2018-08-14T16:53:19-05:00 2017-09-30 930623286 ALDRICH CPAS AND ADVISORS LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2016-10-01 931213059 ASHLAND COMMUNITY HEALTH SERVICES DBA ASHLAND COMMUNITY HOSPITAL ASHL 5417894549 2650 SISKIYOU BLVD MEDFORD OR 97504 GREG WOJTAL CFO 5417894549 2018-08-08 1 JOYLYN M ANKENEY CPA P00366587 5036204489 2018-08-07 2016 2022-09-23 18:48:47Z X GREG WOJTAL 2650 SISKIYOU BLVD MEDFORD OR 97504 62422074 0 X WWW.ASANTE.ORG X 1996 OR ASANTE ASHLAND COMMUNITY HOSPITAL EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES IT SERVES. X 13 11 260 11 0 0 113872 148046 57932605 61110818 862 684 1311200 1162526 59358539 62422074 12093 45646 0 0 28595512 23538823 0 0 0 24955496 28742229 53563101 52326698 5795438 10095376 33168831 0 31212568 0 1956263 0 ASANTE ASHLAND COMMUNITY HOSPITAL EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES IT SERVES. 0 0 43947206 45646 62273344 ASHLAND COMMUNITY HEALTHCARE SERVICES GREATEST PROGRAM SERVICE ACCOMPLISHMENT IS THE OPERATION OF ASANTE ASHLAND COMMUNITY HOSPITAL(AACH), A 49 LICENSED BED NOT-FOR-PROFIT HOSPITAL LOCATED IN ASHLAND, OREGON. DURING THE PERIOD OF OCTOBER 1 2016 TO SEPTEMBER 30, 2017, AACH ADMITTED 1,688 INPATIENTS FOR A TOTAL OF 5,338 PATIENT DAYS. IT ALSO HAD 533 INPATIENT SURGERIES AND DELIVERED 271 BABIES. THE OUTPATIENT DEPARTMENTS ALSO PERFORMED 1,944 OUTPATIENT SURGERIES AND 8,463 HOME HEALTH VISITS. ADDITIONALLY, THERE WERE 10,000 EMERGENCY ROOM VISITS, 18,019 RADIOLOGY STUDIES AND 5,028 WOUND CLINIC TREATMENTS. 43947206 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 36 0 1 260 1 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OR X X GREG WOJTAL 5417894549 2650 SISKIYOU BLVD MEDFORD OR 97504 STEPHEN D ROE CURRENT CHAIR 2.00 X 0 0 0 THOMAS R MCGILLOWAY BOARD MEMBER 2.00 X 0 0 0 RAY A COX TREASURER 2.00 X 0 0 0 PETER ANGSTADT BOARD MEMBER 2.00 X 0 0 0 ANNE GOLDEN SECRETARY 2.00 X 0 0 0 RONALD JONES MD BOARD MEMBER 2.00 X 0 0 0 DOUGLASS SCHMOR VICE CHAIR 2.00 X 0 0 0 THOMAS M TUREK MD BOARD MEMBER 2.00 X 0 0 0 ROY G VINYARD ASANTE CEO 2.00 40.00 X X 0 1076322 235257 KEN TRAUTMAN BOARD MEMBER 2.00 X 0 0 0 SANDRA SLATTERY BOARD MEMBER 2.00 X 0 0 0 LEE MILLIGAN MD BOARD MEMBER 1.00 40.00 X 0 333908 64900 LINDA GANIM BOARD MEMBER 2.00 X 0 0 0 SHEILA CLOUGH ASHLAND CEO 40.00 X 347099 0 115326 PATRICK HOCKING ASANTE CFO 1.00 40.00 X 0 656449 244142 SUSAN MONTGOMERY VP PATIENT CARE 40.00 X 224447 0 96183 DENESE CROSBIE CLINICAL MANAGER 40.00 X 142889 0 45510 MICHAEL TONER PHARMACY MANAGER 40.00 X 152234 0 60032 ROB HIBNER DIRECTOR ANCILLARY SERVICES 40.00 X 134058 0 31061 BRENDA KIZZIRE PHYSICAL THERAPIST 40.00 X 126517 0 40041 1127244 2066679 932452 20 0 1 0 ASHLAND ANESTHESIA ASSOCIATES 638 MAIN STREET ASHLAND OR 97520 PHYSICIAN SERVICES 170001 SOUTHERN OREGON CARDIOLOGY 520 MEDICAL CENTER DR STE 200 MEDFORD OR 97504 PHYSICIAN SERVICES 152210 DIVERSIFIED CLINICAL SERVICES 28525 NETWORK PLACE CHICAGO IL 60673 WOUND CARE MANAGEMENT 123622 3 148046 148046 HOSPITAL SERVICES 621990 61110818 61110818 61110818 684 684 OTHER REVENUE 900099 855821 855821 CAFETERIA 722210 226489 226489 SISKIYOU IMAGING 621990 80216 80216 1162526 62422074 62273344 0 684 45646 45646 347010 173505 173505 20116986 18390296 1726690 1662424 1519734 142690 1412403 1291173 121230 7326 7326 5625 5625 748558 374279 374279 955882 477941 477941 699323 629391 69932 70219 56175 14044 1325016 1192514 132502 9171226 4585613 4585613 2352687 2117418 235269 315331 283798 31533 PATIENT SUPPLIES 10263953 10263953 PURCHASED SERVIVES 1585706 1427135 158571 REPAIRS AND MAINTENANCE 1140382 1026344 114038 OTHER OPERATING EXPENSE 79230 71307 7923 21765 20984 781 52326698 43947206 8379492 0 1644181 0 0 0 5476277 0 0 0 449386 0 373870 0 126543 0 0 24933192 0 0 0 0 0 165382 0 33168831 0 4023611 27188957 0 31212568 0 X 1946524 0 9739 0 1956263 