2012-08-07T18:17:49-05:00 2011-09-30 AKT LLP 5665 SW MEADOWS RD SUITE 200 LAKE OSWEGO OR 97035 990 2010-10-01 930223960 ASANTE ASAN 5417894103 2650 SISKIYOU BLVD MEDFORD OR 97504 MARK COLLINS 5417894103 2012-08-07 1 JOYLYN M ANKENEY CPA 5036204489 2010 2016-02-24 21:20:13Z MARK COLLINS 2650 SISKIYOU BLVD MEDFORD OR 97504 639382868 0 X WWW.ASANTE.ORG X 1938 OR ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 14 13 4151 700 3466358 191230 1576526 2146309 481883156 495435559 20017717 20283185 1810088 1083829 505287487 518948882 288877 355324 0 0 252583306 253848662 0 0 0 206241111 221904141 459113294 476108127 46174193 42840755 720864574 744025680 388703112 387340635 332161462 356685045 X ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 0 0 302205599 352720512 ASANTE'S MAIN PROGRAM SERVICE ACCOMPLISHMENT IS THE OPERATION OF ROGUE VALLEY MEDICAL CENTER (RVMC), A 378 LICENSED BED HOSPITAL LOCATED IN MEDFORD, OREGON. RVMC HAS BEEN NAMED ONE OF THE TOP 100 CARDIOVASCULAR HOSPITALS IN THE U.S. FIVE TIMES (2000-02, 2004, 2005). THE JOINT COMMISSION CERTIFIED RVMC AS A PRIMARY STROKE CENTER IN 2005, AND THE AMERICAN DIABETES ASSOCIATION HAS ALSO AWARDED RVMC ITS RECOGNITION OF EXCELLENCE. RVMC ALSO EARNED THE GOLD PERFORMANCE ACHIEVEMENT AWARD IN CORONARY ARTERY DISEASE (CAD) FROM THE AMERICAN HEART ASSOC AND EARNED ACUMENTRA HEALTH'S "OUTSTANDING PERFORMANCE" AWARD FOR SURGICAL SITE INFECTION PREVENTION AND "EXCELLENT PERFORMANCE" AWARD FOR TREATING HEART FAILURE.KEY HOSPITAL INPATIENT SERVICES INCLUDE CANCER SERVICES, CARDIOVASCULAR SURGERY AND INPATIENT CARDIAC CATHERIZATION LABORATORY, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, NEONATOLOGY, NEUROSCIENCES, OBSTETRICS, ORTHOPEDICS, PEDIATRICS, AND UROLOGY SERVICES. OTHER INPATIENT SERVICES INCLUDE BEHAVIOR HEALTH, REHABILITATION, AND CRITICAL CARE SERVICES, INCLUDING THE REGION'S ONLY LEVEL 3 NEONATAL INTENSIVE CARE UNIT. KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LABORATORY TESTING AND DIAGNOSIS, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING, SLEEP SERVICES, HOSPICE, AND VARIOUS THERAPIES, INCLUDING BEHAVIORAL, OCCUPATIONAL, PHYSICAL, AND SPEECH. DURING FISCAL YEAR 2011, RVMC ADMITTED 14,414 PATIENTS FOR A TOTAL OF 65,776 PATIENT DAYS. IT ALSO HAD OVER 356,000 TOTAL OUTPATIENT VISITS AND DELIVERED 1,556 BABIES. THE EMERGENCY ROOMS TREATED OVER 39,124 PATIENTS AND THE CHEMISTRY LABS PERFORMED OVER 1 MILLION TESTS. SURGICAL SERVICES PERFORMED 12,702 INPATIENT AND OUTPATIENT SURGERIES AT RVMC, INCLUDING 515 OPEN HEART AND 674 ORTHOPEDIC JOINT REPLACEMENTS. OTHER STATISTICS AT RVMC INCLUDE 17,380 HOSPICE VISITS, 55,131 VISITS TO THE VARIOUS REHAB UNITS AND OVER 114,000 VISITS TO IMAGING.RVMC ALSO REOPENED IT'S SPECIAL CARE NURSERY DURING THE YEAR AFTER A $5.5 MILLION REMODEL PROVIDING STATE-OF-THE ART CARE FOR THE AREA'S TINIEST RESIDENTS-PREMATURE BABIES. AND FINALLY, RVMC IS REMODELING BOTH IT'S INPATIENT AND OUTPATIENT LABORATORIES TO PROVIDE BETTER SERVICE WHILE MEETING THE HIGHEST STANDARDS OF ENVIRONMENTALLY FRIENDLY TECHNOLOGY. 109895482 134033514 ASANTE'S SECOND LARGEST PROGRAM SERVICE ACCOMPLISHMENT BY EXPENSE IS THE OPERATION OF THREE RIVERS COMMUNITY HOSPITAL (TRCH), A 125 LICENSED BED HOSPITAL LOCATED IN GRANTS PASS, OREGON. TRCH ALSO HAS ITS SHARE OF SIGNIFICANT AWARDS AND RECOGNITIONS INCLUDING BEING DESIGNATED A BABY FRIENDLY HOSPITAL BY WHO AND UNICEF AND IS THE NATION'S FIRST MOTHER FRIENDLY HOSPITAL BY THE CENTER FOR IMPROVING MATERNITY SERVICES. THE AMERICAN DIABETES ASSOCIATION HAS ALSO DESIGNATED TRCH WITH IT'S "RECOGNITION OF EXCELLENCE". TRCH ALSO EARNED ACUMENTRA HEALTH'S "OUTSTANDING PERFORMANCE" AWARD FOR SURGICAL SITE INFECTION PREVENTION AND AN "EXCELLENT PERFORMANCE" AWARD FOR TREATING HEART FAILURE.SOME OF THE KEY INPATIENT SERVICES AVAILABLE AT TRCH INCLUDE CANCER SERVICES, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, OBSTETRICS AND PEDIATRICS. SOME OF THE KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LAB TESTING, CARDIOPULMONARY SERVICES, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING AND VARIOUS THERAPIES INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH.DURING THE FISCAL YEAR, TRCH ADMITTED 6,759 INPATIENTS FOR A TOTAL OF 21,867 PATIENT DAYS. IT ALSO DELIVERED 705 BABIES AND HAD OVER 201,000 OUTPATIENT VISITS. THE CHEMISTRY LAB PERFORMED NEARLY 460,000 TESTS AND THE EMERGENCY ROOM SAW 38,984 PATIENTS. THERE WERE OVER 5,900 SURGERIES PERFORMED DURING THE YEAR INCLUDING 476 TOTAL JOINT REPLACEMENTS. TRCH'S REHAB DEPARTMENT HAD 19,795 VISITS AND THE VARIOUS IMAGING DEPARTMENT HAD 64,796 VISITS.RENEWING A STRONG COMMITMENT TO REMAIN ON THE LEADING EDGE OF TECHNOLOGY, A NEW 3-TESLA MRI SCANNER, THE MOST POWERFUL MRI AVAILABLE IN THE WORLD, IS NOW IN USE AT TRCH. AND FINALLY, THE NEW WOMEN'S HEALTH CENTER IS UNDER CONSTRUCTION NEAR THE HOSPITAL. CONSTRUCTION WILL ALSO SOON BEGIN ON A NEW OUTPATIENT CENTER ON THE TRCH CAMPUS AS WELL. 7155865 264350 8681533 ASANTE'S THIRD LARGEST PROGRAM SERVICE BY EXPENSES IS ASANTE COMMUNITY SERVICES. ASANTE COMMUNITY SERVICES (ACS) IS A COMPILATION OF VARIOUS SERVICES AND AGENCIES THAT PROVIDE NUMEROUS PROGRAMS TO HELP CREATE AND MAINTAIN A HEALTHY ENVIRONMENT IN THE ROGUE VALLEY. ACS INCLUDES THE MEDFORD AND GRANTS PASS OCCUPATIONAL HEALTH SERVICES. AMONG THE SERVICES OFFERED BY THE OCCUPATIONAL HEALTH GROUPS ARE PRE-EMPLOYMENT HEALTH SCREENINGS AND PROFESSIONAL COUNSELING FOR INJURED WORKERS. ACS HAS PARTNERED WITH THE OREGON DEPT OF TRANSPORTATION TO PERFORM RANDOM DRUG AND ALCOHOL TESTING OF COMMERCIAL TRUCK DRIVERS. ASANTE COMMUNITY SERVICES ALSO INCLUDES THE ROGUE VALLEY RX, ASANTE HOME INFUSION SERVICES, AND THE COUMADIN CLINIC. FINALLY, ACS RUNS "LIFELINE", AN EMERGENCY MONITORING SERVICE, ALLOWING SENIORS TO CONTINUE TO LIVE INDEPENDENT LIFE STYLES.DURING THE LAST FISCAL YEAR, THE TWO OCCUPATIONAL HEALTH AGENCIES SAW 21,782 PATIENTS. THE ROGUE VALLEY RX FILLED OVER 61,458 PRESCRIPTIONS, INCLUDING 3,488 CUSTOM PHARMACY COMPOUNDINGS, AND LIFELINE PROVIDED MONITORING TO 1,543 SENIORS.ASANTE'S CORPORATE DIVISION HAS MADE GENEROUS CASH DONATIONS TO NUMEROUS NON-PROFIT ORGANIZATIONS. THESE DONATIONS HELP SUPPORT LOCAL SCHOOLS AND OTHER YOUTH ACTIVITIES, SUCH AS LITTLE LEAGUE AND DRUG FREE GRAD NIGHTS AT LOCAL HIGH SCHOOLS. THE CORPORATE DIVISION HAS MADE SIGNIFICANT CONTRIBUTIONS TO NATIONALLY RECOGNIZED MEDICAL ASSOCIATIONS, SUCH AS THE AMERICAN RED CROSS AND DIABETES ASSOCIATIONS. OTHER CONTRIBUTIONS HAVE BEEN MADE TO HEALTH ORGANIZATIONS THAT ASSIST THE LOCAL SPANISH SPEAKING POPULATION, AND OTHERS HAVE BEEN MADE TO ORGANIZATIONS THAT ASSIST LOCAL SENIORS.OFTEN, INDIGENT AND MEDICAID PATIENTS WILL SHOW UP AT THE EMERGENCY ROOM IN NEED OF SPECIALIZED MEDICAL CARE. IN ORDER TO ASSURE THAT UNASSIGNED INDIGENT AND MEDICAID PATIENTS HAVE SPECIALIZED CARE AVAILABLE TO THEM, ASANTE CREATED SOUTHERN OREGON TRAUMA AND EMERGENCY SERVICES (SOTES). SOTES CONTRACTS WITH LOCAL INDEPENDENT PHYSICIANS TO PROVIDE SPECIALIZED CARE TO THESE PATIENTS THROUGHOUT THEIR HOSPITAL STAY. THE PHYSICIAN BILLS SOTES, WHICH WILL REIMBURSE THE SPECIALIST AT MEDICARE RATES. SOTES OPERATES AT BREAKEVEN. EXPENSES ARE FULLY FUNDED AND REIMBURSED TO THE DOCTOR BY THE HOSPITALS. 419256946 1 1 0 1 0 0 0 0 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 396 0 1 4151 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 1 1 OR X X MARVIN HAAS 5417894103 2650 SISKIYOU BLVD MEDFORD OR 97504 ROY VINYARD 40.00 X X 802262 0 468328 R RAY HAYSELL 2.00 X X 0 0 0 WILLIAM D THORNDIKE 2.00 X X 0 0 0 TIM ALFORD 2.00 X X 0 0 0 THOMAS R MCGILLOWAY 2.00 X X 0 0 0 DAVID ABDUN-NUR MD 2.00 X 0 0 0 ALAN BINETTE MD 2.00 X 0 0 0 GAYLE BYRNE 2.00 X 0 0 0 CAROL CLARK-MAYFIELD 2.00 X 0 0 0 KENT W DAUTERMAN MD 2.00 X 0 0 0 RONALD RD JONES 2.00 X 0 0 0 ALVIN SPEARS 2.00 X 0 0 0 JAMES M WRIGHT 2.00 X 0 0 0 ROGER BERNARD 2.00 X 0 0 0 WIN HOWARD 40.00 X 303849 0 39156 MARVIN HAAS 40.00 X 410790 0 65457 KENT BROWN 40.00 X 428082 0 47937 GREGG EDWARDS 40.00 X 283434 0 30532 MARK HETZ 40.00 X 338119 0 31380 CHARLES CARMECI MD 40.00 X 914002 0 35386 DAVID FOLSOM MD 40.00 X 885607 0 37834 GEORGE WILKINSON MD 20.00 X 452187 0 8382 BRIAN SOHL MD 26.00 X 420328 0 