2018-11-02T01:24:56-05:00 2017-12-31 861065772 DELOITTE TAX LLP 655 WEST BROADWAY SUITE 700 SAN DIEGO CA 921018590 990 2017-01-01 264146730 GARY AND MARY WEST HEALTH INSTITUTE GARY 8585357000 10350 NORTH TORREY PINES ROAD LA JOLLA CA 92037 SHELLEY LYFORD PRESIDENT AND CEO 8585357000 2018-10-26 1 DIANA J MCCUTCHEN P00545657 6192326500 68.6.158.105 2018-10-26 18:16:06 PD P 76FF2A6BB2396675DA7FC3BECCB7F23E28595D91 FF63A8BEF45084E4111860BF3B06E27E98C16888 2017 2019-02-21 02:37:17Z SHELLEY LYFORD 10350 NORTH TORREY PINES ROAD LA JOLLA CA 92037 18061669 0 X WWW.WESTHEALTH.ORG X 2009 DE CONDUCTING MEDICAL RESEARCH WITH HOSPITALS TO REDUCE HEALTHCARE COSTS WITH A FOCUS ON SENIORS. 5 3 30 5 0 0 20010288 15750000 0 0 132415 -4553446 57414 85115 20200117 11281669 66837 19133 0 0 3758979 4463400 0 0 0 12274224 18018155 16100040 22500688 4100077 -11219019 16037065 12439679 2245371 5408254 13791694 7031425 X MEDICAL RESEARCH TO ENABLE SENIORS TO SUCCESSFULLY AGE, LIVING LIFE ON THEIR OWN TERMS WITH ACCESS TO HIGH-QUALITY HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE. 0 0 15843421 19133 IN 2017, THE GARY AND MARY WEST HEALTH INSTITUTE (INSTITUTE) ACTIVELY CONDUCTED APPLIED MEDICAL RESEARCH, IN CONJUNCTION WITH THE HOSPITALS LISTED ON SCHEDULE A, TO GENERATE THE EVIDENCE NEEDED FOR HEALTHCARE PROVIDERS, POLICYMAKERS AND COMMUNITIES TO ADOPT MODELS OF CARE THAT BETTER SERVE SENIORS AND THEIR FAMILIES. THE GOAL IS TO ENABLE SENIORS TO SUCCESSFULLY AGE IN PLACE WITH ACCESS TO HIGH-QUALITY, AFFORDABLE HEALTH AND SUPPORT SERVICES THAT PRESERVE AND PROTECT THEIR DIGNITY, QUALITY OF LIFE AND INDEPENDENCE.WITH MORE THAN 10,000 U.S. BABY BOOMERS TURNING 65 EVERY DAY, SENIORS ARE ONE OF THE LARGEST POPULATIONS IMPACTING THE HEALTHCARE SYSTEM. THE INSTITUTE IS EXPLORING OPPORTUNITIES THAT WILL IMPROVE ACUTE CARE FOR SENIORS IN THE EMERGENCY DEPARTMENT, HOME AND COMMUNITY; CHRONIC CARE MANAGEMENT FOR OLDER ADULTS THAT MAY NEED HELP AT HOME; AND SUPPORTIVE SERVICES SO SENIORS CAN RECEIVE THE CARE THEY NEED, AT A LOWER COST, WHEREVER THEY ARE. THROUGHOUT 2017, THE INSTITUTE ENGAGED WITH A BROAD ARRAY OF KEY STAKEHOLDERS INCLUDING HEALTH PLANS, ACCOUNTABLE CARE ORGANIZATIONS (ACOS), CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS), COMMUNITY ORGANIZATIONS AND OTHERS TO ADDRESS THE SKY-ROCKETING COST OF HEALTHCARE BY ELIMINATING OPEN-ENDED, FEE-FOR-SERVICE AND VOLUME-ORIENTED PAYMENT METHODS; AND ADVOCATING FOR POLICIES THAT LOWER PRESCRIPTION DRUG PRICES AND INCREASE PRICING TRANSPARENCY.THE INSTITUTE HAS THE FOLLOWING ACTIVE RESEARCH FOCUS AREAS:1. ADVANCING SENIOR-APPROPRIATE ACUTE CARE MODELS - THE INSTITUTE IS RESEARCHING HOW PROVIDING SENIOR-FOCUSED CARE IN AN ACUTE SETTING, SUCH AS IN THE EMERGENCY DEPARTMENT, HOME AND COMMUNITY, CAN HELP SENIORS AGE SUCCESSFULLY.2. ADVANCING SENIOR-APPROPRIATE CHRONIC CARE MODELS - THE INSTITUTE IS EXPLORING HOW TO IMPROVE CARE FOR SENIORS WITH LONG TERM-ILLNESSES AT HOME - WHERE THEY PREFER IT MOST.3. ADVANCING SUPPORTING SERVICES - THE INSTITUTE IS COLLABORATING TO ADVANCE AND INTEGRATE COMMUNITY-BASED SOCIAL SUPPORT PROGRAMS AND NUTRITIONAL SERVICES THAT SUPPORT INDEPENDENCE FOR SENIORS.1. ADVANCING SENIOR-APPROPRIATE ACUTE CARE MODELSGERIATRIC EMERGENCY CARE IN COLLABORATION WITH UC SAN DIEGO HEALTH, IN 2016, THE INSTITUTE LAUNCHED THE GARY AND MARY WEST SENIOR EMERGENCY CARE UNIT AT UC SAN DIEGO HEALTH (SECU), ITS FLAGSHIP MODEL IN AN ACUTE GERIATRIC EMERGENCY CARE SETTING. THE MODEL SERVES AS THE SITE OF A MULTI-YEAR RESEARCH INITIATIVE WHERE THE INSTITUTE IS STUDYING HEALTH OUTCOMES AND COST-EFFECTIVENESS OF PROVIDING ENHANCED CARE FOR SENIORS WITHIN THE EMERGENCY ROOM. THESE INCLUDE THE DELIVERY OF GERIATRIC MEDICINE, ACUTE CARE SCREENINGS, URGENT