2017-08-15T14:03:07-05:00 2016-09-30 930623286 ALDRICH CPAS AND ADVISORS LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2015-10-01 930223960 ASANTE ASAN 5417894103 2650 SISKIYOU BLVD MEDFORD OR 97504 GREG WOJTAL CAFO 5417894103 2017-08-14 1 JOYLYN M ANKENEY CPA P00366587 5036204489 2017-08-14 2015 2021-01-29 14:40:06Z GREG WOJTAL 2650 SISKIYOU BLVD MEDFORD OR 97504 1212539882 0 X WWW.ASANTE.ORG X 1938 OR ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 13 12 4666 0 1772839 -1150858 1238973 1164479 593747841 635114871 40560898 12081776 28817558 22071533 664365270 670432659 193967 212068 0 0 306473044 346684762 0 0 0 248128988 251167500 554795999 598064330 109569271 72368329 980560303 1057412618 381415354 382157071 599144949 675255547 X ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 0 0 377639357 488603920 ASANTE'S MAIN PROGRAM SERVICE ACCOMPLISHMENT IS THE OPERATION OF ASANTE ROGUE REGIONAL MEDICAL CENTER (ARRMC), A 378 LICENSED BED HOSPITAL LOCATED IN MEDFORD, OREGON. ARRMC HAS BEEN NAMED ONE OF THE TOP 100 HOSPITALS IN THE NATION FOUR YEARS IN A ROW (2012-2016). THEY HAVE EARNED THE MISSION: LIFELINE STEMI:RECEIVING CENTER GOLD PLUS TWO YEARS IN A ROW FROM THE AMERICAN HEART ASSOCIATION AND AMERICAN COLLEGE OF CARDIOLOGY (2015 & 2016). IN ADDITION ARRMC WAS LISTED IN THE TOP 100 GREAT COMMUNITY HOSPITALS FOR THE SECOND YEAR IN A ROW. TEHY ALSO EARNED A GRADE "A" HOSPITAL SAFETY SCORE FROM LEAPFROG DURING THE FISCAL YEAR. KEY HOSPITAL INPATIENT SERVICES INCLUDE CANCER SERVICES, CARDIOVASCULAR SURGERY, AND INPATIENT CARDIAC CATHERIZATION LABORATORY, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, NEONATOLOGY, NEUROSCIENCES, OBSTETRICS, ORTHOPEDICS, PEDIATRICS, AND UROLOGY SERVICES. OTHER INPATIENT SERVICES INCLUDE BEHAVIORAL HEALTH, REHABILITATION, AND CRITICAL CARE SERVICES, INCLUDING THE REGION'S ONLY LEVEL 3 NEONATAL INTENSIVE CARE UNIT. KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LABORATORY TESTING AND DIAGNOSIS, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING, SLEEP SERVICES, HOSPICE, AND VARIOUS THERAPIES, INCLUDING BEHAVIORAL, OCCUPATIONAL, PHYSICAL, AND SPEECH.DURING FISCAL YEAR 2016, RRMC ADMITTED 18,199 PATIENTS FOR A TOTAL OF 83,650 PATIENT DAYS. IT ALSO HAD OVER 369,000 TOTAL OUTPATIENT VISITS AND DELIVERED 1,714 BABIES. THE EMERGENCY ROOMS TREATED 49,458 PATIENTS AND THE CHEMISTRY LABS PERFORMED OVER 1 MILLION TESTS. SURGICAL SERVICES PERFORMED 9,019 INPATIENT AND OUTPATIENT SURGERIES AT RRMC. OTHER STATISTICS AT RRMC INCLUDE 19,525 HOSPICE VISITS, 60,813 VISITS TO THE VARIOUS REHAB UNITS, AND OVER 149,000 VISITS TO IMAGING. 125284153 162326490 ASANTE'S SECOND LARGEST PROGRAM SERVICE ACCOMPLISHMENT BY EXPENSE IS THE OPERATION OF ASANTE THREE RIVERS MEDICAL CENTER (ATRMC), A 125 LICENSED BED HOSPITAL LOCATED IN GRANTS PASS, OREGON. ATRMC ALSO RECEIVED A GRADE "A" HOSPITAL SAFETY SCORE FROM LEAPFROG DURING THE FISCAL. THEY WERE ALSO AWARDED THE "PATHWAY TO EXCELLENCE" FROM THE AMERICAN NURSES CREDENTIALING CENTER AND LISTED AS ONE OF THE "100 SAFECARE HOSPITALS, HCAHP SUPERIOR PERFORMANCE" BY SAFECARE. SOME OF THE KEY INPATIENT SERVICES AVAILABLE AT TRMC INCLUDE CANCER SERVICES, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, OBSTETRICS, ORTHOPEDICS, AND PEDIATRICS. SOME OF THE KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LAB TESTING, CARDIOPULMONARY SERVICES, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING AND VARIOUS THERAPIES INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH.DURING THE FISCAL YEAR, TRMC ADMITTED 6,966 INPATIENTS FOR A TOTAL OF 24,245 PATIENT DAYS. IT ALSO DELIVERED 771 BABIES AND HAD OVER 219,000 OUTPATIENT VISITS. THE CHEMISTRY LAB PERFORMED NEARLY 580,000 TESTS AND THE EMERGENCY ROOM SAW 40,036 PATIENTS. THERE WERE 7,583 SURGERIES PERFORMED DURING THE YEAR. TRMC'S REHAB DEPARTMENT HAD 33,794 VISITS AND THE VARIOUS IMAGING DEPARTMENT HAD 94,165 VISITS.RENEWING A STRONG COMMITMENT TO REMAIN ON THE LEADING EDGE OF TECHNOLOGY, A NEW 3-TESLA MRI SCANNER, THE MOST POWERFUL MRI AVAILABLE IN THE WORLD, IS NOW IN USE AT TRMC. 4977563 212068 6449262 ASANTE HEALTH SYSTEM WAS NAMED ONE OF THE "15 TOP HEALTH SYSTEMS IN THE NATION" FOR THE FIFTH YEAR IN A ROW BY TRUVEN HEALTH ANALYTICS. ASANTE'S CORPORATE DIVISION HAS MADE GENEROUS CASH DONATIONS TO NUMEROUS NON-PROFIT ORGANIZATIONS. THESE DONATIONS HELP SUPPORT