FOR TRANSFERS PREVIOUSLY APPROVED BY CSH, EITHER INDIVIDUALLY OR AS PART OF THE CSH HEALTHCARE SYSTEM BUDGET PROCESS, AND EXCEPT FOR TRANSFERS TO AN AFFILIATE OR SUBSIDIARY OF THE CORPORATION, THE CORPORATION SHALL NOT TRANSFER ASSETS TO ENTITIES OTHER THAN CSH OR CSH AFFILIATES WITHOUT THE APPROVAL OF CSH. FORM 990, PART VI, SECTION B, LINE 11B NO REVIEW WAS OR WILL BE CONDUCTED. FORM 990, PART VI, SECTION B, LINE 12C THE GOVERNANCE COMMITTEE OF THE BOARD HAS ACCOUNTABILITY FOR OVERSIGHT OF THE PROCESS FOR DISCLOSURE, EVALUATION AND MANAGEMENT OF CONFLICTS OF INTEREST INVOLVING ANY MEMBER OF THE BOARD, EXECUTIVE LEADERSHIP OR KEY EMPLOYEES ("COVERED PERSON"). PURSUANT TO THE CONFLICTS OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE IS DISTIBUTED TO ALL COVERED PERSONS. IN ADDITION, A COVERED PERSON HAS AN ON-GOING DUTY TO DISCLOSE THE EXISTENCE O A CONFLICT OF INTEREST AT ANY TIME AN ACTUAL OR POTENTIAL CONFLICT ARISES. EACH COVERED PERSON IS REQUIRED UPON APPOINTMENT AND ANNUALLY THEREAFTER TO ATTEST TO A STATEMENT THAT AFFIRMS THAT SUCH PERSN HAS 1) RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) HAS AGREED TO COMPLY WITH THE POLICY; AND 4) UNDERSTANDS THAT THE MEDICAL CENTER IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ITS TAX-EXEMPT PURPOSES. WRITTEN DISCLOSURES ARE REVIEWED BY THE GOVERNANCE COMMITTEE TO DETERMINE IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST EXISTS AND IF SO, HOW SHOULD IT BE MANAGED. THE COVERED PERSO IS INFORMED IN WRITING REGARDING THE DETERMINATION (THE "CONFLICT OF INTEREST MANAGEMENT PLAN"). NO COVERED PERSON WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST SHALL ENGAGE IN AN ACTIVITY ON THE MEDICAL CENTER'S BEHALF RELATED TO THE DISCLOSED ACTUAL OR POTENTIAL CONFLICT OF INTEREST UNLESS SUCH ACTIVITY IS PERMITTED BY THE CONFLICT OF INTEREST MANAGEMENT PLAN OR UNTIL THE COVERED PERSON AS UNDERTAKEN ALL STEPS SET FORTH IN THE MANAGEMENT PLAN TO MANAGE, REDUCE OR ELIMINATE THE CONFLICT. ALL COVERED PERSONS HAVE A DUTY TO DISCLOSE THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO MEETING AGENDA ITEMS. THE CONFLICTS OF INTEREST POLICY REQUIRES THAT COPIES OF THE CONFLICT OF INTEREST QUESTIONNAIRE COMPLETED ANNUALLY BY EACH COVERED PERSON AND ANY CONFLICT OF INTEREST MANAGEMENT PLAN BE MAINTAINED. IN ADDITION, THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL DOCUMENT THE DISCLOSURE AND RESOLUTION OF ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST DISCLOSED AT SUCH MEETING. FORM 990, PART VI, SECTION B, LINE 15 THE VMHS COMPENSATION AND BENEFITS BOARD COMMITTEE, A COMMITTEE COMPOSED SOLELY OF INDEPENDENT DIRECTORS OF VMHS NONE OF WHOM HAVE A CONFLICT OF INTEREST, IS ACCOUNTABLE FOR SETTING REASONABLE TOTAL COMPENSATION PACKAGES FOR EACH MEDICAL CENTER EXECUTIVE, INCLUDING THE CEO, OFFICERS AND KEY EMPLOYEES("EXECUTIVES") CONSISTENT ITH THE MEDICAL CENTER'S PHILOSOPHY AND PRINCIPLES. THE BOARD DEVELOPS AND APPROVES ANNUAL GOALS AND PERFORMANCE CRITERIA WHICH ARE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION OPPORTUNITIES FOR THE MEDICAL CENTER EXECUTIVES. THE COMMITTEE ASSESSES PERFORMANCE AGAINST THESE GOALS. THE COMMITTEE SELECTS AND ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT TO REVIEW AND ANALYZE THE TOTAL COMPENSATION AND