2014-09-22T20:24:41-05:00 2013-12-31 ERNST & YOUNG US LLP 178 S RIO GRANDE STREET SUITE 400 SALT LAKE CITY UT 84101 990 2013-01-01 911577184 COMMUNITY HEALTH NETWORK OF WASHINGTON % Stacy Kessel COMM 2066527174 720 OLIVE WAY Suite 300 SEATTLE WA 98101 Lance Hunsinger CEO 2014-09-17 SHANNON DEFOREST 8013503300 2013 2015-11-30 17:44:51Z Lance Hunsinger 720 Olive way suite 300 Seattle WA 98101 229153635 false X chnw.chpw.org X 1992 WA IMPROVE HEALTH STATUS AND SUSTAIN NETWORK OF COMMUNITY HEALTH CENTERS. 21 21 0 1 0 0 0 0 295160421 228525104 26092 19246 2364052 609285 297550565 229153635 0 0 235375802 167387500 4202646 3380296 0 0 0 49453218 53005991 289031666 223773787 8518899 5379848 64092662 65268387 55484792 51284793 8607870 13983594 TO IMPROVE THE HEALTH STATUS OF OUR COMMUNITIES THROUGH THE PROVISION OF HIGH-QUALITY, AFFORDABLE, COMMUNITY-BASED HEALTH CARE TO UNDERSERVED INDIVIDUALS AND FAMILIES, AND THROUGH SUSTAINING THE NETWORK OF COMMUNITY HEALTH CENTERS AND AFFILIATED BUSINESSES. false false 218496803 0 229134389 PROMOTION OF ACCESSIBLE, AFFORDABLE, AND QUALITY HEALTH CARE FOR WASHINGTON STATE. PROVISION OF PRIMARY HEALTH CARE SERVICES TO ALMOST 121,262 NETWORK MEMBERS PRIMARILY PARTICIAPTING IN MEDICAID AND WASHINGTON STATE BASIC HEALTH PLAN. 218496803 false false true false false false false false false false false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false true X 3291 0 true 0 false false false false false false X 21 21 false false false false true true true true true false false true true true true true true false false false X Stacy Kessel 2065218833 720 Olive way Suite 300 Seattle WA 98101 X Cristobal Guillen Director 1.0 1.0 X 0 12000 0 Barbara Malich Board Secretary 1.0 1.0 X X 0 0 0 David Flentge BOARD MEMBER 1.0 1.0 X 0 0 0 Bob Farrell BOARD MEMBER 1.0 1.0 X 0 0 0 Michael Hassing BOARD MEMBER 1.0 1.0 X 0 0 0 Desmond Skubi BOARD MEMBER 1.0 1.0 X 0 0 0 Teresita Batayola BOARD MEMBER 1.0 1.0 X 0 0 0 Desiree Sweeney BOARD MEMBER 1.0 1.0 X 0 0 0 Steven Clark BOARD MEMBER 1.0 1.0 X 0 0 0 Anita Monoian BOARD MEMBER 1.0 1.0 X 0 0 0 Carlos Olivares BOARD MEMBER 1.0 1.0 X 0 0 0 Julie Keeffe Dir. Exch./Strategy/Implement. 13.0 27.0 X 0 173146 12012 Michael Maples MD Board Member 1.0 1.0 X 0 0 0 Linda McVeigh Board Member 1.0 1.0 X 0 0 0 Diana Bader BOARD MEMBER 1.0 1.0 X 0 15300 0 Thomas Trompeter BOARD VICE CHAIR 1.0 1.0 X X 0 0 0 Peggy Hopkins BOARD CHAIR 1.0 1.0 X X 0 0 0 Sheila Chilson BOARD TREASURER 1.0 1.0 X X 0 0 0 Mark Secord BOARD MEMBER 1.0 1.0 X 0 0 0 Juan Cordova BOARD MEMBER 1.0 1.0 X 0 0 0 Dian Cooper BOARD MEMBER 1.0 1.0 X 0 0 0 Carla DewBerry BOARD MEMBER 1.0 1.0 X 0 0 0 Lance Hunsinger Chief Executive Officer 13.0 27.0 X 0 984172 28174 Stacy Kessel Chief Financial Officer 13.0 27.0 X 0 342518 18726 Marilee K Mcguire Chief Operating Officer 13.0 27.0 X 0 368968 24080 Wade J Harman Chief LEGAL Officer 13.0 27.0 X 0 288444 20126 Alan Lederman SVP, Business Intel & TPA OPS 13.0 27.0 X 0 333962 17852 Pam Sullivan VP, HR & Facilities 4.0 36.0 X 0 191639 21868 Stephen Swanson