CARE, CASE MANAGEMENT, AND SOCIAL AND PSYCHIATRIC CARE. WITH A FOCUS ON FOSTERING SUCCESSFUL AGING, THE DEPARTMENT ALSO FACILITATES HOME- AND COMMUNITY-BASED CARE OPTIONS WHEN POSSIBLE.SINCE LATE 2016, OVER 6,000 SENIORS HAVE BEEN SCREENED AND OVER 600 SENIORS HAVE RECEIVED THE GERIATRIC NURSE INTERVENTION. THE INSTITUTE AND UC SAN DIEGO HEALTH RESEARCH TEAM HAVE FOCUSED ON INITIATING APPLIED MEDICAL RESEARCH TO EVALUATE THIS NEW MODEL BY CONDUCTING A COMPREHENSIVE PRE- AND POST-LAUNCH ASSESSMENT TO EVALUATE THE IMPACT OF THE SECU ON PATIENT, CLINICAL, AND OPERATIONAL OUTCOMES OF INTEREST. UC SAN DIEGO HEALTH AND THE INSTITUTE WILL REFINE, REVISE, OR DEVELOP NEW CARE PROTOCOLS AS NEEDED. ADDITIONALLY, THE TEAM IS IDENTIFYING PRIORITY AREAS FOR FUTURE APPLIED RESEARCH PROJECTS WITHIN THE SECU TO HELP INFORM BEST PRACTICES AND IS TESTING A CLINICAL DECISION SUPPORT TOOL TO IDENTIFY HIGH-RISK SENIORS IN THE ED, WITH AN EMPHASIS ON MEDICATION SAFETY. THE INSTITUTE HAS PARTNERED WITH THE JOHN A. HARFORD FOUNDATION TO ESTABLISH A NATIONAL GERIATRIC EMERGENCY DEPARTMENT COLLABORATIVE (GEDC) OF NINE LEADING GERIATRIC EMERGENCY MEDICINE PROGRAMS TO PROVIDE EARLY EVIDENCE THAT GED GUIDELINE-BASED CARE IMPROVES PATIENT OUTCOMES AND IS COST EFFECTIVE, AS WELL AS BUILD A DATA INFRASTRUCTURE FOR RESEARCH AND EVALUATION AND DETERMINE A PATH FOR SUSTAINABILITY AND BROAD ADOPTION OF THE GEDC INITIATIVE. PARTICIPATING SITES INCLUDE: MOUNT SINAI MEDICAL CENTER, ST. JOSEPH'S REGIONAL MEDICAL CENTER, NORTHWESTERN MEMORIAL HOSPITAL, AURORA HEALTHCARE SYSTEM, MAGEE WOMEN'S HOSPITAL, UNIVERSITY OF NORTH CAROLINA, UC SAN DIEGO HEALTH, EMORY GRADY HOSPITAL AND YALE UNIVERSITY HOSPITAL.THE INSTITUTE IS WORKING WITH THE AMERICAN GERIATRICS SOCIETY (AGS), AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (ACEP), EMERGENCY NURSES ASSOCIATION (ENA), AND THE SOCIETY FOR ACADEMIC EMERGENCY MEDICINE (SAEM), ALONG WITH A GERIATRIC EMERGENCY MEDICINE (GEM) ADVISORY COUNCIL, TO ADVANCE THE ABOVE OBJECTIVES AND LAY THE GROUNDWORK FOR A GERIATRIC EMERGENCY CARE ALLIANCE TO DRIVE ADOPTION OF IMPROVED GERIATRIC EMERGENCY CARE THROUGHOUT THE COUNTRY. IN 2017, ACEP APPROVED THE CREATION OF THE GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION (GEDA) PROGRAM TO STANDARDIZE SENIOR-FRIENDLY EMERGENCY CARE ACROSS HETEROGENEOUS SETTINGS AND FORMALLY ACCREDIT SITES BASED ON MEASURABLE CRITERIA. TO ACCELERATE ADOPTION OF THE GEDA PROGRAM, THE INSTITUTE PARTNERED WITH ACEP AND THE JOHN A. HARTFORD FOUNDATION (JAHF) TO DEVELOP, IMPLEMENT, AND DISSEMINATE THE GEDA PROGRAM ACROSS THE NATION. HOME AND COMMUNITY-BASED ACUTE CARETHE INSTITUTE IS ALSO RESEARCHING HOW NEW, MORE EFFECTIVE WAYS OF DELIVERING CARE COULD SAFELY REPLACE, WHEN APPROPRIATE, HOSPITAL-BASED CARE WITH HOME-BASED ALTERNATIVES THAT ARE MORE PATIENT-CENTERED, AND LOWER IN COST. IN 2016, THE INSTITUTE EXECUTED THE ACUTE CARE AT HOME STUDY WITH UC SAN DIEGO HEALTH. SEVENTY PATIENTS WERE ENROLLED 66 OF WHOM AVOIDED A HOSPITALIZATION. THE STUDY CONCLUDED IN 2017. IN 2016, THE INSTITUTE LAUNCHED A RESEARCH PROJECT WITH HCCI, NORTHWESTERN UNIVERSITY AND RUSH UNIVERSITY. THE RESEARCH AIM WAS TO IDENTIFY CURRENT EFFORTS, GAPS AND CHALLENGES IN COORDINATING CARE BETWEEN HOME-BASED PRIMARY CARE PRACTICES AND COMMUNITY-BASED ORGANIZATIONS (SUCH AS MEAL PROVIDERS, TRANSPORTATION, ETC.). IN 2017, THE INSTITUTE PUBLISHED A PAPER WHICH REVIEWS THE EVIDENCE THAT HOME-CENTERED CARE AND INTEGRATION OF HEALTH CARE WITH SOCIAL SERVICES ARE CORNERSTONES OF A MORE HUMANE AND EFFICIENT HEALTHCARE SYSTEM.2. ADVANCING SENIOR-APPROPRIATE CHRONIC CARE MODELSTHE INSTITUTE IS EXPLORING OPPORTUNITIES FOR ADVANCING CHRONIC CARE SOLUTIONS FOR OUR NATION'S SENIORS. BY IMPROVING