BENEFITS PACKAGES TO THE EXECUTIVES. THE COMMITTEE AS PART OF ITS ANALYSIS OBTAINS FROM THE COMPENSATIO CONSULTANT APPROPRIATE COMPARABILITY DATA INCLUDING TOTAL COMPENSATION PAID BY SIMILARLY SITUATED FOR-PROFIT AND NON-PROFIT HEALTH CARE ORGANIZATIONS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE TO EACH OF THE EXECUTIVES. WITH RESPECT TO THOSE EXECUTIVES BELOW THE LEVEL OF CHAIR/CHIEF EXECUTIVE OFFICER, THE COMMITTEE REQUESTS THAT THE CHAIR/CHIEF EXECUTIVE OFFICER WORK WITH THE COMPENSATION CONSULTANT TO FORMULATE A COMPENSATION RECOMMENDATION FOR EACH SUCH EXECUTIVE, CONSISTENT WITH VMHS'S COMPENSATION PHIOSOPHY AND PRINCIPLES. CONSISTENT WITH VMHS'S COMPENSATION PHILOSOPHY AND PRINCIPLES, THE COMMITTEE APPROVES TOTAL COMPENSATION PACKAGES FOR EACH OF THE EXECUTIVES BASED ON INFORMATION PRESENTED TO THE COMMITTEE, REASONABLENESS AND THE BEST INTERESTS OF THE MEDICAL CENTER. THE COMMITTEE'S DECISIONS REGARDING COMPENSATION FOR EACH EXECUTIVE ARE DOCUMENTED IN WRITTEN RESOLUTIONS AND MINUTES OF THE COMMITTEE. THE COMMITTEE PROMPTLY REPORTS ITS ACTION TO THE BOARD WHOSE REPORTS ARE REFLECTED IN THE BOARD'S MINUTES. THE EXECUTIVES THAT WERE REVIEWED IN 2020 WERE: CHIEF EXECUTIVE OFFICER, PRESIDENT, CHIEF FINANCIAL OFFICER, SENIOR VICE PRESIDENTS, VICE PRESIDENTS, PHYSICIAN CHIEFS, CLINIC MEDICAL DIRECTOR, HOSPITAL MEDICAL DIRECTOR, AND CHIEF MEDICAL OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S ARTICLES, BYLAWS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PENSION ADJUSTMENT 8,098,495. ADDITIONAL RETIREMENT LIABILITY 218,000. INTER-DEPARTMENT CONTRIBUTIONS 2,719,351. CONTRIBUTION OF SERVICES 449,638. 1000 MADISON LLC 1100 NINTH AVENUE SEATTLE WA 98101 204018216 REAL ESTATE WA 1886884 17290579 VMMC 1005 SPRING STREET LLC 1100 NINTH AVENUE SEATTLE WA 98101 204816736 REAL ESTATE WA 428230 3775075 VMMC HEALTH RESOURCE SERVICES LLC 1100 OLIVE WAY SEATTLE WA 98101 262800994 GROUP PURCHASING WA 10273903 41956198 VMMC PUGET SOUND HIGH VALUE NETWORK LLC 1100 NINTH AVENUE SEATTLE WA 98101 472840780 MEDICAL NETWORK WA 0 -4168 VMMC NETWORXHEALTH LLC 1100 OLIVE WAY SEATTLE WA 98101 825288717 HEALTHCARE STAFFING WA 340312 -39109 VMMC VIRGINIA MASON FRANCISCAN HEALTH 1149 MARKET STREET TACOMA WA 98402 861332353 HEALTH CARE WA 501(C)(3) LINE 12B, II N/A 0 VIRGINIA MASON INSTITUTE 1100 NINTH AVENUE SEATTLE WA 98101 263763656 EDUCATION WA 501(C)(3) LINE 10 VMMC 1 NATIONAL PURCHASING PARTNERS LLC 1100 OLIVE WAY SEATTLE WA 98101 203470995 GROUP PURCHASING WA N/A UNRELATED 17857602 7354821 0 18081790 1 0.50000 EMERALD CITY OBSTETRICS ALLIANCE LLC 1100 NINTH AVENUE SEATTLE WA 98101 320594147 GOVERNANCE OVERSIGHT WA N/A RELATED -11301121 1053051 0 0 0.50000 CENTER FOR INTEGRATIVE MEDICINE AT VIRGINIA MASON 1100 NINTH AVENUE SEATTLE WA 98101 831583223 INTEGRATIVE MEDICINE SERVICES WA VMMC C 176564 1.00000 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 BENAROYA RESEARCH INSTITUTE AT VIRGINIA MASON 1201 NINTH AVENUE SEATTLE WA 98101 910653422 0 0 0 37139481 37139481 1000000 250000 0 0 0 VIRGINIA MASON MEDICAL CENTER 1100 NINTH AVENUE SEATTLE WA 98101 910565539 X 126542 78878 205420 580645563 580850983 1000000 250000 0 0 0 VIRGINIA MASON INSTITUTE 1100 NINTH AVENUE SEATTLE WA 98101 263763656 0 0 0 1737758 1737758 236888 59222 0 0 0