2016-09-21T15:19:39-05:00 2015-12-31 930418710 DELAP LLP 5885 MEADOWS ROAD NO 200 LAKE OSWEGO OR 97035 990 2015-01-01 930583856 COLUMBIA LUTHERAN CHARITIES COLU 5033254321 2111 EXCHANGE STREET ASTORIA OR 971033329 STEPHANIE D BRENDEN CFO 5033254321 2016-09-06 1 MARK E EKLUND CPA P00156145 5036974118 2016-09-06 2015 2017-02-10 21:41:12Z COLUMBIA MEMORIAL HOSPITAL STEPHANIE D BRENDEN 2111 EXCHANGE STREET ASTORIA OR 971033329 92696805 0 X WWW.COLUMBIAMEMORIAL.ORG X 1958 OR PROVIDE EXCELLENCE, LEADERSHIP & COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. 12 12 688 115 0 0 733743 290234 76151726 88271302 698482 738811 2590754 3310549 80174705 92610896 38065 52761 0 0 41698697 48043025 0 0 214006 33427207 40420807 75163969 88516593 5010736 4094303 93169432 96537167 50819948 52248520 42349484 44288647 THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. 0 0 74360283 52761 90664955 SEE SCHEDULE O 74360283 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 1 0 1 0 0 0 0 0 1 1 1 0 0 1 109 0 1 688 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 OR X X STEPHANIE D BRENDEN CFO 5033387505 2111 EXCHANGE STREET ASTORIA OR 97103 DAVID PHILLIPS BOARD MEMBER 3.00 X 0 0 0 BILL LIND BOARD MEMBER 3.00 X 0 0 0 HEATHER SEPPA PRESIDENT 3.00 X 0 0 0 KEVIN BAXTER SECRETARY 3.00 X 197008 0 16260 BILL LANDWEHR TREASURER 3.00 X 0 0 0 NANCY MCALLISTER BOARD MEMBER 3.00 X 0 0 0 ED NELSON JR BOARD MEMBER 3.00 X 0 0 0 NORMAN SHATTO BOARD MEMBER 3.00 X 0 0 0 MARK SMITH BOARD MEMBER 3.00 X 0 0 0 CONSTANCE WAISANEN BOARD MEMBER 3.00 X 0 0 0 ROBERT HOLLAND BOARD MEMBER 3.00 X 306147 0 25580 BRUCE BOBEK BOARD MEMBER 3.00 X 0 0 0 ERIK THORSEN CEO 40.00 X 424109 0 77493 STEPHANIE D BRENDEN CFO 40.00 X 241888 0 30099 TERESA L GURRAD CCO 40.00 X 191263 0 25264 JARROD P KARNOFSKI VP - ANCILLIARY SERVICES 40.00 X 178306 0 38594 KATRINA M MCPHERSON VP - MEDICAL GRP OPERATION 40.00 X 257312 0 38360 DOUGLAS ABBOTT MD PHYSICIAN 40.00 X 592364 0 44112 RICHARD CRASS MD PHYSICIAN 40.00 X 380560 0 36591 EDOUARD DURET MD PHYSICIAN 40.00 X 393021 0 45591 PETER BALES MD PHYSICIAN 40.00 X 539121 0 31016 CAMILO ROSALES MD PHYSICIAN 40.00 X 361578 0 24426 4062677 0 433386 68 0 1 0 ANESTHESIA ASSOCIATES NORTHWEST LLC 6400 SE LAKE RD STE 130 PORTLAND OR 97222 ANESTHESIOLOGY PHYSICIANS 1611792 NORTH COAST EMERGENCY PHYSICIANS PC 2111 EXCHANGE STREET ASTORIA OR 97103 EMERGENCY ROOM PHYSICIANS 1527314 RICKENBACH CONSTRUCTIONS INC 37734 EAGLE LANE ASTORIA OR 97103 GENERAL CONTRACTOR 830142 WALSH CONSTRUCTION CO 2905 SW 1ST AVENUE PORTLAND OR 97201 GENERAL CONTRACTOR 819403 HEALTHCARE RESOURCE GROUP INC 12610 EAST MIRABEAU PKWY STE 800 SPOKANE VALLEY WA 99216 BILLING & CODING SERVICES 718747 22 60078 230156 290234 OUTPATIENT REVENUE 621990 97878252 97878252 EMERGENCY ROOM REVENUE 621990 40564076 40564076 INPATIENT REVENUE 621990 36882543 36882543 PROVISION FOR CHARITY CARE 621990 -1980872 -1980872 CONTRACTUAL ALLOWANCE 621990 -84270816 -84270816 -801881 -801881 88271302 473593 473593 261104 