37986 ROGER HALL MD 20.00 X 423180 0 22573 5661840 0 824951 241 0 1 0 SOUTHERN OREGON CARDIOLOGY LLC 520 MEDICAL CENTER DRIVE SUITE 200 MEDFORD OR 97504 CARDIAC SERVICES 3009147 SOUTHERN OREGON HOSPITALISTS PC 2640 E BARNETT RD E-333 MEDFORD OR 97504 HOSPITALISTS 1645215 CVISO MANAGEMENT CO LLC 520 MEDICAL CENTER DR MEDFORD OR 97504 CARDIAC SERVICES 1593875 WEST ASSETS MANAGEMENT PO BOX 2140 OMAHA NE 68103 MEDICAL BILLING SERVICES 1302587 TVA ARCHITECTS INC 920 SW 6TH AVE SUITE 1500 PORTLAND OR 97204 ARCHITECT SERVICES 1175095 46 2146309 2146309 HOSPITAL SERVICES 622110 486754026 486754026 ASANTE COMM SVCS 621990 8131132 8131132 SOTES/CORP 621300 550401 550401 495435559 11652998 11652998 10076 10076 1545419 3927948 -2382529 -2382529 -2382529 120960499 260088 112189127 411349 8771372 -151261 8620111 8620111 5176025 3905562 1270463 1270463 PATHOLOGY LAB 621500 1428520 1428520 LAB OUTREACH 621500 591421 591421 WORK HEALTH 624310 170620 170620 5334 5334 2195895 518948882 495435559 3466358 17900656 264350 264350 90974 90974 3249326 1624663 1624663 179275526 158986216 20289310 9157615 8109385 1048230 48299173 47977878 321295 13867022 12325607 1541415 27803497 21805364 5998133 511040 87603 423437 213609 213609 56121 56121 1870301 1870301 6602076 2403716 4198360 495408 495408 11696840 5848420 5848420 15469047 12495281 2973766 440430 320363 120067 1035909 739930 295979 12560048 11304043 1256005 26148654 21486702 4661952 5173549 4656265 517284 PATIENT SUPPLIES 82306590 82306590 OTHER OPERATING EXPENSE 16918196 14433628 2484568 BAD DEBTS 8741380 8741380 EQUIPMENT RENTAL 2006111 1997487 8624 TAXES 205305 205305 1650030 1045796 604234 476108127 419256946 56851181 0 15453358 17360337 65406120 68465142 1807540 4007990 4040044 3825839 3782373 4783684 583455398 328833251 248420168 254622147 358810381 368337262 23144590 22623279 720864574 744025680 29856343 28669773 321884755 317839352 3208006 2896870 33754008 37934640 388703112 387340635 X 332161462 356685045 332161462 356685045 720864574 744025680 X 42840755 -18317172 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 44121 0 0 1 12000 56121 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: ASANTE MAINTAINS MEMBERSHIPS IN THE AMERICAN HOSPITAL ASSOC (AHA) AND OREGON ASSOC OF HOSPITALS AND HEALTHCARE SYSTEMS (OAHHS). DURING TAX YEAR 2010, ASANTE PAID MEMBERSHIP DUES TO THE AHA AND OAHHS OF $65,887 AND $170,818 RESPECTIVELY. 16.41% OF OAHHS DUES AND 24.42% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, ASANTE MADE INDIRECT LOBBYING EXPENDITURES OF $44,121 THROUGH ITS MEMBERSHIP DUES. ALSO, ASANTE PAID JOHN WATT AND ASSOCIATES (JWA) $12,000 FOR SPECIFIC ISSUES LOBBYING DURING THE TAX YEAR. JWA IS AN ADVOCATE FOR ASANTE AND SPECIALIZES IN BALLOT PROPOSITIONS AFFECTING THE HEALTHCARE INDUSTRY. 18615713 215694 169689 8935 18992161 18631486 28150 109554 153477 18615713 18858075 9192 -234001 1780 18631486 0.80570 0.16620 0.02810 0 1 1 12959946 8283673 21243619 281838678 120546092 161292586 7044999 5489339 1555660 243905395 202797820 41107575 29422707 29422707 254622147 SELF INSURANCE RESERVE 15571077 PROVIDER TAX PAYABLE 6043621 REIMBURSEMENT DUE GOVT AGENCIES 5747582 OTHER CURRENT LIABILITIES 3495787 LONG TERM LIABILITIES 4846204 457B LIABILITY 2230369 37934640 518948882 476108127 42840755 -20379119 2061947 -18317172 24523583 496422909 -20379122 2510294 -17868828 514291737 1870301 2786844 4657145 518948882 476146784 1908958 1908958 474237826 1870301 1870301 476108127 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE ASANTE FOUNDATION, A 501(C)(3) ORGANIZATION, IS DIRECTLY RELATED TO AND CONTROLLED BY ASANTE. IT IS IDENTIFIED ON SCHEDULE R, PART II AS A RELATED TAX-EXEMPT ORGANIZATION. THE ASANTE FOUNDATION MAINTAINS THE ASSETS OF 14 DIFFERENT ENDOWMENTS WITH A NET WORTH OF OVER $18.6 MILLION. THE CORPUS OF THE ENDOWMENTS IS TO REMAIN INTACT AND INVESTED IN MARKETABLE SECURITIES AND OTHER FINANCIAL INSTRUMENTS. AT THE END OF EACH FISCAL YEAR, ANY INVESTMENT INCOME GENERATED FROM THE ENDOWMENTS IS RELEASED TO ASANTE. THE INCOME RECEIVED IS USED TO SUBSIDIZE NUMEROUS PROGRAMS, INCLUDING THE RVMC