LOCAL SCHOOLS AND OTHER YOUTH ACTIVITIES, SUCH AS LITTLE LEAGUE AND DRUG FREE GRAD NIGHTS AT LOCAL HIGH SCHOOLS. THE CORPORATE DIVISION HAS ALSO MADE SIGNIFICANT CONTRIBUTIONS TO NATIONALLY RECOGNIZED MEDICAL ASSOCIATIONS, SUCH AS THE AMERICAN RED CROSS AND DIABETES ASSOCIATIONS. OTHER CONTRIBUTIONS HAVE BEEN MADE TO HEALTH ORGANIZATIONS THAT ASSIST THE LOCAL SPANISH SPEAKING POPULATION, AND OTHERS HAVE BEEN MADE TO ORGANIZATIONS THAT ASSIST LOCAL SENIORS.OFTEN, INDIGENT AND MEDICAID PATIENTS WILL SHOW UP AT THE EMERGENCY ROOM IN NEED OF SPECIALIZED MEDICAL CARE. IN ORDER TO ASSURE THAT UNASSIGNED INDIGENT AND MEDICAID PATIENTS HAVE SPECIALIZED CARE AVAILABLE TO THEM, ASANTE CREATED SOUTHERN OREGON TRAUMA AND EMERGENCY SERVICES (SOTES). SOTES CONTRACTS WITH LOCAL INDEPENDENT PHYSICIANS TO PROVIDE SPECIALIZED CARE TO THESE PATIENTS THROUGHOUT THEIR HOSPITAL STAY. THE PHYSICIAN BILLS SOTES, WHICH WILL REIMBURSE THE SPECIALIST AT MEDICARE RATES. SOTES OPERATES AT BREAKEVEN. EXPENSES ARE FULLY FUNDED AND REIMBURSED TO THE DOCTOR BY THE HOSPITALS. 507901073 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 427 0 1 4666 1 1 1 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OR X X GREG WOJTAL 5417894549 2650 SISKIYOU BLVD MEDFORD OR 97504 ALAN BINETTE CHAIRPERSON 2.00 X X 0 0 0 THOMAS R MCGILLOWAY TREASURER 2.00 X X 0 0 0 RAY A COX SECRETARY 2.00 X X 0 0 0 RONALD JONES MD TRUSTEE 2.00 X 0 0 0 JAMES M WRIGHT TRUSTEE 2.00 X 0 0 0 ROY VINYARD PRESIDENT & CEO 40.00 X X 2062285 0 150348 ANNE GOLDEN TRUSTEE 2.00 X 0 0 0 STEPHEN D ROE VICE CHAIRPERSON 2.00 X X 0 0 0 THOMAS M TUREK MD TRUSTEE 2.00 X 0 0 0 PETER ANGSTADT TRUSTEE 2.00 X 0 0 0 DOUGLASS SCHMOR TRUSTEE 2.00 X 0 0 0 LEE MILLIGAN MD TRUSTEE 40.00 X 0 326574 58818 SANDRA SLATTERY TRUSTEE 2.00 X 0 0 0 SCOTT KELLY RRMC CEO 40.00 X 579427 0 123930 WIN HOWARD TRMC CEO 40.00 X 408328 0 127848 PATRICK HOCKING CFO 40.00 X 505877 0 133520 GREG EDWARDS PEOPLE OFFICER 40.00 X 373398 0 133248 MARK HETZ CH INFO OFFICER 40.00 X 388141 0 120454 JOHN BONK MEDICAL DOCTOR 40.00 X 424069 0 42036 DIRK WOODS MEDICAL DOCTOR 40.00 X 388421 0 63358 JAMES GREBOSKY MEDICAL DOCTOR 40.00 X 454287 0 126192 JENNIFER HALL MEDICAL DOCTOR 40.00 X 383106 0 61661 KENNETH LINDSEY MEDICAL DOCTOR 40.00 X 577627 0 232164 6544966 326574 1373577 347 0 1 0 SOUTHERN OREGON CARDIOLOGY LLC 520 MEDICAL CENTER DRIVE SUITE 200 MEDFORD OR 97504 CARDIAC SERVICES 676271 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA ST STE 420 OMAHA NE 68154 MANAGEMENT SERVICES 226953 PHARMEDIUM SERVICES LLC 150 NORTH FIELD DR STE 350 LAKE FOREST IL 60045 PHARMACY SERVICES 149678 STAR DIALYSIS LLC 760 GOLF VIEW MEDFORD OR 97504 DIALYSIS SERVICES 111911 EDWARDS LIFESCIENCES LLC ONE EDWARDS WAY IRVINE CA 92614 CHRONIC DISEASE MNGMNT 107043 5 1164479 1164479 HOSPITAL SERVICES 622110 635114871 633978826 1136045 635114871 8597039 8597039 1880808 3657474 -1776666 -1776666 -1776666 536904044 189441 533608748 0 3295296 189441 3484737 189441 3295296 5477795 4841001 636794 636794 OTHER OPERATING INCOME 900099 10923194 10923194 NUTRITION SERVICES 621990 9479327 9479327 JV INCOME 621990 2808884 2808884 23211405 670432659 657379672 1772839 10115669 174673 174673 37395 37395 5474486 2737243 2737243 242522196 210902130 31620066 11718652 10107541 1611111 68064181 58049755 10014426 18905247 16195767 2709480 859715 93171 766544 276045 276045 108341 108341 1603357 1603357 10666603 4944075 5722528 1021396 1021396 16148195 8074098 8074097 16223344 13199477 3023867 1666295 1070481 595814 9510656 9028015 482641 36816600 27506216 9310384 4159117 3541315 617802 PATIENT SUPPLIES 100574523 100574523 PURCHASED SERVICES 34814159 27426086 7388073 BAD DEBTS 7939880 7939880 OTHER OPERATING EXPENSE 6023862 3796990 2226872 2755412 2502242 253170 598064330 507901073 90163257 0 38266954 50197909 88536476 79007337 5222993 12192538 6059376 7541291 6368355 7275899 843679765 505785633 314818089 337894132 498994560 538324733 22293500 24978779 980560303 1057412618 12587751 16273351 32675000 32425000 243665522 231847568 92487081 101611152 381415354 382157071 X 599144949 675255547 599144949 675255547 980560303 1057412618 X 72368329 30455516 -26713247 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 51624 0 0 1 51300 102924 0 PART II-B, LINE 1: ASANTE MAINTAINS MEMBERSHIPS IN THE AMERICAN HOSPITAL ASSOC (AHA) AND OREGON ASSOC OF HOSPITALS AND HEALTHCARE SYSTEMS (OAHHS). DURING TAX YEAR 2015, ASANTE PAID MEMBERSHIP DUES TO THE AHA AND OAHHS OF $78,055 AND $188,661 RESPECTIVELY. 