2018-11-12T18:14:22-06:00 2017-12-31 910189318 MOSS ADAMS LLP 2707 COLBY AVENUE SUITE 801 EVERETT WA 98201 990 2017-01-01 910171250 CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION CENT 5096621515 1201 S MILLER ST WENATCHEE WA 98801 PETER D RUTHERFORD MD CHIEF EXECUTIVE OFFICER 5096621515 2018-11-08 1 ROBERT GRANNUM P00355876 4252597227 2018-11-08 12.129.7.100 2018-11-08 12:50:24 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7ABEDE2D465AB02E671AD8304780CB1E1B9D70B4 2017 2019-02-21 02:37:17Z CENTRAL WASHINGTON HOSPITAL PETER D RUTHERFORD MD 1201 S MILLER ST WENATCHEE WA 98801 439015319 0 X WWW.CWHS.COM X 1978 WA DEDICATED TO IMPROVING OUR PATIENTS' HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE. 15 15 1937 44 81581 -93962 1120306 40449 323576418 348292457 3275940 4556633 1514296 1644410 329486960 354533949 10759 14403 0 0 116736406 122705501 0 0 0 184287579 206479343 301034744 329199247 28452216 25334702 378264290 409089816 146045182 145697213 232219108 263392603 X WE ARE DEDICATED TO IMPROVING OUR PATIENTS' HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE IN A COMPASSIONATE AND COST-EFFECTIVE MANNER.OUR CORE VALUES:A. OUR PATIENTS ARE THE REASON FOR OUR BEING, AND THEIR NEEDS WILL DRIVE ALL OF OUR ACTIONS.B. WE WILL TREAT EVERYONE (INCLUDING PATIENTS, THEIR FAMILIES, REFERRING OFFICES AND COLLEAGUES) WITH DIGNITY, RESPECT AND COMPASSION.C. WE WILL WORK AS A TEAM, UTILIZING COLLABORATION, ACTIVE PARTICIPATION AND OPEN COMMUNICATION AMONG ALL PHYSICIANS AND STAFF.D. WE WILL CONTINUE TO INNOVATE WAYS TO IMPROVE THE DELIVERY OF EXCELLENT, HIGH VALUE CARE.E. WE WILL MEASURE SUCCESSES AND FAILURES, AND USE THE RESULTS TO DRIVE FURTHER IMPROVEMENTF. WE WILL BE A GOOD NEIGHBOR IN THE COMMUNITIES WE SERVE WITH DONATIONS OF TIME, TALENT AND CAPITAL.G. WE WILL BE ETHICAL AND ACCOUNTABLE IN ALL OF OUR DECISIONS AND ACTIONS. 0 0 276725464 14403 343361768 CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, DBA CENTRAL WASHINGTON HOSPITAL (THE ASSOCIATION), IS ACCREDITED BY THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS AND OPERATES A LICENSED 198-BED ACUTE CARE HOSPITAL DELIVERING A FULL RANGE OF HEALTH CARE SERVICES IN WENATCHEE, WASHINGTON, AND THE NORTH CENTRAL WASHINGTON AREA. THE ASSOCIATION IS A NOT-FOR-PROFIT INSTITUTION GOVERNED BY A BOARD OF DIRECTORS, PROVIDING GENERAL INPATIENT SERVICES INCLUDING MEDICAL, SURGICAL, HOME INFUSION SERVICES, INTENSIVE CARE AND CORONARY CARE, NEONATAL INTENSIVE CARE, PEDIATRICS, OBSTETRICS, GYNECOLOGY AND ONCOLOGY. THE ASSOCIATION IS A FEDERAL REGIONAL REFERRAL CENTER, AND IS DESIGNATED BY THE STATE AS A LEVEL III GENERAL TRAUMA CENTER AND LEVEL III PEDIATRIC TRAUMA CENTER, SUPPORTED BY A COMPREHENSIVE RANGE OF SURGICAL PROCEDURES IN ORTHOPEDIC, NEUROSURGERY, VASCULAR SURGERY, INTERVENTIONAL CARDIAC CATHETERIZATION, AND OPEN-HEART SURGERY. CONFLUENCE HEALTH WAS FORMED IN 2012 AS A HEALTH SYSTEM THAT REPRESENTS AN AFFILIATION BETWEEN CENTRAL WASHINGTON HOSPITAL (A NOT-FOR-PROFIT ORGANIZATION) AND WENATCHEE VALLEY MEDICAL GROUP (WVMG) (A FOR-PROFIT ORGANIZATION). EFFECTIVE JANUARY 1, 2013, THE ASSOCIATION AFFILIATED WITH CONFLUENCE HEALTH, AND CONFLUENCE HEALTH BECAME THE SOLE MEMBER OF THE ASSOCIATION. THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH CONSISTS OF 9 COMMUNITY MEMBERS AND 6 PHYSICIANS OF WVMG.THE ASSOCIATION PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE ASSOCIATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE.THE ASSOCIATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY AND THE ESTIMATED COST OF THOSE SERVICES AND SUPPLIES. CHARGES FORGONE, BASED ON ESTABLISHED RATES TOTALED $5,207,842 AND $5,074,041 IN 2017 AND 2016 RESPECTIVELY.MANAGEMENT ESTIMATES CHARITY CARE COSTS BY CALCULATING A RATIO OF COST TO GROSS CHARGES, AND THEN MULTIPLYING THAT RATIO BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS. CHARITY CARE COSTS WERE $2,005,000 AND $1,979,000 FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY.THE ASSOCIATION SERVICED 45,895 ACUTE PATIENT DAYS, 11,371 ACUTE DISCHARGES, 1,351 DELIVERIES AND 37,006 EMERGENCY VISITS. 