VP, INFORMATION TECHNOLOGY 13.0 27.0 X 0 213376 15637 Mike Evans VP, Customer Care Ops 13.0 27.0 X 0 220665 22103 Victor Collymore Chief Medical Officer 14.0 26.0 X 0 297388 26766 Lucy Sutphen Medical Director 13.0 27.0 X 0 308936 25714 Abie Castillo VP, Network Development 13.0 27.0 X 0 225222 36924 Mel Yeck Project Manager II 13.0 27.0 X 0 246134 8811 David DiGiuseppe Director Medicare Strategy 4.0 36.0 X 0 172313 20967 Marie Faulring Director Financial Operations 11.0 29.0 X 0 170918 18021 Leslie Demme Program Director Administrativ 13.0 27.0 X 0 185375 23360 0 4750476 341141 0 false true false Milliman 1301 Fifth Avenue Suite 3800 Seattle WA 98101 Actuarial services 191520 Ernst and Young 3712 Solution Center Chicago IL 60677 Auditing 114507 2 0 0 0 PREMIUM REVENUE 900099 228525104 228525104 0 0 228525104 19246 19246 0 0 0 0 0 0 0 0 0 0 MANAGEMENT SERVICE 541611 609285 609285 0 0 609285 229153635 229134389 0 19246 X 0 0 0 0 0 0 167387500 167387500 0 0 0 0 0 0 0 0 2763580 0 2763580 0 123277 0 123277 0 313199 0 313199 0 180240 0 180240 0 0 0 0 0 21797 0 21797 0 117246 0 117246 0 111576 0 111576 0 0 0 0 0 0 0 299306 0 299306 0 0 0 0 0 173127 0 173127 0 74000 0 74000 0 0 0 0 0 156621 0 156621 0 8301 0 8301 0 0 0 0 0 215567 0 215567 0 0 0 0 0 0 0 0 0 0 0 0 0 37081 0 37081 0 Capitation Expenses 20592455 20592455 0 WITHHOLD DISTRIBUTION EXP. 30506953 30506953 0 POLITICAL ACTIVITY 643529 643529 0 LICENSES AND TAXES 35040 35040 0 13392 9895 3497 223773787 218496803 5276984 0 0 0 0 0 0 0 16264408 16164694 0 0 174038 624 0 0 0 0 0 0 0 0 12500 24832 0 0 0 0 956883 969569 0 0 0 0 0 0 46684833 48108668 64092662 65268387 270544 495345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55214248 50789448 55484792 51284793 X 8607870 13983594 0 0 0 0 8607870 13983594 64092662 65268387 5379848 -4124 X false true X true false 61000 61000 0 61000 true Jay Inslee 712 35th Avenue Seattle WA 98122 452533952 1000 0 Ledership Council PO Box 11025 Olympia WA 98508 911714860 16000 0 Harry Truman Fund ELECT BRUCE DAMMEIER PO Box 9100 Seattle WA 98109 911769570 30000 0 The Kennedy Fund 3518 Fremont Ave No 545 Seattle WA 98103 911713677 14000 0 SCHEDULE C, PART I-A DESCRIPTION OF THE ORGANIZATION'S INDIRECT POLITICAL CAMPAIGN ACTIVITIES As one of the state's largest safety net provider networks, providing and expanding access to health care for the underserved is a core part of our mission. Participation in every facet of the public policy process is a natural extension of our efforts. We believe it is both our role and our responsibility to invest in expanding access to health care and health insurance for populations that are very vulnerable and typically have no voice. Therefore, we financially support the campaigns of the policy makers that have prioritized health care access for everyone in Washington State. Intercompany Receivable 47993689 POOL SETTLEMENT RECEIVABLE -PY 99340 POOL SETTLEMENT RECEIVABLE -CY 14705 ACCRUED INVESTMENT INCOME 934 48108668 0 HEALTH CARE CLAIM LIABILITIES 24969493 WITHHOLD DISTRIBUTION PAYABLE -CY 18585101 