34816 226288 226288 226288 316311 51093 265218 265218 265218 JOINT VENTURE 621500 1192364 1192364 COST SETTLEMENT 900099 692121 692121 HOSPITALIST 621110 562101 562101 637675 287052 350623 3084261 92610896 91231228 0 1089434 52761 52761 1640833 1640833 35332082 31044085 4141882 146115 3070806 2695894 361274 13638 5252152 4447635 781028 23489 2747152 2325218 409178 12756 309707 309707 148807 130799 18008 8661301 7443694 1217607 220805 425 220380 284815 175177 109638 1286751 1044479 242272 1784506 1475546 308960 108450 92623 15827 478602 294480 184122 1150067 1150067 4344462 3303913 1040549 1240558 1240558 MEDICAL SUPPLIES & PHAR 11546500 11546500 OTHER PURCHASED SERVICE 2827118 907869 1919249 REPAIRS & MAINTENANCE 1573121 1536784 36337 CONTRACT LABOR 735958 735958 3719279 2846617 872662 88516593 74360283 13942304 214006 33034 61386 2389152 4889203 19245687 16568058 22222 9444 151735 92320 1794224 2380933 971257 857847 83968526 41510299 41901209 42458227 22664385 25548785 1881411 1814415 722194 743067 1392922 1113482 93169432 96537167 9379141 10528211 30113084 29285002 400000 200000 10927723 12235307 50819948 52248520 X 42286216 44225380 63268 63267 42349484 44288647 93169432 96537167 X 4094303 -811586 786 -1344340 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7480255 1147635 8627890 6975139 24437957 16223623 15189473 1511343 665264 846079 41487624 24621412 16866212 928573 928573 42458227 MEDICAL MALPRACTICE CLAIMS 1164445 ACCRUED RETIREMENT PLAN LIABILITY 10932862 ESTIMATED 3RD PARTY PAYOR 138000 12235307 91459849 -811586 34816 -776770 92236619 374277 374277 92610896 88177131 34816 34816 88142315 374278 374278 88516593 PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 34,816. PART XI, LINE 4B - OTHER ADJUSTMENTS: INCOME REPORTED AS EXPENSES ON FORM 990 374,277. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSE 34,816. PART XII, LINE 4B - OTHER ADJUSTMENTS: INCOME REPORTED AS EXPENSES ON FORM 990 374,278. 1 1 1 X 1 X 1 1 0 1 1 1058243 6941 1051302 0.01190 17279138 15342000 1937138 0.02190 18337381 15348941 2988440 0.03380 722904 63729 659175 0.00740 104609 0 104609 0.00120 96482 0 96482 0.00110 923995 63729 860266 0.00970 19261376 15412670 3848706 0.04350 1 3455000 2063516 33325862 56484511 -23158649 X 1 1 1 COASTAL HEALTH ASSURANCE CE/PHYSICIAN ASSC. MEDICAL CONTRACTS 0.50000 0.50000 2 ASTORIA IMAGING LLC MRI JOINT VENTURE 0.51000 0.51000 1 1 COLUMBIA MEMORIAL HOSPITAL 2111 EXCHANGE STREET ASTORIA OR 97103 WWW.COLUMBIAMEMORIAL.ORG 141146 X X X X OTHER COLUMBIA MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X X 13 1 0 0 1 X 1 13 1 WWW.COLUMBIAMEMORIAL.ORG 0 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X X X X 1 X X 1 X X X X 1 X 0 0 COLUMBIA MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THERE ARE SEVERAL SOURCES OF PRIMARY AND SECONDARY DATA FOR THE CHNA ON WHICH THE GOALS AND OUTCOMES OF THIS REPORT ARE BASED: PRIMARY DATA:ENVIRONMENT ASSESSMENT - CONDUCTED IN JUNE 2013 BY AN INDEPENDENT CONSULTANT, STROUDWATER