276725464 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 79 0 1 1937 1 1 1 0 0 0 0 0 0 0 0 0 X 15 15 1 1 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X JOHN DOYLE 5096621511 1201 SOUTH MILLER STREET WENATCHEE WA 98801 KRISTINE S LOOMIS CHAIR 1.00 3.00 X X 0 0 0 FRANK J KUNTZ VICE-CHAIR AND TREASURER 1.00 3.00 X X 0 0 0 GARY LAMMERT MD SECRETARY 1.00 3.00 X X 0 0 0 TOBY BOND MD BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 JENNY CRAVENS BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 D SCOTT DUNCAN BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 MITCHELL A GARRISON MD BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 GUS HEINICKE BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 RICHARD HOURIGAN MD BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 LAURA MOUNTER BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 MICHAEL ROSSI MD BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 DOUG SHAE BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 JULIE SMITH MD BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 ROBERT TRASK JR BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 PATRICIA WACHTEL BOARD OF DIRECTORS 1.00 2.00 X 0 0 0 PETER RUTHERFORD MD CHIEF EXECUTIVE OFFICER 15.00 35.00 X 0 639999 46934 JOHN R DOYLE CHIEF FINANCIAL OFFICER 15.00 35.00 X 0 438443 44539 GLENN W ADAMS SR VP ANCILLARY SERVICES 15.00 35.00 X 0 250220 44591 JEANINE M ALLEN SR VP SPECIALTY CARE 15.00 35.00 X 0 233799 42677 JAY H JOHNSON SR VP NETWORK STRATEGY 15.00 35.00 X 0 340794 50388 TRACEY A KASNIC RN SR VP INPATIENT & CNO 15.00 35.00 X 0 337610 42959 PETER N LOLOS SR VP FACILITY & SUPT SRV 15.00 35.00 X 0 241076 34848 JEANETTE WOOD SR VP PRIMARY CARE 15.00 35.00 X 0 230303 42260 VIKKI L NOYES CHIEF OPERATING OFFICER 15.00 35.00 X 0 419555 36834 ROBERT J PAGELER CHIEF INFORMATION OFFICER 15.00 35.00 X 0 315638 40918 JAMES B WOOD CHIEF ADMIN OFFICER 15.00 35.00 X 0 349496 42438 STUART D FREED MD CHIEF MEDICAL OFFICER 15.00 35.00 X 0 491617 52857 STEPHEN J FORD NURSE - PR13 50.00 X 156385 0 32154 MICHAEL D SIEG EHR/EPIC PROGRAM DIRECTOR 50.00 X 187538 0 15237 CYNTHIA S POTTS PHARMACY RETAIL MANAGER 50.00 X 158693 0 20033 SAMUEL L SCHULTE PHARMACIST 50.00 X 161777 0 20418 DANUTE O SLAPSYS PHARMACIST 50.00 X 162370 0 18197 JOHN B HAMILTON FORMER COO OF CH 0.00 X 0 185288 0 826763 4473838 628282 166 1 1 1 WENATCHEE EMERGENCY PHYSICIANS PO BOX 4600 WENATCHEE WA 98801 ER PHYSICIANS SERVICES 5044298 WENATCHEE VALLEY MEDICAL GROUP PO BOX 489 WENATCHEE WA 98801 MANAGEMENT SERVICES 3728714 EPIC SYSTEMS CORPORATION PO BOX 412702 KANSAS CITY MO 64141 BILLING SUPPORT SYSTEM 3201385 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 BILLING SUPPORT SYSTEM 2508402 IMPACT ADVISORS 400 E DIEHL ROAD SUITE 190 NAPERVILLE IL 60563 EPIC IMPLEMENTATION SUPPORT 2418377 42 31238 9211 40449 PATIENT SERVICES 621900 343225644 343225644 ANCILLARY SERVICES 621900 3211005 3211005 CAFETERIA SERVICES 621900 1835656 1835656 TRAUMA FUNDS 621900 20152 20152 348292457 3806594 3806594 1925894 453923 1471971 1471971 1471971 84503602 83529 83762563 74529 741039 9000 750039 750039 246822 190355 56467 81581 -25114 MISCELLANEOUS 900099 101275 101275 PURCHASE DISCOUNTS 900099 14697 14697 115972 354533949 343361768 81581 11050151 14403 14403 96785724 77428579 19357145 4605334 3684267 921067 13218396 10574717 2643679 8096047 6476838 1619209 52460770 47214693 5246077 110451 110451 206261 206261 152473 106731 45742 81483 65186 16297 5564116 4451293 1112823 1433174 1146539 286635 2477627 2229864 247763 321934 257547 64387 5277093 5277093 10729858 9656872 1072986 -705991 -705991 PATIENT SERVICES 67380293 60642264 6738029 GENERAL SERVICES 44970745 31479522 13491223 LICENSES AND TAXES 8671628 8671628 BAD DEBT EXPENSE 7347428 7347428 329199247 276725464 52473783 0 409128 400477 61697571 58867042 248624 248624 56952461 58194519 15428419 16393114 5648904 5615227 1186012 1166215 322706888 183159251 137005330 139547637 94496016 123771537 