WITHHOLD DISTRIBUTION PAYABLE -PY 7046562 CAPITATION PAYABLE 174492 OTHER LIABILITIES 12675 DUE TO AFFILIATE 1125 50789448 true false false false false false false false false Lance Hunsinger Chief Executive Officer 0 475172 0 491500 0 17500 0 23000 0 5174 0 1012346 0 0 Stacy Kessel Chief Financial Officer 0 267768 0 74750 0 0 0 17072 0 1654 0 361244 0 0 Marilee K Mcguire Chief Operating Officer 0 291289 0 77679 0 0 0 23000 0 1080 0 393048 0 0 Victor Collymore Chief Medical Officer 0 279888 0 0 0 17500 0 23000 0 3766 0 324154 0 0 Wade J Harman Chief LEGAL Officer 0 227553 0 60891 0 0 0 17458 0 2668 0 308570 0 0 Alan Lederman SVP, Business Intel & TPA OPS 0 260141 0 73821 0 0 0 16772 0 1080 0 351814 0 0 Pam Sullivan VP, HR & Facilities 0 166016 0 25623 0 0 0 17500 0 4368 0 213507 0 0 Stephen Swanson VP, INFORMATION TECHNOLOGY 0 183872 0 29504 0 0 0 12963 0 2674 0 229013 0 0 Mike Evans VP, Customer Care Ops 0 190375 0 30290 0 0 0 21743 0 360 0 242768 0 0 Abie Castillo VP, Network Development 0 186082 0 31750 0 7390 0 31750 0 5174 0 262146 0 0 Lucy Sutphen Medical Director 0 141253 0 45712 0 121971 0 23000 0 2714 0 334650 0 0 Mel Yeck Project Manager II 0 184143 0 26143 0 35848 0 8511 0 300 0 254945 0 0 David DiGiuseppe Director Medicare Strategy 0 146869 0 25444 0 0 0 17500 0 3467 0 193280 0 0 Marie Faulring Director Financial Operations 0 146544 0 24374 0 0 0 16839 0 1182 0 188939 0 0 Julie Keeffe Dir. Exch./Strategy/Implement. 0 148784 0 24362 0 0 0 10481 0 1531 0 185158 0 0 Leslie Demme Program Director Administrativ 0 160926 0 24449 0 0 0 23000 0 360 0 208735 0 0 SCHEDULE J, PART I, LINE 3 SUPPLEMENTAL COMPENSATION INFORMATION THE CEO OF THE ORGANIZATION IS NOT PAID BY THE FILING ORGANIZATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINE 15 FOR THE PROCESS USED BY COMMUNITY HEALTH PLAN OF WASHINGTON, A RELATED TAX-EXEMPT ORGANIZATION, TO DETERMINE EXECUTIVE COMPENSATION. SCHEDULE J, PART I, LINE 4A SUPPLEMENTAL COMPENSATION INFORMATION THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT IN 2013: Mel Yeck - $35,848 Lucy Sutphen - $104,471 FORM 990, PART VI, LINE 6 DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS THE ORGANIZATION HAS 20 CORPORATE MEMBERS. EACH CORPORATE MEMBERS IS A 501(C)(3) FEDERALLY QUALIFIED HEALTHCARE CENTER (FQHC). FORM 990, PART VI, LINE 7A DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ALL CEOS/EXECUTIVE DIRECTORS FROM THE 20 NETWORK MEMBERS ARE ELIGIBLE TO SERVE ON THE CHNW BOARD. CURRENTLY 17 CEOS/EXECUTIVE DIRECTORS ARE SERVING ON THE CHNW BOARD. THE CHNW BOARD ALSO ELECTS THREE (3) INDEPENDENT BOARD MEMBERS THAT SERVE ON THE BOARD. FORM 990, PART VI, LINE 7B THE FOLLOWING ACTIONS ARE RESERVED TO THE MEMBERS OF COMMUNITY HEALTH NETWORK OF WASHINGTON (CHNW): A) AMENDMENT TO THE ARTICLES OF INCORPORATION OF EITHER CHNW OR COMMUNITY HEALTH PLAN OF WASHINGTON (CHPW); B) AMENDMENT TO THE BYLAWS OF EITHER CHNW OR CHPW; C) REMOVAL OF ONE OR MORE DIRECTORS FROM THE BOARD OF EITHER CHNW OR CHPW; D) REMOVAL OF A MEMBER; E) APPROVAL OF ARTICLES OF MERGER INVOLVING CHNW OR