2012-11-12T16:41:59-06:00 2011-12-31 346565596 ERNST & YOUNG US LLP 178 S RIO GRANDE STREETSTE 400 SALT LAKE CITY UT 84101 990 2011-01-01 911352172 MULTICARE HEALTH SYSTEM MULT 2534598125 PO BOX 5299 TACOMA WA 984150299 DIANE CECCHETTINI 2534598125 2012-11-12 0 P00712229 8013503300 2011 2016-02-24 21:20:13Z DIANE CECCHETTINI PO BOX 5299 TACOMA WA 984150299 1419589770 0 X WWW.MULTICARE.ORG X 1987 WA MULTICARE HEALTH SYSTEM'S MISSION IS TO PROVIDE QUALITY PATIENT CARE. 9 8 8886 1593 4814381 -488618 13821284 21876174 1025192054 1377489080 -6515168 -24131162 -919410 6344 1031578760 1375240436 5067818 8092530 0 0 583805745 748069182 0 0 0 403085408 575109263 991958971 1331270975 39619789 43969461 1557442619 2270274326 1011384386 1261537187 546058233 1008737139 X MULTICARE HEALTH SYSTEM'S MISSION IS TO PROVIDE QUALITY PATIENT CARE. 0 0 894647481 8092530 1146652621 MULTICARE HEALTH SYSTEM (MHS) OPERATES FOUR COMMUNITY BASED HOSPITALS WITH 821 LICENSED ADULT BEDS AND 72 LICENSED PEDIATRIC BEDS. DURING 2011 MHS HOSPITALS ADMITTED 35,466 PATIENTS FOR A TOTAL OF 142,471 PATIENT DAYS, PERFORMED 26,887 SURGERIES AND DELIVERED 4,634 BABIES. THERE WERE 7,623 NEWBORN DAYS DURING 2011. THEY ALSO PROVIDED CARE FOR 246,959 OUTPATIENT VISITS AND 145,211 EMERGENCY ROOM VISITS, OF WHICH 637 WERE TRAUMA PATIENTS. THE STATISTICS FOR GOOD SAMARITAN HOSPITAL, WHICH IS PART OF MULTICARE HEALTH SYSTEM, INCLUDE PRORATIONS DUE TO THE 3/31/2011 STUB YEAR FILING. 103449245 137638999 MULTICARE HEALTH SYSTEM OPERATES MULTI-SPECIALTY CLINICS THROUGHOUT PIERCE AND SOUTH KING COUNTIES. DURING 2011 THESE CLINICS PROCESSED 438,076 LABORATORY WORKLOAD UNITS, 173,080 IMAGING RELATIVE UNITS, 70,218 ONCOLOGY RELATIVE VALUE UNITS, 26,243 RADIOLOGY ONCOLOGY RELATIVE VALUE UNITS, 39,585 THERAPY VALUE UNITS AND 823 PHARMACY WORKLOAD UNITS. 75688327 56513348 MULTICARE HEALTH SYSTEM OPERATES PRIMARY CARE PHYSICIAN PRACTICES THROUGHOUT PIERCE AND SOUTH KING COUNTIES. THESE PRACTICES PROVIDED 410,665 PATIENT VISITS DURING 2011. 49309969 36684112 MULTICARE HEALTH SYSTEM'S OTHER PROGRAMS INCLUDE URGENT CARE CLINICS, BEHAVIORAL HEALTH, HOME HEALTH SERVICES AND HOSPICE, ADULT DAY HEALTH,PSYCHOLOGY CHILDREN'S THERAPY UNIT. DURING 2011 THE CLINICS PROVIDED 149,050 URGENT CARE VISITS, 48,184 HOME HEALTH VISITS AND 5,812 PHYCHOLOGY CHILDREN'S THERAPY VISITS. THE HOME HEALTH AND HOSPICE PROGRAMS ADMITTED 4,794 PATIENTS DURING 2011. 49309969 36684112 1123095022 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 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 1065 0 1 8886 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WA X JASON MITCHELL 2534598331 737 S FAWCETT TACOMA WA 98402 X ROBERT CORLISS MD PART YEAR 2.00 X 0 0 0 JOHN FOLSOM 2.00 X X 0 0 0 JOHN HALL 2.00 X 0 0 0 SALLY B LEIGHTON 2.00 X X 0 0 0 KAREN J LYNCH PART YEAR 2.00 X 0 0 0 ROB R ROTH MD 2.00 X X 0 0 0 L DALE SOWELL 2.00 X 0 0 0 DEEDRA WALKEY 2.00 X 0 0 0 JOHN WIBORG 2.00 X X 0 0 0 BISHOP DAVID WOLD PART YEAR 2.00 X 0 0 0 LUKE XITCO 2.00 X 0 0 0 ROBERT A YOST 2.00 X 0 0 0 DIANE CECCHETTINI 57.00 X 1633568 0 38961 JOHN LONG PART YEAR 19.00 X 537660 0 17371 VINCENT SCHMITZ 57.00 X 850298 0 44239 WILLIAM STOVER 60.00 X 598842 0 41074 KATHERINE SMITH 60.00 X 599443 0 39677 FLORENCE CHANG 60.00 X 491976 0 26155 SHELLY MULLIN 60.00 X 371454 0 64166 GLENN KASMAN 60.00 X 358683 0 61958 MADLYN MURREY 60.00 X 238212 0 52998 ELISE FORNADLEY 60.00 X 224824 0 29305 MARCIA JOHNSON 60.00 X 363838 0 88638 CLAIRE SPAIN-REMY 60.00 X 344742 0 47454 PATRICK WARD 60.00 X 170409 0 33380 JOHN HUNG 50.00 X 1204415 0 34515 DAVID COONS 50.00 X 1200387 0 56811 JAMES WYMAN 50.00 X 977789 0 30018 WILLIAM MORRIS 50.00 X 964777 0 218986 DOUGLAS SUTHERLAND 50.00 X 837422 0 28313 11968739 0 954019 1016 0 1 0 TACOMA EMERGENCY CARE PHYSICIANS CO 4301 S PINE STREET STE 400 TACOMA WA 98409 MEDICAL 10479155 TACOMA ANESTHESIA ASSOCIATES INC PS 3633 PACIFIC AVE STE 204 TACOMA WA 98418 MEDICAL 7055488 TRAUMA TRUST POBOX 5299 TACOMA WA 98415 MEDICAL 6702008 SOUND PHYSICIANS POBOX 60000 SAN FRANCISCO CA 94160 MEDICAL 3667710 TOTAL RENAL CARE INC POBOX 403008 ATLANTA GA 30384 MEDICAL 1550636 87 10512741 11363433 21876174 HEALTHCARE SERVICES 622110 1164341468 1161924878 2416590 AMBULATORY SRVS AND UR 621493 127062027 125971580 1090447 OFFICES OF PHYSICIANS 621111 71304904 71304904 HOME HEALTH 621610 9385847 9385847 OUTPATIENT MENTAL HEAL 621420 2950288 2950288 2444546 1150942 1293604 1377489080 19843676 13740 19829936 85 85 53263 0 53263 53263 53263 43974923 -43974923 -43974923 -43974923 327492 374411 -46919 -46919 1375240436 1372688439 4814381 -24138558 8092530 8092530 7369325 6119802 1249523 558367226 462442457 95924769 42943068 35661757 7281311 101069898 83932758 17137140 38319665 32069406 6250259 1562407 1562407 337036 337036 116370 116370 118884050 66663598 52220452 2650987 817010 1833977 8686362 6348977 2337385 22831720 18960435 3871285 5228374 4118995 1109379 62979 51672 11307 25675298 21321863 4353435 91034762 75599152 15435610 17468657 14506718 2961939 SUPPLIES 157083936 156370845 713091 PROVISION FOR BAD DEBTS 109282012 109282012 SAFETY NET ASSESMENT 26293292 109664 26183628 LICENSES 18034220 1601216 16433004 -30123199 19024155 -49147354 1331270975 1123095022 208175953 0 161327793 167371520 139274205 176494579 11973550 17717604 9386059 11674175 1967321709 836640147 959189788 1130681562 200695451 674150734 22328000 22953000 53267773 69231152 1557442619 2270274326 124758099 190362434 555039068 782124965 9060000 365888 322527219 288683900 1011384386 1261537187 X 546058233 1008737139 546058233 1008737139 1557442619 2270274326 X 43969461 418709445 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 116370 0 0 116370 0 50488339 50488339 1158381337 318989032 839392305 47390637 27472399 19918238 665184974 490178716 175006258 45876422 45876422 1130681562 ACCRUED INTEREST PAYABLE 10320585 DUE TO AFFILIATES 20691518 ESTIMATED THIRD PARTY SETTLEMENT 7069374 ACCRUED PENSION AND MALPRACTICE LIABILITY 187107587 INTEREST RATE SWAP 63494836 288683900 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF MULTICARE HEALTH SYSTEM FOOTNOTE READS: "EFFECTIVE JANUARY I, 2007, MHS ADOPTED FASB ASC TOPIC 740-10 -INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN MHS' CONSOLIDATED FINANCIAL STATEMENTS. ASC TOPIC 740-10 ALSO PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT STANDARD FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF AN INCOME TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. ONLY TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD AT THE EFFECTIVE DATE MAY BE RECOGNIZED OR CONTINUE TO BE RECOGNIZED UPON ADOPTION. IN ADDITION, ASC TOPIC 740-10 PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. ASC TOPIC 740-10, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS, DID NOT HAVE A SIGNIFICANT IMPACT ON THE CONSOLIDATED FINANCIAL STATEMENTS OF MULTICARE HEALTH SYSTEM. OTHER THAN MEDIS, INC., A TAXABLE CORPORATION, AND GOOD SAMARITAN SURGERY CENTER, LLC, A LIMITED LIABILITY COMPANY (WHICH MERGED INTO MHS IN DECEMBER 2010), ALL OF THE OTHER ENTITIES HAVE OBTAINED DETERMINATION LETTERS FROM THE INTERNAL REVENUE SERVICE THAT THEY ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT FOR TAX ON UNRELATED BUSINESS INCOME." 1 1 X 1 X 1 X 500.000000000000 1 1 1 0 1 1 24480681 0 24480681 0.02000 269019246 192550175 76469071 0.06260 2497000 1576000 921000 0.00080 295996927 194126175 101870752 0.08340 11 8648 1224334 0 1224334 0.00100 10 2934 7260765 509611 6751154 0.00550 30 44287 57090917 31933371 25157546 0.02060 2 101 961315 0 961315 0.00080 4 175 1215969 0 1215969 0.00100 57 56145 67753300 32442982 35310318 0.02890 57 56145 363750227 226569157 137181070 0.11230 2 984 737998 334091 403907 0.00030 9 64106 6984061 200768 6783293 0.00560 4 28713 3254853 5992 3248861 0.00270 6 11394 4162938 158609 4004329 0.00330 3 3 940740 0 940740 0.00080 24 105200 16080590 699460 15381130 0.01270 1 31124000 3256000 169109000 216695000 -47586000 X 1 1 4 1 TACOMA GENERAL HOSPITAL