ASSOCIATES, THIS ASSESSMENT UPDATED THE ENVIRONMENT AND PROVIDER NEED ASSESSMENT DATA GATHERED IN 2011 IN SUPPORT OF THE DEVELOPMENT OF COLUMBIA MEMORIAL HOSPITAL'S 2014 TO 2016 STRATEGIC PLAN. COMMUNITY OPINION SURVEY AND PROVIDER NEED ASSESSMENT - CONDUCTED IN JULY 2011 BY AN INDEPENDENT CONSULTANT, HEALTH FACILITIES PLANNING & DEVELOPMENT, THIS SURVEY AND ASSESSMENT DATA PROVIDES INSIGHT INTO COMMUNITY AWARENESS, PERCEPTIONS AND PRIORITIES FOR THE LOCAL HEALTH SYSTEM.KEY INFORMANT INTERVIEWS - FACE-TO-FACE INTERVIEWS WITH BOTH INDEPENDENT AND EMPLOYED PROVIDERS WERE CONDUCTED IN 2011, 2012, AND 2013 TO ASSESS THE NEEDS OF THE COMMUNITY FROM THE PROVIDER PERSPECTIVE. IN ADDITION, A COMMUNITY LEADERSHIP ROUND TABLE WAS HELD IN 2011 AND INCLUDED REPRESENTATIVES FROM THE CITY OF ASTORIA, U.S. COAST GUARD, CLATSOP COUNTY HEALTH DEPARTMENT, COASTAL FAMILY HEALTH CLINIC, CLATSOP CARE CENTER AND OTHERS.FOCUS GROUPS, PATIENT & FAMILY ADVISORY COUNCIL, AND COMMUNITY LEADERSHIP COUNCIL -A) PATIENT FOCUS GROUPS CONSISTING OF PREVIOUS INPATIENT, EMERGENCY, OUTPATIENT, AND CLINIC PATIENTS WERE CONDUCTED IN BOTH SEPTEMBER OF 2011 AND DECEMBER OF 2012 TO GATHER INFORMATION ABOUT AWARENESS, PATIENT-CENTERED PRACTICES, AND OPINIONS ABOUT OPPORTUNITIES FOR IMPROVEMENT FOR LOCAL HEALTHCARE.B) A PATIENT & FAMILY ADVISORY COUNCIL (PFAC) WAS ESTABLISHED IN 2012 TO FORM A CONTINUOUS FEEDBACK LOOP TO IDENTIFY OPPORTUNITIES.C) A COMMUNITY LEADERSHIP COUNCIL REPRESENTING LOCAL GOVERNMENT, SCHOOL DISTRICTS, AND LOCAL BUSINESSES WAS RECENTLY ESTABLISHED IN LATE 2013 TO SUPPORT THE NEXT STEPS IN CREATING A HEALTHIER COMMUNITY. SECONDARY DATA:CLATSOP COUNTY COMMUNITY ASSESSMENT JULY 2013, THIS ASSESSMENT CREATES A FOUNDATION OF SHARED KNOWLEDGE ABOUT THE COMMUNITY HEALTH AND WELL-BEING IN CLATSOP COUNTY. AT LEAST 75% OF CMH PATIENTS RESIDE IN CLATSOP COUNTY, WITH THE REMAINDER LARGELY RESIDING IN PACIFIC COUNTY, WASHINGTON. 16 1 - ONCOLOGY & INFUSION CLINIC 2158 EXCHANGE ST ASTORIA OR 97103 ONCOLOGY CLINIC 2 - ASTORIA IMAGING LLC 2111 EXCHANGE STREET ASTORIA OR 97103 MRI JOINT VENTURE 3 - ORTHOPEDIC CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 ORTHOPEDIC CLINIC 4 - WARRENTON PRIMARY CARE (RHC) 1639 SE ENSIGN LANE SUITE B103 WARRENTON OR 97146 PRIMARY CARE CLINIC 5 - WOMENS CENTER CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 WOMENS CENTER CLINIC 6 - GENERAL SURGERY CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 GENERAL SURGERY CLINIC 7 - PEDIATRIC CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 PEDIATRIC CLINIC 8 - LOWER COLUMBIA HOSPICE 2158 EXCHANGE STREET SUITE 206 ASTORIA OR 97103 HOSPICE SERVICES 9 - URGENT CARE CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 URGENT CARE CLINIC 10 - UROLOGY CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 UROLOGY CLINIC 11 - CARDIOLOGY CLINIC 2095 EXCHANGE ST SUITE 301 ASTORIA OR 97103 CARDIOLOGY CLINIC 12 - CMH HOME HEALTH 2158 EXCHANGE STREET SUITE 206 ASTORIA OR 97103 HOME SERVICES 