5191825 4885424 378264290 409089816 17913103 21117921 120323317 117382127 188712 174195 7620050 7022970 146045182 145697213 X 231970484 263143979 248624 248624 232219108 263392603 378264290 409089816 25334702 5838793 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 30643 30643 0 PART II-B, LINE 1: WA STATE HOSPITAL ASSOCIATION DUES - 20.00% OF $111,802 = $22,360 AMERICAN HOSPITAL ASSOCIATION DUES - 22.98% OF $36,043 = $8,283 TOTAL $30,643 8276004 8276004 119518185 47354356 72163829 183469854 132603278 50866576 11442845 3201617 8241228 139547637 RESERVE FOR MALPRACTICE INSURANCE CLAIMS 3238777 DUE TO AFFILIATE 3784193 7022970 X 352693730 5838793 5838793 346854937 206261 7472751 7679012 354533949 321520235 0 321520235 206261 7472751 7679012 329199247 PART X, LINE 2: THE ASSOCIATION IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ASSOCIATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. ANY UNRELATED BUSINESS INCOME GENERATED IS NOT SIGNIFICANT; THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. THE ASSOCIATION ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX POSITIONS. AS OF DECEMBER 31, 2017 AND 2016, THE ASSOCIATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 7,347,428. EXPENSES NETTED IN MISC INCOME 579,246. RENTAL EXPENSES -453,923. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 7,347,428. EXPENSES NETTED IN MISC INCOME 579,246. RENTAL EXPENSES -453,923. 1 1 X 1 X 175.000000000000 1 X 1 1 0 1 1 2007178 2007178 0.00610 61407946 44274956 17132990 0.05200 63415124 44274956 19140168 0.05810 556880 302548 254332 0.00080 61763 2523240 51551 2471689 0.00750 648816 648816 0.00200 62697 62697 0.00020 61763 3791633 354099 3437534 0.01050 61763 67206757 44629055 22577702 0.06860 1 7347428 114917782 136956509 -22038727 X 1 1 1 1 CENTRAL WASHINGTON HOSPITAL 1201 S MILLER ST WENATCHEE WA 98801 WWW.CONFLUENCEHEALTH.ORG HAC.FS.00000168 X X X X CENTRAL WASHINGTON HOSPITAL 1 0 0 1 X X X X X X X X 16 1 1 1 1 X WWW.CONFLUENCEHEALTH.ORG/ABOUT-US/ X 1 16 1 WWW.CONFLUENCEHEALTH.ORG/COMMUNITY-BENEFITS-REPORT/ 0 1 X 175.000000000000 300.000000000000 X X X X X X X 1 1 X X X 1 X DOH.WA.GOV/PORTALS/1/DOCUMENTS/2300/HOSPPATIENTDATA/CCPCONFLUENCE-2018.PDF X CONFLUENCEHEALTH.ORG/WP-CONTENT/UPLOADS/2016/11/CCP-APP-2017.PDF X CONFLUENCEHEALTH.ORG/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE/CHARITY-CARE/ X X X X X 1 X 0 X X X 1 X 0 0 CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 5: DURING JULY AND AUGUST 2016, THE CHNA TEAM HELD COMMUNITY STAKEHOLDER MEETINGS IN EACH OF THE COUNTIES WITHIN THE NORTH CENTRAL WASHINGTON REGION. EACH MEETING WAS ATTENDED BY COMMUNITY STAKEHOLDERS FROM HEALTHCARE ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS (FQHC), EDUCATION, HOUSING, AND OTHER SOCIAL AND COMMUNITY SERVICE ORGANIZATIONS. EACH GROUP PARTICIPATED IN A SWOT ANALYSIS (STRENGTHS, WEAKNESSES, OPPORTUNITIES, AND THREATS) DISCUSSING AND RECORDING THE CHALLENGES, ASSETS, GAPS, AND OPPORTUNITIES THAT AFFECT THE HEALTH OF THE COMMUNITY. FURTHER EFFORT WAS TAKEN TO COLLECT INFORMATION FROM THE COMMUNITY ON OPINIONS AND PERCEPTIONS OF HEALTH AND QUALITY OF LIFE. THE CHNA STEERING TEAM ADAPTED A SURVEY USED IN OTHER JURISDICTIONS TO GATHER INFORMATION ABOUT COMMUNITY HEALTH THEMES AND STRENGTHS. THE SURVEY WAS ADMINISTERED USING SURVEYMONKEY, AN ONLINE SURVEY TOOL, TO COMMUNITY STAKEHOLDERS IN THE REGION. 169 INDIVIDUALS, REPRESENTING A VARIETY OF SECTORS, INCLUDING HEALTHCARE, PUBLIC HEALTH, GOVERNMENT, SOCIAL SERVICES, AND THE COMMUNITY AT LARGE, PARTICIPATED IN THE SURVEY. THE SURVEY CAPTURED THE OPINIONS OF THE HEALTH OF THE COMMUNITY, THE GREATEST RISKS TO HEALTH IN THE REGION, THE NEEDS OF THE REGION TO IMPROVE HEALTH, AND THE BEHAVIORS IN THE COMMUNITY THAT POSITIVELY OR NEGATIVELY AFFECT HEALTH.ORGANIZATIONS CONSULTED: AGING & ADULT CARE OF CENTRAL WASHINGTON, AMERIGROUP, BIG BEND COMMUNITY COLLEGE, CASCADE MEDICAL CENTER, CHELAN COUNTY REGIONAL JUSTICE CENTER, CHELAN DOUGLAS COMMUNITY ACTION, CHELAN DOUGLAS HEALTH DISTRICT, CITY OF WENATCHEE, COLUMBIA