CARE TRANSITIONS, PRODUCING BETTER PATIENT OUTCOMES AND INCREASING EFFICIENCY, THIS WORK CAN HELP MORE BENEFICIARIES WITH CHRONIC CONDITIONS RECEIVE CARE IN THEIR OWN HOMES. IN 2017, THE INSTITUTE ENGAGED IN APPLIED MEDICAL RESEARCH PROJECTS FOCUSED ON SENIOR-SPECIFIC MODELS OF CARE WITHIN THE CHRONIC CARE SETTING IN THESE AREAS: A. ORAL HEALTHCARE AND CARE COORDINATIONB. CAREGIVERS C. PALLIATIVE CARED. HOME-BASED PRIMARY CAREA. ORAL HEALTHCARE AND CARE COORDINATIONTO BETTER UNDERSTAND AND DEVELOP OPTIMAL AND EFFICIENT HEALTHCARE MODELS, THE INSTITUTE DEVELOPED AN INTEGRATED RESEARCH AND IMPLEMENTATION ENVIRONMENT AT THE GARY AND MARY WEST SENIOR WELLNESS CENTER AND GARY AND MARY WEST SENIOR DENTAL CENTER THAT UTILIZES DATA-DRIVEN APPROACHES TO TRIAGE CLIENTS, ALLOCATE RESOURCES AND PERFORM ONGOING QUALITY IMPROVEMENT. THE OVERALL GOAL IS TO DEVELOP A CENTER OF EXCELLENCE, WITH A WELL-CHARACTERIZED COHORT OF PATIENTS, WHICH PROVIDES BOTH HIGH-QUALITY, AFFORDABLE CARE TO SENIORS AND INFORMS CARE AND PAYMENT MODELS TO ACHIEVE SUSTAINABLE, NATIONAL DEPLOYMENT.B. CAREGIVERSCAREGIVERS REPRESENT A CRITICAL COMPONENT OF SUCCESSFUL AGING, COMPRISING FAMILY MEMBERS, NONFAMILY MEMBERS AND PAID HELPERS. TRADITIONALLY CONSIDERED UNPAID FAMILY MEMBERS, CAREGIVERS REPRESENT A MUCH LARGER COMMUNITY OF PROFESSIONAL AND NONPROFESSIONAL PROVIDERS AND INCLUDES ANYONE DELIVERING COMMUNITY-BASED SERVICES TO AGING ADULTS SUCH AS MEDICAL, ACTIVITIES OF DAILY LIVING AND OTHER BASIC REQUIREMENTS.IN 2017, THE INSTITUTE RESEARCHED OPPORTUNITIES TO INTEGRATE AND ALIGN THE EFFORTS OF CAREGIVERS, HEALTHCARE PROVIDERS AND SYSTEMS TO REDUCE THE BURDEN, HELP ENSURE COORDINATION AMONG EFFORTS AND ENABLE ACCESS TO MORE CONTINUOUS, COMMUNITY-BASED CARE BETTER ALIGNED WITH EMERGING PATIENT NEEDS AND CORRESPONDING VALUE-BASED INCENTIVES.THE INSTITUTE COLLABORATED WITH THE CENTER TO ADVANCE PALLIATIVE CARE (ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI) AND CAROL LEVINE (UNITED HOSPITAL FUND) TO IDENTIFY AND DEVELOP A NEW PLATFORM AIMED AT STRENGTHENING THE SKILLS, KNOWLEDGE, AND CONFIDENCE OF AMERICA'S MILLIONS OF FAMILY CAREGIVERS.C. PALLIATIVE CARETHE INSTITUTE IS DEVELOPING AND IMPLEMENTING A MODEL OF HOME-BASED PALLIATIVE CARE, WHICH INCLUDES HOME VISITS AND TELEMEDICINE SUPPORT TO IMPROVE CARE FOR SENIORS. 246282 THE RISING COST OF HEALTHCARE IN THE UNITED STATES IS A GROWING CRISIS OF EPIC PROPORTIONS THAT UNDERMINES AMERICA'S ECONOMY, COMPROMISES CARE, DRAINS RESOURCES, AND THREATENS FINANCIAL SECURITY. INCREASED SPENDING CONTINUES TO IMPACT FAMILY BUDGETS. EVERY DOLLAR WASTED ON AN EXPENSIVE AND INEFFICIENT HEALTHCARE SYSTEM IS A DOLLAR THAT CANNOT BE USED TO EDUCATE AMERICA'S CHILDREN, CARE FOR OUR COUNTRY'S SENIORS, STRENGTHEN OUR NATION'S INFRASTRUCTURE, OR DEFEND OUR BORDERS. TO TACKLE THIS CRITICAL ISSUE, THE WEST HEALTH INSTITUTE IS LEADING AN EFFORT TO UNDERSTAND WHY THE UNITED STATES IS SPENDING SO MUCH, GAIN IN-DEPTH KNOWLEDGE OF THE COST DRIVERS, AND IDENTIFY POLICIES THAT CAN SLOW THE TRAJECTORY OF COST WHILE IMPROVING PATIENT ACCESS AND QUALITY OF CARE. TO SUPPLEMENT AND BROADEN THE INSTITUTE'S MEDICAL RESEARCH ACTIVITIES, THE INSTITUTE ALSO PARTICIPATED IN PUBLIC EDUCATION AND THE DISSEMINATION OF RESEARCH FINDINGS TO THOSE INTERESTED IN REDUCING THE COST OF HEALTHCARE SERVICES AND DEVELOPING SENIOR-APPROPRIATE ACUTE, LONG-TERM AND CHRONIC CARE MODELS THAT SUPPORT INDEPENDENCE FOR SENIORS. THE INSTITUTE HAS PROMOTED THE DEVELOPMENT AND IMPLEMENTATION OF POLICIES WHICH ADVANCE TRANSITION OF MODELS OF CARE, HOME-BASED PRIMARY CARE AND PAYMENT MODELS THROUGH CONFERENCE PARTICIPATION AND DIRECT INTERACTION WITH POLICYMAKERS IN BOTH THE REGULATORY AND LEGISLATIVE ARENAS. 