2012-03-14T18:27:34-05:00 2011-04-30 CLARK NUBER PS 10900 NE 4TH STREET SUITE 1700 BELLEVUE WA 98004 990 2010-05-01 910565546 HARRISON MEDICAL CENTER HARR 3607446507 2520 CHERRY AVENUE BREMERTON WA 983104270 FORREST G EHLINGER 3607446507 2012-03-14 1 SARA ELIZABETH J HYRE 4254544919 2010 2016-02-24 21:20:13Z SCOTT BOSCH 2520 CHERRY AVENUE BREMERTON WA 983104270 433387448 0 X WWW.HARRISONMEDICAL.ORG X 1918 WA HARRISON MAKES A POSITIVE DIFFERENCE IN PEOPLE'S LIVES THROUGH EXCEPTIONAL HEALTH CARE. THE RESIDENTS OF KITSAP PENINSULA AND ADJACENT AREAS HAVE ACCESS TO ACUTE MEDICAL AND SURGICAL SERVICES INCLUDING EMERGENCY, ONCOLOGY AND CARDIO VASCULAR SERVICES. ADDITIONALLY, HARRISON PROVIDES OUTPATIENT SERVICES, IN HOME HEALTH AND PEDIATRIC REHABILITATION AND OPERATES URGENT CARE AND PRIMARY CARE FACILITIES IN BOTH PORT ORCHARD AND BELFAIR. 16 13 2696 400 2085429 1039338 412969 702234 343132894 357353527 2836136 5207988 70046 53957 346452045 363317706 422191 411190 0 0 164037248 174432503 0 0 0 161587274 173384550 326046713 348228243 20405332 15089463 346441290 384615110 166037468 149911242 180403822 234703868 X HARRISON MEDICAL CENTER PROVIDES ACUTE MEDICAL AND SURGICAL SERVICES, EMERGENCY SERVICES AND A RANGE OF GENERAL AND SPECIALIZED SERVICES TO RESIDENTS OF THE KITSAP PENINSULA AND ADJACENT AREAS. 0 0 282221505 411190 357353527 DURING THE FISCAL YEAR ENDED APRIL 30, 2011, THE MEDICAL CENTER EXPERIENCED 14,936 HOSPITAL INPATIENT ADMISSIONS REPRESENTING 59,339 DAYS OF CARE TO ADULTS AND PEDIATRIC PATIENTS. SERVICES PROVIDED INCLUDED, 74,112 EMERGENCY ROOM VISITS, 11,715 SURGERY PATIENTS INCLUDING 245 OPEN HEART CASES, 1,925 BIRTHS INCLUDING 3,472 DAYS OF CARE, 21,864 HOME HEALTH VISITS, 36,599 URGENT CARE VISITS, 20,096 PRIMARY CARE VISITS AND 60,994 OUTPATIENT VISITS. HARRISON PROVIDES NEEDED MEDICAL CARE TO INDIGENT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE MEDICAL CENTER HAS ESTABLISHED CRITERIA FOR DETERMINING WHETHER A PATIENT IS ELIGIBLE FOR CHARITY CARE. THE AMOUNT OF PATIENT REVENUES FOREGONE FOR CHARITY CARE PROVIDED BY HARRISON FOR THE FISCAL YEAR ENDED APRIL 30, 2011 AMOUNTED TO $17,966,561.ALL FINANCIAL SURPLUSES FROM OPERATIONS ARE USED TO FURTHER THE CHARITABLE PURPOSES OF THE MEDICAL CENTER. THESE SURPLUSES ARE USED TO HELP FUND NEW HEALTH SERVICE PROGRAMS IN THE FUTURE AND FUND NEW AND REPLACEMENT EQUIPMENT AND FACILITIES.COMMUNITY HEALTH EDUCATION:HARRISON MEDICAL CENTER HAS A LONG-STANDING COMMITMENT TO PROMOTE COMMUNITY EDUCATION IN THE HEALTH CARE AREA. THE COMMITMENT IS DEMONSTRATED THROUGH AN ACTIVE PROGRAM OF CLASSES DIRECTED AT THE COMMUNITY-AT-LARGE AND SPECIALIZED CLASSES DIRECTED AT PERSONS WITH SPECIAL NEEDS. THESE COMMUNITY EDUCATIONAL SERVICES ARE PROVIDED BY STAFF OR TRAINED PROFESSIONALS WHO ARE EMPLOYEES OF THE MEDICAL CENTER. HARRISON MEDICAL CENTER VALUES THE RELATIONSHIPS WE MAINTAIN WITH THE COMMUNITY AND COMMUNITY ORGANIZATIONS. THERE ARE NUMEROUS COMMUNITY BASED SUPPORT GROUPS, WHICH MEET AT HARRISON ON A REGULAR BASIS USING THE MEDICAL CENTER'S MEETING ROOMS AT NO CHARGE. THE FACILITATORS OF THESE GROUPS ARE OFTEN STAFF AND TRAINED PROFESSIONALS OF THE MEDICAL CENTER. HEALTH-RELATED VOLUNTEER SERVICE OF HARRISON MEDICAL CENTER EMPLOYEES:MANY OF HARRISON'S EMPLOYEES SERVE AS COMMUNITY SOCIAL SERVICE ORGANIZATION BOARD MEMBERS AS WELL AS DONATING THEIR TIME TO INDIVIDUAL HEALTH AGENCY PROJECTS. EMPLOYEES OF HARRISON REGULARLY CONTRIBUTE THEIR OWN TIME TO SUPPORT VARIOUS COMMUNITY FUND RAISING EVENTS SUCH AS MARCH OF DIMES WALK-A-THON, MS WALK-A-THON, ALZHEIMER'S MEMORY WALK, AMERICAN CANCER SOCIETY RELAY FOR LIFE, CYSTIC FIBROSIS GREAT STRIDES WALK, KITSAP COUNTY AIDS WALK AND UNITED WAY DAY OF CARING. THE MEDICAL CENTER ALSO CONTRIBUTES TO THESE CAUSES BY PROVIDING EVENT MEALS FOR THE VOLUNTEERS, AND PAID TIME FOR EMPLOYEES DURING REGULAR WORKING HOURS TO ORGANIZE THE EVENTS. HEALTH-RELATED SERVICE OF HARRISON MEDICAL CENTER VOLUNTEERS:HARRISON'S VOLUNTEERS ARE INVOLVED IN A PROGRAM THAT PROVIDES PATIENTS AND THEIR FAMILIES WITH COMPLEMENTARY THERAPIES DURING THEIR STAY AT THE MEDICAL CENTER. THESE THERAPIES INCLUDE HAND MASSAGE, THERAPEUTIC MUSIC, SUCH AS HARP, ACOUSTIC GUITAR, FLUTE AND PIANO, THERAPEUTIC ART, BOOK AND BEVERAGE CART SERVICE AND SERVICE PET ROUNDING.TRAINING AND EDUCATION FOR HEALTHCARE PROFESSIONALS:HARRISON MEDICAL CENTER CONTINUES TO SERVE AS A CLINICAL SITE FOR STUDENTS IN NURSING, PHYSICAL THERAPY, MEDICAL RECORDS, RADIOLOGY, PHARMACY, SOCIAL WORK, AND DIETARY PROGRAMS AND A NON-CLINICAL SITE FOR STUDENTS IN MATERIALS MANAGEMENT. STUDENTS ARE ON-SITE AND UNDER HARRISON'S DIRECTION FOR SERVICE FOR SEVERAL THOUSAND HOURS EACH YEAR.COMMUNITY HEALTHCARE INFORMATION:HARRISON MEDICAL CENTER HAS DEVELOPED AN INTERNET WEB SITE AND PROVIDES THE COMMUNITY WITH AREAS TO LOOK UP HOSPITAL PROGRAMS AND SERVICES, COMMUNITY AND HEALTHCARE NEWS. IT ALSO CONTAINS A PHYSICIAN DATABASE THAT IS USEFUL TO INDIVIDUALS WHO ARE CHOOSING A PHYSICIAN. THE MEDICAL AND HEALTHCARE CONSUMER LIBRARIES MAINTAINED BY HARRISON MEDICAL CENTER ARE RESOURCES FOR HEALTH PROFESSIONALS AND THE PUBLIC IN OUR COMMUNITY. OUR MEDICAL LIBRARY WORKS IN COOPERATION WITH THE REGIONAL PUBLIC LIBRARY, NAVY HOSPITAL AND COMMUNITY COLLEGE LIBRARY TO PROVIDE HEALTHCARE INFORMATION FOR AREA RESIDENTS. 