CHPW; F) APPROVAL OF THE SALE OR LEASE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF CHNW OR CHPW OTHER THAN IN THE ORDINARY COURSE OF BUSINESS; G) APPROVAL OF THE VOLUNTARY DISSOLUTION OF CHNW AND/OR CHPW; AND H) CHANGES TO THE CRITERIA FOR ADMISSION OF NEW CHNW MEMBERS. FORM 990, PART VI, LINE 11B DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 THE 990 INCLUDING ALL REQUIRED SCHEDULES IS REVIEWED BY THE DIRECTOR OF FINANCIAL REPORTING, CHIEF FINANCIAL OFFICER, CHIEF LEGAL OFFICER, AND CHIEF EXECUTIVE OFFICER. THE CHIEF FINANCIAL OFFICER THEN PRESENTS IT TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ALL DIRECTORS, OFFICERS, AND SENIOR EMPLOYEES ARE REQUIRED TO ANNUALLY DISCLOSE POTENTIAL CONFLICTS OF INTEREST. WITH RESPECT TO BOARD MEMBERS, POTENTIAL CONFLICTS ARE DISCLOSED PRIOR TO DELIBERATIONS; IF AN ACTUAL CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT WILL NOT PARTICIPATE AND IS ASKED TO LEAVE THE MEETING DURING FINAL DELIBERATIONS AND VOTE. EMPLOYEES ARE LEASED FROM COMMUNITY HEALTH PLAN OF WASHINGTON ("CHPW", WHICH IS AN AFFILIATE OF THE ORGANIZATION) AND ARE GOVERNED BY CHPW'S CONFLICT OF INTEREST POLICY; ACTUAL OR POTENTIAL CONFLICTS MUST BE DISCLOSED TO THE HUMAN RESOURCES DEPARTMENT OR CORPORATE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER, IN COOPERATION WITH HUMAN RESOURCES, WILL REVIEW THE CONFLICT AND ADVISE THE EMPLOYEE WITH A POTENTIAL CONFLICT CONCERNING ANY LIMITATIONS THEY MUST OBSERVE IN REGARDS TO THE CONFLICT OF INTEREST. FORM 990, PART VI, LINE 15A and 15B OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN THE CEO IS COMPENSATED BY A RELATED TAX-EXEMPT ORGANIZATION, COMMUNITY HEALTH PLAN OF WASHINGTON ("CHPW"), AND THE FOLLOWING PROCESS IS USED BY CHPW: ANNUALLY THE CHPW HUMAN RESOURCES DEPARTMENT REVIEWS COMPENSATION OF ALL EMPLOYEES (INCLUDING EMPLOYED OFFICERS AND KEY EMPLOYEES). THE CHPW HUMAN RESOURCES DEPARTMENT UTILIZES SEVERAL INDEPENDENT THIRD PARTY COMPENSATION SURVEYS TO MAKE RECOMMENDATIONS ABOUT EMPLOYED OFFICER AND KEY EMPLOYEE COMPENSATION. UTILIZING THAT INFORMATION, THE CHPW CEO SETS THE COMPENSATION FOR EMPLOYED OFFICERS AND KEY EMPLOYEES. THE CHPW CEO COMPENSATION IS SET BY THE CHPW BOARD OF DIRECTORS BASED UPON INDEPENDENT THIRD PARTY COMPENSATION INFORMATION AND PROFESSIONAL OPINION. THE DELIBERATIONS AND APPROVAL OF CEO COMPENSATION ARE RECORDED IN THE BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2013. FORM 990, PART VI, LINE 19 AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC COPIES OF GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST MADE TO THE CORPORATE OFFICES AT 720 OLIVE WAY, SUITE 300, SEATTLE, WA 98101 OR BY FAXING A REQUEST TO (206) 521-8834. FORM 990, PART V, LINE 2A; PART VII, SECTION A; AND PART IX, LINES 7 TO 10 SHARED COSTS COMMUNITY HEALTH NETWORK OF WASHINGTON DOES NOT HAVE ANY EMPLOYEES BUT SHARES THE COSTS OF PERSONNEL, SERVICES, FACILITIES AND EXPENSES, WITH COMMUNITY HEALTH PLAN OF WASHINGTON, A RELATED TAX-EXEMPT ORGANIZATION. 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