BASIN HOSPITAL, COLUMBIA VALLEY COMMUNITY HEALTH CENTER, COMMUNITY CHOICE, COMMUNITY HEALTH PLAN OF WASHINGTON, COORDINATED CARE HEALTH, CONFLUENCE HEALTH, FAMILY HEALTH CENTERS, GRANT COUNTY HEALTH DISTRICT, HOUSING AUTHORITY OF CHELAN COUNTY AND THE CITY OF WENATCHEE, HOUSING AUTHORITY OF GRANT COUNTY, INITIATIVE FOR RURAL INNOVATION AND STEWARDSHIP, LAKE CHELAN COMMUNITY HOSPITAL, MID VALLEY HOSPITAL, MOLINA HEALTHCARE OF WASHINGTON, MOSES LAKE COMMUNITY HEALTH CENTER, NATIONAL ALLIANCE ON MENTAL ILLNESS, NORTH CENTRAL EDUCATIONAL SERVICE DISTRICT, NORTH CENTRAL EMERGENCY CARE SERVICES, NORTH VALLEY HOSPITAL, OKANOGAN BEHAVIORAL HEALTH CARE, OKANOGAN VA, ROOM ONE, SAMARITAN HEALTHCARE, SERVE MOSES LAKE, THE CENTER FOR ALCOHOL & DRUG TREATMENT, THREE RIVERS HOSPITAL, TOGETHER! FOR YOUTH, UNITED HEALTHCARE, WENATCHEE VALLEY COLLEGE, WENATCHEE VALLEY LUTHERAN LATINO MINISTRY, WENATCHEE WORLD. CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 6A: WENATCHEE VALLEY HOSPITAL CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 6B: COMMUNITY CHOICE HEALTHCARE NETWORK, CHELAN-DOUGLAS HEALTH DISTRICT CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 11: THERE WERE FOUR SIGNIFICANT NEEDS IDENTIFIED IN THE 2016 CHNA:MENTAL HEALTH CARE ACCESS - CONFLUENCE HEALTH IS CONTINUING TO EXPAND ITS OUTPATIENT BEHAVIORAL HEALTH PROGRAM THROUGH THE HIRING OF A PSYCHIATRIST, PSYCHOLOGISTS, BEHAVIORAL HEALTH NURSE PRACTITIONERS AND LICENSED COUNSELORS IN CHELAN, DOUGLAS, GRANT AND OKANOGAN COUNTY.ACCESS TO HEALTH CARE - CONFLUENCE HEALTH IS CONTINUALLY WORKING TO IMPROVE ACCESS TO HEALTHCARE AND HAS ADDED ADDITIONAL PRIMARY CARE AND SPECIALTY PROVIDERS. ONE OF THE ANNUAL GOALS IS MEASURING IF PATIENTS PERCEIVED THEY GOT AN APPOINTMENT AS SOON AS THEY FELT THEY NEEDED IT. FURTHER, WE ARE EXPLORING ALTERNATIVE AVENUES OF ACCESS SUCH AS TELEMEDICINE TO IMPROVE CURRENT ACCESS.OBESITY - CONFLUENCE HEALTH IS STARTING A MEDICAL AND SURGICAL OBESITY MANAGEMENT PROGRAM IN 2017.EDUCATION - THERE ARE MANY BARRIERS TO EDUCATION. ONE BARRIER TO HIGH SCHOOL GRADUATION IS TEEN PREGNANCY AND CONFLUENCE HEALTH IS WORKING WITH COMMUNITY PARTNERS IN OKANOGAN COUNTY TO DECREASE THE INCIDENCE OF TEEN PREGNANCY. IN ADDITION, ANOTHER BARRIER TO LEARNING IS HEALTH. CONFLUENCE HEALTH IS PARTNERING WITH A LOCAL SCHOOL DISTRICT TO ESTABLISH A SCHOOL-BASED CLINIC. CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 13B: THE INDIVIDUAL FINANCIAL CIRCUMSTANCES STATED IN THE WRITTEN FINANCIAL POLICY IS TO TAKE INTO CONSIDERATION THE PATIENT/GUARANTOR'S ASSETS AND THEIR ABILITY TO PAY. CENTRAL WASHINGTON HOSPITAL PART V, SECTION B, LINE 13H: COMPASSIONATE CARE IS GENERALLY CONSIDERED ONLY AFTER ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THE PATIENT HAVE BEEN EXPLORED AND EXHAUSTED. IN ORDER TO QUALIFY FOR COMPASSIONATE CARE, THE PATIENT/GUARANTOR MUST FULLY COOPERATE WITH THE HOSPITAL IN EXPLORING AND APPLYING FOR THESE RESOURCES. OTHER FINANCIAL RESOURCES INCLUDE BUT ARE NOT LIMITED TO: GROUP OR INDIVIDUAL MEDICAL PLANS, SECONDARY OR SUPPLEMENTAL INSURANCE POLICIES, WORKER'S COMPENSATION, MEDICARE, MEDICAID OR MEDICAL ASSISTANCE PROGRAMS, OTHER STATE, FEDERAL OR MILITARY PROGRAMS, THIRD PARTY LIABILITY SITUATIONS (E.G. AUTO ACCIDENTS OR PERSONAL INJURIES), OR ANY OTHER SITUATION IN WHICH ANOTHER PERSON OR ENTITY MAY HAVE A LEGAL RESPONSIBILITY TO PAY FOR THE COSTS OF MEDICAL SERVICES.COMPASSIONATE CARE FOR NON-EMERGENT SERVICES SHALL BE LIMITED TO THOSE RESIDING WITH THE HOSPITALS DESIGNATED SERVICE AREA, WHICH IS DEFINED AS THE COUNTIES OF CHELAN, DOUGLAS, GRANT AND OKANOGAN AS WELL AS THE TOWN OF OTHELLO. NON-EMERGENT SERVICES SHALL BE DEFINED AS THOSE SERVICES WHICH ARE NOT CONSIDERED AS AN "EMERGENCY MEDICAL CONDITION" UNDER THE POLICY'S DEFINITION.COMPASSIONATE CARE SHALL BE LIMITED TO "APPROPRIATE HOSPITAL (PHYSICIAN)-BASED MEDICAL SERVICES" AS DEFINED IN THE POLICY. ELECTIVE OR COSMETIC PROCEDURES THAT DO NOT MEET THE DEFINITION OF APPROPRIATE AS SET FORTH IN THE WA ADMINISTRATIVE CODE (WAC) 246-453-010(7) ARE