17.93% OF OAHHS DUES AND 22.80% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, ASANTE MADE INDIRECT LOBBYING EXPENDITURES OF $51,624 THROUGH ITS MEMBERSHIP DUES. ALSO, ASANTE PAID JOHN WATT AND ASSOCIATES (JWA) $51,300 FOR SPECIFIC ISSUES LOBBYING DURING THE TAX YEAR. JWA IS AN ADVOCATE FOR ASANTE AND SPECIALIZES IN BALLOT PROPOSITIONS AFFECTING THE HEALTHCARE INDUSTRY. 19809910 65967 149912 257009 19768780 19262867 369173 213139 35278 19809910 18901661 320785 181774 141353 19262867 18536029 268729 163135 66232 18901661 18306191 104176 162870 37198 18536039 0.78030 0.21060 0.00910 0 1 1 13611701 9071019 22682720 374097172 184775182 189321990 7647480 6394845 1252635 397115785 314615606 82500179 42136608 42136608 337894132 SELF INSURANCE RESERVE 7359529 REIMBURSEMENT DUE GOVT AGENCIES & 3RD PARTIES 2700000 OTHER CURRENT LIABILITIES 20421951 LONG TERM LIABILITIES 19995283 PAYROLL/BENEFITS PAYABLE 35814381 CURRENT PORTION LT DEBT 15320008 101611152 X 803514021 147431563 147431563 656082458 1603357 12746844 14350201 670432659 790334935 203462018 203462018 586872917 11191413 11191413 598064330 PART V, LINE 4: THE ASANTE FOUNDATION, A 501(C)(3) ORGANIZATION, IS DIRECTLY RELATED TO AND CONTROLLED BY ASANTE. IT IS IDENTIFIED ON SCHEDULE R, PART II AS A RELATED TAX-EXEMPT ORGANIZATION. THE ASANTE FOUNDATION MAINTAINS THE ASSETS OF 14 DIFFERENT ENDOWMENTS WITH A NET WORTH OF OVER $18.4 MILLION. THE CORPUS OF THE ENDOWMENTS IS TO REMAIN INTACT AND INVESTED IN MARKETABLE SECURITIES AND OTHER FINANCIAL INSTRUMENTS. AT THE END OF EACH FISCAL YEAR, ANY INVESTMENT INCOME GENERATED FROM THE ENDOWMENTS IS RELEASED TO ASANTE. THE INCOME RECEIVED IS USED TO SUBSIDIZE NUMEROUS PROGRAMS, INCLUDING THE RRMC HOSPICE, PHYSICIAN AND NURSING EDUCATION, CHILDREN'S HEALTH, ONCOLOGY PROGRAMS, AND SUPPORT OF THE FRANCIS CHENEY AND THREE RIVERS FAMILY HOUSES. PART X, LINE 2: IT IS THE OPINION OF BOTH THE MANAGEMENT OF ASANTE 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. PART XI, LINE 2D - OTHER ADJUSTMENTS: ASANTE FOUNDATION INVESTMENT INCOME 281,644. OPERATING INCOME FROM AFFILIATES INCLUDED IN CONSOLIDATED FINANCIAL STMT 108,636,921. PROVIDER TAX NETTED WITH REVENUE FOR TAX RETURN 33,377,000. AFFILIATE INVESTMENT REVENUE INCLUDED IN CONSOLIDATED FINANCIAL STMT 294,997. COST OF GOODS SOLD NETTED WITH REVENUE 4,841,001. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NETTED WITH REVENUE ON FINANCIAL STMT 11,191,413. FOUNDATION NONOPERATING LOSS INCLUDED IN CONSOLIDATED FINANCIAL STMT 1,555,431. PART XII, LINE 2D - OTHER ADJUSTMENTS: UNREALIZED LOSS ON INVESTMENTS 33,176,611. AFFILIATE OPERATING EXPENSES INCLUDED IN CONSOLIDATED FINANCIAL STMT 132,067,406. PROVIDER TAX NETTED WITH REVENUE FOR TAX RETURN 33,377,000. COST OF GOODS SOLD NETTED WITH REVENUE 4,841,001. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 11,191,413. SCHEDULE D PART XI, XII AND XIII THE FINANCIAL STATEMENTS AND SCHEDULES OF ASANTE ARE AUDITED BY THE ACCOUNTING FIRM OF KPMG. THEY ARE COMPILED ON A CONSOLIDATED BASIS. THE CONSOLIDATED FINANCIAL STATEMENTS AND SCHEDULES CONTAIN FINANCIAL INFORMATION ABOUT ENTITIES WITHIN ASANTE THAT ARE NOT INCLUDED ON THE ASANTE FORM 990. FINANCIAL INFORMATION ABOUT THE ASANTE FOUNDATION, ASANTE PHYSICIANS PARTNERS, SOUTHERN OREGON INSURANCE COMPANY, AND ASANTE ASHLAND COMMUNITY HOSPITAL ARE INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS BUT, SINCE EACH OF THOSE ENTITIES RETAIN THEIR OWN TAX IDENTIFICATION NUMBER, THEY FILE THEIR OWN SEPARATE FORM 990. THUS, THEIR FINANCIAL INFORMATION IS EXCLUDED FROM THE ASANTE FORM 990 AND ARE INCLUDED AS RECONCILING ITEMS ON SCHEDULE D. ON THE ASANTE FORM 990, SCHEDULE D, PARTS XI, XII, AND XIII, WE HAVE RECONCILED THE TOTAL REVENUES, TOTAL EXPENSES, AND NET ASSETS TO THE CONSOLIDATED STATEMENT OF OPERATIONS ON THE AUDITED FINANCIAL STATEMENTS. IN MANY CASES, THE FINANCIAL INFORMATION OF THESE OTHER ENTITIES IS CONTAINED WITHIN THE REVENUE, EXPENSES, AND NET ASSETS ITEMS IN THE FINANCIAL STATEMENT AND MAY NOT BE READILY DISTINGUISHED ON THE FINANCIAL STATEMENT LINE ITEMS. 