2016-12-14T17:23:14-06:00 2015-10-31 910189318 MOSS ADAMS LLP PO BOX 22650 YAKIMA WA 989072650 990 2014-11-01 910567263 YAKIMA VALLEY MEMORIAL HOSPITAL YAKI 5095758000 2811 TIETON DRIVE YAKIMA WA 989023799 RUSSELL MYERS PRESIDENT/CEO 5095758000 2016-12-09 1 CHRISTOPHER E RIVARD P00022321 5092487750 2016-09-09 2014 2017-02-10 21:41:12Z RUSSELL MYERS 2811 TIETON DRIVE YAKIMA WA 989023799 410415465 0 X WWW.YAKIMAMEMORIAL.ORG X 1950 WA PROVIDE ACUTE INPATIENT AND OUTPATIENT SERVICES TO OUR COMMUNITY. 14 13 2748 368 37099531 -10575607 4102133 4118760 351898680 402945026 -90151 244293 37645445 220773 393556107 407528852 0 144722 0 0 191145667 201916503 0 0 0 210840198 193728057 401985865 395789282 -8429758 11739570 255236646 268457783 123365649 124936465 131870997 143521318 X SEE SCHEDULE O. 0 0 170153158 0 228497708 YAKIMA VALLEY MEMORIAL HOSPITAL SERVED 427,339 OUTPATIENT VISITS FOR VARIOUS SERVICES INCLUDING SURGERY, CANCER CARE, DIAGNOSTIC TESTING, AND THERAPEUTIC SERVICES. THOSE OUTPATIENT SERVICES WERE OFFERED IN A MANNER CONSISTENT WITH THE HOSPITAL'S 501(C)(3) STATUS. THE INTENT OF THE SERVICES IS TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. CHARITY CARE IS PROVIDED PER THE TERMS OF THE HOSPITAL'S CHARITY CARE POLICY. THE HOSPITAL ALSO PROVIDES NUMEROUS EDUCATIONAL SERVICES FOR STUDENT PHYSICIANS, NURSES, AND ALLIED HEALTH CARE PROFESSIONALS. 93373595 0 131331343 YAKIMA VALLEY MEMORIAL HOSPITAL ADMITTED 11,662 PATIENTS FOR A TOTAL OF 45,941 PATIENT DAYS. THOSE INPATIENT SERVICES WERE OFFERED IN A MANNER CONSISTENT WITH THE HOSPITAL'S 501(C)(3) STATUS. THE INTENT OF THE SERVICES IS TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. CHARITY CARE IS PROVIDED PER THE TERMS OF THE HOSPITAL'S CHARITY CARE POLICY. THE HOSPITAL ALSO PROVIDES NUMEROUS EDUCATIONAL SERVICES FOR STUDENT PHYSICIANS, NURSES, AND ALLIED HEALTH CARE PROFESSIONALS. 19276832 0 2038812 YAKIMA VALLEY MEMORIAL HOSPITAL PROVIDES DIRECT SUPPORTING SERVICES TO BETTER ASSIST IN PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES, BUT NOT DIRECTLY IDENTIFIABLE WITH EITHER INPATIENT OR OUTPATIENT SERVICES PROVIDED. THESE SERVICES WERE OFFERED IN A MANNER CONSISTENT WITH THE HOSPITAL'S 501(C)(3) STATUS. THE INTENT OF THE SERVICES IS TO SERVE THE HEALTH CARE NEEDS OF THE COMMUNITY. CHARITY CARE IS PROVIDED PER THE TERMS OF THE HOSPITAL'S CHARITY CARE POLICY. THE HOSPITAL ALSO PROVIDES NUMEROUS EDUCATIONAL SERVICES FOR STUDENT PHYSICIANS, NURSES, AND ALLIED HEALTH CARE PROFESSIONALS. 6275224 144722 1652329 COORDINATION OF CHILDRENS SERVICES, RESIDENCY PROGRAMS, AND COMMUNITY EDUCATION REGARDING HEALTH ISSUES. 6275224 144722 1652329 289078809 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 188 0 1 2748 1 1 1 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WA X TIMMOTHY REED VPCFO 5095758000 2811 TIETON DR YAKIMA WA 98902 JAMES BERG CHAIRMAN 3.60 X X 0 0 0 SCOTT WAGNER VICE-CHAIRMAN 3.60 X X 0 0 0 WILLIAM FELDMANN SECRETARY-TREASURER 3.30 X X 0 0 0 BUFFY ALEGRIA TRUSTEE 2.10 X 0 0 0 SONIA RODRIGUEZ-TRUE TRUSTEE 1.60 X 0 0 0 ROSS KATZ TRUSTEE 1.90 X 0 0 0 LISA SHIELDS TRUSTEE 1.90 X 0 0 0 CRAIG MENDENHALL TRUSTEE 1.90 X 0 0 0 BRIAN PADILLA TRUSTEE 1.90 X 0 0 0 KEITH RIFFE TRUSTEE 2.60 X 0 0 0 DUANE ROSSMAN TRUSTEE 2.50 X 0 0 0 DAVID HARGREAVES TRUSTEE 2.30 X 0 0 0 ROGER VIELBIG TRUSTEE 1.40 X 0 0 0 GAIL WEAVER TRUSTEE 1.80 X 0 0 0 RUSSELL M MYERS PRESIDENT/CEO 40.00 X 458732 0 56603 TIM REED VP/CFO 40.00 X 194723 0 23202 DALE S OLANDER VP/CFO UNTIL 11/14 40.00 X 524785 0 31477 ANNE CAFFERY PRESIDENT/CEO - FOUNDATION 40.00 X 217971 0 53020 DIANE PATTERSON VICE PRESIDENT/CCO 40.00 X 189263 0 37358 JAMES ABERLE VICE PRESIDENT/COO 40.00 X 231311 0 39894 JEFF YAMADA VICE PRESIDENT/CIO 40.00 X 202045 0 39359 RICHARD SPIEGIL PRESIDENT/CEO - SIGNAL HEALTH 40.00 X 302812 0 29515 GREG SAWYER VP/ PRES. - MP UNTIL 11/14 40.00 X 1506064 0 20383 ROBERT J CONROY PHYSICIAN - MP 40.00 X 461694 0 29631 VU LE PHYSICIAN - MP 40.00 X 624122 0 30849 PRAVEEN GUTURU PHYSICIAN - MP 40.00 X 514550 0 33103 TEKCHAND TANWANI PHYSICIAN - MP 40.00 X 497920 0 32294 CHESTER S CHAU PHYSICIAN 40.00 X 460935 0 25220 RICHARD W LINNEWEH JR FORMER PRESIDENT/CEO 6.00 X 174478 0 10452 SANDRA DAHL FORMER VICE PRESIDENT/CCO 40.00 X 526819 0 26220 TERESA PRITCHARD FORMER VICE PRESIDENT/PEOPLE & CULTURE 40.00 X 280438 0 5510 7368662 0 524090 256 1 1 0 EMERGENCY ASSOCIATES OF YAKIMA 2811 TIETON DR YAKIMA WA 98902 MEDICAL AND HEALTH CARE 7553287 PHYSICIAN ANESTHESIA ASSOCIATION 406 S 30TH AVE SUITE 202 YAKIMA WA 98902 MEDICAL AND HEALTH CARE 2370742 COMMUNITY HEALTH OF CENTRAL WASHINGTON 1806 W LINCOLN AVE YAKIMA WA 98902 MEDICAL AND HEALTH CARE 1842028 OBHG WASHINGTON PC 10 CENTIMETER DRIVE MAULDIN SC 29662 MEDICAL AND HEALTH CARE 1683000 YAKIMA CHEST CLINIC 303 HOLTON SUITE 1 YAKIMA WA 98902 MEDICAL AND HEALTH CARE 1151284 49 1837807 2280953 4118760 NET PATIENT REVENUES 900099 362715393 362715393 MEMORIAL PHYSICIANS 621110 36774586 36774586 CAFE 722210 1908555 1908555 