13 - ENDOCRINOLOGY 2185 EXCHANGE ST SUITE 205 ASTORIA OR 97103 ENDOCRINOLOGY 14 - PULMONOLOGY 2055 EXCHANGE ST SUITE 210 ASTORIA OR 97103 PULMONOLOGY 15 - ENT CLINIC 2055 EXCHANGE ST ASTORIA OR 97103 ENT CLINIC 16 - WOUND CARE CLINIC 2265 EXCHANGE ST ASTORIA OR 97103 WOUND CARE CLINIC PART III, LINE 4: THE COLLECTION OF RECEIVABLES FROM THIRD PARTY PAYERS AND PATIENTS IS THE HOSPITAL'S PRIMARY SOURCE OF CASH AND IS CRITICAL TO ITS OPERATING PERFORMANCE. WHEN THE HOSPITAL PROVIDES CARE TO PATIENTS, IT DOES NOT REQUIRE COLLATERAL; HOWEVER, IT MAINTAINS AN ESTIMATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE PRIMARY COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE PAYOR HAS PAID, BUT PATIENT RESPONSIBILITY AMOUNTS (GENERALLY DEDUCTIBLES AND CO PAYMENTS) REMAIN OUTSTANDING. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS ESTIMATED BASED PRIMARILY UPON THE HOSPITAL'S HISTORICAL COLLECTION EXPERIENCE, THE AGE OF THE PATIENT'S ACCOUNT, MANAGEMENT'S ESTIMATE OF THE PATIENT'S ECONOMIC ABILITY TO PAY AND THE EFFECTIVENESS OF COLLECTION EFFORTS. PATIENT ACCOUNTS RECEIVABLE BALANCES ARE ROUTINELY REVIEWED IN CONJUNCTION WITH HISTORICAL COLLECTION RATES AND OTHER ECONOMIC CONDITIONS WHICH MIGHT ULTIMATELY AFFECT THE COLLECTIBILITY OF PATIENT ACCOUNTS WHEN CONSIDERING THE ADEQUACY OF THE AMOUNTS RECORDED IN THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.ACTUAL WRITE-OFFS HAVE HISTORICALLY BEEN WITHIN MANAGEMENT'S EXPECTATIONS. SIGNIFICANT CHANGES IN PAYOR MIX, BUSINESS OFFICE OPERATIONS, ECONOMIC CONDITIONS, OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTHCARE COVERAGE COULD AFFECT THE HOSPITAL'S COLLECTION OF PATIENT ACCOUNTS RECEIVABLE, CASH FLOWS, AND RESULTS OF OPERATIONS. PART III, LINE 8: AS A MISSION-DRIVEN HOSPITAL, HEALTHCARE SERVICES ARE OFFERED TO THE COMMUNITY EVEN WHEN THE COST OF THAT CARE IS KNOWN TO BE MORE THAN THE REVENUE THAT WILL BE RECEIVED. AS THE HOSPITAL ABSORBS THESE LOSSES FROM MEDICARE (DETERMINED BY THE RATIOS USED IN THE MEDICARE COST REPORT), THE ENTIRE COMMUNITY BENEFITS BECAUSE MANY OF THESE PROGRAMS/SERVICES WOULD NOT EXIST WITHOUT HOSPITAL SUPPORT. PART III, LINE 9B: PERSONAL PAY ACCOUNTS AND THE BALANCE AFTER INSURANCE ARE SUBJECT TO A MINIMUM PAYMENT SCHEDULE. IF THE PATIENT OR GUARANTOR IS UNABLE TO MEET THIS PAYMENT SCHEDULE, APPLICATION MAY BE MADE THROUGH PATIENT FINANCIAL SERVICES CREDIT AND COLLECTION CLERK'(S) AND OR THE PATIENT FINANCIAL SERVICES MANAGER FOR CHARITY, FINANCIAL ASSISTANCE, OR REDUCED PAYMENTS. PART VI, LINE 7, REPORTS FILED WITH STATES OR 0 CLATSOP COMMUNITY COLLEGE 1651 LEXINGTON AVE ASTORIA OR 97103 930505508 501(C)3 14560 SCHOLARSHIPS ASTORIA-WARRENTON CHAMBER OF COMMERCE PO BOX 176 ASTORIA OR 97103 930115760 501(C)6 10000 GREAT COLUMBIA CROSSING RUN/WALK EVENT WILSON SAFETY LLC 1104 E MEAD AVE YAKIMA WA 98903 203983891 13380 DEFIBRILLATOR PROGRAM X 1 1 X X X X 0 1 0 0 0 1 0 0 0 KEVIN BAXTER SECRETARY 193328 0 0 0 3680 0 0 0 16260 0 213268 0 0 0 ROBERT