HOSPICE, PHYSICIAN AND NURSING EDUCATION, CHILDREN'S HEALTH, ONCOLOGY PROGRAMS, AND SUPPORT OF THE FRANCIS CHENEY AND THREE RIVERS FAMILY HOUSES. PART XI, LINE 8 - OTHER ADJUSTMENTS: EQUITY IN JOINT VENTURES 646,519. DONATED CAPITAL AND FAS 47 1,415,428. PART XII, LINE 2D - OTHER ADJUSTMENTS: INCOME FROM JOINT VENTURES 868,918. INVESTMENT INCOME-RVMC FOUNDATION 795,526. INVESTMENT INCOME-SO OREG INSURANCE 845,850. PART XII, LINE 4B - OTHER ADJUSTMENTS: OPERATING LOSS-RVMC FOUNDATION 679,933. UNREALIZED LOSS-FOUNDATION 1,334,074. UNREALIZED LOSS-SO OREG INSURANCE 772,837. PART XIII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FROM JOINT VENTURES 1,908,958. 1 1 X 1 X 1 X 1 1 0 1 1 32775 22026975 22026975 0.04630 75343 83137514 53611843 29525671 0.06200 2216 9195358 7728247 1467111 0.00310 110334 114359847 61340090 53019757 0.11140 6030366 6030366 0.01270 70000 70000 0.00010 150608 99696 50912 0.00010 157390 157390 0.00030 6408364 99696 6308668 0.01320 110334 120768211 61439786 59328425 0.12460 49960 49960 0.00010 49960 49960 0.00010 1 3252207 121889265 155511523 -33622258 X 1 1 1 SISKIYOU IMAGING RADIOLOGY & IMAGING SVC 0.33330 0.33330 2 CVI MANAGEMENT CO LLC MANAGEMENT SERVICES 0.25000 0.75000 3 CVI REAL PROPERTY PROPERTY MANAGEMENT 0.25000 0.75000 4 SOUTHERN OREGON LINEN SVCS LINEN PROCESSING 0.34000 5 HEALTH FUTURE LLC SUPPLIES PURCHASING 0.14300 6 GRANTS PASS SURGICAL CENTER OUTPATIENT SURGERY 0.35000 0.65000 7 AIM REAL PROPERTY REAL PROPERTY MGMT 0.65000 0.35000 8 ROGUE VALLEY SLEEP CENTER SLEEP DISORDER SVCS 0.51000 0.49000 9 SURGERY CENTER OF SO OREGON OUTPATIENT SURGERY 0.20000 0.80000 2 1 ROGUE VALLEY MEDICAL CENTER

2825 E BARNETT ROAD MEDFORD OR 97504

X X X 2 THREE RIVERS COMMUNITY HOSPITAL

500 SW RAMSEY AVE GRANTS PASS OR 97527

X X X ROGUE VALLEY MEDICAL CENTER 1 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X X 1 X X X X 1 X X X X X X X X 1 X X 0 0 THREE RIVERS COMMUNITY HOSPITAL 2 0 1 1 200.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X X X 1 X X X X 1 X X X X X X X X 1 X X 0 0 2 ASANTE WORK HEALTH

781 S BLACK OAK DRIVE MEDFORD OR 97504

WORK HEALTH FACILITY ROGUE VALLEY RX

2900 E BARNETT ROAD MEDFORD OR 97504

OUTPATIENT PHARMACY PART II: IN FISCAL YEAR 2011, ASANTE'S CONTRIBUTION TO COMMUNITY HEALTH IMPROVEMENTS ADVOCACY INCLUDES $39,060 TO JACKSON COUNTY DEPT OF SOCIAL SERVICES, $1,500 TO LA CLINICA DEL VALLE, $1,000 TO ONTRACK, A LOCAL DRUG COUNSELING SERVICES, AND $8,400 TO THE WOMEN'S CRISIS SUPPORT CENTER OF SOUTHERN OREGON. PART III, LINE 4: BAD DEBTS RESULT WHEN A PATIENT WHO HAS BEEN DETERMINED TO HAVE THE FINANCIAL CAPACITY TO PAY FOR HEALTHCARE SERVICES IS UNWILLING TO SETTLE THE CLAIM OR DOES NOT PROVIDE FINANCIAL INFORMATION TO ACCESS CAPACITY. CALCULATION: (BAD DEBTS AT FORGONE REVENUE AMOUNT) X (OPERATING EXPENSES EXCLUDING BAD DEBTS) / (GROSS REVENUE)) = BAD DEBT EXPENSE AT COST PART III, LINE 8: CERTAIN GOVERNMENT SPONSORED HEALTH INSURANCE COMPANIES, SUCH AS MEDICARE AND MEDICAID, PAY A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR INSUREES. IN MOST CASES, THE AMOUNT PAID DOES NOT EVEN COVER THE EXPENSES OF RENDERING SERVICES. ASANTE CONSIDERS THE DIFFERENCE BETWEEN THE EXPENSES OF RENDERING SERVICES TO MEDICARE AND MEDICAID PATIENTS, AND THE AMOUNT OF NET REIMBURSEMENT FROM THESE GOVERNMENT SPONSORED INSURANCE COMPANIES A COMMUNITY BENEFIT. CALCULATION: TOTAL MEDICARE PAYMENTS PER COST REPORT LESS TOTAL MEDICARE COSTS PER COST REPORT = UNRECOVERED MEDICARE COST PER COST REPORT. PART III, LINE 9B: IF THERE IS AN INDICATION THAT A PATIENT MAY BE UNABLE TO PAY THEIR BILL, A FINANCIAL QUESTIONNAIRE IS GIVEN OR SENT TO THE PATIENT. ON RECEIPT OF THE COMPLETED QUESTIONNAIRE, THE BUSINESS OFFICE WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT WITHIN 20 DAYS. ELIGIBILITY IS DETERMINED BASED UPON THE QUESTIONNAIRE AND ON FINANCIAL DOCUMENTS, SUCH AS TAX RETURNS, SSI STATEMENTS, PAYCHECK STUBS, AND FSA/HSA INFORMATION. THE PATIENT'S OTHER FINANCIAL OBLIGATIONS, NUMBER OF DEPENDENTS, ASSETS AND OTHER FINANCIAL CIRCUMSTANCES ARE CONSIDERED. OFTEN, A PATIENT WILL NOT PROVIDE A FINANCIAL