16089703 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 51 0 1 30 1 0 0 0 0 0 0 0 0 0 0 X 5 3 1 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 CA DE X SALLY HALLAK 8585357000 10350 N TORREY PINES ROAD LA JOLLA CA 92037 X MICHAEL JOHNS MD DIRECTOR THROUGH 12/14/17 10.00 5.00 X 0 0 0 MICHAEL SCHATZLEIN MD DIRECTOR 10.00 0.00 X 0 0 0 NICHOLAS VALERIANI DIRECTOR,VICE CHAIRMAN 15.00 5.00 X 0 0 0 CHARLES SEDERSTROM DIRECTOR AND SECRETARY 5.00 1.00 X X 0 0 0 MARK MCCLELLAN DIRECTOR 10.00 5.00 X 0 0 0 GARY L WEST DIRECTOR/CHAIRMAN 15.00 10.00 X 0 0 0 ZIA AGHA CHIEF MEDICAL OFFICER & EVP 40.00 0.00 X 623606 0 46712 SHELLEY M LYFORD PRESIDENT & CEO 40.00 15.00 X 556721 8333 9174 DIANA CAMPAU VP COMMUNICATIONS 50.00 0.00 X 0 369829 49352 VALERIE VOLPE VP GOVT AFFAIRS 50.00 0.00 X 0 437685 19722 TIMOTHY LASH EVP/CHIEF STRATEGY OFFICER 0.00 50.00 X 0 525486 35468 MICHAEL CAPONETTO CFO THRU 5/31/17 35.00 15.00 X 0 495256 30037 WILLIAM T EARLEY CAO/GENERAL COUNSEL 40.00 10.00 X 0 143670 13928 SALLY HALLAK TREASURER/DIR FINANCE 35.00 15.00 X 0 165297 16106 JOSE UNPINGCO SR. 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SINCE THE INSTITUTE HAD NO OBLIGATION FOR UNRELATED BUSINESS INCOME TAX FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016, NO PROVISIONS FOR FEDERAL OR STATE INCOME TAXES HAVE BEEN MADE. IN JULY 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ISSUED ACCOUNTING STANDARDS CODIFICATION ("ASC") 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND PRESCRIBES A THRESHOLD OF MORE-LIKELY THAN-NOT FOR RECOGNITION OF TAX BENEFITS OF UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. FASB ASC 740 ALSO PROVIDES RELATED GUIDANCE ON MEASUREMENT, DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, AND DISCLOSURE. THE INSTITUTE HAS APPLIED FASB ASC 740 TO ALL TAX POSITIONS FOR WHICH THE STATUTE OF LIMITATIONS REMAINED OPEN AND DETERMINED THERE WERE NO MATERIAL UNRECOGNIZED TAX BENEFITS. IN ADDITION, THERE HAVE BEEN NO MATERIAL CHANGES IN UNRECOGNIZED BENEFITS SINCE JULY 1, 2008, NOR ARE ANY ANTICIPATED IN THE NEXT TWELVE MONTHS. THERE HAVE BEEN NO RELATED TAX PENALTIES OR INTEREST, WHICH WOULD BE CLASSIFIED AS TAX EXPENSE IN THE STATEMENT OF ACTIVITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: REALIZED LOSS ON SALE OF INVESTMENT (GAAP BASIS) -118,125. PART XI, LINE 4B - OTHER ADJUSTMENTS: REALIZED LOSS ON SALE OF INVESTMENT (TAX BASIS) -4,576,875. 1 GARY AND MARY WEST SENIOR SERVICES INC 10350 N TORREY PINES RD LA JOLLA CA 92037 820635784 501(C)(3) 16833 FMV WEBSITE DEVELOPMENT, MEMBERSHIP DONATION OF ASSETS FOR GENERAL OPERATIONS GARY AND MARY WEST SENIOR DENTAL CENTER 1525 FOURTH AVE SAN DIEGO CA 92101 473001738 501(C)(3) 2300 FMV EQUIPMENT DONATION OF ASSETS FOR GENERAL OPERATIONS 2 0 PART I, LINE 2: GRANTS WILL ONLY BE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE NON-CASH ITEMS WILL BE USED PROPERLY. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 ZIA AGHA CHIEF MEDICAL OFFICER & EVP 492521 0 112500 0 18585 0 13500 0 33212 0 670318 0 0 0 SHELLEY M LYFORD PRESIDENT & CEO 425561 8333 112500 0 18660 0 7500 0 1674 0 565895 8333 0 0 DIANA CAMPAU VP COMMUNICATIONS 0 308461 0 60000 0 1368 0 13500 0 35852 0 419181 0 0 VALERIE VOLPE VP GOVT AFFAIRS 0 375309 0 60000 0 2376 0 0 0 19722 0 457407 0 0 TIMOTHY LASH EVP/CHIEF STRATEGY OFFICER 0 417037 0 90125 0 18324 0 6827 0 28641 0 560954 0 0 MICHAEL CAPONETTO CFO THRU 5/31/17 0 310744 0 148100 0 36412 0 13500 0 16537 0 525293 0 0 WILLIAM T EARLEY CAO/GENERAL COUNSEL 0 125132 0 0 0 18538 0 6267 0 7661 0 157598 0 0 SALLY HALLAK TREASURER/DIR FINANCE 0 146429 0 18750 0 118 0 7389 0 8717 0 181403 0 0 JOSE UNPINGCO SR. DIRECTOR DATA SCIENCE 199572 0 28590 0 283 0 11802 0 29951 0 270198 0 0 0 AMY STUCK