HOLLAND BOARD MEMBER 296878 0 0 0 9269 0 250 0 25330 0 331727 0 0 0 ERIK THORSEN CEO 355902 0 16475 0 51732 0 64828 0 12665 0 501602 0 0 0 STEPHANIE D BRENDEN CFO 216911 0 9900 0 15077 0 19314 0 10785 0 271987 0 0 0 TERESA L GURRAD CCO 178433 0 10998 0 1832 0 10213 0 15051 0 216527 0 0 0 JARROD P KARNOFSKI VP - ANCILLIARY SERVICES 154364 0 6649 0 17293 0 14203 0 24391 0 216900 0 0 0 KATRINA M MCPHERSON VP - MEDICAL GRP OPERATION 241463 0 5279 0 10570 0 13969 0 24391 0 295672 0 0 0 DOUGLAS ABBOTT MD PHYSICIAN 573934 0 5000 0 13430 0 19721 0 24391 0 636476 0 0 0 RICHARD CRASS MD PHYSICIAN 363510 0 1000 0 16050 0 16627 0 19964 0 417151 0 0 0 EDOUARD DURET MD PHYSICIAN 374836 0 4145 0 14040 0 21200 0 24391 0 438612 0 0 0 PETER BALES MD PHYSICIAN 524854 0 5000 0 9267 0 6625 0 24391 0 570137 0 0 0 CAMILO ROSALES MD PHYSICIAN 350002 0 6642 0 4934 0 4462 0 19964 0 386004 0 0 0 PART I, LINE 1A ASTORIA GOLF AND COUNTRY CLUB DUES FOR CEO ERIK THORSEN WERE PAID BY THE ORGANIZATION. PART I, LINE 4B ERIK THORSEN, CEO IS NOW PARTICIPATING IN A 457(F) PLAN. THIS PLAN STARTED IN 2015. PART I, LINE 6 MANAGEMENT BONUSES ARE CONTINGENT ON THE NET EARNINGS OF THE ORGANIZATION. A THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF ASTORIA 270034718 046279BS3 2012-09-27 31993533 FINANCE EHR SYSTEM, ASSET ACQUISTION, REFUNDING OF 2002 & 2007 BOND ISSUES 1 0 0 A 31993533 137103 893237 2481822 2015 1 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 0 A 0 PETER BALES EMPLOYEE SIGN ON BONUS X 20000 9444 0 1 1 9444 72000 0 HEATHER SEPPA CMH PRESIDENT OFFICER AT COLUMBIA STATE BANK, ONE OF THE PRIMARY BANKS USED BY CMH. 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE 990 IS MADE AVAILABLE, ELECTRONICALLY, TO THE BOARD OF TRUSTEES, PRIOR TO THE BOARD MEETING. THE 990 IS REVIEWED AND DISCUSSED AT THE BOARD FINANCE COMMITTEE MEETING PRIOR TO FINALIZING AND FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD OF TRUSTEES, OFFICERS, AND KEY EMPLOYEES ANNUALLY. ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES MUST SIGN AND DATE THE CONFLICT OF INTEREST POLICY ACKNOWLEDGEMENT, QUESTIONNAIRE, AND DISCLOSURE STATEMENT. ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST AT THE BOARD OR OFFICER LEVEL ARE DISCUSSED AT THE BOARD MEETING. ACTUAL CONFLICTS OF INTEREST ARE ADDRESSED, DOCUMENTED, AND FILED IN THE CONFIDENTIAL PERSONNEL FILE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF ALL OFFICERS WAS REVIEWED WITH COMPARABILITY DATA BY A THIRD PARTY CONSULTANT. THE RESULTS OF THE STUDY WERE REVIEWED AND DISCUSSED AT A BOARD OF TRUSTEES' MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL INFORMATION REPORTED IN THE 990 ARE AVAILABLE UPON REQUEST AT THE HOSPITAL. FORM 990, PART XI, LINE 9: DEFINED BENEFIT RETIREMENT PLAN ADJUSTMENT -1,381,840. NET ASSETS RELEASED FROM RESTRICTION - CITY OF ASTORIA GRANT 37,500. FROM 990, PART XI, LINE 2C: THE BOARD OF TRUSTEE FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT, REVIEW, AND SELECTION OF AN INDEPENDENT