QUESTIONNAIRE, SO THE BUSINESS OFFICE WILL USE SOFT CREDIT CHECKS AND ZIP CODES+4 TO HELP DETERMINE ELIGIBILITY. THE PERCENTAGE OF FINANCIAL ASSISTANCE PROVIDED IS BASED UPON A SLIDING SCALE TABLE THAT UTILIZES THE PATIENT FAMILY'S INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES. ROGUE VALLEY MEDICAL CENTER PART V, SECTION B, LINE 13G: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. THREE RIVERS COMMUNITY HOSPITAL PART V, SECTION B, LINE 13G: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. ROGUE VALLEY MEDICAL CENTER PART V, SECTION B, LINE 15E: IF OTHER ACTIONS HAVE PROVEN INEFFECTIVE, ASANTE WILL ATTEMPT TO GARNISH WAGES. THREE RIVERS COMMUNITY HOSPITAL PART V, SECTION B, LINE 15E: IF OTHER ACTIONS HAVE PROVEN INEFFECTIVE, ASANTE WILL ATTEMPT TO GARNISH WAGES. ROGUE VALLEY MEDICAL CENTER PART V, SECTION B, LINE 16E: IF OTHER ACTIONS HAVE PROVEN INEFFECTIVE, ASANTE WILL ATTEMPT TO GARNISH WAGES. THREE RIVERS COMMUNITY HOSPITAL PART V, SECTION B, LINE 16E: IF OTHER ACTIONS HAVE PROVEN INEFFECTIVE, ASANTE WILL ATTEMPT TO GARNISH WAGES. ROGUE VALLEY MEDICAL CENTER PART V, SECTION B, LINE 19D: ASANTE WILL GIVE AN AUTOMATIC 15% REDUCTION OF CHARGES FOR NON-INSURED SELF PAY PATIENTS. ASANTE WILL GIVE ANOTHER 15% DISCOUNT IF THE PATIENT PAYS IN FULL BEFORE THE ACCOUNT BILLS. THREE RIVERS COMMUNITY HOSPITAL PART V, SECTION B, LINE 19D: ASANTE WILL GIVE AN AUTOMATIC 15% REDUCTION OF CHARGES FOR NON-INSURED SELF PAY PATIENTS. ASANTE WILL GIVE ANOTHER 15% DISCOUNT IF THE PATIENT PAYS IN FULL BEFORE THE ACCOUNT BILLS. PART VI, LINE 2: ASANTE'S FIVE PRIMARY SOURCES OF INPUT INCLUDE THE COMMUNITY LEADERS FORUM, THE ENVIRONMENTAL ASSESSMENT, THE COMMUNITY ASSESSMENT SURVEY, FORMAL CONVERSATIONS WITH OUR COLLABORATORS, AND IDENTIFIED STRATEGIC PLAN GAPS FROM THE PREVIOUS YEAR. PART VI, LINE 3: THE FINANCIAL ACCESS SPECIALISTS, CREDIT ANALYSTS, AND REGISTRATION PERSONNEL WORK WITH THE PATIENT EITHER AT THE TIME OF SCHEDULING, ARRIVAL AT THE HOSPITAL, OR DURING THE BILLING PROCESS. IF THE PATIENT DISCLOSES THEY WILL HAVE DIFFICULTY PAYING, WE ASSIST THEM APPLYING FOR THE OREGON HEALTH PLAN, FINANCIAL ASSISTANCE, OR A PAYMENT PLAN. BASED UPON INCOME AND EXPENSES, A PATIENT MAY BE ELIGIBLE FOR CHARITY CARE WRITE-OFF OF BETWEEN 10% AND 100% OF THEIR BILL. PART VI, LINE 4: THE MOST NOTABLE FACT ABOUT THE DEMOGRAPHICS OF OUR SERVICE AREA IS THAT WE HAVE A RATHER ELDERLY POPULATION, BOTH IN OUR PRIMARY SERVICE AREA OF JACKSON AND JOSEPHINE COUNTIES, BUT ALSO OUR SECONDARY SERVICE AREA OF NORTHERN CALIFORNIA AND SOUTHERN OREGON. IN FISCAL 2011, PATIENTS 65+ ACCOUNTED FOR 39.21% AND 47.37% OF ADMISSIONS AT RVMC AND TRCH RESPECTIVELY.FOR THE NEXT 20 YEARS, THE 65+ AGE GROUP IS FORECAST TO BE THE FASTEST GROWING SEGMENT OF THE POPULATION. IN ADDITION, THE OVERALL POPULATION GROWTH OF OUR PRIMARY SERVICE AREA IS ALSO FORECAST TO AVERAGE 1% PER YEAR FOR THE NEXT 30 YEARS. PART VI, LINE 6: ALONG WITH PROVIDING QUALITY HEALTHCARE, ASANTE FURTHERS ITS EXEMPT PURPOSE AND FULFILLS ITS MISSION TO THE COMMUNITY BY PROVIDING OR SUBSIDIZING NUMEROUS CLASSES, SUPPORT GROUPS, HEALTH FAIRS, AND SELF-HELP PROGRAMS. THESE PROGRAMS ARE AT NO OR LOW COST TO THE PUBLIC. THE ASANTE COMMUNITY HEALTH EDUCATION PROGRAM IS AN ONGOING, NO COST PROGRAM, OPEN TO ALL COMMUNITY MEMBERS. IN FY 2011, OVER 40 COMMUNITY HEALTH EDUCATION CLASSES WERE OFFERED AT RVMC AND TRCH. ON AVERAGE, ATTENDANCE WELL EXCEEDED 75 PEOPLE AT EACH EVENT. ASANTE ALSO PROMOTES AND EXTENDS PATIENT CARE BY PROVIDING SPACE AND MATERIALS TO APPROXIMATELY 30 SUPPORT GROUPS. ASANTE HOSPICE, RVMC AND TRCH CANCER SERVICES, AND RVMC/TRCH WOMEN AND CHILDREN'S SERVICES PROVIDE STAFF, RESOURCES AND ORGANIZATIONAL SUPPORT FOR VARIOUS WELL-ATTENDED SUPPORT GROUPS AND DEDICATIONAL EVENTS, SUCH AS "CANCER SURVIVOR'S DAY". MANY OTHER SUPPORT GROUPS ARE COMMUNITY-LED, BUT LOGISTICALLY SUPPORTED BY ASANTE HEALTH SYSTEM AND AFFILIATED CLINICAL STAFF MEMBERS. THE SMULLIN EDUCATION CENTER HOUSES COMMUNITY AND HEALTHCARE RELATED EVENTS. ALONG WITH THE ASANTE COMMUNITY HEALTH EDUCATION PROGRAM AND SUPPORT GROUPS, SMULLIN