CHILD CARE 624410 741693 741693 EXPENSE REIMBURSEMENTS 900009 697222 697222 107577 107577 402945026 165042 165042 1474811 1492074 -17263 -17263 30127 -47390 1473790 1394539 79251 79251 79251 LAB SERVICES 900009 184162 184162 YAKIMA UROLOGY BILLING FEE 900009 79378 79378 HOUSEKEEPING SERVICES 900009 31278 31278 -56782 -56782 238036 407528852 363520192 37099531 2790369 X 144722 144722 5141563 3856172 1285391 127684 85483 42201 149229778 96116352 53113426 10491781 6887240 3604541 24957408 16194839 8762569 11968289 7708831 4259458 1100118 1487 1098631 169832 169832 129978 129978 67146024 54424287 12721737 1008740 1008740 77601549 65833192 11768357 3839747 2879810 959937 7903765 6620870 1282895 1041096 575677 465419 2153424 1615068 538356 17005346 15727423 1277923 2607066 1338422 1268644 LICENSES AND TAXES 11809751 8857313 2952438 MALPRACTICE OUT OF POCK 211621 211621 395789282 289078809 106710473 0 13857008 53680158 963585 517419 52739187 49958739 1746338 1656500 6502476 7973338 6311975 6831296 339464862 221158032 121339270 118306830 46701266 22940086 2416750 2323714 1375779 2979351 1283012 1290352 255236646 268457783 55925761 62857274 86299 41927 59573816 53069465 3710485 8967799 4069288 0 123365649 124936465 X 130566101 142306351 1304896 1214967 131870997 143521318 255236646 268457783 X 11739570 577716 -666965 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 129978 129978 0 PART II-B, LINE 1: THE HOSPITAL PAID THREE COMPANIES FOR LEGISLATIVE CONSULTING AND LOBBYING FOR A TOTAL OF $79,014. PART OF THE DUES PAID TO THE FOLLOWING ORGANIZATIONS, WAS USED FOR LOBBYING: AMERICAN HOSPITAL ASSOCIATION: $7,707; WASHINGTON STATE HOSPITAL ASSOCIATION: $38,031; HEALTH FACILITIES PLANNING & DEVELOPMENT: $5,226. 13766391 13766391 99637543 58356815 41280728 9805746 5817234 3988512 205777138 152676495 53100643 10478044 4307488 6170556 118306830 X PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). THE HOSPITAL HAS WHOLLY-OWNED SUBSIDIARIES AND A GRANTOR TRUST INTEREST THAT ARE TREATED AS DISREGARDED ENTITIES FOR TAX PURPOSES. THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC EXCEPT TO THE EXTENT OF UNRELATED BUSINESS TAXABLE INCOME AS DEFINED UNDER IRC SECTIONS 511 THROUGH 515. THE HOSPITAL HAS ADOPTED ACCOUNTING FOR UNCERTAIN TAX POSITIONS. THE ACCOUNTING STANDARD PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR UNCERTAIN TAX REQUIRING ACCRUAL. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AS OF OCTOBER 31, 2015 AND 2014 REQUIRING ACCRUAL. 1 1 X 1 X 1 X 1 1 0 1 1 6852258 889923 5962335 0.01510 93076619 68069081 25007538 0.06320 0 0 99928877 68959004 30969873 0.07830 2988405 664674 2323731 0.00590 3669891 0 3669891 0.00930 663702 195684 468018 0.00120 324701 975 323726 0.00080 315685 0 315685 0.00080 7962384 861333 7101051 0.01800 107891261 69820337 38070924 0.09630 1 12849 7837 5012 0.00000 1 51890 10000 41890 0.00010 2 1181 0 1181 0.00000 4 65920 17837 48083 0.00010 1 3445833 0 96177067 97760274 -1583207 X 1 1 1 1 YAKIMA VALLEY MEMORIAL HOSPITAL 2811 TIETON DRIVE YAKIMA WA 98902 HTTPS://WWW.YAKIMAMEMORIAL.ORG 58 X X X X YAKIMA VALLEY MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X 12 1 0 0 1 X X 1 13 1 HTTPS://WWW.YAKIMAMEMORIAL.ORG 0 0 1 X 300.000000000000 300.000000000000 X X 1 1 X X X 1 X WWW.YAKIMAMEMORIAL.ORG 1 X 0 X X X X 1 X 0 0 YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 3J: A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY FOLLOWING THE HEALTH PEOPLE 2020 FRAMEWORK. THE AREAS OF ASSESSMENT ARE: DEMOGRAPHICS, ACCESS TO HEALTH SERVICES, CHRONIC DISEASE PROFILE, CLINICAL PREVENTIVE SERVICES, MORTALITY, ENVIRONMENTAL QUALITY, INJURY AND VIOLENCE, MCH, MENTAL HEALTH, NUTRITION, PHYSICAL ACTIVITY, OBESITY, REPRODUCTIVE SEXUAL HEALTH, SOCIAL DETERMINANTS AND SUBSTANCE ABUSE. ADDITIONAL ONGOING ASSESSMENTS ARE CONDUCTED ON AN ONGOING BASIS TO TRACK NEEDS. DATA SOURCES USED ARE INTERNAL, US CENSUS, BRFSS, HEALTH YOUTH SURVEY, DEPARTMENT OF HEALTH, CANCER REGISTRY AND MANY OTHER PUBLIC DATA SOURCES. DISPARITY GAPS WERE IDENTIFIED WHEN COMPARING THE STATE OF WASHINGTON TO YAKIMA COUNTY. FURTHERMORE, WHEN DATA WAS AVAILABLE, INDICATORS WERE STRATIFIED BY AGE, SEX AND RACE/ETHNICITY IN ORDER TO IDENTIFY DISPARITIES IN HEALTH OUTCOMES. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: INPUT FOR DEVELOPMENT OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS THROUGH A WORK GROUP COMPOSED OF REPRESENTATIVES FROM OTHER AGENCIES IN YAKIMA COUNTY AND THE WORK GROUP WAS DIVERSE AND REPRESENTED THE POPULATION SERVED. WE HAD REPRESENTATION FROM THE LATINO/HISPANIC AND NATIVE AMERICAN COMMUNITIES. A FULL LIST OF PARTNERS IS INCLUDED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, WHICH CAN BE FOUND ON YAKIMA VALLEY MEMORIAL HOSPITAL'S WEBSITE: WWW.YAKIMAMEMORIAL.ORG. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA WAS MADE PUBLIC THROUGH PRESENTATIONS TO COMMUNITY COALITIONS AND GROUPS. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: YAKIMA VALLEY MEMORIAL HOSPITAL IDENTIFIED 7 PRIORITY AREAS IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THESE PRIORITY AREAS ARE: ACCESS TO CARE, DISPARITIES IN HEALTH OUTCOMES, ADVERSE CHILDHOOD EXPERIENCES (ACES), MENTAL HEALTH, UNINTENTIONAL NON-FATAL HOSPITALIZATIONS (SPECIFICALLY FALLS), FOOD INSECURITY, AND MATERNAL CHILD HEALTH GAP ANALYSIS PRIORITIES. YAKIMA VALLEY MEMORIAL HOSPITAL IDENTIFIED FOUR OF THOSE PRIORITIES BASED ON NEED AND OUR ABILITY TO ADDRESS THE NEED: ACCESS TO CARE, DISPARITIES IN HEALTH OUTCOMES, ADVERSE CHILDHOOD EXPERIENCES, AND UNINTENTIONAL NON-FATAL HOSPITALIZATIONS."ACCESS TO CARE": YAKIMA VALLEY MEMORIAL HOSPITAL FACILITATES THE EDUCATION OF PATIENTS, EMPLOYEES AND COMMUNITY MEMBERS ON ACCESSING WASHINGTON STATE HEALTH BENEFITS EXCHANGE. WE ARE WORKING WITH PARTNERS AS PART OF THE ACCOUNTABLE CARE COMMUNITY TO EXPLORE DEVELOPMENT OF A REGIONAL HEALTH IMPROVEMENT COLLABORATIVE. WE HAVE INSTITUTED A NUMBER OF INTERNAL INITIATIVES TO IMPROVE ACCESS TO PRIMARY CARE AND SPECIALITY CLINICS, AS WELL AS REDUCE WAIT TIME. WE PARTNER WITH AND FINANCIALLY SUPPORT LOCAL COMMUNITY COLLEGES AND HEALTH PROFESSION EDUCATION PROGRAMS AT: PACIFIC NORTHWEST UNIVERSITY, HERITAGE UNIVERSITY, YAKIMA VALLEY COMMUNITY COLLEGE, WASHINGTON STATE UNIVERSITY AND CENTRAL WASHINGTON FAMILY MEDICINE. ON SITE, YAKIMA VALLEY MEMORIAL HOSPITAL MENTORS AND TRAINS LOCAL HEALTH PROFESSIONALS FROM COLLEGE PROGRAMS ACROSS THE COUNTY. THIS ALLOWS STUDENTS TO PRACTICE IN THEIR RESPECTIVE FIELD OF STUDY AS REQUIRED TO COMPLETE THEIR DEGREE AND SIT FOR ASSOCIATED EXAMS. AFTER TRAINING AND COMPLETION OF COURSE WORK EACH HEALTH PROFESSIONAL IS READY FOR THE WORKFORCE AND FILL MUCH NEEDED VACANCIES WITHIN THE COMMUNITY. YAKIMA VALLEY MEMORIAL HOSPITAL ALSO PROVIDES A NUMBER OF CONTINUING MEDICAL EDUCATION PROGRAMMING EACH YEAR TO SERVE THE MEDICAL PROFESSIONALS ACROSS THE COMMUNITY ALLOWING THEM TO RENEW LICENSING AND CONTINUE TO PRACTICE IN YAKIMA COUNTY."DISPARITIES IN HEALTH OUTCOMES": YAKIMA VALLEY MEMORIAL HOSPITAL IS WORKING ON INITIATIVES TO IMPROVE THE COLLECTION OF DEMOGRAPHIC DATA (E.G. RACE, ETHNICITY AND PREFERRED LANGUAGE). WE DEVELOPED A CULTURAL COMPETENCY ACTION PLAN TO BETTER SERVE OUR DIVERSE COMMUNITY. WE HAVE ESTABLISHED COMMUNITY EDUCATION AND PREVENTION PROGRAMS FOR THE TOP FOUR DISEASE STATES IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT WHICH ARE: CARDIOVASCULAR DISEASE, CANCER, DIABETES AND OBESITY. THESE COMMUNITY EDUCATION AND PREVENTION CLASSES ARE ALL OFFERED IN BOTH SPANISH AND ENGLISH AND INCLUDE: DIABETES EDUCATION PREVENTION, CHRONIC DISEASE MANAGEMENT CLASSES, ACT! GET UP, GET MOVING! CHILDHOOD OBESITY PROGRAM, HEALTHY FOR LIFE EXERCISE AND COOKING CLASSES, AND CARDIAC REHABILITATION EDUCATION. YAKIMA VALLEY MEMORIAL HOSPITAL'S PHARMACY PROVIDES ACCESS TO MEDICATIONS TO THOSE IN THE COMMUNITY WHO WOULD NOT OTHERWISE BE ABLE TO AFFORD IT. "ADVERSE CHILDHOOD EXPERIENCES": WE HAVE WORKED TO MITIGATE ADVERSE CHILDHOOD EXPERIENCES (ACES) BY IMPLEMENTING EVIDENCE BASED PRACTICES PROVEN TO DECREASE LONG-TERM POOR HEALTH OUTCOMES. 'NURSE FAMILY PARTNERSHIPS (NFP)' IS AN EVIDENCE-BASED NURSE HOME VISITATION PROGRAM THAT ENROLLS FIRST-TIME LOW-INCOME MOTHERS EARLY IN THEIR PREGNANCY AND FOLLOWS THEM THROUGHOUT THEIR CHILD'S SECOND BIRTHDAY. THE GOAL OF NFP IS TO IMPROVE CHILD HEALTH AND DEVELOPMENT BY HELPING PARENTS PROVIDE RESPONSIBLE AND COMPETENT CARE FOR THEIR CHILDREN. FURTHERMORE, FAMILIES' ECONOMIC SELF-SUFFICIENCY IS IMPROVED BY HELPING PARENTS DEVELOP A VISION FOR THEIR OWN FUTURE, PLAN FUTURE PREGNANCIES, AND CONTINUE THEIR EDUCATION AND FIND WORK. 'HEALTHY PREGNANCY' IS AN ENHANCED PREVENTIVE HEALTH AND EDUCATION SERVICE INTERVENTION FOR ELIGIBLE PREGNANT CLIENTS. SERVICES ARE PROVIDED ANYTIME IN PREGNANCY BASED ON THE MOTHER'S INDIVIDUAL RISKS AND NEEDS. INFANT CASE CARE MANAGEMENT PROVIDES SERVICES TO IMPROVE THE WELFARE OF INFANTS BY PROVIDING THEIR PARENTS WITH INFORMATION AND ASSISTANCE FOR NECESSARY MEDICAL, SOCIAL, EDUCATIONAL AND OTHER SERVICES THROUGHOUT THE INFANT'S FIRST YEAR. "UNINTENTIONAL NON-FATAL HOSPITALIZATIONS": COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED THAT UNINTENTIONAL FALLS INCREASED IN YAKIMA COUNTY WITH 968 FALLS REPORTED IN 2010; RATES INCLUDE HOSPITALIZATIONS. WE NOTICED RATES OF FALLS WERE INCREASING IN THE HOSPITAL AND RESPONDED BY IMPLEMENTING AN ORGANIZATION WIDE INPATIENT AND OUTPATIENT FALLS POLICY. WE BEGAN DOCUMENTING AND DISCUSSING EVERY FALL THAT OCCURRED BOTH IN FACILITY OR WAS WITNESSED IN THE HOME BY A HOME HEALTH WORKER, WITH THE GOAL OF PUTTING PROCEDURES IN PLACE AND MITIGATING EVERY FACTOR TO REDUCE FALL RISK THAT WAS WITHIN OUR CONTROL. EVERY EMPLOYEE AT MEMORIAL IS GIVEN FALL PREVENTION TRAINING. FALL RISK ASSESSMENTS ARE COMPLETED DURING EVERY NURSE SHIFT IN THE HOSPITAL AND FALL DATA IS DISCUSSED DURING A MONTHLY FALL COMMITTEE MEETING. IMMEDIATELY FOLLOWING ANY NEW FALL EMPLOYEES AND SUPERVISORS MEET TO LOOK AT REASONS FOR