1 1 X 1 X 1 X 1 1 0 1 1 76514 8035844 8035844 0.01340 122486 150975327 70548495 80426832 0.13450 9822 17668376 14078596 3589780 0.00600 208822 176679547 84627091 92052456 0.15390 49875 5604451 671314 4933137 0.00820 18138 0 18138 0.00000 2901456 2601058 300398 0.00050 325529 113150 212379 0.00040 212068 0 212068 0.00040 49875 9061642 3385522 5676120 0.00950 258697 185741189 88012613 97728576 0.16340 42031 42031 0.00010 164037 164037 0.00030 206068 206068 0.00040 1 7939880 3463780 167944281 199970622 -32026341 X 1 1 1 SISKIYOU IMAGING RADIOLOGY & IMAGING SVC 0.33330 0.33330 2 CVI MANAGEMENT CO LLC MANAGEMENT SERVICES 0.25000 0.75000 3 CVI REAL PROPERTY PROPERTY MANAGEMENT 0.25000 0.75000 4 SOUTHERN OREGON LINEN SVCS LINEN PROCESSING 0.34000 5 HEALTH FUTURE LLC SUPPLIES PURCHASING 0.14300 6 GRANTS PASS SURGICAL CENTER OUTPATIENT SURGERIES 0.35000 0.65000 7 SURGERY CENTER OF SO OREGON OUTPATIENT SURGERIES 0.20000 0.80000 8 LHC HOME HEALTH 0.25000 9 ACCENTCARE HOME HEALTH 0.10000 2 1 ROGUE REGIONAL MEDICAL CENTER 2825 E BARNETT ROAD MEDFORD OR 97504 WWW.ASANTE.ORG 14-0451 X X X 2 THREE RIVERS MEDICAL CENTER 500 SW RAMSEY AVE GRANTS PASS OR 97527 WWW.ASANTE.ORG 14-1439 X X X ROGUE REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X HTTP://WWW.ASANTE.ORG/APP/FILES/PUBLIC/2053/2014-COMMUNITY-HEALTH-NEEDS-ASS X 1 13 1 HTTP://WWW.ASANTE.ORG/APP/FILES/PUBLIC/2053/2014-COMMUNITY-HEALTH-NEEDS-ASS 0 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 X X X X 1 X 0 0 THREE RIVERS MEDICAL CENTER 2 0 0 1 X X X X X X X X 13 1 1 1 1 X HTTP://WWW.ASANTE.ORG/APP/FILES/PUBLIC/2053/2014-COMMUNITY-HEALTH-NEEDS-ASS X 1 13 1 HTTP://WWW.ASANTE.ORG/APP/FILES/PUBLIC/2053/2014-COMMUNITY-HEALTH-NEEDS-ASS 0 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 X X X X 1 X 0 0 ROGUE REGIONAL MEDICAL CENTER 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 2014. 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. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACTS REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE PARTNERED WITH PROFESSIONAL RESEARCH CONSULTANTS, INC. TO COMPLETE 600 COMMUNITY SURVEYS IN FISCAL YEAR 2014. 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. ALSO REQUIRED IS THE DEVELOPMENT AND EXECUTION OF AN IMPLEMENTATION STRATEGY TO ADDRESS THESE CONCERNS. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: ASANTE ASHLAND COMMUNITY HOSPITAL IN ASHLAND, OREGONTHREE RIVERS MEDICAL CENTER IN GRANTS PASS, OREGON THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 6A: ASANTE ASHLAND COMMUNITY HOSPITAL IN ASHLAND, OREGONROGUE REGIONAL MEDICAL CENTER IN MEDFORD, OREGON ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: KEY INFORMANTS INCLUDE PARTNERSHIPS WITH LOCAL LAW ENFORCEMENT AND COMMUNITY-BASED ORGANIZATIONS; OTHER COLLABORATIVES INCLUDE SOUTHERN OREGON SUCCESS AND THE UNITED WAY. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 6B: KEY INFORMANTS INCLUDE PARTNERSHIPS WITH LOCAL LAW ENFORCEMENT AND COMMUNITY-BASED ORGANIZATIONS; OTHER COLLABORATIVES INCLUDE SOUTHERN OREGON SUCCESS AND THE UNITED WAY. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: IDENTIFIED HEALTH NEEDS THE TOP FIVE HEALTH NEEDS IDENTIFIED BY BOTH SURVEY AND FOCUS GROUP PARTICIPANTS ARE:1.MENTAL/BEHAVIORAL HEALTH2.SUBSTANCE ABUSE TREATMENT3.ACCESS TO HEALTHCARE4.HEALTH EDUCATION5.OBESITYIMPLEMENTATION STRATEGYASANTE WILL ADDRESS THE TOP IDENTIFIED COMMUNITY HEALTH NEEDS IN THE FOLLOWING WAYS:1.MENTAL/BEHAVIORAL HEALTH 1.CONTINUE TO PROVIDE HIGH-QUALITY CARE TO BEHAVIORAL HEALTH PATIENTS AT ASANTE ROGUE REGIONAL MEDICAL CENTER, WHICH HOUSES THE ONLY INPATIENT BEHAVIORAL HEALTH UNIT IN SOUTHERN OREGON2.PARTNER WITH THE JACKSON COUNTY HEALTH DEPARTMENT TO BUILD ONE OF THE ONLY FULL-SERVICE TREATMENT FACILITIES IN OREGON FOR CHILDREN SUFFERING FROM AUTISM3.DEVELOP PRIMARY CARE BEHAVIORAL HEALTH TEAMS TO COORDINATE THE CARE OF PATIENTS PRIOR TO THEIR NEED FOR INPATIENT CARE2.SUBSTANCE ABUSE TREATMENT 1.CONTINUE TO WORK WITH LOCAL PROVIDERS SUCH AS THE ADDICTIONS RECOVERY CENTER TO COORDINATE CARE2.CONTINUE TO WORK WITH THE JACKSON COUNTY HEALTH DEPARTMENT TO PROVIDE COMMUNITY AWARENESS REGARDING THE GROWING PROBLEM OF OPIOID ABUSE IN SOUTHERN OREGON3.ENGAGE IN A REGION-WIDE OPIOID PROGRAM TO COORDINATE AND STANDARDIZE THE PROVIDER RESPONSE FOR POTENTIAL ABUSERS4.SERVE AS A MAJOR CORPORATE PARTNER FOR THE SOUTHERN OREGON METH PROJECT, A PUBLIC AWARENESS/EDUCATION CAMPAIGN SPONSORED BY KOBI NBC-53.ACCESS TO HEALTHCARE 1.BUILD A GROUP OF 60 TO 80 EMPLOYED PRIMARY