HOSTED OVER 400 EVENTS. OPERATIONALLY, ASANTE HEALTH SYSTEM SUPPORTS THESE EVENTS BY PROVIDING SALAIRES, BENEFITS, SUPPLIES AND CLASSROOM SPACE. ADDITIONALLY, ASANTE IS THE SOLE SUPPORT OF THE FRANCIS CHENEY FAMILY PLACE AND THE THREE RIVERS FAMILY HOUSE. MUCH LIKE THE RONALD MCDONALD HOUSE, THESE HOUSES PROVIDE LOW-COST TEMPORARY LODGING FOR FAMILIES OF PATIENTS AT RVMC OR TRCH. DONATIONS ARE ACCEPTED, BUT NO ONE IS DENIED LODGING FOR AN INABILITY TO CONTRIBUTE.ASANTE HEALTH SYSTEM HAS SEVERAL CLINICAL DEPARTMENTS THAT PROVIDE NON-BILLED SERVICES TO COMMUNITY MEMBERS. THESE DEPARTMENTS INCLUDE THE STERILE PROCESSING DEPARTMENT, IMAGING DEPARTMENT, RVMC/TRCH PHARMACIES (BOTH HOSPITAL AND RETAIL), SOCIAL SERVICES, RESOURCE MANAGEMENT, SENIOR TRANSPORTATION, AND THE SUPPORTIVE CARE TEAM. RVMC ALSO PROVIDES FREE LAB WORK TO THE PATIENTS OF THE COMMUNITY HEALTH CENTERS. THE ASANTE HEALTH SYSTEM STRIVES TO MEET THEIR ON-GOING MISSION: ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. PART VI, LINE 7: ASANTE IS A COMMUNITY OWNED AND GOVERNED NOT-FOR-PROFIT HEALTH SYSTEM PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO MORE THAN 550,000 RESIDENTS IN NINE COUNTIES THROUGHOUT SOUTHERN OREGON AND NORTHERN CALIFORNIA. THE SYSTEM WAS FORMED IN 1995 TO INCLUDE ROGUE VALLEY MEDICAL CENTER (RVMC) IN MEDFORD, AND THREE RIVERS COMMUNITY HOSPITAL (TRCH) IN GRANTS PASS. IN 2003, ASANTE FORMED ASANTE COMMUNITY SERVICES, WHICH PROVIDES OCCUPATIONAL HEALTH AND PHYSICIAN SERVICES. REPORTS FILED WITH STATES PART VI, LINE 7 OR 1 JACKSON COUNTY SOC SVCS 1005 E MAIN ST MEDFORD OR 97504 943096772 501(C)(3) 39060 SUPPORT PRE-NATAL CARESUPPORT INTL MEDICAL RELIEF EFFORT IN HAITI MEDFORD CHAMBER OF COMMERCE 101 E 8TH STREET MEDFORD OR 97501 930197580 501(C)(3) 14680 SUPPORT CHAMBER OF COMMERCE OREG CHAPT OF ACC PO BOX 55424 PORTLAND OR 97213 205915188 501(C)(3) 5100 SUPPORT MEDICAL SOCIETY ROGUE COMMUNITY COLLEGE 3345 REDWOOD HWY GRANTS PASS OR 97527 930591783 501(C)(3) 68500 SUPPORT NURSING PROGRAM WOMEN'S CRISIS SUPPORT 560 NE F STREET GRANTS PASS OR 97526 930763734 501(C)(3) 8400 SUPPORT WOMENS COALITION 64 34 CLOTHING FOR INDIGENT PATIENTS 1100 COST CLOTHING PROVIDED FOR INDIGENT PATIENTS FREE RX TO INDIGENT PATIENTS 2500 36678 COST FREE PRESCRIPTION DRUGS SENIOR SERVICES TRANSPORTATION 1737 53196 COST FREE VAN RIDES PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: ONCE AN APPLICANT HAS BEEN APPROVED FOR GRANT FUNDS, THE GRANT AGREEMENT SPECIFIES THAT ALL GRANT MONIES ARE TO BE SPENT FOR ONLY THE PURPOSE SPELLED OUT IN THE APPLICATION. THE COUNTY CONNECTIONS COMMITTEE MUST KNOW WHERE THE DONATED MONEY WILL BE ALLOCATED, AND IF A FUNDRAISING EVENT, HOW THE RAISED MONEY WILL BE ALLOCATED. USUALLY, A DETAILED BUDGET OF THE GRANTEE'S CURRENT YEAR IS REQUIRED, AS WELL AS ANY REPORTS OR MINUTES FROM PREVIOUS EVENTS. OTHER INFORMATION: PART IV: WHEN ASANTE RECEIVES A REQUEST FOR GRANT FUNDS FROM AN OUTSIDE ORGANIZATION, THE REQUEST IS REVIEWED BY EITHER THE JACKSON COUNTY OR JOSEPHINE COUNTY COMMUNITY CONNECTIONS COMMITTEE. THE APPLICANT MUST FILL OUT AN APPLICATION FORM AND PROVIDE SUPPORTING DOCUMENTS OR EVENT MATERIALS. TO BE SELECTED, THE ORGANIZATION MUST MEET THE FOLLOWING CRITERIA: 1)THE GRANT MUST SUPPORT STRATEGIC INITIATIVES, 2)IT MUST HAVE A DIRECT IMPACT ON THE HEALTHCARE OF THE COMMUNITY, 3)THE ORGANIZATION MUST BE A NOT-FOR-PROFIT HEALTH, HUMAN SERVICES, OR EDUCATION RELATED ORGANIZATION, 4)THE ORGANIZATION COLLABORATES WITH OTHER NOT-FOR-PROFIT ORGANIZATIONS AND, 5)THE GRANT MUST BE A RELATION BUILDING OPPORTUNITY. X X X X X 0 1 0 0 0 0 0 1 0 ROY VINYARD 566662 0 202922 0 32678 0 383567 0 84761 0 1270590 0 154047 0 WIN HOWARD 187941 0 51720 0 64188 0 18470 0 20686 0 343005 0 0 0 MARVIN HAAS 305119 0 87349 0 18322 0 38500 0 26957 0 476247 0 0 0 KENT BROWN 281477 0 82134 0 64471 0 26020 0 21917 0 476019 0 0 0 GREGG EDWARDS 175787 0 51867 0 55780 0 14700 0 15832 0 313966 0 0 0 MARK HETZ 221447 0 67281 0 49391 0 20343 0 11037 0 369499 0 0 0 CHARLES CARMECI MD 60256 0 837246 0 16500 0 14700 0 20686 0 949388 0 0 0 DAVID FOLSOM MD 11241 0 852366 0 22000 0 14700 0 23134 0 923441 0 0 0 GEORGE WILKINSON MD 6623 0 429134 0 16430 0 7350 0 1032 0 460569 0 0 0 BRIAN SOHL MD 381828 0 0 0 38500 0 14700 0 23286 0 458314 0 0 0 ROGER HALL MD 22181 0 400999 0 0 0 7350 0 15223 0 445753 0 0 0 PART I, LINE 7 THE FIVE HIGHEST PAID NON-EXECUTIVE EMPLOYEES, MOSTLY CARDIAC SURGEONS, ARE PAID A BASE SALARY AND THEN RECEIVE PRODUCTIVITY COMPENSATION BASED ON RELATIVE VALUE UNITS (RVU'S). EACH RVU IS $40. TOTAL COMPENSATION IS DETERMINED BY MULTIPLYING THE RVU'S BY $40. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART II SHOWS THE COMPENSATION OF THE OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF ASANTE, AS WELL AS THE COMPENSATION OF THE TOP 5 HIGHEST PAID EMPLOYEES. COLUMNS BI, BII AND BIII DISPLAYS THE AMOUNTS ACTUALLY PAID TO THESE PEOPLE AS WHAT SHOWS UP ON THEIR FORM W-2 ON DECEMBER 31,2010. COLUMNS C AND D INCLUDE AMOUNTS ACCRUED, BUT UNPAID DURING THE FISCAL YEAR, WITH COLUMN E BEING TOTAL COMPENSATION REPORTED FOR FORM 990 PURPOSES. COLUMN F INCLUDES AMOUNTS THAT HAD BEEN REPORTED AS ACCRUED BUT UNPAID COMPENSATION ON PRIOR YEAR FORM 990 TAX RETURNS, BUT PAID-OUT DURING THE CURRENT YEAR. DURING FISCAL YEAR 2011, ROY VINYARD RECEIVED SIGNIFICANT PAY-OUTS FROM HIS EXECUTIVE RESTORATION PLANS. THIS PLAN HAD BEEN ACCUMULATING FUNDS FOR SEVERAL YEARS AND HAD SHOWN UP ON PRIOR YEAR'S FORM 990 AS ACCRUED BUT UNPAID AMOUNTS. HOWEVER, IT WAS NOT ACTUALLY PAID-OUT UNTIL FISCAL 2011. THE PAID-OUT AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN BIII AND WOULD BE INCLUDED IN THE OFFICER'S FORM W-2 ON DECEMBER 31, 2010. ALSO, SINCE THESE CURRENT PAY-OUTS WERE DISPLAYED AS ACCRUED BUT UNPAID AMOUNTS ON PRIOR YEAR'S FORM 990, THE SCHEDULE J'S INSTRUCTIONS REQUIRE THEY ALSO APPEAR ON COLUMN F (COMPENSATION REPORTED ON PRIOR FORM 990), ECCENTIALLY SHOWING THE AMOUNT TWICE. THE HOSPITAL FACILITY AUTHORITY OF THE CITY OF MEDFORD OREGON 521378932 584283FL4 2010-02-17 239059650 FINANCE HOSPITAL EXPANSION 0 0 0 239059650 3511327 2680107 31013405 201854811 2011 1 0 1 1 0 0 1 1 1 0.00200 0.00200 1 0 0 0 0 0 1 FORM 990, PART VI, SECTION A, LINE 1 DAVID ABDUN-NUR, MD DR. DAVID ABDUN-NUR HAS ADMITTING PRIVILEGES AT THREE RIVERS COMMUNITY HOSPITAL. HE IS ALSO A MEMBER OF THE HOSPITAL'S MEDICAL STAFF, BUT IS NOT AN EMPLOYEE OF ASANTE. HIS MEMBERSHIP ON THE ASANTE BOARD IS VOLUNTARY AND HE IS REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. ALAN BINETTE, MD DR. ALAN BINETTE HAS ADMITTING PRIVILEGES AT ROGUE VALLEY MEDICAL CENTER. HE IS ALSO A MEMBER OF THE HOSPITAL'S MEDICAL STAFF, BUT IS NOT AN EMPLOYEE OF ASANTE. HIS MEMBERSHIP ON THE ASANTE BOARD IS VOLUNTARY AND HE IS REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST KENT W. DAUTERMAN, MD DR KENT DAUTERMAN IS A PRACTICING PHYSICIAN AND HAS ADMITTING PRIVILEGES AT BOTH THREE RIVERS COMMUNITY HOSPITAL AND ROGUE VALLEY MEDICAL CENTER. HE IS ALSO ON THE MEDICAL STAFF OF BOTH HOSPITALS, BUT IS NOT A PAID EMPLOYEE OF ASANTE. HIS MEMBERSHIP ON THE ASANTE BOARD IS VOLUNTARY AND HE IS REQUIRED TO DISCLOSE ANY CONFLICTS OF INTEREST. ROY VINYARD ROY VINYARD IS THE PRESIDENT AND CEO OF ASANTE AND IS ALSO A VOTING MEMBER OF THE BOARD OF DIRECTORS. SINCE MR. VINYARD IS A PAID EMPLOYEE OF ASANTE, HE IS CONSIDERED NOT TO BE AN INDEPENDANT VOTING MEMBER OF THE GOVERNING BOARD. FORM 990, PART VI, SECTION B, LINE 11 POLICY SUMMARY: THE FEDERAL FORMS 990 AND 990-T ARE FEDERALLY MANDATED LEGAL DOCUMENTS THAT ARE HIGHLY REGULATED. WITHIN ASANTE, THEY ARE TO BE PREPARED BY PERSONNEL IN THE ACCOUNTING DEPARTMENT. ADDITIONAL ASSISTANCE WILL BE PROVIDED BY PERSONNEL IN THE MARKETING, COMPLIANCE, AND EXECUTIVE DEPARTMENTS. BEFORE FINAL SUBMISSION OF THE DOCUMENTS, THEY ARE TO HAVE ASANTE BOARD REVIEW. POLICY DETAILS: 1. WHEN FINAL AUDITED FINANCIAL INFORMATION IS AVAILABLE, ACCOUNTING PERSONNEL WILL COMPILE THE NEEDED INFORMATION TO PREPARE THE APPROPRIATE TAX RETURNS FOR THE PRIOR FISCAL YEAR. 2. AS NEEDED, ACCOUNTING WILL FILE ALL APPROPRIATE EXTENSIONS ON A TIMELY BASIS. HOWEVER, THE FINAL SUBMISSION CAN NEVER BE EXTENDED PAST AUGUST 15TH OF THE YEAR FOLLOWING THE FISCAL YEAR BEING FILED. 