315 MARTIN LUTHER KING JR WAY TACOMA WA 98405

X X X X X 2 GOOD SAMARITAN HOSPITAL

401 15TH AVE SE PUYALLUP WA 98372

X X X 3 ALLENMORE HOSPITAL

1901 SOUTH UNION TACOMA WA 98411

X X X 4 MARY BRIDGE CHILDRENS HOSPITAL

315 MARTIN LUTHER KING JR WAY TACOMA WA 98405

X X X X X TACOMA GENERAL HOSPITAL 1 1 1 200.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X X X 1 0 1 X 0 0 GOOD SAMARITAN HOSPITAL 2 1 1 200.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X X X 1 0 1 X 0 0 ALLENMORE HOSPITAL 3 1 1 200.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X X X 1 0 1 X 0 0 MARY BRIDGE CHILDRENS HOSPITAL 4 1 1 300.000000000000 1 500.000000000000 1 X X X X X X 1 1 X X X X X 1 0 1 X 0 0 19 COVINGTON AMBULATORY SURGERY CENTER

17700 SE 272ND STREET COVINGTON WA 98042

OP SURGERY, RX, LAB AUBURN LAB

735 12TH STREET SE AUBURN WA 98002

LAB TESTING KENT LAB

222 STATE AVE NORTH KENT WA 98031

LAB TESTING CEDAR MEDICAL LAB

1901 SOUTH CEDAR STREET SUITE B5 TACOMA WA 98405

LAB TESTING GIG HARBOR MEDICAL PARK

4545 POINT FOSDICK DRIVE GIG HARBOR WA 98335

OP SURG,RX,LAB,ONCOLOGY AUBURN IMAGING

202 CROSS STREET SE AUBURN WA 98001

IMAGING AUBURN VASCULAR LAB

202 N DIVISION ST SUITE 300-301 AUBURN WA 98001

VASCULAR LAB TACOMA FAMILY MEDICINE

521 MARTIN LUTHER KING JR WAY TACOMA WA 98405

OP PHYSICIAN CLINIC OBSTETRICS ACCESS CLINIC

522 MARTIN LUTHER KING JR WAY TACOMA WA 98405

OP PHYSICIAN CLINIC MULTICARE OBGYN ASSOCIATES

523 MARTIN LUTHER KING JR WAY TACOMA WA 98405

OP PHYSICIAN CLINIC PODIATRY CLINIC

524 MARTIN LUTHER KING JR WAY TACOMA WA 98405

OP PHYSICIAN CLINIC MATERNAL FETAL MEDICINE

524 MARTIN LUTHER KING JR WAY TACOMA WA 98405

OP PHYSICIAN CLINIC SILVERDALE CLINIC

1780 NW MYRTLE RD SUITE G220 SILVERDALE WA 98383

OP PHYSICIAN CLINIC OLYMPIA CLINIC

200 LILLY ROAD NE BUILDING C OLYMPIA WA 98506

OP PHYSICIAN CLINIC PUYALLUP CLINIC

1803 SOUTH MERIDIAN SUITE B PUYALLUP WA 98371

OP PHYSICIAN CLINIC CHILDREN'S THERAPY UNIT

402 15TH AVE SE PUYALLUP WA 98372

OUTPATIENT CHILDREN'S THERAPY UNIT HEALTH RESOURCE CENTER

2622 S MERIDIAN PUYALLUP WA 98372

OP PHYSICIAN CLINIC CARDIAC REHABILITATION CENTER

16515 MERIDIAN E SUITE 200B PUYALLUP WA 98372

CARDIAC REHABILITATION PET-CT CLINIC

400 15TH AVE SE PUYALLUP WA 98372

IMAGING TESTING FACILITY PART I, LINE 7: THE AMOUNTS ARE CALCULATED BASED ON A COST-TO-CHARGE RATIO WHICH WAS CALCULATED BASED ON WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ XXX-XX-XXXX. PART II: MULTICARE HEALTH SYSTEM PARTICIPATES IN A WIDE VARIETY OF COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES WE SERVE. THESE INCLUDE:-TACOMA TRAUMA TRUST IS A COLLABORATION OF MULTICARE, FRANCISCAN HEALTH SYSTEM AND MADIGAN ARMY MEDICAL CENTER TO PROVIDE TRAUMA CARE TO THE SOUTH PUGET SOUND REGION;-FALLS PREVENTION PROGRAM FOR THE ELDERLY;-TACOMA SOBERING CENTER PROVIDING OVERNIGHT HOUSING FOR INDIVIDUALS WITH DRUG AND ALCOHOL ISSUES; -SEXUAL ASSAULT PREVENTION PROGRAM AND THE FORENSIC NURSE EXAMINER PROGRAM, PROVIDING CARE TO ADULT VICTIMS OF SEXUAL ASSAULT;-BEHAVIORAL HEALTH CRISIS INTERVENTION PROGRAM;-MARY BRIDGE CENTER FOR CHILDHOOD SAFETY AND THE MARY BRIDGE CHILDREN'S ADVOCACY CENTER; -BRIDGES: A CENTER FOR GRIEVING CHILDREN;-HOME HEALTH, HOSPICE AND PALLIATIVE CARE SERVICES;-GRIEF AND LOSS SERVICES;-FAMILY CAMP ERIN FOR CHILDREN SUFFERING LOSSES OF FAMILY MEMBERS;-CANCER CAMP FOR CHILDREN WITH CANCER;-WOMEN, INFANT AND CHILDREN (WIC) PROGRAM;-SAFE KIDS;-SAFE SHORES;-CENTER FOR HEALTHY LIVING NUTRITION AND FITNESS EDUCATION AND COMMUNITY HEALTH IMPROVEMENT PROGRAMS;-DIABETES SERVICES;-CONSULTING NURSE TELEPHONE SERVICE;-CHRONIC DISEASE MANAGEMENT SUPPORT GROUPS;-WORKFORCE DEVELOPMENT PARTNERSHIPS WITH THE PIERCE COUNTY WORKFORCE DEVELOPMENT COUNCIL AND THE PIERCE COUNTY HEALTH CAREERS COUNCIL TO PREPARE PEOPLE FOR HEALTH CARE CAREERS;-PARTNERSHIPS WITH AREA COLLEGE NURSING PROGRAMS AND A NURSE RESIDENCY PROGRAM;-FREE SPORTS PHYSICALS FOR THE STUDENTS AT THE FIRST CREEK MIDDLE SCHOOL;- 5-2-1-0 LET'S GO!, A COMMUNITY-WIDE PUBLIC-PRIVATE PARTNERSHIP INITIATIVE TO PREVENT CHILDHOOD OBESITY;-SIBLING SUPPORT PROJECT TO BENEFIT SIBLINGS OF CHILDREN WITH SPECIAL HEALTHCARE NEEDS;-SCHOLARSHIPS FOR PARENT EDUCATION;-ASSISTIVE TECHNOLOGY PROGRAM- PROVIDING ADAPTATIONS TO THE ENVIRONMENT TO IMPROVE INDEPENDENCE;-"HOST SITE FOR PARENTS NIGHT OUT" FOR PARENTS WITH CHILDREN WITH SPECIAL NEEDS;-SIGN LANGUAGE CLASSES THROUGH PIERCE COUNTY LIBRARY. PART III, LINE 4: 1. FOOTNOTES:THE FINANCIAL STATEMENTS DO NOT HAVE A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSES.2. COSTING METHODOLOGY:THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.3-4. RATIONALE FOR BAD DEBT AMOUNT ATTRIBUTABLE TO COMMUNITY BENEFIT:IT IS OUR BELIEF THAT $3,256,000 OF BAD DEBT SHOULD BE INCLUDED AS COMMUNITY BENEFIT. AS A TAX-EXEMPT HOSPITAL WE MUST PROVIDE NECESSARY SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY FOR THE SERVICES PROVIDED. AS A NOT-FOR-PROFIT, PATIENT CARE IS PROVIDED TO ALL, REGARDLESS OF THE ABILITY TO PAY FOR THAT CARE. MAKING QUALITY PATIENT CARE AVAILABLE TO ALL IN OUR COMMUNITY, REGARDLESS OF THEIR ECONOMIC MEANS, QUALIFIES BAD DEBTS AS A COMMUNITY BENEFIT. AS PART OF OUR COMMUNITY NEEDS ASSESSMENT, WE STUDIED THE INCOME CHARACTERISTICS OF THE UNINSURED POPULATION IN OUR COMMUNITY. AS PART OF THIS STUDY, WE ALSO LOOKED AT WHAT PORTION OF UNINSURED INDIVIDUALS IN THE HOSPITAL'S SERVICE AREA WOULD BE ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. WE APPLIED THIS PERCENTAGE TO OUR TOTAL AMOUNT OF BAD DEBT EXPENSE RECORDED TO ESTIMATE THE PORTION OF SELF-PAY BAD DEBT THAT WAS REASONABLY ATTRIBUTABLE TO INDIVIDUALS ELIGIBLE FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BUT NOT PREVIOUSLY RECORDED AS SUCH. WE SUBTRACTED THE ACTUAL AMOUNT OF FINANCIAL ASSISTANCE RECORDED FROM