CARE PHYSICIANS BY THE YEAR 2016 THROUGH ASANTE PHYSICIAN PARTNERS; MANY OF THESE PROVIDERS WILL OFFER AFTER-HOURS AND WEEKEND WALK-IN CLINICS2.PROVIDE ACCESS TO URGENT CARE IN GRANTS PASS IN THE ASANTE CENTER FOR OUTPATIENT HEALTH ON THE CAMPUS OF ASANTE THREE RIVERS MEDICAL CENTER BEGINNING AUGUST OF 20144.HEALTH EDUCATION 1.PROVIDE FOUR NO-COST COMMUNITY HEALTH EDUCATION PRESENTATIONS EACH YEAR TO BE HELD IN MEDFORD, ASHLAND, AND GRANTS PASS2.OFFER COMMUNITY COOKING AND NUTRITION CLASSES IN GRANTS PASS AT THE DEMONSTRATION KITCHEN LOCATED IN THE ASANTE CENTER FOR OUTPATIENT HEALTH ON THE CAMPUS OF ASANTE THREE RIVERS MEDICAL CENTER BEGINNING AUGUST 20143.DEVELOP A PATIENT CENTERED MEDICAL HOME MODEL IN WHICH PATIENT EDUCATION AND ENGAGEMENT IN THEIR HEALTHCARE IS A CRITICAL SUCCESS FACTOR5.OBESITY 1.CONTINUE OUR PARTNERSHIP WITH OREGON SURGICAL SPECIALISTS TO PROVIDE WEIGHT LOSS SURGERY AT THE SOUTHERN OREGON BARIATRIC CENTER, INCLUDING MAKING IT AVAILABLE FOR ALL 10,000 LIVES COVERED BY ASANTE'S HEALTHCARE COVERAGE PLAN2.INCORPORATE NUTRITION AND WEIGHT MANAGEMENT INFORMATION IN COMMUNITY HEALTH EDUCATION PRESENTATIONS WHEN APPROPRIATE THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 11: IDENTIFIED HEALTH NEEDS THE TOP FIVE HEALTH NEEDS IDENTIFIED BY BOTH SURVEY AND FOCUS GROUP PARTICIPANTS ARE:1.MENTAL/BEHAVIORAL HEALTH2.SUBSTANCE ABUSE TREATMENT3.ACCESS TO HEALTHCARE4.HEALTH EDUCATION5.OBESITYIMPLEMENTATION STRATEGYASANTE WILL ADDRESS THE TOP IDENTIFIED COMMUNITY HEALTH NEEDS IN THE FOLLOWING WAYS:1.MENTAL/BEHAVIORAL HEALTH 1.CONTINUE TO PROVIDE HIGH-QUALITY CARE TO BEHAVIORAL HEALTH PATIENTS AT ASANTE ROGUE REGIONAL MEDICAL CENTER, WHICH HOUSES THE ONLY INPATIENT BEHAVIORAL HEALTH UNIT IN SOUTHERN OREGON2.PARTNER WITH THE JACKSON COUNTY HEALTH DEPARTMENT TO BUILD ONE OF THE ONLY FULL-SERVICE TREATMENT FACILITIES IN OREGON FOR CHILDREN SUFFERING FROM AUTISM3.DEVELOP PRIMARY CARE BEHAVIORAL HEALTH TEAMS TO COORDINATE THE CARE OF PATIENTS PRIOR TO THEIR NEED FOR INPATIENT CARE2.SUBSTANCE ABUSE TREATMENT 1.CONTINUE TO WORK WITH LOCAL PROVIDERS SUCH AS THE ADDICTIONS RECOVERY CENTER TO COORDINATE CARE2.CONTINUE TO WORK WITH THE JACKSON COUNTY HEALTH DEPARTMENT TO PROVIDE COMMUNITY AWARENESS REGARDING THE GROWING PROBLEM OF OPIOID ABUSE IN SOUTHERN OREGON3.ENGAGE IN A REGION-WIDE OPIOID PROGRAM TO COORDINATE AND STANDARDIZE THE PROVIDER RESPONSE FOR POTENTIAL ABUSERS4.SERVE AS A MAJOR CORPORATE PARTNER FOR THE SOUTHERN OREGON METH PROJECT, A PUBLIC AWARENESS/EDUCATION CAMPAIGN SPONSORED BY KOBI NBC-53.ACCESS TO HEALTHCARE 1.BUILD A GROUP OF 60 TO 80 EMPLOYED PRIMARY CARE PHYSICIANS BY THE YEAR 2016 THROUGH ASANTE PHYSICIAN PARTNERS; MANY OF THESE PROVIDERS WILL OFFER AFTER-HOURS AND WEEKEND WALK-IN CLINICS2.PROVIDE ACCESS TO URGENT CARE IN GRANTS PASS IN THE ASANTE CENTER FOR OUTPATIENT HEALTH ON THE CAMPUS OF ASANTE THREE RIVERS MEDICAL CENTER BEGINNING AUGUST OF 20144.HEALTH EDUCATION 1.PROVIDE FOUR NO-COST COMMUNITY HEALTH EDUCATION PRESENTATIONS EACH YEAR TO BE HELD IN MEDFORD, ASHLAND, AND GRANTS PASS2.OFFER COMMUNITY COOKING AND NUTRITION CLASSES IN GRANTS PASS AT THE DEMONSTRATION KITCHEN LOCATED IN THE ASANTE CENTER FOR OUTPATIENT HEALTH ON THE CAMPUS OF ASANTE THREE RIVERS MEDICAL CENTER BEGINNING AUGUST 20143.DEVELOP A PATIENT CENTERED MEDICAL HOME MODEL IN WHICH PATIENT EDUCATION AND ENGAGEMENT IN THEIR HEALTHCARE IS A CRITICAL SUCCESS FACTOR5.OBESITY 1.CONTINUE OUR PARTNERSHIP WITH OREGON SURGICAL SPECIALISTS TO PROVIDE WEIGHT LOSS SURGERY AT THE SOUTHERN OREGON BARIATRIC CENTER, INCLUDING MAKING IT AVAILABLE FOR ALL 10,000 LIVES COVERED BY ASANTE'S HEALTHCARE COVERAGE PLAN2.INCORPORATE NUTRITION AND WEIGHT MANAGEMENT INFORMATION IN COMMUNITY HEALTH EDUCATION PRESENTATIONS WHEN APPROPRIATE ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16I: 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 HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 16I: 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 HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 18D: ROGUE REGIONAL MEDICAL CENTER'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. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 18D: THREE RIVERS MEDICAL CENTER'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. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 22D: THE DISCOUNT ROGUE REGIONAL MEDICAL CENTER OFFERS IS BASED ON A SLIDING FEE SCHEDULE DETERMINED BY AN EMERGENCY PATIENT'S LEVEL OF INCOME. A DISCOUNT OF UP TO 100% IS POSSIBLE IF THE PHYSICIAN DETERMINES THAT A PROCEDURE IS "MEDICALLY NECESSARY". THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 22D: THE DISCOUNT THREE RIVERS MEDICAL CENTER OFFERS IS BASED ON A SLIDING FEE SCHEDULE DETERMINED BY AN EMERGENCY PATIENT'S LEVEL OF INCOME. A DISCOUNT OF UP TO 100% IS POSSIBLE IF THE PHYSICIAN DETERMINES THAT A PROCEDURE IS "MEDICALLY NECESSARY". 1 1 - ROGUE VALLEY RX 2900 E BARNETT ROAD MEDFORD OR 97504 OUTPATIENT PHARMACY PART II, COMMUNITY BUILDING ACTIVITIES: IN FISCAL 2016, ASANTE'S CONTRIBUTION TO COMMUNITY HEALTH IMPROVEMENTS ADVOCACY INCLUDES $1,000 TO THE JACKSON COUNTY CHILD ABUSE TASKFORCE, $50,000 TO KIDS HEALTH CONNECT, AND $4,000 TO HEARTS WITH A MISSION. IN ADDITION, ASANTE CONTRIBUTED OVER $50,000 TO VARIOUS COMMUNITY ORGANIZATIONS, INCLUDING THE BOYS AND GIRLS CLUBS AND YMCA OF MEDFORD, THE JACKSONVILLE BRITT FESTIVAL, AND THE OREGON SHAKESPEAREAN FESTIVAL.ASANTE ALSO CONTIBUTED $42,031 TO LOCAL CHAMBERS OF COMMERCE TO HELP BUILD LEADERSHIP AMONG BUSINESSES IN THE COMMUNITY. PART III, LINE 2: COST TO CHARGE RATIO PART III, LINE 3: PERCENTAGE OF THE POPULATION THAT WOULD QUALIFY FOR CHARITY CARE ACCORDING TO POVERTY RATE FROM CENSUS BUREAU, 14.8% POVERTY RATE IN 2015, THAT PERCENTAGE OF BAD DEBT IS ASSUMED TO BE PART OF MISSED CHARITY CARE. PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED BASED ON GROSS PATIENT CHARGES THAT HAVE BEEN WRITTEN OFF DUE TO NON-PAYMENT. 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. ASANTE 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 COMMUNITY 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 VI, LINE 2: ASANTE'S FIVE PRIMARY SOURCES OF INPUT INCLUDE THE COMMUNITY LEADERS FORUM, THE ENVIRONMENTAL ASSESSMENT, THE COMMUNITY ASSESSMENT SURVEY, FORMAL CONVERSATIONS WITH OUR COLLABORATORS, AND IDENTIFIED STRATEGIC PLAN GAPS FROM THE PREVIOUS YEAR. 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 MOST NOTABLE FACT ABOUT THE DEMOGRAPHICS OF OUR SERVICE AREA IS THAT WE HAVE A RATHER ELDERLY POPULATION, BOTH IN OUR PRIMARY SERVICE AREA OF JACKSON AND JOSEPHINE COUNTIES, BUT ALSO OUR SECONDARY SERVICE AREA OF NORTHERN CALIFORNIA AND SOUTHERN OREGON. IN FISCAL 2015, PATIENTS 65+ ACCOUNTED FOR 38.26% AND 46.60% OF ADMISSIONS AT RRMC AND TRMC RESPECTIVELY.FOR THE NEXT 20 YEARS, THE 65+ AGE GROUP IS FORECAST TO BE THE FASTEST GROWING SEGMENT OF THE POPULATION. IN ADDITION, THE OVERALL POPULATION GROWTH OF OUR PRIMARY SERVICE AREA IS ALSO FORECAST TO AVERAGE 1% PER YEAR FOR THE NEXT 30 YEARS. PART VI, LINE 5: ALONG WITH PROVIDING QUALITY HEALTHCARE, ASANTE 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. THE ASANTE COMMUNITY HEALTH EDUCATION PROGRAM IS AN ONGOING, NO COST PROGRAM, OPEN TO ALL COMMUNITY MEMBERS. IN FY 2016, OVER 30 COMMUNITY HEALTH EDUCATION CLASSES WERE OFFERED AT RRMC AND TRMC. ON AVERAGE, ATTENDANCE WELL EXCEEDED 75 PEOPLE AT EACH EVENT. ASANTE ALSO PROMOTES AND EXTENDS PATIENT CARE BY PROVIDING SPACE AND MATERIALS TO APPROXIMATELY 30 SUPPORT GROUPS. ASANTE HOSPICE, RVMC AND TRMC CANCER SERVICES, AND RVMC/TRMC WOMEN AND CHILDREN'S SERVICES PROVIDE STAFF, RESOURCES AND ORGANIZATIONAL SUPPORT FOR VARIOUS WELL-ATTENDED SUPPORT GROUPS AND DEDICATIONAL EVENTS, SUCH AS "CANCER SURVIVOR'S DAY". MANY OTHER SUPPORT GROUPS ARE COMMUNITY-LED, BUT LOGISTICALLY SUPPORTED BY ASANTE HEALTH SYSTEM AND AFFILIATED CLINICAL STAFF MEMBERS. THE SMULLIN HEALTH EDUCATION CENTER HOUSES COMMUNITY AND HEALTHCARE RELATED EVENTS. ALONG WITH THE ASANTE COMMUNITY HEALTH EDUCATION PROGRAM AND SUPPORT GROUPS, SMULLIN HOSTED OVER 250 EVENTS. OPERATIONALLY, ASANTE HEALTH SYSTEM SUPPORTS THESE EVENTS BY PROVIDING SALAIRES, BENEFITS, SUPPLIES AND CLASSROOM SPACE. ADDITIONALLY, ASANTE IS THE SOLE SUPPORT OF THE FRANCIS CHENEY FAMILY PLACE AND THE THREE RIVERS FAMILY HOUSE. MUCH LIKE THE RONALD MCDONALD HOUSE, THESE HOUSES PROVIDE LOW-COST TEMPORARY LODGING FOR FAMILIES OF PATIENTS AT RVMC OR TRMC. DONATIONS ARE ACCEPTED, BUT NO ONE IS DENIED LODGING FOR AN INABILITY TO CONTRIBUTE.ASANTE HEALTH SYSTEM HAS SEVERAL CLINICAL DEPARTMENTS THAT PROVIDE NON-BILLED SERVICES TO COMMUNITY MEMBERS. THESE DEPARTMENTS INCLUDE THE STERILE PROCESSING DEPARTMENT, IMAGING DEPARTMENT, RRMC/TRMC