3. IN ADDITION TO NORMAL PREPARATION, ACCOUNTING PERSONNEL WILL COORDINATE WITH PERSONNEL IN MARKETING, COMPLIANCE, AND POSSIBLY THE EXECUTIVE DEPARTMENTS IN PREPARING THE VARIOUS SCHEDULES NEEDED TO COMPLETE THE RETURN. ALL WORK PAPERS ARE TO BE RETAINED IN A PERMANENT FILE. 4. WHEN ALL NECESSARY INFORMATION HAS BEEN COMPILED, IT IS TO BE LOADED INTO APPROPRIATE TAX SOFTWARE. 5. WHEN COMPLETED, A DRAFT RETURN WILL BE REVIEWED BY THE CHIEF ADMINISTRATIVE AND FINANCE OFFICER. AFTER THE REVIEW, ACCOUNTING WILL CLEAR ALL REVIEW NOTES AND COMMENTS. 6. ONCE REVIEWED BY THE CAFO, AN ADDITIONAL REVIEW WILL BE PERFORMED BY AN OUTSIDE CPA FIRM. ACCOUNTING WILL AGAIN CLEAR ANY ADDITIONAL REVIEW NOTES AND COMMENTS SUBMITTED BY THE OUTSIDE CPA. 7. THE CHIEF EXECUTIVE OFFICER AND MEMBERS OF THE BOARD OF DIRECTORS WILL LOOK OVER THE FINAL SET OF RETURNS AND MAKE FURTHER COMMENTS AND CORRECTIONS, AS IS APPROPRIATE. 8. ONCE ALL REVIEWS AND CORRECTIONS ARE MADE, THE CAFO WILL SIGN ALL APPROPRIATE RETURNS FOR FILING. 9. ALL RETURNS WILL THEN BE FILED EITHER ELECTRONICALLY OR PAPER COPY WITH THE APPROPRIATE GOVERNMENT AGENCY. A COPY OF EACH RETURN IS TO BE KEPT IN THE ACCOUNTING DEPARTMENT AND A COPY OF THE 990 AND 990-T WILL BE KEPT AT CORPORATE HEADQUARTERS FOR PUBLIC DISPLAY AND COPYING, AS REQUESTED. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ASANTE MAILS TO ALL ASANTE MANAGEMENT, KEY EMPLOYEES, AND BOARD MEMBERS A CONFLICT OF INTEREST QUESTIONAIRE TO COMPLY WITH ASANTE'S CONFLICT OF INTEREST POLICY# 400-LD-034 AND 036. THE PURPOSE OF THE POLICY IS TO PROTECT ASANTE'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF A BOARD MEMBER OR OFFICER OF THE CORPORATION. IN ADDITION, ALL ASANTE EMPLOYEES HAVE AN OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS TO THEIR SUPERVISOR. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR ADMINISTERING, MONITORING, AND INVESTIGATING ANY POSSIBLE CONFLICTS AND MAKE AN ANNUAL REPORT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES. THE REVIEW COMPARES THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES WITH COMPENSATION DATA FOR JOB INCUMBENTS IN COMPARABLE POSITIONS AT OTHER HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND SCOPE. THE DATA IS PROVIDED AND PRESENTED TO THE COMPENSATION COMMITTEE BY AN OUTSIDE CONSULTANT. THE COMPENSATION COMMITTEE SETS THE ACTUAL ANNUAL CASH COMPENSATION FOR THE CEO AND SALARY RANGES FOR THE OTHER KEY EMPLOYEES. THE COMMITTEE ALSO SETS TOTAL COMPENSATION OPPORTUNITY FOR THE CEO AND EACH OF THE KEY EMPLOYEES, CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY. MINUTES OF THE COMMITTEE DELIBERATIONS AND DECISIONS ARE RECORDED AND MAINTAINED. THE MOST RECENT EXECUTIVE COMPENSATION REVIEW WAS COMPLETED IN 2011. FORM 990, PART VI, SECTION C, LINE 19 CURRENTLY, ASANTE DOES NOT MAKE AVAILABLE TO THE GENERAL PUBLIC COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR ITS FINANCIAL STATEMENTS. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -20,379,119. EQUITY IN JOINT VENTURES 646,519. DONATED CAPITAL AND FAS 47 1,415,428. TOTAL TO FORM 990, PART XI, LINE 5: -18,317,172. ASANTE COMMUNITY SERVICES LLC 731 BLACK OAK DRIVE MEDFORD OR 97504 571181752 MEDICAL BILLING OR 0 0 ASANTE ASANTE THREE RIVERS MEDICAL CENTER LLC 731 BLACK OAK DRIVE MEDFORD OR 97504 571181758 MEDICAL BILLING OR 0 0 ASANTE ASANTE FOUNDATION 2650 SISKIYOU BLVD MEDFORD OR 97504 936087366 FUNDRAISING OR 501(C)(3) 509(A)(3) #1 ASANTE 1 SOUTHERN OREGON INSURANCE COMPANY 745 FORT STREET SUITE 800 HONOLULU HI 96813 201578637 CAPTIVE INSURANCE HI 501(C)(3) 509(A)(3) #1 ASANTE 1 ROGUE VALLEY SLEEP CENTER 555 BLACK OAK DRIVE STE 300 MEDFORD OR 97504 731733282 SLEEP STUDY OR ASANTE RELATED 69258 41395 0 1 0.51000 AIM REAL PROPERTY LLC 2650 SISKIYOU BLVD MEDFORD OR 97504 710994008 REAL ESTATE OR ASANTE EXCLUDED -14094 235682 0 1 0.65000 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 ASANTE FOUNDATION C 2146309 ASANTE FOUNDATION N 495890 ASANTE FOUNDATION R 3000000 SOUTHERN OREGON INSURANCE COMPANY N 111504 SOUTHERN OREGON INSURANCE COMPANY P 1788733