282221505 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 176 0 1 2696 1 1 1 0 0 0 0 0 0 0 0 0 X 16 13 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 0 X FORREST G EHLINGER 3607446507 2520 CHERRY AVENUE BREMERTON WA 98310 JOHN WALLEN 2.00 X X 0 0 0 JAMES CIVILLA 2.00 X X 0 0 0 DAVID VETERANE 2.00 X X 0 0 0 GORDON CROMWELL 2.00 X X 25462 0 0 FRED BARRETT 2.00 X 0 0 0 GRIFFITH BLACKMON 2.00 X 688 0 0 CARL CRAMER 2.00 X 0 0 0 MARY GARGUILE 2.00 X 0 0 0 RUTH HANSTEN 2.00 X 0 0 0 GREGORY HENDERSON 2.00 X 5000 0 0 RALPH LINTZ 2.00 X 0 0 0 RON MUHLEMAN 2.00 X 0 0 0 KELLY NELSON 2.00 X 0 0 0 JOAN SORIANO 2.00 X 0 0 0 RICK TIFT 2.00 X 0 0 0 JAMES SMALLEY 2.00 X 0 0 0 SCOTT BOSCH 50.00 X 564992 0 217154 PATRICIA COCHRELL 50.00 X 334499 0 56729 ADAR PALIS 50.00 X 345814 0 56660 SANDON K SAFFIER 50.00 X 237879 0 45682 FORREST G EHLINGER 50.00 X 13573 0 13750 ANDREW STEFO 50.00 X 194824 0 10949 RICHARD SMITH 50.00 X 161254 0 26278 MARIEL KAGAN 50.00 X 286756 0 47483 THOMAS KRUSE 50.00 X 274967 0 52660 JOSEPH LOWELL JOHNSON 40.00 X 817360 0 29443 ROBERT C KING 40.00 X 571648 0 49443 RONALD ROBERT REIMER 40.00 X 965900 0 25447 DENNIS MICHAEL WILLERFORD 40.00 X 1033629 0 29443 MALCOLM W WINTER 40.00 X 1034265 0 29443 REBECCA KELLY 50.00 X 215700 0 9599 CYNTHIA MAY 50.00 X 222165 0 13808 7306375 0 713971 182 1 1 0 SOUND PHYSICIANS 1123 PACIFIC AVE TACOMA WA 98402 PHYSICIAN 1991032 ADVANCED MEDICAL IMAGING PO BOX 269 PORT ORCHARD WA 98366 IMAGING 1755349 S&S SECURITY SERVICES PO BOX 459 BELFAIR WA 98528 SECURITY 1599403 PATHOLOGY ASSOCIATES OF KITSAP COUNTY PO BOX 2171 BREMERTON WA 98310 PHYSICIAN 923084 OLYMPIC ANESTHESIA SERVICES 1010 SYLVAN WAY BREMERTON WA 98310 PHYSICIAN 754120 22 405205 137656 159373 23654 702234 PATIENT REVENUE 621110 198827221 197465885 1361336 MEDICARE/MEDICAID 621110 158526306 158526306 357353527 2891468 724093 2167375 53957 53957 53957 53957 72273694 112568 70026185 43557 2247509 69011 2316520 2316520 363317706 355992191 2085429 4537852 411190 411190 2554549 2554549 134539982 114236172 20303810 3550428 3041360 509068 22617327 19017810 3599517 11170217 9325170 1845047 744572 744572 84772 84772 41870 41870 27212151 19385052 7827099 1188564 25161 1163403 2584619 1153085 1431534 4319851 804630 3515221 2810879 2075016 735863 1056946 448017 608929 4010619 4010619 17838840 9806385 8032455 3721223 3507342 213881 MEDICAL SUPPLIES 70406576 69101006 1305570 BAD DEBT PROVISION 21455286 21455286 EQUIP RENT/MAINTENANCE 7921372 4263720 3657652 BUSINESS TAXES 7009070 7009070 UNRELATED BUS INC TAXES 163000 163000 814340 154484 659856 348228243 282221505 66006738 0 20917298 13136840 2234942 2481715 44600307 45710965 3002844 2909014 3748120 2391084 2974007 272477686 145520952 117441183 126956734 103461188 137030834 42455593 30434079 10030681 19138972 346441290 384615110 36486129 35419215 90291615 87438659 39259724 27053368 166037468 149911242 X 174915979 220123360 3548838 12652762 1939005 1927746 180403822 234703868 346441290 384615110 X 15089463 39210583 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 41870 41870 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: A PORTION OF THE MEMBERSHIP DUES PAID TO WASHINGTON STATE HOSPITAL ASSOCIATION AND AMERICAN HEART ASSOCIATION WERE EXPENDED FOR LOBBYING ACTIVITIES. 8272226 6832354 15104580 65907104 30807039 35100065 178163562 110532956 67630606 13302440 4180957 9121483 126956734 INVESTMENT IN JOINT VENTURES 781441 F ALTERNATIVE INVESTMENTS 29652638 F 30434079 ACCRUED PENSION LIABILITY 12357832 RESERVE FOR PROFESSIONAL LIABILITY CLAIMS 12145675 DEFERRED GAIN FROM SALE OF FACILITIES 704870 CAPITAL LEASE 1844991 27053368 363317706 348228243 15089463 14354130 24856453 39210583 54300046 401968569 14354130 24296733 38650863 363317706 0 363317706 347668523 0 347668523 559720 559720 348228243 PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN OBLIGATIONS UNDER PENSION PLAN 15,375,594. CHANGE IN INTEREST IN HARRISON MEDICAL CENTER FOUNDATION 9,480,859. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES GROUPED WITH REVENUES ON FINANCIAL STATEMENTS -559,720. CHANGE IN OBLIGATIONS UNDER PENSION PLAN 15,375,594. CHANGE IN INTEREST IN HARRISON MEDICAL CENTER FOUNDATION 9,480,859. PART XIII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES GROUPED WITH REVENUES ON FINANCIAL STATEMENTS 559,720. 1 1 X 1 X 1 X 100.000000000000 1 1 1 0 0 4904648 4904648 0.01410 34758190 24862039 9896151 0.02840 12491603 11385289 1106314 0.00320 52154441 36247328 15907113 0.04570 257282 25397 231885 0.00070 153800 153800 0.00040 89928 89928 0.00030 501010 25397 475613 0.00140 52655451 36272725 16382726 0.04710 37018 37018 0.00010 132700 132700 0.00040 411391 411391 0.00120 581109 581109 0.00170 1 5857027 0 108365934 124401107 -16035173 X 1 1 1 1 HARRISON MEDICAL CENTER