FALL AND MAKE IMMEDIATE CHANGES TO PREVENT FUTURE FALLS.DUE TO RESOURCES AND PARTNER AGENCIES BEING BETTER SUITED TO ADDRESS CERTAIN NEEDS, YAKIMA VALLEY MEMORIAL HOSPITAL DID NOT ADDRESS FOOD INSECURITY, MENTAL HEALTH OR MATERNAL CHILD HEALTH GAP ANALYSIS PRIORITIES. "FOOD INSECURITY": WE ARE WORKING WITH OUR REGIONAL ACCOUNTABLE COMMUNITIY OF HEALTH AND PARTNERING WITH OTHERS IN YAKIMA COUNTY TO ADDRESS FOOD INSECURITY AT A SYSTEMS-LEVEL."MENTAL HEALTH": YAKIMA VALLEY MEMORIAL HOSPITAL ONLY HAS AN INPATIENT PSYCHIATRIC DEPARTMENT WHICH IS LICENSED TO SPECIFICALLY TREAT PATIENTS WHO ALSO REQUIRE MEDICAL ATTENTION IN ADDITION TO PSYCHIATRIC SERVICES; WE ARE CURRENTLY THE ONLY FACILITY IN THE COUNTY LICENSED TO DO THIS. WE REFER ANY OUTPATIENT BEHAVIORAL HEALTH SERVICES TO OUR COMMUNITY PARTNER COMPREHENSIVE. COMPREHENSIVE IS A FULL SERVICE INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH SERVICE WHICH WORKS IN 9 COUNTIES IN THE STATE OF WASHINGTON. COMPREHENSIVE WORKS WITH ALL AGE GROUPS, OFFERS A DROP IN CENTER FOR AT RISK YOUTH, OPERATES A CRISIS LINE AND DOES A WIDE RANGE OF COMMUNITY EDUCATION ACTIVITIES THROUGHOUT YAKIMA COUNTY. "MATERNAL CHILD HEALTH GAP ANALYSIS PRIORITIES": THE COMMUNITY HEALTH NEEDS ASSESSMENT SHOWED HIGH AND INCREASING RATES OF INFANT MORTALITY RATE IN THE NATIVE AMERICAN POPULATION IN YAKIMA COUNTY. YAKIMA VALLEY MEMORIAL HOSPITAL IS A PARTNER IN 'TTAWAXT' A MULTI-AGENCY COLLABORATIVE EFFORT LED BY INDIAN HEALTH SERVICES ON THE YAKIMA RESERVATION TO INVESTIGATE AND REDUCE INFANT MORTALITY AND PROMOTE HEALTHY FAMILIES WITHIN TRIBAL COMMUNITIES. YAKIMA VALLEY MEMORIAL HOSPITAL PARTICIPATES IN THE 'OBSTETRICS CLINICAL OUTCOMES ASSESSMENT PROGRAM (OB COAP)', A FOUNDATION FOR HEALTH CARE QUALITY (FHCQ) PROGRAM WHICH FOCUSES ON HEALTH PROFESSIONAL'S DECISIONS MADE DURING LABOR AND DELIVERY. AS AN OB COAP PARTICIPANT WE PROVIDE SPECIFIC CHART-ABSTRACTED DATA ABOUT THE CARE GIVEN TO WOMEN DURING LABOR, DELIVERY AND POSTPARTUM PERIODS WHICH FHCQ THEN UTILIZES FOR ANALYSIS AND DISCUSSION TO EVALUATE LABOR MANAGEMENT PRACTICES AND INTERVENTIONS COMMONLY USED IN LABOR AND DELIVERY AND COMPARE IMPLICATIONS OF CARE DECISIONS. THIS ALLOWS FOR OPPORTUNITIES TO EXPLORE METHODS FOR ACTIONABLE AND SUSTAINABLE IMPROVEMENTS IN HOSPITALS ACROSS THE STATE. DATA HAS SHOWN THIS PROGRAM HAS THE POTENTIAL TO REDUCE UP TO 3,000 NEONATAL INTENSIVE CARE CASES PER YEAR. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: WWW.YAKIMAMEMORIAL.ORG 21 YAKIMA GASTROENTEROLOGY ASSOCIATES 3909 CREEKSIDE LOOP YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC YAKIMA EAR NOSE AND THROAT 1601 CREEKSIDE LOOP YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC CORNERSTONE LAB 4003 CREEKSIDE LOOP YAKIMA WA 98908 MEDICAL LABRATORY YAKIMA HEART CENTER TRUST AT MEMORIAL 2811 TIETON DRIVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC GARDEN VILLAGE 206 S 10TH AVE YAKIMA WA 98902 SKILLED NURSING FACILITY FAMILY MEDICINE OF YAKIMA 504 S 40TH AVE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC YAKIMA VASCULAR ASSOCIATES 3999 ENGLEWOOD SUITE 202 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC CASCADE SURGICAL PARTNERS 3003 TIETON DRIVE SUITE 300 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC MEMORIAL CORNERSTONE MEDICINE 4003 CREEKSIDE LOOP YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC SELAH FAMILY MEDICINE 620 N PARK DRIVE SELAH WA 98942 OUTPATIENT PHYSICIAN CLINIC PACIFIC CREST FAMILY MEDICINE 311 S 72ND AVE YAKIMA WA 98908 OUTPATIENT PHYSICIAN CLINIC APPLE VALLEY FAMILY MEDICINE 1008 S 38TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC MEMORIAL SLEEP SPECIALISTS 406 S 30TH AVE SUITE 206 YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC LAKEVIEW SPINE 1470 N 16TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC HEALTHY NOW 3909 CREEKSIDE LOOP SUITE 130 YAKIMA WA 98908 URGENT CARE CLINIC MEMORIAL OUTPATIENT PSYCH 1460 N 16TH AVE SUITE C YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC YAKIMA ENDOCRINOLOGY ASSOCIATES 1470 S 40TH AVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC HEALTHY NOW EAST VALLEY 3904 TERRACE HEIGHTS DRIVE SUITE D YAKIMA WA 98901 URGENT CARE CLINIC HEALTHY NOW WEST VALLEY 120 S 72ND AVE SUITE 102 YAKIMA WA 98908 URGENT CARE CLINIC HEALTHY NOW ZILLAH 616 RAILROAD AVENUE SUITE 1 2 ZILLAH WA 98953 URGENT CARE CLINIC YAKIMA UROLOGY ASSOCIATES TRUST AT MEMOR 2811 TIETON DRIVE YAKIMA WA 98902 OUTPATIENT PHYSICIAN CLINIC PART I, LINE 7: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT REPORTED IN THE TABLE DERIVED FROM WORKSHEETS 1 AND 2. PART II, COMMUNITY BUILDING ACTIVITIES: THERE IS ONE PROGRAM WHICH PROVIDES COMMUNITY SUPPORT: "RESOLUTION THROUGH SHARING" PROVIDES SUPPORT TO FAMILIES WITH A PREGNANCY OR CHILDBIRTH LOSS. SUPPORT INCLUDES BURIAL AND COORDINATION EXPENSES. THERE IS ONE PROGRAM WHICH PROVIDES COMMUNITY HEALTH IMPROVEMENT ADVOCACY: "YOUTHWORKS" IS A YOUTH EMPOWERMENT AND COMMUNITY SERVICE INITIATIVE ENGAGING