THIS CALCULATED FIGURE. THE RESULT IS OUR ESTIMATE OF THE AMOUNT THAT SHOULD BE CONSIDERED COMMUNITY BENEFIT COST AND IS ENTERED ON PART III, LINE 3. PART III, LINE 8: COSTING METHODOLOGY:THE SOURCE USED TO CALCULATE THE MEDICARE ALLOWABLE COSTS FOR TACOMA GENERAL, ALLENMORE AND GOOD SAMARITAN HOSPITALS WAS THE 2011 MEDICARE COST REPORT. SINCE MARY BRIDGE CHILDREN'S HOSPITAL FILES A LOW MEDICARE UTILIZATION COST REPORT, THE PROVIDER STATISTICAL AND REIMBURSEMENT SYSTEM REPORT (PS&R) WAS USED. THE COST TO CHARGE RATIO, AS CALCULATED FROM THE INCOME STATEMENT, WAS APPLIED TO THE PS&R GROSS MEDICARE CHARGES TO CALCULATE THE MEDICARE ALLOWABLE COSTS REPORTED ON LINE 6. MARYBRIDGE COSTS REPRESENT LESS THAT 0.1% OF THE TOTAL.MEDICARE SHORTFALL TREATED AS COMMUNITY BENEFIT:THE HOSPITAL BELIEVES THAT ALL OF THE $47.5 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 29.9% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. PART III, LINE 9B: MULTICARE'S DEBT COLLECTION POLICY STATES THAT "MHS WILL ALSO CLEARLY COMMUNICATE TO PATIENTS AND APPLICABLE PARTIES THE VARIOUS ASSISTANCE PROGRAMS MHS OFFERS BASED ON THE SITE OF SERVICE." IF THE PATIENT FOLLOWS THROUGH WITH THE APPLICABLE ASSISTANCE APPOINTMENTS, I.E., MEETING WITH MEDICAID OR COUNTY AGENCIES TO COMPLETE THE NECESSARY APPLICATION PROCESS, MULTICARE WILL NOT SEND THE ACCOUNT TO A BAD DEBT COLLECTION AGENCY.IF AN ACCOUNT DOES GET SENT TO A BAD DEBT COLLECTION AGENCY, AS LONG AS IT MEETS MULTICARE'S CHARITY AND FINANCIAL ASSISTANCE POLICY'S FEDERAL POVERTY GUIDELINES (FPG), GARNISHMENT OF WAGES WILL NOT BE PURSUED. TACOMA GENERAL HOSPITAL PART V, SECTION B, LINE 13G: THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY. GOOD SAMARITAN HOSPITAL PART V, SECTION B, LINE 13G: THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY. ALLENMORE HOSPITAL PART V, SECTION B, LINE 13G: THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY. MARY BRIDGE CHILDRENS HOSPITAL PART V, SECTION B, LINE 13G: THE POLICY IS POSTED ON THE WA STATE - DEPARTMENT OF HEALTH WEBSITE. THE HOSPITAL'S BILLING INVOICES INCLUDE REFERENCES TO WHERE AND HOW TO CONTACT SOMEONE TO OBTAIN A COPY OF THE FINANCIAL ASSISTANCE POLICY. TACOMA GENERAL HOSPITAL PART V, SECTION B, LINE 19D: TACOMA GENERAL HOSPITAL CHARGES PATIENTS ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WITH FEDERAL POVERTY LEVELS (FPL) UP TO 425.4% OF THE FPL AT A RATE THAT IS EQUAL TO OR LOWER THAN OUR THREE LOWEST NEGOTIATED COMMERCIAL RATES. ADDITIONALLY, INDIVIDUALS BETWEEN 425.5% AND 500.4% OF THE FPL ARE OFFERED SLIDING SCALE DISCOUNTS AT OR ABOVE THE AMOUNT OFFERED TO INDIVIDUALS WHO PAY WITHIN 60 DAYS FROM THE DATE OF BILLING. THESE INDIVIDUALS ARE ALSO OFFERED INTEREST FREE PAYMENT ARRANGEMENTS FOR UP TO 12 MONTHS FOR THESE DISCOUNTED RATES. GOOD SAMARITAN HOSPITAL PART V, SECTION B, LINE 19D: GOOD SAMARITAN HOSPITAL CHARGES PATIENTS ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WITH FEDERAL POVERTY LEVELS (FPL) UP TO 425.4% OF THE FPL AT A RATE THAT IS EQUAL TO OR LOWER THAN OUR THREE LOWEST NEGOTIATED COMMERCIAL RATES. ADDITIONALLY, INDIVIDUALS BETWEEN 425.5% AND 500.4% OF THE FPL ARE OFFERED SLIDING SCALE DISCOUNTS AT OR ABOVE THE AMOUNT OFFERED TO INDIVIDUALS WHO PAY WITHIN 60 DAYS FROM THE DATE OF BILLING. THESE INDIVIDUALS ARE ALSO OFFERED INTEREST FREE PAYMENT ARRANGEMENTS FOR UP TO 12 MONTHS FOR THESE DISCOUNTED RATES. ALLENMORE HOSPITAL PART V, SECTION B, LINE 19D: ALLENMORE HOSPITAL CHARGES PATIENTS ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WITH FEDERAL POVERTY LEVELS (FPL) UP TO 425.4% OF THE FPL AT A RATE THAT IS EQUAL TO OR LOWER THAN OUR THREE LOWEST NEGOTIATED COMMERCIAL RATES. ADDITIONALLY, INDIVIDUALS BETWEEN 425.5% AND 500.4% OF THE FPL ARE OFFERED SLIDING SCALE DISCOUNTS AT OR ABOVE THE AMOUNT OFFERED TO INDIVIDUALS WHO PAY WITHIN 60 DAYS FROM THE DATE OF BILLING. THESE INDIVIDUALS ARE ALSO OFFERED INTEREST FREE PAYMENT ARRANGEMENTS FOR UP TO 12 MONTHS FOR THESE DISCOUNTED RATES. MARY BRIDGE CHILDRENS HOSPITAL PART V, SECTION B, LINE 19D: MARY BRIDGE CHILDRENS HOSPITAL CHARGES PATIENTS ELIGIBLE FOR OUR FINANCIAL ASSISTANCE PROGRAM WITH FEDERAL POVERTY LEVELS (FPL) UP TO 425.4% OF THE FPL AT A RATE THAT IS EQUAL TO OR LOWER THAN OUR THREE LOWEST NEGOTIATED COMMERCIAL RATES. ADDITIONALLY, INDIVIDUALS BETWEEN 425.5% AND 500.4% OF THE FPL ARE OFFERED SLIDING SCALE DISCOUNTS AT OR ABOVE THE AMOUNT OFFERED TO INDIVIDUALS WHO PAY WITHIN 60 DAYS FROM THE DATE OF BILLING. THESE INDIVIDUALS ARE ALSO OFFERED INTEREST FREE PAYMENT ARRANGEMENTS FOR UP TO 12 MONTHS FOR THESE DISCOUNTED RATES. PART VI, LINE 2: MULTICARE WORKS COLLABORATIVELY WITH REGIONAL AGENCIES AND ORGANIZATIONS TO IDENTIFY THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE AND TO DEVELOP PROGRAMS AND SERVICES TO MEET THOSE NEEDS. COMMUNITY PARTNERS INCLUDE THE TACOMA-PIERCE COUNTY HEALTH DEPARTMENT, THE PIERCE COUNTY MEDICAL SOCIETY, THE UNITED WAY OF PIERCE COUNTY, YMCA OF PIERCE COUNTY, THE CITY OF TACOMA AND THE TACOMA SCHOOL DISTRICT AND OTHERS. WE UTILIZE THE DATA FROM THE HEALTH DEPARTMENT'S PERIODIC COMMUNITY NEEDS ASSESSMENT AS WELL AS FEDERAL DATA TO DETERMINE THE MOST PRESSING HEALTH CARE NEEDS FOR OUR POPULATION. FOR 2011, TOP COMMUNITY HEALTH PRIORITIES WERE: PREVENTING AND CURING COMMUNICABLE AND CHRONIC DISEASES, IMPROVING ACCESS TO MEDICAL CARE, INFANT AND CHILD DEVELOPMENT, CHILDHOOD AND ADULT OBESITY, DISASTER PREPAREDNESS. MULTICARE ADDRESSED THESE PRIORITIES THROUGH COLLABORATIVE POLICY DEVELOPMENT AND FUNDING OF: MRSA PREVENTION AND TREATMENT ACTIVITIES, DEVELOPING A CHRONIC DISEASE MANAGEMENT PILOT PROGRAM, THE PROJECT ACCESS PROGRAM, A PIERCE COUNTY MEDICAL SOCIETY CASE MANAGEMENT MODEL WHICH COORDINATES UNDER- OR UNINSURED PATIENT ACCESS TO VOLUNTEER HEALTH PROVIDERS, AND FINANCIAL SUPPORT FOR THE COUNTY'S