PHARMACIES (BOTH HOSPITAL AND RETAIL), SOCIAL SERVICES, RESOURCE MANAGEMENT, SENIOR TRANSPORTATION, AND THE SUPPORTIVE CARE TEAM. RRMC ALSO PROVIDES FREE LAB WORK TO THE PATIENTS OF THE COMMUNITY HEALTH CENTERS. THE ASANTE HEALTH SYSTEM STRIVES TO MEET THEIR ON-GOING MISSION: ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. PART VI, LINE 6: ASANTE IS A COMMUNITY OWNED AND GOVERNED NOT-FOR-PROFIT HEALTH SYSTEM PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO MORE THAN 550,000 RESIDENTS IN NINE COUNTIES THROUGHOUT SOUTHERN OREGON AND NORTHERN CALIFORNIA. THE SYSTEM WAS FORMED IN 1995 TO INCLUDE ROGUE REGIONAL MEDICAL CENTER (RRMC) IN MEDFORD, AND THREE RIVERS MEDICAL CENTER (TRMC) IN GRANTS PASS. IN 2003, ASANTE FORMED ASANTE COMMUNITY SERVICES, WHICH PROVIDES LIFELINE AND RUNS THE OUTPATIENT PHARMACY. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 MEDFORD CHAMBER OF COMMERCE 101 E 8TH STREET MEDFORD OR 97501 930197580 501(C)(3) 42031 CASH SUPPORT LOCAL CHAMBER OF COMMERCE HEARTS WITH A MISSION PO BOX 1441 MEDFORD OR 97501 501(C)(3) 4133 CASH SUPPORT LOCAL NON-PROFIT 2 2 SENIOR VAN TRANSPORTATION 37395 COST FREE VAN RIDES TO MED APPTS PART I, LINE 2: ONCE AN APPLICANT HAS BEEN APPROVED FOR GRANT FUNDS, THE GRANT AGREEMENT SPECIFIES THAT ALL GRANT MONIES ARE TO BE SPENT FOR ONLY THE PURPOSE SPELLED OUT IN THE APPLICATION. THE COUNTY CONNECTIONS COMMITTEE MUST KNOW WHERE THE DONATED MONEY WILL BE ALLOCATED, AND IF A FUNDRAISING EVENT, HOW THE RAISED MONEY WILL BE ALLOCATED. USUALLY, A DETAILED BUDGET OF THE GRANTEE'S CURRENT YEAR IS REQUIRED, AS WELL AS ANY REPORTS OR MINUTES FROM PREVIOUS EVENTS. SCHEDULE I, PART I, LINE 2 WHEN ASANTE RECEIVES A REQUEST FOR GRANT FUNDS FROM AN OUTSIDE ORGANIZATION, THE REQUEST IS REVIEWED BY EITHER THE JACKSON COUNTY OR JOSEPHINE COUNTY COMMUNITY CONNECTIONS COMMITTEE. 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 STRATEGIC INITIATIVES, 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, 4)THE ORGANIZATION COLLABORATES WITH OTHER NOT-FOR-PROFIT ORGANIZATIONS AND, 5)THE GRANT MUST BE A RELATION BUILDING OPPORTUNITY. 1 X X X X X 1 1 0 0 0 0 0 1 0 ROY VINYARD PRESIDENT & CEO 699558 0 0 0 1362727 0 120900 0 29448 0 2212633 0 1023495 0 LEE MILLIGAN MD TRUSTEE 0 306582 0 19992 0 0 0 33900 0 24918 0 385392 0 0 SCOTT KELLY RRMC CEO 447698 0 54521 0 77208 0 110300 0 13630 0 703357 0 0 0 WIN HOWARD TRMC CEO 305712 0 45415 0 57201 0 99500 0 28348 0 536176 0 0 0 PATRICK HOCKING CFO 371026 0 67454 0 67397 0 104600 0 28920 0 639397 0 0 0 GREG EDWARDS PEOPLE OFFICER 265165 0 43937 0 64296 0 107450 0 25798 0 506646 0 0 0 MARK HETZ CH INFO OFFICER 284405 0 44175 0 59561 0 97900 0 22554 0 508595 0 0 0 JOHN BONK MEDICAL DOCTOR 409283 0 14786 0 0 0 21113 0 20923 0 466105 0 0 0 DIRK WOODS MEDICAL DOCTOR 368580 0 19841 0 0 0 34074 0 29284 0 451779 0 0 0 JAMES GREBOSKY MEDICAL DOCTOR 375577 0 37789 0 40921 0 98821 0 27371 0 580479 0 0 0 JENNIFER HALL MEDICAL DOCTOR 383106 0 0 0 0 0 33900 0 27761 0 444767 0 0 0 KENNETH LINDSEY MEDICAL DOCTOR 129717 0 33268 0 414642 0 210726 0 21438 0 809791 0 0 0 PART I, LINES 4A-B ASANTE HAS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR ROY VINYARD, THE ASANTE CEO. THIS PLAN STATES HE IS TO RECEIVE FIXED PAYMENTS AT PRE-DETERMINED INTERVAL FROM ASANTE IF HE IS EMPLOYED BY ASANTE AS CEO AT THE TIME OF VESTING. MR. VINYARD HAS THE AUTHORITY TO DIRECT HOW HIS PLAN ASSETS ARE TO BE INVESTED. IF MR. VINYARD IS NOT EMPLOYED AS CEO BY ASANTE FOR ANY REASON PRIOR TO VESTING, HE WILL NOT HAVE CLAIM TO THE FUNDS. FOR THE FISCAL YEAR ENDED SEPT 30, 2016, THERE WAS $263,250 CONTRIBUTED TO MR. VINYARD'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THIS AMOUNT IS NOT INCLUDED IN HIS REPORTED COMPENSATION UNTIL PAID OUT. HE DID RECEIVE A PAYOUT IN TAX YEAR 2015 IN THE AMOUNT OF $1,286,746 FROM THIS RETIREMENT ACCOUNT. OF THE AMOUNT PAID OUT IN THE CURRENT FISCAL YEAR $1,023,495 WAS ACCRUED IN AND DISCLOSED IN TAX YEARS 2011-2014. ASANTE HAS AN EXECUTIVE RESTORATION PLAN WHICH INCLUDES ASANTE CFO PATRICK HOCKING 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, 2016, THERE WAS $10,010 CONTRIBUTED FOR MR. HOCKING AND $107,919 CONTRIBUTED FOR MR. VINYARD. THESE AMOUNTS WERE INCLUDED IN DEFERRED COMPENSATION REPORTED IN PART II. PART I, LINE 7 TWO OF THE FIVE HIGHEST PAID NON-EXECUTIVE EMPLOYEES, MOSTLY CARDIAC SURGEONS, ARE PAID A