0 33168831 0 X 10095376 -12051639 X 0 1 X 0 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 2925 0 0 1 2700 5625 0 PART II-B, LINE 1: ASHLAND HOSPITAL MAINTAINS MEMBERSHIPS IN THE AMERICAN HOSPITAL ASSOC (AHA) AND OREGON ASSOC OF HOSPITALS AND HEALTHCARE SYSTEMS (OAHHS). DURING TAX YEAR 2016, ASHLAND HOSPITAL PAID MEMBERSHIP DUES TO THE AHA AND OAHHS OF $4,190 AND $10,668 RESPECTIVELY 18.39% OF OAHHS DUES AND 22.98% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, ASHLAND HOSPITAL MADE INDIRECT LOBBYING EXPENDITURES OF $2,925 THROUGH ITS MEMBERSHIP DUES. ALSO, ASHLAND HOSPITAL PAID JOHN WATT AND ASSOCIATES (JWA) $2,700 FOR SPECIFIC ISSUES LOBBYING DURING THE TAX YEAR. JWA IS AN ADVOCATE FOR ASANTE AND SPECIALIZES IN BALLOT PROPOSITIONS AFFECTING THE HEALTHCARE INDUSTRY. 0 X PART X, LINE 2: FIN 48 FOOTNOTE. THE FINANCIAL STATEMENTS AND SCHEDULES OF ASANTE PHYSICIAN PARTNERS ARE AUDITED BY THE ACCOUNTING FIRM OF KPMG. THEY ARE COMPILED ON A CONSOLIDATED BASIS ALONG WITH OTHER ASANTE AFFILITATES. IT IS OF THE OPINION OF BOTH THE MANAGEMENT OF ASANTE PHYSICIAN PARTNERS AND KPMG THAT NO UNCERTAIN TAX POSITIONS WERE TAKEN DURING THE FISCAL YEAR. THIS OPINION IS STATED IN THE FOOTNOTES OF THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS. PART XII LINE 2B IT IS THE OPINION OF BOTH THE MANAGEMENT OF ASHLAND HOSPITAL AND KPMG THAT NO UNCERTAIN TAX POSITIONS WERE TAKEN DURING THE FISCAL YEAR. THIS OPINION IS STATED IN THE FOOTNOTES OF THE AUDITED CONSOLIDATED FINANCIAL STATMENTS. 1 1 1 X 1 X 1 1 0 1 1 10330 863773 863773 0.01650 0 0 616 1379083 1089484 289599 0.00550 10946 2242856 1089484 1153372 0.02200 14 940 363009 131740 231269 0.00440 10 205 169759 0 169759 0.00320 2 588542 100362 488180 0.00930 0 0 12 604 89473 0 89473 0.00170 38 1749 1210783 232102 978681 0.01860 38 12695 3453639 1321586 2132053 0.04060 2 3572 1072 2500 0.00000 2 65 2326 0 2326 0.00000 4 65 5898 1072 4826 0.00000 1 0 0 12988889 16944228 -3955339 X 1 1 1 SISKIYOU IMAGING IMAGING SERVICES 0.33000 0.33000 1 1 ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET ASHLAND OR 97520 WWW.ASHLANDHOSPITAL.ORG 14-1445 X X X ASHLAND COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.ASANTE.ORG/APP/FILES/PUBLIC/2053/2016-COMMUNITY-HEALTH-NEEDS-ASS X 1 16 1 HTTP://WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X X 1 1 X X X 1 X HTTP://WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X HTTP://WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X HTTP://WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X X X X X X 1 0 1 X 0 0 ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT'S REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE AND ASHLAND COMMUNITY HOSPITAL PARTNERED WITH PROFESSIONAL RESEARCH CONSULTANTS, INC. TO COMPLETE 600 COMMUNITY SURVEYS IN FISCAL YEAR 2017. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 7 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: ROGUE REGIONAL MEDICAL CENTER OF MEDFORD, OREGONTHREE RIVERS MEDICAL CENTER OF GRANTS PASS, OREGON ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: ACCESSALLCAREALLIED SOLUTIONSASHLAND EMERGENCY FOOD BANKASHLAND FIRE & RESCUEASHLAND GRACE POINT CHURCHASHLAND HIGH SCHOOLASHLAND SCHOOL DISTRICTBOYS & GIRLS CLUBS OF THE ROGUE VALLEYCASA OF JACKSON AND JOSEPHINE COUNTIESCENTRAL POINT SCHOOL DISTRICT 6CHILDREN'S ADVOCACY CENTER OF JACKSON COUNTYCITY COUNCILCITY OF ASHLANDCITY OF EAGLE POINTCITY OF JACKSONVILLECITY OF MEDFORDCITY OF TALENTCOMMUNITY VOLUNTEER NETWORKCOMPASS HOUSE EASTWOOD BAPTIST CHURCH FOOD & FRIENDS: MEALS ON WHEELSGORDON ELWOOD FOUNDATION GRANTS PASS CITY COUNCIL GRANTS PASS DAILY COURIER GRANTS PASS DEPARTMENT OF PUBLIC SAFETY GRANTS PASS FAMILY YMCA GRANTS PASS FIRE RESCUE GRANTS PASS SCHOOL DISTRICT GRANTS PASS SCHOOL DISTRICT 7 HABITAT FOR HUMANITY HEARTS WITH A MISSION HIGHLAND ELEMENTARY