SAFETY NET PROVIDER AND THE COMMUNITY HEALTH CARE CLINIC NETWORK. IN ADDITION, MULTICARE FUNDED AND OPERATED THE COMMUNITY MEDICAL CARE CLINIC FOR CHILDREN AT MARY BRIDGE CHILDREN'S HOSPITAL AND HEALTH CENTER AND THE TACOMA FAMILY MEDICINE CLINIC WHICH PROVIDES A RANGE OF PRIMARY CARE AND OB/GYN MEDICAL SERVICES TO LOW-INCOME INDIVIDUALS AND FAMILIES. IN 2011 IN PUYALLUP GOOD SAMARITAN HOSPITAL STARTED THE EAST PIERCE FAMILY MEDICINE RESIDENCY PROGRAM. THE CLINIC HAS RECEIVED ACCREDITATION FROM THE AMERICAN OSTEOPATHIC ASSOCIATION, AN ACCREDITATION THAT ALLOWS THE CLINIC TO BEGIN RECRUITING PHYSICIANS FOR THE RESIDENCY PROGRAM. FOR THE EAST PIERCE COUNTY COMMUNITY GOOD SAMARITAN HOSPITAL EXPANDED THE CARE TRANSITIONS PROGRAM TO ASSIST IN THE TRANSITION OF CHRONICALLY ILL PATIENTS BACK TO THE COMMUNITY AFTER THEIR HOSPITAL STAY.MULTICARE ADDRESSES THE GROWING PROBLEM OF CHILDHOOD AND ADULT OBESITY ON SEVERAL FRONTS. WE ARE AN ACTIVE PARTNER IN A COMMUNITY-WIDE, CDC-FUNDED COALITION, ACHIEVE, WHICH FOCUSES ON REGIONAL POLICIES TO PREVENT AND TREAT CHILDHOOD OBESITY. THROUGH THE HEALTHY COMMUNITIES PROGRAM, WE PARTNER WITH AREA AGENCIES AND HEALTH SYSTEMS TO PROVIDE EDUCATION FOR CHILDREN AND FAMILIES ON HEALTHY NUTRITION AND EXERCISE. MULTICARE ALSO OPERATES A SCHOOL-BASED NUTRITION EDUCATION PROGRAM IN THE TACOMA PUBLIC SCHOOLS AND THE HEALTHY KIDS INITIATIVE WITH THE YMCA. IN PARTNERSHIP WITH THE TACOMA-PIERCE COUNTY HEALTH DEPARTMENT, WE OFFER PIERCE COUNTY GETS FIT, A MULTI-FACETED PROGRAM AIMED AT ENCOURAGING ADULTS TO MAKE HEALTHY LIFE CHOICES. OTHER COMMUNITY-BASED MULTICARE SERVICES INCLUDE NUTRITION CONSULTATION, WEIGHT MANAGEMENT, TOBACCO CESSATION PROGRAMS, MOBILE IMMUNIZATION CLINICS, ADULT DAY HEALTH, PARENT PARTNERSHIP PROGRAMS FOR FAMILIES AT RISK, MOBILE MENTAL HEALTH OUTREACH SERVICES, PERINATAL OUTREACH SERVICES, HEALTH EDUCATION AND SCREENINGS TO UNDERSERVED COMMUNITIES, SENIOR WELLNESS AND CORPORATE WELLNESS PROGRAMS. MULTICARE IS AN ACTIVE PARTICIPANT IN THE COUNTY-WIDE COORDINATED EMERGENCY PREPAREDNESS EFFORT WHICH INCLUDES PERIODIC MEETINGS, TRAININGS AND COUNTY-WIDE DRILLS AND DISASTER PREPAREDNESS EXERCISES.THROUGH OUR RELATIONSHIP WITH THE REGIONAL UNITED WAY, WE REVIEW THEIR COMMUNITY NEEDS ASSESSMENT DATA AND SUPPORT PRIORITY PROGRAMS. IN 2011, EARLY LEARNING, EDUCATION, EMPLOYMENT, SAFETY, VOLUNTEERISM AND HOUSING WERE AREAS OF FOCUS. TO MEET THESE NEEDS, MULTICARE HAS PROVIDED DAYCARE SERVICES, READING PROGRAMS, CAREER PARTNERSHIPS, MIDDLE AND HIGH SCHOOL HEALTH CAREER EXPLORATION PROGRAMS, INCLUDING MEDICAL EXPLORERS, NURSE CAMP FOR HIGH SCHOOL STUDENTS, AND TRANSITION, A PROGRAM THAT PROVIDES CAREER OPPORTUNITIES FOR DISABLED, DISADVANTAGED YOUTH. MULTICARE EMPLOYEES PARTICIPATE IN A WIDE VARIETY OF VOLUNTEER PROGRAMS IN THE COMMUNITY, INCLUDING THE AMERICAN RED CROSS, THE PIERCE COUNTY DIABETES COALITION, SAFE STREETS COALITION, THE YWCA WHICH OPERATES A DOMESTIC VIOLENCE SHELTER FOR WOMEN AND CHILDREN, THE AMERICAN CANCER SOCIETY, THE PLAN TO END CHRONIC HOMELESSNESS AND MANY OTHER ORGANIZATIONS. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION IS PROVIDED IN A VARIETY OF WAYS. PRE-SERVICE CENTER STAFF START CONVERSATIONS WITH PATIENTS ABOUT THEIR POTENTIAL FINANCIAL RESPONSIBILITY AND SHARE PAYMENT OPTIONS INCLUDING FINANCIAL ASSISTANCE INFORMATION WITH THE PATIENT DURING THIS INITIAL PHONE CALL. AT THE TIME OF REGISTRATION (WHETHER PRE-REGISTERED OR NOT), PATIENTS ARE NOTIFIED ABOUT THEIR INSURANCE COVERAGE AND FINANCIAL LIABILITIES. FINANCIAL COUNSELORS ARE AVAILABLE IF A NEED IS IDENTIFIED. IF A PATIENT DOES NOT HAVE INSURANCE, MULTICARE WORKS WITH PATIENTS TO VERIFY POTENTIAL STATE/FEDERAL ELIGIBILITY OR ROUTE THEM TO CHARITY OR FINANCIAL AID IF APPROPRIATE. FINANCIAL AID APPLICATIONS ARE HANDED OUT AT ALL SERVICE LOCATIONS UPON REQUEST OR WHEN A NEED IS IDENTIFIED BY STAFF. PATIENTS ARE ALSO GIVEN AN INFORMATIONAL BILLING HANDOUT AT REGISTRATION/ADMISSION WITH INFORMATION TO CONTACT FINANCIAL COUNSELORS IF THEY MAY HAVE DIFFICULTY PAYING THEIR HOSPITAL BILL. PART VI, LINE 4: MULTICARE HEALTH SYSTEM'S PRIMARY SERVICE AREA IS DEFINED AS PIERCE COUNTY WHICH INCLUDES TACOMA, PUYALLUP, UNIVERSITY PLACE, LAKEWOOD, PARKLAND AND GIG HARBOR. SECONDARY SERVICE AREA IS DEFINED AS SOUTH KING COUNTY AND INCLUDES THE CITIES OF FEDERAL WAY, AUBURN, ENUMCLAW, COVINGTON AND KENT. THE PRIMARY SERVICE AREA MULTICARE SERVES IS A MIX OF BOTH URBAN AND SUBURBAN COMMUNITIES. THE POPULATION OF PIERCE COUNTY IS APPROXIMATELY 800,000 INDIVIDUALS. A MAJOR MILITARY INSTALLATION -JOINT BASE LEWIS MCCHORD- IS LOCATED IN PIERCE COUNTY AND AS A RESULT, MULTICARE PROVIDES HEALTH CARE SERVICES TO A LARGE NUMBER OF ACTIVE AND RETIRED MILITARY PERSONNEL. THE MEDIAN AGE IN PIERCE COUNTY IS 35.9 YEARS OLD. SEVENTY PERCENT OF THE POPULATION IN PIERCE COUNTY IS OVER THE AGE OF TWENTY-ONE YEARS OLD. 77% OF PIERCE COUNTY'S POPULATION IS CAUCASIAN; 9% IS LATINO/HISPANIC; 7% IS AFRICAN-AMERICAN; 6% IS ASIAN; AND 1% IS NATIVE-AMERICAN. THE MEDIAN HOUSEHOLD INCOME FOR MULTICAREHEALTH SYSTEM'S PRIMARY SERVICE AREA IS $57,869 AND FOR THE SECONDARY SERVICE AREA IS $68,789. BASED ON THE 2010 WASHINGTON STATE POPULATION SURVEY, APPROXIMATELY 94,313 INDIVIDUALS IN PIERCE COUNTY (MULTICARE'S MAIN SERVICE AREA) ARE UNINSURED. OVER 10 PERCENT OF INDIVIDUALS IN MULTICARE'S SERVICE AREA ARE LIVING BELOW THE POVERTY LEVEL.MULTICARE HEALTH SYSTEM EMPLOYS THE LARGEST NUMBER OF PRIMARY AND SPECIALTY PROVIDERS IN THE REGION, OPERATES 893 BEDS, SEVERAL OUTPATIENT SURGICAL SITES AND OTHER URGENT CARE, PRIMARY CARE AND MULTISPECIALTY CLINICS. MULTICARE HEALTH SYSTEM PROVIDES SERVICES DESIGNED TO MEET THE SPECIFIC HEALTHCARE REQUIREMENTS OF THE POPULATION, WITH A COMPREHENSIVE ARRAY OF INPATIENT AND OUTPATIENT PROGRAMS MADE AVAILABLE IN CONJUNCTION