EXCLUDED AS WELL AS PROCEDURES DONE OUTSIDE OF THE HOSPITAL.IN THOSE SITUATIONS, WHERE APPROPRIATE PRIMARY PAYMENT SOURCES ARE NOT AVAILABLE, OR IN CERTAIN SITUATIONS WHEN THE PRIMARY PAYMENT SOURCE LEAVES A BALANCE THAT IS THE PATIENT'S LIABILITY, PATIENTS WILL BE CONSIDERED FOR COMPASSIONATE CARE UNDER THE POLICY.OTHER ELIGIBILITY CRITERIA INCLUDES CIRCUMSTANCES THAT INDICATE SEVERE FINANCIAL HARDSHIP OR PERSONAL LOSS. 2 1 - PROFESSIONAL BUILDING 933 RED APPLE RD WENATCHEE WA 98801 INTERNAL MEDICINE, INFECTIOUS DISEASE, AND WOMEN'S HEALTH 2 - FAMILY PHYSICIANS BUILDING 1215 S MILLER ST WENATCHEE WA 98801 BEHAVIORAL MEDICINE AND FAMILY MEDICINE PART III, LINE 2: NET PATIENT SERVICE REVENUE - THE ASSOCIATION HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS TO THE ASSOCIATION AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. RETROACTIVE ADJUSTMENTS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.PATIENT ACCOUNTS RECEIVABLE - FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 4: ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE ASSOCIATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ASSOCIATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ASSOCIATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ASSOCIATION'S SELF-PAY WRITE-OFFS WERE $7,347,000 AND $6,740,000 FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, RESPECTIVELY. PART III, LINE 8: MEDICARE - INPATIENT ACUTE CARE SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARIES ARE PAID AT PROSPECTIVELY DETERMINED RATES. THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE ASSOCIATION QUALIFIES FOR DISPROPORTIONATE SHARE (DSH) PAYMENTS FROM MEDICARE. THE DSH PAYMENT RATE IS ADDED TO THE PROSPECTIVE RATE FOR EACH INPATIENT DISCHARGE. THE ASSOCIATION IS ELIGIBLE FOR A HIGHER DISPROPORTIONATE SHARE PAYMENT RATE ESTIMATED AT 16.04% IN 2017 AND 15.22% IN 2016. THE ASSOCIATION MET THE CRITERIA FOR THIS ADDITIONAL PAYMENT AS A RESULT OF THE HIGH NUMBER OF LOWINCOME PATIENTS SERVED EXCEEDING THE ELIGIBILITY THRESHOLD OF QUALIFIED PATIENT DAYS AS A PERCENTAGE OF TOTAL PATIENT DAYS. SECTION 3133 OF THE AFFORDABLE CARE ACT AMENDED DSH PAYMENTS EFFECTIVE OCTOBER 1, 2013. WITH THIS CHANGE, THE ASSOCIATION RECEIVES 25 PERCENT OF THE PREVIOUS PAYMENT METHOD ALONG WITH PAYMENTS FOR UNCOMPENSATED CARE BASED ON CHANGES IN THE PERCENTAGE OF INDIVIDUALS THAT ARE UNINSURED. THE UNCOMPENSATED CARE PAYMENTS ARE SET ANNUALLY BY MEDICARE. EACH HOSPITAL ELIGIBLE FOR DSH WILL RECEIVE UNCOMPENSATED CARE PAYMENTS. THE MAJORITY OF OUTPATIENT SERVICES ARE REIMBURSED ON A PROSPECTIVE PAYMENT SYSTEM OR FEE SCHEDULE. THE ASSOCIATION'S MEDICARE COST REPORTS HAVE BEEN AUDITED BY THE MEDICARE ADMINISTRATIVE CONTRACTOR FISCAL INTERMEDIARY THROUGH 2013. NET REVENUE BILLED UNDER THE MEDICARE PROGRAM TOTALED APPROXIMATELY $148,282,000 AND $131,290,000 FOR 2017 AND 2016, RESPECTIVELY. PART III, LINE 9B: IT IS THE POLICY TO WORK WITH PATIENT TO OBTAIN PAYMENT IN FULL, SECURE FINANCIAL ASSISTANCE, OR ESTABLISH APPROPRIATE PAYMENT ARRANGEMENTS ON PATIENT BALANCES WITHIN 30 DAYS OF THE INITIAL STATEMENT DATE. 1. WHEN POSSIBLE THE SCHEDULER, AND/OR RECEPTIONS, WILL ALERT THE PATIENT OF ANY SELF-PAY DEPOSIT, PRE-PAYMENT OR INSURANCE CO-PAYMENT, WHICH MAY BE REQUESTED AT THE TIME OF SERVICE.2. PAYMENT IN FULL ON ALL SELF-PAY BALANCES IS EXPECTED WITHIN 30 DAYS OF RECEIPT OF THE FIRST STATEMENT. THE RESPONSIBILITY FOR PAYMENT REMAINS WITH THE GUARANTOR. THE ASSOCIATION DOES NOT BECOME INVOLVED IN DISPUTES THAT OCCUR AS A RESULT OF DIVORCE SETTLEMENTS, CHILD CUSTODY, AND ACCIDENTAL INJURY OR THIRD PARTY LITIGATION.3. WORKING WITH THE GUARANTOR, THE ASSOCIATION WILL ESTABLISH PAYMENT ARRANGEMENTS WHEN PAYMENT IN FULL CANNOT BE MADE. COLLECTION EFFORTS ARE SUSPENDED WHEN THE GUARANTOR REQUESTS A FINANCIAL ASSISTANCE APPLICATION. THIS SUSPENSION IS IN EFFECT FOR 30 CALENDAR DAYS GIVING THE APPROPRIATE PARTY TIME TO COMPLETE THE APPLICATION AND PROVIDE THE REQUIRED DOCUMENTATION. COLLECTION EFFORTS REMAIN SUSPENDED UNTIL THE FINAL