YOUTH DIRECTLY THROUGH MENTORING, VOLUNTEERING & PHILANTHROPY.THERE ARE TWO PROGRAMS WHICH PROVIDE WORKFORCE DEVELOPMENT: "ADVISORY BOARD PARTICIPATION" ALLOWS EMPLOYEE PARTICIPATION IN BOARDS TO PROMOTE STUDENT ENROLLMENT IN HEALTH CARE PROFESSIONS. "HEALTH PROFESSION PRESENTATIONS" ASSISTS STUDENTS AT LOCAL COLLEGES WITH WORK APPLICATIONS AND INTERVIEW READINESS TO HELP THEM SECURE JOBS AND BRINGS ECONOMIC BENEFIT TO THE COMMUNITY. PART III, LINE 2: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT ON LINE 2. OUR FINANCIAL STATEMENTS INCLUDE A FOOTNOTE REGARDING UNCOLLECTIBLE ACCOUNTS WHICH ARE REPORTED AS AN OFFSET TO PATIENT REVENUES. PART III, LINE 4: THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT ON LINE 2. OUR FINANCIAL STATEMENTS INCLUDE A FOOTNOTE REGARDING UNCOLLECTIBLE ACCOUNTS ON PAGE 16 AND 17 WHICH ARE REPORTED AS AN OFFSET TO PATIENT REVENUES. PART III, LINE 8: TO THE EXTENT THAT COSTS (USING THE MEDICARE COST REPORT) EXCEED CHARGES, THIS SHORTFALL SHOULD BE REGARDED AS COMMUNITY BENEFIT BECAUSE WE TREAT AND MAINTAIN THE HEALTH OF OUR LARGE LOCAL MEDICARE POPULATION DESPITE THE NECESSARY SUBSIDIZATION OF THESE HEALTH BENEFITS.THE HOSPITAL USED RATIO OF PATIENT CARE COST TO CHARGES METHODOLOGY TO CALCULATE THE AMOUNT ON LINE 6. OUR FINANCIAL STATEMENTS INCLUDE A FOOTNOTE REGARDING UNCOLLECTIBLE ACCOUNTS WHICH ARE REPORTED AS AN OFFSET TO PATIENT REVENUES. PART III, LINE 9B: DURING THE ADMITTANCE PROCESS AT YAKIMA VALLEY MEMORIAL HOSPITAL, ALL PATIENTS ARE PROVIDED WITH THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION. ELIGIBILITY FOR ASSISTANCE IS DETERMINED UPON ADMISSION TO THE HOSPITAL, AND ELIGIBLE PATIENTS ARE NOT BILLED FOR SERVICES. PART VI, LINE 2: YVMH CONDUCTS A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, THIS CAN BE FOUND AT WWW.YAKIMAMEMORIAL.ORG. IN ADDITION, THE HOSPITAL ROUTINELY LOOKS AT HEALTH CARE INDICATORS FROM: COUNTY HEALTH RANKINGS, US CENSUS, HEALTHY YOUTH SURVEY, WASHINGTON STATE DEPARTMENT OF HEALTH AND OTHER SOURCES TO ASSIST WITH PROGRAM PLANNING AND DEVELOPMENT OF COMMUNITY BENEFIT PROGRAMS. INTERNAL DATA IS ALSO ANALYZED FOR DEVELOPMENT AND QUALITY IMPROVEMENT OF COMMUNITY BENEFIT HEALTH PROGRAMS. THE CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED AT THE END OF FISCAL YEAR 2012/2013 AND IS PUBLICLY AVAILABLE. THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT IS CURRENTLY IN PROGRESS AND WILL BE AVAILABLE BY END OF FISCAL YEAR 2015/2016. PART VI, LINE 3: THE FOLLOWING LANGUAGE, OR A CLOSE VARIATION, IS INCLUDED IN OUR GUIDE TO PATIENT SERVICES, UNDERSTANDING YOUR HOSPITAL BILL BROCHURE, PUBLIC SIGNAGE AT THE MAIN AND EMERGENCY ENTRANCES, AS WELL AS ON OUR PATIENT STATEMENTS:"YAKIMA VALLEY MEMORIAL HOSPITAL PROVIDES CHARITY CARE IN ACCORDANCE WITH RCW 70.170.060. APPLYING FOR MEDICAL ASSISTANCE WITH DSHS IS A PRE-REQUISITE TO A CHARITY CARE DETERMINATION OF ELIGIBILITY. PLEASE CONTACT PATIENT ACCOUNTS IF YOU WOULD LIKE TO APPLY FOR CHARITY OR HAVE QUESTIONS REGARDING MEMORIAL'S CHARITY CARE PROGRAM. AND/OR "THE HOSPITAL IS ABLE TO PROVIDE FREE OR DISCOUNTED CARE FOR ALL OR PART OF YOUR HOSPITAL BILLS IF YOU QUALIFY, BASED ON YOUR INCOME. PLEASE REQUEST A CHARITY CARE APPLICATION, FILL IT OUT COMPLETELY, AND PROMPTLY RETURN IT TO BUSINESS SERVICES." WE ALSO CONTRACT WITH CARDON OUTREACH TO SCREEN ALL SELF-PAY AND CONTRACT CARE PATIENTS FOR MEDICAID ELIGIBILITY AND ASSIST THEM WITH COMPLETING ALL OF THE REQUISITE PAPERWORK, ETC. IF A PATIENT IS NOT ELIGIBLE FOR ASSISTANCE AND CANNOT PAY, CARDON PROVIDES THE PATIENT WITH A CHARITY CARE APPLICATION. PART VI, LINE 4: YAKIMA COUNTY IS COMPOSED OF PRIMARILY RURAL COMMUNITIES (14 CITIES AND TOWNS) IN CENTRAL WASHINGTON, SPANNING 4,296 SQUARE MILES, WITH A 65% MEDICARE/MEDICAID PAYER MIX. TOTAL CURRENT POPULATION FOR YAKIMA COUNTY AS OF JULY 1, 2015 IS 248,830, A 2.3% INCREASE FROM 2010. SINCE 2000 THE POPULATION OF YAKIMA COUNTY HAS INCREASED BY 11.6%. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 57.36 PERSONS PER SQUARE MILE, IS LESS THAN THE NATIONAL AVERAGE POPULATION DENSITY OF 88.93 PERSONS PER SQUARE MILE. THE PRIMARY SERVICE AREA (PSA) OF YAKIMA VALLEY MEMORIAL HOSPITAL IS COMPRISED OF YAKIMA COUNTY. SECONDARY SERVICE AREAS (SSA) FOR HIGHLY SPECIALIZED PROGRAMS AND SERVICES STRETCHES INTO NEIGHBORING COUNTIES INCLUDING KITTITAS AND KLICHITAT, THIS COMPRISES LESS THAN 15% OF PATIENT VOLUME. YAKIMA COUNTY IS HOME TO OVER 75,000 MIGRANT AND SEASONAL FARM WORKERS AND THEIR DEPENDENTS. THE PERCENTAGE OF THE POPULATION LIVING IN URBAN AREAS IS 76.5% COMPARED WITH 24% LIVING IN RURAL AREAS, WHICH IS HIGHER THAN BOTH THE NATIONAL AND WASHINGTON STATE AVERAGES 81% VS. 19% AND 84% VS. 16%, RESPECTIVELY. LOCATED IN YAKIMA COUNTY IS THE YAKAMA NATION RESERVATION WITH IS OVER 1.3 MILLION ACRES AND REACHES ACROSS THE CASCADES. OUR COMMUNITY IS COMPRISED OF MAJORITY 46.5% PERSONS OF HISPANIC OR LATINO ORIGIN AND 46.2% OF PERSONS OF WHITE NON-HISPANIC OR LATINO ORIGIN, AND 3.6% AMERICAN INDIAN AND ALASKA NATIVE. 