PROGRAM MANAGER 143853 0 14730 0 526 0 7586 0 39852 0 206547 0 0 0 GREGORY NORMAN SR. DIR, CLINICAL RESEARCH 205794 0 27782 0 430 0 11679 0 1782 0 247467 0 0 0 ADRIAN KWONG DATA SCIENCE ADMINISTRATOR 155665 0 15380 0 194 0 7920 0 17072 0 196231 0 0 0 CHRISTOPHER CROWLEY PROGRAM MANAGER 193242 0 17460 0 764 0 9894 0 23530 0 244890 0 0 0 NANCY SCHROEDER SR DIRECTOR - FORMER 0 161216 0 21012 0 331 0 8487 0 31396 0 222442 0 0 JOSEPH SMITH CMO THRU 3/31/16 0 774730 0 176288 0 1032 0 0 0 28124 0 980174 0 0 PART I, LINE 1A THE USE OF BUSINESS CLASS MAY BE AUTHORIZED UNDER THE CIRCUMSTANCES LISTED BELOW: (1) INTERNATIONAL TRAVEL; (2) BUSINESS OR FIRST CLASS IS THE ONLY SERVICE OFFERED BETWEEN TWO POINTS; (3) COACH CLASS WOULD BE MORE EXPENSIVE OR TIME CONSUMING, E.G., WHEN, BECAUSE OF SCHEDULING DIFFICULTIES, TRAVELING BY COACH WOULD REQUIRE AN UNNECESSARY HOTEL EXPENSE, CIRCUITOUS ROUTING (2 OR MORE LAYOVERS), OR AN UNDULY LONG LAYOVER WHEN MAKING CONNECTIONS; (4) AN ITINERARY INVOLVES OVERNIGHT TRAVEL WITHOUT THE OPPORTUNITY FOR NORMAL REST BEFORE THE COMMENCEMENT OF WORKING HOURS; OR (5) THE USE OF BUSINESS CLASS IS NECESSARY TO REASONABLY ACCOMMODATE A DISABILITY OR MEDICAL NEED OF A TRAVELER. PART I, LINE 4B EACH OF THE FOLLOWING INDIVIDUALS ZIA AGHA AND SHELLEY M. LYFORD (LISTED ON SCHEDULE J) PARTICIPATED IN THE 457(B) NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE WEST HEALTH INSTITUTE. THE GARY AND MARY WEST HEALTH INSTITUTE MAKES AN ANNUAL CASH CONTRIBUTION FOR EACH EMPLOYEE IN AN AMOUNT EQUAL TO THE APPLICABLE DOLLAR AMOUNT IN EFFECT FOR THAT YEAR. FOR 2017 THIS AMOUNT WAS $18,000. CONTRIBUTIONS WERE MADE FOR ZIA AGHA AND SHELLEY LYFORD. THE FOLLOWING EMPLOYEES LISTED ON SCHEDULE J PARTICIPATED IN THE 409A NONQUALIFIED DEFINED CONTRIBUTION PLAN OFFERED BY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED ORGANIZATION. THE WEST MANAGEMENT COMPANY MAKES A CASH CONTRIBUTION FOR EACH EMPLOYEE IN AN AMOUNT EQUAL TO THE APPLICABLE DOLLAR AMOUNT IN EFFECT. FOR 2017 THIS AMOUNT WAS $18,000: CONTRIBUTIONS WERE MADE FOR WILLIAM EARLEY AND TIMOTHY LASH. PART I, LINE 7 EACH OF THE MANAGERS IS ELIGIBLE FOR AN ANNUAL DISCRETIONARY BONUS, SUBJECT TO BOARD APPROVAL, WHICH IS BASED ON INDIVIDUAL PERFORMANCE AND LIMITED TO A MAXIMUM PERCENTAGE OF BASE COMPENSATION. SEE PART V DISCLOSURE 0 SCHEDULE L, PART V GARY WEST, CHAIRMAN OF THE WEST HEALTH INSTITUTE, IS A MEMBER OF THE FOLLOWING ORGANIZATIONS: WEST RB, LLC; WEST INN & SUITES, LLC; WEST STEAK SEAFOOD AND SPIRITS; AND WEST DEVELOPMENT, LLC. GARY WEST (AND THE LLCS) ARE TREATED AS INTERESTED PERSONS FRO PURPOSES OF SCHEDULE L, PART IV, ADDRESSING BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS. THERE WERE BUSINESS TRANSACTIONS BETWEEN THE INSTITITUE AND THE LLCS DURING 2015, BUT THE MAGNITUDE OF THE TRANSACTIONS WAS LESS THAN THAT REQUIRING DISCLOSURE ON SCHEDULE L. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS THE OBJECTIVE OF THE INSTITUTE'S RESEARCH IS TO HIGHLIGHT THE NEED FOR HOME- AND COMMUNITY-BASED MODELS OF PALLIATIVE CARE, IDENTIFY ALTERNATIVE METHODS OF PAYMENT AND DEVELOP A SUSTAINABLE HOME- AND COMMUNITY-BASED PALLIATIVE CARE PROGRAM. IN 2017, THE INSTITUTE LAUNCHED A FIVE-YEAR PROJECT WITH THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI FOCUSED ON CREATING, DELIVERING AND EVALUATING A CLINICAL MODEL THAT PROVIDES PALLIATIVE CARE TO PATIENTS IN THEIR HOME. THE INSTITUTE IS DEVELOPING A RISK STRATIFICATION MODEL TO IDENTIFY THE APPROPRIATE PATIENTS FOR PALLIATIVE CARE, DEVELOP CLINICAL PATHWAYS FOR DELIVERY OF CARE USING COMMUNITY HEALTH WORKERS AND TELEMEDICINE, AND EVALUATE THE IMPACT OF THE HOME-BASED CARE USING A RIGOROUS RANDOMIZED CONTROLLED TRIAL. IN SEPTEMBER 2017, THE INSTITUTE