AUDIT FIRM. TRADITIONALLY, A THREE YEAR CONTRACT WITH A SELECTED AUDIT FIRM IS APPROVED. ANNUALLY, A SPECIAL BOARD MEETING IS HELD AND THE AUDIT FIRM PRESENTS THE AUDITED FINANCIAL STATEMENTS TO THE BOARD OF TRUSTEES. DURING THE MEETING, THE BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO ASK QUESTIONS WITHOUT MANAGEMENT PRESENT. FOLLOW-UP INFORMATION ON THE MANAGEMENT LETTER RECOMMENDATIONS IS ALSO PRESENTED SEMI-ANNUALLY TO THE BOARD FINANCE COMMITTEE. FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS MISSION STATEMENT: THE MISSION OF COLUMBIA MEMORIAL HOSPITAL IS TO PROVIDE EXCELLENCE, LEADERSHIP, AND COMPASSION IN THE ENHANCEMENT OF HEALTH FOR THOSE WE SERVE. UTILIZATION STATISTICS FOR 2015: AVAILABLE BEDS: 25 ADMISSIONS: 1,789 PATIENT DAYS: 4,595 OBSERVATIONS: 536 AVERAGE LENGTH-OF-STAY: 2.57 DAYS OCCUPANCY RATE: 50.4% DELIVERIES: 317 EMERGENCY ROOM VISITS: 13,255 URGENT CARE VISITS: 14,806 OUTPATIENT VISITS (NET OF ER): 160,544 SURGICAL CASES: 2,448 PLANETREE THE HOSPITAL HAS ADOPTED A PHILOSOPHY OF PROVIDING PATIENT-CENTERED CARE THROUGHOUT ITS FACILITIES. IN 2000, THE HOSPITAL JOINED AN ORGANIZATION CALLED PLANETREE, INC. ("PLANETREE") AS AN AFFILIATE MEMBER. PLANETREE PARTNERS WITH HEALTHCARE ORGANIZATIONS AROUND THE WORLD TO DEVELOP AND ADVANCE PATIENT-CENTERED APPROACHES TO CARE. IN 2013, THE HOSPITAL BECAME ONLY THE SECOND HOSPITAL IN OREGON TO ACHIEVE THE PRESTIGIOUS PLANETREE-DESIGNATION STATUS. PLANETREE-DESIGNATION REPRESENTS THE HIGHEST LEVEL OF ACHIEVEMENT IN PATIENT-/PERSON-CENTERED CARE BASED ON EVIDENCE AND STANDARDS, ACCORDING TO PLANETREE. PLANETREE-DESIGNATED HOSPITALS MUST DEMONSTRATE THEIR COMMITMENT AND SUCCESSFUL ADOPTION OF THE PATIENT CENTER CARE PRINCIPLES BY PASSING A RIGOROUS SURVEY PROCESS, PERFORMED BY PLANETREE EVERY THREE (3) YEARS. THE HOSPITAL HAS MAINTAINED PLANETREE-DESIGNATION BY CREATING AN ORGANIZATIONAL CULTURE COMMITTED TO PROVIDING THE LATEST IN MEDICAL TECHNOLOGY IN A HEALING, NURTURING ENVIRONMENT THAT ENCOURAGES A PATIENT'S INVOLVEMENT IN THE CARE THAT THEY RECEIVE. THE HOSPITAL CONTINUALLY STRIVES TO OFFER PEACEFUL, COMFORTABLE SURROUNDINGS, WARM AND SUPPORTIVE CAREGIVERS, ACCESS TO HEALTH INFORMATION ALTERNATIVE THERAPIES, AND EDUCATION TO HELP PATIENTS GET WELL FASTER AND STAY WELL LONGER. COLUMBIA MEMORIAL HOSPITAL RECENT ACCREDITATIONS: HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP) A NATIONALLY RECOGNIZED ACCREDITATION ORGANIZATION WITH DEEMING AUTHORITY FROM THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS). COMMISSION ON OFFICE LABORATORY ACCREDITATION (COLA) - LABORATORY ACCREDITATION AMERICAN COLLEGE OF RADIOLOGY MAMMOGRAPHY QUALITY STANDARDS ACT (ACR/MSQA) - IMAGING SERVICES - MAMMOGRAPHY ACCREDITATION INTERSOCIETAL ACCREDITATION COMMISSION (IAC) - ECHOCARDIOGRAPHY ACCREDITATION AMERICAN ASSOCIATION OF CARDIOVASULAR PULMONARY REHABILITATION (AACVP) - CARDIAC REHABILITATION ACCREDITATION AMERICAN ASSOCIATION FOR RESPIRATORY CARE QUALITY RESPIRATORY