BASE SALARY AND THEN RECEIVE PRODUCTIVITY COMPENSATION BASED ON RELATIVE VALUE UNITS (RVU'S). EACH RVU IS $40. TOTAL COMPENSATION IS DETERMINED BY MULTIPLYING THE RVU'S BY $40. A HOSP AUTH OF MEDFORD OR 521378932 584283FL4 2010-02-17 239059650 FINANCE HOSPITAL EXPANSION 0 0 0 B STATE OF OREGON 936001787 NONEAVAIL 2011-12-29 30000000 FINANCE ELEC MED REC SOFTWARE 0 0 0 A 22685000 239059650 3511327 2680107 31041115 201827101 2011 1 0 1 1 B 19998366 30000000 192035 29807965 2013 0 0 1 1 A 0 0 1 1 1 1 0.00250 0.00250 0 0 1 B 0 0 0 1 1 0.00100 0.00100 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: HOSP AUTH OF MEDFORD OR DATE THE REBATE COMPUTATION WAS PERFORMED: 02/19/2016 ISSUER NAME: STATE OF OREGON DATE THE REBATE COMPUTATION WAS PERFORMED: 02/19/2016 PART IV LINE 2C ARBITRAGE REBATE CLACULATION PERFORMED BY BLX ON FEB 19, 2016. NO REBATE LIABILITY DUE. FORM 990, PART VI, SECTION B, LINE 11 POLICY SUMMARY: THE FEDERAL FORMS 990 AND 990-T ARE FEDERALLY MANDATED LEGAL DOCUMENTS THAT ARE HIGHLY REGULATED. WITHIN ASANTE, THEY ARE TO BE PREPARED BY PERSONNEL IN THE ACCOUNTING DEPARTMENT. ADDITIONAL ASSISTANCE WILL BE PROVIDED BY PERSONNEL IN THE MARKETING, COMPLIANCE, AND EXECUTIVE DEPARTMENTS. BEFORE FINAL SUBMISSION OF THE DOCUMENTS, THEY ARE TO HAVE ASANTE 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 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 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 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 AND 990-T WILL BE KEPT AT CORPORATE HEADQUARTERS FOR PUBLIC DISPLAY AND COPYING, AS REQUESTED. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ASANTE MAILS TO ALL ASANTE MANAGEMENT, KEY EMPLOYEES, AND BOARD MEMBERS A CONFLICT OF INTEREST QUESTIONAIRE TO COMPLY WITH ASANTE'S CONFLICT OF INTEREST POLICY# 400-LD-034 AND 036. THE PURPOSE OF THE POLICY IS TO PROTECT ASANTE'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF A BOARD MEMBER OR OFFICER OF THE CORPORATION. IN ADDITION, ALL ASANTE EMPLOYEES HAVE AN OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS TO THEIR SUPERVISOR. THE 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 B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES. THE REVIEW COMPARES THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES WITH COMPENSATION DATA FOR JOB INCUMBENTS IN COMPARABLE POSITIONS AT OTHER HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND SCOPE. THE DATA IS PROVIDED AND PRESENTED TO THE COMPENSATION COMMITTEE BY AN OUTSIDE CONSULTANT. THE COMPENSATION COMMITTEE SETS THE ACTUAL ANNUAL CASH COMPENSATION FOR THE CEO AND SALARY RANGES FOR THE OTHER KEY EMPLOYEES. THE COMMITTEE ALSO SETS TOTAL COMPENSATION OPPORTUNITY FOR THE CEO AND EACH OF THE KEY EMPLOYEES, CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY. MINUTES OF THE COMMITTEE DELIBERATIONS AND DECISIONS ARE RECORDED AND MAINTAINED. THE MOST RECENT EXECUTIVE COMPENSATION REVIEW WAS COMPLETED IN 2012. FORM 990, PART VI, SECTION C, LINE 19 CURRENTLY, ASANTE DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR ITS FINANCIAL STATEMENTS. FORM 990, PART XI, LINE 9: PRIOR YEAR EQUITY TRANSFER ADJUSTMENT 1,923,193. DONATED CAPITAL 297,011. EQUITY TRANSFERS TO AFFILIATES -28,933,451. ASANTE COMMUNITY SERVICES LLC 731 BLACK OAK DRIVE MEDFORD OR 97504 571181175 MEDICAL BILLING OR 168723 53636 ASANTE ASANTE THREE RIVERS MEDICAL CENTER LLC 731 BLACK OAK DRIVE MEDFORD OR 97504 571181758 MEDICAL BILLING OR 12273616 69115882 ASANTE ASANTE FOUNDATION 2650 SISKIYOU BLVD MEDFORD OR 97504 936087366 FUNDRAISING OR 501(C)(3) LINE 11A, I ASANTE 1 SOUTHERN OREGON INSURANCE COMPANY 745 FORT STREET SUITE 800 HONOLULU HI 96813 201578637 CAPTIVE INSURANCE HI 501(C)(3) LINE 11A, I ASANTE 1 ASANTE PHYSICIAN PARTNERS 2650 SISKIYOU BLVD MEDFORD OR 97504 383849354 PHYSICIAN GROUP OR 501(C)(3) LINE 3 ASANTE 1 ASANTE ASHLAND COMMUNITY HOSPITAL 2650 SISKIYOU BLVD MEDFORD OR 97504 931213059 HOSPITAL OR 501(C)(3) LINE 3 ASANTE 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 ASANTE FOUNDATION C 1164479 CASH ASANTE FOUNDATION O 800008 CASH SOUTHERN OREGON INSURANCE COMPANY O 118000 CASH SOUTHERN OREGON INSURANCE COMPANY Q 3099074 CASH ASANTE PHYSICIAN PARTNERS B 32793288 EQUITY TRANSFER ASANTE ASHLAND COMMUNITY HOSPITAL P 139727 CASH ASANTE ASHLAND COMMUNITY HOSPITAL D 0 LOAN GUARANTEE ASANTE ASHLAND COMMUNITY HOSPITAL O 17626232 CASH