WITH THE RESOURCES OF OTHER COMMUNITY HEALTH PROVIDERS. PART VI, LINE 5: THE HOSPITALS OF THE AFFILIATED GROUP UTILIZE SURPLUS FUNDS TO MAINTAIN ACCESS TO PATIENT SERVICES AND TO EXPAND ACCESS POINTS OF CARE TO PATIENTS THROUGHOUT THE COMMUNITY INCLUDING, BUT NOT LIMITED TO THE FOLLOWING:-EDUCATIONAL PROGRAMS THE PROVIDE CLASSES AND INFORMATION ON TOBACCO CESSATION, HEALTHY AGING, CHILDBIRTH, INFANT CARE, HEALTH AND WELLNESS, NUTRITION AND MORE;-FREE MAMMOGRAMS TO QUALIFYING INDIVIDUALS, FREE OR LOW COST SCREENINGS AT A VARIETY OF HEALTH FAIRS HELD THROUGHOUT THE YEAR, LOW COST IMMUNIZATIONS IN THE COMMUNITY; -EXPANSION OF THE EMERGENCY DEPARTMENTS TO ACCOMMODATE AN INCREASE IN EMERGENCY DEPARTMENT PATIENTS;-EXPANSION OF THE CANCER CENTER TO ACCOMMODATE AN INCREASE IN CANCER PATIENTS;-BUILDING OF THE PATIENT CARE TOWER IN PUYALLUP TO ACCOMMODATE FOR AN INCREASE IN THE POPULATION;-SENIOR MEMBERSHIP AFFINITY PROGRAM;-CANCER TRIALS AND RESEARCH;-CARE MANAGEMENT, POWER OF ATTORNEY, NOTARY SERVICE CHARITY MEDICATIONS, THE WAL-MART PROGRAM; -CHILDREN'S THERAPY UNIT, ASSISTIVE TECHNOLOGY PROGRAM "THE SMILE FACTORY"SIBSHOPS, ARK ANGELS; -COMMUNITY EDUCATION: MEDICAL EXPLORERS, TRANSFUSION FREE MEDICAL & SURGICAL PROGRAM, TRAUMA NURSES TALK TOUGH, CELEBRATE SENIORITY COMMUNITY IN SCHOOLS, MULTICARE GOOD SAMARITAN READERS, AMERICAN RED CROSS,MULTICARE GOOD SAMARITAN HOSPITAL PLAY PARK @ SOUTH HILL MALL; -FAMILY BIRTH CENTER: LACTATION SUPPORT SERVICES, TEEN PARENT RESOURCE CENTER,MOM AND BABY SUPPORT CLASS,FAMILY BIRTH CENTER CLASSES; -MOBILE HEALTH SERVICES, PALLIATIVE CARE, PHYSICAL MEDICINE & REHABILITATION, VOLUNTEER SERVICES. PART VI, LINE 6: MULTICARE HEALTH SYSTEM ("MULTICARE") IS A WASHINGTON NOT-FOR-PROFIT CORPORATION, AND ORGANIZED AS A TAX-EXEMPT ENTITY UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986. MULTICARE ALSO HAS THREE AFFILIATED FOUNDATIONS: MARY BRIDGE CHILDREN'S FOUNDATION, MULTICARE HEALTH FOUNDATION AND GOOD SAMARITAN FOUNDATION, ALL WASHINGTON NONPROFIT CORPORATIONS. MULTICARE IS ALSO THE SOLE SHAREHOLDER OF MEDIS CORPORATION, A WASHINGTON FOR-PROFIT CORPORATION. MULTICARE HEALTH SYSTEM HAS FOUR ACUTE-CARE HOSPITALS INCLUDING LEVEL II ADULT AND PEDIATRIC TRAUMA CENTERS, THE REGION'S ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT, THE REGION'S ONLY LEVEL I TRAUMA REHABILITATION CENTER, AN INTERNATIONALLY RENOWNED THERAPY UNIT FOR CHILDREN WITH SPECIAL NEEDS, AND SOUTHWEST WASHINGTON'S ONLY CHILDREN'S HOSPITAL. MULTICARE'S FOUR HOSPITALS SERVE INDIVIDUALS OF ALL AGES. MARY BRIDGE CHILDREN'S HOSPITAL AND HEALTH CENTER SERVES THE PEDIATRIC NEEDS OF THE COMMUNITY; TACOMA GENERAL HOSPITAL AND GOOD SAMARITAN HOSPITAL HAVE SPECIALTY SERVICES THAT FOCUS ON ADULT POPULATIONS; AND ALLENMORE HOSPITAL HAS SPECIALTY HEALTHCARE SERVICES THAT FOCUS ON THE ELDERLY POPULATION. MULTICARE CONTINUALLY REINVESTS IN THE COMMUNITIES WE SERVE TO IMPROVE ACCESS TO HEALTHCARE. IN 2011 MULTICARE OPENED A NEW 9-STORY PATIENT CARE TOWER AT MULTICARE GOOD SAMARITAN HOSPITAL IN PUYALLUP AND NEW MEDICAL OFFICE BUILDINGS THROUGHOUT PIERCE COUNTY.MULTICARE HEALTH SYSTEM IS GOVERNED BY A COMMUNITY-BASED BOARD OF DIRECTORS. EACH OF THE FOUNDATION BOARDS ARE ALSO GOVERNED BY COMMUNITY-BASED BOARD OF DIRECTORS AS WELL. SCHEDULE H, PART VI, LINE 7 IN 2011 WASHINGTON STATE DID NOT HAVE A COMMUNITY BENEFIT REPORT FILING REQUIREMENT. THE ORGANIZATION FILES THE REPORT EVERY YEAR AND IS POSTED ON MULTICARE HEALTH SYSTEM'S WEBSITE. 1 MARY BRIDGE CHILDREN'S FOUNDATION PO BOX 5299 TACOMA WA 98415 943030039 501(C)(3) 2891826 ASSISTANCE FOR OPERATING EXPENSES. MULTICARE HEALTH FOUNDATION PO BOX 5299 TACOMA WA 98415 911514257 501(C)(3) 1595449 ASSISTANCE FOR OPERATING EXPENSES. GOOD SAMARITAN FOUNDATION PO BOX 5299 TACOMA WA 98415 912004312 501(C)(3) 3605255 ASSISTANCE FOR OPERATING EXPENSES. 3 0 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: MULTICARE HEALTH SYSTEM MAINTAINS SEPARATE GENERAL LEDGER ACCOUNTS FOR THE AMOUNTS FUNDED TO RELATED ORGANIZATIONS. X X 1 1 X X X X X 0 1 0 0 0 1 1 0 0 DIANE CECCHETTINI 815284 0 817088 0 1196 0 25970 0 12991 0 1672529 0 0 0 JOHN LONG PART YEAR 242227 0 281585 0 13848 0 13358 0 4013 0 555031 0 0 0 VINCENT SCHMITZ 435907 0 400043 0 14348 0 25970 0 18269 0 894537 0 0 0 WILLIAM STOVER 364034 0 229756 0 5052 0 25970 0 15104 0 639916 0 0 0 KATHERINE SMITH 381755 0 214292 0 3396 0 25970 0 13707 0 639120 0 0 0 FLORENCE CHANG 310885 0 179435 0 1656 0 9749 0 16406 0 518131 0 0 0 SHELLY MULLIN 283298 0 86952 0 1204 0 46421 0 17745 0 435620 0 0 0 GLENN KASMAN 248153 0 80155 0 30375 0 35809 0 26149 0 420641 0 7846 0 MADLYN MURREY 183954 0 53136 0 1122 0 35424 0 17574 0 291210 0 0 0 ELISE FORNADLEY 168100 0 55046 0 1678 0 18515 0 10790 0 254129 0 0 0 MARCIA JOHNSON 231015 0 57140 0 75683 0 64761 0 23877 0 452476 0 73195 0 CLAIRE SPAIN-REMY 268044 0 75079 0 1619 0 28470 0 18984 0 392196 0 0 0 PATRICK WARD 133610 0 34891 0 1908 0 15101 0 18279 0 203789 0 0 0 JOHN HUNG 1087542 0 25370 0 91503 0 9326 0 25189 0 1238930 0 0 0 DAVID COONS 1188233 0 9150 0 3004 0 31565 0 25246 0 1257198 0 0 0 JAMES WYMAN 839604 0 25370 0 112815 0 9221 0 20797 0 1007807 0 0 0 WILLIAM MORRIS 931499 0 28420 0 4858 0 200109 0 18877 0 1183763 0 0 0 DOUGLAS SUTHERLAND 807222 0 28420 0 1780 0 8878 0 19435 0 865735 0 0 0 PART I, LINE 1A LINE 1A - COUNTRY CLUB DUES ARE PAID FOR THE FOLLOWING OFFICERS AND THE AMOUNTS ARE AS FOLLOWS: VINCENT SCHMITZ - $5,971 AND DIANE CECCHETTINI - $500. THE PERSONAL USE OF THE CLUB DUES ARE ADDED TO THEIR TAXABLE WAGES AND REPORTED ON THEIR W-2. LINE 1A - HOUSING ALLOWANCE IS PAID TO JOHN LONG AND GLENN KASMAN, THE AMOUNT IS ADDED TO THEIR TAXABLE WAGES AND REPORTED ON THEIR W-2S. PART I, LINE 4B THE FOLLOWING REPORTED PEOPLE PARTICIPATED IN A 457(F) DEFERRED COMPENSATION PLAN: SHELLY MULLIN $20,451, MADLYN MURREY $11,197, CLAIRE SPAIN-REMY $19,002, DAVID COONS $16,220, PATRICK WARD $8,598, ELISE FORNADLEY $10,291, GLENN KASMAN $12,217, MARCIA JOHNSON $55,453 AND WILLIAM MORRIS $186,450. PART I, LINE 6 THE COMPENSATION COMMITTEE SETS ANNUAL GOALS FOR THE INCENTIVE COMPENSATION PLAN COVERING SENIOR VICE PRESIDENTS, VICE PRESIDENTS, ADMINISTRATORS, DIRECTORS, MANAGERS AND SUPERVISORS. TARGETS IN QUALITY OF CARE, PATIENT SAFETY, CUSTOMER SERVICE, PEOPLE AND PERFORMANCE ALONG WITH A SYSTEM WIDE OPERATING MARGIN GOAL MUST BE MET IN ORDER FOR THE INCENTIVE COMPENSATION PLAN PAYMENTS TO BE MADE. THE INCENTIVE COMPENSATION PLAN IS CALCULATED AND THEN PAID BASED ON THE NUMBER OF TARGETS ACHIEVED. SUPPLEMENTAL INFORMATION PART III SCHEDULE J, PART III- SUPPLEMENTAL INFORMATION: THE REPORTABLE COMPENSATION FOR THE OFFICERS OF THE CORPORATION AND KEY EMPLOYEES IS BASED ON THE TOTAL AMOUNT PAID DURING THE FISCAL YEAR FOR MANAGEMENT AND LEADERSHIP OF MULTICARE HEALTH SYSTEM ENTITIES (91-1352172, 91-1514257, 94-3030039, AND 91-2004312), INCLUDING CURRENT YEAR PAYMENTS OF AMOUNTS REPORTED IN PRIOR YEARS AS CONTRIBUTIONS TO EMPLOYEE BENEFIT PLANS AND DEFERRED COMPENSATION PLANS, TOGETHER WITH INVESTMENT EARNINGS FROM THOSE PRIOR YEAR CONTRIBUTIONS. AS A RESULT, CERTAIN AMOUNTS HAVE BEEN REPORTED TWICE, BOTH IN PRIOR YEARS WHEN EARNED OR ACCRUED, AND AGAIN IN THE CURRENT YEAR WHEN PAID. THE AMOUNTS UNDER OTHER COMPENSATION INCLUDE DEFERRED COMPENSATION, AND THE VALUE OF MEDICAL, DENTAL, LIFE, DISABILITY INSURANCE, AND PENSION BENEFITS. COMPENSATION ON THIS TAX RETURN INCLUDES AMOUNTS THAT ARE NOT VESTED, ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE AND MAY NOT BE PAID OUT IN THE FUTURE. THE PROCESS FOR DETERMINING EXECUTIVE COMPENSATION AT MULTICARE HEALTH SYSTEM (I) COMPLIES WITH IRS GUIDELINES FOR TAX-EXEMPT ORGANIZATIONS; (II) IS DETERMINED BY A SEPARATE COMMITTEE OF THE BOARD OF DIRECTORS WHOSE MEMBERS ARE ALL INDEPENDENT, DO NOT HAVE A CONFLICT OF INTEREST, AND ARE NON-PAID; AND (III) IS ANNUALLY EVALUATED IN THE CONTEXT OF COMPENSATION DATA GATHERED BY INDEPENDENT EXTERNAL CONSULTANTS FROM A PEER GROUP COMPRISED OF SIMILAR HIGH PERFORMING HEALTHCARE INSTITUTIONS, PRIMARILY INTEGRATED HEALTHCARE ORGANIZATIONS. COMPENSATION PAID IS DETERMINED TO BE REASONABLE AND NECESSARY BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS AND THE INDEPENDENT EXTERNAL CONSULTANT. IN ADDITION, A SIGNIFICANT PORTION OF COMPENSATION IS AT RISK AND BASED ON ACHIEVEMENT OF GOALS SET BY THE BOARD OF DIRECTORS AT THE START OF EACH FISCAL YEAR IN AREAS SUCH AS PATIENT SAFETY, QUALITY, WORKFORCE DEVELOPMENT, FINANCE AND OTHER MISSION-RELATED AREAS. THE BOARD PLACES A HIGH PRIORITY ON THE NEED TO RECRUIT AND RETAIN A STRONG LEADERSHIP TEAM AND TO CREATE A HIGHLY MOTIVATED AND ENGAGED WORKFORCE TO DRIVE SUPERIOR ORGANIZATIONAL PERFORMANCE IN ORDER TO ACHIEVE TOP TIER INTEGRATED CARE DELIVERY SYSTEM STATUS. THE COMPENSATION COMMITTEE ROUTINELY REVIEWS BENEFITS AND RETIREMENT PROGRAMS TO ENSURE THE PLANS ARE MARKET-BASED AND OTHERWISE CONSISTENT WITH IRS GUIDELINES. THE OFFICERS OF MULTICARE HEALTH SYSTEM, 91-1352172, ALSO FULFILL OFFICER AND EXECUTIVE FUNCTIONS FOR ITS RELATED ENTITIES. COMPENSATION DISCLOSED IS REPORTED TO THE RELATED ENTITIES TAX RETURNS IN ACCORDANCE WITH IRS REGULATIONS, BUT IS NOT CHARGED TO THE SUBSIDIARY OR AFFILIATE. AN OFFICER LISTED DEVOTES AN AVERAGE OF 60 HOURS PER WEEK TO PERFORM HIS OR HER RESPONSIBILITIES. WASHINGTON HEALTH CARE FACILITIES SERIES 2004 A 911108929 93978EL83 2008-05-15 50000000 CONSTRUCTION AND EQUIPMENT TACOMA GENERAL L WING AND MARY BRIDGE CLINIC 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2004 B 911108929 93978EM74 2008-05-15 50000000 CONSTRUCTION AND EQUIPMENT TACOMA GENERAL L WING AND MARY BRIDGE CLINIC 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2004 C 911108929 93978EN65 2008-05-15 50000000 CONSTRUCTION AND EQUIPMENT TACOMA GENERAL L WING AND MARY BRIDGE CLINIC 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2007 A 911108929 93978EQ54 2008-05-15 78725000 CONSTRUCTION & EQUIP TG EMER. DEPT, STEAM PLANT, GIG HARBOR MEDICAL PARK 0 0 0 50000000 2344811 47655189 2005 0 0 1 1 50000000 2344811 48439399 2005 0 0 1 1 50000000 2344811 48439399 2005 0 0 1 1 78725000 1981663 76743337 2009 0 0 1 1 0 1 0 1 1 0.00000 0.00800 0.00800 1 0 1 0 1 1 0.00000 0.00800 0.00800 1 0 1 0 1 1 0.00000 0.00800 0.00800 1 0 1 0 1 1 0.00000 0.01240 0.01240 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 XL 1.916000000000 1 0 1 X SCHEDULE K, PART I, COLUMN C BOND'S ISSUE MATURITY DATES AND CUSSIP NUMBERS SERIES 2004A 8/15/2023-93978EL26 8/15/2024-93978EL34 8/15/2025-93978EL42 8/15/2026-93978EL59 8/15/2027-93978EL67 8/15/2028-93978EL75 8/15/2034-93978EL83 SERIES 2004B 8/15/2023-93978EL91 8/15/2024-93978EM25 8/15/2025-93978EM33 8/15/2026-93978EM41 8/15/2027-93978EM58 8/15/2028-93978EM66 8/15/2034-93978EM74 SERIES 2004C 8/15/2023-93978EM82 8/15/2024-93978EM90 8/15/2025-93978EM24 8/15/2026-93978EM32 8/15/2027-93978EM40 8/15/2028-93978EM57 8/15/2034-93978EM65 SERIES 2007A 08/15/2012-93978EN73 08/15/2013-93978EN81 08/15/2014-93978EN99 08/15/2015-93978EP22 08/15/2016-93978EP30 08/15/2017-93978EP48 08/15/2018-93978EP55 08/15/2019-93978EP63 08/15/2020-93978EP71 08/15/2021-93978EP89 08/15/2022-93978EP97 08/15/2025-93978EQ21 08/15/2031-93978EQ39 08/15/2038-93978EQ47 08/15/2041-93978EQ54 SERIES 2007B 08/15/2012-93978EQ62 08/15/2013-93978EQ70 08/15/2014-93978EQ88 08/15/2015-93978EQ96 08/15/2016-93978ER20 08/15/2017-93978ER38 08/15/2018-93978ER46 08/15/2019-93978ER53 08/15/2020-93978ER61 08/15/2021-93978ER79 08/15/2022-93978ER87 08/15/2025-93978ER95 08/15/2031-93978ES29 08/15/2038-93978ES37 08/15/2041-93978ES45 SERIES 2007C 08/15/2041-93978EE99 SERIES 2007D 08/15/2041-93978EF23 SERIES 2008A 08/15/2010-93978E2E1 08/15/2011-93978E2F8 