2520 CHERRY AVENUE BREMERTON WA 98310

X X X HARRISON MEDICAL CENTER 1 12 HARRISON MEDICAL CENTER

2525 WHEATON WAY BREMERTON WA 98310

OUTPATIENT REHAB HARLOW MEDICAL BUILDING

1780 NW MYHRE RD SILVERDALE WA 98383

HOSPITAL PHARMACY, PEDIATRIC REHAB CLINIC & HOSPITAL LAB OLYMPIC PROFESSIONAL BUILDING

2600 CHERRY AVENUE SUITE 203 BREMERTON WA 98310

IV OPTIMUM CLINIC HARRISON HEALTH PARTNERS BREMERTON

1225 CAMPBELL WAY SUITE 101 BREMERTON WA 98310

THORACIC AND VASCULAR CENTER HARRISON HEALTH PARTNERS POULSBO

19500 10TH AVE SUITE 100 POULSBO WA 98370

MEDICAL ONCOLOGY HARRISON BREMERTON ONCOLOGY

2720 CLARE AVE BREMERTON WA 98310

MEDICAL ONCOLOGY HARRISON HOME HEALTH

750 LEBO BLVD BREMERTON WA 98310

HOME HEALTH HARRISON MEDICAL CENTER

1800 NW MYHRE ROAD SILVERDALE WA 98383

ER, ACCUTE CARE AND SURGICAL CENTER HARRISON BELFAIR URGENT CARE

21 NE ROMANCE HILL ROAD BELFAIR WA 98528

PRIMARY & URGENT CARE HARRISON PORT ORCHARD URGENT CARE

450 S KITSAP BLVD PORT ORCHARD WA 98366

PRIMARY & URGENT CARE CASCADE VIEW

22180 OLYMPIC COLLEGE WY STE 102-104 POULSBO WA 98370

INTERNAL & ADULT PRIMARY CARE HARRISON HEALTH PARTNERS

2771 HEMLOCK SUITE 100 BREMERTON WA 98310

CARDIOTHORACIC SURGERY CLINIC PART II: HARRISON MEDICAL CENTER VALUES THE RELATIONSHIPS IT MAINTAINS WITH THE COMMUNITY AND COMMUNITY ORGANIZATIONS. THERE ARE NUMEROUS COMMUNITY BASED SUPPORT GROUPS, WHICH MEET AT HARRISON ON A REGULAR BASIS USING THE MEDICAL CENTER'S MEETING ROOMS AT NO CHARGE. THE FACILITATORS OF THESE GROUPS ARE OFTEN STAFF AND TRAINED PROFESSIONALS OF THE MEDICAL CENTER. THESE GROUPS INCLUDE DIABETES SUPPORT FOR CHILDREN AND PARENTS, STOP SMOKING SUPPORT, AMPUTEE SUPPORT, LUPUS SUPPORT, WOMEN'S CARDIAC HEALTH & CANCER PROGRAM, CANCER EDUCATION SUPPORT, LOOK GOOD AND FEEL BETTER SUPPORT, SLEEP APNEA SUPPORT, BETTER BREATHERS CLUB, PARKINSON'S, OVARIAN/GYNECOLOGICAL CANCER SUPPORT, BARIATRIC SURGERY SUPPORT, COMPASSIONATE FRIENDS SUPPORT, STROKE SUPPORT, BREAST CANCER SUPPORT, TRAUMATIC BRAIN INJURY SUPPORT, WOMEN WITH CANCER SUPPORT, HEART AND VASCULAR SUPPORT, KIDS CARE SUPPORT, LAP-BAND SUPPORT, ANCHOR SENIOR SUPPORT, AND ORTHOPEDIC SUPPORT.HARRISON MEDICAL CENTER'S SOCIAL WORKERS PROVIDE OVER 250 HOURS PER YEAR OF ASSISTANCE TO COMMUNITY MEMBERS WITH QUESTIONS REGARDING SERVICES OUTSIDE OF HMC AND ANOTHER 300 HOURS PER YEAR OF ASSISTANCE WITH ACCESS TO THESE SERVICES. SOCIAL WORKERS FREQUENTLY ARRANGE TRANSPORTATION FOR PATIENTS AND THEIR FAMILIES WHO LACK RESOURCES, PROCURE URGENTLY REQUIRED DISCHARGE MEDICATIONS TO LOW INCOME PATIENTS, PROVIDE 1.2 FTE'S OF SOCIAL WORK SERVICES FOR UNBILLED OUTPATIENT COUNSELING FOR RADIATION ONCOLOGY AND REHAB PATIENTS, AND THE SOCIAL WORK DIRECTOR SPENDS 15-20 HOURS EACH MONTH WORKING WITH COMMUNITY GROUPS ON MUTUAL PROJECTS AND SERVING ON VARIOUS COMMUNITY BOARDS.HARRISON MEDICAL CENTER RECRUITS PHYSICIANS TO FILL UNMET NEEDS IN THE COMMUNITY. ANALYSIS OF THE NUMBER AND TYPE OF PHYSICIANS AND MID-LEVEL PROVIDERS IS USED TO EVALUATE ACCESS TO PRIMARY AND SPECIALTY CARE PROVIDERS IN THE COMMUNITY. WHERE GAPS EXIST, HARRISON WORKS WITH OUR PHYSICIAN PARTNERS TO RECRUIT NEW PROVIDERS TO MEET THE GAPS IDENTIFIED BY THE ANALYSIS. PART III, LINE 4: HARRISON MEDICAL CENTER SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. WHILE PROCESSES AND PROCEDURES ARE IN PLACE TO COLLECT PAYMENTS FROM INDIVIDUALS AND INSURERS AS APPROPRIATE, SOME PATIENTS ARE UNABLE TO PAY AND DO NOT HAVE ADEQUATE INSURANCE COVERAGE OR ACCESS TO SERVICES TO ASSIST WITH THIS PAYMENT. THESE PATIENT ACCOUNTS ARE TREATED EITHER AS CHARITY CARE (FINANCIAL ASSISTANCE) IF THE PATIENT MEETS CERTAIN FINANCIAL QUALIFICATIONS OUTLINED IN THE CHARITY CARE/FINANCIAL ASSISTANCE POLICY. IF THE PATIENT DOES NOT MEET THOSE FINANCIAL QUALIFICATIONS AND IS UNABLE TO PAY, THE ACCOUNT IS TREATED AS BAD DEBT. FROM AN ACCOUNTING PERSPECTIVE, THESE ACCOUNTS ARE TREATED DIFFERENTLY ON THE INCOME STATEMENT AND BALANCE SHEET. BAD DEBT EXPENSE IS RECORDED BASED ON A REVIEW OF OUTSTANDING ACCOUNTS RECEIVABLE BALANCES BY AGE AND FINANCIAL CLASS. BASED ON HISTORICAL CLOSED CASE DATA, AN ESTIMATED WRITE OFF AMOUNT IS CALCULATED AND A RESERVE IS ESTABLISHED ON THE BALANCE SHEET FOR THIS ESTIMATE. THE RESERVE IS COMPARED WITH THE PRIOR PERIOD RESERVE AND THE NECESSARY INCREASE IS BOOKED AS AN EXPENSE FOR THE PERIOD. BALANCES FOR PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE ARE HANDLED SEPARATELY.CHARITY CARE (FINANCIAL