2014-09-15T21:31:36-05:00 2013-10-31 990 2012-11-01 910567263 YAKIMA VALLEY MEMORIAL HOSPITAL YAKI 5095758000 2811 TIETON DRIVE YAKIMA WA 989023799 RUSSELL MYERS 5095758000 2014-09-12 2012 2015-11-30 17:44:51Z RUSSELL MYERS 2811 TIETON DRIVE YAKIMA WA 989023799 372606160 0 X WWW.YAKIMAMEMORIAL.ORG X 1950 WA YAKIMA VALLEY MEMORIAL HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THOSE WE SERVE. WE HAVE 226 INPATIENT BEDS AND ALSO PROVIDE NUMEROUS DIAGNOSTIC AND THERAPEUTIC SERVICES ON AN OUTPATIENT BASIS. 14 14 2503 513 35334964 -9652173 7867263 5763278 311839705 321949966 3237582 5506013 34977663 37513716 357922213 370732973 0 0 0 0 200316254 162417376 0 0 0 164120297 170014590 364436551 332431966 -6514338 38301007 254524051 258259345 155696480 121130767 98827571 137128578 X YAKIMA VALLEY MEMORIAL HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF THOSE WE SERVE. WE HAVE 226 INPATIENT BEDS AND ALSO PROVIDE NUMEROUS DIAGNOSTIC AND THERAPEUTIC SERVICES ON AN OUTPATIENT BASIS. 0 0 130316346 196543652 YAKIMA VALLEY MEMORIAL HOSPITAL SERVED 424,530 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. 80836794 121200733 YAKIMA VALLEY MEMORIAL HOSPITAL ADMITTED 12,530 PATIENTS FOR A TOTAL OF 53,315 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. 16902139 3192409 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. 3037795 1013172 COORDINATION OF CHILDRENS SERVICES, RESIDENCY PROGRAMS, COMMUNITY EDUCATION REGARDING HEALTH ISSUES. 3037795 1013172 231093074 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1 0 0 0 1 189 0 1 2503 1 1 1 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X ACCOUNTING DEPARTMENT 5095758070 3800 SUMMITVIEW YAKIMA WA 98902 X BILL DOLSEN 6.00 X X 0 0 0 JIM BERG 6.00 X X 0 0 0 SCOTT WAGNER 6.00 X X 0 0 0 BUFFY ALEGRIA 2.00 X 0 0 0 BILL FELDMANN 2.00 X 0 0 0 ROSS KATZ 2.00 X 0 0 0 LISA SHIELDS LONG 2.00 X 0 0 0 CRAIG MENDENHALL 2.00 X 0 0 0 BRIAN PADILLA 2.00 X 0 0 0 KEITH RIFFE 2.00 X 0 0 0 DUANE ROSSMAN 2.00 X 0 0 0 BENJAMIN SORIA 2.00 X 0 0 0 DARCI SWANSON 2.00 X 0 0 0 ROGER VIELBIG 2.00 X 0 0 0 RICHARD W LINNEWEH JR 40.00 X 525950 0 39491 RUSSELL M MYERS 40.00 X 308489 0 226838 DALE S OLANDER 40.00 X 227789 0 122444 BRETT T QUAVE 40.00 X 546633 0 24526 GEORGE GADE 0.00 40.00 X 0 729000 42227 GILBERT K ONG 0.00 40.00 X 0 581900 48010 TIMOTHY E BROWN 0.00 40.00 X 0 515815 50204 THOMAS J ATTAWAY 0.00 40.00 X 0 514789 53735 JOHN G VORNBROCK 0.00 X 121367 0 0 1730228 2341504 607475 196 1 1 0 EMERGENCY ASSOCIATES OF YAKIMA 2811 TIETON DR YAKIMA WA 98902 MEDICAL SERVICES 6656165 PHYSICIAN ANESTHESIA ASSOCIATION 406 S 30TH AVE YAKIMA WA 98902 MEDICAL SERVICES 2339375 COMMUNITY HEALTH OF CENTRAL WASHINGTON 1806 W LINCOLN AVE YAKIMA WA 98902 SUPPORT OF RESIDENCY PROGRAM 1641515 MILLER NASH LLP 111 SW FIFTH AVE 3500 PORTLAND OR 97204 LEGAL SERVICES 1180622 MEDICAL CENTER LABORATORY 