CARE RECOGNITION (AARC'S QRCR) - RESPIRATORY THERAPY ACCREDITATION INFORMATION TECHNOLOGY: THE HOSPITAL'S INVESTMENTS IN THE HEALTHCARE INFORMATION TECHNOLOGY ALONG WITH THE NECESSARY HUMAN RESOURCES AND ASSOCIATED PROCESS CHANGE HAVE RESULTED IN IMPROVED CLINICAL OPERATIONS, QUALITY, PATIENT SAFETY, AND OVERALL EFFICIENCY. THE HOSPITAL RECEIVED THE MOST WIRED AWARD FROM THE AMERICAN HOSPITAL ASSOCIATION IN FIVE CONSECUTIVE YEARS OF 2011- 2015. THE HOSPITAL ALSO ACHIEVED COMPLIANCE WITH THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009 MEANINGFUL USE OF HEALTHCARE IT CRITERIA BOTH STAGE 1 AND STAGE 2. SINCE 2012, THE HOSPITAL HAS REALIZED MEANINGFUL USE INCENTIVE REVENUES OF APPROXIMATELY $3,164,000 FROM ITS HOSPITAL AND OWNED PHYSICIAN PROVIDERS. THE HOSPITAL INVESTED IN AN INDUSTRY LEADING BUSINESS INTELLIGENCE PLATFORM WHICH IS UTILIZED IN OPTIMIZING OPERATIONS AND FINANCIAL PERFORMANCE. THE CMH MEDICAL GROUP THE HOSPITAL OWNS AND OPERATES A NUMBER OF PROVIDER-BASED PRIMARY, URGENT CARE, AND SPECIALTY CARE CLINICS ORGANIZED AND COLLECTIVELY KNOWN AS THE CMH MEDICAL GROUP. THE CLINICS OPERATE IN THREE (3) SEPARATE ASTORIA LOCATIONS AND ONE (1) WARRENTON, OREGON LOCATION. THE WARRENTON LOCATION OPERATES AS A PROVIDER-BASED RURAL HEALTH CLINIC, WHICH EXPANDED AND DOUBLED THE CAPACITY TO PROVIDE PRIMARY CARE SERVICES FOR THE COMMUNITY IN 2015. THERE ARE THIRTY (30) PHYSICIANS AND MID-LEVEL PROVIDERS EMPLOYED WITHIN THE CMH MEDICAL GROUP IN ELEVEN (11) DIFFERENT MEDICAL SPECIALTIES. THESE SPECIALTIES INCLUDE: GENERAL SURGERY, PEDIATRICS, PRIMARY CARE, URGENT CARE, UROLOGY, ENDOCRINOLOGY, ORTHOPEDICS, PODIATRY, AND WOMEN'S HEALTHCARE, ONCOLOGY IN COLLABORATION WITH OHSU, AND CARDIOLOGY IN COLLABORATION WITH OHSU. CLINICAL COLLABORATIONS IN ORDER TO ENHANCE THE SERVICES THAT THE HOSPITAL PROVIDES TO THE COMMUNITY, THE HOSPITAL ESTABLISHED A CLINICAL ALLIANCE WITH OHSU IN 2010. THROUGH THIS ALLIANCE, THE HOSPITAL AND OHSU INITIALLY CREATED THE CMH/OHSU CANCER CARE CENTER, WHICH IS DEDICATED TO PROVIDING COMPREHENSIVE, INTERDISCIPLINARY, CONSULTATIVE, AND ONGOING ONCOLOGY AND HEMATOLOGY CARE. IN 2011, THE HOSPITAL AND OHSU ESTABLISHED THE CMH/OHSU CARDIOLOGY CLINIC, WHICH PROVIDES COMPREHENSIVE CARE FOR A RANGE OF HEART HEALTH AND HEART DISEASE PREVENTION NEEDS IN THE COMMUNITY. SINCE 2011, THE ALLIANCE HAS BROADENED SUBSTANTIALLY AND NOW INCLUDES CLINICAL OVERSIGHT AND STAFFING OF THE HOSPITAL'S EMERGENCY DEPARTMENT, GENERAL SURGERY AND RESIDENCY PROGRAMS, TELEMEDICINE, A WOMEN'S HEART HEALTH RESEARCH PROJECT, AND CONTINUING MEDICAL EDUCATION. IN TOTAL, THERE ARE APPROXIMATELY SIXTEEN (16) OHSU PHYSICIANS WORKING FULL-TIME IN THE HOSPITAL'S FACILITIES. IN MARCH 2015, THE HOSPITAL ENTERED INTO A NEW JOINT OPERATING AGREEMENT ("JOA") WITH OHSU THROUGH THE OHSU KNIGHT CANCER INSTITUTE TO BETTER SERVE THE ONCOLOGY CARE NEEDS OF THE ASTORIA AREA AND SURROUNDING COMMUNITIES. THE JOA WILL ADD RADIATION ONCOLOGY SERVICES TO THE EXISTING CMH/OHSU CANCER