ASSISTANCE) EXPENSE IS RECORDED AT THE TIME THE FINANCIAL ASSISTANCE APPLICATION IS PROCESSED. THE AMOUNT RECORDED AS CHARITY CARE IS DETERMINED BY THE LEVEL OF FINANCIAL ASSISTANCE THAT IS APPROVED BASED ON INCOME CRITERIA ESTABLISHED IN THE POLICY. HARRISON MEDICAL CENTER UTILIZES THE POVERTY GUIDELINES AS OUTLINED ON THE U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES WEBSITE AT WWW.ASPE.HHS.GOV/POVERTY/INDEX.SHTML. THE AMOUNT APPLIED TO A PATIENT'S ACCOUNT IS IDENTIFIED AS FINANCIAL ASSISTANCE AND IS NOT PURSUED FROM THE APPLICANT/PATIENT.CHARITY CARE - THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA, UNDER ITS CHARITY CARE POLICY, WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF CHARGES FORGONE FOR CHARITY CARE PROVIDED BY THE MEDICAL CENTER FOR THE YEARS ENDED APRIL 30, 2011 AND 2010 WAS $17,966,561 AND $14,851,580, RESPECTIVELY.THE MISSION OF HARRISON MEDICAL CENTER IS "TO MAKE A POSITIVE DIFFERENCE IN PEOPLE'S LIVES THROUGH EXCEPTIONAL HEALTH CARE." IN ORDER TO ENSURE THE FUTURE OF THIS MISSION WITHIN OUR COMMUNITY WE MUST REMAIN FINANCIALLY HEALTHY BY RECEIVING APPROPRIATE PAYMENT FOR THE SERVICES WE PROVIDE. IN ADDITION, OUR FINANCIAL ASSISTANCE PRACTICES WILL ALWAYS COMPLY WITH WASHINGTON STATE LAWS AND REGULATIONS AND BE CONSISTENT WITH BEST PRACTICES OF OTHER MEDICAL CENTERS. TO OBTAIN CURRENT FINANCIAL ASSISTANCE GUIDELINES THE WEBSITE USED IS HTTP://WWW.ASPE.HHS.GOV/POVERTY/INDEX.SHTMLIT IS THE GOAL THAT EACH PATIENT WHO INDICATES FINANCIAL DIFFICULTY IN PAYING FOR HEALTHCARE SERVICES IS FULLY AND FAIRLY EVALUATED AND OFFERED APPROPRIATE FINANCIAL ASSISTANCE. HARRISON IS ALSO OBLIGATED TO PURSUE OUTSTANDING BALANCES FOR THE DEDUCTIBLES OR CO-INSURANCE AMOUNTS REQUIRED BY A THIRD PARTY PAYER ON PATIENT ACCOUNTS FAIRLY AND CONSISTENTLY.1. HARRISON IS COMMITTED TO NEVER DENY NECESSARY MEDICAL CARE BASED ON THE INABILITY TO PAY.2. HARRISON WILL PROVIDE A WRITTEN NOTICE TO ALL PATIENTS INFORMING THEM ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE.3. HARRISON WILL ACTIVELY SUPPORT PATIENTS IN THEIR EFFORTS TO OBTAIN APPROPRIATE FINANCIAL ASSISTANCE.4. UNCOMPENSATED HEALTHCARE WILL NEVER BE DENIED BASED UPON RACE, CREED, COLOR, SEX, NATIONAL ORIGIN, SEXUAL ORIENTATION, DISABILITY, AGE OR SOURCE OF INCOME.5. UNDER ALL CIRCUMSTANCES THE COLLECTION PRACTICES OF HARRISON ENTITIES WILL BE PERFORMED PROFESSIONALLY AND CONSISTENT WITH OUR MISSION AND THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT.6. HARRISON WILL COMPLY WITH OR EXCEED THE STATE OF WASHINGTON LEGISLATIVE DIRECTIVES ENACTED BY RCW 70.170.060 AND ANY UPDATES.7. HARRISON WILL ABIDE BY AND COMPLY WITH THE RULES AND MONITORING OF THE DEPARTMENT OF HEALTH.8. HARRISON WILL MAINTAIN A COLLECTION PROCEDURE WHICH DEFINES ACCOUNT PARAMETERS FOR REFERRAL TO COLLECTIONS BASED ON ALPHA PREFIX AND PLACEMENT OF LIENS.9. THE FINANCE COMMITTEE OF THE BOARD WILL RECEIVE AN ANNUAL REPORT SUMMARIZING OUR COLLECTION ACTIVITY.PROCEDURE CRITERIA:1. HARRISON WILL COMPLY WITH THE STATE DEPARTMENT OF HEALTH ACCOUNTING RULES OF UNIFORM PROCEDURES, DATA REQUIREMENTS AND CRITERIA FOR IDENTIFYING PATIENTS RECEIVING FINANCIAL ASSISTANCE.2. ASSISTANCE WILL BE PROVIDED IN ACCESSING ENTITLEMENT PROGRAMS SUCH AS STATE MEDICAL ASSISTANCE AND CRIME VICTIMS.3. THE AMOUNT OF DISCOUNT RELATED TO THE INDIGENT CARE AFTER MEDICARE PAYMENT WILL BE IDENTIFIED.4. PROCEDURES WILL BE IN PLACE TO INFORM THE PUBLIC ABOUT AVAILABLE FINANCIAL ASSISTANCE.5. HARRISON WILL SUBMIT ANNUAL REPORTS REQUESTED BY THE DEPARTMENT OF HEALTH.6. APPLICATION FOR FINANCIAL ASSISTANCE WILL BE WRITTEN WITH SUPPORTING DOCUMENTATION.7. FAILURE TO COMPLY WITH OUTREACH SERVICES PROTOCOL WILL RESULT IN THE DENIAL OF FINANCIAL ASSISTANCE. PART III, LINE 8: HARRISON USES THE MEDICARE COST REPORT TO ALIGN REVENUE WITH EXPENSES FOR EACH ESTABLISHED MEDICARE DEFINED COST CENTER BY USING THE STEP-DOWN METHOD OF COST ALLOCATION. HOSPITAL GENERAL LEDGER DEPARTMENTS ARE GROUPED INTO MEDICARE-DEFINED COST CENTERS. EXPENSES ARE OFFSET BY OTHER OPERATING REVENUES TO EXCLUDE SERVICES UNRELATED TO PATIENT CARE. KEY STATISTICS ARE USED TO ALLOCATE THE COSTS TO THE MAJOR FUNCTION SERVICES. ADJUSTMENTS TO CREATE A BETTER MATCHING OF REVENUES AND COSTS ARE PERFORMED AS NEEDED. NON-PATIENT INCOME IS OFFSET AGAINST THE ASSOCIATED NON-PATIENT CARE EXPENSES ASSOCIATED WITH THE SERVICES. IN ADDITION, PROFESSIONAL SERVICES PROVIDED BY PHYSICIANS ARE EXCLUDED. ONCE THE GENERAL LEDGER