DETERMINATION OF QUALIFICATION IS COMPLETED.4. ALL TRANSACTIONS ARE REQUIRED TO AGE A MINIMUM OF 120 DAYS, ALLOWING FOR 4 STATEMENTS AND AT LEAST 1 LETTER, BEFORE BEING CONSIDERED FOR TRANSFER TO AN OUTSIDE COLLECTION AGENCY.5. IF AN ACCOUNT HAS A MAIL RETURN STATUS AND ALL STEPS TAKEN TO FIND THE ADDRESS WERE UNSUCCESSFUL THE ACCOUNT MAY BE TURNED TO COLLECTION FOR FURTHER RESEARCH. PART VI, LINE 2: CENTRAL WASHINGTON HOSPITAL PARTICIPATED IN A COMMUNITY WIDE NEEDS ASSESSMENT IN COOPERATION WITH COMMUNITY CHOICE HEALTHCARE NETWORK AND CHELAN-DOUGLAS HEALTH DISTRICT. PART VI, LINE 3: COMMUNICATIONS TO THE PUBLIC: INFORMATION ABOUT THE ASSOCIATION'S FINANCIAL ASSITANCE AND CHARITY CARE POLICY ALSO KNOWN AS COMPASSIONATE CARE PROGRAM (CCP) SHALL BE MADE PUBLICLY AVAILABLE AS FOLLOWS:1. A NOTICE ADVISING PATIENTS THAT THE HOSPITAL PROVIDES COMPASSIONATE CARE SHALL BE POSTED IN KEY PUBLIC AREAS OF THE FACILITY.2. THE ASSOCIATION WILL DISTRIBUTE A WRITTEN NOTICE ABOUT THE AVAILABILITY OF COMPASSIONATE CARE TO ALL PATIENTS AT THE TIME OF NEW PATIENT REGISTRATION THROUGH THE EMERGENCY DEPARTMENT AND DURING ADMISSIONS. THIS INFORMATION WILL ALSO BE AVAILABLE ON THE WEBSITE, WITH EACH BILLING STATEMENT, AND IN ANY COLLECTION LETTERS SENT BY THE ASSOCIATION.3. THE WRITTEN NOTICE SHALL BE AVAILABLE IN ANY LANGUAGE SPOKEN BY MORE THAN FIVE PERCENT OF THE POPULATION IN THE ASSOCIATION'S SERVICE AREA, AND INTERPRETED FOR OTHER NON-ENGLISH SPEAKING OR LIMITED-ENGLISH SPEAKING PATIENTS AND FOR OTHER PATIENTS WHO CANNOT UNDERSTAND THE WRITING AND/OR EXPLANATION. THE ASSOCIATION'S SERVICE AREA IS DEFINED AS; CHELAN, DOUGLAS, OKANOGAN AND GRANT COUNTIES. THE ASSOCIATION FINDS THAT FOLLOWING NO-ENGLISH TRANSLATION(S) OF THE NOTICE SHALL BE MADE AVAILABLE: SPANISH.4. THE ASSOCIATION WILL REFER ALL COMPASSIONATE CARE INQUIRIES TO THE FINANCIAL ASSISTANCE DEPARTMENT OR WHEN POSSIBLE DIRECTLY TO THE COMPASSIONATE CARE COORDINATOR SO THAT ALL CONCERNS CAN BE ADDRESSED IN A TIMELY MANNER.5. WRITTEN NOTICE ABOUT THE ASSOCIATION'S COMPASSIONATE CARE POLICY SHALL BE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION, EITHER BY MAIL, BY TELEPHONE OR IN PERSON. THE ASSOCIATION'S COMPASSIONATE CARE SLIDING SCALE DISCOUNT TABLE SHALL ALSO BE MADE AVAILABLE UPON REQUEST. PART VI, LINE 4: THE ASSOCIATION IS ACCREDITED BY DNV GL HEALTHCARE AND OPERATES A LICENSED 198-BED ACUTE CARE HOSPITAL DELIVERING A FULL RANGE OF HEALTH CARE SERVICES IN WENATCHEE, WASHINGTON, AND THE NORTH CENTRAL WASHINGTON AREA. THE ASSOCIATION IS A NOT-FOR-PROFIT INSTITUTION GOVERNED BY A BOARD OF DIRECTORS, PROVIDING GENERAL INPATIENT SERVICES INCLUDING MEDICAL, SURGICAL, HOME INFUSION SERVICES, INTENSIVE CARE AND CORONARY CARE, NEONATAL INTENSIVE CARE, PEDIATRICS, OBSTETRICS, GYNECOLOGY, AND ONCOLOGY. THE ASSOCIATION IS A FEDERAL REGIONAL REFERRAL CENTER, AND IS DESIGNATED BY THE STATE AS A LEVEL III GENERAL TRAUMA CENTER AND LEVEL III PEDIATRIC TRAUMA CENTER, SUPPORTED BY A COMPREHENSIVE RANGE OF SURGICAL PROCEDURES IN ORTHOPEDIC, NEUROSURGERY, VASCULAR SURGERY, INTERVENTIONAL CARDIAC CATHETERIZATION, AND OPEN-HEART SURGERY.WENATCHEE, WASHINGTON IS APPROXIMATELY 150 MILES EAST OF SEATTLE, WASHINGTON AND 170 MILES WEST OF SPOKANE, WASHINGTON. CHELAN AND DOUGLAS COUNTIES COMPRISE THE ASSOCIATION'S PRIMARY SERVICE AREA WHILE GRANT AND OKANOGAN COUNTIES REPRESENT SECONDARY SERVICE AREAS. APPROXIMATELY 96% OF THE ASSOCIATION'S PATIENT ADMISSIONS ARE FROM THE PRIMARY AND SECONDARY SERVICE AREAS. THE SERVICE AREA'S POPULATION IS HEAVILY WEIGHTED IN THE 65+ AGE COHORT. IN ADDITION, THE ASSOCIATION HAS A HIGH CONCENTRATION OF FARM AND AGRICULTURE RELATED EMPLOYERS/EMPLOYEES. PART VI, LINE 5: CENTRAL WASHINGTON HOSPITAL'S GOVERNING BOARD IS COMPRISED OF LOCAL AREA RESIDENTS. THE HOSPITAL EXTENDS ITS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. CWH USES ITS INCOME TO UPDATE EQUIPMENT, TECHNOLOGY AND FACILITIES TO IMPROVE PATIENT CARE. THE HOSPITAL OFFERS EDUCATION FOR AREA PHYSICIANS AND COMMUNITY MEMBERS. ALSO AVAILABLE TO PHYSICIANS AND