08/15/2012-93978E2G6 08/15/2013-93978E2H4 08/15/2014-93978E2J0 08/15/2015-93978E2K7 08/15/2016-93978E2L5 08/15/2017-93978E2M3 08/15/2018-93978E2N1 08/15/2019-93978E2P6 08/15/2024-93978E2Q4 08/15/2029-93978E2R2 08/15/2039-93978E2S0 SERIES 2008B 08/15/2010-93978E2U5 08/15/2011-93978E2V3 08/15/2012-93978E2W1 08/15/2013-93978E2X9 08/15/2014-93978E2Y7 08/15/2015-93978E2Z4 08/15/2016-93978E3A8 08/15/2017-93978E3B6 08/15/2018-93978E3C4 08/15/2019-93978E3D2 08/15/2024-93978E3E0 08/15/2029-93978E3F7 08/15/2039-93978E3G5 SERIES 2008C 8/15/2043-93978EK92 SERIES 2009A 8/15/2044-93978E3U4 SERIES 2009B 8/15/2044-93978E3V2 SERIES 2010A 08/15/2010-93978E6N7 08/15/2011-93978E6P2 08/15/2012-93978E6Q0 08/15/2013-93978E6X5 08/15/2014-93978E6Y3 08/15/2015-93978E6Z0 08/15/2016-93978E7A4 08/15/2017-93978E7B2 08/15/2017-93978E6R8 08/15/2018-93978E7C0 08/15/2019-93978E6S6 08/15/2020-93978E6T4 08/15/2021-93978E6V9 08/15/2022-93978E6W7 SCHEDULE K, PART I, COLUMN E SERIES 2004A - JOINT PREMIUM 2004 A,B,C OF $977,057 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 6/22/2004. SERIES 2004B - JOINT PREMIUM 2004 A,B,C OF $977,057 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 6/22/2004. SERIES 2004C - JOINT PREMIUM 2004 A,B,C OF $977,057 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 6/22/2004. SERIES 2007A - JOINT PREMIUM 2007 A,B,C OF $1,042,602 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 2/15/2007. SERIES 2007B - JOINT PREMIUM 2007 A,B,C OF $1,042,602 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 2/15/2007. SERIES 2007C - JOINT PREMIUM 2008 A,B,C OF $1,042,602 AT REISSUANCE 5/15/2008. ORIGINAL ISSUE 2/15/2007 SERIES 2008A - JOINT PREMIUM 2008 A,B,C OF $81,316 AT REISSUANCE 2/26/2009. ORIGINAL ISSUE 5/15/2008 SERIES 2008B - JOINT PREMIUM 2008 A,B,C OF $81,316 AT REISSUANCE 2/26/2009. ORIGINAL ISSUE 5/15/2008 SERIES 2008C - JOINT PREMIUM 2008 A,B,C OF $81,316 AT REISSUANCE 2/26/2009. ORIGINAL ISSUE 5/15/2008 SCHEDULE K, SUPPLEMENTAL INFORMATION MULTICARE HEALTH SYSTEM (MHS), THE PARENT AND SURVIVING CORPORATION AND GOOD SAMARITAN HOSPITAL (GSH), A SUBSIDIARY DISSOLVED AND MERGED WITH THE PARENT/SURVIVING CORPORATION ON 04/01/2011, WERE MEMBERS OF THE OBLIGATED GROUP, AND THEY WERE JOINTLY AND SEVERALLY OBLIGATED ON ALL BOND DEBT. UPON THE MERGER MULTICARE HEALTH SYSTEM, THE SURVIVING CORPORATION, TOOK OVER ON ALL THE ASSETS AND LIABILITIES OF GSH AND MHS. SCHEDULE K, PART I, COLUMN A NAME OF THE ISSUER FOR ALL BOND ISSUES WASHINGTON HEALTH CARE FACILITIES AUTHORITY REVENUE BONDS SCHEDULE K, SUPPLEMENTAL INFORMATION ANY CHANGES IN THE LEASE AGREEMENTS DURING 2011 WERE NOT MATERIAL ENOUGH TO CHANGE THE PRIVATE BUSINESS USE PERCENTAGE AND/OR THE LOANS. WASHINGTON HEALTH CARE FACILITIES SERIES 2007 B 911108929 93978ES45 2008-05-15 78725000 CONSTRUCTION & EQUIP TG EMER. DEPT, STEAM PLANT, GIG HARBOR MEDICAL PARK 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2007 C 911108929 93978EE99 2007-02-15 52915000 CONSTRUCTION & EQUIP TG EMER. DEPT, STEAM PLANT, GIG HARBOR MEDICAL PARK 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2007 D 911108929 93978EF23 2007-02-15 105635000 CONSTRUCTION & EQUIP TG EMER. DEPT, STEAM PLANT, GIG HARBOR MEDICAL PARK 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2008 A 911108929 93978ES52 2009-02-26 50000000 CONSTRUCTION GOOD SAMARITAN HOSPITAL TOWER 0 0 0 78725000 1981663 76743337 2009 0 0 1 1 52915000 1331974 51583026 2009 0 0 1 1 105635000 2659040 102975960 2009 0 0 1 1 50000000 2608752 47391248 2009 0 0 1 1 0 1 0 1 1 0.00000 0.01240 0.01240 1 0 1 0 1 1 0.00000 0.01240 0.01240 1 0 1 0 1 1 0.00000 0.01240 0.01240 1 0 1 0 0 0.00000 0.00290 0.00290 0 0 0 0 1 XL 1.916000000000 1 0 1 1 1 0 1 XL 1.916000000000 1 0 0 1 1 0 1 RBC 1.916000000000 1 0 1 0 0 0 0 0 1 WASHINGTON HEALTH CARE FACILITIES SERIES 2008 B 911108929 93978ES60 2009-02-26 50000000 CONSTRUCTION GOOD SAMARITAN HOSPITAL TOWER 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2008 C 911108929 93978EK92 2009-02-26 30000000 CONSTRUCTION GOOD SAMARITAN HOSPITAL TOWER 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2009 A 911108929 93978E3U4 2009-05-15 50000000 CONSTRUCTION OF GOOD SAMARITAN TOWER 0 0 0 WASHINGTON HEALTH CARE FACILITIES SERIES 2009 B 911108929 93978E3V2 2009-05-15 50000000 CONSTRUCTION OF THE GOOD SAMARITAN TOWER 0 0 0 50000000 2608752 47391248 2009 0 0 1 1 30000000 1565251 28424749 2009 0 0 1 1 50000000 729490 499270510 2010 0 0 1 1 50000000 729490 499270510 2010 0 0 0 1 0 1 0 0 0.00000 0.00290 0.00290 1 0 1 0 0 0.00000 0.00290 0.00290 1 0 0 0 0 0.00000 0.00290 0.00290 1 0 0 0 0 0.00000 0.00290 0.00290 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 WASHINGTON HEALTH CARE FACILITIES SERIES 2010 A 911108929 93978E6N7 2010-01-05 105127578 CURRENT REFUNDING OF THE WHCA SERIES 1998 0 0 0 105127578 574 105127578 2010 1 0 1 1 0 1 0 0 0.00000 0.00290 0.00290 1 0 0 0 0 0 1 WESTERN WA PATHOLOGY ROB ROTH/VICE CHAIRMAN 1029174 REIMBURSEMENT FOR PROFESSIONAL SERVICES: ROB ROTH, MD OWNS 12.5% OF WESTERN WASHINGTON PATHOLOGY PS. IN 2011 MULTICARE HEALTH SYSTEM ENGAGED WESTERN WASHINGTON PATHOLOGY PS FOR PROFESSIONAL SERVICES. 