1120 W SPRUCE ST YAKIMA WA 98902 MEDICAL SERVICES 1151733 31 1924428 3838850 5763278 NET PATIENT REVENUES 900099 321610645 321610645 EDUC CLASSES AND CONV SALES 900099 339321 339321 321949966 5726641 5726641 1320270 1623432 -303162 -303162 -18026 -285136 29127 249755 -220628 -220628 -220628 MEMORIAL PHYSICIANS 621110 34878134 34878134 CAFE 722210 1781834 1781834 LABORATORY SERVICES 621500 427192 427192 729718 47664 682054 37816878 370732973 321949966 35334964 7684765 X 1113700 1113700 141038506 90541862 50496644 -14448427 -9275392 -5173035 23110671 14836255 8274416 11602926 7448679 4154247 1005161 20268 984893 190063 190063 132239 132239 59133656 48457158 10676498 65995404 57095675 8899729 3030706 3030706 6996486 2324187 4672299 1032827 467767 565060 2547724 2547724 18159148 18141764 17384 1660356 458226 1202130 LICENSES AND TAXES 9692689 9692689 MALPRACTICE OUT OF POCK 576625 576625 ANNUITY -138494 -138494 332431966 231093074 101338892 0 1792596 10593263 3156782 1224439 52693345 55769157 1424165 576834 6102598 7257266 6165488 6764875 315115886 188299498 124248348 126816388 51967624 44571101 3012154 2518058 1770629 1572396 2190322 595568 254524051 258259345 75916254 51253407 208559 84551 64017781 56720554 5665617 6987766 9888269 6084489 155696480 121130767 X 97680771 135850401 1146800 1278177 98827571 137128578 254524051 258259345 38301007 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 1 132239 132239 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: PART II-B, LINE 1I: THE HOSPITAL PAID LOBBYING EXPENSES AS A PORTION OF VARIOUS ORGANIZATION MEMBERSHIPS FOR A TOTAL OF $48,424. THE HOSPITAL ALSO PAID THREE COMPANIES FOR LEGISLATIVE CONSULTING AND LOBBYING FOR A TOTAL OF $83,815. 13548706 13548706 96815570 51694084 45121486 9467316 4465384 5001932 188934163 128199566 60734597 6350131 3940464 2409667 126816388 LEASE PAYABLE 306907 LINE OF CREDIT 5580373 REIMBURSEMENTS 197209 6084489 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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 POSITIONS. THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS AS OF OCTOBER 31, 2013 AND 2012 REQUIRING ACCRUAL. THE HOSPITAL FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND IS NO LONGER SUBJECT TO EXAMINATION BY U.S. FEDERAL AUTHORITIES FOR YEARS BEFORE 2010. 1 1 X 1 X 1 X 1 1 1 0 1 1 9413586 0 9413586 0.02830 70723805 50966217 19757588 0.05940 0 0 80137391 50966217 29171174 0.08770 1556295 499888 1056407 0.00320 3209646 814715 2394931 0.00720 4778221 81583 4696638 0.01410 561431 0 561431 0.00170 1676027 0 1676027 0.00500 11781620 1396186 10385434 0.03120 91919011 52362403 39556608 0.11890 0 0 0 0 16032 0 16032 0.00000 0 0 0 0 0 0 0 0 76807 0 76807 0.00020 1552573 419405 1133168 0.00340 1645412 419405 1226007 0.00360 1 3901583 0 106441421 137853731 -31412310 X 1 0 1 1 YAKIMA VALLEY MEMORIAL HOSPITAL ASSOC