20.5% OF PERSONS LIVING BELOW POVERTY LEVEL, 8.4% IS UNEMPLOYED AND 16% HAVE NO HEALTH INSURANCE. . PART VI, LINE 5: YAKIMA VALLEY MEMORIAL HOSPITAL IS COMMITTED TO LEADING, FACILITATING, PARTNERING AND PROMOTING THE HEALTH OF THE CENTRAL WASHINGTON COMMUNITY. THE PROMOTION OF COMMUNITY HEALTH IS ACCOMPLISHED THROUGH COLLABORATIONS, RESEARCH BASED EDUCATION AND INTERVENTIONS FOCUSED ON DISPARITY GAPS AND SOCIAL DETERMINANTS OF HEALTH. SURPLUS FUNDING IS USED TO PROVIDE OVERSIGHT, PROGRAM PLANNING AND EVALUATION; AS WELL AS DIRECT CARE TO CHILDREN WITH SPECIAL HEALTH CARE NEEDS THROUGH CHILDREN'S VILLAGE AND PROMOTION OF WELL-BEING THROUGH EVIDENCE BASED COMMUNITY HEALTH PROGRAMMING. THIS INCLUDES CHRONIC HEALTH ISSUES AND OTHER RISK FACTORS THAT CONTRIBUTE TO POOR HEALTH OUTCOMES. THE HOSPITAL HAS A DEDICATED STAFF, CONTRACTORS AND FTE POSITIONS TO ACCOMPLISH THE DEVELOPMENT, PLANNING AND INTERVENTIONS TO ADDRESS COMMUNITY NEEDS. FURTHERMORE, MEMORIAL BUDGETS SURPLUS FUNDS TOWARDS CONTINUED SUPPORT OF EDUCATION THROUGH OUR PARTNERSHIP WITH PACIFIC NORTHWEST UNIVERSITY, CENTRAL WASHINGTON FAMILY PRACTICE RESIDENCY, OBSTETRICAL EDUCATION AND ENSURING WE HAVE THE STAFF TO SUPPORT OUR COMMUNITIES EDUCATION NEEDS. FINALLY, SURPLUS FUNDS ARE ALSO USED TO ENSURE THAT WE HAVE THE FACILITIES AND EQUIPMENT TO MEET THE GREATEST NEEDS OF THE COMMUNITY; EXAMPLES INCLUDE: HEALTHY NOW CLINICS, EXPANDING THE INPATIENT PSYCHIATRIC DEPARTMENT AND COTTAGE IN THE MEADOW FOR END OF LIFE CARE. TO MEET THE ACCESS NEEDS OF THE COMMUNITY, YAKIMA VALLEY MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS WITHIN THE COMMUNITY WHO APPLY TO ITS MEDICAL STAFF AND ALLIED HEALTH STAFF AND WHO MEET QUALIFICATIONS SET FORTH IN THE MEDICAL STAFF'S BYLAWS, RULES AND REGULATIONS, POLICIES AND SPECIFIC DEPARTMENTAL PRIVILEGING DOCUMENTS. IN ADDITION, FOR THE MOST CRITICAL SHORTAGES, PARTICULARLY WITHIN SPECIALITY AREAS, MEMORIAL PRIVILEGES PHYSICIANS OUTSIDE OF THE COMMUNITY TO MEET THE NEED.THE MAJORITY OF YAKIMA VALLEY MEMORIAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSON WHO RESIDE WITHIN THE PRIMARY SERVICE AREA OF THE HOSPITAL: YAKIMA COUNTY; AND THE MAJORITY ARE NOT CONSIDERED EMPLOYEES OR INDEPENDENT CONTRACTORS, NOR DO THEY HAVE FAMILY MEMBERS THEREOF. PART VI, LINE 6: YAKIMA VALLEY MEMORIAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM AS OF END OF FISCAL YEAR 2015. PART IV, LINE 7: NO COMMUNITY BENEFIT REPORT IS REQUIRED TO BE FILED WITH THE STATE OF WASHINGTON. OUR COMMUNITY BENEFIT REPORT IS MADE PUBLICLY AVAILABLE ON THE HOSPITAL WEBSITE: WWW.YAKIMAMEMORIAL.ORG. 1 YAKIMA SYMPHONY 32 N 3RD STREET 333 YAKIMA WA 98901 237346119 501 (C)(3) 32000 $7,000 - SINFONIETTA SERIES, $5,000 - TEACHING ARTIST, $20,000 - POPS SERIES MARCH OF DIMES 1904 THIRD AVENUE SUITE 230 SEATTLE WA 98101 131846366 501 (C)(3) 20000 SPONSORSHIP YAKIMA TOWN HALL 5000 W LINCOLN AVENUE YAKIMA WA 98908 237209728 501 (C)(3) 5000 SPEAKER SERIES YAKIMA VALLEY MUSEUM 2105 TIETON DRIVE YAKIMA WA 98902 910828572 501 (C)(3) 10000 NATIONAL ENDOWMENT HUMANITIES CHALLENGE MEMORIAL FOUNDATION 2701 TIETON DR YAKIMA WA 98902 911022358 501 (C)(3) 5000 PARTNERSHIP PACKAGE SUPPORT FOR PASSION FOR THE VILLAGE YAKIMA COUNTY DEVELOPMENT PO BOX 1387 YAKIMA WA 98907 911284283 501 (C)(6) 12500 PLEDGE TO NEW VISION 7/SPONSORSHIP FOR RELOCATION TOM STOKES SCHOOL CO WASHINGTON APPLE EDUCATION FOUNDATION 2900 EUCLID AVENUE WENATCHEE WA 98801 911638890 501 (C)(3) 5000 PLEDGE FOR SCHOLARSHIP GREATER YAKIMA CHAMBER OF COMMERCE 10 NORTH 9TH STREET PO BOX 1490 YAKIMA WA 98907 910480620 501 (C)(6) 10000 SPONSOR LEADERSHIP YAKIMA PROGRAM ROTARY OF YAKIMA PO BOX 464 6 SOUTH 2ND STREET SUITE 1104 YAKIMA WA 98907 916075401 501 (C)(4) 8750 $750 - RAFFLE SPONSORSHIP, $3,000 - CONFERENCE SUPPORT, $5,000 - SPONSOR CHARITIES AUCTION SOIREE. THE CAPITAL THEATER PO BOX 102 19 SOUTH 3RD STREET YAKIMA WA 98907 910939384 501 (C)(3) 10000 COMMUNITY SUPPORT CW FAIR ASSOCIATION 1301 S FAIR AVENUE YAKIMA WA 98901 910171268 501 (C)(3) 9472 HAND-SANITIZER STATION SPONSOR SEASONS PERFORMANCE HALL 101 N NACHES AVENUE YAKIMA WA 98901 203242324 501 (C)(3) 5000 SPONSORSHIP ALZHEIMER'S ASSOCIATION WESTERN & CENTRAL WA STATE CHAPTER NORTH TOWER 100 W HARRISON STREET SUITE N200 SEATTLE WA 98119 133039601 501 (C)(3) 12000 SUPPORT PHYSICIAN EDUCATION PORTION (CME) OF CONFERENCE 10 3 PART I, LINE 2: YAKIMA VALLEY MEMORIAL HOSPITAL SUPPORTS PROGRAMS OR ACTIVITIES THAT DEMONSTRATE A COMMUNITY BENEFIT, ARE CONSISTENT WITH THE OBJECTIVES OF THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT, SUPPORT THE VALUES OF THE HOSPITAL AND IMPROVE HEALTH IN AND AROUND YAKIMA COUNTY. DONATION REQUESTS WILL BE COMPILED ON A REGULAR BASIS AND THOSE THAT MEET THE GENERAL CRITERIA WILL BE FORWARDED TO A DETERMINATION PANEL EVERY MONTH FOR FURTHER EVALUATION AND RECOMMENDATION. IF NECESSARY, REQUESTERS MAY BE ASKED TO PARTICIPATE IN FURTHER DIALOGUE, INCLUDING MEETING WITH MEMBERS OF