HAS BEEN ADJUSTED FOR THE RECLASSIFICATIONS AND INCOME OFFSETS, THE EXPENSES ARE ALLOCATED USING THE STEP-DOWN METHOD. THE STEP-DOWN METHOD ALLOCATES THE COST OF EACH COST CENTER, AS WELL AS THE COSTS STEPPED DOWN TO IT, TO THE MAJOR FUNCTIONAL SERVICES.OVERHEAD, CAPITAL COSTS, DEPRECIATION, AND INTEREST ARE ALLOCATED BASED ON COST CENTER KEY STATISTICS. IN THE STEP-DOWN ALLOCATION PROCESS, COSTS WILL ACCUMULATE FROM PREVIOUSLY STEPPED DOWN COST CENTERS. THE ACCUMULATED COST FOR EACH COST CENTER WILL BE STEPPED DOWN USING ITS SPECIFIC STATISTIC. THE NEXT GROUP OF COST CENTERS TO BE ALLOCATED IS THE ANCILLARY COST CENTERS, WHICH ARE STEPPED DOWN BASED ON GROSS CHARGES PROVIDED TO EACH FUNCTIONAL SERVICE. THE FINAL RESULT PROVIDES FULLY ALLOCATED COSTS TO THE MAJOR FUNCTIONAL SERVICES, SUCH AS MEDICAL SURGICAL INPATIENTS, OBSTETRICS AND EMERGENCY DEPARTMENTS. PART III, LINE 9B: HARRISON MEDICAL CENTER'S DEBT COLLECTION POLICY APPLIES TO BOTH PATIENTS WHO QUALIFY FOR FINANCIAL ASSISTANCE AND TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY A MEDICAL BILL BUT DON'T QUALIFY FOR MEDICAL ASSISTANCE PROGRAMS. SINCE THE PROVISION OF CARE IS NOT DEPENDENT ON ONE'S ABILITY TO PAY, HARRISON WILL PROVIDE FREE CARE TO PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. THE PATIENT OR GUARANTOR MUST PROVIDE THE FOLLOWING INFORMATION IN ORDER FOR HARRISON TO DETERMINE IF THE PATIENT QUALIFIES FOR ASSISTANCE AND AT WHAT LEVEL:A. A COMPLETED HARRISON MEDICAL CENTER FINANCIAL ASSISTANCE APPLICATION.B. MOST CURRENT W-2 WITHHOLDING STATEMENTS.C. MOST RECENT FEDERAL AND STATE INCOME TAX FORMS.D. PROOF OF INCOME (PAYCHECK STUBS, UNEMPLOYMENT CHECK STUBS, LETTER FROM EMPLOYER, STATEMENT OF MONTHLY SOCIAL SECURITY BENEFITS, ETC.)E. IF SELF-EMPLOYED, A PROFIT AND LOSS STATEMENT MUST BE PROVIDED.F. DOCUMENTATION REGARDING APPROVAL OR DENIAL OF UNEMPLOYMENT BENEFITS, WORKERS COMPENSATION, OR (STATE) DEPARTMENT OF HUMAN SERVICESG. CHECKING AND SAVINGS ACCOUNT STATEMENTS FOR THE PAST 3 MONTHS.CONSIDERATION FOR FINANCIAL ASSISTANCE (CHARITY CARE) IS BASED ON THE FINANCIAL STATUS OF THE PATIENT AND GUARANTOR IN COMPARISON WITH THE MOST CURRENT U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FEDERAL INCOME POVERTY GUIDELINES AND THAT ALL OTHER SOURCES OF PAYMENT HAVE BEEN EXHAUSTED. PART VI, LINE 2: HARRISON MEDICAL CENTER'S ASSESSMENT OF THE COMMUNITY'S HEALTH CARE NEEDS IS DATA DRIVEN, FACTORING A NUMBER OF CONSIDERATIONS. THE ORGANIZATION REVIEWS MARKET SHARE DATA BY VARIOUS CLINICAL DEFINITIONS TO UNDERSTAND WHICH PATIENTS ARE LEAVING THE COMMUNITY FOR CARE. WE ALSO RANDOMLY SURVEY OUR COMMUNITY EVERY TWO TO THREE YEARS TO ASSIST IN DETERMINING IF THERE IS AN UNMET NEED WITHIN THE COMMUNITY. OUR PHYSICIAN WORKFORCE PLAN IDENTIFIES SHORTAGES OF PHYSICIANS BY SPECIALTY AND REGION. DEMOGRAPHIC DATA IS ANALYZED ALONG WITH HISTORICAL USE RATES TO DETERMINE FUTURE CHANGES IN HEALTH CARE NEEDS. ALSO, DATA FROM THE CDC'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) IS REVIEWED TO UNDERSTAND CHANGES IN THE OVERALL HEALTH STATUS AND RISK FACTORS FOR VARIOUS DISEASES SUCH AS SMOKING AND OBESITY. FINALLY, HARRISON IS A SPONSOR OF, AND PARTICIPATES IN, THE KITSAP COUNTY HEALTH PRIORITIES PROJECT WHICH ASSESSES THE OVERALL HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIES THOSE AREAS IN WHICH WE CAN MAKE THE MOST SIGNIFICANT DIFFERENCE IN OUR COMMUNITY WITH LIMITED RESOURCES. THIS PROJECT IS NEW THIS YEAR AND IS SUPPORTED BY AT LEAST 37 DIFFERENT AGENCIES PROVIDING CARE IN THE COUNTY. PART VI, LINE 3: FINANCIAL ASSISTANCE INFORMATION AND APPLICATIONS ARE AVAILABLE AT EACH HARRISON MEDICAL CENTER LOCATION. CONSISTENT WITH OUR POLICY, PATIENTS THAT DO PRESENT FOR SERVICES AS SELF PAY OR INSURED ARE OFFERED AN OPPORTUNITY TO APPLY FOR OUR FINANCIAL ASSISTANCE PROGRAM. APPLICATIONS ARE AVAILABLE IN BOTH ENGLISH AND SPANISH, WHILE INTERPRETERS ARE OFFERED AT NO COST TO HELP PROVIDE INFORMATION TO OTHER NON-ENGLISH SPEAKING FAMILIES. THIS SAME INFORMATION IS ALSO AVAILABLE ON THE HOSPITAL'S WEB SITE. DURING THE PREVIOUS YEAR, HARRISON MEDICAL CENTER PROCESSED OVER 10,000 FINANCIAL ASSISTANCE APPLICATIONS. ONCE AN APPLICATION IS RECEIVED, OUR FINANCIAL ASSISTANCE SPECIALIST REVIEWS THE APPLICATION AND CONTACTS THE PATIENT FOR ADDITIONAL INFORMATION IF NEEDED. WE ALSO HAVE PATIENT ACCOUNTS SPECIALISTS AVAILABLE TO MEET WITH PATIENTS AND OR THEIR FAMILIES TO HELP COMPLETE THE APPLICATION IF NEEDED. IF THE APPLICANT