0 CAROLINE RUTTER MD DAUGHTER OF THE VICE CHAIRMAN 646935 EMPLOYEE OF THE MHS 0 FORM 990, PART VI, SECTION B, LINE 11 PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY INTERNAL STAFF AND REVIEWED BY AN OUTSIDE ACCOUNTING FIRM. INITIAL REVIEWS WERE PERFORMED BY LEVELS OF MANAGEMENT IN VARIOUS DEPARTMENTS THROUGHOUT THE ORGANIZATION, INCLUDING THE CHIEF EXECUTIVE OFFICER, AND THE CHIEF FINANCIAL OFFICER. A REVIEW WAS THEN PERFORMED BY THE AUDIT COMMITTEE OF THE BOARD, AND INCLUDED A PRESENTATION BY THE OUTSIDE ACCOUNTING FIRM. LASTLY, A COPY OF THE FINAL FORM 990, INCLUDING ALL REQUIRED SCHEDULES, WAS PROVIDED TO EACH VOTING MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW, PRIOR TO ITS FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PROCESS USED TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST THE BOARD OF DIRECTORS HAS ACCOUNTABILITY FOR OVERSIGHT OF THE PROCESS FOR DISCLOSURE, EVALUATION, AND MANAGEMENT OF CONFLICTS OF INTEREST INVOLVING ANY DIRECTOR ON THE BOARD, EXECUTIVE LEADERSHIP, OR KEY EMPLOYEE. IN ACCORDANCE WITH THE CONFLICTS OF INTEREST POLICY, THESE INDIVIDUALS ARE REQUIRED TO COMPLETE THE CONFLICTS OF INTEREST QUESTIONNAIRE AT LEAST ANNUALLY, AND HAVE AN ONGOING OBLIGATION TO UPDATE THE DISCLOSURE IN THE EVENT AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. THE CONFLICTS OF INTEREST QUESTIONNAIRE INCLUDES A STATEMENT THAT THE PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION MUST ENGAGE PRIMARILY IN ACTIVITIES THAT FURTHER ITS TAX EXEMPT PURPOSES. WRITTEN DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER, AND IN CERTAIN CIRCUMSTANCES, THERE IS FURTHER REVIEW BY THE GENERAL COUNSEL AND BOARD. NO PERSON WITH A CONFLICT OF INTEREST PARTICIPATES IN AN ACTIVITY RELATED TO THE CONFLICT OF INTEREST UNLESS DISCLOSED, RESOLVED, AND PERMITTED IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY. CONFLICTS OF INTEREST ARE DOCUMENTED. FORM 990, PART VI, SECTION B, LINE 15 A-B: PROCESS USED TO DETERMINE COMPENSATION OF CEO THE BOARD, THROUGH ITS COMPENSATION COMMITTEE CONSISTING OF INDEPENDENT, NON-PAID, BOARD MEMBERS, IS ACCOUNTABLE FOR ENSURING AND APPROVING A REASONABLE TOTAL COMPENSATION PACKAGE, CONSISTENT WITH ITS COMPENSATION PHILOSOPHY, FOR THE CEO FOR HER MANAGEMENT AND LEADERSHIP OF MULTICARE HEALTH SYSTEM ENTITIES (91-1352172, 91-1514257, 94-3030039, AND 91-2004312). THE COMPENSATION COMMITTEE DIRECTS THE DEVELOPMENT AND IT APPROVES ANNUAL GOALS AND PERFORMANCE CRITERIA THAT ARE USED TO DETERMINE VARIABLE COMPENSATION OPPORTUNITIES FOR THE CEO. THE COMPENSATION COMMITTEE ASSESSES PERFORMANCE AGAINST THESE GOALS AND PERFORMANCE CRITERIA, WHICH INCLUDE IMPROVING PATIENT CARE, CARE ACCESS TO THE UNDERSERVED, CLINICAL OUTCOMES, AND PATIENT SAFETY, AS WELL AS EARNING AN OPERATING MARGIN TO ENABLE INVESTMENT IN PEOPLE, TECHNOLOGY, AND FACILITIES. THE COMPENSATION COMMITTEE SELECTS AND ENGAGES A QUALIFIED INDEPENDENT COMPENSATION CONSULTANT EACH YEAR TO REVIEW AND ANALYZE THE TOTAL COMPENSATION PACKAGE FOR ALIGNMENT WITH APPROPRIATE PRACTICES FOR SIMILAR NOT-FOR-PROFIT HEALTHCARE SYSTEMS. THE COMPENSATION COMMITTEE, AS PART OF ITS ANALYSIS, OBTAINS FROM THE INDEPENDENT COMPENSATION CONSULTANT APPROPRIATE COMPARABILITY DATA, INCLUDING TOTAL COMPENSATION PAID BY SIMILARLY SITUATED NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS FOR POSITIONS THAT ARE FUNCTIONALLY COMPARABLE. THE COMPENSATION DELIBERATION AND DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED. THE LAST TIME THIS PROCESS WAS UNDERTAKEN WAS 2011. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED CONSOLIDATED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. ADDITIONALLY THIS YEAR THE AUDITED FINANCIAL STATEMENTS ARE INCLUDED AS PART OF THE FORM 990. HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII DIANE CECCHETTINI IS THE PRESIDENT AND CEO OF MULTICARE HEALTH SYSTEM AND AFFILIATES. SHE IS COMPENSATED BY MULTICARE HEALTH SYSTEM (MHS) AND DEVOTES ON AVERAGE A TOTAL OF 60 HOURS PER WEEK TO MHS AND AFFILIATES AS FOLLOWS: 1 HOUR PER WEEK TO MARY BRIDGE CHILDREN'S FOUNDATION (MBCF), 1 HOUR PER WEEK TO MULTICARE HEALTH FOUNDATION (MHF), 1 HOUR PER WEEK TO GOOD SAMARITAN FOUNDATION (GSF), AND 57 HOURS PER WEEK TO MULTICARE HEALTH SYSTEM. VINCENT SCHMITZ IS THE CFO OF MULTICARE HEALTH SYSTEM AND AFFILIATES. HE IS COMPENSATED BY MHS AND DEVOTES ON AVERAGE A TOTAL OF 60 HOURS PER WEEK TO MHS AND ITS AFFILIATES AS FOLLOWS: 1 HOUR PER WEEK TO MBCF, 1 HOUR PER WEEK TO MHF, 1 HOUR PER WEEK TO GSF, AND 57 HOURS PER WEEK TO MHS. JOHN LONG WAS THE PRESIDENT OF GOOD SAMARITAN HOSPITAL FROM JANUARY THROUGH APRIL 2011. ON APRIL 1ST, 2011 GOOD SAMARITAN HOSPITAL MERGED WITH MULTICARE HEALTH SYSTEM AND JOHN LONG'S ROLE AS AN OFFICER ENDED WHILE HE CONTINUES TO WORK FOR MULTICARE AS A NON-MEDICAL CONSULTANT. HE IS COMPENSATED BY MHS AND DEVOTES ON AVERAGE A TOTAL OF 60 HOURS PER WEEK TO MHS AND ITS AFFILIATES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -8,091,895. TRANSFER OF ASSETS FROM AFFILIATES 1,131,210. UNFUNDED DB PENSION LIABILITY -39,974,391. GOOD SAMARITAN'S GROUP DISTRIBUTION TO THE PARENT 465,412,272. A-133 FUNDED ASSETS 232,249. TOTAL TO FORM 990, PART XI, LINE 5: 418,709,445. MULTICARE HEALTH FOUNDATION 409 S J STREET TACOMA WA 98405 911514257 SOLICIT CONTRIBUTIONS WA 501(C)(3) LINE 7 MULTICARE HEALTH SYSTEM 1 MARY BRIDGE CHILDREN'S FOUNDATION 409 S J STREET TACOMA WA 98405 943030039 SOLICIT CONTRIBUTIONS WA 501(C)(3) LINE 7 MULTICARE HEALTH SYSTEM 1 GOOD SAMARITAN HOSPITAL 407 14TH AVE SE PUYALLUP WA 98372 910961134 HOSPITAL WA 501(C)(3) LINE 3 MULTICARE HEALTH SYSTEM 1 GOOD SAMARITAN OUTREACH SERVICES 325 E PIONEER AVE PUYALLUP WA 98372 911203564 MEDICAL SERVICES WA 501(C)(3) LINE 9 MULTICARE HEALTH SYSTEM 1 GOOD SAMARITAN FOUNDATION 402 15TH AVE SE SUITE 101 PUYALLUP WA 98372 912004312 SOLICIT CONTRIBUTIONS WA 501(C)(3) LINE 7 MULTICARE HEALTH SYSTEM 1 MEDIS CORPORATION 315 S K STREET TACOMA WA 98405 911111928 MEDICAL BUILDING RENTAL WA MULTICARE HEALTH SYSTEM C 8236679 2065814 1.00000 1 1 1 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 MEDIS CORPORATION A 13944 MULTICARE HEALTH FOUNDATION B 1595449 MARY BRIDGE CHILDREN'S FOUNDATION B 2891826 GOOD SAMARITAN FOUNDATION B 3605255 MULTICARE HEALTH FOUNDATION C 3393572 MARY BRIDGE CHILDREN'S FOUNDATION C 4679758 GOOD SAMARITAN FOUNDATION C 2439411 MEDIS CORPORATION J 312520 MULTICARE HEALTH FOUNDATION P 863518 MARY BRIDGE CHILDREN'S FOUNDATION P 1308449 GOOD SAMARITAN FOUNDATION P 646540 MEDIS CORPORATION P 1196253