MEMORIAL'S LEADERSHIP TEAM. A DETERMINATION PANEL WILL MEET MONTHLY TO REVIEW, EVALUATE AND MAKE SPONSORSHIP RECOMMENDATIONS. X X X X 1 1 0 0 0 0 0 0 0 RUSSELL M MYERS PRESIDENT/CEO 411494 0 42086 0 5152 0 36682 0 19921 0 515335 0 0 0 TIM REED VP/CFO 166731 0 22221 0 5771 0 11556 0 11646 0 217925 0 0 0 DALE S OLANDER VP/CFO UNTIL 11/14 252008 0 0 0 272777 0 17838 0 13639 0 556262 0 0 0 ANNE CAFFERY PRESIDENT/CEO - FOUNDATION 190811 0 23765 0 3395 0 34900 0 18120 0 270991 0 0 0 DIANE PATTERSON VICE PRESIDENT/CCO 165427 0 20540 0 3296 0 15407 0 21951 0 226621 0 0 0 JAMES ABERLE VICE PRESIDENT/COO 202974 0 24081 0 4256 0 17758 0 22136 0 271205 0 0 0 JEFF YAMADA VICE PRESIDENT/CIO 181011 0 17731 0 3303 0 17541 0 21818 0 241404 0 0 0 RICHARD SPIEGIL PRESIDENT/CEO - SIGNAL HEALTH 296960 0 0 0 5852 0 15293 0 14222 0 332327 0 0 0 GREG SAWYER VP/ PRES. - MP UNTIL 11/14 189206 0 0 0 1316858 0 13075 0 7308 0 1526447 0 0 0 ROBERT J CONROY PHYSICIAN - MP 460794 0 0 0 900 0 21200 0 8431 0 491325 0 0 0 VU LE PHYSICIAN - MP 431042 0 192180 0 900 0 13550 0 17299 0 654971 0 0 0 PRAVEEN GUTURU PHYSICIAN - MP 418056 0 95594 0 900 0 15804 0 17299 0 547653 0 0 0 TEKCHAND TANWANI PHYSICIAN - MP 413333 0 83687 0 900 0 14995 0 17299 0 530214 0 0 0 CHESTER S CHAU PHYSICIAN 208500 0 39986 0 212449 0 15385 0 9835 0 486155 0 0 0 RICHARD W LINNEWEH JR FORMER PRESIDENT/CEO 173925 0 0 0 553 0 9586 0 866 0 184930 0 0 0 SANDRA DAHL FORMER VICE PRESIDENT/CCO 243010 0 0 0 283809 0 15890 0 10330 0 553039 0 0 0 TERESA PRITCHARD FORMER VICE PRESIDENT/PEOPLE & CULTU 58990 0 0 0 221448 0 4154 0 1356 0 285948 0 0 0 PART I, LINES 4A-B YAKIMA VALLEY MEMORIAL HOSPITAL DOES NOT HAVE A SEVERANCE POLICY. THE TERMS AND CONDITIONS ARE DETERMINED ON A CASE BY CASE SITUATION. GREG SAWYER RECEIVED A PAYMENT OF: $273,489 IN SEVERANCE. TERESA PRITCHARD RECEIVED A PAYMENT OF: $120,983 IN SEVERANCE. D. SCOTT OLANDER RECEIVED A PAYMENT OF: $273,390 IN SEVERANCE. IN JULY 2002, THE HOSPITAL'S BOARD OF TRUSTEES ADOPTED A SALARY CONTINUATION PLAN (THE "PLAN"), IN THE FORM OF A NON-QUALIFIED RETIREMENT BENEFIT FOR SENIOR EXECUTIVES. THE RETIREMENT BENEFIT PROVIDED BY THE PLAN IS SUPPLEMENTARY TO THE HOSPITAL'S EMPLOYEE PENSION PLAN, TAX-DEFERRED ANNUITY RETIREMENT PLAN, 401(K) PLAN AND SOCIAL SECURITY RETIREMENT EARNINGS. BENEFITS ARE CALCULATED AS THE DIFFERENCE BETWEEN THE PROJECTED AGE-65 VALUE OF THE AFOREMENTIONED BENEFITS AND 75% OF THE LUMP SUM AT AGE 65. NO BENEFITS UNDER THE PLAN ARE GENERALLY AVAILABLE FOR A SENIOR EXECUTIVE WHO RETIRES PRIOR TO HIS/HER 65TH BIRTHDAY. FUNDING FOR THE PLAN BEGAN IN 2002, AND THE HOSPITAL FIRST BEGAN ACCRUING A LIABILITY FOR THE PLAN DURING THE FISCAL YEAR ENDING OCTOBER 31, 2005. THE HOSPITAL'S LIABILITY ACCRUAL IS BASED ON THE ASSUMPTION THAT ALL EIGHT EXECUTIVES WILL BE WORKING UNTIL AGE 65. RUSSELL MYERS'S ACCRUED BENEFITS PAYABLE UNDER THE PLAN INCREASED BY: $17,302. JAMES ABERLE'S ACCRUED BENEFITS PAYABLE UNDER THE PLAN DECREASED BY: $749. SANDRA DAHL RECEIVED A PAYMENT OF: 281,202 FROM THE NON-QUALIFIED RETIREMENT PLAN. ANNE CAFFERY'S ACCRUED BENEFITS UNDER THE PLAN INCREASED BY: $18,902. GREG SAWYER RECEIVED A PAYMENT OF: $1,040,978 FROM THE NON-QUALIFIED RETIREMENT PLAN. TERESA PRITCHARD RECEIVED A PAYMENT OF: $100,000 FROM THE NON-QUALIFIED RETIREMENT PLAN. DIANE PATTERSON'S ACCRUED BENEFITS UNDER THE PLAN INCREASED BY: $266. JEFF YAMADA'S ACCRUED BENEFITS UNDER THE PLAN INCREASED BY: $1,380. A WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 NONEAVAIL 2012-02-16 24845525 SEE PART VI 0 0 0 B WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 93870HGN0 2012-08-17 38005000 SEE PART VI 0 0 0 C WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 NONEAVAIL 2014-02-21 7050000 EQUIPMENT 0 0 0 D WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 NONEAVAIL 2008-11-18 2100000 RETIRE TAXABLE DEBT 0 0 0 A 9161659 24847230 119976 22008715 2718539 2013 1 0 1 1 B 7740000 38011438 2292484 687697 37323741 2005 1 1 1 1 C 1575467 7050158 50000 5899470 1100688 0 0 1 1 D 455029 2100000 2100000 2008 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 1 1 1 0 0.00480 0.00230 0.00710 0 0 0 A 0 0 1 1 1 0 0 0 1 B 0 1 1 0 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 1 1 0 0 0 0 0 A 1 B 1 C 1 D 1 SCHEDULE K, PART IV, ARBITRAGE, LINE 2C: (A) ISSUER NAME: WASHINGTON HEALTH CARE FACILITIES AUTH DATE THE REBATE COMPUTATION WAS PERFORMED: 09/30/2014 (A) ISSUER NAME: WASHINGTON HEALTH CARE FACILITIES AUTH DATE THE REBATE COMPUTATION WAS PERFORMED: 04/01/2015 (A) ISSUER NAME: WASHINGTON HEALTH CARE FACILITIES AUTH DATE THE REBATE COMPUTATION WAS PERFORMED: 05/18/2009 NOTE REGARDING THE REBATE COMPUTATIONS (09/30/2014) & (04/01/2015): SINCE THE BOND PROCEEDS HAVE BEEN SPENT, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. NOTE REGARDING THE REBATE COMPUTATION (05/18/2009): SINCE THE BOND PROCEEDS HAVE BEEN SPENT, A SPENDING EXCEPTION WAS MET, AND THE DEBT SERVICE FUND WAS OPERATED ON A BONA FIDE BASIS, NO FURTHER REBATE