DOES NOT QUALIFY FOR OTHER STATE PROGRAMS THEN THE APPLICATION WILL BE PROCESSED AND APPROVED BASED UPON FEDERAL POVERTY GUIDELINES. PART VI, LINE 4: HARRISON'S PRIMARY MARKET AREA, KITSAP COUNTY, HAS A POPULATION IN EXCESS OF 240,000, WITH OVER 13 PERCENT OF THE COUNTY'S RESIDENTS 65 YEARS OF AGE OR OLDER. HARRISON'S SECONDARY MARKET IS CLALLAM, JEFFERSON, AND NORTH MASON COUNTIES. HARRISON MEDICAL CENTER ACCEPTS ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THIS POLICY EXTENDS OUTSIDE THE BOUNDARIES OF OUR HOSPITALS AND INTO OUR URGENT CARES AND PHYSICIAN PRACTICES. IT IS ALSO OUR POLICY TO NOT ASSIST IN THE RECRUITMENT OF ANY PHYSICIAN INTO A PRIVATE PRACTICE UNLESS THEY AGREE TO ABIDE BY THE SAME IDEALS. PART VI, LINE 6: HARRISON MEDICAL CENTER PROMOTES THE HEALTH OF THE COMMUNITY IN MANY WAYS. HARRISON'S OPEN MEDICAL STAFF PRACTICES IN FIVE LOCATIONS THROUGHOUT KITSAP COUNTY AND NORTH MASON COUNTY, PROVIDING PRIMARY AND URGENT CARE AS WELL AS ADVANCED SPECIALTY CARE. FOR THE PAST SIX YEARS, HARRISON HAS SPONSORED THE KITSAP COUNTY MEDICAL SOCIETY FOUNDATION'S FAMILY FUN RUN. THE EVENT MARKS THE CULMINATION OF A TWO-MONTH PROGRAM, ENCOURAGING SCHOOL CHILDREN TO EXERCISE AND MAKE HEALTHY NUTRITION CHOICES. IN AN EFFORT TO "LEAD BY EXAMPLE", OUR DIETARY DEPARTMENT HAS CREATED A 17-WEEK WELLNESS PROGRAM FOR EMPLOYEES. THE PROGRAM OFFERS GROUP EXERCISE CLASSES, PERSONALIZED DIET AND ACTIVITY PLANS, ONLINE COMMUNITY FORUMS, AND HEALTH SCREENINGS ALL MEANT TO ENABLE EMPLOYEES TO LEAD HEALTHIER LIVES. HARRISON ALSO OFFERS A NURSING RESIDENCY PROGRAM DESIGNED TO AID THE TRANSITION OF NURSING STUDENTS TO STAFF NURSES PROVIDING CARE FOR PATIENTS AT THE BEDSIDE. FURTHER, HARRISON ALSO OFFERS A MULTITUDE OF CLASSES FOR THE COMMUNITY, FROM SMOKING CESSATION TO DIABETES EDUCATION. 1 HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON WA 98310 911197626 501(C)(3) 284471 N/A N/A PROVIDE SALARIES AND BENEFITS FOR FOUNDATION STAFF KIDS DISCOVERY MUSEUM 305 MADISON AVE SUITE C BAINBRIDGE ISLAND WA 98110 300167480 501(C)(3) 10000 N/A N/A MEDICAL CLINIC EXHIBIT SPONSORSHIP KITSAP COUNTY MEDICAL SOCIETY PO BOX 339 BREMERTON WA 98383 237087265 501(C)(6) 7500 N/A N/A EVENT SPONSORSHIP MARCH OF DIMES 1904 3RD AVE SUITE 230 SEATTLE WA 98101 131846366 501(C)(3) 6500 N/A N/A MARCH FOR BABIES 2011 BREMERTON AREA CHAMBER OF COMMERCE PO BOX 229 BREMERTON WA 98337 910153620 501(C)(6) 9500 N/A N/A MULTIPLE EVENT SPONSORSHIP PORT ORCHARD CHAMBER OF COMMERCE 1014 BAY ST SUITE 8 PORT ORCHARD WA 98366 910519613 501(C)(6) 5720 N/A N/A MULTIPLE EVENT SPONSORSHIP 3 3 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: SUPPORT IS PROVIDED TO HARRISON MEDICAL CENTER FOUNDATION IN THE FORM OF SALARIES AND BENEFITS FOR SEVERAL STAFF MEMBERS. HARRISON MEDICAL CENTER REVIEWS THE RECORDS AND PREPARES THE FINANCIAL STATEMENTS OF THE FOUNDATION. WHEN CONSIDERING FINANCIAL DONATIONS TO OTHER ORGANIZATIONS, HARRISON MEDICAL CENTER FOCUSES ON THREE AREAS: HEALTH AND WELLNESS PROGRAMS THAT ENHANCE OPPORTUNITIES FOR FAMILIES IN KITSAP COUNTY; SPORTS PROGRAMS THAT SUPPORT HEALTHY, ACTIVE LIFESTYLES; AND BUSINESS DEVELOPMENT OPPORTUNITIES THAT EXPAND THE WELLNESS COMPONENT OF OUR SERVICES. WE BELIEVE OUR EMPLOYEES ARE THE BEST RESOURCE WE CAN OFFER OUR COMMUNITIES AND THEREFORE WE ALSO SUPPORT ORGANIZATIONS IN WHICH THEY ARE ACTIVE VOLUNTEERS. X X 0 1 X X X X 1 1 0 0 0 0 0 1 0 SCOTT BOSCH 494222 0 61340 0 9430 0 199395 0 17759 0 782146 0 0 0 PATRICIA COCHRELL 297712 0 35807 0 980 0 41222 0 15507 0 391228 0 0 0 ADAR PALIS 258850 0 29750 0 57214 0 41960 0 14700 0 402474 0 0 0 SANDON K SAFFIER 213187 0 0 0 24692 0 35775 0 9907 0 283561 0 0 0 ANDREW STEFO 149265 0 33320 0 12239 0 3033 0 7916 0 205773 0 0 0 RICHARD SMITH 151263 0 0 0 9991 0 9783 0 16495 0 187532 0 0 0 MARIEL KAGAN 246316 0 29131 0 11309 0 36734 0 10749 0 334239 0 0 0 THOMAS KRUSE 239017 0 27917 0 8033 0 35505 0 17155 0 327627 0 0 0 JOSEPH LOWELL JOHNSON 745281 0 71099 0 980 0 12250 0 17193 0 846803 0 0 0 ROBERT C KING 530975 0 16499 0 24174 0 32250 0 17193 0 621091 0 0 0 RONALD ROBERT REIMER 931309 0 33086 0 1505 0 12250 0 13197 0 991347 0 0 0 DENNIS MICHAEL WILLERFORD 1033105 0 0 0 524 0 12250 0 17193 0 1063072 0 0 0 MALCOLM W WINTER 1033285 0 0 0 980 0 12250 0 17193 0 1063708 0 0 0 REBECCA KELLY 51251 0 0 0 164449 0 1025 0 8574 0 225299 0 0 0 CYNTHIA MAY 197100 0 24276 0 789 0 3825 0 9983 0 235973 0 0 0 PART I, LINE 1A KITSAP GOLF AND COUNTRY CLUB MEMBERSHIP DUES