2811 TIETON DRIVE YAKIMA WA 98902

X X X X YAKIMA VALLEY MEMORIAL HOSPITAL 1 1 X X X X X X X X 12 1 0 1 X X X X X X X X 0 0 1 1 300.000000000000 1 300.000000000000 1 X X X 1 1 X X X X 1 X X 1 X X X X X X 1 X 0 0 19 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 YAKIMA HEART CENTER

2811 TIETON DRIVE YAKIMA WA 98902

OUTPATIENT PHYSICIAN CLINIC FAMILY MEDICINE OF YAKIMA

504 S 40TH AVE YAKIMA WA 98908

OUTPATIENT PHYSICIAN CLINIC GARDEN VILLAGE

206 S 10TH AVE YAKIMA WA 98902

SKILLED NURSING FACILITY CORNERSTONE LAB

402 S 12TH AVE YAKIMA WA 98902

MEDICAL LABRATORY CASCADE SURGICAL PARTNERS

3003 TIETON DRIVE SUITE 300 YAKIMA WA 98902

OUTPATIENT PHYSICIAN CLINIC SELAH FAMILY MEDICINE

620 N PARK DRIVE SELAH WA 98942

OUTPATIENT PHYSICIAN CLINIC MEMORIAL CORNERSTONE MEDICINE

402 S 12TH AVE YAKIMA WA 98902

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 YAKIMA VASCULAR ASSOCIATES

3999 ENGLEWOOD SUITE 303 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 MEMORIAL OUTPATIENT PSYCH

1460 N 16TH AVE SUITE C YAKIMA WA 98902

OUTPATIENT PHYSICIAN CLINIC MEMORIAL HOSPITAL PHYSICIANS

2811 TIETON DRIVE YAKIMA WA 98902

OUTPATIENT PHYSICIAN CLINIC YAKIMA ENDOCRINOLOGY ASSOCIATES

1020 S 40TH AVE SUITE B YAKIMA WA 98908

OUTPATIENT PHYSICIAN CLINIC YAKIMA INTERNAL MEDICINE

3003 TIETON DRIVE SUITE 350 YAKIMA WA 98902

OUTPATIENT PHYSICIAN CLINIC YAKIMA NEUROSURGERY ASSOCIATES

3003 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: LINE 3- THERE ARE THREE PROGRAMS WHICH PROVIDE COMMUNITY SUPPORT: "RESOLUTION THROUGH SHARING" PROVIDES SUPPORT TO FAMILIES WITH A PREGNANCY OR CHILDBIRTH LOSS. SUPPORT INCLUDES BURIAL AND COORDINATION EXPENSES. "STUDENT ADVISORY BOARD PARTICIPATION" ALLOWS EMPLOYEES TO SERVE AS BOARD MEMBERS FOR PARTNERS SUCH AS YV TECH; WV CAREER & TECHNICAL SCIENCE. "DISASTER/EMERGENCY PREPAREDNESS" PROVIDES DESIGNATED EMPLOYEES TO ATTEND MEETINGS IN COMMUNITY, REGION AND COUNTY TO PLAN AND PRACTICE REGIONAL EMERGENCY RESPONSE TO DISASTERS. LINE 8- THERE IS ONE PROGRAM WHICH ASSIST IN WORKFORCE DEVELOPMENT: "YOUTHWORKS" IS A YOUTH EMPOWERMENT AND COMMUNITY SERVICE INITIATIVE ENGAGING YOUTH DIRECTLY THROUGH MENTORING, VOLUNTEERING, & PHILANTHROPY.LINE 9- FINANCIAL SUPPORT OF ONCOLOGY CANCER CARE, CHILDRENS SERVICES, AND OTHER UNMET COMMUNITY HEALTH NEEDS. 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 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. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY DOESN'T ADDRESS COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY OR FINANCIAL ASSISTANCE. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 1J: A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY COLLECTING DATA FOLLOWING THE HEALTHY 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 DETERMINATES AND SUBSTANCE USE. ADDITIONAL ONGOING ASSESSMENTS ARE CONDUCTED ON AN ONGOING BASIS TO TRACK NEEDS. DATA SOURCES USED ARE INTERNAL, US CENSUS, BRFSS, HEALTHY 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. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 3: INPUT FOR DEVELOPMENT OF THE CHNA WAS THROUGH A WORKGROUP COMPOSED OF REPRESENTATIVES FROM OTHER AGENCIES IN YAKIMA COUNTY AND THE WORKGROUP WAS DIVERSE AND REPRESENTATIVE OF THE POPULATION SERVED. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5C: THE CHNA WAS MADE PUBLIC THROUGH PRESENTATIONS TO COMMUNITY COALITIONS AND GROUPS. YAKIMA VALLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 7: ALL NEEDS CANNOT BE ADDRESSED BY YAKIMA VALLEY MEMORIAL HOSPITAL, DUE TO THE RESOURCES AVAILABLE AND OTHER ORGANIZATIONS BETTER FIT TO MEET THE NEEDS. PART VI, LINE 2: THE HOSPITAL ROUTINELY LOOKS AT HEALTH CARE INDICATORS FROM; COUNTY HEALTH RANKINGS, US CENSUS, HEALTHY YOUTH SURVEY 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. A COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN DECEMBER OF 2013 AND IS PUBLICLY AVAILABLE. PART VI, LINE 3: WE HAVE A CHARITY CARE POLICY WHICH HAS RECEIVED STATE APPROVAL. THERE ARE NUMEROUS MECHANISMS DOCUMENTED UNDER THE POLICY FOR INFORMING AND EDUCATING PATIENTS AND GUARANTORS. PART VI, LINE 4: THE COMMUNITY SERVED IS PRIMARILY RESIDENTS OF YAKIMA COUNTY, WASHINGTON WITH A SMALL PERCENTAGE (LESS THAN 15%) FROM OUTLYING AREAS. OUR COMMUNITY IS COMPRISED OF 18.5% OF PERSONS BELOW POVERTY LEVEL, 45.7% OF PERSONS OF HISPANIC OR LATINO ORIGIN AND 54.3% OF PERSONS OF WHITE NON-HISPANIC OR LATINO ORIGIN. 6.7% OF THE POPULATION IS UNEMPLOYED AND 24.7% HAVE NO HEALTH INSURANCE. PART VI, LINE 5: YAKIMA VALLEY MEMORIAL HOSPITAL IS COMMITTED TO LEADING, FACILITATING, PARTNERING AND PROMOTING THE HEALTH OF CENTRAL WASHINGTON. THE PROMOTION OF COMMUNITY HEALTH IS ACCOMPLISHED THROUGH COLLABORATIONS, RESEARCH BASED EDUCATION AND INTERVENTIONS FOCUSED ON DISPARITY GAPS AND SOME SOCIAL DETERMINATES OF HEALTH. CHILDREN (INCLUDING CHILDREN WITH SPECIAL HEALTH CARE NEEDS), CHRONIC HEALTH ISSUES, AND OTHER RISK FACTORS WHICH CONTRIBUTE TO POOR HEALTH OUTCOMES ARE ADDRESSED. THE HOSPITAL HAS A DEDICATED STAFF, CONTRACTORS AND FTE POSITIONS TO ACCOMPLISH THE DEVELOPMENT, PLANNING AND INTERVENTIONS TO ADDRESS NEED. PART VI, LINE 6: YAKIMA VALLEY MEMORIAL HOSPITAL IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM. FORM 990, PART VI, LINE 7 NO COMMUNITY BENEFIT REPORT IS REQUIRED TO BE FILED WITH THE STATE. OUR COMMUNITY BENEFIT REPORT IS MADE PUBLICALLY AVAILABLE ON THE HOSPITAL WEBSITE. X X X 0 1 0 0 0 0 0 0 0 RICHARD W LINNEWEH JR 525950 0 0 0 0 0 20000 0 19491 0 565441 0 0 0 RUSSELL M MYERS 308489 0 0 0 0 0 207347 0 19491 0 535327 0 0 0 DALE S OLANDER 227789 0 0 0 0 0 98319 0 24125 0 350233 0 0 0 BRETT T QUAVE 320683 0 225950 0 0 0 12500 0 12026 0 571159 0 0 0 GEORGE