CALCULATIONS ARE NECESSARY. PART I, LINE A, COLUMN (F) - REFUND PRIOR BONDS (08/20/09) AND CONSTRUCT, REMODEL, RENOVATE, EQUIP HEALTH CARE FACILITIES OWNED BY THE HOSPITAL PART I, LINE B, COLUMN (F) - REFUND PRIOR BONDS (03/14/96 & 11/13/02) PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. PART II, LINE 3 - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 -12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. KATE ROSSMAN FAMILY MEMBER OF DUANE ROSSMAN, TRUSTEE 83920 EMPLOYMENT WITH HOSPITAL 0 MICHAEL LINNEWEH FAMILY MEMBER OF RICHARD LINNEWEH, FORMER PRESIDENT/CEO 53889 EMPLOYMENT WITH HOSPITAL 0 MIRANDA YAMADA FAMILY MEMBER OF JEFF YAMADA, VICE PRESIDENT/CIO 14628 EMPLOYMENT WITH HOSPITAL 0 FORM 990, PART III, LINE 1 YAKIMA VALLEY MEMORIAL HOSPITAL'S CORE PURPOSE IS TO INSPIRE PEOPLE TO THRIVE BY CREATING A HEALTHY COMMUNITY. WE HAVE 226 ACUTE INPATIENT BEDS AND ALSO PROVIDE NUMEROUS DIAGNOSTIC AND THERAPEUTIC SERVICES ON AN OUTPATIENT BASIS. WE ALSO SPONSOR HEALTH RELATED EDUCATIONAL OPPORTUNITIES. FORM 990, PART VI, SECTION B, LINE 11 UPON COMPLETION A COMPLETE COPY OF THE 990 AND 990T ARE REVIEWED BY THE CHIEF ACCOUNTANT, DIRECTOR OF FINANCE, CFO, AND CEO. ONCE THIS REVIEW IS DONE IT IS REVIEWED BY THE HOSPITAL'S COMPLIANCE AND AUDIT COMMITTEE BEFORE IT GOES TO THE BOARD FINANCE COMMITTEE THEN GOVERNING BOARD. A COMPLETE COPY OF THE 990 AND 990T ARE SENT AHEAD OF THE FINANCE COMMITTEE AND BOARD MEETING SO THAT THE BOARD OF TRUSTEES HAVE TIME TO UNDERSTAND THE REPORT BEFORE IT IS PRESENTED TO THEM. PRIOR TO SUBMITTING THE 990 AND 990T KPMG WILL REVIEW THE ENTIRE 990 AND 990T IN DETAIL. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTEREST OF YAKIMA VALLEY MEMORIAL HOSPITAL ASSOCIATION, A WASHINGTON NON-PROFIT CORPORATION UNDER RCW 24.03 OF THE WASHINGTON NONPROFIT CORPORATION ACT (HEREINAFTER "HOSPITAL"), WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR TRUSTEE OF THE HOSPITAL OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE STATE AND FEDERAL LAWS GOVERNING CONFLICT OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE ORGANIZATIONS. THIS POLICY COVERS ANY TRUSTEE, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. QUESTIONNAIRES ARE SENT OUT ANNUALLY BY THE BOARD OR BOARD COMMITTEE. THE HOSPITAL MAY, BUT NEED NOT, USE OUTSIDE ADVISORS. THEIR USE WILL NOT RELIEVE THE GOVERNING BOARD OF ITS RESPONSIBILITY FOR TO CONDUCT ANNUAL REVIEWS. IF A CONFLICT OF INTEREST IS PRESENT, THE INTERESTED PERSON WILL ABSTAIN FROM VOTING ON THE RELATED MATTER. THE GOVERNING BOARD OR COMMITTEE WILL INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT AND MAKE REASONABLE EFFORTS TO SEE IF THERE IS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE GOVERNING BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED TRUSTEES WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HOSPITAL'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE PRESIDENT/CEO, CFO, AND ALL VICE PRESIDENTS IS SET AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FOLLOWING REVIEW OF COMPARABILITY AND PERFORMANCE DATA. THE PROCESS AND APPROVAL ARE DOCUMENTED IN THE BOARD OF COMPENSATION COMMITTEE MINUTES AND THEN PAYROLL ADJUSTMENT FORMS ARE SUBMITTED FOR THE SALARY CHANGE. IT WAS APPROVED IN JULY 2015 BY THE COMMITTEE AND THE INCREASE WAS BACK DATED TO JANUARY 1. A THIRD PARTY, MILLIMAN WAS USED TO VERIFY RESONABLENESS OF EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G REFERENCE LABS: PROGRAM SERVICE EXPENSES 573,345. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 573,345. PHYSICIANS SERVICES: PROGRAM SERVICE EXPENSES 36,757,273. MANAGEMENT AND GENERAL EXPENSES 386,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,143,732. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 666,451. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 666,451. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 7,473,640. MANAGEMENT AND GENERAL EXPENSES 1,150,163. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,623,803. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,682,162. MANAGEMENT AND GENERAL EXPENSES 5,323,331. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,005,493. LAB PROCESSING SERVICES: PROGRAM SERVICE EXPENSES 1,201,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,201,699. RESIDENCY SUPPORT SERVICES: PROGRAM SERVICE EXPENSES 1,350,824. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,350,824. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 610,136. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 610,136. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,608,948. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,608,948. TRANSCRIPTION AND CODING SERVICES: PROGRAM SERVICE EXPENSES 718,893. MANAGEMENT AND GENERAL EXPENSES 642,700. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,361,593. FORM 990, PART XI, LINE 9: ACOI PENSION BOOK/TAX DIFFERENCE -795,265. PRIOR PERIOD NET ASSETS ADJUSTMENT 128,300. 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