WAS A STRATEGIC RESEARCH PARTNER WITH THE CALIFORNIA STATE UNIVERSITY, SAN MARCOS PALLIATIVE CARE INSTITUTE'S ANNUAL PALLIATIVE CARE SYMPOSIUM DESIGNED TO EDUCATE MORE PROVIDERS ON THE IMPORTANCE OF PROVIDING THIS CARE FOR SERIOUSLY-ILL PATIENTS, WHICH HELPED ESTABLISH THE INSTITUTE AS A LEADER IN SUCCESSFUL AGING AND PALLIATIVE CARE. AS PART OF THIS SYMPOSIUM, THE INSTITUTE ASSISTED IN IDENTIFYING TOPICS FOR THE SYMPOSIUM AND MODERATED A PANEL OF SPEAKERS WHO WERE EXPERTS IN THE DELIVERY OF PALLIATIVE CARE IN THE HOME AND COMMUNITY. D. HOME-BASED PRIMARY CARE CHRONIC CARE FOR THE FRAIL ELDERLY REQUIRES ONGOING, LOW-INTENSITY SUPPORT, MUCH OF IT NOT STRICTLY MEDICAL, WHICH IS IN STARK CONTRAST TO ACUTE CARE DELIVERED IN U.S. HOSPITAL SYSTEMS. HOME-BASED PRIMARY CARE (HBPC) IS A MULTIDISCIPLINARY ONGOING CARE STRATEGY FOR PROVIDING IN-HOME TREATMENT PRIMARILY TO MEDICALLY COMPLEX HOMEBOUND SENIORS. IN 2017, THE INSTITUTE COLLABORATED WITH THE UNIVERSITY OF PENNSYLVANIA TO CONDUCT AN ANALYSIS OF THE SHARED SAVINGS METHODOLOGY FOR THE CENTERS FOR MEDICARE & MEDICAID SERVICES' (CMS) INDEPENDENCE AT HOME (IAH) DEMONSTRATION TO DETERMINE THE APPROPRIATE RISK ADJUSTMENT AND SAVINGS MODEL FOR PRACTICES PARTICIPATING IN IAH. IN SEPTEMBER 2017, THE INSTITUTE DELIVERED A DETAILED REPORT TO CMS' CENTER FOR MEDICARE & MEDICAID INNOVATION (CMMI) PRESENTING OUR METHODOLOGY AND FINDINGS FOR RECOMMENDED IMPROVEMENTS TO THE IAH PAYMENT MODEL FOR HBPC PRACTICES. IN 2016, THE INSTITUTE WORKED CLOSELY WITH THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO; JOHNS HOPKINS UNIVERSITY; AND THE JOHN A. HARTFORD FOUNDATION TO ESTABLISH A QUALIFIED CLINICAL DATA REGISTRY (QCDR) FOR HOME-BASED PRIMARY CARE AND PALLIATIVE CARE MEDICINE. IN 2017, THE REGISTRY WAS SUCCESSFULLY REAPPROVED AS A QCDR BY CMS. THE INSTITUTE OFFICIALLY LAUNCHED THE REGISTRY IN 2017 AND BEGAN INPUTTING DATA FROM U.S. MEDICAL MANAGEMENT HBPC PRACTICES. IN 2017, THE INSTITUTE LAUNCHED A NEW FOUR-YEAR RESEARCH PROJECT WITH THE FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH AND NORTHWELL HEALTH TITLED, "HOME-BASED MONITORING TO ENHANCE AND SCALE A HIGH-TOUCH HOME-BASED PRIMARY CARE PROGRAM." THE RESEARCH AIMS TO DOUBLE THE PATIENT CENSUS IN NORTHWELL'S HOUSE CALLS PRACTICE OVER A FOUR-YEAR PERIOD THROUGH REDESIGN OF THE SCHEDULED IN-HOME VISITS AND THE EVALUATION OF A TELEHEALTH TECHNOLOGY TO ENHANCE COMMUNICATION BETWEEN PATIENT AND PROVIDER. 3. ADVANCING SUPPORTIVE SERVICES LONG-TERM SERVICES AND SUPPORTS (LTSS) ARE A FLEXIBLE ARRAY OF SOCIAL SUPPORT PROGRAMS THAT HELP SENIORS ACROSS THE COUNTRY REMAIN INDEPENDENT IN THEIR HOME OR COMMUNITY AND AVOID OUT-OF-HOME NURSING HOME PLACEMENT FOR AS LONG AS POSSIBLE. AS THE LARGEST FUNDER OF LTSS, MEDICAID PROVIDES ASSISTANCE TO SENIORS WITH DAILY TASKS SUCH AS BATHING, DRESSING, TOILETING AND EATING. NURSING HOME CARE, ADULT DAY HEALTHCARE AND HOME-AND COMMUNITY-BASED SERVICES SUCH AS HOME-DELIVERED AND CONGREGATE MEALS, TRANSPORTATION, AND CARE MANAGEMENT ARE ALSO COMPONENTS OF LTSS. TOTAL NATIONAL SPENDING ON THESE SERVICES WAS $240 BILLION IN 2015, WITH MEDICAID COVERING 30 PERCENT OF TOTAL EXPENDITURES. ALTHOUGH SUPPORTIVE SERVICES ARE NOT A COVERED MEDICARE BENEFIT, WITH THE EXPANSION OF MEDICAID MANAGED CARE ACROSS THE COUNTRY, NEW FUNDING OPPORTUNITIES ARE EMERGING. IN RECOGNITION THAT SOCIAL FACTORS HAVE A SIGNIFICANT IMPACT ON HEALTHCARE COSTS AND OUTCOMES FOR SENIORS, THE INSTITUTE IS RESEARCHING NEW WAYS FOR SENIORS TO RECEIVE THESE IMPORTANT CAREGIVING, NUTRITION, IN-HOME SUPPORTS AND OTHER NON-MEDICAL SERVICES, AND COORDINATING THESE ESSENTIAL SUPPORT SERVICES WITH THEIR HEALTHCARE SERVICES. IN COLLABORATION WITH BROWN UNIVERSITY AND MEALS ON WHEELS (MOW) AMERICA, THE