IN THE AMOUNT OF $4,251 FOR SCOTT BOSCH, CEO ARE PAID FOR BY THE MEDICAL CENTER AND ARE A NON-TAXABLE BENEFIT TO THE INDIVIDUAL BECAUSE MEMBERSHIP IS ONLY USED FOR BUSINESS PURPOSES. COMPANION TRAVEL IS AVAILABLE TWICE A YEAR FOR THE CEO'S SPOUSE, PER THE EMPLOYMENT AGREEMENT AND IS TREATED AS NON-TAXABLE COMPENSATION. PART I, LINE 1B ANY ADDITIONAL BENEFITS PROVIDED BY THE ORGANIZATION ARE DETERMINED BY THE BOARD OF DIRECTORS DURING THE EMPLOYMENT CONTRACT NEGOTIATIONS. PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS: REBECCA KELLY RECEIVED SEVERANCE IN THE AMOUNT OF $137,275. THESE PAYMENTS ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (B)(III) AS OTHER REPORTABLE COMPENSATION. THE FOLLOWING INDIVIDUALS PARTICIPATED IN OR RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: REBECCA KELLY = $7,251, MARIEL KAGAN = $8,946, ADAR PALIS = $21,141, ROBERT KING = $23,946. ALL AMOUNTS WERE RECEIVED FROM THEIR CAPITAL ACCUMULATION ACCOUNTS. PART I, LINE 6 DEFERRED COMPENSATION: AS PART OF THE EXECUTIVE BENEFITS PACKAGE AVAILABLE TO EXECUTIVES AND 1 PHYSICIAN, THERE IS A PROVISION THAT A CERTAIN PERCENTAGE OF THEIR ANNUAL BASE COMPENSATION CAN BE USED FOR THE PURCHASE OF ADDITIONAL BENEFITS (E.G., LIFE INSURANCE, LONG TERM CARE INSURANCE, ETC.) OR BE DEFERRED AS AN AT RISK (SUBJECT TO RISK RULES, AS DEFINED). NO PART OF THIS ADDITIONAL BENEFIT IS PREDICATED ON THE EARNINGS OF HARRISON MEDICAL CENTER. INCENTIVE COMPENSATION: AN INCENTIVE COMPENSATION PLAN IS ALSO IN PLACE FOR SENIOR EXECUTIVES (VICE PRESIDENT LEVEL AND THE CEO). THIS PLAN, WHICH PLACES A PORTION OF EACH EXECUTIVE'S OVERALL COMPENSATION AT RISK, IS PREMISED ON A SERIES OF GOALS THAT RANGE FROM QUALITY TO FINANCIAL PERFORMANCE. WHILE A TRIGGER DOES EXIST IN THE PLAN THAT THE OPERATING BUDGET FOR THE FISCAL YEAR MUST BE MET, NO PART OF THE INCENTIVE IS COMPUTED AS A PERCENTAGE OF OPERATING INCOME. THE TARGETS ARE ADJUSTED EACH YEAR BY THE BOARD OF DIRECTORS, DEPENDENT ON THE ORGANIZATIONAL OBJECTIVES FOR THE YEAR. PART I, LINE 7 PHYSICIANS JOSEPH LOWELL JOHNSON AND RONALD ROBERT REIMER RECEIVED PAYMENTS PURSUANT TO THE PHYSICIAN PRODUCTIVITY INCENTIVE PLAN. WA HEALTH CARE FACILITIES AUTHORITY 2010 SERIES 911108929 2010-04-29 30000000 SEE PART V 0 0 0 30000000 580665 11717746 9571012 2012 0 0 0 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 1 0 0 0 0 0 (F) DESCRIPTION OF PURPOSE: FUNDS TO PAY FOR COSTS OF CONSTRUCTING, REMODELING AND EQUIPPING A DEDICATED CARDIOVASCULAR CENTER, DIETARY SERVICES, AND OTHER CAMPUS FACILITY IMPROVEMENTS AND EQUIPMENT. PATHOLOGY ASSOCIATES OF KITSAP COUNTY PARTNERSHIP MORE THAN 5% OWNED BY GREGORY HENDERSON, MD, DIRECTOR 928637 ANATOMIC PATHOLOGY SERVICES AGREEMENT AND LAB DIRECTOR SERVICES 0 KITSAP CHEST CONSULTANTS PARTNERSHIP MORE THAN 5% OWNED BY GRIFFITH BLACKMON, MD, DIRECTOR 469675 MANAGEMENT FEES AND ICU CALL COVERAGE CONTRACT 0 FORM 990, PART I, LINE 6 VOLUNTEER RESOURCES RECRUITS, ORIENTS, PLACES, TRAINS AND SUPPORTS VOLUNTEERS FROM 14 TO OVER 90 YEARS OF AGE. PEOPLE VOLUNTEER BECAUSE THEY VALUE SERVICE, TO GAIN WORK EXPERIENCE, MEET JUNIOR/HIGH SCHOOL REQUIREMENTS, MEET CRITERIA FOR COLLEGE APPLICATIONS OR PROGRAMS, OR FOR CAREER EXPLORATION. WE COORDINATE WITH SCHOOLS AND LOCAL ORGANIZATIONS IN ORDER TO PROVIDE OPPORTUNITIES FOR THEIR CLIENTS AND FOR THOSE WITH SPECIAL NEEDS. DURING THE FISCAL YEAR, MAY 1, 2010 THROUGH APRIL 30, 2011, VOLUNTEER RESOURCES SUPPORTED OVER 400 VOLUNTEERS AND JOB SHADOWS WITH OVER 200 ACTIVE VOLUNTEERS EACH MONTH. CURRENTLY, ONE HALF OF NEW VOLUNTEERS ARE VOLUNTEERING TO MEET SCHOOL REQUIREMENTS OR TO ENHANCE THEIR WORK EXPERIENCE. IN-HOSPITAL VOLUNTEERS ARE PROJECTED TO DONATED OVER 41,000 HOURS OF SERVICE THROUGHOUT HARRISON AND ITS HEALTHPARTNERS' CLINICS. VOLUNTEERS WERE PLACED AND/OR COMPLETED OVER 2,800 WORK ORDERS FOR OVER 50 DEPARTMENTS OR LOCATIONS: BELFAIR PRIMARY CARE/URGENT CARE, BEREAVEMENT SUPPORT GROUPS, BIO MED, BUSINESS/COMMUNITY DEVELOPMENT, COMMUNICATIONS, COMPLEMENTARY THERAPIES, DIABETES CENTER, DIETARY/CULINARY, EDUCATION SERVICES, EMERGENCY DEPARTMENT, EMERGENCY PREPAREDNESS, EMPLOYEE HEALTH, ENVIRONMENTAL SERVICES, FACILITIES, FOUNDATION, GIFT SHOPS (AUXILIARY), INFORMATION TECHNOLOGY, SOUTH KITSAP URGENT CARE AND PRIMARY CARE, HOME HEALTH, HUMAN RESOURCES, INFECTION PREVENTION, MARKETING, MATERIALS MANAGEMENT, MEDICAL SERVICES, MEDICAL IMAGING, NURSING ADMINISTRATION, NURSING UNITS (ALL), PALLIATIVE CARE, PATIENT