THE COMMUNITY IS THE HEMINGER HEALTH LIBRARY. WE COLLABORATE WITH MANY LOCAL AND STATE COLLEGES, UNIVERSITIES, AND OUR LOCAL HIGH SCHOOL IN SUPPORT OF STUDENT LEARNING OPPORTUNITIES. AN ELECTRONIC MEDICAL RECORD WAS IMPLEMENTED. IT GIVES OUR PROVIDERS ALL THE MEDICAL INFORMATION NEEDED TO MAKE THE BEST DECISIONS IN THE CARE OF OUR PATIENTS. THE HOSPITAL IS A FEDERAL REGIONAL REFERRAL CENTER AND A LEVEL III GENERAL AND PEDIATRIC TRAUMA CENTER. PART VI, LINE 6: CONFLUENCE HEALTH WAS FORMED IN 2012 AS A HEALTH SYSTEM THAT REPRESENTS AN AFFILIATION BETWEEN THE ASSOCIATION AND WENATCHEE VALLEY MEDICAL GROUP (A FOR-PROFIT ORGANIZATION) AND WENATCHEE VALLEY HOSPITAL. EFFECTIVE JANUARY 1, 2013, THE ASSOCIATION AFFILIATED WITH CONFLUENCE HEALTH, AND CONFLUENCE HEALTH BECAME THE SOLE MEMBER OF THE ASSOCIATION. THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH CONSISTS OF 9 COMMUNITY MEMBERS AND 6 PHYSICIANS OF WENATCHEE VALLEY MEDICAL GROUP. THE MISSION STATEMENT OF CONFLUENCE HEALTH IS: WE ARE DEDICATED TO IMPROVING OUR PATIENT'S HEALTH BY PROVIDING SAFE, HIGH-QUALITY CARE IN A COMPASSIONATE AND COST EFFECTIVE MANNER. 1 UNITED WAY PO BOX 488 WENATCHEE WA 98807 910657766 501(C)(3) 14403 GENERAL SUPPORT 1 PART I, LINE 2: OUTSIDE ORGANIZATIONS SUBMIT REQUESTS TO THE ORGANIZATION THROUGHOUT THE YEAR. THE REQUESTS ARE SEPARATED BASED ON THE MONETARY VALUE REQUESTED. EACH REQUEST REQUIRES SUPPORT FROM THE REQUESTING ORGANIZATION AS TO THE PURPOSE/USE OF THE FUNDS AND WHETHER THE REQUEST BENEFITS THE COMMUNITY. TWO COMMITTEES REVIEW THE REQUESTS BASED ON THE MONETARY VALUE OF THE REQUEST. X X X 0 0 0 0 0 1 1 0 0 PETER RUTHERFORD MD CHIEF EXECUTIVE OFFICER 0 584866 0 55133 0 0 0 29350 0 17584 0 686933 0 0 JOHN R DOYLE CHIEF FINANCIAL OFFICER 0 392854 0 37804 0 7785 0 25375 0 19164 0 482982 0 0 GLENN W ADAMS SR VP ANCILLARY SERVICES 0 228113 0 22107 0 0 0 23553 0 21038 0 294811 0 0 JEANINE M ALLEN SR VP SPECIALTY CARE 0 209508 0 20149 0 4142 0 25200 0 17477 0 276476 0 0 JAY H JOHNSON SR VP NETWORK STRATEGY 0 302632 0 29160 0 9002 0 29350 0 21038 0 391182 0 0 TRACEY A KASNIC RN SR VP INPATIENT & CNO 0 297421 0 28471 0 11718 0 25375 0 17584 0 380569 0 0 PETER N LOLOS SR VP FACILITY & SUPT SRV 0 212643 0 20149 0 8284 0 25637 0 9211 0 275924 0 0 JEANETTE WOOD SR VP PRIMARY CARE 0 210154 0 20149 0 0 0 24783 0 17477 0 272563 0 0 VIKKI L NOYES CHIEF OPERATING OFFICER 0 382760 0 36795 0 0 0 21400 0 15434 0 456389 0 0 ROBERT J PAGELER CHIEF INFORMATION OFFICER 0 277482 0 27032 0 11124 0 21400 0 19518 0 356556 0 0 JAMES B WOOD CHIEF ADMIN OFFICER 0 313157 0 30136 0 6203 0 21400 0 21038 0 391934 0 0 STUART D FREED MD CHIEF MEDICAL OFFICER 0 450633 0 40984 0 0 0 31338 0 21519 0 544474 0 0 STEPHEN J FORD NURSE - PR13 156310 0 75 0 0 0 12990 0 19164 0 188539 0 0 0 MICHAEL D SIEG EHR/EPIC PROGRAM DIRECTOR 183808 0 3730 0 0 0 7553 0 7684 0 202775 0 0 0 CYNTHIA S POTTS PHARMACY RETAIL MANAGER 149351 0 3571 0 5771 0 10768 0 9265 0 178726 0 0 0 SAMUEL L SCHULTE PHARMACIST 155226 0 716 0 5835 0 12770 0 7648 0 182195 0 0 0 DANUTE O SLAPSYS PHARMACIST 161657 0 713 0 0 0 10513 0 7684 0 180567 0 0 0 JOHN B HAMILTON FORMER COO OF CH 0 0 0 0 0 185288 0 0 0 0 0 185288 0 185288 PART I, LINE 6 EVERY PAY PERIOD, THE EMPLOYER CONTRIBUTES THE MATCH PERCENTAGE PER THE PLAN DOCUMENT INTO THE EMPLOYEES' RETIREMENT ACCOUNT. ANNUALLY, THE BOARD DETERMINES BASED ON FINANCIAL RESULTS IF AN ADDITIONAL (OR DISCRETIONARY) AMOUNT WILL BE CONTRIBUTED TO THE EMPLOYEES' ACCOUNTS. THE PERCENTAGE IS BASED ON EMPLOYEE CLASSIFICATION AND LENGTH OF SERVICE. THE DECISION IS BASED ON MEETING ORGANIZATIONAL GOALS, AND ONE OF THOSE GOALS IS THE COMBINED OPERATING MARGIN OF THE THREE CONFLUENCE HEALTH SYSTEM ORGANIZATIONS: CONFLUENCE HEALTH, CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, AND WENATCHEE VALLEY HOSPITAL. PART II: COMPENSATION FOR DR. STUART FREED IS REVIEWED, APPROVED, AND PAID BY AN UNRELATED THIRD PARTY, WENATCHEE VALLEY MEDICAL GROUP, FOR SERVICES PERFORMED FOR CONFLUENCE HEALTH. COMPENSATION PAID IN 2017 WAS $555,273. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978E4M1 2009-08-12 114560771 CONSTRUCTION OF HEALTHCARE FACILITY 1 0 0 B WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93978HPZ2 2015-05-05 109863859 CONSTRUCTION OF HEALTHCARE FACILITY 0 0 0 A 114560771 114560771 4670405 7667467 2145873 88211125 11865901 2011 0 1 1 1 B 7280000 109863859 2713618 103477535 1391468 2281238 0 1 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 A 1 0 0 1 1 0 1 B 0 1 0 0 0 0 0 0 1 A 0 B 0 FORM 990, SCHEDULE K, PART III, LINE 9 THE ORGANIZATION HAS ESTABLISHED PROCEDURES TO ENSURE THAT ANY NONQUALIFIED BONDS ARE REMEDIATED IN ACCORDANCE WITH REQUIREMENTS. THE ORGANIZATION IS CURRENTLY IN THE PROCESS OF FORMALLY PUTTING THESE PROCEDURES IN WRITING. FORM 990, SCHEDULE K, PART IV, LINE 5B AND 5C, COLUMN A: NAME OF PROVIDER OF GIC, LINE 5B: RBC CAPITAL MARKETS LINE 5C: 10 YEARS FORM 990, PART VI, SECTION A, LINE 2 CONFLUENCE HEALTH AND AFFILIATES SHARE THE SAME BOARD AS PART OF THE OPERATING STRUCTURE. AS SUCH, ALL BOARD MEMBERS SERVE WITH EACH OTHER IN A SIMILAR CAPACITY ON RELATED ORGANIZATIONS. ADDITIONALLY, SOME BOARD MEMBERS ARE MINORITY OWNERS IN AN ENTITY THAT HAS A PROFESSIONAL SERVICE AGREEMENT WITH THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 3 CENTRAL WASHINGTON HOSPITAL HAS A MANAGEMENT SERVICES ARRANGEMENT WITH CONFLUENCE HEALTH, AN AFFILIATED ORGANIZATION EXEMPT UNDER SECTION 501(C)(3) AS A SUPPORTING ORGANIZATION. THIS AGREEMENT PROVIDES FOR SHARED USE OF FACILITIES, OFFICER, EMPLOYEES, SUPPLIES AND OTHER ITEMS. THE COMPENSATION REPORTED IN PART VII IS PAID BY CONFLUENCE HEALTH UNDER THIS ARRANGEMENT. FORM 990, PART VI, SECTION A, LINE 6 CONFLUENCE HEALTH, A NON-PROFIT CORPORATION ORGANIZED AND EXISTING PURSUANT TO CHAPTER 24.03 OF THE REVISED CODE OF WASHINGTON, WHICH IS KNOWN AS CONFLUENCE HEALTH AND IS THE PARENT ENTITY OF THE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7A UPON THE EXPIRATION OF THE TERM OF OFFICE OF ANY BOARD MEMBER, INCLUDING EACH OF THE INITIAL BOARD MEMBERS SET FORTH IN THE BYLAWS, THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH SHALL SELECT THE PERSON WHO SHALL FILL THE POSITION OF THE BOARD MEMBER WHOSE TERM IS EXPIRING, SUBJECT TO THE COMPOSITION REQUIREMENTS FOR THE BOARD OF DIRECTORS AS SET FORTH IN THE BYLAWS. THE PERSONS SELECTED BY THE BOARD OF DIRECTORS OF CONFLUENCE HEALTH TO FILL THE POSITION OF THE BOARD MEMBER WHOSE TERM IS EXPIRING SHALL BE OF THE HIGHEST COMPETENCE AND QUALITY WHO ARE WITHOUT CONFLICTS WITH CENTRAL WASHINGTON HOSPITAL THAT WOULD PROHIBIT THEIR SERVING IN ACCORDANCE WITH THE BYLAWS AND TAX OR OTHER REGULATORY REQUIREMENTS. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 AND SCHEDULE B, IF ANY, IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND VICE PRESIDENT OF FINANCE. SUBSEQUENT TO THIS REVIEW THE FORM 990 AND SCHEDULE B IS REVIEWED BY THE GOVERNING BOARD BEFORE BEING FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS, EXECUTIVE TEAM MEMBERS, AND DIRECTORS ARE REQUIRED TO REVIEW THE CURRENT CONFLICT OF INTEREST POLICY AND COMPLETE AN ANNUAL QUESTIONNAIRE. THE NOMINATING COMMITTEE OF THE BOARD REVIEWS QUESTIONNAIRES OF EXISTING AND NEW MEMBERS FOR POTENTIAL CONFLICTS OF INTEREST. ANY POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED BY THE NOMINATING COMMITTEE. THE EXECUTIVE TEAM REVIEWS QUESTIONNAIRES SUBMITTED BY EXECUTIVE TEAM MEMBERS AND DIRECTORS FOR POTENTIAL CONFLICTS OF INTEREST. POTENTIAL CONFLICTS OF INTEREST ARE RESOLVED BY THE EXECUTIVE TEAM IN COLLABORATION WITH THE CORPORATE COMPLIANCE OFFICER. REVIEW OF ALL CONFLICT OF INTEREST STATEMENTS IS NOTED WITHIN THE BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 CENTRAL WASHINGTON HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CONFLUENCE HEALTH 1201 SOUTH MILLER STREET WENATCHEE WA 98801 454789950 HEALTH SYSTEM WA 501(C)(3) LINE 12C, III-FI N/A 0 WENATCHEE VALLEY HOSPITAL 820 NORTH CHELAN AVE WENATCHEE WA 98801 455563741 HOSPITAL WA 501(C)(3) LINE 3 CONFLUENCE HEALTH 0 0 0 0 1 0 0 1 1 0 1 0 0 1 1 0 1 0 0 0