INSTITUTE LAUNCHED A STUDY IN MAY 2016 FOCUSED ON INVESTIGATING CURRENT CAPABILITIES OF MOW PROGRAMS, ENHANCING MEAL DELIVERY PRACTICES BY LEVERAGING MOBILE TECHNOLOGY TO IDENTIFY CHANGES IN THE HEALTH, SAFETY AND OVERALL WELLNESS OF SENIORS AND RESPONDING BY CONNECTING SENIORS TO HEALTH AND SOCIAL SUPPORT SERVICES IN THE COMMUNITY TO ADDRESS THEIR UNMET NEEDS. IN 2017, THE INSTITUTE IMPLEMENTED A MOBILE APPLICATION THAT ALLOWS DRIVERS TO SEND ALERTS THROUGH THEIR CELL PHONE TO A CARE NAVIGATOR EMBEDDED IN THE MOW PROGRAM WHEN THEY IDENTIFY A CHANGE IN A CLIENT'S HEALTH STATUS OR AN UNMET NEED AT TWO PILOT SITES. THE CARE NAVIGATOR FOLLOWS UP WITH THE SENIOR, ESTABLISHES A RAPPORT AND GETS TO THE ROOT CAUSE OF THE OBSERVED CHANGE. TOGETHER, THE CARE NAVIGATOR AND SENIOR IDENTIFY SOLUTIONS AND APPROPRIATE REFERRALS ARE MADE TO SUPPORTIVE SERVICES OR A HEALTHCARE PROFESSIONAL TO REDUCE THE IDENTIFIED RISK AND SUPPORT SUCCESSFUL AGING. IN COLLABORATION WITH THE UNIVERSITY OF CALIFORNIA, IRVINE, IN 2017, THE INSTITUTE ADVANCED CARE COORDINATION PRACTICES WITHIN AN ESTABLISHED SENIOR HEALTH CENTER BY EMBEDDING A CARE NAVIGATION MODEL THAT LINKS PATIENTS TO COMMUNITY-BASED SUPPORT SERVICES TO ENSURE COORDINATION OF THEIR HEALTH AND SUPPORT SERVICES. THROUGH CARE NAVIGATION, THE INSTITUTE IS DEMONSTRATING TO HEALTHCARE PROVIDERS THE VALUE OF ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH TO A SENIOR'S OVERALL HEALTH AND WELL-BEING. FORM 990, PART VI, SECTION A, LINE 2 ALMOST ALL OF THE CURRENT DIRECTORS AND OFFICERS HAVE A "BUSINESS RELATIONSHIP" AS DEFINED IN THE FORM 990 INSTRUCTIONS, WITH EACH OF THE OTHER CURRENT OFFICERS AND DIRECTORS BECAUSE OF POSITIONS THEY HOLD WITH AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 3 ADMINISTRATIVE SUPPORT AND MANAGEMENT OF SPECIFIC FUNCTIONAL AREAS ARE PERFORMED BY THE EMPLOYEES OF GARY AND MARY WEST MANAGEMENT COMPANY, INC., A NON-PROFIT, TAXABLE ENTITY THAT PROVIDES SERVICES TO AFFILIATED ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION IS A NON-PROFIT, NON-STOCK CORPORATION WITH THREE MEMBERS DURING 2017. ONE INCORPORATED MEMBER DESIGNATED AS A PERMANENT MEMBER, THE GARY AND MARY WEST FOUNDATION, AND TWO NON-INCORPORATED MEMBERS WHICH ARE ELECTED AND TERM-BASED MEMBERS, WILLIAM PATRICK KRUER AND THOMAS CULHANE. ADDITIONALLY, MEMBERS APPOINT AND CAN REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION HAVE THE AUTHORITY TO ELECT AND REMOVE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS REQUIRE MEMBER APPROVAL: 1. THE DISSOLUTION, LIQUIDATION, MERGER, CONSOLIDATION, RECAPITALIZATION OR OTHER REORGANIZATION OF THE CORPORATION; 2. THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OF THE CORPORATION; AND 3. ANY CHANGES PROPOSED TO BE MADE BY THE CORPORATION'S BOARD OF DIRECTORS TO THE CORPORATION'S CERTIFICATE OF INCORPORATION OR BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 INFORMATION WAS COMPILED FROM THE ORGANIZATION'S CORPORATE AND ACCOUNTING RECORDS AND PROVIDED TO THE ORGANIZATION'S OUTSIDE TAX PREPARER. THE COMPLETED FORM 990 WAS REVIEWED BY THE ORGANIZATION'S CONTROLLER AND DIRECTOR OF FINANCE, CAO, CEO AND ATTORNEY. UPON SATISFACTORY COMPLETION OF THE INTERNAL REVIEW PROCESS, A DRAFT OF THE FORM 990 WAS CIRCULATED TO THE ORGANIZATION'S AUDIT COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW. THE FORM 990 WAS THEN FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS AND OFFICERS OF THE INSTITUTE MET REGULARLY THROUGHOUT 2017 AND DISCUSSED ALL ACTUAL AND POTENTIAL CONFLICTS OF INTEREST THAT EXISTED WITH RESPECT TO OTHER NON-PROFIT AND BUSINESS ORGANIZATIONS. THE DIRECTORS AND OFFICERS ALSO COLLECTED ANNUAL WRITTEN CONFLICT OF INTEREST STATEMENTS FROM ALL DIRECTORS AND OFFICERS. NO FAILURES OF COMPLIANCE WITH THE POLICY WERE FOUND. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A COMPENSATION APPROVAL PROCESS FOR ITS EMPLOYEES. FOR THOSE PAID IN EXCESS OF $100,000, A BASIC COMPENSATION STUDY IS PERFORMED AND COMPENSATION RANGES ARE REQUIRED TO BE APPROVED BY THE BOARD OF DIRECTORS. FOR THOSE PAID IN EXCESS OF $250,000, SUCH AS THE CEO, AN ENHANCED STUDY OF COMPARABLE COMPENSATION IS PERFORMED AND THE BOARD OF DIRECTORS REVIEWS AND APPROVES COMPENSATION LEVELS. THE ORGANIZATION ALSO RETAINS THE SERVICES OF AN OUTSIDE COMPENSATION CONSULTANT ON A PERIODIC BASIS. THE MOST RECENT REVIEW WAS DONE IN EARLY 2016. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CERTIFICATE OF INCORPORATION AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON THE REQUEST FOR SUCH DOCUMENTS. FORM 990, PART VII THE ORGANIZATION HAS A MANAGEMENT SERVICES AGREEMENT WITH THE GARY AND MARY WEST MANAGEMENT COMPANY, INC., A RELATED NON-PROFIT CORPORATION, WHEREBY THE GARY AND MARY WEST MANAGEMENT COMPANY, INC. PROVIDES MANAGEMENT OF SPECIFIC FUNCTIONAL AREAS AND ADMINISTRATIVE SUPPORT SERVICES TO THE ORGANIZATION. SUCH SERVICES INCLUDE THAT OF CHIEF ADMINISTRATION OFFICER AND OTHER SENIOR MANAGEMENT ROLES. FORM 990, PART IX, LINE 11G CONSULTANTS: PROGRAM SERVICE EXPENSES 1,107,589. MANAGEMENT AND GENERAL EXPENSES 1,109,723. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,217,312. STUDIES/WHITEPAPERS/RESEARCH: PROGRAM SERVICE EXPENSES 7,794,660. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,794,660. STAKEHOLDER COMMUNICATIONS: PROGRAM SERVICE EXPENSES 77,519. MANAGEMENT AND GENERAL EXPENSES 302,896. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 380,415. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,052. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,052. FORM 990, PART XI, LINE 9: REALIZED TAX LOSS ON SALE OF INVESTMENT 4,576,875. REALIZED LOSS PER BOOKS ON SALE OF INVESTMENT - GAAP BASIS -118,125. GARY AND MARY WEST HEALTH POLICY CENTER 1909 K STREET NW SUITE 730 WASHINGTON DC 20006 275388874 SEE SCH R, PART VII DE 501(C)(3) PF N/A 0 GARY AND MARY WEST HEALTH ENDOWMENT INC - 1603 ORRINGTON AVE SUITE 810 EVANSTON IL 60201 272953865 FINANCIAL SUPPORT DE 501(C)(3) LINE 11, TYPE II N/A 0 REFLEXION HEALTH INC 225 BROADWAY SUITE 650 SAN DIEGO CA 92101 455417842 SEE SCH R, PART VII DE DIGITAL HEALTH CORP C 0 GARY AND MARY WEST MANAGEMENT COMPANY INC 5796 ARMADA DRIVE SUITE 300 CARLSBAD CA 92008 454040871 SEE SCH R, PART VII DE N/A C 0 DIGITAL HEALTH CORP 225 BROADWAY SUITE 300 SAN DIEGO CA 92101 820903337 SEE SCH R, PART VII DE WEST HEALTH ENDOWMENT C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: DIGITAL HEALTH CORP. PRIMARY ACTIVITY: HEALTHCARE COMPANY THAT HARNESSES THE POWER OF THE LATEST TECHNOLOGY TO ACCELERATE AND IMPROVE PATIENT RECOVERY AT HOME. PART II: IDENTIFICATION OF RELATED TAX-EXEMPT ORGANIZATIONS: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST HEALTH POLICY CENTER, INC. PRIMARY ACTIVITY: POLICY RESEARCH TO DEVELOP MORE AFFORDABLE HEALTHCARE MODELS ENABLING SENIORS TO SUCCESSFULLY AGE. PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: REFLEXION HEALTH INC. PRIMARY ACTIVITY: DEVELOPING SOFTWARE TO BE USED BY PHYSICAL THERAPISTS AND PATIENTS IN PHYSICAL REHABILITATION TO LOWER THE COST OF HEALTH CARE. PART IV: IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION: NAME OF RELATED ORGANIZATION: GARY AND MARY WEST MANAGEMENT COMPANY, INC. TYPE OF ENTITY: GARY AND MARY WEST MANAGEMENT COMPANY, INC. IS A NON-STOCK, NON-PROFIT CORPORATION TAXED AS A C-CORPORATION THAT PROVIDES CERTAIN MANAGERIAL AND ADMINISTRATIVE SUPPORT SERVICES. PRIMARY ACTIVITY: PROVIDING MANAGEMENT AND ADMINISTRATIVE SUPPORT SERVICES.