SCHOOL HOUSING AUTHORITY OF JACKSON COUNTY JACKSON CARE CONNECT JACKSON COUNTY BOARD OF COMMISSIONERS JACKSON COUNTY HEALTH AND HUMAN SERVICES JACKSON COUNTY LIBRARY JACKSON COUNTY MENTAL HEALTH JACKSON COUNTY PUBLIC HEALTH JEFFERSON REGIONAL HEALTH ALLIANCE JEROME PRAIRIE BIBLE CHURCH JOSEPHINE COUNTY JOSEPHINE COUNTY BOARD OF COMMISSIONERS JOSEPHINE COUNTY FOUNDATION JOSEPHINE COUNTY PUBLIC HEALTH JOSEPHINE COUNTY SCHOOL SYSTEM JOSEPHINE HOUSING COUNCIL JWA PUBLIC AFFAIRS KAIROS KTVL TV LA CLINICALAW ENFORCEMENTLINCOLN ELEMENTARY SCHOOL MAIL TRIBUNE MASLOW PROJECT MEDFORD FIRE-RESCUE MEDFORD PARKS AND RECREATION MEDFORD POLICE DEPARTMENT MEDFORD SCHOOL DISTRICT MERCY FLIGHTS MOUNT ASHLAND ASSOCIATION NAMI NORTH MEDFORD HIGH SCHOOL ONTRACK, INC. OPTIONS FOR SOUTHERN OREGON OREGON COMMUNITY FOUNDATION OREGON HEALTH AUTHORITY OREGON SHAKESPEARE FESTIVAL OSU EXTENSION SERVICES OUR LADY OF THE MOUNTAIN CATHOLIC CHURCH PRIMECARE, INC. ROGUE COMMUNITY COLLEGE ROGUE COMMUNITY HEALTH ROGUE VALLEY COUNCIL OF GOVERNMENTS ROGUE VALLEY FAMILY YMCA ROGUE VALLEY METROPOLITAN PLANNING ORGANIZATION SISKIYOU COMMUNITY HEALTH CENTER SOREDI (SOUTHERN OREGON REGIONAL ECONOMIC DEVELOPMENT, INC.) SOUTHERN OREGON GOODWILL INDUSTRIES ST. MARY'S SCHOOLCOMMUNICATION STRATEGIES THE ARC OF JACKSON COUNTY THE CHAMBER OF MEDFORD/JACKSON COUNTY THE SALVATION ARMY, MEDFORD UNITED COMMUNITY ACTION NETWORK UCANUNITED WAY OF JACKSON COUNTY WORKSOURCE ROGUE VALLEY ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: IDENTIFIED HEALTH NEEDS THE TOP TWELVE HEALTH NEEDS IDENTIFIED BY BOTH SURVEY AND FOCUS GROUP PARTICIPANTS ARE:1. ACCESS TO HEALTH CARE SERVICES 2. MENTAL HEALTH & SUBSTANCE ABUSE 3. HEART DISEASE AND STROKE 4. INFANT HEALTH AND FAMILY PLANNING 5. DIABETES 6. NUTRITION 7. RESPIRATORY DISEASES 8. CANCER 9. DISABILITY AND HEALTH 10. INJURY AND VIOLENCE PREVENTION 11. TOBACCO USE 12. DEMENTIAS, INCLUDING ALZHEIMER'S DISEASEIMPLEMENTATION STRATEGYEACH OF THE INITIATIVES AND ACTIONS BELOW AS THEY RELATE TO THE TOP 12 COMMUNITY HEALTH NEEDS (ONLY 8 ARE LISTED DUE TO SPACE CONSTRAINTS) CATEGORIES AS IDENTIFIED IN THE CHNA WILL BE FULFILLED OR IMPLEMENTED BY: - ASANTE - ASANTE ASHLAND COMMUNITY HOSPITAL (AACH) - ASANTE ROGUE REGIONAL MEDICAL CENTER (ARRMC) - ASANTE THREE RIVERS MEDICAL CENTER (ATRMC) - ASANTE PHYSICIAN PARTNERS (APP) 1. ACCESS TO HEALTH CARE SERVICES CURRENT: - INCREASED THE NUMBER OF APP PROVIDERS - HIRED CERTIFIED APPLICATION COUNSELORS TO HELP INCREASE ACCESS TO CARE FOR OHP PATIENTS - OPENED THE TRANSITIONAL CARE CLINIC AT ATRMC - ADDED AN URGENT CARE LOCATION IN MEDFORD - SPONSORED ROGUE COMMUNITY COLLEGE HEALTH PROFESSIONALS CURRICULUM PROGRAMS FOR STUDENTS - PROVIDED FUNDING FOR THE SCHOOL NURSE PROGRAM IN THE ASHLAND AND PHOENIX-TALENT SCHOOL DISTRICTS - ADDED DISCHARGE PLANNERS AND CASE MANAGERS AT ARRMC TO REDUCE READMISSION RATES - IMPLEMENTED A NURSE TRIAGE PROGRAM AT THE CONTACT CENTER FOR SELECT APP CLINICS - ADDED 24/7 ACCESS TO TELE-INTENSIVISTS FOR ICU PATIENTS AT ATRMC AND AACH - SPONSORED THE HOLMES PARK HOUSE HOSPICE CARE FACILITY - SPONSORED THE ST. VINCENT DE PAUL DENTAL VAN- SPONSORED THE ROGUE VALLEY SOROPTIMIST WINE WALK FOR WOMEN'S HEALTH TO BENEFIT PREVENTION, DETECTION, TREATMENT AND SUPPORT SERVICES FOR UNINSURED AND UNDER-INSURED WOMEN AND CHILDREN FUTURE: - EXPAND THE USE OF TELEMEDICINE CAPABILITIES FOR APP PROVIDERS - RECRUIT AND HIRE ADDITIONAL APP PROVIDERS - OPEN AN URGENT CARE CLINIC IN WHITE CITY AND EXPLORE URGENT CARE OPPORTUNITIES IN CENTRAL POINT - OPEN ADDITIONAL RETAIL HEALTH CARE CLINICS WITHIN ASANTE'S SERVICE AREA - EXPAND THE NURSE TRIAGE PROGRAM FOR ALL APP PRIMARY CARE CLINICS 2. MENTAL HEALTH & SUBSTANCE ABUSE CURRENT: - ADDED FOUR BEHAVIORAL HEALTH "SWING" ROOMS IN THE ARRMC EMERGENCY DEPARTMENT - REMODELED AND ADDED ONE ROOM TO THE PSYCHIATRIC