ACCOUNTS, PATIENT ADVOCACY, POULSBO ONCOLOGY CLINIC, PUBLIC RELATIONS, PRE ADMIT, QUALITY, RADIATION ONCOLOGY, REGISTRATION, REHABILITATION (ALL AREAS), SECURITY, SLEEP CLINIC, SOCIAL WORK, SPIRITUAL CARE (ALL INPATIENT AREAS), SURGERY (INPATIENT AND SAME DAY SURGERY), PHARMACY, AND TELECOMMUNICATIONS. VOLUNTEER RESOURCES SUPPORTED TWO NEW OPPORTUNITIES THIS YEAR: THE "CARING PRESENCE PROGRAM" USES EMPLOYEE VOLUNTEERS AND OTHER VOLUNTEERS TO SIT WITH PATIENTS WHO REQUEST A COMPANION AT THE END OF LIFE. ALSO, DEPARTMENTS MENTORED YOUTH VOLUNTEERS DURING THE SUMMER TO INTRODUCE THEM TO CAREERS IN HEALTHCARE. ACCESS TO HARRISON FOR PREVOCATIONAL AND VOCATIONAL ACTIVITIES IS IN HIGH DEMAND. OUR GOAL IS TO PROVIDE ALL COMMUNITY PARTNERS AND THEIR DIVERSE/SPECIAL NEEDS CUSTOMERS OR STUDENTS EQUAL ACCESS FOR THESE OPPORTUNITIES. OUTREACH AND PARTNERSHIPS ARE ONGOING WITH VOCATIONAL REHABILITATION AND THEIR CONTRACTED VENDORS, GOODWILL, KITSAP COUNTY HIGH SCHOOL DISTRICTS, CARES OF WASHINGTON, EASTER SEALS, ABLE OPPORTUNITIES AND KITSAP COUNTY DEVELOPMENTAL DISABILITIES. DURING THE 2011 PROGRAM YEAR, 15 HIGH SCHOOL STUDENTS, 4 CARES OF WASHINGTON CLIENTS, 2 EASTER SEALS CLIENTS, AND 3 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM CLIENTS SERVED AS VOLUNTEERS IN ORDER TO OBTAIN ASSESSMENTS, JOB TRAINING, WORK EXPERIENCE, COMPLETE INFORMAL INTERNSHIPS, INDEPENDENT EMPLOYMENT PLANS OR COMMUNITY ACCESS PROGRAMS. IN ADDITION, OLYMPIC COLLEGE AND OTHER LEARNING INSTITUTIONS PLACE VOLUNTEERS IN AREAS FOR CREDIT INCLUDING REHABILITATION, DIETARY, MEDICAL ASSISTING, PUBLIC RELATIONS, ETC. EXAMPLES OF VOLUNTEER TASKS INCLUDE PROVIDING CUSTOMER SERVICE BY GREETING AND ESCORTING PATIENTS AND VISITORS, BEING COMMUNICATION LIAISONS, STAFFING RECEPTION DESKS, MAKING PHONE CALLS, PROVIDING CLERICAL AND COMPUTER ASSISTANCE, STAFFING SPECIAL EVENTS, ASSISTING NURSES IN CLINICAL AREAS, STOCKING SUPPLIES, GIVING TOURS, PICKING UP SHRED AND RECYCLE, AND PROVIDING COMPLEMENTARY THERAPIES INCLUDING HAND RUBS, MUSIC, DOG THERAPY, AND "ART IN THE LOBBY" DEMONSTRATIONS. VOLUNTEERS ALSO COMPLETE THOUSANDS OF WORK ORDERS WHICH INCLUDE COPYING, COLLATING, ART PROJECTS, SPECIAL PROJECTS AND MAKING THOUSANDS OF PATIENT CHARTS, DISCHARGE PACKETS, AND EMERGENCY PREPAREDNESS SUPPLY PACKETS THAT WERE JUST DISTRIBUTED THROUGHOUT HARRISON. THE LATEST REPORT FROM THE INDEPENDENT SECTOR ESTIMATES THE AVERAGE DOLLAR VALUE OF VOLUNTEER TIME AT $21.36 PER HOUR IN 2010 ($18.80 WITHOUT FRINGE BENEFITS OF 12% EQUALS $759,200). NOTE MINIMUM WAGE PLUS 15% INCREASE SUGGESTED BY HUMAN RESOURCES COMES TO OVER A $400,000 INVISIBLE REVENUE STREAM. BY ANY COUNT, THESE FIGURES HELP US MEASURE THE BROADER CONTRIBUTION OF VOLUNTEERS WHO DEDICATE THEIR TIME, TALENTS, AND ENERGY TO MAKING A POSITIVE DIFFERENCE AT HARRISON. FORM 990, PART VI, SECTION A, LINE 4 THE HARRISON MEDICAL CENTER BYLAWS WERE REVISED WITH UPDATED LANGUAGE REFLECTING CURRENT GOVERNING RESPONSIBILITIES OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE AND THE CHIEF FINANCIAL OFFICER TO ENSURE ACCURACY AND COMPLETENESS OF DATA. ONCE THEIR REVIEW IS COMPLETE, THE FORM 990 IS SHARED WITH THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS RECEIVES AN ELECTRONIC COPY OF THE FORM PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ARE ANNUALLY REQUIRED TO ACKNOWLEDGE RECEIPT OF THE MEDICAL CENTER'S CURRENT CONFLICT OF INTEREST POLICY AND COMPLETE AND SUBMIT PROVIDED QUESTIONNAIRES. MEDICAL CENTER COUNSEL REVIEWS THE SUBMITTED QUESTIONNAIRES AND PROVIDES A FORMAL REPORT BACK TO THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 CONSULTANTS ARE RETAINED BY THE CHAIRMAN OF THE BOARD FOR THE EXPRESS PURPOSE OF SETTING EXECUTIVE COMPENSATION AND OPINING AS TO ITS COMPARABILITY AND REASONABLENESS. CONSULTANTS MAY USE A VARIETY OF RESOURCES TO MAKE THIS DETERMINATION INCLUDING SURVEYS, INFORMATION FROM OTHER ORGANIZATIONS' FORM 990, AND VARIOUS COMPARATIVE DATA. THIS REVIEW PROCESS IS DONE ANNUALLY FOR THE EXECUTIVE STAFF AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 14,354,130. CHANGE IN OBLIGATIONS UNDER PENSION PLAN 15,375,594. CHANGE IN INTEREST IN HARRISON MEDICAL CENTER FOUNDATION 9,480,859. TOTAL TO FORM 990, PART XI, LINE 5: 39,210,583. HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVENUE BREMERTON WA 98310 911197626 RAISES & MANAGES CHARITABLE GIFTS FOR HARRISON MEDICAL CENTER WA 501(C)(3) LINE 7 HARRISON MEDICAL CENTER 0 0 1 1 0 0 0 0 0 1 0 0 1 0 1 0 1 0 0