GADE 0 720000 0 9000 0 0 0 32949 0 9278 0 771227 0 0 GILBERT K ONG 0 490168 0 91732 0 0 0 32949 0 15061 0 629910 0 0 TIMOTHY E BROWN 0 440445 0 75370 0 0 0 32949 0 17255 0 566019 0 0 THOMAS J ATTAWAY 0 437909 0 76880 0 0 0 32949 0 20786 0 568524 0 0 JOHN G VORNBROCK 0 0 0 0 121367 0 0 0 0 0 121367 0 0 0 PART I, LINE 4B 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 SEVEN EXECUTIVES WILL BE WORKING UNTIL AGE 65. MR. RUSSELL M MYERS IS THE COO OF YAKIMA VALLEY MEMORIAL HOSPITAL. AS OF 10/31/2013 MR. MYERS IS 59 YEARS OLD AND HAS BEEN IN HIS CURRENT AND OTHER CAPACITIES AT THE HOSPITAL SINCE 1989. MR. MYERS ACCRUED BENEFITS UNDER THE PLAN IN THE AMOUNT OF $181,097 DURING THE 2013 CALENDAR YEAR. MR. DALE S OLANDER IS THE CFO OF YAKIMA VALLEY MEMORIAL HOSPITAL. AS OF 10/31/13 MR. OLANDER IS 57 YEARS OLD AND HAS BEEN IN CURRENT AND OTHE CAPACITIES AT THE HOSPITAL SINCE 2000. MR. OLANDER ACCRUED BENEFITS UNDER THE PLAN IN THE AMOUNT OF $80,324 DURING THE 2013 CALENDAR YEAR. 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 REFUND PRIOR BONDS (3/14/96 & 11/13/02) 0 0 0 C WASHINGTON HEALTH CARE FACILITIES AUTHORITY 911108929 NONEAVAIL 2008-11-18 2100000 BUILDING MORTGAGE 0 0 0 A 3439971 24847211 119976 21843672 2718539 165024 2013 1 1 1 1 B 2690000 38011438 2309800 687697 37323741 2005 1 1 1 1 C 2100000 2100000 0 0 1 0 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 A 0 1 1 0 1 0 0 0 1 B 0 1 1 0 0 0 0 0 0 A 1 B 1 C 1 FORM 990, SCHEDULE K, PART I, LINE A, COLUMN (F) REFUND PRIOR BONDS (08/20/09) AND CONSTRUCT, REMODEL, RENOVATE, EQUIP HEALTH CARE FACILITIES OWNED BY THE HOSPITAL. FORM 990, SCHEDULE K, PART II, LINE 3 COLUMN (A) - THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENT EARNINGS. COLUMN (B) - THE TOTAL PROCEEDS DO NOT EQUAL THE SUMMATION OF LINES 4 - 12 DUE TO TRANSFERRED OR REPLACEMENT PROCEEDS IN LINE 4. EMERGENCY ASSOCIATES OF YAKIMA PLLC BRIAN PADILLA, TRUSTEE, IS A PHYSICIAN SHAREHOLDER OF THE INTERESTED PERSON 7200790 EMERGENCY ROOM PHYSICIAN COMPENSATION AND MEDICAL STAFF OFFICER COMPENTSATION 0 KATE ROSSMAN FAMILY MEMBER OF DUANE ROSSMAN, TRUSTEE 66342 EMPLOYEE OF HOSPITAL 0 MICHAEL LINNEWEH FAMILY MEMBER OF RICHARD LINNEWEH, KEY EMPLOYEE 30004 EMPLOYEE OF HOSPITAL. 0 PHYSICIAN ANESTHESIA ASSOCIATION ROSS KATZ, SHAREHOLDER OF PHYSICIAN ANESTHESIA ASSOC., TRUSTEE OF YVMH 2366691 PHYSICIAN ANESTHESIA ASSOCIATION PROVIDES ANESTHESIA SERVICES FOR THE HOSPITAL. 0 MARK MYERS FAMILY MEMBER OF RUSS MYERS, KEY EMPLOYEE 36019 EMPLOYEE OF HOSPITAL 0 FORM 990, PART VI, SECTION B, LINE 11 REVIEW IS CONDUCTED BY THE CHIEF ACCOUNTANT, ASSISTANT CFO, CFO, CEO AND BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS ARE DISCLOSED. PERSONS HAVING A CONFLICT MAY NOT BE DECISION-MAKERS IN AREAS WHERE CONFLICTS EXIST. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS SET BY A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES FOLLOWING REVIEW OF COMPARABILITY AND PERFORMANCE DATA. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE FILED WITH THE WASHINGTON SECRETARY OF STATE. CONFLICT OF INTEREST POLICY IS CONTAINED IN A BUSINESS ETHICS BROCHURE. FINANCIAL STATEMENTS ARE FILED WITH THE WASHINGTON STATE DEPARTMENT OF HEALTH. FORM 990, PART VII, COLUMN (A) COMPENSATION PAID BY A RELATED ORGANIZATION IS PROVIDED FOR THE ENTIRE CALENDAR YEAR ENDING WITHIN THE TAX YEAR. THE RELATED ORGANIZATION WAS RELATED DURING THE ENTIRE TAX AND CALENDAR YEAR. OTHER FEES FORM 990, PART IX, LINE 11G REFERENCE LABS: PROGRAM SERVICE EXPENSES 1,959,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,959,100. SUPPORT OF RESIDENCY PROGRAMS: PROGRAM SERVICE EXPENSES 1,514,586. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,514,586. PHYSICIANS SERVICES: PROGRAM SERVICE EXPENSES 31,755,589. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 31,755,589. RED CROSS PROCESSING: PROGRAM SERVICE EXPENSES 1,982,092. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,982,092. PUBLIC RELATION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 940,356. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 940,356. LAUNDRY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 874,511. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 874,511. INDEPENDENT CONTRACTORS: PROGRAM SERVICE EXPENSES 4,268,625. MANAGEMENT AND GENERAL EXPENSES 210,493. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,479,118. MEDICAL RECORD CODING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 750,872. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 750,872. SECURITY SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 606,108. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 606,108. DIALYSIS SERVICE: PROGRAM SERVICE EXPENSES 356,859. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 356,859. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,620,307. MANAGEMENT AND GENERAL EXPENSES 7,294,158. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,914,465. FORM 990, PART XII, LINE 2C: NO CHANGE FROM LAST YEAR. MEMORIAL PHYSICIANS PO BOX 2947 YAKIMA WA 98907 911615998 MEDICAL SERVICES WA 34878134 9102492 YAKIMA VALLEY MEMORIAL HOSPITAL CENTRAL WASHINGTON HEALTHCARE PARTNERS LLC PO BOX 2947 YAKIMA WA 98907 453483343 ACCOUNTABLE CARE ORG WA 112371 1861096 YAKIMA VALLEY MEMORIAL HOSPITAL YAKIMA VALLEY MEMORIAL PHYSICIANS PO BOX 9787 YAKIMA WA 98909 753186720 MEDICAL SERVICES WA 35153080 0 YAKIMA VALLEY MEMORIAL HOSPITAL YAKIMA HEART CENTER AT MEMORIAL TRUST 2811 TIETON DR YAKIMA WA 98902 457017902 MEDICAL SERVICES WA 8516116 0 YAKIMA VALLEY MEMORIAL HOSPITAL GARDEN VILLAGE 206 S 10TH AVE YAKIMA WA 98902 912090034 SKILLED NURSING WA 501(C)(3) 9 N/A 0 0 1 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 0 0