CRISIS UNIT IN THE ARRMC EMERGENCY DEPARTMENT TO ACCOMMODATE PATIENTS OF ALL AGES - ADOPTED THE TRAUMA-INFORMED CARE MODEL - CREATED THE COMFORT ROOM IN THE BEHAVIORAL HEALTH UNIT AT ARRMC - PAINTED THE PSYCHIATRIC CARE ROOMS AT ATRMC TO A MORE SOOTHING COLOR - INCREASED THE NUMBER OF APP BEHAVIORAL HEALTH STAFF MEMBERS - ADDED LICENSED CLINICAL SOCIAL WORKERS TO APP FAMILY PRACTICE CLINICS AS PART OF THE MEDICAL HOME MODEL OF CARE - PROVIDED FINANCIAL SUPPORT TO COMPASS HOUSE FOR TRANSITIONAL CARE FROM HOSPITAL TO HOME - SPONSORED THE NATIONAL ALLIANCE ON MENTAL ILLNESS MARCH 4 HOPE, REESTABLISHING ASANTE'S RELATIONSHIP WITH NAMI OF SOUTHERN OREGON - PARTNERED WITH NAMI OF SOUTHERN OREGON TO CREATE A QUARTERLY COMMUNITY MENTAL HEALTH LECTURE SERIES - PROVIDED FINANCIAL COMMITMENT TO SUPPORT THE CRISIS RESOLUTION CENTER IN MEDFORD - PROVIDED ONGOING FINANCIAL SUPPORT FOR THE GRANTS PASS SOBERING CENTER - PROVIDED FINANCIAL SUPPORT FOR ADDICTIONS RECOVERY CENTER'S MEDICALLY-MONITORED DETOXIFICATION CENTER - PARTNERED WITH ASHLAND POLICE DEPARTMENT, ON TRACK AND AACH TO CREATE A DRUG-SURRENDER PROGRAM FOR PEOPLE WITH CHEMICAL DEPENDENCY FUTURE: - RENOVATE THE BEHAVIORAL HEALTH UNIT AND INCREASE THE NUMBER OF BEDS FROM 18 TO 24 - OFFER TELEMEDICINE CONSULTS AND EVALUATIONS FOR MENTAL HEALTH PATIENTS 3. HEART DISEASE AND STROKE CURRENT: - PRIMARY FINANCIAL SPONSOR OF THE PULSEPOINT HEART ATTACK NOTIFICATION APP IN JACKSON AND JOSEPHINE COUNTIES - ESTABLISHED A CO-MANAGEMENT AGREEMENT WITH SOUTHERN OREGON CARDIOLOGY - REDUCED CLINICAL VARIATION AND STANDARDIZED SUPPLY COSTS IN THE CATH LAB AT ARRMC - PARTNERED WITH OHSU FOR TELESTROKE AT ATRMC - RECEIVED ACUTE STROKE READY CERTIFICATION AT ATRMC BY OUR ACCREDITING AGENCY, DNV GL (DET NORSKE VERITAS GERMANISCHER LLOYD) - PROMOTED NATIONAL HEART MONTH ACTIVITIES AND EDUCATION - SUPPORTED MENDED HEARTS PEER-TO-PEER SUPPORT GROUP - REINSTATED SEVERAL CATH LABS AT ARRMC TO ACCOMMODATE INCREASED PATIENT VOLUMES - ADDED A TRANSCATHETER AORTIC VALVE REPLACEMENT PROGRAM AT ARRMC AS LEADING EDGE HEART CARE FOR PATIENTS - EXPANDED THE SCOPE OF CARDIAC REHABILITATION SERVICES AT ARRMC SPONSORED THE AMERICAN COLLEGE OF CARDIOLOGY OREGON CARDIOVASCULAR SYMPOSIUM AND NURSING HEART FAILURE CONFERENCE - CONSISTENTLY MET QUALITY AND SAFETY CRITERIA TO BE AWARDED THE AMERICAN HEART ASSOCIATION MISSION: LIFELINE RECEIVING CENTER GOLD PLUS RECOGNITION - CONSISTENTLY MET QUALITY AND SAFETY CRITERIA TO BE AWARDED THE AMERICAN HEART ASSOCIATION MISSION: LIFELINE GOLD PLUS STEMI RECOGNITION FUTURE: - SUPPORT THE RECRUITMENT OF ADDITIONAL NEUROSURGEONS TO SOUTHERN OREGON - ATTAIN LEVEL II TRAUMA CENTER STATUS AT ARRMC 4. INFANT HEALTH AND FAMILY PLANNING CURRENT: - HIRED MATERNAL FETAL MEDICINE PROVIDERS - CREATED A MIDWIFERY PROGRAM AT APP AND AACH - MAINTAINED THE ONLY REGIONAL NEONATAL INTENSIVE CARE UNIT (NICU) - PURCHASED AN ISOLETTE TRANSPORTER FOR FRAGILE INFANTS - HIRED SIX PEDIATRIC HOSPITALISTS - DEVELOPED A FORMAL PEDIATRIC HOSPITALIST PROGRAM - HIRED A PEDIATRIC ONCOLOGIST - RENOVATED THE PEDIATRIC UNIT AT ARRMC - PARTNERED WITH OHSU TO PROVIDE TELEMEDICINE FOR PEDIATRIC INPATIENTS - IMPLEMENTED OHSU ROTATING CLINICS FOR PEDIATRIC PATIENTS - IMPLEMENTED QUIET TIME IN THE NICU AND SPECIAL CARE NURSERY TO PROMOTE HEALING - RENOVATED AND EXPANDED THE FAMILY BIRTH CENTER AT AACH - ADDED THREE PEDIATRIC CARE ROOMS AT ATRMC FUTURE: - DEVELOP AN OBSTETRICAL LABORIST SERVICE AT ARRMC 5. DIABETES CURRENT: - BUILT A DEMONSTRATION KITCHEN AT ASANTE CENTER FOR OUTPATIENT HEALTH FOR DIABETES NUTRITION EDUCATION - ESTABLISHED A DIABETES CARE CENTER AND NUTRITION SERVICES IN MEDFORD AND GRANTS PASS - ADDED INPATIENT CONSULTS FOR PEOPLE WITH DIABETES - ESTABLISHED BLOOD GLUCOSE MONITORING CLINICS - HIRED AN APP ENDOCRINOLOGIST 6. NUTRITION, PHYSICAL ACTIVITY AND WEIGHT