CARE CENTER MEDICAL ONCOLOGY PROGRAM AND REBRAND THE CENTER AS THE CMH - OHSU KNIGHT CANCER COLLABORATIVE. IT IS ANTICIPATED THAT THIS NEW COLLABORATION WILL PROVIDE FOR HIGH-QUALITY, COST-EFFICIENT, SAFE, AND EFFECTIVE ONCOLOGY SERVICES FOR THE RESIDENTS OF ASTORIA AND SURROUNDING COMMUNITIES. A NEW BOND ISSUE IS ANTICIPATED IN 2016 TO PROVIDE FINANCING FOR THE CONSTRUCTION AND EQUIPPING OF A NEW 19,000 SQUARE-FOOT, TWO-STORY COMPREHENSIVE CANCER TREATMENT CENTER (THE "CANCER CENTER"). THE CANCER CENTER WILL INCORPORATE AND ALLOW FOR THE EXPANSION OF THE CURRENT MEDICAL ONCOLOGY AND INFUSION THERAPY CLINIC. IN ADDITION, THE CANCER CENTER WILL BRING RADIATION ONCOLOGY SERVICES TO THE REGION. THERE ARE CURRENTLY NO RADIATION THERAPY SERVICES AVAILABLE ON THE NORTH OREGON COAST. CMH FOUNDATION THE HOSPITAL BENEFITS FROM SUBSTANTIAL COMMUNITY SUPPORT. THE FOUNDATION PROVIDES A DIRECT LINK TO THE REGION'S NEED FOR COMPASSIONATE HEALTH CARE BY SUPPORTING THE ENHANCEMENT OF THE HOSPITAL'S PROGRAMS AND SERVICES. THE FOUNDATION WAS INCORPORATED IN 1991 BY A GROUP OF CITIZENS TO SERVE AS THE BRIDGE BETWEEN THE COMMUNITY AND THE HOSPITAL TO ENCOURAGE FINANCIAL SUPPORT OF HEALTH PROGRAMS AND SERVICES. THE FOUNDATION IS A DEDICATED FUND DEVELOPMENT ENTITY THAT HAS SUCCESSFULLY RAISED OVER $5,000,000. IN 2010, THE FOUNDATION CONTRIBUTED $500,000 TO THE HOSPITAL TO ASSIST WITH THE SURGERY CENTER RENOVATION. THIS SUPPORT CONTINUED WITH A $185,000 DONATION IN 2012 FOR THE CONTINUED EXPANSION OF THE CANCER CENTER AND HAS RAISED AN ADDITION $2,000,000 TO BENEFIT THAT PROGRAM. THE FOUNDATION FOCUSES ON WORKING WITH DONORS WHO WISH TO MAKE MAJOR AND PLANNED GIFTS IN SUPPORT OF THE HOSPITAL. IN SOME CASES, THE FOUNDATION WILL SELECT ONE PROJECT TO FUND, AND IN OTHER CASES, THE FOUNDATION RAISES FUNDS TO SUPPORT A VARIETY OF PRIORITIES AS IDENTIFIED BY THE HOSPITAL AND IN PARTNERSHIP WITH DONORS. THE FOUNDATION PROVIDES OPPORTUNITIES FOR DONORS TO SUPPORT A MISSION THAT MATCHES THEIR OWN INTERESTS SUCH AS PROVIDING EQUIPMENT, CREATING PROGRAMS TO SERVE THE COMMUNITY, OR FUNDING THE FUTURE THROUGH ENDOWMENT. COLUMBIA MEMORIAL HOSPITAL FOUNDATION 2111 EXCHANGE STREET ASTORIA OR 97103 931091701 FUNDRAISING FOR THE HOSPITAL OR 501(C)3 LINE 11A, I 1 COLUMBIA MEMORIAL HOSPITAL AUXILIARY 2111 EXCHANGE STREET ASTORIA OR 97103 931306211 PROVIDE VOLUNTEERS OR 501(C)3 LINE 11A, I 0 ASTORIA IMAGING LLC 2111 EXCHANGE STREET ASTORIA OR 97103 800240381 MRI JOINT VENTURE OR RELATED 950298 1793587 0 1 0.51000 COASTAL HEALTH ASSURANCE INC 2111 EXCHANGE STREET ASTORIA OR 97103 911818894 PHYSICAN ASSOCIATION, MEDICAL CONTRACT MANAGEMENT OR C 20828 0.50000 0 0 1 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 0 0 CMH FOUNDATION (IN-KIND CONTRIBUTIONS) B 19148 ACTUAL CMH FOUNDATION (IN-KIND CONTRIBUTIONS SALARY EXPENSES) O 198229 ACTUAL ASTORIA IMAGING LLC (SALARY EXPENSES FOR MRI MGMT TECHS & REGISTRATION) O 362793 ACTUAL CMH FOUNDATION (TOTAL QUARTERLY TRANSFERS) Q 124259 ACTUAL