CURRENT: - BUILT A DEMONSTRATION KITCHEN AT ASANTE CENTER FOR OUTPATIENT HEALTH FOR COOKING CLASSES AND DIABETES NUTRITION EDUCATION - PARTNERED WITH SOUTHERN OREGON BARIATRIC CENTER AND OREGON SURGICAL SPECIALISTS - HIRED INPATIENT AND OUTPATIENT NUTRITION COUNSELORS - HELD ANNUAL EMPLOYEE FITNESS AND WEIGHT MANAGEMENT CHALLENGES - SPONSORED THE ANNUAL PEAR BLOSSOM RUN AND WALK - SPONSORED SEVERAL COMMUNITY SPORTING EVENTS TO SUPPORT LOCAL SCHOOL AND YOUTH PROGRAMS - SPONSORED THE HEALTHY FOOD FESTIVAL IN GRANTS PASS - SPONSORED THE ACCESS FOOD SHARE PROGRAM - SPONSORED THE FRIENDS OF JOSEPHINE COUNTY FOOD BANK - DONATED FOOD TO HEARTS WITH A MISSION FOR HOMELESS YOUTH - SPONSORED BLUE ZONES PROJECT IN GRANTS PASS FOR HEALTHIER, MORE ACTIVE LIVING - SPONSORED THE ASHLAND HIGH SCHOOL SPORTS PROGRAM AND ATHLETIC TRAINERS TO ENSURE PLAYER SAFETY - SPONSORED THE ASHLAND CHAMBER OF COMMERCE COMMUNITY-WIDE HEALTH AND WELL BEING INITIATIVE FUTURE: - ADD COMPREHENSIVE PRIMARY CARE PLUS (CPC+) AS PART OF THE MEDICAL HOME MODEL OF CARE 7. RESPIRATORY DISEASES CURRENT: - REMODELED AND EXPANDED CARDIOPULMONARY SERVICES AT ARRMC - HIRED SEVEN PULMONOLOGISTS AND TWO PULMONARY NURSE PRACTITIONERS TO APP - EXPANDED CARDIOPULMONARY TESTING SERVICES TO AACH - IMPLEMENTED A PROCESS TO SCHEDULE DISCHARGED PATIENTS WITH PNEUMONIA AND RESPIRATORY ISSUES TO AN APP PULMONOLOGIST - IMPLEMENTED A ROTATING APP PULMONOLOGIST IN GRANTS PASS - IMPLEMENTED TELEMEDICINE PULMONARY INTENSIVISTS CONSULTS AT ALL THREE HOSPITALS - ADDED A SLEEP LAB PROGRAM AT ATRMC FUTURE: - OFFER LUNG CANCER SCREENING CLINICS - RECRUIT ADDITIONAL PULMONOLOGISTS TO APP 8. CANCER CURRENT: - ESTABLISHED A GYNECOLOGIC CANCER SUPPORT GROUP - HIRED A PEDIATRIC ONCOLOGIST - PARTNERED WITH OHSU TO BRING A CANCER SPECIALIST/SURGEON TO ARRMC EACH MONTH - PROMOTED NATIONAL BREAST CANCER AWARENESS MONTH ACTIVITIES AND EDUCATION - HIRED AN ONCOLOGY NURSE NAVIGATOR FOR ALL CANCER-TYPES - EXPANDED THE BREAST CANCER NURSE NAVIGATOR PROGRAM TO JOSEPHINE COUNTY - ADDED 3-D MAMMOGRAPHY TO ALL THREE IMAGING CENTERS - ADDED BREAST MRI CAPABILITY AT ARRMC - REMODELED THE SPEARS CANCER CENTER AND UPGRADED WITH A NEW LINEAR ACCELERATOR FUTURE: - RECRUIT AN EAR, NOSE AND THROAT PHYSICIAN TO DO NECK AND THROAT CANCER SURGERIES - PROVIDE DIRECT INFUSION INTERVENTION FOR CHEMO PATIENTS - OFFER LUNG CANCER SCREENING CLINICS - BUILD AN ONCOLOGY MEDICAL OFFICE TO PROVIDE COMPREHENSIVE CANCER SERVICES ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. THE ENTIRE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE ASANTE WEBSITE AT WWW.ASANTE.ORG. THE ENTIRE POLICY IS ALSO ON POSTERS IN THE PATIENT REGISTRATION DEPARTMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE ASANTE BUSINESS OFFICE FOR A FINANCIAL ASSISTANCE APPLICATION. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 18E: ASHLAND COMMUNITY HOSPITAL'S "POLICY" IS TO ALLOW THIRD PARTIES TO PERFORM LAWSUITS, PLACE LIENS ON RESIDENCES AND GARNISH WAGES BUT ONLY AS A FINAL RESORT. HOWEVER, THE ASANTE BUSINESS OFFICE IS AUTHORIZED TO PLACE A VOLUNTARY LIEN ON A PATIENTS RESIDENCE ON CERTAIN RARE CIRCUMSTANCES. THE PATIENT MUST APPROVE THE VOLUNTARY LIEN FIRST. 3 1 - CENTER FOR INTERNAL MEDICINE 530 CATALINA STREET ASHLAND OR 97520 INTERNAL MEDCINE CLINIC 2 - CENTER FOR FAMILY MEDICINE 628 N MAIN STREET ASHLAND OR 97520 FAMILY MEDICINE CLINIC 3 - CENTER FOR FAMILY MEDICINE 49 TALENT AVE TALENT OR 97540 FAMILY MEDICINE CLINIC PART I, LINE 7: COST TO CHARGE RATIO IS USED TO CALCULATE BENEFIT EXPENSES. PART I, LINE 7G: SUBSIDIZED SERVICES INCLUDE HOME HEALTH AND SOUTHERN OREGON TRAUMA AND EMERGENCY SERVICES. PART III, LINE 2: A YEAR OVER YEAR ADJUSTMENT WAS MADE DURING THE CURRENT FISCAL YEAR WHICH RESULTED IN NEGATIVE BAD DEBT EXPENSE FOR THE FISCAL YEAR ENDING 9/30/17. PART III, LINE 4: BAD DEBTS RESULT WHEN A PATIENT WHO HAS BEEN DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES IS UNWILLING TO SETTLE THE CLAIM OR DOES NOT PROVIDE FINANCIAL INFORMATION TO ACCESS CAPACITY. PART III, LINE 8: CERTAIN GOVERNMENT SPONSORED HEALTH INSURANCE COMPANIES, SUCH AS MEDICARE AND MEDICAID, PAY A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR INSUREES. IN MOST CASES, THE AMOUNT PAID DOES NOT EVEN COVER THE EXPENSES OF RENDERING SERVICES. ASHLAND COMMUNITY HOSPITAL CONSIDERS THE DIFFERENCE BETWEEN THE EXPENSES OF RENDERING SERVICES TO MEDICARE AND MEDICAID PATIENTS AND THE AMOUNT OF NET REIMBURSEMENT FROM THESE GOVERNMENT SPONSORED INSURANCE COMPANIES A COMMNUITY BENEFIT. CALCULATION: TOTAL MEDICARE PAYMENTS PER COST REPORT LESS TOTAL MEDICARE COSTS PER COST REPORT = UNRECOVERED MEDICARE COST PER COST REPORT. PART III, LINE 9B: IF THERE IS AN INDICATION THAT A PATIENT MAY BE UNABLE TO PAY THEIR BILL, A FINANCIAL QUESTIONNAIRE IS GIVEN OR SENT TO THE PATIENT. ON RECEIPT OF THE COMPLETED QUESTIONNAIRE, THE BUSINESS OFFICE WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT WITHIN 20 DAYS. ELIGIBILITY IS DETERMINED BASED UPON THE QUESTIONNAIRE AND ON FINANCIAL DOCUMENTS, SUCH AS TAX RETURNS, SSI STATEMENTS, PAYCHECK STUBS, AND FSA/HSA INFORMATION. THE PATIENT'S OTHER FINANCIAL OBLIGATIONS, NUMBER OF DEPENDENTS, ASSETS AND OTHER FINANCIAL CIRCUMSTANCES ARE CONSIDERED. OFTEN, A PATIENT WILL NOT PROVIDE A FINANCIAL QUESTIONNAIRE, SO THE BUSINESS OFFICE WILL USE SOFT CREDIT CHECKS AND ZIP CODES+4 TO HELP DETERMINE ELIGIBILITY. THE PERCENTAGE OF FINANCIAL ASSISTANCE PROVIDED IS BASED UPON A SLIDING SCALE TABLE THAT UTILIZES THE PATIENT FAMILY'S INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES. PART III, SECTION B UNREIMBURSED COSTS FROM THE MEDICARE PROGRAM (USING THE MEDICARE COST REPORT). PART V DURING THE PERIOD OF OCTOBER 1, 2016 THROUGH SEPTEMBER 30, 2017, ASANTE ASHLAND COMMUNITY HOSPITAL WAS COMPRISED OF A FULL SERVICE ACUTE CARE HOSPITAL, AN INTERNAL MEDICINE CLINIC AND TWO FAMILY MEDICINE CLINICS. PART VI, LINE 2: ASHLAND COMMUNITY HOSPITAL'S PRIMARY SOURCES OF INPUT INCLUDE THE COMMUNITY LEADERS FORUM, FORMAL CONVERSATIONS WITH OUR COLLABORATORS, IDENTIFIED STRATEGIC PLAN GAPS, AND ENVIRONMENTAL AND COMMUNITY ASSESSMENT SURVEYS FROM MEMBERS OF THE COMMUNITY. PART VI, LINE 3: THE FINANCIAL ACCESS SPECIALISTS, CREDIT ANALYSTS, AND REGISTRATION PERSONNEL WORK WITH THE PATIENT EITHER AT THE TIME OF SCHEDULING, ARRIVAL AT THE HOSPITAL, OR DURING THE BILLING PROCESS. IF THE PATIENT DISCLOSES THEY WILL HAVE DIFFICULTY PAYING, WE ASSIST THEM APPLYING FOR THE OREGON HEALTH PLAN, FINANCIAL ASSISTANCE, OR A PAYMENT PLAN. BASED UPON INCOME AND EXPENSES, A PATIENT MAY BE ELIGIBLE FOR CHARITY CARE WRITE-OFF OF BETWEEN 10% AND 100% OF THEIR BILL. PART VI, LINE 4: THE POPULATION OF THE HOSPITAL'S PRIMARY SERVICE AREA IS PROJECTED TO INCREASE BY APPROXIMATELY 6.5% OVER THE FIVE YEAR PERIOD OF 2010-2015. SIMILARLY, THE POPULATION OF THE SECONDARY SERVICE AREA IS PROJECTED TO INCREASE BY 6.9% OVER THE SAME PERIOD. ALMOST 50% OF THE POPULATION GROWTH IN BOTH THE PRIMARY AND SECONDARY SERVICE AREAS IS PROJECTED TO OCCUR IN THE 65+ AGE COHORT. THE SIGNIFICANT INCREASE IN THE PORTION OF THE HOSPITAL'S TOTAL REVENUE DERIVED FROM THE MEDICARE PROGRAM INCREASED FROM APPROXIMATELY 40% OF GROSS REVENUE IN 2005 TO 50.4% IN 2015. PART VI, LINE 5: ALONG WITH PROVIDING QUALITY HEALTHCARE, ASANTE ASHLAND COMMUNITY HOSPITAL FURTHERS ITS EXEMPT PURPOSE AND FULFILLS ITS MISSION TO THE COMMUNITY BY PROVIDING OR SUBSIDIZING NUMEROUS CLASSES, SUPPORT GROUPS, HEALTH FAIRS, AND SELF-HELP PROGRAMS. THESE PROGRAMS ARE AT NO OR LOW COST TO THE PUBLIC. PART VI, LINE 6: FOUNDED IN 1996, ASANTE ASHLAND COMMUNITY HOSPITAL IS A COMMUNITY OWNED AND GOVERNED NOT-FOR-PROFIT ACUTE CARE HOSPITAL PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO MORE THAN 550,000 RESIDENTS IN NINE COUNTIES THROUGHOUT SOUTHERN OREGON AND NORTHERN CALIFORNIA. SINCE MERGING WITH ASANTE, THE HOSPITAL TODAY IS AFFILITATED WITH ROGUE REGIONAL MEDICAL CENTER (RRMC) IN MEDFORD, OREGON AND THREE RIVERS MEDICAL CENTER (TRMC) IN GRANTS PASS, OREGON. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 JACKSON COUNTY SART 2305 ASHLAND ST C-148 ASHLAND OR 97520 810650183 501(C)(3) 5000 SUPPORT SEXUAL ASSAULT RESPONSE TEAM ASHLAND CHAMBER OF COMMERCE PO BOX 1360 ASHLAND OR 97520 930115140 501(C)(3) 30000 SUPPORT LOCAL CHAMBER OF COMMERCE AND WELLNESS INITIATIVE 2 PART I, LINE 2: ONCE A REQUESTOR HAS BEEN APPROVED FOR GRANT FUNDS, A LETTER OF RESTRICITON IS WRITTEN WHICH DETAILS THE MANNER IN WHICH THE MONEY CAN BE USED BY THE REQUESTING ORGANIZATION. SCHEDULE I, PART I, LINE 2 WHEN ASHLAND COMMUNITY HOSPITAL RECEIVES A REQUEST FOR GRANT FUNDS FROM AN OUTSIDE ORGANIZATION, THE REQUEST IS REVIEWED BY THE EXECUTIVE STAFF. THE APPLICANT MUST FILL OUT AN APPLICATION FORM AND PROVIDE SUPPORTING DOCUMENTS OR EVENT MATERIALS. TO BE SELECTED, THE ORGANIZATION MUST MEET THE FOLLOWING CRITERIA: 1)THE GRANT MUST SUPPORT ONE OF THE TOP TWELVE INDENTIFIED HEALTH NEEDS, 2)IT MUST HAVE A DIRECT IMPACT ON THE HEALTHCARE OF THE COMMUNITY, 3)THE ORGANIZATION MUST BE A NOT-FOR-PROFIT HEALTH, HUMAN SERVICES, OR EDUCATION RELATED ORGANIZATION, AND 4)THE ORGANIZATION COLLABORATES WITH OTHER NOT-FOR-PROFIT ORGANIZATIONS. X X 0 1 0 0 0 0 0 0 0 ROY G VINYARD ASANTE CEO 0 680027 0 238134 0 158161 0 196157 0 39100 0 1311579 0 0 LEE MILLIGAN MD BOARD MEMBER 0 300296 0 27735 0 5877 0 39900 0 25000 0 398808 0 0 SHEILA CLOUGH ASHLAND CEO 246989 0 61870 0 38240 0 90140 0 25186 0 462425 0 0 0 PATRICK HOCKING ASANTE CFO 0 389153 0 87679 0 179617 0 214872 0 29270 0 900591 0 0 SUSAN MONTGOMERY VP PATIENT CARE 165562 0 26738 0 32147 0 78975 0 17208 0 320630 0 0 0 DENESE CROSBIE CLINICAL MANAGER 142339 0 550 0 0 0 32550 0 12960 0 188399 0 0 0 MICHAEL TONER PHARMACY MANAGER 136863 0 10081 0 5290 0 33134 0 26898 0 212266 0 0 0 ROB HIBNER DIRECTOR ANCILLARY SERVICES 122684 0 11374 0 0 0 22641 0 8420 0 165119 0 0 0 BRENDA KIZZIRE PHYSICAL THERAPIST 125567 0 950 0 0 0 31568 0 8473 0 166558 0 0 0 PART I, LINE 3 THE SALARY RANGE OF THE CEO IS SET BY THE ASANTE COMPENSATION COMMITTEE AND IS APPROVED BY THE ASANTE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE ACTUAL SALARY IS SET BY THE ASANTE CEO. PART I, LINE 4B ASANTE, THE PARENT CORPORATION OF ASHLAND COMMUNITY HOSPITAL, HAS AN EXECUTIVE RESTORATION PLAN WHICH INCLUDES ASANTE VP& CHIEF MEDICAL INFORMATION OFFICER LEE MILLIGAN, MD, ASANTE CFO PATRICK HOCKING, ASHLAND CEO SHEILA CLOUGH, AND ASANTE CEO ROY VINYARD. THIS PLAN STATES FIXED PAYMENTS WILL BE RECEIVED AT PRE-DETERMINED INTERVALS FROM ASANTE IF STILL EMPLOYED BY ASANTE IN THEIR CURRENT ROLL AT THE TIME OF VESTING. IF EMPLOYMENT TERMINATES BY ASANTE FOR ANY REASON PRIOR TO VESTING,THEY WILL NOT HAVE CLAIM TO THE FUNDS. FOR THE FISCAL YEAR ENDED SEPT 30, 2017, THERE WAS $18,000 EACH CONTRIBUTED FOR DR. MILLIGAN, MR. HOCKING, MRS. CLOUGH AND MR. VINYARD. THESE AMOUNTS WERE INCLUDED IN DEFERRED COMPENSATION REPORTED IN PART II. WHOLE HOSPITAL INCLUDING ALL ASSETS AND LIABILITIES 2017-08-31 11996875 BALANCE SHEET VALUE TRANSFERRED 930223960 ASANTE 2650 SISKIYOU BLVD MEDFORD OR 97504 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: ALL DIRECTORS AND EMPLOYEES PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THE DIRECTORS FOR ASHLAND COMMUNITY HEALTH SERVICES ARE THE SAME AS THE DIRECTORS OF THE RECIPIENT ORGANIZATION. ACHS HAS BEEN GOVERNED BY THE ASANTE BOARD SINCE THE AGREEMENT WITH THE PRIOR GOVERNING BODY, THE CITY OF ASHLAND, APPROVED THE CHANGE IN GOVERNANCE IN JUNE 2013. THE PLAN FOR THE CHANGE IN GOVERNANCE TOOK SOME YEARS TO COMPLETE AND AS OF THIS FISCAL YEAR END (9/30/2017) ACHS IS FULLY INTEGRATED INTO ASANTE. MOST ACHS EMPLOYEES BECAME ASANTE EMPLOYEES AS PART OF THIS TRANSITION. FORM 990, PART VI, SECTION B, LINE 11B THE FEDERAL FORM 990 IS A FEDERALLY MANDATED LEGAL DOCUMENT THAT IS HIGHLY REGULATED. WITHIN ASHLAND COMMUNITY HEALTHCARE SERVICES, THEY ARE TO BE PREPARED BY PERSONNEL IN THE ASANTE ACCOUNTING DEPARTMENT. ASANTE IS THE PARENT CORPORATION OF ASHLAND COMMUNITY HEALTHCARE SERVICES. ADDITIONAL ASSISTANCE WILL BE PROVIDED BY PERSONNEL IN THE ASANTE MARKETING, COMPLIANCE, AND EXECUTIVE DEPARTMENTS. BEFORE FINAL SUBMISSION OF THE DOCUMENTS, THEY ARE TO HAVE ASHLAND COMMUNITY HEALTHCARE SERVICES BOARD REVIEW. POLICY DETAILS: 1. WHEN FINAL AUDITED FINANCIAL INFORMATION IS AVAILABLE, ACCOUNTING PERSONNEL WILL COMPILE THE NEEDED INFORMATION TO PREPARE THE APPROPRIATE RETURNS FOR THE PRIOR FISCAL YEAR. 2. AS NEEDED, ACCOUNTING WILL FILE ALL APPROPRIATE EXTENSIONS ON A TIMELY BASIS. HOWEVER, THE FINAL SUBMISSION CAN NEVER BE EXTENDED PAST AUGUST 15TH OF THE YEAR FOLLOWING THE FISCAL YEAR BEING FILED. 3. IN ADDITION TO NORMAL PREPARATION, ACCOUNTING PERSONNEL WILL COORDINATE WITH PERSONNEL IN MARKETING, COMPLIANCE, AND POSSIBLY THE EXECUTIVE DEPARTMENTS IN PREPARING THE VARIOUS SCHEDULES NEEDED TO COMPLETE THE RETURN. ALL WORK PAPERS ARE TO BE RETAINED IN A PERMANENT FILE. 4. WHEN ALL NECESSARY INFORMATION HAS BEEN COMPILED, IT IS TO BE LOADED INTO APPROPRIATE TAX SOFTWARE. 5. WHEN COMPLETED, A DRAFT RETURN WILL BE REVIEWED BY THE ASANTE CHIEF ADMINISTRATIVE AND FINANCE OFFICER. AFTER THE REVIEW, ACCOUNTING WILL CLEAR ALL REVIEW NOTES AND COMMENTS. 6. ONCE REVIEWED BY THE CAFO, AN ADDITIONAL REVIEW WILL BE PERFORMED BY AN OUTSIDE CPA FIRM. ACCOUNTING WILL AGAIN CLEAR ANY ADDITIONAL REVIEW NOTES AND COMMENTS SUBMITTED BY THE OUTSIDE CPA. 7. THE ACHS CHIEF EXECUTIVE OFFICER AND MEMBERS OF THE BOARD OF DIRECTORS WILL LOOK OVER THE FINAL SET OF RETURNS AND MAKE FURTHER COMMENTS AND CORRECTIONS, AS IS APPROPRIATE. 8. ONCE ALL REVIEWS AND CORRECTIONS ARE MADE, THE ASANTE CAFO WILL SIGN ALL APPROPRIATE RETURNS FOR FILING. 9. ALL RETURNS WILL THEN BE FILED EITHER ELECTRONICALLY OR PAPER COPY WITH THE APPROPRIATE GOVERNMENT AGENCY. A COPY OF EACH RETURN IS TO BE KEPT IN THE ACCOUNTING DEPARTMENT AND A COPY OF THE 990 WILL BE KEPT AT THE ASANTE CORPORATE HEADQUARTERS FOR PUBLIC DISPLAY AND COPYING, AS REQUESTED. FORM 990, PART VI, SECTION B, LINE 12C ALL ASHLAND COMMUNITY HOSPITAL MANAGERS, KEY EMPLOYEES, AND BOARD MEMBERS ARE REQUIRED TO FILE A CONFLICT OF INTEREST QUESTIONAIRE. THE PURPOSE OF THE QUESTIONAIRE IS THE PROTECT THE HOSPITAL'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THE MIGHT BENEFIT THE PRIVATE INTERESTS OF A BOARD MEMBER OR OFFICER OF THE COMPANY. IN ADDITION, ALL EMPLOYEES OF THE HOSPITAL HAVE AN OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS TO THEIR SUPERVISOR. THE ASANTE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR ADMINISTERING, MONITORING, AND INVESTIGATING ANY POSSIBLE CONFLICTS AND MAKE AN ANNUAL REPORT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 NO DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: DONATED CAPITAL -57,891. CHANGE IN TEMP RESTRICT BALANCE 3,127. LIQUIDATING NET ASSET TRANSFER (SEE SCHEDULE N) -11,996,875. ASANTE 2650 SISKIYOU BLVD MEDFORD OR 97504 930223960 HOSPITAL/HEALTHCARE OR 501(C)(3) LINE 11 0 ASHLAND COMMUNITY HOSPITAL FOUNDATION 280 MAPLE STREET ASHLAND OR 97520 930691238 SUPPORT ASHLAND COMM HOSP OR 501(C)(3) LINE 12B, II 0 SISKIYOU IMAGING LLC 278 MAPLE STREET ASHLAND OR 97520 753006992 IMAGING SERVICES OR ASANTE HEALTH SYSTEM RELATED 79180 135911 0 1 0.33330 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 ASANTE O 20463995 CASH ASHLAND COMMUNITY HOSPITAL FOUNDATION C 148046 CASH ASSET TRANSFER TO ASANTE R 11996875 BOOK VALUE